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Abarham Martadiansyah
Department of Obstetrics and Gynecology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia.
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Unveiling the Uncommon: Intrauterine Diagnosis of a Fetal Ovarian Cyst – A Rare Case Report and Review of the Literature Leo Setyadi; Peby Maulina Lestari; Nuswil Bernolian; Putri Mirani; Abarham Martadiansyah
Media of Health Research Vol. 4 No. 3 (2026): Media of Health Research, August 2026
Publisher : Lembaga Publikasi Ilmiah Nusantara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70716/mohr.v4i3.602

Abstract

Fetal Ovarian Cysts (FOCs) are a rare condition that can be detected through prenatal ultrasonography. This report discusses a case of a preterm primigravida with suspected FOCs, identified via ultrasound at 34 weeks of gestation. Conservative management with serial monitoring was implemented. Spontaneous delivery occurred at 36 weeks, resulting in a live birth, followed by postnatal monitoring. Fetal ovarian cysts result from hormonal stimulation, leading to abnormal follicular growth and fluid-filled cyst formation. Detection is primarily through prenatal ultrasound, with MRI aiding further evaluation. Management depends on cyst size and characteristics, with conservative monitoring for smaller cysts and intervention for larger or complicated cases. Most fetal ovarian cysts regress spontaneously postnatally, though persistent hormone levels may prolong their presence. Conservative management is often effective, with postnatal monitoring essential to prevent complications and unnecessary surgery. This case highlights the importance of early detection, close monitoring, and a multidisciplinary approach in managing FOCs.
Prenatal Ultrasound Diagnosis and Conservative Management of Fetal Lower Urinary Tract Obstruction with Bilateral Hydroureteronephrosis and Severe Oligohydramnios at 23 Weeks of Gestation: A Case Report Jackson Mandala Putra; Abarham Martadiansyah; Nuswil Bernolian
Media of Health Research Vol. 4 No. 3 (2026): Media of Health Research, August 2026
Publisher : Lembaga Publikasi Ilmiah Nusantara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70716/mohr.v4i3.603

Abstract

Fetal lower urinary tract obstruction (LUTO) is a rare group of congenital anomalies characterized by megacystis, bilateral hydroureteronephrosis, and, in severe forms, oligohydramnios that predisposes to pulmonary hypoplasia and renal dysplasia. This report described a 37-year-old multigravida (G3P2A0) referred at 23 weeks of gestation with intermittent abdominal pain and a suspected fetal anomaly. Serial fetal ultrasonography demonstrated bilateral hydronephrosis and hydroureter, a distended, thick-walled bladder with a keyhole sign suggestive of LUTO, and severe oligohydramnios (deepest vertical pocket 0.59 cm). Maternal renal function and infection screening were unremarkable. After multidisciplinary counseling regarding the guarded prognosis and the local unavailability of fetal therapy, expectant management was undertaken, comprising tocolysis with nifedipine, antenatal corticosteroids, maternal rehydration, and planned amnioinfusion with serial ultrasound surveillance. The patient stabilized and was discharged for close follow-up. This case underscored the central role of prenatal ultrasonography in early recognition of LUTO and the importance of severity-based, multidisciplinary counseling. When severe oligohydramnios presents in the second trimester, the prognosis is guarded, and standardized staging and timely referral to a fetal-therapy center are essential to optimize perinatal outcomes
Bilateral Ureterovesical Rupture Complicating Total Hysterectomy with Ureteral Neoimplantation for Placenta Accreta Spectrum in a Preterm Multigravida: A Case Report Afif Naufal Akbarsyah; Abarham Martadiansyah
Media of Health Research Vol. 4 No. 3 (2026): Media of Health Research, August 2026
Publisher : Lembaga Publikasi Ilmiah Nusantara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70716/mohr.v4i3.604

Abstract

Placenta accreta spectrum (PASD) is an increasingly common obstetric condition that carries a substantial risk of life-threatening hemorrhage and urinary tract injury, particularly when cesarean hysterectomy is required. We reported a 28-year-old multigravida (G2P1A0) with one previous cesarean delivery who presented at 25 weeks of gestation with recurrent antepartum bleeding and marginal placenta previa. Antenatal sonography yielded a Placenta Accreta Index of 6 (probability of invasion approximately 69%) and an ISUOG score above 3, while magnetic resonance imaging suggested percreta infiltrating the rectosigmoid wall. Because of massive bleeding and threatened maternal and fetal deterioration, an emergency cesarean delivery followed by total abdominal hysterectomy was performed without prior ureteral stenting. During dissection of dense parametrial adhesions, bilateral ureteral ruptures occurred, which were repaired by extravesical ureteral neoimplantation using the Lich-Gregoir technique with double-J stenting. Histopathology confirmed PASD grade II (revised FIGO). The patient later developed a suspected vesicovaginal fistula during follow-up. This case underscored that antenatal diagnosis, multidisciplinary planning, and pre-emptive urological mapping are essential to minimize urinary tract injury in PASD surgery, and that the urological consequences of emergency hysterectomy can be considerable.
Body Stalk Anomaly in a 24-Week Singleton Pregnancy: Prenatal Sonographic Diagnosis and Differentiation from OEIS Complex and Pentalogy of Cantrell - A Case Report Edvans Henry; Abarham Martadiansyah; Nuswil Bernolian
Media of Health Research Vol. 4 No. 3 (2026): Media of Health Research, August 2026
Publisher : Lembaga Publikasi Ilmiah Nusantara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70716/mohr.v4i3.605

Abstract

Body stalk anomaly (BSA), also known as the limb–body wall complex, is a rare and almost uniformly lethal fetal malformation characterized by a large anterior abdominal wall defect with visceral herniation, severe kyphoscoliosis, and an absent or markedly short umbilical cord. We report a 19-year-old woman, gravida 1, referred at 17–18 weeks with a presumptive diagnosis of gastroschisis and diaphragmatic hernia. Serial transabdominal ultrasonography at our maternal–fetal medicine unit demonstrated a wide anterior abdominal wall defect with total herniation of the liver, stomach, and bowel into a covering membrane, oligohydramnios at 20 weeks, scoliosis, and a short umbilical cord with the fetal trunk lying close to the placenta. These findings fulfilled the Van Allen diagnostic criteria for BSA and allowed differentiation from OEIS complex and pentalogy of Cantrell. The fetal karyotype was clinically presumed normal, and maternal serology was non-contributory. Given the lethal nature of the condition, the family received detailed counseling regarding the grave fetal prognosis, recurrence risk, and management options, including elective termination at a tertiary center. This report underscores the central role of systematic second-trimester sonography in diagnosing BSA, distinguishing it from other anterior abdominal wall defects with more favorable outcomes, and guiding parental counseling.
Spasmophilia Grade IV in Pregnancy: Diagnosis and Conservative Management of a Rare Neuromuscular Disorder of Calcium Dysregulation - A Case Report Muhammad Satria Erlangga Sinum; Nuswil Bernolian; Abarham Martadiansyah; Hasnawi Haddani
Media of Health Research Vol. 4 No. 3 (2026): Media of Health Research, August 2026
Publisher : Lembaga Publikasi Ilmiah Nusantara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70716/mohr.v4i3.606

Abstract

Spasmophilia is an uncommon neurovegetative disorder characterized by tissue-level calcium dysregulation and neuromuscular hyperexcitability. Its occurrence in pregnancy is rarely reported, and the physiological remodeling of calcium and magnesium homeostasis during gestation poses distinctive diagnostic and therapeutic challenges. Case Presentation. A 26-year-old primigravida at 36–37 weeks of gestation presented with a history of intermittent stiffness and cramping of the hands and feet that had been diagnosed electrophysiologically as grade IV spasmophilia prior to conception. Involuntary movements had abated during pregnancy. Physical examination revealed positive Chvostek and Trousseau signs; a nerve conduction study demonstrated the repetitive multiplet discharges characteristic of grade IV disease. Laboratory evaluation showed mild anemia (hemoglobin 6 g/dL) with calcium and magnesium within the lower reference ranges. Management and Outcome. The patient was managed conservatively with oral calcium carbonate, folic acid, ferrous sulfate, and neurotropic B vitamins, along with non-pharmacological measures, while avoiding benzodiazepine muscle relaxants, which are contraindicated in pregnancy. She delivered a healthy female neonate (3,175 g, Apgar 8/9) at term without neuromuscular complications. Spasmophilia in pregnancy can be diagnosed through a structured integration of clinical signs, electrophysiological assessment, and electrolyte assessment, and is amenable to safe conservative management centered on calcium supplementation and avoidance of teratogenic relaxants.
Co-Authors Afif Naufal Akbarsyah Edvans Henry Hasnawi Haddani Jackson Mandala Putra Leo Setyadi Muhammad Satria Erlangga Sinum Nuswil Bernolian Peby Maulina Lestari Putri Mirani