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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Narra J
Cut M. Yeni
Department Obstetrics and Gynecology Faculty of Medicine Syiah Kuala University, Banda Aceh,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Herlyn-Werner-Wunderlich syndrome: Challenges in diagnosis and management Roziana, Roziana; Nora, Hilwah; Maharani, Cut R.; Yeni, Cut M.; Dewi, Tengku P.; Rusnaidi, Rusnaidi; Indirayani, Ima; Aditya, Rizka; Al-shather, Zain; Haryani, Siti D.
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.223

Abstract

Herlyn-Werner-Wunderlich syndrome (HWWS), also known as OHVIRA syndrome (obstructed hemivagina and ipsilateral renal anomaly) is a complex congenital malformation characterized by a triad including uterine didelphys, hemivaginal obstruction, and ipsilateral renal agenesis. In this case report, we present a case of HWWS along with the challenges in diagnosis and multi-step treatment processes. A 25-year-old woman presented to Dr. Zainoel Abidin Hospital in Banda Aceh, Indonesia with a chief complaint of lower back pain for the past six months (two months after the marriage). The patient also complained of late menstruation, followed by thick yellow vaginal discharge resembling malodorous pus occurring after menstruation. Additionally, a history of fever and pain during intercourse was reported. Vaginal examination revealed purulent fluid emerging from a pinpoint hole on the right vaginal wall. Vaginal palpation revealed a two-branched uterus, along with a palpable cystic mass on the right vaginal wall. Ultrasound examination indicated the presence of the right and left hemi-uteri, measuring 4.7x1.35 cm and 5.7x1.26 cm in size, respectively with both ovaries appearing normal. Fluid accumulation was observed in the right hemivagina, while the left kidney exhibited normal features, and the right kidney showed signs of hypoplasia. The patient was diagnosed with uterus didelphys, fluid accumulation in the hemivagina, and right kidney hypoplasia. Magnetic resonance imaging (MRI) confirmed uterus didelphys and revealed narrowing of the right hemivagina, suggestive of HWWS. Hysteroscopy was performed to resect the vaginal septum with laparoscopic guidance, along with drainage of hematocolpos, pyocolpos and placement of an intracervical mold. Despite HWWs having conservative gradual management, it was opted to perform vaginal septum resection, hematocolpos and pyocolpos drainage and placement of an intracervical mould in this case, in order to relieve symptoms and restore the reproductive and sexual functions.
Comparison of interleukin-6 and serum creatinine levels in preeclampsia and normal pregnancy patients: A cross-sectional study in Indonesia Dewi, Syerli R.; Yeni, Cut M.; Munizar, Munizar; Dewi, Tgk. Puspa; Utami, Niken A.; Rusnaidi, Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3016

Abstract

Preeclampsia (PE) is a complication of pregnancy with high morbidity and mortality, characterized by endothelial dysfunction, systemic inflammation, and impaired renal function. Interleukin-6 (IL-6) and serum creatinine have potential as biomarkers for early detection of PE; however, data from Indonesia are limited. The aim of this study was to compare IL-6 and serum creatinine levels between pregnant women with PE and normotensive controls, as well as their diagnostic performance in identifying PE. A cross-sectional study involving pregnant women with PE and normotensive controls was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. Serum IL-6 and creatinine levels were measured using the ECLIA method. Levels were compared using the Mann–Whitney test; diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis, and multivariable logistic regression was used to evaluate combined diagnostic contribution. A total of 68 pregnant women were included, comprising 34 patients with PE and 34 normotensive controls. Median IL-6 levels were significantly higher in the PE group (16.05 pg/mL) than in the control group (3.71 pg/mL). Receiver operating characteristic analysis demonstrated excellent diagnostic performance of IL-6, with an are under the curve (AUC) of 0.831 (95%CI: 0.734–0.929). At an optimal cutoff value of 5.52 pg/mL, IL-6 achieved a sensitivity of 73.53%, specificity of 76.47%, and diagnostic accuracy of 86.76%. Median serum creatinine levels were also significantly elevated in the PE group (0.56 mg/dL) compared with controls (0.44 mg/dL; p<0.001). The AUC for serum creatinine was 0.806 (95%CI: 0.700–0.912), indicating good diagnostic performance. At a cutoff value of 0.475 mg/dL, serum creatinine demonstrated a sensitivity of 70.59%, specificity of 73.53%, and accuracy of 72.06%. Multivariable logistic regression confirmed that IL-6 (B=0.123; p=0.005) and serum creatinine (B=9.306; p=0.023) were independently associated with PE, explaining 57.5% of PE variability (Nagelkerke R²=0.575). These findings indicate that serum IL-6 and creatinine are significantly associated with PE, and their combined assessment shows potential as a predictive biomarker with good diagnostic performance.
The Association between Cesarean Section and Placenta Accreta Yeni, Cut M.; Handayani, Hafni; Nasir, Aulia; Ima Indirayani; Razali, Rezania
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 3 July 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i3.1572

Abstract

Objective: To determine the relationship between the history of cesarean section and the incidence of placenta accreta in Dr. Zainoel Abidin Hospital Banda Aceh. Methods: The data collection method used was secondary data collection which was assessed through retrospective medical records. Sampling in this study using total sampling method. The results of the study were processed using the chi square statistical test on 781 research samples that were collected from period April 2019 - April 2020. Results: The results obtained were 22 respondents (2.8%) experienced placenta accreta where 18 respondents (2.30%) had placenta accreta with a history of CS and 4 respondents (0.51%) placenta accreta without a history of CS. The p value obtained was 0.000 (p value <0.05). In this study, the value of the Risk Estimate (RE) was 6.483 with a Confident Interval (CI) of 95% being (2.21-18.97). Conclusions: There is a very significant relationship between the history of cesarean section and the incidence of placenta accreta at RSUDZA Banda Aceh and mothers with a history of CS have a 6 times greater risk of experiencing placenta accreta. Keywords: cesarean section, placenta accrete. Abstrak Tujuan: Untuk mengetahui hubungan riwayat seksio sesarea dengan kejadian plasenta akreta di Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh. Metode: Jenis penelitian ini adalah penelitian analitik dengan desain potong lintang. Metode pengambilan data yang digunakan adalah pengambilan data sekunder yang dinilai melalui rekam medik secara retrospektif. Pengambilan sampel pada penelitian ini menggunakan metode total sampling. Hasil penelitian diolah menggunakan uji statistik chi square terhadap 781 sampel penelitian yang telah dikumpulkan dari data periode April 2019 – April 2020. Hasil: Hasil yang didapatkan sebanyak 22 responden (2,8%) mengalami plasenta akreta dimana 18 responden (2,30%) plasenta akreta dengan riwayat SC dan 4 responden (0,51%) plasenta akreta tanpa riwayat SC. Nilai p value yang didapatkan adalah 0.000 (p value <0,05). Pada penelitian ini didapatkan nilai Risk Estimate (RE) 6,483 dengan Confident Interval (CI) 95% berada (2,21- 18,97). Kesimpulan: Hasil ini menunjukkan terdapat hubungan yang sangat signifikan antara riwayat seksio sesarea dengan kejadian plasenta akreta di RSUDZA Banda Aceh dan ibu dengan riwayat SC memiliki risiko 6 kali lebih besar untuk mengalami plasenta akreta. Kata kunci: plasenta akreta, seksio sesarea.
Co-Authors Aditya, Rizka Al-shather, Zain Dewi, Syerli R. Dewi, Tengku P. Dewi, Tgk. Puspa Handayani, Hafni Haryani, Siti D. Hilwah Nora Ima Indirayani Indirayani, Ima Maharani, Cut R. Munizar Munizar, Munizar Nasir, Aulia Razali, Rezania Roziana Roziana, Roziana Rusnaidi Utami, Niken A.