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All Journal Majalah Kedokteran Sriwijaya Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Indonesian Journal of Perinatology Jurnal RSMH Palembang
Cindy Kesty
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Universitas Sriwijaya / General Hospital Dr. Mohammad Hoesin, Palembang, South Sumatera, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Kehamilan pada Skar Seksio Sesaria Nuswil Bernolian; Win T. Pangemanan; A. Kurdi Syamsuri; M. Hatta Ansyori; Putri Mirani; Peby Maulina Lestari; Abraham Martadiansyah; Cindy Kesty
Indonesian Journal of Obstetrics & Gynecology Science Volume 3 Nomor 2 September 2020
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v3n2.198

Abstract

Tujuan: Memaparkan klasifikasi, faktor risiko, epidemiologi, cara diagnosis, tatalaksana, dan komplikasi kehamilan pada skar seksio sesareaMetode: Tinjauan pustakaKesimpulan: Kehamilan pada skar SC merupakan kehamilan yang kantung kehamilannya terdapat pada miometrium yang menipis akibat SC sebelumnya. Secara umum, kehamilan pada skar Caesarean Scar Pregnancy (CSP) dapat dibedakan menjadi 2 tipe, yaitu tipe 1 (endogenik) dan tipe 2 (eksogenik). Kejadiannya berkisar antara 1 per 8.000 dan 1 per 2.500 SC dengan risiko rekurensi 3,2-5,0% pada wanita dengan riwayat SC 1 kali yang ditatalaksana dengan dilatasi dan kuretase dengan atau tanpa embolisasi arteri uterina. Adapun faktor risiko CSP adalah tebal Segmen Bawah Rahim (SBR) <5 mm, kantong kehamilan menonjol ke plika vesikouterina, SC di rumah sakit umum daerah, dan riwayat perdarahan melalui vagina ireguler dan nyeri abdomen selama CSP sebelumnya. Pengobatan CSP dapat secara konservatif dengan metotreksat (MTX) maupun operatif termasuk eksisi jaringan kehamilan dengan laparoskopi, histerotomi, atau histerektomi. Pilihan pengobatan lain termasuk dilatasi dan kuretase, reseksi transervikal (TCR) dengan histeroskopi, embolisasi arteri uterina (UEA), kemoembolisasi arteri uterina, atau penempatan kateter balon ganda.Caesarean Scar PregnancyAbstractObjective: To explain about classification, risk factors, epidemiology, diagnostic methods, management, and complications of Caesarean Scar Pregnancy (CSP).Method: Literature review Conclusion: CSP is a pregnancy where the gestational sac is found in the thin myometrium due to previous CS. In general, Caesarean Scar Pregnancy (CSP) can be divided into 2 types, namely type 1 (endogenic) and type 2 (exogenic). Its incidence ranges from 1 per 8,000 and 1 per 2,500 SC with a recurrence risk of 3.2-5.0% in women with a history of 1 time CS who are treated with dilatation and curettage with or without uterine artery embolization. The risk factors for CSP are lower uterine segment thickness <5 mm, gestational sac pouches protruding into the vesicouterine fold, CS in regional public hospitals, and a history of irregular vaginal bleeding and abdominal pain during previous CSP. Caesarean scar pregnancy treatment can be conservative with methotrexate (MTX) or operatively including excision of pregnancy tissue with laparoscopy, hysterotomy, or hysterectomy. Other treatment options include dilatation and curettage, transcervical resection (TCR) with hysteroscopy, uterine artery embolization (UAE), chemoembolization of the uterine arteries, or placement of a double-balloon catheter.Key words: Caesarean scar pregnancy
Primigravida Hamil 12 Minggu dengan Atrial Septal Defect Secundum dan Hipertensi Pulmonal Berat Janin Tunggal Hidup Intrauterin Cindy Kesty; Nuswil Bernolian; Kgs Irawan Satria Arjanggi
Indonesian Journal of Obstetrics & Gynecology Science Special Issue: Case Report
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (603.446 KB)

Abstract

Latar Belakang: Atrial Septal Defect (ASD) apabila disertai hipertensi pulmonal berat harus dikonseling karena tingginya insiden morbiditas dan mortalitas ibu dan janin. Tujuan: Memaparkan sebuah kasus primigravida dengan ASD secundum dan hipertensi pulmonal berat sehingga dapat dilakukan tatalaksana dan pemilihan kontrasepsi yang sesuai.Metode: Laporan kasus seorang wanita berusia 30 tahun, hamil 12 minggu, mengeluh sesak nafas, batuk pada malam hari, dan jantung berdebar-debar. Hasil rontgen thoraks menunjukkan gambaran hipertensi pulmonal disertai peningkatan vaskularisasi paru. Kateterisasi jantung menunjukkan ASD secundum besar, hipertensi pulmonal berat, high flow, high resistance, dan reaktif dengan tes O2. Hasil ekokardiografi (2017) menunjukkan ASD secundum berat, regurgitasi trikuspid dan pulmonal moderat. Ultrasonografi abdomen menunjukkan kesan hamil 12 minggu janin tunggal hidup intrauterin, mioma uteri intramural dan subserosum, perdarahan subamnion dan subkorion. Pada pasien ini, dilakukan abortus provokatus medisinalis melalui pemberian Prostaglandin dilanjutkan dengan dilatasi dan kuretase.Kesimpulan: Kehamilan pada wanita dengan ASD umumnya ditoleransi dengan baik, dengan luaran ibu dan janin yang baik. Pasien dengan penyakit jantung berat sebaiknya tidak hamil dan bila hamil sebaiknya diterminasi. Preparat estrogen merupakan kontraindikasi pada pasien jantung. Pemilihan kontrasepsi harus mempertimbangkan keparahan, tipe anatomis kelainan jantung, dan keinginan ibu untuk mempertahankan fungsi reproduksinya.Kata Kunci: primigravida, ASD secundum, hipertensi pulmonal  AbstractBackground: Atrial Septal Defect (ASD) with severe pulmonary hypertension should be counseled because of the high incidence of maternal and fetal morbidity and mortality. Objective: Describing a case of primigravida with ASD secundum and severe pulmonary hypertension so that appropriate management and contraception can be selected.Method: A 30-year-old woman, 12 weeks pregnant, suffered from shortness of breath, coughing at night, and palpitations. Chest X-ray showed pulmonary hypertension with increased pulmonary vascularity. Cardiac catheterization showed a large ASD secundum, severe pulmonary hypertension, high flow, high resistance, and reactive O2 test. Echocardiography (2017) showed severe ASD secundum, moderate tricuspid, and pulmonary regurgitation. Abdominal ultrasonography showed 12 weeks gestational age single live fetus intrauterine, intramural and subserosal uterine myoma, and also subamniotic and subchorionic bleeding. We did provoked abortion using Prostaglandin continued with dilatation and curettage.Conclusion: Pregnancy in women with ASD is generally well tolerated, with good maternal and fetal outcomes. Patients suffered from severe heart disease should not be pregnant, and if necessary get pregnancy terminated. Estrogen preparations are contraindicated in these patients. The choice of contraception must consider the severity, the anatomy of heart abnormality, and mother's desire to maintain her reproductive function. Key words: primigravida, ASD secundum, pulmonary hypertension.
Preeklamsia Pascasalin Nuswil Bernolian; Wim T. Pangemanan; A. Kurdi Syamsuri; M. Hatta Ansyori; Putri Mirani; Peby Maulina Lestari; Abarham Martadiansyah; Cindy Kesty
Indonesian Journal of Obstetrics & Gynecology Science Special Issue: Article Review
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v4n2s.196

Abstract

AbstrakTujuan: Memaparkan etiologi dan faktor risiko, diagnosis banding, patofisiologi, pemantauan, terapi, komplikasi, rekurensi dan tindakan preventif pada kasus preeklamsia pascasalin.Metode: Tinjauan pustaka dengan berbagai referensi yang diakses melalui mesin pencarian seperti Pubmed dan Sci-Hub dengan menggunakan kata kunci preeclampsia, hypertension, postpartum, management. Sumber referensi yang digunakan yaitu guidelines, jurnal, dan buku teks yang diterbitkan dalam 15 tahun terakhir.Kesimpulan: Insiden preeklamsia di Indonesia yaitu 128.273/tahun atau sekitar 5,3%. Sebanyak 0,3 – 27,5% kasus yang dilaporkan mengalami preeklamsia atau hipertensi pascasalin. Gejala-gejala preeklamsia pascasalin muncul setelah melahirkan. Mayoritas kasus berkembang dalam 48 jam setelah persalinan, walaupun sindrom dapat muncul hingga 6 minggu setelah persalinan. Periode pascasalin merupakan waktu kritis bagi spesialis obstetri dan ginekologi untuk menjamin wanita dengan riwayat preeklamsia untuk dipantau dalam jangka waktu pendek dan panjang. Akan tetapi, pemantauan pascasalin sangatlah rendah, berkisar antara 20-60%. Pemilihan antihipertensi pasca salin yaitu berikatan kuat dengan protein dan solubilitas lipid yang rendah sehingga lebih sedikit yang masuk ke ASI. Selain itu, dipengaruhi juga oleh ionisasi, berat molekul dan konstituen ASI (kandungan lemak, protein, dan air). Agen lini pertama untuk preeklamsia pascasalin adalah labetalol dan hidralazin intravena serta nifedipin. Wanita dengan hipertensi gestasional ataupun preeklamsia biasanya dapat menghentikan antihipertensi dalam 6 minggu pasca salin.Postpartum PreeclampsiaAbstractObjective: To explain about etiologies and risk factors, differential diagnosis, pathophysiology, follow up, treatment, complications, recurrence, and prevention of preeclampsia post delivery discharged.Method: Literature review with several references accessed through search engines such as Pubmed and Sci-Hub by using keywords preeclampsia, hypertension, postpartum, management. Reference sources used are guidelines, journals, and textbooks published in the last 15 years.Conclusion: The incidence of preeclampsia in Indonesia is 128,273/year or around 5.3%. As many as 0.3-27.5% of cases reported postpartum preeclampsia or hypertension. Symptoms of postpartum preeclampsia appear after delivery. The majority of cases develop within 48 hours after delivery, although the syndrome can appear up to 6 weeks after delivery. The postpartum period is a critical time for obstetricians and gynecologists to ensure women with a history of preeclampsia are monitored in the short and long term. However, postpartum monitoring is very low, ranging from 20-60%. The choice of antihypertensive postpartum is that it is strongly bound to protein with low lipid solubility so that fewer enter breast milk. In addition, it is also influenced by ionization, molecular weight and constituents of breast milk (fat content, protein, and water). The first line agent for postpartum preeclampsia is intravenous labetolol and hydralazine and also nifedipine. Women with gestational hypertension or preeclampsia can usually stop antihypertension within 6 weeks postpartum.Key word: postpartum preeclampsia, antihypertension
The Role of Low Dosage Combined Oral Contraceptive Pill in Perimenopausal Women A. Abadi; Fatimah Usman; Awan Nurtjahyo; Cindy Kesty
Jurnal RSMH Palembang Vol. 2 No. 1 (2021): Jurnal RSMH Palembang
Publisher : RSUP Dr Moh Hoesin Palembang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (223.726 KB) | DOI: 10.37275/jrp.v2i1.13

Abstract

The perimenopausal period refers to the time period of the menstrual cycle and endocrine changes. Usually, it starts with a variation in the menstrual cycle length and ending with FMP. The rates of unwanted pregnancies for these women are reported to be around 40–45%. Thus, contraceptive counselling and contraceptive use among perimenopausal women are important aspects of their overall health care if they are sexually active and do not wish to become pregnant. One of them is by using low dose combined oral contraceptive pill containing ethynylestradiol (EE) containing less than 50 µg EE/day. It acts by supressing gonadotropin. There are several positive effects of COC, namely pregnancy prevention; regulation of menstrual cycle; relieving menopausal symptoms; bone protection; protection against ovarian, endometrial and colorectal cancer; lipid metabolism; and blood pressure lowering effect. In contrast, the negative effects of COC are increases the risk of breast cancer, venous thromboembolism, and myocardial infarction. We presented a literature review to describe the usage of low dosage combined oral contraceptive pill as one of contraception method in perimenopausal women, including its positive and negative effects.
Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome: Angka Kematian Ibu di RSUD Ogan Komering Ulu Timur (OKU Timur) dalam Periode Empat Tahun: Pola, Faktor yang Berkaitan dan Luaran Neonatus Cindy Kesty; Hendra S Saputra
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (52.885 KB) | DOI: 10.32771/inajog.v7i2.980

Abstract

Objective: To determine the MMR trends, its associated factors, and neonatal outcome at East OKU Regional Public Hospital from 2013 until 2016. Methods: This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East OKU Regional Public Hospital, South Sumatera. Data was collected from medical records. There were 17 maternal deaths, but 1 data was excluded due to lack of data. Results: We recorded 2,191 pregnancies and 17 maternal deaths. Over 4 years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major etiology of maternal deaths were hypertensive disorder (37.5%), followed by hypertensive disorder + hemorrhage and hypertensive disorder + infection in the same proportion. MMR were higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%). Conclusion: MMR trends in our hospital were fluctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays significant role in maternal deaths. In addition, most of neonates were born alive. We hope that this study can be a feedback for hospital to do maternal and perinatal audit. Keywords: Factors, Maternal mortality rate, Neonatal outcome, Regional public hospital, Trends Tujuan: Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD OKU Timur dari 2013 hingga 2016. Metode: Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD OKU Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap. Hasil: Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui sectio caesaria (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%). Kesimpulan: Pola AKI di RSUD berfluktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifikan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal. Kata kunci: Angka kematian ibu, Faktor, Luaran neonatus, Pola, Rumah sakit umum daerah
Risk Factors of Postpartum Urinary Retention: Faktor Risiko Retensio Urine Pascasalin Eka H. Oktharina; Amir Fauzi; Nuswil Bernolian; Theodorus Theodorus; Cindy Kesty
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 4 October 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i4.1117

Abstract

Objective: To determine the correlation between risk factors and the incidence of postpartum urinary retention (PUR) at RSUP Dr. Mohammad Hoesin Palembang. Method: Analytical observational study with cross sectional design to find out the correlation between risk factors and incidence of PUR at emergency room, delivery room and ward at dr. Mohammad Hoesin General Hospital Palembang since October 2018 to April 2019. There were 82 samples that met inclusion criteria. The correlation between risk factors and the incidence of urinary retention was analyzed using Chi Square test/ Fisher Exact test, and the most important risk factor was determined using the Logistic Regression test. Data analysis used SPSS version 22.0. Result: In this study, it was found that there was a significant relationship between prolonged second stage of labor (PR=40.75, p=0.000), type of labor (PR=9.028 CI 95% 2.114–38.558; p=0.004 ) and perineal laceration (PR=12.938 CI95% 1.872–89.414; p=0.016) with PUR. However, there was no significant relationship between age, parity, neonatal birth weight, episiotomy, vulvar edema and urinary retention (p>0.05). It was concluded that instrumental delivery had a significant effect on the incidence of urinary retention (PR=13,541 CI95% 2.381–77.018, p value=0.003) by using logistic regression test.Conclusion: The most important risk factor of urinary retention was instrumental delivery.Keywords: instrumental delivery, perineal laceration, postpartum urinary retention, type of labor Abstrak Tujuan: Untuk mengetahui hubungan antara faktor risiko dan kejadian retensio urine pascasalin di RSUP Dr. Mohammad Hoesin Palembang.Metode: Penelitian observasional analitik dengan desain potong lintang untuk mengetahui hubungan antara faktor risiko dan kejadian retensio urine pascasalin di IGD, kamar bersalin dan bangsal perawatan RSUP Dr. Mohammad Hoesin Palembang sejak Oktober 2018 sampai April 2019. Didapatkan 82 sampel yang memenuhi kriteria inklusi. Hubungan antara faktor risiko dan kejadian retensio urine dianalisis menggunakan uji Chi Square/Fisher Exact, sedangkan untuk mengetahui faktor risiko yang paling berperan menggunakan uji regresi logistik. Analisis data menggunakan SPSS versi 22.0.Hasil: Pada penelitian ini, didapatkan hubungan yang signifikan antara lama kala II (PR=40,75, p=0,000), jenis persalinan (PR=9,028 IK95% 2,114–38,558; p=0,004), laserasi perineum (PR=12,938 CI95% 1,872–89,414; p=0,016), dan retensio urine pascasalin. Namun, didapatkan hubungan yang tidak signifikan antara usia, paritas, BBL bayi, episiotomi, edema vulva, dan kejadian retensio urin (p>0,05). Dengan uji regresi logistik, didapatkan kesimpulan bahwa jenis persalinan dengan instrumen berpengaruh secara signifikan terhadap kejadian retensio urine (PR = 13,541 IK95% 2,381–77,018, p value = 0,003).Kesimpulan: Faktor risiko yang paling berperan terhadap kejadian retensio urine pascasalin adalah persalinan dengan instrumen.Kata Kunci: jenis persalinan, instrumen, laserasi perineum, retensio urine pascasalin
Clinical Efficacy of the Use of Honey as Wound Treatment in Surgical Site Infection due to Hysterectomy Patient with Type 2 Diabetes Mellitus Hartati; Mufida Muzakkie; Yusuf Effendi; Ferry Yusrizal; Ramzi Amin; Cindy Kesty; Vicela Patricia Virgyna
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 8 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i8.343

Abstract

Introduction: Honey is believed to be used in the topical treatment of wounds and burns due to its anti-bacterial and wound healing promotion activities. The sugar content in honey is high enough to inhibit microbial growth. This case report reports the clinical efficacy of using honey as a postoperative hysterectomy wound dressing with type 2 diabetes mellitus complications. Case Presentation: A woman, 40 years old, lived in Palembang, housewife, came with complaints of open surgical scars and smelling pus. The patient is a postoperative patient with cesarean section with indications of a prolonged latent phase and macrosomia. The patient also had a history of uncontrolled diabetes mellitus since 8 years ago. Intraoperatively, a wound dehiscence is obtained in the lower uterine segment and adhesions between the anterior uterine body and the omentum and transverse colon. The patient finally underwent a supracervical hysterectomy and the surgical secretions were examined for bacterial culture and antibiotic resistance. During wound care, the patient's surgical wound was treated using honey dressings. Patient experienced improvement after treatment for 12 days post-operation. Conclusion: Honey has antibacterial and tissue regeneration ability which is high enough to heal surgical wounds. Further studies are needed for the application of honey to postoperative wounds more widely
Congenital Heart Diseases in Pregnancy Nuswil Bernolian; Radiyati Umi Partan; Siti Nurmaini; Cindy Kesty; Benedictus Wicaksono Widodo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.376

Abstract

This research aims to shed light into congenital heart diseases, the pathophysiology, and the ultrasonographic findings of congenital heart diseases. Congenital heart diseases are a major health concern, affecting 1.35 million children born every year. Ventricular septal defect, atrial septal defect, and atrioventricular septal defect are found in 57.9% cases of congenital heart diseases. The risk factors include consanguineous marriage, family history of congenital heart diseases, old maternal and paternal age, and exposure to teratogens, and genetic factors. Missteps in cardiac development are the main pathophysiology of congenital heart diseases. Ultrasonography screening in 18–22 weeks gestational age is utilized to screen. Follow-up screening can increase detection rate to 80%. This study has limitation of only discussing most common congenital heart diseases and did not delve into rarer types of congenital heart diseases and did not discuss impacts or burden of congenital heart diseases in adulthood and health comorbidities associated. This literature review is beneficial for general practitioners and obstetricians focusing in maternal fetal medicine.
Abnormal Uterine Bleeding in Adolescent Kms Yusuf Effendi; Rizani Amran; Iskandar Zulqarnain; Heriyadi Manan; Adnan Abadi; Fatimah Usman; Awan Nurtjahyo; Cindy Kesty; Siti Chodijah; Selly Rizany
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 1 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v6i1.431

Abstract

Abnormal uterine bleeding (AUB) is defined as the abnormal bleeding from the uterine corpus in term of duration, volume, frequency and/or regularity. This condition occurs in 37% of adolescents and may affect the quality of life and increased hospitalization. Etiology is divided into structural and non-structural causes, known as PALM-COEIN. The most common etiology in adolescents is anovulatory menstruation due to immature hypothalamus-hypophysis axis. Diagnostic evaluation should include investigation in the etiology of AUB, anemia signs, and hemodynamic status. Treatment of AUB consists of hormonal and non-hormonal therapy. Therapy in adolescent is given based on the severity of bleeding, grading of anemia, and hemodynamic stability. Follow-up is required after therapy. Understanding AUB in adolescents can help clinicians deliver appropriate and comprehensive treatment. This review was aimed to explain about definition, epidemiology, etiology, pathophysiology, diagnosis, and treatment of abnormal uterine bleeding in adolescent.
Multigravid Women with Uterine Rupture: A Case Report Firmansyah Basir; Adnan Abadi; Abarham Martadiansyah; Cindy Kesty; Febi Stevi Aryani; Murwani Emasrissa Latifah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.443

Abstract

Introduction: Uterine rupture is the discontinuation of the uterine scar that creates connection between uterine and peritoneal cavity. The most common etiology for uterine rupture is dehiscence of uterine scar tissue from previous cesarean section. In patient with uterine rupture and fetal expulsion to the peritoneal cavity, fetal survival becomes extremely poor. Therefore, it is important for clinician to understand the uterine rupture and be able to give prompt treatment in order to prevent maternal and fetal morbidity and mortality. Case Presentation: A 34-year-old woman, G3P2A0 38 weeks of gestation complained that she had abdominal pain, couldn’t feel her baby movement, watery discharge since 10 hours before admission. Bloody discharge and trauma were all denied. Patient underwent twice cesarean section before. Patient only had four times antenatal care with obstetrician at 24, 28, 32, and 36 weeks of gestation. She was scheduled for caesarean section at 38 weeks of gestation. Patient looked alert with low blood pressure and tachycardia. On physical examination, we found that she was pale, fundal height could not be determined, and there was no fetal heart rate detected. Speculum examination showed livide portio, closed external orifice of uterus, and inactive blood. There was positive slinger sign and Douglas cavity was bulging. Ultrasound examination showed intrauterine fetal demise, complete uterine rupture on lower segment, and positive sign of free fluid on abdominal cavity. Patient underwent operation and we found the died male neonate was in the peritoneal cavity and the placenta was still attached in the uterine cavity. We delivered the baby and placenta completely. There was uterine rupture on the previous CS scar, the edge of the uterine wound was regular with no necrosis and extended to the right side of uterus. Then, we performed hysterorrhaphy in order to stop the bleeding and repair the uterus, and we also performed tubal ligation. The died neonate had maceration grade I. Conclusion: Uterine rupture causes poor fetal and maternal prognosis. Early diagnosis and prompt treatment is really important in uterine rupture. Prevention of uterine rupture could be done by meticulous antenatal care, especially visiting to obstetrician in order to review maternal and fetal condition and determine mode of delivery.
Co-Authors A. Abadi A. Kurdi Syamsuri Abdullah Sahab Adnan Abadi Alia Desmalia Amir Fauzi Aria Indrabrata Awan Nurtjahyo Benedictus Wicaksono Widodo Benedictus Wicaksono Widodo Chairil Anwar Citra Dewi Eddy Roflin Eka H. Oktharina Fatimah Usman Febi Stevi Aryani Ferry Yusrizal Firmansyah Basir Hartati Hendra S Saputra Heriyadi Manan Irawan Sastradinata Iskandar Zulqarnain Kgs Irawan Satria Arjanggi Kms Yusuf Effendi M. Hatta Ansyori Martadiansyah, Abarham Mufida Muzakkie Murwani Emasrissa Latifah Nuswil Bernolian Nuswil Bernolian Nuswil Bernolian Nuswil Bernolian Nyimas Aliyah Faizatun Muthmainnah Peby Maulina Lestari, Peby Maulina Putri Mirani Putri Mirani Putri Mirani Radiyati Umi Partan Radiyati Umi Partan Ramzi Amin, Ramzi Rizal Sanif Rizani Amran Saputra, Hendra S Selly Rizany Siti Chodijah Siti Hardianti Harahap Siti Nurmaini Theodorus Theodorus Theodorus Theodorus Theodorus Vicela Patricia Virgyna Wim T. Pangemanan Win T. Pangemanan