Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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    Management of anaemia in pregnancy: experience from a Sri Lankan tertiary hospital unit
    (Wiley-Blackwell, 2015) Palihawadana, T.; Dias, T.; Motha, C.; Thulya, S.D.; Herath, R.; Wijesinghe, P.S.
    INTRODUCTION: Higher rates of pregnancy complications have been reported among anaemic pregnant women. Universal iron supplementation during pregnancy is recommended in countries where iron deficiency anaemia (IDA) prevalence rates are high. Sri Lanka also carries out a policy of such supplementation. The effectiveness of such programmes in different settings is variable. A retrospective analysis of the effectiveness of our current policy on prevention and treatment of anaemia was done for programme evaluation. METHODS: The North Colombo Obstetric Database (NORCOD) was used retrospectively to analyse the data between March and August 2014, at the university obstetric unit of the North Colombo Teaching Hospital, Sri Lanka. All singleton pregnancies without medical comorbidities were included in the analysis. Those who did not have haemoglobin (Hb) recording in the first trimester or in the third trimester were excluded at the data cleaning stage. An Hb level of <11 g/dL and a level of <10.5 g/dL were considered as anaemia in first and third trimesters respectively. The prevalence of anaemia at booking, and the Hb status in the third trimester were assessed. RESULTS: A total of 1340 singleton pregnancies were included in the analysis and 74 were excluded from the analysis due to incomplete data. 28.9% (n = 366) were found to be anaemic at booking while 63.9% (n = 809) were with a normal Hb and 7.1% (n = 91) were with an Hb of >13 g/dL. In the third trimester the prevalence of anaemia was 11.5% (n = 146) while 64.7% (n = 820) were with normal Hb and 23.6% (n = 300) were with an Hb of >13 g/dL. Among the anaemic women at booking, 22% (n = 81) persisted to be anaemic in the third trimester while 65% (n = 238) became normal and 12.8% (n = 47) developed a higher Hb level. Among those with a high Hb at booking only 1% became anaemic by third trimester while 40.6% persisted to have a high Hb level. CONCLUSION The prevalence of anaemia in this population was of moderate severity (>20% but <40%) as defined by the WHO. Major shortcoming in our practice is that we were unable to successfully treat nearly quarter of women who present with anaemia at booking, thus highlighting sub-optimal treatment. Furthermore, a policy of universal supplementation seems to over treat women with a high Hb at booking. Therefore, a more individualised supplementation and treatment policy should be encouraged in routine clinical practice.
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    An audit on perineal pain felt following childbirth: level of pain experienced and degree of analgesia used
    (Sri Lanka College of Obstetricians & Gynaecologists, 2016) Jayawardena, G.R.M.U.G.P.; Gunarathna, S.M.S.G.; Jogarasah, K.; Herath, R.
    BACKGROUND: Perineal pain is a common symptom following vaginal childbirth. Reducing of the degree of pain experienced has been shown to improve maternal wellbeing and normal functioning within the family. METHODS: We performed the audit in the professorial ward of the Colombo North Teaching Hospital. Participants perception of pain was assessed using a verbal numeric rating scale. RESULT: All participants had experienced some degree of perineal pain. However significantly reduced levels of pain were experienced in those who had received analgesia. CONCLUSION: Perineal pain is a common symptom among women following childbirth. However such pain can be significantly reduced with appropriate interventions
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    An audit on the completeness of partogramsin two obstetric units in two separate teaching hospitals in Sri Lanka
    (Sri Lanka College of Obstetricians & Gynaecologists, 2016) Liyanapatabandi, D.; Bhabu, B.; Krishoban, B.; Wenurajith, B. K.; Karunasinghe, J.; Jayasinghe, K. S.; Jayawardena, G.R.M.U.G.P.; Herath, R.; Gunarathna, S.M.S.G.
    INTRODUCTION: A systematic approach to labour is needed to make sure serious mistakes and variations are not made in management and cost effectiveness maintained. . We undertook an audit in two separate teaching hospital settings to assess thecompleteness of partogram maintenance in labour. METHODS: Retrospective analyses of partograms were done in non consecutive bed head tickets from January to April 2016. The research was conducted at Obstetric wards in the Colombo North Teaching Hospital and Colombo South Teaching Hospital. Annonymised data were entered into a database.RESULTS: A total of 72 and 81 bed head tickets were analysed in the two wards postnatal sections respectively. The completed partogram was available in 48 (66.7%) and 59 (72.8%) respectively with completeness of personal data as follows; name (100%, 97.5%), age (100%, 98.8%) parity (100%, 91.7%), bed head ticket (100%, 100%) and blood group (91.6%, 96.3%). Interpartum labour monitoring was documented as follows; fetal heart sounds (100%, 70.4%), contraction (37.5%, 43.2%), dilation (54.1%, 35.8%), alert and action lines (50%, 42%), descent (12.5%, 14.8%), liquor (50%, 66.7%), position (8.3%, 12.3%), caput (12.5%, 8.6%), and molding (8.3%, 4.9%). CONCLUSIONS: Both maternal and labour parameters show high levels of incompleteness which destroys the true use of a partogram which is early identification and prompt intervention in the instance of maternal or labour complications.
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    Term versus preterm induction of labor: Does it change the outcome?
    (Sri Lanka College of Obstetricians & Gynaecologists, 2016) Dias, T.; Gunasena, J.; Herath, R.; Pieris, V.; Wijesinghe, P.
    ABSTRACT: Induction of labour is important to timely deliver the fetus and minimize adverse perinatal outcomes to both the mother and the neonate. Therefore, comparison of the outcomes following induction of labour at term and preterm is invaluable to assess its benefits and detriments. OBJECTIVE: Compare fetal and labour outcomes following induction of preterm and term singleton pregnancies. METHOD:This was a retrospective studycarried out at North Colombo Teaching Hospital using North Colombo Obstetric Database (NORCOD) between March 2014 and May 2016. Six hundred and one singleton pregnancies that underwent induction of labour were included. Timing of induction of labor was categorized intopreterm labor induction (<38 weeks) and term labour induction (38-42 weeks). Vaginal delivery rate and neonatal outcomes were compared.RESULTS: Out of 601 cases 18.5% (N=111) were induced preterm and 81.5% (N=490) were induced at term. Vaginal delivery rates between the two groups were 71.2% (N=79) and 78.6% (N=385) (P>0.05). Preterm induced deliveries had an APGAR <7 at 5 minutes in 3 babies (2.7%) and six term babies(1.2%) had an APGAR <7 at 5 minutes (P>0.05). Preterm induced pregnancies reported 28.8% (N=32) NICU admissions and term induced pregnancies had 14.9% (N=73) NICU admissions (P<0.05). CONCLUSION: There’s no significant difference in LSCS rates and low 5 min APGAR among two groups. However preterm induction significantly increases NICU admission of the newborn, which is expected due to the complications associated with prematurity of the newborn.
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    Term versus preterm induction of labor: Does it change the outcome?
    (Sri Lanka College of Obstetricians & Gynaecologists, 2016) Dias, T.; Gunasena, J.; Pieris, V.; Herath, R.; Wijesinghe, P.
    ABSTRACT: Induction of labour is important to timely deliver the fetus and minimize adverse perinatal outcomes to both the mother and the neonate. Therefore, comparison of the outcomes following induction of labour at term and preterm is invaluable to assess its benefits and detriments. OBJECTIVE: Compare fetal and labour outcomes following induction of preterm and term singleton pregnancies. METHOD: This was a retrospective studycarried out at North Colombo Teaching Hospital using North Colombo Obstetric Database (NORCOD) between March 2014 and May 2016. Six hundred and one singleton pregnancies that underwent induction of labour were included. Timing of induction of labor was categorized intopreterm labor induction (<38 weeks) and term labour induction (38-42 weeks). Vaginal delivery rate and neonatal outcomes were compared. RESULTS: Out of 601 cases 18.5% (N=111) were induced preterm and 81.5% (N=490) were induced at term. Vaginal delivery rates between the two groups were 71.2% (N=79) and 78.6% (N=385) (P>0.05). Preterm induced deliveries had an APGAR <7 at 5 minutes in 3 babies (2.7%) and six term babies(1.2%) had an APGAR <7 at 5 minutes (P>0.05). Preterm induced pregnancies reported 28.8% (N=32) NICU admissions and term induced pregnancies had 14.9% (N=73) NICU admissions (P<0.05). CONCLUSION: There’s no significant difference in LSCS rates and low 5 min APGAR among two groups. However preterm induction significantly increases NICU admission of the newborn, which is expected due to the complications associated with prematurity of the newborn.