Medicine

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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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    Screening for pre-eclampsia by using changes in uterine artery Doppler indices with advancing gestation
    (Wiley, 2012) Napolitano, R.; Melchiorre, K.; Arcangeli, T.; Dias, T.; Bhide, A.; Thilaganathan, B.
    OBJECTIVE: The aim of the study was to assess the relationship of changes in uterine artery (UtA) Doppler pulsatility indices (PI) between first and second trimesters and the subsequent development of pre-eclampsia. METHODS: A retrospective study of singleton pregnancies undergoing both first and second trimesters UtA Doppler screening between 2002 and 2009 was conducted. Multiples of median of UtA Doppler PI were used for developing indices describing UtA changes between the two trimesters. Receiver-operating characteristics curves (ROC) were calculated for multiple comparisons. RESULTS:Three thousand five hundred sixty women had UtA Doppler screening in the first and second trimesters. Eleven women were excluded because of termination of pregnancy before 24 weeks. Out of the 3549 women recruited, 126 developed Pre-eclampsia (PE; 22 early PE delivered <34 weeks and 41 preterm PE delivered <37 weeks). The best index for predicting pre-eclampsia was the difference between the mean second trimester and mean first trimester UtA PI (areas under the ROC for early PE and preterm PE of 0.851 and 0.786, respectively). CONCLUSION:Changes of UtA resistance between the first and second trimesters can be calculated as the difference between UtA PI at these gestations. The data of this study demonstrate that the difference in mean PI is the best index in predicting early PE and preterm PE.
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    Villous syncytial knots in hypertensive placenta
    (Sri Lanka College of Obstetricians and Gynaecologists, 2004) Salgado, S. S.; Angunawela, P.; de Tissera, A.; Sirisena, J.
    Syncytial knots are seen on many terminal villi of all mature placentae. Syncytial knots in more than 30 percent of mature terminal villi, is considered as an indication of postmaturity. The aim of this study was to find out whether there is significant increase in syncytial knot formation in pre-eclampsia and to assess the relationship between syncytial knot formation and maternal age, parity, and period of gestation and effects of syncytial knots on the birthweight, and apgar score of the newborn. The study sample consisted of 150 normal and 200 hypertensive mothers. Light microscopic studies were done on sections taken from fetal surface of their placentae. Hundred terminal villi in fetal subdivisions of each placenta were counted and the number of villi with syncytial knots was recorded. Multivariate analysis was done to find out the difference between the number of placentae with high syncytial knot counts in normal and hypertensive groups and the relationship between high syncytial knot counts and the maternal age, parity, period of gestation and birthweight, head circumference and apgar score of the newborn. Statistically significant increase of syncytial knot counts was seen in hypertensive group than the normal group. There was no relationship between syncytial knot formation and maternal age and parity. In normal and hypertensive groups, an increase in the number of placentae with high syncytial counts was observed with increasing maturity. Although the number of placentae with high syncytial knot counts were higher in relation to low apgar score than the normal counts, difference was not statistically significant. A significant difference in the birth weight and the head circumference of newborns in relation to normal and high syncytial knot counts was observed in hypertensive group.
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    Do women with pre-eclampsia and their babies benifit from management sulphate? The Magpie Trial: a randomised placebo controlled trial
    (Lancet Publishing Group, 2002) Altman, D.; Carroli, G.; Duley, L.; Farrell, B.; Moodley, J.; Neilson, J.; Smith, D.; Fernando, S. with Magpie Trial Collaborative Group
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