Context of the study: Low lying placenta alarms obstetrician about antepartum haemorrhage which is a major cause of maternal mortality and morbidity in India. The incidence is increasing with availability of antenatal scan, elderly mothers, repeated usage of dilatation and curettage and high rate of Caesarean sections in tertiary hospitals. AIM OF THIS STUDY was to find out the incidence of placental migration in the present study and factors influencing the same. SETTING AND DESIGN: The study was done in Kolkata Medical College during July 2007 to June 2008. It was a prospective longitudinal study. MATERIALS AND METHODS: Total 726 antenatal mother was attended in this study at Kolkata Medical College. Sixty mothers had low lying placenta by transabdominal scan confirmed by transvaginal scan. STATISTICAL ANALYSIS: Data were put on Microsoft excel chart. Percentage and p value were calculated using statistics software Epi info. RESULTS: The incidence of low lying placenta in our study was 8.26%.Subsequent sonography at four weeks interval showed placenta was moving more than three centimeter from internal os among 41 mothers. The rate of placental migration was 68.3% in the present study. The prevalence of placenta praevia at term was 2.61%. Age had no relationship but increasing parity of mother and increasing number of abdominal deliveries had direct relationship with low lying placental incidence. When the distance between leading edge of placenta and internal os was less than 1.5 centimeter, placental migration was not seen. About 88.23% cases placental migration was seen when the distance was more than 2 centimeter. Posterior placenta had more rate of migration (81.81%) than anterior. CONCLUSION: Migration of low lying placenta was influenced by maternal age, parity, mode of delivery and position of the placenta.

Background:Misoprostol is very effective in cervical ripening and is used for termination of pregnancy. A similar effect on the nonpregnant uterus will facilitate gynecological operations, and hence we assessed the effect of misoprostol on the nonpregnant uterus of premenopausal women.Materials and Methods:In a prospective double-blinded randomized controlled trial, 280 women were randomly allocated into two groups (12 women did not complete the intervention). Study (A) and control (B) group received 400 μg of misoprostol or 400 mg of metronidazole tablets (as a placebo) respectively in the posterior vaginal wall 6 h prior to gynecological procedures.Results:The mean cervical dilatation was significantly higher (P < 0.0001) in misoprostol compared to placebo group (4.6 ± 0.96 mm vs. 3.6 ± 0.82 mm), benefit were also observed on secondary outcome measures which were need for further dilatation, time taken for further dilatation, ease of dilatation, subjective assessment of pain by visual analog scale. Only 3.61% patients complained of intolerable pain during dilatation in the study group while in control group 48.74% complained of intolerable pain and required anesthesia. Most common side effects of misoprostol were abdominal pain and mild vaginal bleeding.Conclusion:Misoprostol was effective in cervical ripening of nonpregnant premenopausal uterus to facilitate gynecological procedures.