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All Journal Devotion: Journal of Research and Community Service KESANS : International Journal of Health and Science
Ardiani, Vani
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Chemistry Health Professions Medicine & Pharmacology Physics Public Health

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Improving General Practitioners’ Competence in Basic Obstetric and Gynecologic Ultrasound for Early Fetal Abnormality Detection Donel, Donel; Febriani, Febriani; Hidayatullah, Amiruddin; Ardiani, Vani; Frymonalitza, Ninda; Homaira, Kesuma Anggreini; Nugraha, Iriandanu; Hernita, Nisa Faradisa
Jurnal KESANS : Kesehatan dan Sains Vol 5 No 2 (2025): KESANS: International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v5i2.478

Abstract

In order to reduce maternal and infant mortality rates, interventions must focus on improving the quality of antenatal care, particularly at primary care level. One key competency that general practitioners must possess is the ability to perform basic obstetric ultrasound examinations to detect intrauterine foetal abnormalities early on. This community service activity aims to enhance general practitioners' skills in this area using a six-step approach. Implementation involves theoretical education, hands-on training and pre- and post-test evaluations of participants' knowledge and skills. The activity involved 30 general practitioners from the Kampar Regency area. Training results showed an average increase in post-test scores of 31.67% compared to pre-test scores, indicating significant improvements in participants' competencies. The activity also facilitated the distribution of practice- based teaching modules and strengthened collaboration with local community health centres to support maternal and child health services. Basic obstetric ultrasound training has proven to be an effective way of strengthening primary healthcare services and reducing maternal and perinatal mortality and morbidity rates.
Case Analysis of Cesarean Scar Pregnancy (CSP) in G3P2A0H2 Gravid at 16-17 Weeks with A History of Two Previous Cesarean Sections Alhudri, M. Ardaris; Ardiani, Vani; Razali, Renardy Reza
Devotion : Journal of Research and Community Service Vol. 7 No. 2 (2026): Devotion: Journal of Community Research
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/devotion.v7i2.25635

Abstract

Cesarean Scar Pregnancy (CSP) is a rare but serious form of ectopic pregnancy with an increasing incidence corresponding to rising cesarean delivery rates. It carries significant risks of massive hemorrhage and uterine rupture. This case report presents a 33-year-old woman (G3P2A0H2) at 16–17 weeks of gestation with two prior cesarean sections, who presented with vaginal spotting. Transvaginal ultrasound revealed a 6.08 × 6.03 cm complex mass in the lower uterine segment consistent with CSP. Initial management with a single-dose methotrexate (50 mg/BSA) regimen was unsuccessful, as bleeding persisted and the mass enlarged to 6.9 × 5.9 cm on follow-up ultrasound. Surgical intervention via CSP resection laparotomy with hysterorrhaphy and Pomeroy bilateral tubectomy was subsequently performed, with an estimated blood loss of approximately 800 cc. The patient recovered well postoperatively, and histopathological examination confirmed the presence of trophoblastic tissue. This case underscores the diagnostic challenges and management complexities associated with advanced CSP. Medical therapy with methotrexate may be ineffective in later gestational stages, necessitating timely surgical intervention to prevent life-threatening complications. Counseling on permanent contraception is essential due to the high recurrence risk. This report highlights the importance of early clinical suspicion, accurate imaging, and multidisciplinary management to optimize outcomes for CSP, particularly in patients with multiple prior cesarean deliveries.
Co-Authors Alhudri, M. Ardaris Donel, Donel Febriani Febriani Frymonalitza, Ninda Hernita, Nisa Faradisa Hidayatullah, Amiruddin Homaira, Kesuma Anggreini Nugraha, Iriandanu Razali, Renardy Reza