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Management of Eclampsia Patients Post-ROSC (Return of Spontaneous Circulation) at RSUP M Djamil Padang Permatasari, Ressy; Emilzon Taslim; Yusrawati
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.801-808.2024

Abstract

Background: Eclampsia is a convulsive condition associated with hypertensive disorders in pregnancy which threatens maternal and fetal life which generally requires intensive care. Worsening conditions can complicate multi-organ disorders, coagulation disorders, and infections. Case: A 20 year old, nulliparous woman, preterm gestational age 35-36 weeks of gestation, referred to M Djamil General Hospital with complaints of 3 seizures at home and loss of consciousness. At the time of examination, we found apathetic consciousness; blood pressure of 210/118 mmHg. Urine protein is +3. The patient was terminated by emergency cesarean section. The patient was anesthetized under general anesthesia, and was treated in the postoperative intensive care unit with a ventilator attached. During hospitalization, the patient developed recurrent seizure, laryngeal edema and cardiac arrest, but returned to circulation spontaneously after resuscitation. Hemodynamic and metabolic monitoring is strict on the patient and managed appropriately with good result. Discussion: Eclampsia preceded by preeclampsia is known as a theoretical disease with a two-stage pathogenesis. The principles of eclampsia management are control of seizure, regulation of blood pressure, and termination of pregnancy. Collaboration between multidisciplinary teams determines the success of managing eclampsia cases and improving outcomes for the better.
Atypical eclampsia: A case report Sriyanti, Roza; Aldhi, Aldhi; Permatasari, Ressy
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.2.167-172.2022

Abstract

Background: Most women with eclampsia have a previous history of preeclampsia (proteinuria and hypertension). However, there has been a paradigm shift in this philosophy. There is evidence that atypical eclampsia can occur even in the absence of proteinuria and hypertension which presents a diagnostic dilemma and challenge for obstetricians and gynecologists. The purpose of this case report is to raise awareness about nonclassical and atypical signs of eclampsia so as to avoid complications Case: A multigravida woman with 39-40 weeks gestational age came to the hospital with signs of labor. On examination, blood pressure was 120/70 mmHg without a history of hypertension during antenatal examination, fetal heart rate was 146-156 beats/minute, cervical dilatation was 7-8 cm, with routine blood results within normal limits and planned for vaginal delivery . When monitoring the patient suddenly had a tonic clonic seizure, a complete blood count was performed, liver, kidney, electrolyte function was within normal limits, and proteinuria was found to be +2. The patient was treated with magnesium sulfate and the baby was delivered by vacuum extraction. This patient was managed appropriately with good outcome Discussion: Atypical eclampsia accounts for about 8% of all cases of eclampsia. Atypical forms of eclampsia have an erratic onset. This experience highlights some of the difficulties in managing atypical cases of eclampsia, namely the erratic onset and unpredictable course of the disease that can interfere with timely diagnosis and treatment and contribute to maternal and fetal morbidity and mortality. While controlling seizures by initiating magnesium sulfate therapy,
Eklamsia Atipikal: Laporan Kasus Aldhi, Aldhi; Permatasari, Ressy; Sriyanti, Roza
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (173.974 KB) | DOI: 10.36418/syntax-literate.v8i2.10584

Abstract

Kebanyakan wanita yang mengalami eklamsia memiliki riwayat preeklamsia sebelumnya (proteinuria dan hipertensi). Namun telah terjadi pergeseran paradigma dalam filosofi ini. Ada bukti bahwa eklamsia atipikal dapat terjadi bahkan tanpa protein uria dan hipertensi yang muncul sebagai dilemma diagnostik dan tantangan bagi dokter Obgin yang merawat. Tujuan dari laporan kasus ini adalah untuk meningkatkan kewaspadaan tentang tanda eklampsi anonklasikdan atipikal sehingga dapat menghindari komplikasi. Pada penelitian ini menggunakan metode literature review. Eklamsia atipikal menyumbang sekitar 8% dari semua kasus eklamsia. Bentuk eklamsia atipikal memiliki onset yang tidak menentu. Pengalaman ini menyoroti beberapa kesulitan dalam mengelola kasus eklamsia atipikal, yaitu onset yang tidak menentu dan perjalanan penyakit yang tidak dapat diprediksi sehingga dapat mengganggu diagnosis dan pengobatan yang tepat waktu dan berkontribusi pada morbiditas dan mortalitas ibu dan janin. Sementara mengendalikan kejang dengan memulai terapi magnesium sulfat, pencarian simultan untuk setiap penyebab organik/metabolic untuk kejang perlu dicari.
Activin A and Heart Function in Severe Preeclampsia: Insights From Global Longitudinal Strain Sriyanti, Roza; Permatasari, Ressy; Kino, Kino
Journal of Health and Nutrition Research Vol. 4 No. 3 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i3.605

Abstract

Preeclampsia, a serious pregnancy complication affecting 2–5% of women globally, is a leading cause of maternal and fetal mortality. Its prevalence in Indonesia ranges from 0.8–7% depending on parity. Associated with long-term cardiovascular risks, recent research suggests that elevated maternal activin A levels may play a causal role in linking severe preeclampsia to subsequent cardiovascular complications, particularly through mechanisms involving cellular damage, including to the heart. The aim of this study was to assess the correlation between Activin A circulating level and cardiac ventricular function as assessed by cardiac global longitudinal strain (GLS) in severe preeclampsia. A cross-sectional study was conducted at M. Djamil Hospital, Padang, West Sumatera, Indonesia with a total of 31 patients with severe preeclampsia. The Enzyme-Linked Immunosorbent Assay (ELISA) as used to determine the level of Activin A in the blood serum. Ventricular function was assessed from the global longitudinal strain using echocardiographic evaluation. The mean level of Activin A was 2.97 ± 1.91 ng/mL. From the echocardiographic evaluation, the mean cardiac GLS value was 18.01 ± 3.27%.  The correlation between activin A levels and cardiac ventricular function was analyzed using Pearson's correlation test, which showed a strong negative correlation (r = -0.718, p < 0.001). This indicates that higher activin A levels are significantly associated with lower GLS values, demonstrating worse ventricular function.