Browsing by Author "Pathiraja, R.P."

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Importance of public perception on the genetic link between parents and offspring in the determination of attitudes towards surrogacy.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Withana, J.L.; Beneragama, D.M.; Grero, K.L.W.; Carnage, T.G.J.N.; Munasinghe, M.A.A.; Pathiraja, R.P.; Prathapan, S.
Introduction: Surrogacy, an unknown albeit discreetly commodified Assisted Reproductive Technology (ART) in Sri Lanka might be controversial as it’s a third-party ART. Objective: To describe attitude and factors associated with surrogacy among 20-40-year- old adults in Sri Lanka. Methods: This descriptive cross-sectional study was conducted among men and women aged 20-40 years, currently residing in Colombo District. Study instrument was an online questionnaire with close ended questions. Data collection was conducted among a sample recruited via snowball sampling method. Results: Acceptance of traditional surrogacy was lower among participants with positive attitudes towards the presence of genetic link between the parents and offspring (n = 168, 54.02%). In comparison, those who claimed that a genetic link was not of notable importance showed a significantly higher acceptance of the traditional form (n=80, 66.67%, p=0.017). A similar pattern in attitudes was observed in the acceptance of gestational surrogacy among the participants. However, the proportion of respondents who claimed that a genetic link was important and who also accepted the gestational form, was higher (n=245, 78.78%) than the proportion who accepted traditional surrogacy (p=0.012). Disapproval rates of gestational surrogacy among those who did not find a genetic link between parents and offspring dropped to a mere 10.83% (n=13) when compared to the traditional form. Conclusion: The need for genetic ties that links a parent to their children played a significant role in the formation of attitudes for and against surrogacy in general as well as between the two formats of the ART.
Perifartum hysterectomy from 2000 to 2004: Any new lessons?
(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Pathiraja, R.P.; Wijesinghe, P.S.; Fernando, W.S.; Fernandopulle, R.C.
OBJECTIVE: We aimed to identify the risk factors and subsequent maternal and perinatal outcome associated with the procedure of peripartum hysterectomy. MATERIALS AND METHODS: This was a retrospective case review carried out at the Professorial unit, North Colombo Teaching Hospital, Ragama, of all patients who underwent a peripartum hysterectomy from January 2000 to December 2004. RESULTS: Eighteen cases were performed during the study period from a total of 28,038 deliveries (0.064%) mean maternal age was 33 years (24-43), There were five nulliparous patients. Seven patients had previous vaginal deliveries. Six had a history of previous caesarean section, four of whom had more than one caesarean sections. The indications for the hysterectomy were placenta praevia (2), abruptio placenta (1), atonic postpartum haemorrhage (7), placenta accreta (3), traumatic postpartum haemorrhage (5). All Abstracts - Free Papers patients received blood transfusions, 27% receiving more than 10 units. There were five maternal deaths (Maternal mortality rate 17.8 /100,000). There were two stillbirths and one neonatal death secondary to antepartum haemorrhage. CONCLUSION: Even though the maternal mortality was not very high, the associated maternal morbidity and perinatal mortality were high. One third of the cases were associated with previous caesarean section. The caesarean section rate is increasing worldwide for many reasons, including recent emphasis on maternal request. We recommend that caesarean section be performed only for valid clinical indications which should help reduce the problems associated with peripartum hysterectomy.
Public perspective on the uses and indications of surrogacy within the Sri Lankan context.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Munasinghe, M.A.A.; Beneragama, D.M.; Grero, K.L.W.; Gamage, T.G.J.N.; Withana, J.L.; Pathiraja, R.P.; Prathapan, S.
Introduction: Although surrogacy is a controversial Assisted Reproductive Technology (ART) in Sri Lanka, there are various platforms that advertise surrogate mothers anonymously Objectives: To describe attitude and factors associated with surrogacy among 20-40-year- old adults in Sri Lanka. Methods: This descriptive cross-sectional study was conducted among men and women aged 20-40 years, currently residing in the Colombo District. Study instrument was an online questionnaire with close ended questions. Data collection was conducted among a sample recruited by the snowball sampling method. Results: Participants in general preferred the usage of surrogacy in women unable to have children due to medical conditions over the other instances provided (83.30%). However, in the instance of same-sex couples opting for surrogacy, non-heterosexuals (n=22, 88.00%), Buddhists (n=202, 58.21%), respondents with more liberal religious beliefs (n=78, 63.93%) and those without children (n=233, 58.54%) showed significantly higher levels of acceptance of surrogacy. Heterosexuals (n=165,40.64%), non-Buddhists (n=40, 57.14%) and respondents with firm religious beliefs had significantly higher rejection rates for the use of surrogacy to circumvent the effects of pregnancy. Participants who had positive attitudes towards having children also depicted higher acceptance rates for both these scenarios (p=0.001 each). Conclusions: Non-heterosexuals, Buddhists and respondents with more liberal religious beliefs were deemed more open minded as to the usage of surrogacy in various instances as opposed to their counterparts. This may have a significant socio-cultural impact on the acceptance and normalization of a third-party reproduction methods like surrogacy, even if properly regulated.