Hermawan, Gezta Nasafir
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Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice Hermawan, Gezta Nasafir; Wibisono, Jacobus Jeno; Nembo, Lidya F
Medicinus Vol 10, No 2 (2021): February : 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i3.3767

Abstract

Abdominal wound dehiscence (AWD) is considered as a severe postoperative complication in which there is a partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration. The incidence and mortality rate varies in different health centers. Risk factors are classified into three groups, which includes: pre-operative, intra-operative, and post-operative. The management of Burst Abdomen or Wound Dehiscence is diverse from conservative treatment to surgical treatment.
Late Intra-Uterine Fetal Demise with Fetal Hydrops: Challenges of Management Planning in Indonesia Hermawan, Gezta Nasafir; Wibisono, Jacobus Jeno; Nainggolan, Julita D.L.
Medicinus Vol 10, No 1 (2020): October:2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i2.3445

Abstract

Intra-Uterine Fetal Demise (IUFD) is defined as death of human conception at age of 20 weeks’ gestation or older or with a minimum 500-g birthweight before complete delivery from the mother and induced termination involved. In 2015, Indonesia has contributed a stillbirth rate of 13 out of 1,000 total births in which 17.1% of the cases were caused by congenital anomalies. Fetal Hydrops as a pathological condition in which there is an accumulation of fluid in fetal soft tissues and serous cavities. With the advancements of sonographic technology, identification of fetal hydrops has become uncomplicated. However, what remains a challenge is to investigate etiology and determine management. In order to plan proper management, the etiology of fetal hydrops must first be determined to predict the prognosis of fetal hydrops. In Indonesia; limited facilities and experts combined with high costs in etiology determination and management have complicated the matter. Furthermore, the strong influence of several Eastern communities’ norms and religious views have further complicated both physicians and patients in decision making. In this report, we present a case of late intra-uterine fetal demise with fetal hydrops, whom was admitted on her 35 weeks age gestation. We performed elective Caesarean Section in order to deliver the stillborn fetus, with no significant post-operative complication. Unfortunately, this condition was actually diagnosed earlier during 20th weeks of gestation, hence advised to continue the pregnancy without further evaluation and information to the mother regarding the hydrops condition.
Late Intra-Uterine Fetal Demise with Fetal Hydrops: Challenges of Management Planning in Indonesia Hermawan, Gezta Nasafir; Wibisono, Jacobus Jeno; Nainggolan, Julita D.L.
Medicinus Vol. 10 No. 1 (2020): October:2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i2.3445

Abstract

Intra-Uterine Fetal Demise (IUFD) is defined as death of human conception at age of 20 weeks’ gestation or older or with a minimum 500-g birthweight before complete delivery from the mother and induced termination involved. In 2015, Indonesia has contributed a stillbirth rate of 13 out of 1,000 total births in which 17.1% of the cases were caused by congenital anomalies. Fetal Hydrops as a pathological condition in which there is an accumulation of fluid in fetal soft tissues and serous cavities. With the advancements of sonographic technology, identification of fetal hydrops has become uncomplicated. However, what remains a challenge is to investigate etiology and determine management. In order to plan proper management, the etiology of fetal hydrops must first be determined to predict the prognosis of fetal hydrops. In Indonesia; limited facilities and experts combined with high costs in etiology determination and management have complicated the matter. Furthermore, the strong influence of several Eastern communities’ norms and religious views have further complicated both physicians and patients in decision making. In this report, we present a case of late intra-uterine fetal demise with fetal hydrops, whom was admitted on her 35 weeks age gestation. We performed elective Caesarean Section in order to deliver the stillborn fetus, with no significant post-operative complication. Unfortunately, this condition was actually diagnosed earlier during 20th weeks of gestation, hence advised to continue the pregnancy without further evaluation and information to the mother regarding the hydrops condition.
Abdominal Wound Dehiscence: A Review of Risk Factors, Prevention and Management in Obstetrics and Gynecology Practice Hermawan, Gezta Nasafir; Wibisono, Jacobus Jeno; Nembo, Lidya F
Medicinus Vol. 10 No. 2 (2021): February : 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v8i3.3767

Abstract

Abdominal wound dehiscence (AWD) is considered as a severe postoperative complication in which there is a partial or complete disruption of an abdominal wound closure with or without protrusion and evisceration. The incidence and mortality rate varies in different health centers. Risk factors are classified into three groups, which includes: pre-operative, intra-operative, and post-operative. The management of Burst Abdomen or Wound Dehiscence is diverse from conservative treatment to surgical treatment.
A Case Series on Pregnant Patients with Ovarian Cysts and Management of Potential Complications Hermawan, Gezta Nasafir; Laihad, Bismarck Joel
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 3 July 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i3.2004

Abstract

Abstract (English) Objective: To report a series of ovarian cyst cases in pregnancy that we diagnosed in our obstetrics and gynecology department; and to provide literary perspective in management of potential complications. Methods: A case series Case: We present three cases of pregnant patients with ovarian cysts diagnosed at different trimesters of gestational age. Patients included in this case series were shown to have cysts at the time of sonographic examination. Each patient displayed different complications and underwent specific management for each complication which includes laparotomy and emergency cesarean section. All patients were discharged in clinically stable conditions and the mass was evaluated for further histopathologic examination. This case series will also discuss possible complications of pregnancy with ovarian cysts, and the prevalence of each complication based on the gestational age. Due to its potential complications, ovarian cysts in pregnancy must be accurately evaluated and given appropriate management. Conclusion: Ovarian cysts in pregnancy must be evaluated accurately so that appropriate management is carried out. Clinicians should be aware of cyst complications during pregnancy. Keywords: Ovarian Cysts, Pregnancy, Potential Complications
Thanatophoric Skeletal Dysplasia Type 2: Diagnostic and Management Dilemmas Hermawan, Gezta Nasafir; Wibisono, Jacobus Jeno; Velies, Dyana Safitri
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 1 January 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i1.1598

Abstract

Abstract (English) Objective: To report a rare case of thanatophoric skeletal dysplasia type 2 that we diagnosed during prenatal period; and to provide further review of dilemmas in diagnostic methods and management, based on appropriate literatures and guidelines available. Methods: Case report Case: A 33-year old primigravida women was diagnosed with pre-term pregnancy (24th weeks of gestation) and intra-uterine singleton live fetus with thanatophoric skeletal dysplasia type 2 via ultrasonography. Pregnancy termination via elected caesarean section at 26th weeks of gestation was performed per the patient request after considering the fetus’s lethality. A female neonate was born weighing 980 grams with frontal bossing (Head Circumference: 26 cm), lower set of ears, hypertelorism, bilateral exopthalmos, short neck, rhizomelic short extremities, and narrow thorax (Thorax Circumference: 17 cm). The newborn was immediately transferred to NICU for post-natal management and observation. The newborn is in stable condition for the first several hours; nevertheless, significant destabilization occurred afterwards and the newborn deceased approximately 10 hours after birth due to cardiorespiratory failure. No further invasive resuscitative efforts and post-mortem examinations were performed on the parent’s request. Conclusion: Thanatophoric dysplasia is primarily diagnosed using ultrasonography, which has a high detection rate for both diagnosis and prognostications. Even though, There has been a dilemma in performing molecular diagnostic testing, prediction of recurrence risk in future pregnancies can be assessed with its use. Although still remains a challenge in ethical and medicolegal grounds; proper management requires holistic considerations of maternal, fetal, and perinatal aspects. Keywords: Thanatophoric, Skeletal Dysplasia, FGFR3 mutation Abstrak (Indonesia) Tujuan: Melaporkan suatu kasus langka displasia skeletal tanatoforik tipe 2 yang kami diagnosa dalam periode perinatal; serta memberikan ulasan lanjut mengenai dilema dalam metode diagnostik dan manajemen, berdasarkan literatur dan pedoman ilmiah yang tersedia. Metode: Laporan Kasus Kasus: Seorang perempuan primigravida berusia 33 tahun di diagnosa dengan kehamilan pre-term (24 minggu gestasi), janin tunggal hidup intrauterin dengan displasia skeletal tanatoforik tipe 2 via ultrasonografi. Terminasi kehamilan dengan Sectio Caesarea dilakukan atas permintaan pasien setelah mempertimbangkan letalitas janin. Lahir bayi perempuan berat 980 gram, dengan ‘frontal bossing’ (lingkar kepala: 26 cm), kedua telinga rendah, hipertelorisme, eksoftalmos bilateral, leher pendek, ektremitas pendek rizomelik, dan rongga dada kecil (lingkar dada: 17 cm). Bayi segera dipindahkan ke NICU untuk manajemen paska-natal dan observasi. Kondisi bayi stabil selama beberapa jam pertama; namun, ketidakstabilan yang signifikan terjadi setelah itu dan bayi dinyatakan meninggal 10 jam paska kelahiran dikarenakan kegagalan kardiorespirasi. Bayi tidak dilakukan tindakan resusitasi invasif dan pemeriksaan paska kematian atas permintaan pasien. Kesimpulan: Displasia tanatoforik dapat di diagnosa secara primer menggunakan pemeriksaan ultrasonografi (US) dengan tingkat deteksi diagnosis dan prognosis yang tinggi. Meskipun pemeriksaan diagnostik molekular masih menjadi dilema, pemeriksaan ini dapat memprediksi resiko rekurensi pada kehamilan selanjutnya. Walaupun masih merupakan suatu tantangan dalam segi etika dan medikolegal; manajemen ideal perlu mempertimbangkan secara holistik seluruh aspek yang mencakup: ibu, janin, dan paska kelahiran. Kata Kunci: Tatanoforik, Displasia Skeletal, Mutasi FGFR3 Correspondence: Gezta Nasafir Hermawan, Faculty of Medicine, Sam Ratulangi University. Email: gezta.hermawan@gmail.com