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All Journal Andalas obstetrics and gynecology journal
Lisa Novianti
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Nursing Public Health

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Pendekatan Konservatif pada Kanker Serviks Selama Kehamilan Rima Irwinda; Lisa Novianti; M Adya F Dilmy; Hariyono Winarto
Andalas Obstetrics And Gynecology Journal Vol. 10 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.10.2.194-217.2026

Abstract

Background: Cervical cancer diagnosed during pregnancy poses a complex clinical and ethical dilemma, requiring a balance between timely maternal cancer treatment and fetal preservation. Recent studies show that pregnancy itself does not worsen long-term cancer outcomes, allowing for a more individualized approach especially in early-stage disease, where delaying treatment until fetal viability can be both safe and practical   Purpose: This evidence-based review aimed to summarize current evidence on the safety and outcomes of conservative management for early-stage cervical cancer during pregnancy   Methods: We explored journal databases (PubMed, Cochrane, and Google Scholar). We included meta-analyses, systematic reviews, or observational studies published in English   Results: We found three studies that fulfilled our inclusion criteria; they were two meta-analyses and one retrospective cohort study. Zuoxi et al concluded that there was no survival difference between the 2 groups (100% vs. 90.91%, P=0.54), and none of the pregnant women who died had delayed treatment due to pregnancy. Zeng et al, the primary outcome of interest is long-term survival, as pregnancy termination and timing of delivery did not significantly affect the 5-year OS (P > 0.05).   Conclusion: This evidence-based case report underscores the feasibility and clinical efficacy of a conservative, individualized management strategy for patients diagnosed with early-stage cervical cancer during pregnancy, where a comprehensive understanding of current evidence empowers clinicians and patients to collaborate on treatment plan that addresses both maternal survival and fetal well-being.
ERCP dengan Non atau Rendah Fluoroskopi pada Pasien Hamil dengan Kolangitis Akut: Tinjauan Berbasis Bukti tentang Luaran Ibu dan Janin Rima Irwinda; Lisa Novianti; Kristian Alda Sianipar
Andalas Obstetrics And Gynecology Journal Vol. 10 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.10.2.330-342.2026

Abstract

Background: Acute cholangitis in pregnancy is a rare but life-threatening condition, where delays in source control may accelerate maternal sepsis and compromise fetal viability. Objective: This study aimed to evaluate whether early endoscopic retrograde cholangiopancreatography (ERCP), performed with non- or low-fluoroscopy techniques, improves maternal stabilization and fetal outcomes compared with conservative or delayed intervention. Methods: A systematic evidence-based case review was conducted, combining a clinical vignette of a 28-week pregnancy complicated by severe cholangitis and sepsis with a focused literature search in PubMed, ScienceDirect, and ProQuest. Inclusion criteria followed the PICO framework, emphasizing pregnant patients with TG18-defined moderate-to-severe cholangitis, early ERCP (≤24 hours), and maternal and fetal outcomes. Critical appraisal was undertaken using the Oxford Centre for Evidence-Based Medicine methodology. Results: Findings from two eligible studies—a systematic review of over 500 ERCPs in pregnancy and a single-center cohort of 24 cases—showed consistently high technical success rates and low maternal complication rates. Post-ERCP pancreatitis emerged as the most frequent adverse event but was significantly reduced in tertiary centers with skilled operators. Fetal outcomes were generally favorable when dose-reduction strategies and shielding were applied, with preterm birth and perinatal mortality remaining uncommon. Our case illustrates the risks of clinical deterioration when source control is deferred; earlier temporizing drainage could have provided stabilization without definitive sphincterotomy until postpartum. Conclusion: Early therapeutic ERCP using radiation-sparing techniques appears safe and effective for managing severe cholangitis in pregnancy, balancing maternal survival with fetal safety.
Co-Authors Hariyono Winarto Kristian Alda Sianipar M Adya F Dilmy Rima Irwinda Rima Irwinda