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All Journal Syntax Literate: Jurnal Ilmiah Indonesia Narra J The Journal of Society Medicine (JSOCMED)
Septivera, Yusra
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Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

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Cesarean Scar Pregnancy Presenting with Persistent Bleeding After Curettage: A Case Report of Uterine Resection and Reconstruction Arfita, Ika; Septivera, Yusra
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i9.61461

Abstract

Background: Cesarean scar pregnancy (CSP) is a rare and potentially life-threatening form of ectopic pregnancy in which the gestational sac implants within the myometrial scar from a previous cesarean section. It is associated with significant risks, including uterine rupture and severe hemorrhage. Case Presentation: We report the case of a 35-year-old multiparous woman (G5P4A1) with two prior cesarean deliveries who presented with persistent vaginal spotting for three weeks, worsening over the last three days. She had undergone uterine curettage for incomplete abortion three weeks prior. A transvaginal ultrasound revealed a hypoechoic mass in the cesarean scar niche, with positive vascularization, consistent with a diagnosis of CSP. Surgical intervention via laparotomy was performed, including evacuation of retained products of conception, uterine resection and reconstruction, bilateral tubectomy, and adhesiolysis. The patient recovered well and was discharged after three days of postoperative care. Conclusion: Early diagnosis and prompt surgical management of cesarean scar pregnancy are essential to prevent severe complications. This case emphasizes the importance of considering CSP in patients with prior cesarean sections presenting with abnormal uterine bleeding after early pregnancy loss.
Clinical Hirsutism Secondary to Ovarian Clear Cell Carcinoma: A Rare Case Report Muknisa, Liza; Nainggolan, Sarah Ika Nainggolan; Rusnaidi, Rusnaidi; Septivera, Yusra
Journal of Society Medicine Vol. 4 No. 10 (2025): October
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i10.240

Abstract

Introduction: Hirsutism affects 5–15% of premenopausal women, predominantly due to hyperandrogenemia (80–90% of cases), with the remainder classified as idiopathic or normoandrogenic. While virilizing ovarian tumors are known causes, the association between hirsutism and ovarian clear cell carcinoma (OCCC) has not been previously documented. Case Description: A 51-year-old multiparous woman presented with progressive abdominal distension over one year and new-onset hirsutism (Ferriman–Gallwey score 13) involving the face, axillae, pubic area, and lower limbs. She reported abdominal pain, nausea, vomiting, anorexia, 5-kg weight loss, vaginal discharge, regular menses, and poorly controlled type 2 diabetes. Examination revealed an underweight habitus and a firm, irregular, mobile, tender pelvic-abdominal mass extending above the umbilicus. Laboratory evaluation showed hypoalbuminemia (3.22 g/dL), elevated creatinine (1.64 mg/dL), markedly raised CA-125 (1,480 U/mL), and normal serum testosterone (7.5 ng/dL). Imaging confirmed a 9.5 × 8.3 × 5.5 cm solid-cystic right ovarian mass with ascites and suspected peritoneal metastases. Total abdominal hysterectomy with surgical staging was performed; histopathology confirmed OCCC. Conclusion: This is the first reported case of clinical hirsutism in OCCC with normal testosterone levels, supporting a diagnosis of idiopathic hirsutism. Potential mechanisms include increased peripheral 5α-reductase activity, androgen receptor hypersensitivity, or local androgen production, warranting further molecular investigation.
Cortisol and pregnancy-related anxiety in relation to preeclampsia among third-trimester pregnant women: A case–control study from Aceh, Indonesia Hezron, Teuku M.; Dewi, Tgk. Puspa; Septivera, Yusra; Rajuddin, Rajuddin; Utami, Niken A.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2985

Abstract

Despite extensive research, the interplay between hormonal stress markers and pregnancy-specific anxiety in the pathogenesis of preeclampsia remains insufficiently understood. This study aimed to analyze the simultaneous relationships between serum cortisol levels, pregnancy-related anxiety, and the occurrence of preeclampsia among third-trimester pregnant women. A case–control study was conducted at three hospitals in Banda Aceh, Indonesia, involving third-trimester pregnant women. Serum cortisol concentrations were measured using an immunoassay, and anxiety levels were assessed with the validated Pregnancy Related Anxiety Questionnaire (PRAQ). Preeclampsia diagnosis followed standard clinical and laboratory criteria. Associations between cortisol levels (categorized into high and normal) and PRAQ scores (classified as high and low–moderate) with preeclampsia were evaluated using the Chi-squared test, and crude odds ratios (OR) with 95% confidence intervals (95%CI). The Spearman’s correlation was used to determine the correlation between cortisol levels and PRAG scores. A total of 66 pregnant women were included in the final analysis (33 with preeclampsia and 33 with normal pregnancy). Women with high serum cortisol levels had a markedly greater likelihood of developing preeclampsia compared with those with normal cortisol levels (odds ratio (OR)=34.00; 95% confidence interval (95%CI): 4.93–234.46). Similarly, women with high pregnancy-related anxiety exhibited a significantly elevated risk of preeclampsia (OR=16.71; 95%CI: 4.95–56.39). No significant correlation was observed between cortisol levels and PRAQ scores in both groups (preeclampsia: r=-0.041, p=0.821; normal pregnancy: r=0.278, p=0.117). In conclusion, elevated serum cortisol and high pregnancy-related anxiety are independently associated with preeclampsia, although not directly correlated with each other. These findings highlight the potential of dual screening for cortisol and pregnancy-specific anxiety as an innovative approach for early identification of women at high risk of preeclampsia.
Associations of VEGF and CA125 with disease stage and pain among women with endometriosis: A cross-sectional study in Indonesia Sujudi, Akmal; Rusnaidi, Rusnaidi; Rajuddin, Rajuddin; Septivera, Yusra
Narra J Vol. 6 No. 1 (2026): January 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3013

Abstract

Endometriosis is a chronic gynecological disease characterized by the presence of endometrial tissue outside the uterine cavity, affecting approximately 10% of women of reproductive age. Vascular endothelial growth factor (VEGF) and cancer antigen 125 (CA125) have been proposed as potential biomarkers in endometriosis; however, evidence regarding their association with disease stage and pain severity remains limited, particularly in the Indonesian population. The aim of this study was to evaluate the relationship between peritoneal fluid VEGF and serum CA125 levels with endometriosis stage and pain severity. A cross-sectional study was conducted involving patients with surgically and histopathologically confirmed endometriosis who underwent laparoscopy or laparotomy at Dr. Zainoel Abidin Hospital, Banda Aceh, between February and July 2025. Peritoneal fluid VEGF and serum CA125 levels were measured using enzyme-linked immunosorbent assay and chemiluminescence immunoassay, respectively. Endometriosis stage was classified according to the revised American Society for Reproductive Medicine (rASRM) criteria, and pain severity was assessed using the Numeric Rating Scale. Statistical analyses included Spearman’s correlation and receiver operating characteristic (ROC) curve analysis. Our data suggested no significant correlation between VEGF levels and endometriosis stage (r=0.042; p=0.813). Peritoneal fluid VEGF levels showed a moderate positive correlation with pain severity (r=0.505; p<0.05), and ROC analysis identified an optimal cut-off value of 39.45 pg/mL, with a sensitivity of 73.68% and specificity of 73.33% for distinguishing severe pain from mild-to-moderate pain. Serum CA125 levels demonstrated a significant positive correlation with endometriosis stage (r=0.422; p=0.013), and ROC analysis yielded an optimal cut-off value of 32.45 U/mL, with a sensitivity of 86.95% and a specificity of 63.64% for distinguishing stage IV endometriosis from lower stages. No significant correlation was observed between CA125 levels and pain severity (r=0.186; p=0.292). This study represents the first report from Indonesia to simultaneously evaluate peritoneal fluid VEGF and serum CA125 in relation to endometriosis stage and pain severity. This study highlights that CA125 is primarily associated with endometriosis stage, whereas VEGF is more closely related to pain severity, supporting their complementary roles in endometriosis assessment.
Co-Authors Arfita, Ika Dewi, Tgk. Puspa Hezron, Teuku M. Muknisa, Liza Nainggolan, Sarah Ika Nainggolan Rajuddin Rajuddin Rusnaidi Sujudi, Akmal Utami, Niken A.