Donel Suhaimi
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Riau, Pekanbaru, Indonesia

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A Clinical Dilemma Of Bilateral Hematosalpinx In Ectopic Pregnancy: Case Report Ratu Astuti Dwi Putri; Fadler Hidayat; Donel Suhaimi; Tubagus Odih Rhomdaniwahid
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1052

Abstract

Background: Blastocyst implantation outside the uterine cavity leads to ectopic pregnancy. About 96% of ectopic pregnancies occur in the fallopian tubes, where it most frequently occurs; the fimbrial end accounts for 11% of all ectopic pregnancies. There was an uncommon type of ectopic pregnancy called bilateral tubal ectopic pregnancy. Bilateral tubal ectopic pregnancy is estimated to affect 1 out of 725 - 1580 ectopic pregnancies or 1 out of 200,000 live births. However, the villi quickly penetrate the endosalpinx once the implantation of the ectopic pregnancy has occurred before reaching the tubal wall and peritoneum. Vascular growth and a peritubal hematoma or hematosalpinx, which frequently involves the contralateral tubal section, are also present with this penetration. The purpose of this article is to report on the dilemmas that often occur in the case of bilateral hematosalpinx in ectopic pregnancy. Case Description: In this report, we discuss a 33-year-old woman with a positive pregnancy test and transvaginal ultrasound result that was suggestive of ectopic pregnancy in a stable hemodynamic state. The patient underwent an exploratory laparotomy, which showed bilateral hematosalpinx with right ectopic pregnancy with damaged fimbria. The left fallopian tube had a blue-purple bulge that suggested hematosalpinx secondary to ectopic pregnancy rather than bilateral ectopic pregnancy condition. The decision for definitive management was made, right salpingectomy puncture and drainage of the hematosalpinx were performed without complication. The final diagnosis was confirmed on pathology examination that showing chorionic villi within the right damaged fimbria, focal decidua, a few trophoblast-like cells that indicated ectopic pregnancy in the left tubal cavity. Conclusion: This approach encourages both shared decision-making and preparedness, both of which are required to provide patient-centered and comprehensive caremanagement such as bilateral hematosalpinx in ectopic pregnancy case, that must always be individualized, and patient's desire for future conception must be taken into account.
Gene and Germline Editing in Maternal and Reproductive Health: A Narrative Review of Ethical Dilemmas and Scientific Advances Donel Suhaimi; Sofyan Andri; Anastasya Hutapea; Sandi Arihta
Indonesian Journal of Obstetrics & Gynecology Science Volume 9 Number 1 March 2026
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v9i1.939

Abstract

Introduction: In Utero Genetic Editing (IUGE) is an emerging technology intended to modify the fetal genome to prevent or treat genetic disorders before birth. While it presents significant medical potential, it raises complex ethical, legal, and regulatory challenges. Current interventions remain largely animal-based, with human applications at theoretical or preclinical stages.Methods: This review examines ethical guidelines, legal frameworks, and regulatory perspectives globally and in Indonesia. Sources included WHO, the Indonesian Obstetrics and Gynecology Association (POGI), Indonesian health laws, and journals such as the American Journal of Obstetrics and Gynecology (AJOG). Literature was drawn from PubMed, WHO databases, Indonesian archives, and AJOG publications (2015–2025).Results: WHO emphasized precaution and transparency, while POGI stressed maternal–fetal safety under strict oversight. Indonesia lacks specific regulation, requiring interventions to respect safety and human dignity. The United States and European Union maintain restrictive regulations, including embryo research bans.Conclusion: IUGE is promising for reproductive health but remains ethically and legally unresolved, requiring clearer frameworks before clinical translation. AbstrakPendahuluan: In Utero Genetic Editing (IUGE) merupakan teknologi baru untuk memodifikasi genom janin guna mencegah atau mengobati kelainan genetik sejak sebelum lahir. Teknologi ini menjanjikan manfaat medis, namun menimbulkan tantangan etik, hukum, dan regulasi. Hingga kini, sebagian besar intervensi masih berbasis penelitian hewan, sementara aplikasi pada manusia berada pada tahap teoritis atau pra-klinis.Metode: Kajian ini menelaah pedoman etik, kerangka hukum, dan regulasi dari perspektif global dan Indonesia. Sumber mencakup WHO, Perkumpulan Obstetri dan Ginekologi Indonesia (POGI), peraturan kesehatan nasional, serta jurnal internasional seperti American Journal of Obstetrics and Gynecology (AJOG). Literatur diperoleh dari PubMed, basis data WHO, arsip hukum Indonesia, dan publikasi AJOG (2015–2025).Hasil: WHO menekankan prinsip kehati-hatian dan transparansi, sementara POGI menegaskan keselamatan ibu–janin dengan pengawasan ketat. Indonesia belum memiliki regulasi khusus, tetapi mensyaratkan intervensi genetik menjaga keselamatan dan martabat manusia. Negara seperti Amerika Serikat dan Uni Eropa menetapkan aturan restriktif, termasuk larangan riset embrio.Kesimpulan: IUGE berpotensi meningkatkan kesehatan reproduksi, namun memerlukan regulasi yang lebih jelas sebelum penerapan klinis.Kata kunci: In Utero Genetic Editing, etika, regulasi, terapi janin, bioetika