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Journal : Andalas obstetrics and gynecology journal

Amniotic Fluid Embolism in Post Caesarean Section Defrin, Defrin; Farnas, Heri
Andalas Obstetrics And Gynecology Journal Vol. 4 No. 2 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.2.161-166.2020

Abstract

Background: According to WHO, around 73% of maternal deaths globally are caused by direct obstetric causes. The amniotic fluid embolism is a life-threatening obstetric emergency characterized by sudden cardiopulmonary system failure and can be accompanied by Disseminated Intravascular Coagulation (DIC). The amniotic fluid embolism event usually occurs during labor and birth, but can also occur immediately in the post partum period or after pregnancy termination. About 56% of women will not survive for first 2 hours after the acute event. Amniotic fluid embolism is an unpredictable event, so that no prophylactic intervention can be carried out effectively and the handling and enforcement of a diagnosis that still debatable.Objective: To report maternal deaths due to amniotic fluid embolism post cesarean sectionMethod: Case ReportCase:  Reported case of a 30 years old woman with an initial diagnosis in emergency departement with decreased consciousness due to Severe hypoxia due to Pulmonary emboli due to Amniotic fluid emboli on P2A0L2 post Cesarean Section first day of puerperium. The patient experienced a sudden loss of consciousness accompanied by severe shortness of breath after 6 hours after cesarean section surgery in a private hospital. After initial examination and treatment by administering oxygen through the Nonrebreathing Mask, there was no improvement in the O2 saturation value and then the patient was intubated by the anesthetist. After intubation, the O2 saturation value still does not increase, then the patient suddenly experiences cardiac arrest and followed with cardiac resuscitation for 2 cycles accompanied by resuscitation drugs then the patient returns to spontaneous circulation. From the cardiology department, inotropic therapy was given and echocardiographic investigations were carried out. On echocardiographic examination, they found McConnel's sign which showed suspicios of pulmonary embolism. At the time the patient will be moved to the intensive care unit, the patient experiences a cardiac arrest for the second time, then resuscitation is performed again for 2 cycles, but it does not work and the patient is declared dead.Conclusion: Amniotic fluid embolism is an obstetric emergency condition that cannot be predicted and has a high mortality rate. Treatment is supportive to support the cardiopulmonary system and management of coagulopathy that may occur.Keywords: maternal mortality, amniotic fluid embolism 
MODE OF DELIVERY DOES NOT CORRELATE FETAL OUTCOME IN PREGNANCY WITH COVID-19 AT DR. M. DJAMIL HOSPITAL PADANG Farnas, Heri; Sriyanti, Roza
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.1.42-49.2022

Abstract

Introduction: Corona Virus Disease 2019 (COVID-19) was first reported in Wuhan, China. Knowledge about COVID-19 infection in relation to pregnancy and the fetus is still limited. Report from China shows high rate of caesarean delivery (> 90%) due to the suspicion for vertical transmission. Globally there is an increase of caesarean delivery in women with COVID-19 infection. Clinical implications mode of delivery in pregnancies with COVID-19 infection are not fully understood.Objective: The aims of this study to assess differences in fetal outcome based on the mode of delivery in pregnancies with COVID-19 infection.Methods: This observational analytic study with cross sectional study design was conducted in single center at dr. M. Djamil General Hospital Padang from March 2020-March 2021. All study subjects qualified to inclusion and exclusion criteria included. The fetal outcome analyzed based on APGAR scores and COVID-19 status in newborn baby using Mann-Whitney test.Results: A total of 49 patients were analyzed. The results showed mean APGAR score 1 minute in the vaginal delivery was lower than caesarean delivery (6.87±1.06 vs 7.38±0.82) but not significant (p=0.09). No significant difference between vaginal delivery and caesarean delivery based on APGAR score 5 minutes (p=0.19). None newborn babies infected with COVID-19 in both groups.Conclusions: There was no difference of fetal outcome based on the APGAR score in pregnancies with COVID-19 infection by mode of delivery. There were no cases of infants with COVID-19 infection in both groups.Keywords: COVID-19, mode of delivery, APGAR score
Clinical Characteristics, Laboratory, Maternal and Fetal Outcomes in Pregnancy with Covid-19 at RSUP dr. M. Djamil Padang Sriyanti, Roza; Farnas, Heri; Djanas, Dovy
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.1.569-578.2024

Abstract

Introduction : The data obtained from various studies about covid-19 conducted in several hospitals in the world are currently considered not sufficient to provide a clinical picture that occurs in pregnancies with Covid-19 infection. The aims to provide an overview of the clinical, laboratory, maternal and fetal outcomes in pregnancy with Covid-19 infection at dr. M. Djamil Padang. Methods: This study used a descriptive design with data collection starting from March 01, 2020 - March 31, 2021 based on medical record data. Carried out in a single center at RSUP dr. M. Djamil Padang in pregnant patients with confirmed Covid-19 by PCR examination. Results: Total 136 pregnant patients confirmed Covid-19 by PCR examination. Most of the symptoms were asymptomatic (47.1%) and without any comorbidities (76.5%). There were 3 patients who experienced critical symptoms (2.2%). Maternal mortality was found at 2.3% and fetal death 4.7%. The values of d-dimer and NLR were found increasing significantly, 2025.35±1392.18 for d-dimer and 6.39±4.43 for NLR. Pregnancy terminations done for 77.9% patients with cesarean section is the most method (83%). There were 4 cases (3.8%) of babies infected with Covid-19 from mothers who had pregnancy terminations. Conclusions: Most cases had asymptomatic clinical symptoms (47.1%). There are 2.3% cases of maternal death and 4.7% cases of fetal death. Most of the pregnancy terminations were performed by cesarean section (88%). On laboratory examination, there was a significant increase in maternal d-dimer (2,025.35±1.392.18) and NLR (6.39±4.43) in pregnancies with Covid-19.