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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  [45 journals]
  • Mirror syndrome: a rare presentation with a trisomy 21 fetus

    • Authors: D P G G M Prasanga, T D Dias, T S Palihawadena, S N M P K Gunathilaka, H M R Herath, C D Wasalathilaka
      Abstract: No abstract available
      DOI : http://dx.doi.org/10.4038/sljog.v36i3.7726Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 83-84
      PubDate: 2014-12-03
      Issue No: Vol. 36 (2014)
       
  • An audit on performance of medical students of the University of Kelaniya
           in completing the clinical tasks during their final year obstetrics &
           gynaecology clinical attachment

    • Authors: T S Palihawadana, M B C Motha, T D Dias, P S Wijesinghe
      Abstract: No abstract available
      DOI : http://dx.doi.org/10.4038/sljog.v36i3.7724Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 79-82
      PubDate: 2014-12-03
      Issue No: Vol. 36 (2014)
       
  • Neurological disorders in pregnancy and puerperium

    • Authors: L K Sarella, D S Rao
      Abstract: Objectives: To study the clinical profile of the patients presenting with neurological disorders during pregnancy and puerperium. Methods: The study was carried out at Government General Hospital, Kakinada, Andhra Pradesh, India between June 2006 and May 2007. Patients in pregnancy, postabortal and postpartum period evaluated in Neurology out-patient and in-patient departments and referred to Neurology department, Government General Hospital, Kakinada during this time were included in this study.Results: A total of 55 patients presented during pregnancy and puerperium with neurological disorders. Age of the patients ranged from 17 to 31 years. The total number of deliveries in this hospital during this period was 9726. Out of 55 patients Epilepsy—27[49.09%], Eclampsia—11[20%], Cerebro vascular disorders—6[10.9%], Neuropathies —4[7.27%], Extrapyramidal disorders---2[3.64%], CNS infections—Tubercular meningitis –1[1.81%], Myelopathy—1[1.81%], Toxic/ metabolic encephalopathy—1[1.81%]. Conclusions: Epilepsy was the most common neurological condition followed by Eclampsia and Cerebrovascular diseases. Health education measures for prospective mothers regarding the appropriate, adequate and regular use of anti-epileptic drugs should be taken up. Diligent care is to be taken to watch for neurological deficit in cases of Pre-eclampsia/ Eclampsia to identify special investigation team—Obstetrician, Neurologist, Physicians and Neurologist. The treating team should have the complete knowledge of the effects of rare neurological disorders during pregnancy and puerperium.
      DOI : http://dx.doi.org/10.4038/sljog.v36i3.7722 Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 74-78
      PubDate: 2014-12-02
      Issue No: Vol. 36 (2014)
       
  • A study on factors associated with clomifene resistance in infertile women
           with WHO group II anovulation at a teaching hospital in Sri Lanka

    • Authors: T S Palihawadana, D M A B Dissanayake, P S Wijesinghe, H R Seneviratne
      Abstract: Background: Anovulation is a common cause of infertility and induction of ovulation with oral agents such as clomifene is the treatment of choice in women with normogonadotropic anovulation. While such treatment is able to achieve ovulation in many, some women fail to respond thus termed as having clomifene resistance. Knowledge on factors associated with such resistance would enable us to counsel patients more accurately and offer alternative treatment modalities without undue delays. This study was aimed at identifying factors associated with clomifene resistance among infertile women with WHO group II anovulation at a teaching hospital in Sri Lanka. Method: A case control study was done at the Infertility clinic of the North Colombo teaching hospital, Ragama conducted by the department of obstetrics & Gynaecology of the University of Kelaniya. Women with WHO group II anovulation (n=128) were included and underwent induction of ovulation with clomifene citrate starting at a dose of 50mg per day, increased up to 150mg till ovulation was achieved. Those who fail to respond to a maximum dose of 150mg were termed as clomifene resistant. The factors known to be associated with clomifene resistance were compared between the two groups who responded and those who failed to respond. The study was registered with the Sri Lankan clinical trial registry maintained by the Sri Lanka Medical association. The study was funded by the National Science foundation of Sri Lanka through a research grant (Grant No: RG/2007/HS/08) Results: Ovulation was achieved in 77.3% (n=99) of subjects and therefore the prevalence of clomifene resistance was 22.8% (n=29). Among those who responded, 41 did so at a dose of 50mg per day while 40% did with 100mg, thus over 80% achieving ovulation at a dose of 100mg per day or less. The factors associated with clomifene resistance in this population included infertility of more than three years (OR 2.06, 95%CI 1.51-9.14), presence of hirsutism (OR 2.76, 95%CI 1.18-6.46), a higher AFC (16 vs 13, p=0.04), PCOS (OR 2.99, 95%CI 1.06-8.41) and an LH:FSH ratio of > 1(OR3.11, 95%CI 1.33-7.24). Other factors that have been described to be associated with clomifene resistance such as advanced age, a BMI > 25, and a higher ovarian volume did not show any significant associations in this study. Discussion: This study was able to identify factors associated with clomifene resistance in a local population. Most factors identified included clinical and laboratory findings of PCOS thus highlighting the limitations in treatment success of clomifene among women with PCOS. This information may be used in clinical practice to counsel patients prior to treatment or to consider other alternative treatment options such as Letrozole or gonadotropins.
      DOI : http://dx.doi.org/10.4038/sljog.v36i3.7715 Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 71-73 
      PubDate: 2014-12-02
      Issue No: Vol. 36 (2014)
       
  • Intra Cervical Foley Catheter vs oral misoprostol for pre induction
           cervical ripening of postdated pregnancies

    • Authors: M Goonewardene, D M A Kumara, M H Ziard, B Bhabu
      Abstract: Introduction: An intracervical Foley catheter is a common method used for pre-induction cervical ripening in Sri Lanka. Low dose oral Misoprostol (25 μg 2 hrly) has been recently recommended as a method for ripening of cervix and induction of labour (IOL) Objectives: To compare the effectiveness of the insertion of an intra-cervical Foley catheter for 24 hrs versus two doses of oral Misoprostol - 25μg four hours apart, in ripening the cervix prior to IOL, in postdated pregnancies. Methods: A Randomized controlled trial. Women with uncomplicated singleton pregnancies, having a cephalic presentation and a cervix unfavorable for IOL [modified Bishop Score (MBS) < 6] at 40 weeks and 6 days of gestation, were allocated to receive either two doses of oral Misoprostol - 25 μg, four hours apart (n=74) or intracervical Foley Catheter for 24 hrs (n=78), by stratified (primip / multip) block randomization. The following morning all were assessed and their MBS recorded by one of the last three authors, all of whom were blind to the interventions, as other doctors supervised and carried out the interventions. If the cervix was favourable, IOL was carried out with amniotomy and intravenous oxytocin infusion. The method of delivery and induction delivery interval (IDI) were recorded. If spontaneous labour (SOL) was established prior to this assessment, it was recorded. Results: There were no significant differences in the distribution of parity, and the mean ages and the mean pre intervention MBS in the primigravidae and multigravidae, between the two study groups. There were significant increases in mean MBS (ranging from 2.6 – 3.3 and 95% CIs 1.7- 4.1, p <0.001) after the interventions in both groups. However there was no significant difference between the mean increases of MBS between the groups. In the primigravidae, the mean MBS after 24 hours was greater in the Foley catheter group compared to the misoprostol group (6.9, 95%CI 6.3 – 7.5 vs 5.7, 95% CI 4.8 – 6.7, p < 0.05). There were no significant differences in the proportions of primips and multips establishing SOL. More primips and multips had cervices favourable for IOL in the Foley catheter group compared to the misoprostol group (p < 0.05). There were no significant differences in the mean IDI after IOL; successful vaginal delivery after IOL; and the caesarean section rates between the groups. In the Misoprostol group there were no cases of uterine hyperstimulation, but two women complained of dyspepsia. Conclusions: Intracervical Foley catheter for 24 hours was better than two doses of 25 μg misoprostol administered orally four hours apart, for pre induction cervical ripening in postdated pregnancies.
      DOI : http://dx.doi.org/10.4038/sljog.v36i3.7714 Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 66-70
      PubDate: 2014-12-01
      Issue No: Vol. 36 (2014)
       
  • Iron deficiency anaemia in pregnancy: diagnosis, prevention and treatment

    • Authors: T S Palihawadana, I M R Goonewardene, M B C Motha, H S A Williams
      Abstract: No abstract available
      DOI : http://dx.doi.org/10.4038/sljog.v36i3.7713Sri Lanka Journal of Obstetrics and Gynaecology 2014; 36: 61-65
      PubDate: 2014-12-01
      Issue No: Vol. 36 (2014)
       
 
 
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