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All Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Indonesian Journal of Obstetrics & Gynecology Science Bioscientia Medicina : Journal of Biomedicine and Translational Research Andalas obstetrics and gynecology journal Indonesian Journal of Global Health research Nusantara Science and Technology Proceedings Bioscientia Medicina : Journal of Biomedicine and Translational Research Malahayati International Journal of Nursing and Health Science
Fakhrizal, Edy
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Universitas Riau, Pekanbaru
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Dentistry Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Silent threat in early pregnancy: A case of spontaneous heterotopic pregnancy with tubal rupture Oktama, Nizan Dani; Fakhrizal, Edy
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 7 (2025): Volume 8 Number 7
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i7.968

Abstract

Background: Heterotopic pregnancy (HP) is a rare but potentially life-threatening condition characterized by the coexistence of intrauterine and extrauterine pregnancies. While its incidence in natural conception is estimated at 1 in 30,000 cases, the risk increases considerably with the use of assisted reproductive technologies. Because its symptoms often mimic those of ectopic pregnancy, HP remains a diagnostic challenge, particularly in patients without recognized risk factors. Purpose: To highlight the silent yet serious threat of spontaneous heterotopic pregnancy in early gestation, illustrated by a case of tubal rupture in a natural conception. Method: A descriptive case report of a 43-year-old multigravida woman who presented at 7 weeks of gestation with sudden lower abdominal pain and clinical features of intra-abdominal hemorrhage. Diagnostic evaluation included ultrasonography and laboratory investigations, followed by an emergency laparotomy. Results: Ultrasound imaging revealed two intrauterine gestational sacs along with free fluid in the pouch of Douglas. Laboratory tests indicated anemia (hemoglobin 8.1 g/dL) and marked leukocytosis. Emergency laparotomy confirmed a ruptured right fallopian tube with massive intraperitoneal bleeding. The patient underwent right salpingectomy, left tubectomy, and intrauterine curettage at her request. Her postoperative recovery was uneventful, and she was discharged in good condition after two days. Conclusion: This case underscores the diagnostic difficulty of heterotopic pregnancy in spontaneous conceptions. The presence of an intrauterine pregnancy may create false reassurance, masking a concurrent ectopic gestation. Clinicians should consider HP in the differential diagnosis of any reproductive-aged woman with abdominal pain, regardless of conception method, to prevent life-threatening maternal complications.
Case Report: Effective Pregnancy Management in Uterus Didelphys Lubis, Munawar Adhar; Fakhrizal, Edy
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.v7i3.738

Abstract

Introduction: Uterus didelphys is a rare congenital anomaly resulting from incomplete fusion of the Müllerian ducts, accounting for 10% of such anomalies. It often goes unnoticed until reproductive age, sometimes causing dyspareunia or dysmenorrhea. This anomaly is associated with increased obstetric risks, including higher rates of miscarriages, preterm births, breech presentations, and lower live birth rates. Diagnosis is typically achieved through imaging techniques such as ultrasound, hysterosalpingography, or magnetic resonance imaging. Case Report: This case study involves a 37-year-old primigravida at 34 weeks gestation presenting with premature contractions. Ultrasound revealed a singleton foetus in the breech position, and speculum examination identified two cervical os. The patient had a history of primary infertility and was diagnosed with uterus didelphysis during fertility assessments. Despite the complexities associated with this condition, she successfully conceived through artificial insemination. Her pregnancy was closely monitored, and due to the presence of labour signs and uterus didelphys condition, a planned Caesarean section was performed, resulting in the delivery of a healthy infant. Conclusion: This case underscores the importance of individualised care and continuous monitoring in managing pregnancies complicated by uterine anomalies to mitigate associated risks and improve maternal and foetal outcomes.Laporan Kasus: Managemen Efektif Kehamilan Pada Uterus DidelphysAbstrakPendahuluan: Uterus didelphys merupakan anomali kongenital langka yang disebabkan oleh fusi duktus Müllerian yang tidak sempurna, yang mencakup 10% dari anomali tersebut. Kondisi ini sering tidak disadari hingga usia reproduksi, terkadang menyebabkan dispareunia atau dismenore. Anomali ini dikaitkan dengan peningkatan risiko obstetrik, termasuk tingkat keguguran yang lebih tinggi, kelahiran prematur, presentasi bokong, dan tingkat kelahiran hidup yang lebih rendah. Diagnosis biasanya dicapai melalui teknik pencitraan seperti Ultrasonografi, histerosalpingografi, atau pencitraan resonansi magnetik.Laporan Kasus: Studi kasus ini melibatkan seorang primigravida berusia 37 tahun dengan usia kehamilan 34 minggu yang mengalami kontraksi prematur. Ultrasonografi menunjukkan janin tunggal dalam presentasi bokong dan pemeriksaan spekulum mengidentifikasi dua ostium serviks. Pasien memiliki riwayat infertilitas primer dan didiagnosis dengan uterus didelphysis selama penilaian kesuburan. Meskipun kondisi ini rumit, ia berhasil hamil melalui inseminasi buatan. Kondisi kehamilan pasien dipantau secara ketat, namun karena adanya tanda-tanda persalinan disertai kondisi uterus didelphys, maka diputuskan untuk dilakukan operasi caesar. Pasca operasi kondisi ibu dan bayi sehat.Kesimpulan: Kasus ini menggarisbawahi pentingnya perawatan individual dan pemantauan berkelanjutan dalam mengelola kehamilan yang rumit karena anomali uterus untuk mengurangi risiko dan menjaga keselamatan ibu dan bayi.Kata kunci: uterus didelphys, anomali uterus kongenital, risiko obstetrik, operasi caesar
A Simple Protocol for Managing Post-Operative Urinary Retention (POUR): An Experience and Evidence Fakhrizal, Edy; Maryuni, Sri Wahyu; Koerslo, Hamka; Novri, Dhini Aiyulie; Yuda, Dika Putra
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.4021

Abstract

Proposing a simple protocol in the management of urinary retention in postoperative patients that can provide promising results. Methods: We analyzed women who underwent pelvic organ prolapse surgery for 6 years from January 2018 to July 2023. The incidence of postoperative urinary retention was identified and we implemented a simple protocol and assessed its success rate.Result : There were 503 surgeries due to POP incidence in Arifin Achmad General Hospital, Riau Province - Indonesia for 6 years. One hundred sixteen cases (23 %) experienced POUR, with mean first residual urine was about 393 ml (110–1.200 ml). The protocol was applied, and 81 % cases revealed satisfying results. In successful group, the patients were discharged after 4±1 days. There were significant differences in the first residual urine between patients who were successfully treated with the simple protocol (350±227 ml) and patients requiring physiotherapy consultation (576±325 ml), with p = 0.005. Conclusion: Most cases of postoperative urinary retention can be managed using this protocol. So this protocol can be considered to be applied.
Co-Authors Budi I. Santoso Dafnil Akhir Putra Dhini Aiyulie Novri Djusad, Suskhan Fernandi Moegni Hutapea, Anastasya Junizaf Junizaf Koerslo, Hamka Lubis, Munawar Adhar M. Lingga Primananda Maryuni, Sri W. Maryuni, Sri Wahyu Oktama, Nizan Dani Primananda, M. Lingga Ruza Prima Rustam Simanjuntak, Arya Marganda Sri Wahyu Maryuni Sri Wahyu Maryuni Sumarlin, Sofi Surahman Hakim Tyas Priyatini Vani Ardiani Yuda, Dika Putra