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Journal Cover Sri Lanka Journal of Obstetrics and Gynaecology
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  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]
  • Posterior reversible encephalopathy syndrome in postpartum woman: a case

    • Abstract: No abstract available Published on 2016-08-19 00:00:00
  • The antibiotic sensitivity pattern and the use of antibiotics in women
           with asymptomatic bacteriuria in pregnancy

    • Abstract: Background: Nitrofurantoin has been recommended as a first line therapy in Sri Lanka for urinary tract infections in pregnancy but it is not used frequently.Materials and Methods: At the Colombo South Teaching Hospital a descriptive cross sectional study was carried out from June 2015 to April 2016 on 98 consecutive pregnant women between eight to 24 weeks of gestation, residing in Colombo district and presenting with no urinary symptoms suggestive of urinary tract infection at the time of urine collection but having a positive urine culture (colony count of > 105 per ml of urine). The antibiotic sensitivity of the identified pathogens was studied.Results: The commonest organism found was Coliforms (n = 79) .The other organisms identified were Staphylococci (n = 10), Streptococci (n = 7) and Enterococci (n = 2). All the organisms were sensitive to Nitrofurantoin. However, Nitrofurantoin was used only in 57 women.Conclusion: As all the organisms were sensitive to Nitrofurantoin, prescribing practices need to be changed to include Nitrofurantoin as the first line of therapy for asymptomatic bacteriuria of pregnancy. Published on 2016-08-19 00:00:00
  • What should we in Sri Lanka do about Zika in pregnancy

    • Abstract: No abstract available Published on 2016-08-19 00:00:00
  • Comparison of surgical site infections and patients’ comfort level with

    • Abstract: Introduction: In the prevention of surgical site infections (SSIs), the ideal timing for removal of dressing remains unresolved.Objectives: To determine the outcomes of early removal of wound dressing in terms of surgical site infections (SSI), patients’ comfort level and whether it was acceptable to the patientsMethods: The study was conducted at the Obstetric Unit of the Professorial Unit of Colombo South Teaching Hospital from September 2012 to February 2013.Out of 498 patients assessed for eligibility, 400 were randomised using a stratified [emergency versus elective caesarean sections (CS)] design into the intervention and control groups. There were 281 and 119 patients in the emergency CS and elective CS groups respectively. In the total sample, 205 patients underwent the intervention (removal of dressing between six and 12 hours after CS) and 195 patients underwent delayed wound exposure between 24 to 30 hours after CS (controls). Patients were reviewed before discharge and in two weeks. On the 1st post-operative day, using a visual analogue scale, their ability to sit up, get off the bed, walk and squat was assessed. The acceptability of early wound exposure was assessed in the intervention group with a structured closed ended questionnaire administered on the 1st post-operative day.Results: There was no significant difference in the SSI rates between the two groups, in both strata. Patients in the intervention group were able to perform all the given tasks more easily than in the control group (p < 0.001). Of the 183 respondents in the intervention group, 85% would prefer to have the wound dressings removed early for their next CS, 78% thought early removal of dressing improved their hygiene and 90% thought it improved their overall comfort.Conclusion: Clean, primarily sutured CS wounds ,exposed within six to 12 hours after surgery do not have an increased incidence of SSI compared to those that are exposed within 24 to 36 hours. The patients were more comfortable and better able to carry out simple tasks after early exposure compared to delayed exposure, and early exposure was well accepted by the majority of patients who had this intervention. Published on 2016-08-19 00:00:00
  • Central Serous Chorioretinopathy in pregnancy

    • Abstract: No Abstract available Published on 2016-06-14 00:00:00
  • Factors associated with compliance to a course of physical exercises for a
           selected group of primigravida mothers in Sri Lanka

    • Abstract: Introduction: The aim of this study was to assess factors associated with compliance to a course of exercises administered for a selected group of primigravida mothers in second trimester.Methods: This was a descriptive cross sectional and qualitative study performed at a Medical Officer of Health area in Kegalle district. Study population was a group of postnatal mothers who had taken part in the course of exercises from second trimester, for a period of 16 weeks. Sample size was 138 postnatal mothers. Study instruments were a self-administered questionnaire to obtain baseline data, psychological state and compliance to exercises, a diary and an interviewer administered questionnaire for views of husband and household members.Results: There were statistically significant associations between maternal age being less than or equal to 30 years and increase regularity of exercises (p<0.05), levels of education of husbands and the exercise regularity of pregnant mothers (p<0.05) and absence of physical symptoms and increase participation in regular exercises (p<0.05). There was no statistically significant association (p>0.05) between psychological distress status at six weeks postpartum and exercise regularity. There was a statistically significant association (p<0.05) between regularity of exercise and reduced presentation of depression at six weeks postpartum. Lethargy (41%), tiredness (20%), lack of time (16%), lack of privacy (13%) and absence of husband (11%) were reasons for not carrying out exercises regularly. Encouragement and motivation by family members (38%), husband (33%) and Public Health Midwife (27%) and feeling of good health after doing exercises (20%) were the main factors which helped a mother to carry out exercise regularly. Conclusions: Younger age, absence of physical symptoms and absence of depressive symptoms is significantly associated with regularity of exercises as opposed to irregularity Published on 2016-06-14 00:00:00
  • Hypertension in pregnancy

    • Abstract: No abstract available Published on 2016-06-14 00:00:00
  • Complications of blunt versus sharp expansion of the uterine incision in
           lower segment caesarean section. A randomized controlled trial

    • Abstract: Introduction: Caesarean section has now become the most frequently performed major surgical procedure in women in the field of Obstetrics and Gynaecology. There is however a wide variation in the surgical technique of caesarean section. Our objective was to compare incidence of complications associated with blunt versus sharp expansion of the uterine incision at the time of caesarean section.Methods: 274 women who underwent a lower segment caesarean section at North Colombo Teaching Hospital, Ragama was assigned randomly to have the expansion of the primary uterine incision either bluntly using the index fingers of both hands of the surgeon or sharply using a curved scissors. Rest of the surgery was performed alike in all participants.Results: The blunt expansion group (n=141) and the sharp expansion group (n=133) were similar with regard to age distribution, BMI, parity, history of previous LSCS and proportion of elective or emergency procedures and the cervical dilatation at the time of LSCS. The incidence of inadvertent extensions (42.1% vs 28.4%; p=0.02) and the mean time taken to repair the uterine incision (14.9min vs 13.7min; p=0.03) was significantly higher in the blunt expansion group compared to the sharp expansion group. The percentage drop in haematocrit more than 10% (30.8% vs 28.4%; p=0.48) and the drop in haemoglobin more than 2g/dl (22.6% vs 20.6%; p=0.47) was not significantly different in the blunt expansion group compared to the sharp expansion group. Incidence of inadvertent extensions was significantly different (38.5 vs 24.1; p=0.03) during elective LSCS but not during emergency LSCS (50% vs 44.8%; p=0.67) between the blunt expansion group and sharp expansion group. The incidence of inadvertent extensions was significantly higher (36.5% vs 24%; p=0.03) when the cervical dilatation was less than 4cm at the time of LSCS in the blunt expansion group compared to the sharp expansion group. Blunt expansion group required more blood pint transfusions when compared to the sharp expansion group (6 vs 2).Conclusion: The sharp expansion of the uterine incision at the time LSCS is associated with a lower risk of inadvertent extensions as well as extensions into broad ligament and uterine vessels compared to the blunt expansion method.The sharp expansion of the uterine incision is preferable to blunt expansion during LSCS and its advantage is more evident during elective LSCS than during emergency LSCS and when the cervical dilatation was less than 4cm at the time of LSCS. Published on 2016-06-14 00:00:00
  • Knowledge, attitudes and practices regarding antenatal exercises among
           pregnant mothers attending De Soyza Maternity Hospital Colombo

    • Abstract: Introduction: Antenatal exercises provide many health benefits not only to pregnant mothers but also to the fetuses. Adequate knowledge among pregnant mothers is vital to promote practicing of it. The aim of this study was to describe the knowledge, attitudes and practices regarding antenatal exercises and factors associated with them among pregnant women attending De Soyza Maternity Hospital (DMH) Colombo.Methods: A descriptive cross-sectional study was conducted among 110 pregnant mothers with a period of amenorrhoea of 20 weeks or more using an interviewer-administered questionnaire.Results: Knowledge regarding antenatal exercises was ‘poor’ among a majority (72.7%, n=80). Only 6.4% (n=7) and 5.5% (n=6) knew the importance of pelvic floor strengthening exercises and its technique, respectively. Most had somewhat favourable (49.1%, n=54) and favourable (35.5%, n=39) attitudes towards antenatal exercises while overall practices were ‘poor’ with a majority not exercising (86.4%, n=95). The sources of information were written media (49.1%, n =54) and electronic media (48.2%, n=53). Doing a job during pregnancy was significantly associated with possessing a ‘Good/Excellent’ level of knowledge (p=0.02) while living in a district other than Colombo was also associated significantly with a ‘Good/Excellent’ level of knowledge (p=0.039) and a ‘Good’ level of practice (p=0.042). Average family monthly income of > Rs. 25000 was associated with a level of ‘Favorable’ attitude (p=0.004).Conclusion: Knowledge and practices regarding antenatal exercises among pregnant women attending DMH were suboptimal while their attitudes were mostly favourable. Measures should be taken to improve knowledge and practices of antenatal exercises during pregnancy Published on 2016-06-14 00:00:00
  • A Clinical Study of Maternal and Fetal Outcome in Abruptio Placenta -
           Couvelaire Uterus a Preventable Obstetric Catastrophe

    • Abstract: Introduction : Hemorrhage is the single most important cause of maternal death worldwide. Obstetrical hemorrhage accounts for almost half of all postpartum deaths in developing countries. Among them Abruptio placenta occurs in around 1% of all pregnancies. Aim of this study was to determine the maternal and fetal outcome in pregnancy complicated by abruption placenta in relation to the risk factors.Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology, Mamata medical college, khammam from January 2010 to December 2014 for a period of five years. All pregnant women who were diagnosed with abruptio placenta after 28 weeks of gestation were included in the study. Patients were identified from the admission and labour room registers.Results: Total number of deliveries during the study period were 4000. Patients identified with abruptio placenta were 100, giving a frequency of 2.5%. Majority women were multigravidae and 56% of all the between 26-30 years of age. The mean gestational age at diagnosis was 34 ± 4.21 weeks. Vaginal bleeding was the most common clinical finding seen in 80% of the women, followed by blood stained amniotic fluid in 16% suggesting concealed abruption placenta. Fetal heart sounds were absent on admission in 65% of the women. Most common cause of abruption 44% was either patients with past history of pre – eclampsia or PIH in the present pregnancy. 9 patients with couvelaire uterus were identified and treated effectively. Among them, two patients died due to postpartum hemorrhage. Parity and gestational age were found to be significant risk factors for abruptio placentae.Conclusion: Abruptio placenta was associated with poor maternal and fetal outcomes. Early diagnosis and significant treatment of pre eclampsia during the antenatal period would prevent abruption and related complications.Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(3) 2015: 38-41 Published on 2016-02-22 15:04:06
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