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All Journal Althea Medical Journal Indonesian Journal of Obstetrics & Gynecology Science Contagion: Scientific Periodical Journal of Public Health and Coastal Health
Amarullah, Mulyanusa
Dept/KSM Obstetri Dan Ginekologi FK Unpad/RS Hasan Sadikin Bandung
Health Professions Medicine & Pharmacology Public Health

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Overview of Menstrual Patterns in Female Patients Diagnosed with Tuberculosis with a History of Infertility at DOTS Polyclinic Hasan Sadikin Hospital and Community Health Centers in Bandung City Madjid, Tita Husnitawati; Utomo, Suhendro Rahmat; Susilo, Artha Falentin Putri; Ritonga, Mulyanusa Amarullah; Arya, Insi Farisa Desy
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 1 Maret 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i1.725

Abstract

Introduction: Female genital tuberculosis (FGTB) is one of the leading causes of infertility in countries with high cases of tuberculosis. However, there is a lack of data showing the menstrual patterns of FGTB patients in Indonesia. This study was conducted to describe the menstrual patterns of female patients diagnosed with TB and who have a history of infertility at the Directly Observed Treatment Short Course Polyclinic of Hasan Sadikin Hospital and community health centers in Bandung City.Method: This is a descriptive observational study using primary data. The subjects were outpatient TB patients with a history of infertility in the Directly Observed Treatment Short Course polyclinic of Hasan Sadikin Hospital and community health centers in Bandung City from 2018 to 2022. Data collection was conducted through questionnaire-based interviews.Results: Out of 950 TB patients of childbearing age recorded in medical records, 41 patients matched the specified criteria. The menstrual disorders experienced by patients included polymenorrhagia, oligomenorrhea, amenorrhea, prolonged menstrual cycles, irregular cycles, hypomenorrhea, heavy menstrual bleeding, and intermenstrual bleeding.Conclusion: The most common menstrual disorders in TB patients with a history of infertility were irregular cycles (36.6%), hypomenorrhea (31.7%), and oligomenorrhea (19.5%).Gambaran Pola Menstruasi pada Pasien Perempuan dengan Diagnosis Tuberkulosis dan Riwayat Infertilitas di Poli DOTS RSHS dan Puskesmas Kota BandungAbstrakPendahuluan: Female genital tuberculosis merupakan salah satu penyebab utama infertilitas pada negara dengan kasus tuberkulosis yang tinggi. Sebagai salah satu dari gejalanya, belum ada data yang menunjukkan pola menstruasi dari pasien female genital tuberculosis di Indonesia. Penelitian ini bertujuan untuk mengetahui gambaran pola menstruasi pada pasien wanita dengan diagnosis tubekulosis dan memiliki riwayat infertilitas di Poliklinik Directly Observed Treatment Short Course Rumah Sakit Hasan Sadikin dan Puskesmas Kota Bandung.Metode: Penelitian deskriptif dengan menggunakan data primer. Subjek penelitian adalah pasien tuberkulosis wanita dengan riwayat infertilitas yang dirawat jalan di poliklinik Directly Observed Treatment Short Course Rumah Sakit Hasan Sadikin dan 4 Puskesmas di Kota Bandung dari tahun 2018 - 2022. Subjek diperoleh melalui wawancara berbasis kuesioner.Hasil: Dari 950 pasien tuberkulosis wanita usia subur yang terdata di rekam medis, didapatkan 41 data pasien yang sesuai dengan kriteria yang ditentukan. Gangguan menstruasi yang dialami pasien dapat berupa polimenore, oligomenore, amenore, siklus menstruasi yang memanjang, siklus yang irreguler, hipomenore, heavy menstrual bleeding, dan perdarahan intermenstrual.Kesimpulan: Gangguan menstruasi yang paling sering terjadi pada pasien TB dengan riwayat infertilitas adalah siklus yang irreguler (36.6%), hipomenore (31.7%), dan oligomenore (19.5%).Kata Kunci: Infertilitas, Kota Bandung, Pasien TB wanita, Pola Menstruasi.
Rare Case: Tetra-Amelia Syndrome Alifa, Dhara; Aziz, Muhammad Alamsyah; Ritonga, Mulyanusa Amarullah; Pribadi, Adhi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.694

Abstract

Introduction: Congenital abnormalities are anomalies that become a fear for a family, when a mother experiences pregnancy. Some abnormalities are temporary and can be corrected, while some are permanent and cannot be corrected, so screening at antenatal time is very important.Objective: To explain and analyze a rare case of Tetra-amelia syndrome and how to diagnose it.Case: A 32-year-old woman with a 32-week-old G3P0A2 pregnancy visited the maternal-fetal clinic. According to ultrasound data, a single fetus with a gestational age of 31-32 weeks and a fetal weight of 1837 grams is in breech presentation. Only the proximal components of the arm and leg are formed, leaving the radius bones, ulna, tibia, and fibula unformed. The femur has a length that corresponds to 16 weeks, while the humerus has a length that corresponds to 20 weeks. These findings also revealed a discrepancy in pregnancy age. A tetra-amelia abnormality was discovered at the end of the ultrasound scan. Caesarean section performed on August 6, 2021, at the age of 39 weeks, a baby girl has been born baby girl a baby girl weighing 2300 grams, a body length of 31 cm, with mild asphyxia.Conclusion: During antenatal care, ultrasound on the unidentified distal part of the entire extremity can detect Tetra-amelia syndrome.Kasus Langka: Sindrom Tetra-ameliaAbstrak Pendahuluan: Kelainan bawaan adalah anomali yang menjadi trauma bagi keluarga, ketika seorang ibu mengalami kehamilan. Beberapa kelainan bersifat sementara dan dapat diobati, sementara beberapa bersifat permanen dan tidak dapat diperbaiki sehingga skrining pada waktu antenatal sangat penting.Tujuan: Artikel ini untuk menjelaskan dan menganalisis kasus langka sindrom Tetra-amelia dan cara mendiagnosisnya.Kasus: Seorang wanita berusia 32 tahun dengan kehamilan G3P0A2 berusia 32 minggu mengunjungi klinik fetomaternal. Hasil pemeriksaan ultrasonografi menunjukan janin tunggal dengan usia kehamilan 31 - 32 minggu dan berat janin 1837 gram dalam letak sungsang. Hanya komponen proksimal lengan dan kaki yang terbentuk, sedangkan tulang jari-jari, ulna, tibia, dan fibula tidak terbentuk. Femur memiliki panjang yang sesuai dengan 16 minggu, sedangkan humerus memiliki panjang yang sesuai dengan 20 minggu. Kelainan tetra-amelia dapat dideteksi dengan pemindaian ultrasonografi. Pada tanggal 6 Agustus 2021 presentasi sungsang, dilakukan operasi caesar, lahir bayi perempuan pada usia 39 minggu, berat 2300 gram, panjang 31 cm, disertai asfiksia ringan.Kesimpulan: Pemeriksaan ultrasonografi pada perawatan antenatal dapat mendeteksi sindrom Tetra-amelia, bila bagian distal ekstremitas tidak teridentifikasi.Kata kunci:Sindrom Tetra-amelia, Ultrasonografi, Kelainan Kongenital
Amniotic Membrane Graft and Hysteroscopic Adhesiolysis as Treatment for Asherman Syndrome Case Rusly, Dewi Karlina; Ritonga, Mulyanusa Amarullah; Rachmawati, Anita; Rinaldi, Andi; Djuwantono, Tono
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.603

Abstract

Introduction: Secondary amenorrhea which caused by intrauterine adhesions is called Asherman’s syndrome. This occurs when the uterine cavity becomes partially or completely blocked, which can damage the basal layer of the endometrium and cause the formation of adhesive cicatricial tissue. The prevalence or incidence of Asherman Syndrome ranges from 2.84-5.5% in women. Case Report: A woman 33 years old had a history of amenorrhea for 2 years and three times curettage due to miscariage. Ultrasound findings showed 1.35 cm long cicatrix in the uterine cavity, and probe had only entered 3 cm. The patient underwent hysteroscopy adhesiolysis and grafting of intrauterine amniotic membrane. The intrauterine catheter was monitored for 1 month. Postoperatively the patient also received estradiol valerate therapy 3 x 2 mg for three months. Management of Asherman syndrome with hysteroscopy adhesiolysis with direct observation accompanied by grafting of amniotic membrane using intrauterine catheter tube is one of the techniques to overcome recurrent intrauterine adhesion. Conclusion:  Secondary amenorrhea in Asherman syndrome is better treated operatively with direct observation of the hysteroscopy and adhesiolysis. The using of amniotic membrane graft and supportive therapy are very helpful for the success of endometrial growth and preventing recurrent adhesions, increase the menstrual volume and chances of pregnancy.Pencangkokan Selaput Ketuban dan Histeroskopi Adhesiolisis sebagai Penatalaksanaan untuk Kasus Sindrom AshermanAbstrakPendahuluan: Amenorea sekunder yang disebabkan oleh perlengketan intrauterin disebut sindrom Asherman dengan prevalensi berkisar antara 2,84 - 5,5%.Laporan Kasus: Seorang wanita berusia 33 tahun mempunyai riwayat amenore 2 tahun dan kuretase sebanyak 3 kali akibat abortus. Temuan USG menunjukkan cicatrix sepanjang 1,35 cm di rongga rahim, sondage hanya masuk 3cm. Pasien menjalani histeroskopi adhesiolisis dan pemasangan cangkok selaput ketuban intrauterin. Kateter intrauterin dipantau selama 1 bulan. Pascaoperasi pasien juga mendapat terapi estradiol valerat 3 x 2mg selama tiga bulan. Penatalaksanaan sindrom Asherman dengan histeroskopi adhesiolisis dengan observasi langsung disertai pemasangan cangkok selaput ketuban menggunakan selang kateter intrauterin merupakan salah satu teknik yang efekstif untuk mengatasi adhesiolisis intrauterin berulang.Kesimpulan: Amenore sekunder pada sindrom Asherman lebih baik ditangani secara operatif dengan observasi langsung berupa histeroskopi dan adhesiolisis. Pemasangan cangkok selaput ketuban dan terapi suportif sangat membantu keberhasilan pertumbuhan endometrium dan mencegah perlengketan berulang, meningkatkan volume darah saat menstruasi dan peluang terjadinya pembuahan.Kata kunci: Adhesi intrauterin, Histeroskopi, Pencangkokan selaput ketuban, Rekonstruksi endometrium, Sindrom Asherman.
Recurrent Pregnancy Loss with Hypertensive Complication, Obesity and Suspected APS: A Case Based Approach to Antenatal Care Challenges Husna Bulkis Dasopang; Mulyanusa Amarullah Ritonga; Amillia Siddiq
Contagion: Scientific Periodical Journal of Public Health and Coastal Health Vol 7, No 2 (2025): CONTAGION
Publisher : Universitas Islam Negeri Sumatera Utara, Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30829/contagion.v7i2.24401

Abstract

Recurrent miscarriage, defined as the loss of two or more consecutive pregnancies, is a multifactorial condition associated with genetic, hormonal, anatomical, autoimmune, and maternal age-related factors. In Indonesia, data remain limited; however, at Dr. Kariadi Semarang Hospital, 18.7% of recurrent miscarriage cases between 2015 and 2017 were reported as idiopathic. We report a case of a 23-year-old woman, G7P0A6, at 33-34 weeks' gestation, presenting with elevated blood pressure and a history of chronic hypertension since 2016 with poor medication adherence. Ultrasonography revealed symmetrical fetal growth restriction (FGR) with an estimated fetal weight of 1500-1800 grams, and an obstetric history notable for six first-trimester miscarriages, suggestive of antiphospholipid syndrome (APS). Physical examination showed a blood pressure of 160/110 mmHg and obesity (BMI 32.9 kg/m²) without other features of severe preeclampsia; fetal monitoring and Doppler studies were normal. The patient was diagnosed with chronic hypertension exacerbated by preeclampsia, symmetrical fetal, suspected APS, recurrent miscarriage, and obesity. Management included conservative hospitalization, administration of magnesium sulfate, corticosteroids, and antihypertensive therapy, with cesarean delivery planned after 34 weeks once fetal lung maturation was achieved. This case highlights the challenges of managing high-risk pregnancies complicated by APS, FGR, and hypertensive disorders, emphasizing the importance of adequate antenatal care, multidisciplinary coordination, and appropriate timing of delivery to optimize maternal and fetal outcomes.Keywords: Antenatal Care, Poor Obstetric, Recurrent Pregnancy Loss, Fetal Growth Restriction; Preganancy Termination.
Co-Authors Adhi Pribadi Alifa, Dhara Amillia Siddiq Andi Rinaldi Aziz, Muhammad Alamsyah Azzahra, Mutiara Dewi Karlina Rusly Dodi Suardi Hanom Husni Syam Hartanto Bayuaji Husna Bulkis Dasopang Imelda Rosmaida Siagian Insi Farisa Desy Arya Istriati Istriati Istriati Istriati, Istriati Kemala Isnainiasih Mantilidewi M. Rizkar Arev Sukarsa Madjid, Tita Husnitawati Maharani, Chintia Dewi MARINGAN DIAPARI LUMBAN TOBING Maryam Maryam Maryam Maryam Mutiara Azzahra Rachmawati, Anita Rahmani, Shofiatunisa Firdhausy Rosita Indriani Ruswana Anwar Sasongko, Elsa Pudji Setiawati Sharon Gondodiputro Sharon Gondodiputro Susilo, Artha Falentin Putri Syarief, Sri Dewi Rahmawati Tono Djuwantono Utomo, Suhendro Rahmat Yuni Susanti Pratiwi, Yuni Susanti