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Pregnancy in patient with congenitally corrected transposition of the great artery and ventricular septal defect without pulmonary stenosis: A case report Auliya, Faiza Fardha; Bambang Rahardjo; Indrawan, I Wayan Agung
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.17

Abstract

Background: Transposition of the Great Arteries (TGA) is a congenital heart defect affected by an embryological misalignment between the aorta and pulmonary trunk. Congenitally Corrected Transposition of the Great Arteries (CCTGA) or L-TGA, accounts for less than 1 % of congenital cardiac disease cases. This report presents the case of a pregnant woman with a history of CCTGA who successfully delivered an infant. Case illustration: A 32-year-old woman presented with vaginal bleeding at 30-32 weeks of gestation and a history of CC-TGA. Her medical history included CCTGA, ventricular septal defect (VSD) without pulmonary stenosis, prior molar pregnancy curettage, breech fetal position, moderate acute respiratory distress syndrome (ARDS), and low body mass index (BMI 16.6 kg/m²). She was classified as WHO Cardiac Risk Class IV due to the high risk of maternal mortality. Following corticosteroid administration for fetal lung maturation and multidisciplinary evaluation, a planned cesarean section was performed at 30 weeks. A male infant was delivered, weighing 1,480 grams, measuring 41 cm in length, with Apgar scores of 7 and 9, and a Ballard score of 18. Conclusion: Early risk assessment, multidisciplinary collaboration, and individualized management are pivotal in reducing maternal and fetal morbidity in patients with CC-TGA.
Diagnostic and Therapeutic Dilemmas in Inguinal Endometriosis: A Case Report Auliya, Faiza Fardha; Siswanto, Yudi
Asian Journal of Health Research Vol. 4 No. 3 (2025): Volume 4 No 3 (December) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i3.275

Abstract

Introduction: Endometriosis is a common gynecological condition, but its extragenital forms, particularly inguinal endometriosis, are rare and pose significant diagnostic and therapeutic challenges. This case highlights the complexities encountered in managing endometriosis in an unusual location. Case Presentation: We report the case of Mrs. C, a 34-year-old married woman, who presented with a 4-year history of a painful, cyclically bleeding lump in the right pubic region, was initially misdiagnosed as a traumatic cyst. Histopathological examination of an external genital biopsy in 2023 confirmed endometriosis. Initial monthly Depo Medroxyprogesterone Acetate (DMPA) therapy for six cycles proved ineffective. Subsequently, Gonadotropin-Releasing Hormone (GnRH) agonist (Endrolin) injections were administered for a total of 12 cycles, with symptom improvement, specifically cessation of bleeding, noted only after the seventh cycle. No hypoestrogenic side effects were reported despite prolonged GnRH agonist use without add-back therapy. Conclusion: This case illustrates the diagnostic delay often associated with extragenital endometriosis due to its atypical presentation, with the patient receiving only symptomatic treatment for years. The need for prolonged GnRH agonist therapy (12 cycles), exceeding standard guidelines of six months, highlights individual variability in treatment response, even without add-back therapy. Recurrence of bleeding occurred shortly after cessation of Dienogest maintenance therapy due to economic constraints, underscoring the chronic, hormone-dependent nature of the disease and the importance of continuous, accessible treatment. The patient consistently declined operative laparoscopy for wider excision.