Renal colic in pregnant patients can be complicated by pyelonephritis and premature labor, especially if misdiagnosed or inadequately treated. Ultrasound is a safe and sensitive diagnostic test. Approximately two-thirds of renal calculi will pass spontaneously. For those who require intervention, placement of a Double-J stent is a safe and effective option.

Objective To assess neonatal outcomes according to gestational weight gain (GWG) in twins Study Design This was a retrospective cohort study of twins delivered at ≥ 24 weeks. GWG was defined using the IOM guidelines as the referent. Birthweight and NICU admissions were compared with Chi-square and ANOVA tests, stratified by BMI. Results In all three BMI groups, mean birthweight of the larger and smaller twin increased as GWG increased, p<0.01. For the underweight/normal weight group, both twins < 2500 g, <1500 g and small for gestational age decreased significantly as GWG increased. Birthweight < 2500 g increased in all groups with GWG below the IOM guidelines, p < 0.01. In the multivariate analysis, both twins < 2500 g was significantly decreased with GWG above IOM guidelines. There was no difference in NICU admissions with GWG above the IOM guidelines. Conclusion GWG above the IOM guidelines may improve twin birthweights, with the findings most significant in underweight/normal weight women.

Increased maternal morbidity was noted; however, only those neonatal morbidities associated with preterm delivery occurred in the placenta previa group.

Does Prior Cesarean Delivery Matter?lacenta previa complicates approximately 0.4% of all thirdtrimester pregnancies. Risk factors for placenta previa include prior cesarean delivery, history of placenta previa with a prior pregnancy, increasing parity, advanced maternal age, prior uterine surgery, tobacco use, and multiple gestations. Prior cesarean delivery is one of the most important risk factors for development of placenta previa, and the risk of placenta previa increases as a woman has more cesarean deliveries. After 1 cesarean delivery, the risk of previa is reported to be approximately 1.9%; the risk increases to 5.5% after 2 cesarean deliveries and reaches 14.3% after 3 cesarean deliveries. 1 Associated conditions with placenta previa include placenta accreta, malpresentation, preterm premature rupture of membranes, intrauterine growth restriction, and vasa previa. ORIGINAL RESEARCHObjectives-The purpose of this study was to prospectively assess the rate of resolution of complete placenta previa diagnosed at second-trimester sonography in patients with and without previous cesarean delivery.Methods-This prospective study evaluated patients at 3 institutions with complete placenta previa diagnosed at second-trimester screening sonography. All patients were followed with sonography every 4 to 6 weeks until either resolution of the previa or delivery occurred. Patients with persistent/nonresolving complete placenta previa underwent cesarean delivery.Results-A total of 67 patients were enrolled in the study; 18 patients had a prior cesarean delivery. Resolution of placenta previa occurred in 11 of 18 patients (61%) with a prior cesarean delivery, whereas 44 of 49 patients (90%) without a prior cesarean delivery had resolution of placenta previa (P = .012, Fisher exact test). Placental location per se (anterior or posterior) was not associated with resolution of placenta previa (P = .22). Complete placenta previa persisted to delivery in 5 of 9 patients (56%) with a prior cesarean delivery and an anterior placental location.Conclusions-This prospective study indicates that patients with a prior cesarean delivery and complete placenta previa diagnosed at second-trimester sonography are less likely to have subsequent resolution of the previa when compared to those without a history of cesarean delivery.