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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    Epilepsy and outcome of pregnancy
    (Sri Lanka Medical Association, 2005) Gunatilake, S.B.; Senanayake, A.E.S.; Mapa Pathirana, T.S.L.; Balasooriya, B.L.H.; Mettananda, K.C.D.
    BACKGROUND: Pregnancy in women with epilepsy is associated with increased obstetric risks and adverse fetal outcomes. OBJECTIVE: To study the effect of epilepsy and its treatment on pregnancy and the offspring. Methods: All females with epilepsy who had given birth or had a miscarriage were included in the sample. Two medical officers using a questionnaire, elicited from them their obstetric history, the presence of any noticeable mental or physical defects in their children, and the antiepileptic drugs they have been taking during the pregnancy. RESULTS: Forty five mothers were enrolled to the study. Their mean age was 32.8 years (SD 9.5). Forty of them had idiopathic epilepsy. The 45 mothers have given birth to 73 children. Nine mothers have had abortions but two were not on medication during the pregnancy, and five have had pre-term deliveries. None of the children had any congenital abnormalities. Two'children were having epilepsy and one had speech delay. Five mothers have not taken the drugs during the pregnancy. Commonly prescribed drug was carbamazepine (55%), and sodium valproate was taken by 12% and a combination of carbamazepine and valproate was taken by 21%. CONCLUSIONS: The adverse effects of epilepsy and drugs on the pregnancy are negligible in this sample. It appears that the prevalent fear of a bad pregnancy outcome is exaggerated and further larger studies are needed to confirm this.