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All Journal Health Dynamics
Azkia, Razita Aulia
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Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Case Report: Term Birth with Unknown Intrauterine Device (IUD) in Situ Mustikasari, Melisa Indah; Pamungkas, Aditya Fendi Uji; Azkia, Razita Aulia; Putri, Made Chindy Dwiyanti Marheni; Wiguna, I Made Ananta
Health Dynamics Vol 2, No 1 (2025): January 2025
Publisher : Knowledge Dynamics

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hd20102

Abstract

Intrauterine contraceptive devices (IUDs) are highly efficient at preventing unintended pregnancies, without minimal failure rates, rare complications such as retention or displacement during pregnancy may lead to significant clinical challenge. This case discusses the diagnostic and management challenges of presumed IUD retention in the background of poor antenatal care. Multigravida woman, GIII/PII/A0, 24 years old with two previous caesarean deliveries, admitted in active labor at term. She received no antenatal care for her pregnancy because she could not afford it, and she thought that, because she had an IUD placed after her last cesarean section, she was infertile. On examination, uterine fundal height was 34 cm, amniotic membranes were intact, and the cervix was fully dilated as labor progressed. Spontaneous vaginal delivery was achieved and a 4050-gram (9 lb) neonate was delivered with Apgar scores of 4 at one minute and 5 at five minutes. In the postpartum period, she experienced complications including retained placenta requiring manual extraction and an estimated blood loss of 250 mL. After complete exploration and subsequent imaging, the IUD was not visualized, suggesting either early expulsion, unnoticed displacement or misplacement occurred at insertion. The patient’s postpartum course was unremarkable with appropriate uterotonic therapy and close observation. This case highlights the need for full antenatal care to prevent and manage complications associated with IUDs including displacement or retention that may result in adverse maternal and fetal outcomes. Timely diagnosis and early interventions coupled with appropriate imaging and clinical follow-up services are essential to optimize outcomes and minimize associated risks. 
How Do Maternal Gestational Diabetes and Preterm Premature Rupture of Membrane (PROM) Contribute to Neonatal Jaundice and Sepsis? A Case Report and Narrative Review Mustikasari, Melisa Indah; Pamungkas, Aditya Fendi Uji; Sugondo, Alexander Tikara; Putri, Made Chindy Dwiyanti Marheni; Azkia, Razita Aulia
Health Dynamics Vol 2, No 3 (2025): March 2025
Publisher : Knowledge Dynamics

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hd20304

Abstract

Gestational diabetes mellitus (GDM) and preterm premature rupture of membranes (PPROM) are significant obstetric conditions associated with heightened maternal and neonatal morbidity and mortality. Globally, complications of preterm birth, particularly due to PPROM, account for 35% of neonatal deaths. The coexistence of GDM and PPROM compounds risks, exacerbating adverse neonatal outcomes. This report about a 21 years old primigravida at 32–34 weeks of gestation with untreated GDM and PPROM for over 12 hours. The patient presented with decreased fetal movement and was managed conservatively with corticosteroids, antibiotics, and tocolytics. However, signs of fetal distress necessitated cesarean delivery, resulting in the birth of a male neonate 2370 g, APGAR 2/3, with asphyxia, respiratory distress, and hypoglycemia. Postnatal complications included jaundice and neonatal sepsis, which required 22 days of intensive NICU care with respiratory support, dextrose infusion, and antibiotics. The neonate showed gradual improvement. The coexistence of GDM and PPROM significantly increases the risk of adverse neonatal outcomes such as respiratory distress, hypoglycemia, jaundice, and sepsis. Early diagnosis, glycemic control, prophylactic antibiotics, and administration of corticosteroids are critical to improving maternal and neonatal outcomes. This case underscores the importance of a multidisciplinary approach and further research to refine best practices in managing GDM complicated by PPROM.
Co-Authors Mustikasari, Melisa Indah Pamungkas, Aditya Fendi Uji Putri, Made Chindy Dwiyanti Marheni Sugondo, Alexander Tikara Wiguna, I Made Ananta