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All Journal The Indonesian Journal of General Medicine International Journal of Community Services
Lina Haryani
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Dentistry Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Journal : The Indonesian Journal of General Medicine

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How Does Fetal Surgery Impact Long-Term Neurological And Develop- Mental Outcomes In Children With Twin-Twin Transfusion Syndrome? Yunike Putri Nurfauzia; I Made Adi Saputra Wijaya; Mutia Juliana; Lina Haryani; Yahya Nurlianto
The Indonesian Journal of General Medicine Vol. 12 No. 2 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/zv7crn36

Abstract

Introduction: Twin-Twin Transfusion Syndrome (TTTS) is a serious complication in monochorionic twin pregnancies caused by unbalanced blood flow through placental vascular anastomoses. Fetoscopic laser surgery has become the primary intervention to improve survival and reduce neurological morbidity. Methods: This review synthesizes data from randomized controlled trials, prospective and retrospective cohort studies conducted over the last decade. Studies included patients undergoing fetoscopic laser surgery with follow-up periods ranging from weeks to years, assessing survival, neurological, and developmental outcomes. Results: Survival rates after fetal laser surgery range from mid-70% to mid-80%, with one trial reporting 67-68% survival without neurodevelopmental impairment at 2 years. Cerebral palsy incidence is low (1-2%), and cognitive or motor impairments occur in 2-8% of survivors. Comparisons between surgical techniques (Solomon vs. standard laser, sequential vs. selective coagulation) show similar survival and neurodevelopmental outcomes. Immediate surgery versus expectant management in early-stage TTTS showed no significant difference in 6-month survival without severe neurologic morbidity (78% vs. 77%). Laser surgery reduces severe cerebral injury compared to no treatment (5% vs. 18%). Discussion: While fetal surgery improves survival and neurological outcomes, challenges such as preterm birth and growth discordance remain. Adjunctive therapies and long-term neurodevelopmental monitoring are essential to optimize care. Conclusion: Fetoscopic laser surgery is effective in managing TTTS, offering improved survival and reduced neurological morbidity. Continued research is needed to refine techniques and adjunctive treatments
What Is The Association Between Long-Term Intrauterine Device (IUD) Use And The Risk Of Developing Uterine Cancer In Women Aged 35-65? Yunike Putri Nurfauzia; I Made Adi Saputra Wijaya; Mutia Juliana; Lina Haryani; Yahya Nurlianto
The Indonesian Journal of General Medicine Vol. 12 No. 2 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/faa30y69

Abstract

Introduction: Uterine cancer is a significant health concern, especially among women aged 35-65 years. Intrauterine devices (IUDs), including hormonal levonorgestrel-releasing intrauterine systems (LNG-IUS) and copper IUDs (Cu-IUD), are widely used for contraception and have been investigated for their potential role in reducing uterine cancer risk. Methods: A comprehensive review of studies published in the last decade was conducted, focusing on the association between long-term IUD use and uterine cancer risk in women aged 35-65. Studies included randomized controlled trials, prospective and retrospective cohorts, with follow-up durations ranging from six months to over ten years. Results: Evidence indicates that long-term use of both LNG-IUS and Cu-IUD is associated with a reduced risk of uterine cancer and its precursor lesions. LNG-IUS demonstrated superior efficacy compared to oral progestogens in treating atypical endometrial hyperplasia (AEH) and reducing cancer recurrence. Cu-IUD use was also linked to lower risks of endometrial and cervical cancers. Adverse events were generally mild, with weight gain being the most common side effect, and device-related complications such as expulsion and perforation were rare. Discussion: The protective effects of LNG-IUS are attributed to localized progestin release causing endometrial atrophy, while Cu-IUDs may exert effects through local inflammatory mechanisms. Despite promising findings, age-stratified data remain limited, and further long-term studies are needed. Conclusion: Long-term use of LNG-IUS and Cu-IUD offers effective contraception and a favorable reduction in uterine cancer risk with a good safety profile, supporting their role in preventive strategies for women aged 35-65.
Co-Authors Bunga Tiara Carolin I Made Adi Saputra Wijaya Mega Dewi Lestari Mutia Juliana Nanik Cahyati NOVIYANTI Ranti Widayanti Sophia Yahya Nurlianto Yeni Rosyeni Yunike Putri Nurfauzia