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Overview of Non-Pharmacological Treatment Option for Adolescent Girls with Dysmenorrhea in Cimahi, West Java, Indonesia Rahmani, Shofiatunisa Firdhausy; Anwar, Ruswana; Sasongko, Elsa Pudji Setiawati; Ritonga, Mulyanusa Amarullah; Arya, Insi Farisa Desy
Althea Medical Journal Vol 11, No 1 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n1.3064

Background: Dysmenorrhea is a condition of pain during menstruation that may affect daily activities. The phenomenon of dysmenorrhea in West Java has reached 54,9%. When dysmenorrhea is not treated, it can decrease productivity at school. This study aimed to find out which therapy was more widely used, the reasons for using the therapy, and to identify changes in non-pharmacological therapy as seen from the visual analog scale (VAS) assessment.Methods: This research used quantitative data with a descriptive study conducted with a cross-sectional method, and the instrument used was a questionnaire. The study was conducted in July 2022 with a total sample of 457 participants, and 366 samples met the inclusion criteria. This data analysis used Statistical Package for Social Scientists (SPSS version 28) to identify changes before and after non-pharmacological therapy options and the frequency distribution of the data.Results: The non-pharmacological therapy option was preferred by students (n= 366), and the reasons students used this therapy were seen from various aspects. Rest was the most frequently chosen activity by students (n= 329). All students felt a change in the pain scale before and after using non-pharmacological therapy with the visual analog scale (VAS).Conclusion: Students in grades 1 and 2 of SMAN 1 Cimahi prefer non-pharmacological therapy with rest. They have various aspects of reasoning and feeling changed after using the therapy. There is a change in the pain scale after using non-pharmacological therapy.

Outcome of Fetuses with Anterior Abdominal Wall Defects in A Tertiary Referral Hospital Alifa, Dhara; Aziz, Muhammad Alamsyah; Ritonga, Mulyanusa Amarullah; Pribadi, Adhi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.691

Introduction: The most common abdominal wall defects are gastroschisis and omphalocele. Gastroschisis is a case of intraabdominal herniation caused by an abdominal wall defect from exposure to amniotic fluid during pregnancy. Omphalocele is a case of intraabdominal herniation covered with a membranous sac on the umbilical cord’s base. Gastroschisis occurred in 1/4000 of the of the global birth rate. Prevalence of omphalocele in between 1/3000 and 1/5000 cases of pregnancy. The purpose of the purpose of the research is to present an overview of patients with congenital defects such as Gastroschisis and Omphalocele.Method: Research design is observational and descriptive. Data obtained from medical records in Hasan Sadikin tertiary referral hospital Bandung. Sample size was obtained by total sampling and conducted in April 2020–April 2023. Results: The demographics of gastroschisis include male (50%), female (50%), preterm (20%), stillbirth (30%), severe asphyxia (14.29%), moderate asphyxia (57.14%), normal asphyxia (8.57%), newborn mortality (14.29%), and other congenital anomalies (40%). In comparison, the demographics of omphalocele are male (66.67%), female (33.33%), preterm (58.33%), stillbirth (16.67%), severe asphyxia (40%), moderate asphyxia (40%), normal asphyxia (20%), newborn mortality (50%), and other congenital abnormalities (25%). Abdominal wall defects are seldom related with gender.Conclusion: Abdominal wall defect is a very rare congenital abnormality. This abnormality will require primary abdomen closure surgery to enhance the baby’s prognosis. The more other risk factors exist within abdominal wall defect babies, the worse their following prognosis will be. The prognosis for omphalocele is more severe than gastroschisis due to the presence of asphyxia and prematurity.Luaran Janin dengan Defek Dinding Abdominal Anterior di Rumah Sakit Rujukan TersierAbstrakPendahuluan: Cacat dinding depan abdomen yang paling banyak terjadi adalah gastroschisis dan omphalocele. Gastroschisis adalah kasus herniasi intraabdomen yang disebabkan oleh cacat dinding perut akibat paparan cairan ketuban selama kehamilan. Omphalocele adalah kasus herniasi intraabdomen yang ditutupi kantung membran di dasar tali pusat. Gastroschisis terjadi pada 1/4000 angka kelahiran global. Prevalensi omfalokel antara 1/3000 dan 1/5000 kasus kehamilan. Tujuan dari penelitian ini adalah untuk menyajikan gambaran pasien dengan kelainan bawaan seperti Gastroschisis dan Omphalocele.Metode: Desain penelitian adalah observasional dan deskriptif. Data diperoleh dari rekam medis di rumah sakit rujukan tersier Hasan Sadikin Bandung. Besar sampel diperoleh dengan cara total sampling dan dilakukan pada bulan April 2020–April 2023.Hasil: Demografi gastroschisis meliputi laki-laki (50%), perempuan (50%), prematur (20%), lahir mati (30%), asfiksia berat (14,29%), asfiksia sedang (57,14%), asfiksia normal (8,57%). ), kematian bayi baru lahir (14,29%), dan kelainan kongenital lainnya (40%). Sebagai perbandingan, demografi omfalokel adalah laki-laki (66,67%), perempuan (33,33%), prematur (58,33%), lahir mati (16,67%), asfiksia berat (40%), asfiksia sedang (40%), asfiksia normal (20). %), kematian bayi baru lahir (50%), dan kelainan bawaan lainnya (25%). Cacat dinding perut jarang berhubungan dengan jenis kelamin.Kesimpulan: Cacat dinding perut merupakan kelainan bawaan yang sangat tidak biasa. Kelainan ini memerlukan operasi penutupan perut utama untuk meningkatkan peluang hidup bayi. Adanya faktor risiko tambahan pada bayi baru lahir dengan kelainan dinding perut memperburuk prognosisnya. Omphalocele sering menyebabkan asfiksia dan prematur, sehingga prognosisnya lebih buruk dibandingkan gastroschisis.Kata Kunci : Cacat dinding depan abdomen, Gastroschisis, Omphalocele

Characteristics of Endometrioma Recurrence Patients Maharani, Chintia Dewi; Bayuaji, Hartanto; Syam, Hanom Husni; Ritonga, Mulyanusa Amarullah; Mantilidewi, Kemala Isnainiasih; Rinaldi, Andi; Pratiwi, Yuni Susanti
Indonesian Journal of Obstetrics & Gynecology Science Volume 6 Nomor 3 November 2023
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v6i3.576

Objective: To identify the characteristics of endometrioma recurrence cases. Method: This study was a descriptive retrospective, using secondary data taken from all medical records of Clinic Aster and Medical Records Installation in Dr. Hasan Sadikin General Hospital, Bandung, from 1st January 2018 – 31st December 2022. Data were presented in tables.Results: Of the 37 endometrioma recurrences, most of the patients are 20 to 35 in age. None of them has a parity history after the first surgical procedure. Both previous and recent cases are dominantly unilateral endometriomas. The history of postoperative medication is higher (54,1%). Obstetricians/Gynecologists appear to perform the most surgical procedure (67,6%). Mass is the main clinical manifestation of the recurrence. While menstrual and BMI profiles appear to be normal.Conclusions: The characteristic of the recurrence of endometrioma is related parity status after the first surgery, history of the previous medical treatment, and previous form of endometrioma are related to the current characteristic of endometrioma (age, lesion form, clinical manifestation, and recurrence interval).Karakteristik Pasien Endometrioma RekurenAbstrakTujuan: Mengetahui karakteristik dari pasien endometrioma rekuren.Metode: Penelitian ini merupakan penelitian deskripsi retrospektif dengan menggunakan data sekunder yang diambil dari seluruh rekam medis pasien kista endometriosis rekuren di Klinik Aster dan Instalasi Rekam Medis di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dengan periode 1 Januari 2018 – 31 Desember 2022. Kemudian, data-data disajikan dalam bentuk tabel. . Hasil: Dari 37 kasus e ndometrioma rekuren, sebagian besar pasien berusia 20 hingga 35 tahun. Seluruh pasien tidak mempunyai riwayat paritas setelah prosedur pembedahan sebelumnya. Baik kasus-kasus kista endometriosis sebelumnya maupun yang kambuh, keduanya dominan dalam bentuk unilateral. Riwayat pengobatan pasca operasi lebih tinggi (54,1%). Dokter Spesialis Obstetri/Ginekologi tampak melakukan tindakan pembedahan terbanyak (67,6%). Massa adalah manifestasi klinis utama dari kekambuhan. Selain itu, profil menstruasi dan BMI tampak normal.Kesimpulan: Karakteristik pada endometrioma rekuren berkaitan dengan status paritas setelah operasi pertama, riwayat pengobatan medis sebelumnya, dan bentuk endometrioma sebelumnya berhubungan dengan karakteristik endometrioma saat ini (usia, bentuk lesi, manifestasi klinis, dan rentang rekurensi)Kata kunci: karakteristik, rekuren, endometrioma

Management of Ovarian Cancer in the Second Trimester of Pregnancy: A Case Report and Literature Review Syarief, Sri Dewi Rahmawati; Ritonga, Mulyanusa Amarullah; Anwar, Ruswana; Suardi, Dodi
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 1 Maret 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i1.778

Introduction: Ovarian carcinoma during pregnancy is a rare but clinically significant condition that requires swift and precise management to optimize maternal and fetal outcomes. This case report highlights the successful conservative surgical management of malignant mucinous ovarian cancer diagnosed in the second trimester. It provides insights into the feasibility and safety of surgical intervention during pregnancy, contributing valuable evidence to the existing literature on oncologic care during pregnancy.Case Illustration: A 21-year-old woman, G1P0A0, presented at 17-18 weeks of gestation with no complaints related to her pregnancy but reported abdominal enlargement over the past three months. At 6 weeks gestation, the patient was diagnosed with an ovarian cyst, later confirmed as a large cystic mass on the right ovary with papillary components through ultrasound. The IOTA simple rules indicate that the mass was suspected to be malignant. The provisional diagnosis was suspected ovarian malignancy with a differential diagnosis of multilocular ovarian cyst. The patient underwent a planned right oophorectomy at 18 weeks gestation. Histopathology revealed a mucinous malignant tumor of the right ovary that had not invaded the right fallopian tube. The pregnancy was continued, and the patient was closely monitored, with plans for further evaluation postpartum.Conclusion: This case highlights the feasibility and safety of conservative surgical management of ovarian cancer in the second trimester, demonstrating that timely intervention can optimize both maternal and fetal outcomes. The successful continuation of pregnancy after surgery reinforces the importance of individualized, multidisciplinary approaches to oncologic care during pregnancy.Penatalaksanaan Kanker Ovarium pada Kehamilan Trimester Kedua: Sebuah Laporan Kasus dan Tinjauan PustakaAbstrakPendahuluan: Karsinoma ovarium pada kehamilan merupakan kondisi yang jarang terjadi tetapi, memiliki implikasi klinis yang signifikan. Penatalaksanaannya memerlukan keputusan yang cepat dan tepat untuk mengoptimalkan hasil bagi ibu dan janin. Laporan kasus ini menyoroti keberhasilan manajemen bedah konservatif pada kanker ovarium mucinous ganas yang terdiagnosis pada trimester kedua kehamilan. Kasus ini memberikan wawasan mengenai kelayakan dan keamanan tindakan bedah selama kehamilan, serta berkontribusi terhadap literatur ilmiah terkait onkologi kehamilan.Ilustrasi Kasus: Seorang wanita berusia 21 tahun, G1P0A0, datang pada usia kehamilan 17 – 18 minggu tanpa keluhan, namun melaporkan pembesaran perut selama tiga bulan terakhir. Pada usia kehamilan 6 minggu, pasien didiagnosis dengan kista ovarium yang kemudian dikonfirmasi sebagai massa kistik besar pada ovarium kanan dengan komponen papiler melalui pemeriksaan ultrasonografi. Berdasarkan IOTA simple rules, massa tersebut dicurigai ganas. Diagnosis sementara adalah dugaan keganasan ovarium dengan diagnosis banding kista ovarium multilokular. Pasien menjalani operasi ooforektomi kanan yang terencana pada usia kehamilan 18 minggu. Hasil histopatologi menunjukkan tumor mukinosa ganas pada ovarium kanan yang tidak menyerang tuba falopi kanan. Kehamilan dilanjutkan, dan pasien dipantau secara ketat dengan rencana evaluasi lebih lanjut setelah persalinan.Kesimpulan: Kasus ini menyoroti kelayakan dan keamanan manajemen bedah konservatif pada kanker ovarium trimester kedua. Intervensi yang tepat dapat mengoptimalkan hasil bagi ibu dan janin. Keberhasilan kelanjutan kehamilan setelah tindakan bedah ini menegaskan pentingnya pendekatan multidisiplin yang disesuaikan dengan kondisi pasien dalam penatalaksanaan kanker pada kehamilan.Kata kunci: kanker ovarium, kehamilan, kanker ovarium musinosum

Overview of Menstrual Patterns in Female Patients Diagnosed with Tuberculosis with a History of Infertility at DOTS Polyclinic Hasan Sadikin Hospital and Community Health Centers in Bandung City Madjid, Tita Husnitawati; Utomo, Suhendro Rahmat; Susilo, Artha Falentin Putri; Ritonga, Mulyanusa Amarullah; Arya, Insi Farisa Desy
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 1 Maret 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i1.725

Introduction: Female genital tuberculosis (FGTB) is one of the leading causes of infertility in countries with high cases of tuberculosis. However, there is a lack of data showing the menstrual patterns of FGTB patients in Indonesia. This study was conducted to describe the menstrual patterns of female patients diagnosed with TB and who have a history of infertility at the Directly Observed Treatment Short Course Polyclinic of Hasan Sadikin Hospital and community health centers in Bandung City.Method: This is a descriptive observational study using primary data. The subjects were outpatient TB patients with a history of infertility in the Directly Observed Treatment Short Course polyclinic of Hasan Sadikin Hospital and community health centers in Bandung City from 2018 to 2022. Data collection was conducted through questionnaire-based interviews.Results: Out of 950 TB patients of childbearing age recorded in medical records, 41 patients matched the specified criteria. The menstrual disorders experienced by patients included polymenorrhagia, oligomenorrhea, amenorrhea, prolonged menstrual cycles, irregular cycles, hypomenorrhea, heavy menstrual bleeding, and intermenstrual bleeding.Conclusion: The most common menstrual disorders in TB patients with a history of infertility were irregular cycles (36.6%), hypomenorrhea (31.7%), and oligomenorrhea (19.5%).Gambaran Pola Menstruasi pada Pasien Perempuan dengan Diagnosis Tuberkulosis dan Riwayat Infertilitas di Poli DOTS RSHS dan Puskesmas Kota BandungAbstrakPendahuluan: Female genital tuberculosis merupakan salah satu penyebab utama infertilitas pada negara dengan kasus tuberkulosis yang tinggi. Sebagai salah satu dari gejalanya, belum ada data yang menunjukkan pola menstruasi dari pasien female genital tuberculosis di Indonesia. Penelitian ini bertujuan untuk mengetahui gambaran pola menstruasi pada pasien wanita dengan diagnosis tubekulosis dan memiliki riwayat infertilitas di Poliklinik Directly Observed Treatment Short Course Rumah Sakit Hasan Sadikin dan Puskesmas Kota Bandung.Metode: Penelitian deskriptif dengan menggunakan data primer. Subjek penelitian adalah pasien tuberkulosis wanita dengan riwayat infertilitas yang dirawat jalan di poliklinik Directly Observed Treatment Short Course Rumah Sakit Hasan Sadikin dan 4 Puskesmas di Kota Bandung dari tahun 2018 - 2022. Subjek diperoleh melalui wawancara berbasis kuesioner.Hasil: Dari 950 pasien tuberkulosis wanita usia subur yang terdata di rekam medis, didapatkan 41 data pasien yang sesuai dengan kriteria yang ditentukan. Gangguan menstruasi yang dialami pasien dapat berupa polimenore, oligomenore, amenore, siklus menstruasi yang memanjang, siklus yang irreguler, hipomenore, heavy menstrual bleeding, dan perdarahan intermenstrual.Kesimpulan: Gangguan menstruasi yang paling sering terjadi pada pasien TB dengan riwayat infertilitas adalah siklus yang irreguler (36.6%), hipomenore (31.7%), dan oligomenore (19.5%).Kata Kunci: Infertilitas, Kota Bandung, Pasien TB wanita, Pola Menstruasi.

Rare Case: Tetra-Amelia Syndrome Alifa, Dhara; Aziz, Muhammad Alamsyah; Ritonga, Mulyanusa Amarullah; Pribadi, Adhi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.694

Introduction: Congenital abnormalities are anomalies that become a fear for a family, when a mother experiences pregnancy. Some abnormalities are temporary and can be corrected, while some are permanent and cannot be corrected, so screening at antenatal time is very important.Objective: To explain and analyze a rare case of Tetra-amelia syndrome and how to diagnose it.Case: A 32-year-old woman with a 32-week-old G3P0A2 pregnancy visited the maternal-fetal clinic. According to ultrasound data, a single fetus with a gestational age of 31-32 weeks and a fetal weight of 1837 grams is in breech presentation. Only the proximal components of the arm and leg are formed, leaving the radius bones, ulna, tibia, and fibula unformed. The femur has a length that corresponds to 16 weeks, while the humerus has a length that corresponds to 20 weeks. These findings also revealed a discrepancy in pregnancy age. A tetra-amelia abnormality was discovered at the end of the ultrasound scan. Caesarean section performed on August 6, 2021, at the age of 39 weeks, a baby girl has been born baby girl a baby girl weighing 2300 grams, a body length of 31 cm, with mild asphyxia.Conclusion: During antenatal care, ultrasound on the unidentified distal part of the entire extremity can detect Tetra-amelia syndrome.Kasus Langka: Sindrom Tetra-ameliaAbstrak Pendahuluan: Kelainan bawaan adalah anomali yang menjadi trauma bagi keluarga, ketika seorang ibu mengalami kehamilan. Beberapa kelainan bersifat sementara dan dapat diobati, sementara beberapa bersifat permanen dan tidak dapat diperbaiki sehingga skrining pada waktu antenatal sangat penting.Tujuan: Artikel ini untuk menjelaskan dan menganalisis kasus langka sindrom Tetra-amelia dan cara mendiagnosisnya.Kasus: Seorang wanita berusia 32 tahun dengan kehamilan G3P0A2 berusia 32 minggu mengunjungi klinik fetomaternal. Hasil pemeriksaan ultrasonografi menunjukan janin tunggal dengan usia kehamilan 31 - 32 minggu dan berat janin 1837 gram dalam letak sungsang. Hanya komponen proksimal lengan dan kaki yang terbentuk, sedangkan tulang jari-jari, ulna, tibia, dan fibula tidak terbentuk. Femur memiliki panjang yang sesuai dengan 16 minggu, sedangkan humerus memiliki panjang yang sesuai dengan 20 minggu. Kelainan tetra-amelia dapat dideteksi dengan pemindaian ultrasonografi. Pada tanggal 6 Agustus 2021 presentasi sungsang, dilakukan operasi caesar, lahir bayi perempuan pada usia 39 minggu, berat 2300 gram, panjang 31 cm, disertai asfiksia ringan.Kesimpulan: Pemeriksaan ultrasonografi pada perawatan antenatal dapat mendeteksi sindrom Tetra-amelia, bila bagian distal ekstremitas tidak teridentifikasi.Kata kunci:Sindrom Tetra-amelia, Ultrasonografi, Kelainan Kongenital

Amniotic Membrane Graft and Hysteroscopic Adhesiolysis as Treatment for Asherman Syndrome Case Rusly, Dewi Karlina; Ritonga, Mulyanusa Amarullah; Rachmawati, Anita; Rinaldi, Andi; Djuwantono, Tono
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.603

Introduction: Secondary amenorrhea which caused by intrauterine adhesions is called Asherman’s syndrome. This occurs when the uterine cavity becomes partially or completely blocked, which can damage the basal layer of the endometrium and cause the formation of adhesive cicatricial tissue. The prevalence or incidence of Asherman Syndrome ranges from 2.84-5.5% in women. Case Report: A woman 33 years old had a history of amenorrhea for 2 years and three times curettage due to miscariage. Ultrasound findings showed 1.35 cm long cicatrix in the uterine cavity, and probe had only entered 3 cm. The patient underwent hysteroscopy adhesiolysis and grafting of intrauterine amniotic membrane. The intrauterine catheter was monitored for 1 month. Postoperatively the patient also received estradiol valerate therapy 3 x 2 mg for three months. Management of Asherman syndrome with hysteroscopy adhesiolysis with direct observation accompanied by grafting of amniotic membrane using intrauterine catheter tube is one of the techniques to overcome recurrent intrauterine adhesion. Conclusion: Secondary amenorrhea in Asherman syndrome is better treated operatively with direct observation of the hysteroscopy and adhesiolysis. The using of amniotic membrane graft and supportive therapy are very helpful for the success of endometrial growth and preventing recurrent adhesions, increase the menstrual volume and chances of pregnancy.Pencangkokan Selaput Ketuban dan Histeroskopi Adhesiolisis sebagai Penatalaksanaan untuk Kasus Sindrom AshermanAbstrakPendahuluan: Amenorea sekunder yang disebabkan oleh perlengketan intrauterin disebut sindrom Asherman dengan prevalensi berkisar antara 2,84 - 5,5%.Laporan Kasus: Seorang wanita berusia 33 tahun mempunyai riwayat amenore 2 tahun dan kuretase sebanyak 3 kali akibat abortus. Temuan USG menunjukkan cicatrix sepanjang 1,35 cm di rongga rahim, sondage hanya masuk 3cm. Pasien menjalani histeroskopi adhesiolisis dan pemasangan cangkok selaput ketuban intrauterin. Kateter intrauterin dipantau selama 1 bulan. Pascaoperasi pasien juga mendapat terapi estradiol valerat 3 x 2mg selama tiga bulan. Penatalaksanaan sindrom Asherman dengan histeroskopi adhesiolisis dengan observasi langsung disertai pemasangan cangkok selaput ketuban menggunakan selang kateter intrauterin merupakan salah satu teknik yang efekstif untuk mengatasi adhesiolisis intrauterin berulang.Kesimpulan: Amenore sekunder pada sindrom Asherman lebih baik ditangani secara operatif dengan observasi langsung berupa histeroskopi dan adhesiolisis. Pemasangan cangkok selaput ketuban dan terapi suportif sangat membantu keberhasilan pertumbuhan endometrium dan mencegah perlengketan berulang, meningkatkan volume darah saat menstruasi dan peluang terjadinya pembuahan.Kata kunci: Adhesi intrauterin, Histeroskopi, Pencangkokan selaput ketuban, Rekonstruksi endometrium, Sindrom Asherman.

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