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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  [46 journals]
  • Assessment of Tumour Vascularity by Transvaginal Colour Doppler
           Ultrasound: a Novel Prognostic Factor of Cancer Cervix

    • Abstract: Background :Transvaginal Color Doppler Ultrasound is proposed as a novel prognostic tool in women with cervical cancer. We evaluated the assessment of tumour vascularity as a prognostic factor and its correlation with other well-known prognostic factors such as tumour size, parametrial invasion and lymph node status determined by MRI.Method : Transvaginal Colour Doppler Ultrasound (TVCDUS) was used to assess vascularity of tumour among 56 patients with histologically proven cervical carcinoma. A visual analyzing system of 1 to 5 was used to grade vascularity. Correlation between the visual grading of vascularity and size of lesion, lymphadenopathy and stromal invasion were studied.Result: All patients who had a tumour volume of >0.1cm3 had abundant vascularisation (a vascularity of 4 or more on visual grading). Thirteen out of 15 patients who had lymphadenopathy had a visual grading of vascularity of 4 or more. Out of 45 patients who showed parametrial invasion 20 had a visual grading of vascularity of>=4.Conclusion : The vascularity of tumour as assessed by TVCDUS correlated very well with well established prognostic factors of cancer cervix such as lymphadenopathy, parametrial invasion and size of tumour mass lesion. Transvaginal Colour Doppler ultrasound is a useful non-invasive method to assess tumour vascularity, which has some value in predicting prognosis..Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(1) 2015: 6-9 Published on 2015-11-06 00:00:00
  • Non-Invasive Prenatal Testing (NIPT) for Low-Risk Women

    • Abstract: No abstract available Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(1) 2015: 13-15 Published on 2015-11-06 00:00:00
  • Xanthogranulomatous inflammation in female pelvis: a diagnostic and
           therapeutic challenge

    • Abstract: Xanthogranulomatous inflammation is an unusual form of chronic inflammation that can present clinically with destructive or obstructive symptoms. It may also mimic malignancy at times. It is a rare entity as far as female genital tract is concerned. Histologically well characterized by a massive infiltration of the tissues by lipid-laden histiocytes, it usually poses diagnostic and therapeutic challenges for the clinician. We present here two interesting cases of the same, encountered by us.Case 1: A 42-year-old lady with history of intra-uterine device (IUD) in situ for 8 years presented with a picture of acute on chronic pelvic inflammatory disease (PID). She was started on inpatient CDC regimen of PID. Despite this her symptoms persisted and based on high index of suspicion she was started empirically on anti-tubercular treatment (ATT). Three months later she presented again with similar complaints. Laparotomy picture was typical of abdominal tuberculosis and thus multiple biopsies were obtained. Histo-pathological report showed xanthogranulomatous inflammation. As there is no specific treatment for this condition, patient was continued with ATT. On three, six and twelve months follow up patient had been asymptomatic.Case 2: A 48 year old lady with history of vaginal hysterectomy 6 months ago presented with right sided hydro-uretero nephrosis. CT scan showed this was because of external compression caused by an adnexal mass measuring 5.8×3.9 cms. She underwent laparotomy with right oophorectomy. Right distal ureter was fibrotic so was excised and Boari flap was done. Histopathological diagnosis rendered was Xanthogranulomatous inflammation with abscess formation and chronic ureteritis with fibrosis.Xanthogranulomatous inflammation of the genital tract is enigmatic disorder of unknown etiology. Gynecologist should be aware of this entity whenever the clinical presentation is atypical and not fitting into a diagnosis, or when the patient is not responding to conventional treatment of PID. Early diagnosis and management is very important as it can cause tissue destruction or may lead to obstructive disasters. Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(1) 2015: 18-20  Published on 2015-11-06 00:00:00
  • Invasive prenatal testing at a Tertiary Fetal Medicine referral center in
           Sri Lanka: A service evaluation audit

    • Abstract: No abstract available Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(1) 2015: 10-12 Published on 2015-11-06 00:00:00
  • Choriocarcinoma of the ovary: a case report

    • Abstract: Ovarian choriocarcinoma whether gestational or non-gestational, is an extremely rare malignant germ cell tumour. We report a young patient with an ovarian choriocarcinoma who was successfully treated with fertility sparing conservative surgery and adjuvant chemotherapy. Sri Lanka Journal ofObstetrics and Gynaecology Vol.37(1) 2015: 16-17 Published on 2015-11-06 00:00:00
  • Thyroid dysfunction in pregnancy

    • Abstract: No abstract available Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(1) 2015: 1-5 Published on 2015-11-06 00:00:00
  • Determinants of timely pregnancy dating scan in a Sri Lankan antenatal
           clinic setup

    • Abstract: Background: Early accurate estimation of gestational age is the most important intervention in pregnancy. Ultrasound between 11 and 13 weeks is most reliable in dating. There is no uniform policy in timing of dating scan in Sri Lanka.Objective: Aim of this study was to find out factors that determine the timely dating scan before 14 weeks in a district general hospital in Sri Lanka.Methods: This was a prospective observational study carried out at District General Hospital in Sri Lanka. A detail history was taken in order to ascertain age, parity, menstrual history, time taken to reach the hospital, distance to the hospital, level of education and gestation at the first booking visit with public health midwife (PMH). We offered dating scans for every pregnant mother before 14 weeks. Logistic regression analyses were performed to evaluate the association of socio-demographic factors and receiving timely dating scan before 14 Weeks.Results:A total 199 women were included for the analysis with a mean age of 26.98 years (SD 5.58). A 190 out of total recruitments (95.5%) were booked with PHM before 14 weeks. A total of 171 (86%) pregnant women received their first scan before 14 weeks. Logistic regression analysis demonstrated that only booking before 14 weeks with PMH (Odds ratio 12.272 (95% CI, 4.563-33.000) p<0.000) contributed significantly to receive dating scan before 14 weeks, while maternal age, parity, time taken to reach the hospital, distance to the hospital and mother’s level of education did not.Conclusion: Our study showed it is entirely possible to offer dating scan before 14 weeks even in a peripheral District General Hospital. Moreover, we demonstrated that none other than booking before 14 weeks was determined the dating scan prior to 14 weeks.
      Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(2) 2015: 7-9 Published on 2015-11-04 00:00:00
  • An audit on the outcome of vaginal Birth after Caesarean Section (VBAC) in
           a Sri Lankan tertiary care setting and factors associated with failure

    • Abstract: Introduction: Caesarean section is a major surgical operation and its rate is on the rise in Sri Lanka as well as in the world. It is recommended to lower the Caesarean section rate due to the risk of potential complications and burden on the health care system. Previous Caesarean is a common indication for planned Caesarean section and vaginal birth after Caesarean section (VBAC) is considered a safe alternative for many women. This audit study was aimed at determining the success rate of VBAC in a local setting and to identify the factors that are associated with failure in this study population.Method: An audit study was carried out in two obstetric units if South Colombo Teaching hospital, Kalubowila and De Soysa hospital for women, Colombo 8 to assess the success rate among women who underwent VBAC. The unit policies included patient choice for decision to undergo VBAC and non-usage of medication either for induction or augmentation of labour. The audit standards were set as a VBAC success rate of 72% (RCOG Green-top guidelines) and a low APGAR (<7) in less than 2% of neonates (set by clinical experience. The demographic and past obstetric factors were compared between groups to determine significant associations.Results: A total of 161 women (37.8% of those with a previous one Caesarean) had opted to undergo VBAC during the study period. It was successful in 69.6% of the total study sample and 84.6% who has had a previous vaginal delivery. Low APGAR scores at 5 minutes was observed in two neonates (1.2%) and both these were in the group with a successful VBAC.The factors associated with failed VBAC in this study population included not having had a previous vaginal delivery (Odds ratio 2.99), poor progress of labour being the indication for previous section (OR 2.32), a cervical dilatation of <2cm at onset of labour (OR 4.43), malpositions in early labour (OR 12.24), and a birth weight of more than 3000g (OR 2.11). Other preciously described factors such as a high BMI and inter-delivery interval failed to show a significant association in this study group.Discussion and recommendations: The take up rate of VBAC in our study population seems to be low. However, the study did not study the reasons contributing to this low rate hence no recommendations can be made. The success rate of VBAC on our group (69%) was very close to the set standards (72%) and the rate of low APGAR at 5 minutes was 1.2% and was achieving the set standard. These figures along with the factors identified to be associated with the failure at VBAC should be used for patient counseling in our local setting. Other units also should carry out such audit projects to find out the success rate of VBAC in their respective units. More in-depth studies should be carried out to find causes for low rate of undergoing VBAC and to determine effective ways to improve it.
      Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(2) 2015: 14-18 Published on 2015-11-04 00:00:00
  • Diabetes mellitus in pregnancy

    • Abstract: No abstract available

      Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(2) 2015: 1-6 Published on 2015-11-04 00:00:00
  • Antenatal Diagnosis and Management of Conjoined Twins : a case report

    • Abstract: No abstract available Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(2) 2015: 24-26 Published on 2015-11-05 00:00:00
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