Objective Caesarean section (CS) rates are increasing in Sri Lanka. More than half of births will occur through CS by 2025. CS should be medically indicated to reduce maternal morbidity. Robson classification is useful in assessing the indications for CS. It is difficult to obtain high-quality prospective data using traditional data collection methods. We intend to assess the use of new technology for this purpose. Design A prospective audit, comparing smart phone app based data collection with the previous studies. Setting Professorial unit De Soysa Hospital for Women (DSHW) in Sri Lanka Study population 1712 deliveries were taken for the study from April to October 2019 Methods We used the RobsApp® which is a newly developed smart phone application for prospective data collection according to the Robson classification. This data is compared with Robson standards and previous traditional data collection methods. Outcome measures The caesarean section rates according to each Robson category and data quality. Results The quality of data gathered matched the recommendations by Robson guidance. The overall CS rate was 33.0%. Majority of the CS were carried out for Robson category 5a. Breech presentation accounted for 11.6% of CSs. Emergency CS contributed to 49.6% with CTG abnormalities being the most frequent indication. Conclusions RobsApp® is a convenient method for prospective data collection which allows achievement of the data quality recommended by the Robson guidance. The CS rates are rising in professorial unit DSHW. Increasingly CS are being performed for reasons other than for past sections.

Objective Hypothesis: Exposure of the patient to a theatre setting prior to surgery reduced the preoperative anxiety and adverse outcomes. Design: Single-center randomized controlled trial Setting: Professorial Gynecology Unit, Colombo South Teaching Hospital, Sri Lanka Sample: 64 adult patients. Methods: The patients were randomized and the intervention arm was given a pre-operative visit with an informative session regarding the surgery. These patients were assessed using an interviewer-administered questionnaire. The Statistical Package for Social Sciences (SPSS-17) was used to analyze the data. Main Outcome measures: Anxiety level before surgery, at the time of surgery and post-surgery, pre-induction parameters, and pain score. Results APAIS average combined anxiety level before the intervention was 10.19 ± 3.872 for the intervention group and 10.53 ± 4.303 for the control. This is on the day of the surgery after the intervention was 8.25 in the intervention group and 8.75 in the control. The reduction of anxiety as per HADS and VAS after surgery for the intervention group was 3.28 and 2.41 respectively, this is for control was 2.72 and 2.28. The pain score at 6 hours after surgery was 5.04 for the intervention group and 6.08 for the control. Conclusion Preoperative theatre visit prior to surgery made no significant difference in the patient’s anxiety, though a trend in reduction of pain and anxiety noted. Trial Registration Sri Lankan Clinical Trial Registry (Registration No: SLCTR/2019/015) https://slctr.lk/trials/slctr-2019-015.