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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana E-Jurnal Udayana Medica WMJ (Warmadewa Medical Journal) JNKI (Jurnal Ners dan Kebidanan Indonesia) (Indonesian Journal of Nursing and Midwifery) Indonesian Journal of Obstetrics & Gynecology Science ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Ilmiah Sangkareang Mataram Indonesian Journal of Perinatology Public Health and Preventive Medicine Archive Journal Research of Social Science, Economics, and Management Journal of Global Pharma Technology
I Nyoman Hariyasa Sanjaya
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Udayana University
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Economics, Econometrics & Finance Education Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health Social Sciences Other

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Metastatic breast cancer during pregnancy: a case report Widi, Made Yudha Ganesa Wikantyas; Putra, Wayan Artana; Kusuma, Anak Agung Ngurah Jaya; Wiradnyana, Anak Agung Putra; Sanjaya, I Nyoman Hariyasa; Budiana, I Nyoman Gede; Mahayasa, Putu Doster; Marta, Kadek Fajar
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.73

Abstract

Introduction: Breast cancer is the most prevalent malignancy among women and a notable comorbidity during pregnancy. Pregnancy-associated breast cancer (PABC) presents unique challenges due to physiological breast changes that complicate early diagnosis. This case report aimed to present a 31-year-old female with a diagnosis of bilateral breast tumors, pleural effusion, and multiple thoracic soft tissue tumors during her second pregnancy, highlighting the complexities and treatment considerations involved. Case presentation: A 31-year-old female patient, referred to Prof. Dr. I. G.N.G Ngoerah General Hospital, Denpasar, was in her second pregnancy at 20-21 weeks of gestation. She presented with bilateral breast lumps, worsening pain, and shortness of breath. Her obstetric history included a previous cesarean delivery and two abortions. Clinical examination revealed pleural effusion and multiple nodules suggestive of metastases. Biopsies confirmed tubular adenoma in the right breast and invasive breast carcinoma in the left breast. Ultrasound and chest x-ray findings indicated metastases to the liver and lungs. The patient was diagnosed with G4P1021 at 20 weeks of gestation with pregnancy-associated bilateral breast cancer and metastases. Conclusion: PABC diagnosis and treatment are fraught with challenges due to the need to balance maternal and fetal health. Delays in diagnosis, limited antenatal care, and the aggressive nature of PABC contribute to poor outcomes. This case underscores the necessity of early detection, prompt multidisciplinary intervention, and tailored treatment strategies to improve PABC patients' prognoses.
Water Birth as Neuroendocrine Medicine: A Critical and Integrative Review of Hormonal and Psychophysiological Impacts on Maternal and Neonatal Outcomes Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Darmawan, Ernawati; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.79

Abstract

Background: Water birth, defined as labor and/or delivery conducted in warm water, has gained increasing recognition as a patient-centered and physiologically supportive birth practice. Beyond analgesia, growing evidence indicates that water immersion during labor modulates maternal neuroendocrine regulation, psychological well-being, and neonatal physiological adaptation. Nevertheless, these hormonal and psychophysiological mechanisms remain insufficiently integrated into conventional perinatal research and clinical frameworks. This review aims to synthesize current evidence on the neuroendocrine, psychophysiological, obstetric, and neonatal effects of water birth and to evaluate its clinical effectiveness and safety in low-risk pregnancies. Methods: An integrative review was conducted using a PRISMA-guided approach to identify peer-reviewed studies published between 2000 and 2025. Literature searches retrieved 3,287 records from major biomedical databases, of which 44 studies (12 randomized controlled trials, 19 cohort studies, 6 case–control studies, and 7 systematic reviews) met inclusion criteria. Data were synthesized thematically, focusing on maternal hormonal responses (oxytocin, β-endorphins, cortisol, prolactin), labor outcomes, breastfeeding, postpartum mood, neonatal adaptation, and safety considerations. Results: Across study designs, water immersion during labor was associated with increased endogenous oxytocin and β-endorphin activity and reduced stress-related hormonal responses. Clinically, first-stage labor was shortened by approximately 42–78 minutes, and epidural analgesia use was reduced by 30–50% compared with conventional land birth. Episiotomy rates were generally below 5%, and maternal satisfaction scores were consistently higher. Early breastfeeding initiation occurred in 86–92% of water birth cases, with exclusive breastfeeding rates at six weeks ranging from 66–77%. Neonatal outcomes, including 5-minute Apgar scores and NICU admission rates, were comparable to or slightly better than conventional birth in low-risk populations, with no consistent increase in infection or respiratory complications when standardized protocols were applied. Conclusion: Water birth supports a hormonally optimized and psychologically protective labor environment, with measurable benefits for labor efficiency, maternal experience, breastfeeding success, and neonatal physiological transition. When implemented under evidence-based guidelines, it represents a credible non-pharmacological option within contemporary, physiology-informed maternity care.
Feasibility Study on the Implementation of Clinic SIM and ERM integrated Pcare as a BPJS Kesehatan Application at Udayana University Clinic luh sudiarmini; Fajar Manuaba Ida Bagus; Hariyasa Sanjaya I Nyoman
WMJ (Warmadewa Medical Journal) Vol 5 No 2 (2020): November 2020
Publisher : Warmadewa University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22225/wmj.5.2.1636.60-69

Abstract

The development of an information system and communication technology has an impact on the health service sector in the form of electronic-health or e-health. One of the e-health applications is a Clinic SIM and electronic medical records. Not only provides information for the academic communities, but Udayana University Clinic also serves BPJS Kesehatan patients since 2014. After occupying a new building, there have been various obstacles related to the implementation of the management information system. Which it is still being done manually and limited space to store medical record files. One of the efforts to overcome this problem is by implementing a Clinic SIM and ERM. Before the implementation of these activities, a feasibility study was proposed on the application of CSIM and ERM integrated BPJS Healthcare. The purpose of this study was to determine the feasibility of implementing Clinic SIM and ERM which are integrated with Pcare-BPJS at Udayana University Clinic. This study used a qualitative research design. Data collection was started between December 2019 and January 2020 using the in-depth interview method on 9 informants. This study informs that the application of Clinic SIM and ERM integrated BPJS Kesehatan meets the feasibility aspect based on acceptance, demand, integration, and practicality. Conclusion: the obstacles in this study are related to the implementation aspect due to lack of human resources, infrastructure, implementation methods, budget, and minimal application of Clinic SIM and ERM. Keywords: feasibility study, Clinic SIM, ERM, Pcare BPJS Kesehatan
Co-Authors Adhi Pribadi Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Aloysius Suryawan Anak Agung Ngurah Anantasika Anak Agung Ngurah Jaya Kusuma Anak Agung Wahyu Putri Agustini Anak Agung Wahyu Putri Agustini Anak Agung Wahyu Putri Agustini Anak Agung Wahyu Putri Agustini Andonotopo, Wiku Bachnas, Muhammad Adrianes Bambang Rahardjo Cokorda Istri Mirayani Pemayun Cokorda Istri Mirayani Pemayun Cokorda Istri Mirayani Pemayun Cokorda Istri Mirayani Pemayun Cut Meurah Yeni Daniel H. Susanto Darmawan, Ernawati Denni Prasetyo Dyah Pradnyaparmita Duarsa Eka Setiawan, Putu Pandu Endang Sri Widiyanti Evert Solomon Pangkahila Firsta Sesarina Mintariani Firsta Sesarina Mintariani Firsta Sesarina Mintariani Hartanto Hartanto I G A A Novya Dewi I Gede Ngurah Harry Wijaya Surya I Gusti Kamasan Arijana I Ketut Surya Negara I Made Gede Widnyana I Made Mahardika I Nyoman Gede Budiana I Nyoman Wirata I Wayan Murdita Ida Bagus Gde Fajar Manuaba Ida Bagus Putra Adnyana Ida Bagus Putra Adnyana, Ida Bagus IGP Surya, IGP Julian Dewantiningrum Kadek Budi Juliantari Kamajaya, I Gusti Ngurah Agung Trisnu Ketut Widyani Astuti Kurjak, Asim luh sudiarmini Made Adi Kusuma Made Diah Vendita Sakuntari Made Diah Vendita Sakuntari Made Diah Vendita Sakuntari Made Wiryana Marta, Kadek Fajar Murdita, I Wayan Ni Kadek Mulyantari Ni Komang Anik Pirgantari Ni Komang Anik Pirgantari Ni Komang Anik Pirgantari Ni Komang Erny Astiti Ni Luh Made Diah Mas Cahyani Putri Ni Luh Made Diah Mas Cahyani Putri Ni Luh Made Diah Mas Cahyani Putri Ni Luh Md Dwi Laxmi Satriani Ni Luh Md Dwi Laxmi Satriani Ni Luh Md Dwi Laxmi Satriani Ni Luh Putu Yulia Padmawati Ni Nyoman Dewi Purwanti Ni Nyoman Sri Budayanti Ni Putu Nining Gianni Ni Putu Nining Gianni Ni Putu Nining Gianni Ni Wayan Dewi Purwanti Ni Wayan Dewi Purwanti Ni Wayan Dewi Purwanti Ni Wayan Dewi Purwanti Nuswil Bernolian Pramono, Mochammad Besari Adi Putra, Wayan Artana Putu Doster Mahayasa Putu Pandu Eka Setiawan Rey Jauwerissa Ryan S. Mulyana Ryan Saktika Mulyana Sri Sulistyowati Stanojevic, Milan Sutandi, Chatrine Syauta, Fetrisya Tasa Riszkia Theresia Monica Rahardjo Tjokorda Gde Agung Suwardewa Utarini, Gusti Ayu Eka Widi, Made Yudha Ganesa Wikantyas Wijaya Surya, I Gede Ngurah Harry Wiradnyana, Anak Agung Gede Putra Wiradnyana, Anak Agung Putra