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All Journal AcTion: Aceh Nutrition Journal Narra J The Journal of Society Medicine (JSOCMED) Journal of International Surgery and Clinical Medicine
Indirayani, Ima
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Herlyn-Werner-Wunderlich syndrome: Challenges in diagnosis and management Roziana, Roziana; Nora, Hilwah; Maharani, Cut R.; Yeni, Cut M.; Dewi, Tengku P.; Rusnaidi, Rusnaidi; Indirayani, Ima; Aditya, Rizka; Al-shather, Zain; Haryani, Siti D.
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.223

Abstract

Herlyn-Werner-Wunderlich syndrome (HWWS), also known as OHVIRA syndrome (obstructed hemivagina and ipsilateral renal anomaly) is a complex congenital malformation characterized by a triad including uterine didelphys, hemivaginal obstruction, and ipsilateral renal agenesis. In this case report, we present a case of HWWS along with the challenges in diagnosis and multi-step treatment processes. A 25-year-old woman presented to Dr. Zainoel Abidin Hospital in Banda Aceh, Indonesia with a chief complaint of lower back pain for the past six months (two months after the marriage). The patient also complained of late menstruation, followed by thick yellow vaginal discharge resembling malodorous pus occurring after menstruation. Additionally, a history of fever and pain during intercourse was reported. Vaginal examination revealed purulent fluid emerging from a pinpoint hole on the right vaginal wall. Vaginal palpation revealed a two-branched uterus, along with a palpable cystic mass on the right vaginal wall. Ultrasound examination indicated the presence of the right and left hemi-uteri, measuring 4.7x1.35 cm and 5.7x1.26 cm in size, respectively with both ovaries appearing normal. Fluid accumulation was observed in the right hemivagina, while the left kidney exhibited normal features, and the right kidney showed signs of hypoplasia. The patient was diagnosed with uterus didelphys, fluid accumulation in the hemivagina, and right kidney hypoplasia. Magnetic resonance imaging (MRI) confirmed uterus didelphys and revealed narrowing of the right hemivagina, suggestive of HWWS. Hysteroscopy was performed to resect the vaginal septum with laparoscopic guidance, along with drainage of hematocolpos, pyocolpos and placement of an intracervical mold. Despite HWWs having conservative gradual management, it was opted to perform vaginal septum resection, hematocolpos and pyocolpos drainage and placement of an intracervical mould in this case, in order to relieve symptoms and restore the reproductive and sexual functions.
Esophageal Varices in Pregnancy Secondary to Hepatic Cirrhosis: A Case Report Royda D, Syerli; Indirayani, Ima; Roziana, Roziana
Journal of Society Medicine Vol. 4 No. 8 (2025): August
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.218

Abstract

Introduction: Pregnancy complicated by liver disease is a rare but clinically challenging condition. Portal hypertension is one such liver disease that may occur in pregnant women, primarily caused by cirrhosis. Esophageal varices, a manifestation of portal hypertension, carry significant maternal and fetal mortality risks. Case Description: We present the case of a 22-year-old woman referred from the Internal Medicine-Gastroenterology Department with a diagnosis of grade IV esophageal varices and grade IV gastric fundal varices. At the initial referral to the Obstetrics and Gynecology clinic, her pregnancy was estimated at 5–6 weeks gestation. Despite the high morbidity and rarity of this case, the patient maintained the pregnancy until 34–35 weeks of gestation. She had a two-year history of esophageal varices, with previous hospitalizations for melena and hematemesis. Fetomaternal ultrasound revealed a singleton fetus in cephalic presentation, consistent with 34–35 weeks of gestation, with suspected intrauterine growth restriction (IUGR). Abdominal ultrasound suggested hepatic cirrhosis, and endoscopic evaluation confirmed grade IV esophageal and gastric fundal varices. Termination of pregnancy was performed via abdominal delivery. Conclusion: Preventing pregnancy complications, accurate diagnosis, and meticulous management that balances maternal and fetal risks are crucial in such cases to improve outcomes.
The relationship of parity, education and maternal knowledge with complementary feeding at the Jeulingke Primary Health Center, Banda Aceh Zuhra, Sofi Alfia; Sovira, Nora; Indirayani, Ima; Ismy, Jufitriani; Salawati, Liza
AcTion: Aceh Nutrition Journal Vol 10, No 4 (2025): December
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v10i4.2369

Abstract

Inappropriate complementary feeding negatively affects children under two years. Parity, education, and maternal knowledge were associated with inappropriate complementary feeding. This study aimed to analyze the relationship between parity, education, and maternal knowledge of complementary feeding at the Jeulingke Primary Health Center in Banda Aceh, Indonesia. This analytical, observational study used a cross-sectional design. Data will be collected from September to October 2024 through interviews using questionnaires and 1 × 24-hour food recalls. This study included 76 mothers selected using consecutive sampling at seven integrated health service points in the Jeulingke Primary Health Center area. Statistical analysis was performed using Spearman’s test with a 90% confidence interval and an alpha level of 0.1. The study showed that 65.8% of the mothers provided appropriate complementary feeding practices. Parity was not significantly associated with complementary feeding (p = 0.194; r = -0.151). Maternal education (p = 0.049; r = 0.227) and knowledge (p = 0.028; r = 0.253) had weak relationships with complementary feeding practices. In conclusion, to implement appropriate complementary feeding, the education and knowledge of mothers as primary providers of complementary feeding at the Jeulingke Primary Health Center in Banda Aceh must be improved.
The Effects of Prednisone and Aspirin Administration on Pregnancy Outcomes in Mothers with RhD Isoimmunization and a History of Recurrent Pregnancy Loss: A Case Report Susanty, Devi; Marhadisony, Regina; Indirayani, Ima; Aditya, Rizka; M Fuad
Journal of International Surgery and Clinical Medicine Vol. 5 No. 2 (2025): Available online : 1 December 2025
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v5i2.83

Abstract

Introduction: Rhesus incompatibility arises when an Rh-negative mother becomes sensitized to the D antigen of an Rh-positive fetus, triggering the production of anti-D antibodies, a process known as isoimmunization. This condition is associated with severe obstetric complications, including Recurrent Pregnancy Loss (RPL) and Hemolytic Disease of the Fetus and Newborn (HDFN). Clinical management remains challenging, as no single therapeutic modality can comprehensively eliminate the adverse effects of isoimmunization. A targeted and integrated management approach is therefore imperative to optimize pregnancy outcomes. Emerging evidence suggests that corticosteroids combined with aspirin may confer beneficial effects in patients with rhesus incompatibility. Case Presentation: A 27-year-old woman, G5P0A4, with RhD-negative status, experienced recurrent pregnancy loss and was managed with prednisone (10 mg/day), aspirin, and Rh immunoglobulin (RhIg) at appropriate gestational intervals. The patient successfully carried the pregnancy to 36 weeks and six days, resulting in the birth of a healthy neonate. Discussion: Rhesus incompatibility is a clinically significant condition in which Rh-negative mothers develop isoimmunization following exposure to Rh-positive fetal blood, producing antibodies against fetal red blood cell antigens. This immunological response contributes to adverse pregnancy outcomes, most notably RPL and HDFN, both carrying substantial maternal and neonatal morbidity. Effective management continues to pose considerable clinical challenges due to limited therapeutic interventions capable of mitigating the immunological consequences of isoimmunization. Evidence from published case reports indicates that combined prednisone and aspirin administration may represent a promising adjunctive therapeutic strategy alongside RhIg prophylaxis. Conclusion: The integrated management incorporating RhIg prophylaxis as the cornerstone of therapy alongside adjunctive prednisone and aspirin was associated with a successful pregnancy outcome in this RhD-negative mother with a history of RPL. The relative contribution of each therapeutic component cannot be determined from a single case report. Further prospective studies with larger sample sizes are needed to evaluate the independent efficacy of corticosteroids and aspirin in this clinical context.
Co-Authors Aditya, Rizka Al-shather, Zain Cut M. Yeni Dewi, Tengku P. Haryani, Siti D. Hilwah Nora Ismy, Jufitriani Liza Salawati, Liza M Fuad Maharani, Cut R. Nora Sovira, Nora Regina Marhadisony Royda D, Syerli Roziana Roziana, Roziana Rusnaidi Susanty, Devi Zuhra, Sofi Alfia