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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]
  • 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
  • Use of mirena (levonorgestrel-releasing intrauterine system) in
           menorraghia in a young female with von Willebrand disease (vWD) Type 3 - A
           case report

    • Abstract: von Willebrand disease (vWD) is a bleeding disorder that is predominantly attributable to reduced levels of von Willebrand factor (vWF) activity. vWD prevalence is 1% in the population and vWD Type 3 is very rare. vWD Type 3 is inherited as autosomal recessive manner and accounts for less than 5% of all cases. Individuals with vWD type 3 can have a severe internal and joint bleeding. However, type 3 and type 2 variants are extremely difficult to manage and there is no guarantee that haemostasis will be achieved even when plasma concentrations have apparently been corrected into the normal range. We report a female child aged 10 years presented to us with heavy menstrual bleeding for three days which continued for another seven days. This episode was after recent onset of menarche and was diagnosed as having vWD Type 3. It was considered as a life threatening bleeding. Immediate and long term management of this patient with a major bleed was a daunting task. She was treated with Intermediate purity factor viii/ factor viii (cryoprecipitate), activated factor vii, Blood and antifibrinolytics. Long term endometrial suppression was the key to hinder excessive bleeding during menstruation (which could be life threatening) as she would need prophylaxis during each episode. Selecting the correct method which suits her best was not without difficulty. Intrauterine use of Mirena (levonogestrel-releasing intrauterine system-LNG-IUS) Was a better option and there are very few reports if at all of its use in a similar situation. We have used it as a novel method to suppress excessive menstrual bleeding (long term) in this patient with von Willebrand disease type 3. Published on 2017-11-01 00:00:00
  • Total laparoscopic hysterectomy : an achievable reality throughout Sri

    • Abstract: No abstract available Published on 2017-11-01 00:00:00
  • Clinical utility of PALM-COEIN classification for abnormal uterine

    • Abstract: No abstract available Published on 2017-11-01 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
  • Abstracts of the SLCOG Golden Jubilee Congress, 3rd – 6th August 2017,
           BMICH, Colombo, Sri Lanka "Women’s Health: Past Experiences; Future

    • Abstract:        Published on 2017-09-21 00:00:00
  • The agreement between hematological indices obtained from two laboratories

    • Abstract: Introduction: Agreement between hematological indices obtained by different laboratories has been shown to be unsatisfactory in the past. Objectives: To evaluate the agreement between the hemoglobin concentrations (Hb) and between the hematocrits obtained from two laboratories. Method: Consecutive pregnant women (n = 350), with gestations between 12 to 20 weeks, presenting to the Academic Obstetric Unit at the Teaching Hospital Mahamodera Galle (THMG), from 10 November 2014 to 13 January 2015 had their Hb and hematocrit measured by flow-cytometry and hydro-dynamic focusing methods at the Durdan’s Hospital Laboratory, Galle (DHLG) and the colorimetric method at the laboratory of the THMG (THMGL). The agreement between the Hb values and between the hematocrit values obtained from the two laboratories were assessed by comparison of means, Pearson’s correlation, and the calculation of the limits of agreement and the clinical limits of indifference. Results: No significant differences were seen between the mean Hb values and between the mean hematocrit values obtained from the two laboratories. Strong, positive correlations were seen between the Hb values as well as between the hematocrit values obtained from the two laboratories (r =0.86, p < 001 and r =0.83, p < 001 respectively). The limits of agreement and the clinical limits of indifference between the Hb as well as between the hematocrit values obtained from the two laboratories were satisfactory, but individual differences of > 10% were seen in 6.6% of results Conclusion: Although there was good agreement between the Hb values as well as between the hematocrit values obtained from the two laboratories, individual differences of > 10% were seen in 6.6% of cases. Published on 2017-06-30 00:00:00
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