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Reinaldo, Poldo
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Nursing Public Health

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Placenta Percreta With Bladder Infiltration : A Case Report Reinaldo, Poldo; Permana, Bayu; Syahredi, Syahredi
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.1.104-109.2022

Abstract

Objective : To report a case of placenta percreta with bladder infiltration.Method : Case reports.Case :a 24-year-old female G2P1A0H1 gravid 26-27 weeks, placenta percreta with gross hematuria. The second pregnant patient was less months pregnant with the results of a fetal ultrasound examination with a placenta covering the uterine internum (OUI) and suspected of penetrating the uterine wall (percreta), and a cesarean hysterectomy was performed.Discussion : The cause of placenta percreta is unknown, it is associated with several clinical risk factors like the previous cesarean, placenta previa, grand multiparity, and previous uterine curettage. The management of placenta percreta can be challenging because the loss occurs at two sites in labor. Refractory hematuria occurs in 25% of patients due to placenta percreta invasion of the bladder. Management involves a team of obstetricians, urologists, intensivists, and neonatologists. Treatment is preferably carried out in tertiary care where there is a definite stock of blood with adequate blood products, a fully equipped neonatal intensive care unit (NICU). Delivery may be considered at 34-35 weeks gestation if there is no maternal and fetal deterioration because the incidence of antepartum hemorrhage appears to increase sharply at 36 weeks.Conclusion : Management is recommended for placenta percreta cases, planning for premature cesarean hysterectomy with placenta left in situ. However, the diagnosis is made based on the results of the anatomic pathology obtained after hysterectomy, and is not considered a first-line treatment for women who still wish to maintain future fertility.Keywords:placenta percreta, cesarean hysterectomy
Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA): Case report Utama, Bobby Indra; Reinaldo, Poldo; Sari, Puspita
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.2.173-178.2022

Abstract

Background: Hemivaginal obstruction syndrome and ipsilateral renal anomalies are known as Herlyn-Werner-Wunderlich syndrome (HWWs) or better known by the acronym OHVIRA (Obstructed Hemivagina and Ipsilasteral Renal Anomaly). It occurs as a result of complete failure of the Müllerian ducts to fuse and accounts for about 5% of Müllerian duct anomalies. Initial manifestations usually appear as a result of secretions accumulating within the hemivaginal obstruction. Patients with HWWs can come with complaints of lower abdominal pain, severe dysmenorrhea, pelvic or vaginal mass, abnormal vaginal discharge, acute urinary retention, fever or vomiting. Therefore, careful diagnosis and appropriate management of this condition is desirable. The objective of the study was to report on the management of the obstruction due to HWWs. Case Report: A 12-year-old patient was admitted to the gynecology ward of Dr. M. Djamil Central General Hospital from polyclinic with abdominal pain since 4 months before being admitted to the hospital. The pain gets worse every day before menstruation and decreases when given painkillers. Bleeding from the vagina often recurs with blackish color, a little smelly since the 1 month ago. Conclusion: OHVIRA syndrome is a triad characterized by hemivaginal obstruction and agenesis of the ipsilateral kidney (OHVIRA) and uterus in the delphys. Clinical symptoms in general are cyclic dysmenorrhea, palpable mass due to accumulation of menstrual flow, and severe pelvic pain which can later develop into a persistent form as a result of prolonged retention of menstrual secretions, obstructed hemivagina. Management options are surgical resection of the obstructed vaginal septum and drainage.
Co-Authors PERMANA, BAYU Puspita Sari Syahredi, Syahredi Utama, Bobby Indra