Izaak, Revynca Petronella
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Ruptur Uteri Komplit Disertai Fetal Death pada Pasien Multipara: Sebuah Laporan Kasus Izaak, Revynca Petronella; Linasari, Lydia
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.589

Abstract

Pendahuluan : Ruptur uteri adalah suatu kondisi yang mengancam nyawa yaitu terjadi robekan pada rahim baik sebagian atau seluruhnya selama kehamilan atau persalinan.Presentasi kasus: Wanita 43 tahun G3P2002 usia kehamilan 37 - 38 minggu datang ke RSUD Dr. TC. Hillers mengeluh nyeri perut dan perut terasa tegang sejak 4 jam yang lalu. Pemeriksaan fisik didapatkan hipotensi, takikardi, takipnea, konjungtiva anemia, ekspansi dada bilateral, distensi perut, dan nyeri tekan suprapubik. Pemeriksaan dalam belum ada pembukaan dan perdarahan aktif. DJJ tidak terdeteksi dan satu janin dapat dipalpasi. Dilakukan operasi sesar darurat, ditemukan kematian janin di rongga perut dan robekan 10 cm pada segmen bawah rahim juga anterior dinding vagina. Diskusi: Kurangnya ANC yang adekuat, multipara, operasi sesar sebelumnya merupakan faktor risiko ruptur uteri. Ruptur uteri terjadi secara tiba-tiba dengan gejala akut yang bervariasi. Tatalaksana berupa pembedahan yaitu sterilisasi lengkap dengan histerektomi dan pilihan yang konservatif termasuk uterine sparing dengan atau tanpa ligasi tuba.Kesimpulan: Ruptur uteri merupakan suatu kegawatdaruratan obstetri yang berpotensi menimbulkan kematian ibu dan bayi. Diagnosis yang cepat, transportasi dini, transfusi produk darah yang memadai, dan tim bedah berpengalaman sangat penting untuk penatalaksanaan ruptur uteri.Complete Uterine Rupture with Fetal Death in a Multiparous Patient: A Case ReportAbstractIntroduction: Uterine rupture is a life-threatening condition when there is a tearing of the uterus either partially or completely during pregnancy or delivery.Case presentation: A 43 year old pregnant woman visited RSUD Dr. T.C. Hillers with the main complains of abdominal pain and tension since 4 hours prior to the visit. physical examinations showed hypotension, tachycardia, tachypnea, anemic conjunctiva, bilateral chest expansion, abdominal distension, and suprapubic tenderness. However, the results of intravaginal examination showed no dilated cervix or active bleeding. No FHR were detected, and a single fetus can be palpated. An emergency caesarean section was performed, and fetal death was found in the abdominal cavity with 10 cm sized tear in the lower uterine segment and anterior vaginal wall.Discussion: Poor ANC follow up, multiparous women and previous history of caesarean section are the core risk factors for uterine rupture. Uterine rupture often is sudden and may be catastrophic, and the acute signs and symptoms are variable. The treatment is often surgical and limited to two options which are either complete sterilization with hysterectomy and the more conservative option including uterine sparing option of surgical repair with or without tubal ligation.Conclusion: Uterine rupture is an obstetric emergency which could potentially cause of maternal and perinatal mortality. Prompt diagnosis, early transport, adequate blood products transfusion, and an experience surgical team are essential for the management of uterine rupture.Key words: Uterine rupture, fetal death, multiparous 
Carbetosine, a Long-acting Oxytocin Agonist, as a Uterotonic in the Prevention of the Occurrence of Postpartum Bleeding Izaak, Revynca Petronella
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.2037

Abstract

Objective: To evaluate the comparative effect of carbetocin vs. other uterotonic agents in the prevention of the occurrence of postpartum bleeding. Methods: Medical search engines like Pubmed, Google Scholar, and Cochrane are used for literature searches. The year period covered by the literature is 2013–2023. “Carbetocin” or “long-acting oxytocin” and “uterotonic” are the essential words, together with “post-partum hemorrhage” or “post-partum bleeding.” Data analysis was performed using the RevMan 5.4 application. Results: This study involved 12 clinical trials with a total sample of 32,312 people. Based on forest plot analysis, it was found that patients receiving carbetocin therapy had a risk of developing postpartum bleeding of 0.42 times compared to those receiving other uterotonic agents (misoprostol and oxytocin) (OR: 0.42; 95% CI: 0.26-0.68; p<0.0004; with heterogeneity p<0.00001, I2 85%) Conclusion: With its effectiveness and efficacy, carbetocin can be considered one modality that can prevent postpartum hemorrhage. In addition, it can benefit women at risk of having a major obstetric hemorrhage. Keywords: carbetocin, uterotonic, meta-analysis, clinical trial