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Tiarma Uli
Divisi Fetomaternal, Departemen Obstetri Ginekologi, RS Kepresidenan Gatot Soebroto, Jakarta, Indonesia
Health Professions Medicine & Pharmacology Public Health

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Gastroschisis - Deteksi Intrauterin, Penanganan Tim yang Optimal Gregorius Tanamas; Tiarma Uli
Cermin Dunia Kedokteran Vol 44, No 4 (2017): Optalmologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v44i4.851

Abstract

Gastroschisis adalah kelainan kongenital seluruh atau sebagian lapisan dinding abdomen, sehingga organ intestinal dan organ abdomen mengalami herniasi ke dalam kantung amnion. Angka kejadian gastroschisis berkisar 4-5 : 10.000 kelahiran. Kasus ini dapat dikoreksi dengan prognosis baik. Pengenalan kasus gastroschisis intrauterin sedini mungkin, dapat meningkatkan kualitas antenatal care dan memberikan waktu yang cukup untuk persiapan tim, sehingga akan memberikan kualitas bayi yang optimal mulai intrauterin sampai postpartum. Di RS kami ditatalaksana satu kasus gastroskisis pada kehamilan 34 minggu dengan kondisi pertumbuhan janin terhambat. Setelah terapi nutrisi pada ibu dan persiapan tim (obstetrik, perinatologi dan bedah anak), dilakukan terminasi kehamilan dilanjutkan koreksi operatif gastroschisis. Perawatan perinatologi dan pemantauan tumbuh kembang janin sampai usia 3 bulan memberikan hasil yang baik.Gastroschisis is a congenital abdominal wall defect, occurs as a full-thickness periumbilical cleft or separated by a strip of skin, resulting in herniation of the abdominal contents into the amniotic sac. The incidence of gastroschisis is 4-5 : 10000 birth. The case can be corrected with a good prognosis. Ultrasound diagnosis of intrauterine gastroschisis as early as possible can improve antenatal care quality and provide sufficient time for teamwork preparation, and will provide optimum intrauterine until postpartum care. A case of fetus at 34 weeks with gastroschisis was admitted to our hospital. Nutrition therapy was given to improve to preoperative condition as we prepared the team (obstetrician, pediatrician and pediatric surgery). Termination of pregnancy was directly continued with correction of abdominal defect. Perinatology care results in good condition until 3 months of age. 
Sirenomelia “The Mermaid Syndrome “ - Kasus Serial Mediana Sutopo; Tiarma Uli
Cermin Dunia Kedokteran Vol 44, No 5 (2017): Gastrointestinal
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v44i5.799

Abstract

Sirenomelia adalah kelainan kongenital yang jarang, angka kejadiannya 0,8 – 1 kasus / 100.000 kelahiran. Sirenomelia bersifat lethal dan biasanya bayi meninggal setelah lahir akibat kelainan kongenital multipel. Etiologi dan patogenesis sirenomelia masih belum diketahui, diduga akibat defek formasi embrional saat pembentukan regio kaudal. Dalam satu tahun kami menemukan 2 kasus sirenomielia. Pada kasus pertama didapatkan gambaran ultrasonografi hipoplasia thorak dan anhidramnion. Pada kasus kedua didapatkan gambaran horseshoe kidney, tidak tampak vesika urinaria, anhidramnion dan penumpukan long bones daerah caudal (femur, tibia dan fibula). Kedua kasus dirujuk dalam keadaan lanjut (trimester dua dan tiga), Jila diketahui dini (pada trimester satu), dapat dilakukan terminasi kehamilan dini pervaginam sehingga dapat mengurangi morbiditas ibu.Sirenomelia is a rare congenital disorder, the incidence is 0.8-1 case/100,000 births. Sirenomelia is lethal, the baby usually die after birth due to multiple congenital anomaly. The etiology and pathogenesis of sirenomelia is suspected due to a defect in the embryonic formation of the caudal region. We found two cases of sirenomielia in a year. The first case was found with thoracic hypoplasia and anhidramnion. The second case was found with horseshoe kidney, without clear bladder appearance, anhidramnion and piled long bones the caudal region (femur, tibia and fibula ). Both cases were referred to our hospital in second and third trimesters of pregnancy. Identification in early stage can reduce maternal morbidity by earlier vaginal termination of pregnancy.
Co-Authors Gregorius Tanamas Mediana Sutopo