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Riana, Salsabila
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Manual Aid in the Vaginal Delivery of Spontaneous Twin Cephalic-Complete Breech Pregnancy: A Case Report Nanda R.P, Gustie; Sujatmiko, Tejo; G.T, Kanesti Ismirajna; Riana, Salsabila
Jurnal Health Sains Vol. 6 No. 11 (2025): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v6i11.2740

Abstract

Multiple gestation, particularly those involving a combination of breech and cephalic presentations, presents a complex obstetric challenge. This case report describes the successful vaginal delivery of a twin pregnancy with mixed presentation at 36/37 weeks of gestation. A 28-year-old woman, G2P1A0, presented in active labor with a cervical dilation of 4 cm. The first twin was in cephalic presentation, while the second was in breech. Following the NICE guidelines for twin delivery with a cephalic-presenting first twin, a vaginal delivery was planned. The first baby was delivered spontaneously. For the second, breech-presenting twin, an amniotomy was performed, followed by a Manual Aid for Breech Delivery, resulting in a safe vaginal birth. Both infants had satisfactory Apgar scores, and the third stage was managed without significant postpartum haemorrhage. This case demonstrates that with careful monitoring and skilled intervention, vaginal delivery is a viable and safe option for twin pregnancies with a cephalic-breech combination, potentially avoiding the need for cesarean section. The successful outcome underscores the importance of preparedness for breech extraction and holistic management during the intrapartum and postpartum periods.
A Case of Anencephaly with Concomitant Maternal Overweight: Clinical Presentation and Outcome Ismirajna G.T, Kanesti; Panggung T.S, Sir; Nanda R.P, Gustie; Riana, Salsabila
Jurnal Health Sains Vol. 6 No. 11 (2025): Journal Health Sains
Publisher : Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jhs.v6i11.2741

Abstract

Anencephaly, a lethal neural tube defect (NTD), results from failed cranial neural tube closure during early embryogenesis. Maternal risk factors, including obesity and inadequate periconceptional folic acid intake, are well-established contributors. This report describes a case involving a 29-year-old primigravida with a Body Mass Index (BMI) of 28.03 kg/m² (overweight) who was referred at 39 weeks gestation for delivery following a prenatal diagnosis of anencephaly. The patient had no personal history of chronic illness but had not taken folic acid supplements prior to conception, initiating prenatal vitamins only after pregnancy confirmation. A cesarean section delivered a male infant with classic features of anencephaly. Despite resuscitation, the newborn died shortly after birth. The development of anencephaly in this instance is associated with two key modifiable risk factors: maternal overweight status and the absence of preconceptional folic acid supplementation. Neural tube closure occurs within the first month of pregnancy, often before pregnancy recognition, making folic acid initiation after confirmation too late to prevent NTDs. Maternal overweight or obesity is an independent risk factor that can compromise the fetal environment and potentially alter folate metabolism. This case underscores the critical importance of preconception health counseling, emphasizing the necessity of folic acid supplementation for all women of reproductive age, commencing before conception. This public health measure is particularly crucial for women with elevated BMI.
Co-Authors G.T, Kanesti Ismirajna Ismirajna G.T, Kanesti Nanda R.P, Gustie Panggung T.S, Sir Sujatmiko, Tejo