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Sri Lanka Journal of Obstetrics and Gynaecology
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1391-7536 - ISSN (Online) 2279-1655
Published by Sri Lanka Journals Online Homepage  [48 journals]
  • A message from the Editor in Chief

    • Abstract: No abstract available Published on 2018-04-12 00:00:00
  • Knowledge and practices on birth preparedness and complication readiness
           among antenatal mothers; A study from southern province

    • Abstract: Background: Birth preparedness (BP) and complication readiness (CR) is a concept introduced by World Health Organization (WHO) for reduction of maternal and neonatal mortality rate of a country. This study was aimed to evaluate the level of knowledge and practices on BP and CR and associated factors among antenatal mothers attending antenatal clinic (ANC) of Teaching Hospital Mahamodara (THM). Methods: A descriptive cross sectional study was conducted in THM,Galle, from 200 third trimester antenatal mothers who attended to ANC using pretested self-administered questionnaire from July 2016. It consisted with close ended questions in three sections; basic socio-demographic data, 47 facts about awareness of BP and CR and evaluation of practices of BP and CR based on WHO criteria. Data were analyzed using t-test, Chi-square test and logistic regression. Results: Mean age of the study participants was 29 (+/-5.34). BP and CR were known concepts by 88.5% (95% CI: 84.08% to 92.92%) participants. Knowledge on BP and CR were reported as above average in 92.5% (95% CI: 88.85 to 96.15%) and 78.0% (95% CI: 72.26% to 83.74%) mothers respectively. Mothers who practiced BP and CR were 83.5% (95% CI: 78.36% to 88.64%). Young mothers have better knowledge on BP than older mothers (OR = 3.77; 95% CI: 1.16 to 12.24). Older mothers had statistically significant better knowledge on CR (OR = 0.73; 95% CI 0.66 to 0.93). There were statistically significant positive association of knowledge on CR with ethnicity (p = 0.03), family income (p = 0.04) and parity (p = 0.03). There was statistically significant positive association with better educational level (OR=0.31, 95% CI=0.11 to 0.91) and planned pregnancy (OR=0.26, 95% CI=0.10 to 0.70) with level of practice on BP and CR. Conclusion: BP and CR were well-known concept among third trimester mothers. Level of knowledge and practices on BP and CR were satisfactory among the study sample. Women with higher maternal age had poor knowledge on BP. Women with better educational level and planned pregnancy had satisfactory practices on BP and CR. Published on 2018-03-27 00:00:00
  • Comparison of transvaginal ultrasonographic and digital cervical
           assessment in predicting successful induction of labour in nulliparous
           pregnancy beyond 40 weeks with unfavourable cervix – A prospective
           cohort study

    • Abstract: Introduction: To date, the Bishop score remains as the standard method to predict the successfulness of labour induction. Possible role of transvaginal ultrasound measurement of cervical length provides conflicting evidences. This study compares the value of transvaginal ultrasound cervical length (TVSCL) and the Bishop score (BS), in predicting the success of labour induction in nulliparous pregnancy beyond 40 weeks with unfavourable cervix. Method: In this prospective cohort study pre induction TVSCL and Bishop score were measured in 392 nulliparous women who underwent induction with vaginal Prostaglandin (PGE2) at 40 weeks+6 days. Achieving a cervical dilation of 8cm was considered as a successful induction. Predictive value of TVSCL and BS, in determining successful induction, and amniotomy to successful induction time interval (TI) were analyzed using chi-square test, unpaired t-test, multiple logistic regression, Pearson’s co-efficient and receiver-operating characteristics (ROC) curves. Results: Induction of labour was successful in 75.5% (n=296) of the women. There was a significant difference in mean TVSCL, between successful and failed induction groups (P=0.02). Best cut-off value of TVSCL for predicting successful induction was 3.3cm. However TVSCL failed to demonstrate significant discriminatory value (Area under the ROC curve (AUC)= 0.545;95% CI,0.496-0.597;P=0.17). Meanwhile the AUC for the Bishop score >3 was significant (AUC=0.548;95%CI,0.548-0.647;P=0.006). However, sensitivity and specificity of the Bishop score in predicting induction success were 76.0% and 44.8% respectively. There was no significant association between TVSCL and TI (R=0.02, P=0.06). Conclusion: TVSCL is not an accurate predictor for the outcome of labour induction in nulliparous pregnancy beyond 40 weeks with unfavourable cervix. Nevertheless, the Bishop score appears to be of poor predictive value. Published on 2018-03-27 00:00:00
  • Why do Mothers Continue to Die' Passing the Buck

    • Abstract: No abstract available Published on 2018-03-27 00:00:00
  • Meeting challenges through professional development

    • Abstract: No abstract available Published on 2018-03-27 00:00:00
  • Antimicrobials in Gynaecological practice

    • Abstract: Surgical site infections are a common complication of Gynaecological surgeries. Up to 8-10% of Gynaecological patients undergoing an operative procedure will develop a surgical site infection. In surgeries with high rates of post-operative infection, antibiotic prophylaxis can play a major role in improving outcomes. In addition there are many indications where antimicrobial treatment is necessary in day-to-day Gynaecological practice. This review summarizes the available medical literature to assess the indications and appropriate antimicrobials for common circumstances in Gynaecological practice. Published on 2017-12-23 00:00:00
  • Screening for Cytomegalovirus Infection During Pregnancy in a Teaching
           Hospital, Western province, Sri Lanka

    • Abstract: Primary Cytomegalovirus (CMV) infection during pregnancy is a serious threat to the fetus. Although vertical transmission is likely to occur as a result of maternal infection, the rate of permanent sequelae is higher among infants born to mothers with primary CMV infection. Diagnosis of CMV infection among healthy adults generally relies on serological testing as most of them are asymptomatic. CMV infection in pregnancy is barely studied in Sri Lanka. This study aims in screening for CMV infection of selected pregnant population in a major maternity hospital and to describe associated factors with seropositivity. This study included 385 pregnant women in second trimester presented during a period of 6 months. Mothers with immunocompromised states were not recruited. Questionnaire was used to gather sociodemographic and clinical factors. All serum samples were tested for CMVIgG and IgG-avidity assay for seropositives. CMV-IgM test was carried out on samples with negative CMV-IgG and low/equivocal-avidity levels. All 3 seromarkers were tested using commercial Enzyme Linked Immunosorbent Assays. Data were analyzed by SPSS. Majority (97%) of the population were positive for CMV-IgG. CMV-avidity was low, equivocal or high in 0.25%, 2.75% and 97% of IgG seropositives respectively. Age, bad obstetric history and multiparity didn’t show association with IgG seropositivity. In conclusion, CMV seroprevalence was high in this study population with low rates of recent primary infection. Education regarding preventive measures for CMV infection in antenatal care has a value as some proportion were seronegative for CMV with prone to get new infections. Published on 2017-12-23 00:00:00
  • Effects of umbilical cord milking compared to differed cord clamping in
           term infants, a randomized controlled trial

    • Abstract: Introduction: Differed cord clamping (DCC) at delivery is currently recommended to increase neonatal haemoglobin levels (Hb) and reduce the risk of infant anemia. It needs waiting for two to three minutes, which is considered to be associated with most of its unwanted effects. An alternative could be umbilical cord milking (UCM) with early clamping. Although effects of UCM have been assessed in preterm neonates such evidence is sparse for term neonates. Objectives: To evaluate whether the effects on Hb, bilirubin and haemodynamic parameters in infants, and blood loss in the mother are better with UCM than with DCC during elective caesarean delivery at term. Methods: Sixty term pregnant mothers undergoing elective caesarean delivery (CD) in Teaching Hospital Kandy, from 1st February to 31st March 2015 were randomized to UCM and DCC. The UCM group had the umbilical cord milked towards the umbilicus of the baby in a standard method soon after delivery. The DCC group had the umbilical cord clamped after two minutes of delivery or once the cord pulsations had ceased. Neonatal Hb, bilirubin and haemodynamic parameters, and maternal blood loss were assessed within 48 hours of delivery. Results: Thirty three participants underwent UCM while 27 participants underwent DCC. Main indications for the CD were past CD (47%), failed induction (12%), past bad obstetric history (10%), maternal medical conditions (8%) and suspected gross cephalo pelvic disproportion (8%). All CD were performed under spinal aneasthesia. There were no significant differences between the UCM and DCC groups with regard to mean neonatal Hb (17.6g/dl, sd 2.0 vs 17.4g/dl, sd 2.4, p=0.67), mean neonatal total bilirubin (111.8 mmol/l, sd 47.6 vs 123.0mmol/l, sd 35.0, p=0.69) and mean maternal decrease in Hb (1.0g/dl, sd 0.7 vs 1.3g/dl, sd 1.0, p=0.37). All the neonates had birth APGAR of 10 at 5 minutes. The volume of blood remaining in the placenta was significantly higher in the UCM group (29.5ml, sd 20.3 vs 19.5ml, sd 13.1, p=0.03). Conclusions: Neonatal and maternal outcomes are not better with UCM than with DCC during elective CD. Published on 2017-12-23 00:00:00
  • Fetal thanatophoric dysplasia

    • Abstract: Thanatophoric dysplasia (TD) is a rare autosomal dominant lethal skeletal dysplasia with two subtypes. Mutations in the fibroblast growth factor receptor 3 gene (FGFR3) results in both subtypes. In prenatal diagnosis of TD by three-dimensional ultrasound examination in second trimester aids in visualizing facial features and other soft tissue findings such as cloverleaf skull, very short extremities and small thorax. Most of the affected fetuses die in utero or shortly after birth due to either respiratory insufficiency or brain stem compression or combination of both. We report one such rare case of type I TD encountered at 32 weeks of gestational age. Published on 2017-12-23 00:00:00
  • Impact of urinary incontinence on quality of life of women in a community
           sample in three districts of Sri Lanka – a cross sectional study

    • Abstract: Wellbeing of a person includes a good quality of life (QOL), which can be perceived and mediated by a many factors. Although UI has no impact on mortality it is one of the conditions that can significantly affect a person’s QOL. This paper aims to investigate the impact of UI on the women’s QOL. Methods: This study is a community based cross-sectional study performed in three districts of Sri Lanka targetting the population of women who were above 18 years of age. A sample of 2310 women was selected for this study in cluster basis. A cluster was a Public Health Midwife area, and from each cluster 15 women were selected. An interviewer administered questionnaire consisting of sociodemographic factors, medical and Obstetric history, and the King’s Health Questionnaire (KHQ) was used. A trend test, Jonckheere-Terpstra test was performed and significance was set at 5%. Results: Majority of the women in all three districts felt that felt that UI had no impact on their general health. QOL showed an impact on the trend of severity on stress incontinence and on the severity trend on urge incontinence, which was statistically significant with each domain namely role limitations, physical limitations, social limitations, personal relationships, emotional problems and sleep/energy issues. Coping strategies like wear sanitary pads to avoid getting wet with urine (5.4%), limiting their fluid intake at all times (11%) were also observed. Conclusions: The negative effect of UI on QOL needs to be addressed targeting those at higher risk. Awareness on treatment needs to be addressed, as all QOL domains were affected by UI. Published on 2017-11-01 00:00:00
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