{"title":"Normal value and changes in CRP values on maternal and fetal umbilical cord blood with the labor and intrapartum interventions","authors":"Sri Lanka, D. S. Siriwardhana, S. Lanerolle","doi":"10.4038/sljog.v45i3.8101","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8101","url":null,"abstract":"Introduction: C-reactive protein (CRP) is widely used as an inflammatory marker. Since labour is an inflammatory process, CRP values vary during the intrapartum and postpartum period due to multiple factors.Methods: A descriptive-analytical study was carried out at Castle Street Hospital for Women. Mothers who have term singleton pregnancies with uneventful antenatal periods and have undergone vaginal delivery were recruited for the study. Samples were obtained just after admission to the labour ward (S1), 24 hours after the delivery (S2), and the fetal umbilical cord blood (S3). Reference ranges for S2 and S3 were determined using the interquartile range (IQR).Results: Out of 300 mothers recruited for the study, the mean age was 26.73 years (95% Confidence interval 19.5-36.9). There were 266 samples of S1,177 samples of S2, and 173 samples of S3 were collected. The reference range for S2 is 12.70-150.83 mg/dl, and for S3 is 0.1-8.1 mg/dL. The S2 value is significantly associated with duration of labor (r=0.47, p=0.046), number of vaginal examinations (VEs) (p < 0.001), augmentation of labor (AOL) (p=0.001), method of cervical ripening (p=0.014) and intrapartum intervention (p < 0.001). The number of vaginal examinations (p=0.02) and augmentation of labor (p=0.025) are significantly associated with fetal umbilical cord blood (S3).Conclusion: Early postpartum CRP can be risen up to 151 mg/dL after 24 hours of vaginal delivery. It may be associated with prolonged labor, number of VEs performed, AOL, method of cervical ripening, and episiotomy. Fluctuation of normal CRP values during the periods of antenatal, intrapartum, and postpartum needs to be assessed in the Sri Lankan community.","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"116 11-12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139263439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cervical cerclage in difficult situations: giving life a chance!","authors":"M. Rishard","doi":"10.4038/sljog.v45i3.8104","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8104","url":null,"abstract":"No abstract available","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"2006 319","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139263948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Dodampahala, S. Marleen, A. H. Banu, T. G. J. N. Gamage
{"title":"Managing reduced fetal movements","authors":"S. Dodampahala, S. Marleen, A. H. Banu, T. G. J. N. Gamage","doi":"10.4038/sljog.v45i3.8106","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8106","url":null,"abstract":"No abstract available","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"48 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139264884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. N. Kumarasinghe, C. V. Jayawickrama, T. S. Karunasekara, S. Jayashani, C. V. Senaratna
{"title":"Insomnia and potential risk factors during pregnancy","authors":"K. N. Kumarasinghe, C. V. Jayawickrama, T. S. Karunasekara, S. Jayashani, C. V. Senaratna","doi":"10.4038/sljog.v45i3.8073","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8073","url":null,"abstract":"Background: Insomnia during pregnancy adversely affects both mother and newborn, but evidence for its proportion and potential risk factors in Sri Lankan pregnant women is limited. Therefore, this study aimed to determine the proportion and factors associated with insomnia during pregnancy.Methods: A descriptive cross-sectional study was conducted among 404 antenatal women who participated in pregnancysupport groups on Facebook during the COVID-19 pandemic. They responded to a self-administered questionnaire that included the Insomnia Severity Index (ISI) to detect insomnia and questions adapted from the Stanford Sleep Questionnaire and an abbreviated version of the Penn State Worry Questionnaire to determine associated factors. Habitual sleep efficiency was calculated using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models were used to determine the associations of risk factors with insomnia.Results: The proportion of insomnia overall was 32.7%, with proportions of moderate and severe insomnia being 28% and 1.5%, respectively. The proportion of insomnia was lowest in the 1st trimester (19.2%) and highest in the 3rd trimester (42.8%). The risk factors that were associated with insomnia included age ≥30 years (OR = 1.6, 95% CI 1.09-2.52), third trimester (OR = 3.1, 95% CI 1.49-6.56), overweight or obesity in early pregnancy (OR = 1.8, 95% CI 1.04-3.16), irregular sleep routine (OR = 5.2, 95% CI 3.28-8.42), sleeping on lateral position (OR = 1.6, 95% CI 1.03-2.71), trait of worry (OR = 2.4, 95% CI 1.50-4.02), night back pain (OR = 1.7, 95% CI 1.01-2.91), difficulty in breathing (OR = 2.4, 95% CI 1.37-4.39), heart burn and regurgitation (OR = 1.9, 95% CI 1.24-2.99), and awakening due to foetal movements (OR = 1.8, 95% CI 1.14-2.96).Conclusion: Insomnia during pregnancy was high and may have clinical implications for primary antenatal care practice. Many factors associated with insomnia during pregnancy are modifiable and can form the basis for prevention and management.","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"39 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139265374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sri Lanka, K. Guruparan, A. P. Ginige, K. Kowsikanth, K. Muhunthan
{"title":"Cervical aggressive angiomyxoma – a rare case report","authors":"Sri Lanka, K. Guruparan, A. P. Ginige, K. Kowsikanth, K. Muhunthan","doi":"10.4038/sljog.v45i3.8086","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8086","url":null,"abstract":"Aggressive angiomyxomas are rare tumours affecting the pelvic perineum of reproductive-age females with high recurrence rates. Cervical aggressive angiomas are always reported after histopathological confirmation of cervical polyps, which warrants long term follow up.","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"11 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139264775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Abeywardane, L. Rajapakse, T. Kadotgajan, S. Lanerolle, H. Dodampahala, Sri Lanka
{"title":"Blood transfusion in pregnancy","authors":"A. Abeywardane, L. Rajapakse, T. Kadotgajan, S. Lanerolle, H. Dodampahala, Sri Lanka","doi":"10.4038/sljog.v45i3.8105","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8105","url":null,"abstract":"No abstract available","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139263834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outcomes of breast abscesses during lactation: a retrospective study","authors":"V. Abeysuriya, S. Dodampahala, L. Chandrasena","doi":"10.4038/sljog.v45i3.8084","DOIUrl":"https://doi.org/10.4038/sljog.v45i3.8084","url":null,"abstract":"Introduction: During breastfeeding one of the most common problems which can encounter is breast abscess. Our retrospective study aimed to assess the outcomes of breast abscesses among a cohort of lactating mothers.Methods: A single-centre retrospective study was carried out. Randomly selected 2000 medical records of mothers, referred as outpatients and hospitalized from 2002 to 2022 were retrieved. There were 32 breastfeeding mothers with breast abscesses. The diagnosis of lactational breast abscess was made by documented signs of a localized inflammatory, palpable breast lump confirmed with an ultrasound findings. From the retrieved database, data on maternal, perinatal, and breastfeeding features, ultrasound scan reports, methods of interventions and outcomes and microbiological testing reports were evaluated. Ethics Committee Approval was received from Nawaloka Research and Education Unit. No conflict of interest.Results: The mean age of the 32 patients was 28.7 ± 5.7 years. There were 85% primiparous and 15% multiparous. Exclusive breastfeeding at diagnosis was present in 20/32 (63%). Most of the women developed breast abscesses during the initial 40 days (36.3 ± 1.4 days) after delivery. The majority of 26/32 (81.3%) of the breast abscesses were <5cm in diameter in the ultrasound examination. The majority of the patients 28/32 (87%) underwent ultrasound-guided aspiration while on antibiotic coverage according to the standard clinical guidelines. Four patients had repeated ultrasound-guided aspiration. Four patients who had abscesses >5cm, with overlying skin necrosis underwent incising and drainage. None of the patients developed mammary fistulae or sinuses. All of the incision and drainage abscesses were healed within 3 to 5 weeks with repeated wound dressings. Ninety-one percent of the cultures revealed S. aureus positive. None of the patients stops breastfeeding during the acute phase.Conclusion: Our retrospective study showed that needle aspiration may be performed, regardless of the size of the breast abscesses in most instances.","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"37 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139263839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasitha Abeysuriya, H. Dodampahala, L. Chandrasena, Sri Lanka
{"title":"Acute appendicitis in pregnancy","authors":"Vasitha Abeysuriya, H. Dodampahala, L. Chandrasena, Sri Lanka","doi":"10.4038/sljog.v45i2.8081","DOIUrl":"https://doi.org/10.4038/sljog.v45i2.8081","url":null,"abstract":"Introduction: The early diagnosis and management of appendicitis in pregnancy are essential in maternal and fetal morbidity and mortality. In this 20-year retrospective study, we aimed to assess the outcomes of pregnant patients diagnosed with acute appendicitis.Methods: A single-center retrospective study was carried out. Randomly selected 2000 medical records of pregnant mothers referred as outpatients and hospitalized from 2002 to 2022 were retrieved. Six pregnant patients who were diagnosed and treated in Nawaloka Hospital with the diagnosis of acute appendicitis during 2002-2022 were examined retrospectively. Ethics Committee approval was received. No conflicting interest.Results: The age range of our patients was 22 to 31 years, mean of 26± 3.4. The mean gestational week was 20±5.3 weeks, and most were in the second trimester 4 (68%). All patients were admitted with the complaint of abdominal pain, the majority of them had the right iliac fossa pain (RIF). All had elevated inflammatory markers. No computed tomography (CT) was performed. One patient was diagnosed clinically of having acute appendicitis without any imaging. Acute appendicitis was diagnosed in 3/5 patients who underwent ultrasound scan examination. The other two patients (one from 2nd trimester and one in the third trimester) were diagnosed with acute appendicitis on MRI examination. All patients underwent open appendectomy under general anaesthesia. No maternal or foetal morbidity or mortality was noted during pre or post-surgical and anaesthesia procedures. The mean hospital stay was 3.9±0.9 days. All appendixes were pathologically proven to have acute appendicitis. Except for minor superficial surgical site infection rest of the mothers and foetus had no morbidity or mortality recorded in the follow-up.Conclusion: Although appendicitis is not frequent during pregnancy, it is a disease that requires urgent surgical and obstetrics care for timely diagnosis and treatment.","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128947036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Local injection of diluted vasopressin at the time of the modified Shirodkar cerclage","authors":"M. Rishard","doi":"10.4038/sljog.v45i2.8090","DOIUrl":"https://doi.org/10.4038/sljog.v45i2.8090","url":null,"abstract":"Objective: To report surgical outcomes of the modified Shirodkar method performed using diluted vasopressin.Case presentations: The age range of patients who underwent hydrodissection was 24-39 years (Mean age 30.9 years). Out of the 10 cases, four (40%) of them had failed McDonald cerclage in previous pregnancies, four (40%) of them had emergency cerclage, one (10%) of them had previous second trimester (T2) miscarriage/miscarriages and short cervix on USS and one (10%) had short cervix on ultrasound alone as indications. Four (40%) of them had the stitch performed after 20 weeks of gestation and six (60%) had it done before 20 weeks.During the procedure no single case of adverse cardiac events or raised blood pressure was noted. Estimated blood loss (EBL) ranged from 5 to 10 ml (mean EBL - 6.5 ml). Four (40%) procedures were recorded as difficult procedures by the operator. Not a single case of tonic uterine contractions was recorded following the procedure. One (10%) of them had a vaginal delivery at term, one (10%) had a vaginal delivery at 26 weeks, four had CS (40%) at term, and four (40%) of them delivered vaginally between 34-37 weeks. Only one (10%) case had a retained piece of stitch in the cervix and in one (10%) the stitch was left in-situ as requested by the patient. Only one (10%) patient had delivered at 26 weeks, eight of them (80%) had continued their pregnancies beyond 34 weeks.Conclusion: Our experience shows that judicious use of local injection of diluted vasopressin to perform hydrodissection during the modified Shirodkar cerclage is a safe and efficacious method and would increase the overall quality of the technique by reducing the blood loss and enhancing the plane of dissection.","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115356020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Madugalle, D. M. C. S. Jayasundara, C. S. Gunasekara
{"title":"Management of symphysial dysfunction in pregnancy and post-partum period: A review","authors":"T. Madugalle, D. M. C. S. Jayasundara, C. S. Gunasekara","doi":"10.4038/sljog.v45i2.8083","DOIUrl":"https://doi.org/10.4038/sljog.v45i2.8083","url":null,"abstract":"No abstract available","PeriodicalId":186118,"journal":{"name":"Sri Lanka Journal of Obstetrics and Gynaecology","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114366237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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