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Association between Serum Cotinine Levels, Fetal Biometry, and Umbilical Artery Flow in Pregnant Women Exposed to Secondhand Smoke Diana, Margaret; Riu, Deviana Soraya; Madya, Fatmawati; Chalid, St. Maisuri T.; AM, Nasrudin; Tessy, Telly
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.956

Objective: This study aimed to investigate the impact of SHS exposure on fetal biometry and umbilical artery flow at 24 – 28 weeks of gestation.Methods: This cross-sectional study included 110 pregnant women, divided into a study group (55 passive) smokers and a control group (55 non-passive smokers). Serum cotinine levels were measured using ELISA. Fetal biometry (biparietal diameter, head circumference, abdominal circumference, and femur length) and umbilical artery flow (pulsatility and resistance indices) were assessed via ultrasound and Doppler ultrasonography. Group comparisons were conducted using Chi-square and independent t-tests.Results: The passive smoker group had significantly higher mean serum cotinine levels compared with the control group (10.97 ng/mL vs. 4.53 ng/mL; p = 0.01). However, no statistically significant differences (p > 0.05) were found in any of the fetal biometric parameters or umbilical artery flow indices between the groups. Correlation analyses also showed no significant association between cotinine levels and the measured fetal outcomes.Conclusion: In this second-trimester study, SHS exposure, confirmed by elevated cotinine levels, was not associated with measurable adverse effects on fetal biometry or umbilical artery flow. These non-significant findings underscore the need for longitudinal research to evaluate the cumulative impact of SHS, particularly in the third trimester and on final birth outcomes.Hubungan antara Kadar Kotinin Serum, Biometri Janin, dan Aliran Arteri Umbilikalis pada Ibu Hamil yang Terpapar Asap Rokok PasifAbstrakTujuan: Penelitian ini bertujuan untuk menelaah dampak paparan asap rokok pasif terhadap biometri janin dan aliran arteri umbilikalis pada usia kehamilan 24 – 28 minggu.Metode: Penelitian potong lintang ini melibatkan 110 ibu hamil yang dibagi menjadi kelompok studi (55 perokok pasif) dan kelompok kontrol (55 bukan perokok pasif). Kadar kotinin serum diukur menggunakan metode ELISA. Biometri janin (meliputi diameter biparietal, lingkar kepala, lingkar perut, dan panjang femur) serta aliran arteri umbilikalis (indeks pulsasi dan indeks resistensi) dinilai melalui ultrasonografi (USG) dan USG Doppler. Perbandingan antarkelompok dianalisis menggunakan uji Chi-square dan uji t independen.Hasil: Kelompok perokok pasif memiliki rerata kadar kotinin serum yang secara signifikan lebih tinggi dibandingkan kelompok kontrol (10,97 ng/mL vs. 4,53 ng/mL; p = 0,01). Namun, tidak ditemukan perbedaan bermakna secara statistik (p > 0,05) pada parameter biometri janin maupun indeks aliran arteri umbilikalis antara kedua kelompok. Analisis korelasi juga tidak menunjukkan adanya hubungan bermakna antara kadar kotinin dengan luaran janin yang diukur.Kesimpulan: Pada penelitian trimester kedua ini, paparan asap rokok pasif yang dikonfirmasi dengan peningkatan kadar kotinin tidak berhubungan dengan efek merugikan yang terdeteksi pada biometri janin maupun aliran arteri umbilikalis. Temuan yang tidak signifikan ini menekankan pentingnya penelitian longitudinal untuk menilai dampak kumulatif paparan asap rokok pasif, terutama pada trimester ketiga dan luaran kelahiran akhir.Kata kunci: Aliran arteri umbilikalis; biometri janin; kotinin; paparan asap rokok pasif

Urinary Complications after Radical Hysterectomy in Cervical Cancer: A Retrospective Cohort Study Pradoto, Muhammad Edo Antariksa; Sutrisno, Sutrisno; Tjahyadi, Dian
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.932

Objective: Radical hysterectomy and pelvic lymphadenectomy are standard treatments for cervical cancer. A common long-term complication is lower urinary tract dysfunction (LUTD), which can lead to urinary tract infections (UTIs) due to urinary stasis. Incontinence may also increase UTI risk by allowing bacteria to enter through the urethra. This study aims to determine the incidence of LUTD and UTI in cervical cancer patients after radical hysterectomy and to analyze their relationship.Methods: A retrospective cohort study was conducted on patients with stage IA2–IIA2 cervical cancer who underwent radical hysterectomy at Margono Soekarjo General Hospital. Urinary catheters were placed postoperatively, and bladder training was initiated on postoperative day three. Urine samples were collected on day fourteen or upon the return of bladder sensation to assess for urinary tract infection (UTI). The relationship between lower urinary tract dysfunction (LUTD) and UTI was analyzed using.Result: LUTD incidence was 13.8%. UTI incidence was significantly higher in patients with LUTD than in those without (7.7% vs. 1.5%, p < 0.001). The relative risk of UTI in patients with LUTD was 31.1 (95% CI: 6.396–739.029), likely due to the limited sample size.Conclusion: There is a significant association between LUTD and UTI in cervical cancer patients after radical hysterectomy. Early detection and monitoring of bladder function are essential in postoperative care.Keywords: Lower urinary tract dysfunction; radical hysterectomy; urinary tract infection.Komplikasi Urinaria Setelah Histerektomi Radikal pada Kanker Serviks: Studi Kohort RetrospektifAbstrak Tujuan: Histerektomi radikal dan limfadenektomi pelvik merupakan terapi standar untuk kanker serviks. Salah satu komplikasi jangka panjang yang umum adalah disfungsi saluran kemih bagian bawah (Lower Urinary Tract Dysfunction/LUTD), yang dapat menyebabkan infeksi saluran kemih (ISK) akibat stasis urin. Inkontinensia urin juga dapat meningkatkan risiko ISK melalui masuknya bakteri melalui uretra. Penelitian ini bertujuan untuk mengevaluasi insidensi LUTD dan ISK pada pasien kanker serviks pasca-histerektomi radikal tipe II serta hubungan antara keduanya.Metode: Sebuah studi kohort retrospektif dilakukan pada pasien kanker serviks stadium IA2–IIA2 yang menjalani histerektomi radikal di RSUD Margono Soekarjo. Setelah operasi kateter urin dipasang dan melatih kandung kemih dimulai pada hari ketiga pascaoperasi. Sampel urin dikumpulkan pada hari keempat belas atau saat sensasi kandung kemih kembali untuk menilai adanya infeksi saluran kemih (ISK). Hubungan antara disfungsi traktus urinarius bawah (LUTD) dan ISK dianalisis menggunakan uji Fisher’s exact.Hasil: Penelitian ini menunjukan insidensi LUTD adalah 13,8%. Insidensi ISK secara signifikan lebih tinggi pada pasien dengan LUTD dibandingkan yang tidak mengalami LUTD (7.7% vs. 1.5%, p < 0.001). Risiko relatif ISK pada pasien dengan LUTD adalah 31.1 (CI 95%: 6.396–739.029) karena jumlah subjek penelitian sedikit.Kesimpulan: Terdapat hubungan yang signifikan antara LUTD dan kejadian ISK pada pasien kanker serviks pasca-histerektomi radikal. Deteksi dini dan pemantauan fungsi kandung kemih sangat penting dalam perawatan pascaoperasi.Kata kunci: Disfungsi urin; histerektomi radikal; infeksi saluran kemih

Disruption of Nutrient Transport, Especially Glucose, in Preeclampsia Triggers Stunted Fetal Growth Pribadi, Adhi
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.v9i1.1095

Preeclampsia is a relatively common complication in obstetrics. The real problem currently faced is the adverse effects of preeclampsia on the mother and fetus, while the pathophysiology useful for prevention remains unclear. The clinical symptoms and complications that arise are highly variable and ultimately lead to multi-organ failure. This condition results in preeclampsia being one of the three causes of maternal death worldwide, including in Indonesia. The incidence of preeclampsia/eclampsia in various literature and studies ranges from 4to10% of pregnancies.

Correlation between Maternal Lactate Dehydrogenase Levels and APGAR Scores in Preeclampsia Patients at Margono Soekarjo Hospital from 2022–2024 Wicaksono, Bagas Satriyo; Aditiyono, Aditiyono; Susiarno, Hadi; Marlina, Dina; Grazielle, Grazielle
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.v9i1.1036

Objective: This study aims to investigate the correlation between maternal lactate dehydrogenase (LDH) levels and neonatal APGAR scores in preeclamptic patients.Methods: This is an observational analytic study with a cross-sectional design conducted at Margono Soekarjo Hospital from January 2022 to May 2024, involving 78 women with preeclampsia who underwent cesarean delivery. Participants were categorized into early-onset (<34 weeks) and late-onset (≥34 weeks) preeclampsia groups. LDH levels and APGAR scores were analyzed using Spearman’s correlation and ROC analysis.Results: This study showed that elevated LDH levels were significantly associated with lower one-minute APGAR scores, showing moderate correlations in both groups, and were related to five-minute APGAR scores. The LDH cut-off points predicting poor one-minute APGAR outcomes were 284 IU/L (sensitivity 82.1%, specificity 66.7%) for early-onset and 491.5 IU/L (sensitivity 44.4%, specificity 96.2%) for late-onset preeclampsia.Conclusion: Elevated maternal LDH levels are associated with lower one-minute APGAR scores in preeclamptic patients, especially in early-onset cases, indicating they may serve as an early marker for fetal hypoxia and asphyxia risk. AbstrakTujuan: Penelitian ini bertujuan untuk meneliti hubungan antara kadar laktat dehidrogenase (LDH) maternal dan skor APGAR neonatus pada pasien preeklampsia.Metode: Penelitian ini merupakan studi analitik observasional dengan desain potong lintang yang dilakukan di RSUD Margono Soekarjo pada Januari 2022 hingga Mei 2024, melibatkan 78 wanita dengan preeklampsia yang menjalani persalinan melalui seksio sesarea. Peserta dibagi menjadi dua kelompok, yaitu preeklampsia onset dini (<34 minggu) dan onset lambat (≥34 minggu). Kadar LDH dan skor APGAR dianalisis menggunakan korelasi Spearman dan analisis ROC.Hasil: Hasil penelitian ini menunjukkan bahwa peningkatan kadar LDH berhubungan signifikan dengan skor APGAR satu menit yang lebih rendah, menunjukkan korelasi sedang pada kedua kelompok, serta menandai adanya kaitan dengan skor APGAR lima menit. Titik potong kadar LDH yang memprediksi hasil APGAR satu menit yang buruk adalah 284 IU/L (sensitivitas 82,1%, spesifisitas 66,7%) untuk preeklampsia onset dini dan 491,5 IU/L (sensitivitas 44,4%, spesifisitas 96,2%) untuk onset lambat.Kesimpulan: Kadar LDH maternal yang meningkat berhubungan dengan penurunan skor APGAR satu menit pada pasien preeklampsia, terutama pada kasus onset dini. Hal ini menunjukkan bahwa LDH dapat berfungsi sebagai penanda dini risiko hipoksia dan asfiksia janin.

Gene and Germline Editing in Maternal and Reproductive Health: A Narrative Review of Ethical Dilemmas and Scientific Advances Suhaimi, Donel; Andri, Sofyan; Hutapea, Anastasya; Arihta, Sandi
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

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

A Descriptive Study of Fertility-Related Quality of Life in Women Receiving Infertility Treatment Afifah, Siti Jihan; Lubis, Hilma Putri; Siregar, Irma Sepala Sari; Sari, Mutiara Indah
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.v9i1.1053

Objective: This study aimed to describe fertility-related quality of life among women with infertility who are undergoing fertility treatment at a single tertiary fertility center, based on sociodemographic, clinical, and treatment characteristics.Methods: The study design was descriptive with a cross-sectional approach, using a consecutive sampling technique. The study sample consisted of infertile women undergoing pregnancy programs at Halim Fertility Center (HFC) RSIA Stella Maris Medan and met the inclusion and exclusion criteria. Data were collected using the FertiQoL (Fertility Quality of Life Tool) questionnaire and were presented as a frequency distribution. Results: Of the 60 respondents, most were in the 31–35 age group (38.3%) and were overweight (55%), followed by normal weight (41.7%). Most of them experienced primary infertility (83.3%), with infertility lasting 2–5 years (41.7%), and the most common cause was ovulation disorders (31.7%). Based on the type of pregnancy program, In Vitro Fertilization (76.7%) was the most common procedure. FertiQoL assessment revealed a wide range of fertility-related quality-of-life scores across treatment options.Conclusion: Most women undergoing infertility treatment reported a high fertility-related quality of life (60%), with higher average scores seen in those undergoing in vitro fertilization (58.7%). AbstrakTujuan: Penelitian ini bertujuan untuk menggambarkan tingkat kualitas hidup terkait fertilitas pada wanita infertil yang menjalani program kehamilan berdasarkan karakteristik sosiodemografi, klinis, dan jenis terapi. Metode: Desain penelitian adalah deskriptif dengan pendekatan cross-sectional menggunakan teknik consecutive sampling. Sampel penelitian adalah wanita infertil yang menjalani program kehamilan di Halim Fertility Center (HFC) RSIA Stella Maris Medan serta memenuhi kriteria inklusi dan eksklusi. Data dikumpulkan menggunakan kuesioner FertiQoL (Fertility Quality of Life Tool) dan disajikan dalam bentuk distribusi frekuensi.Hasil: Dari 60 responden, mayoritas berada pada kelompok usia 31 – 35 tahun (38,3%) dan memiliki status berat badan berlebih (55%) dan diikuti normoweight (41,7%). Sebagian besar responden mengalami infertilitas primer (83,3%) dengan durasi infertilitas 2 – 5 tahun (41,7%), dan penyebab tersering adalah gangguan ovulasi (31,7%). Berdasarkan jenis program kehamilan, Fertilisasi In Vitro (76,7%) merupakan prosedur yang paling banyak dilakukan. Pengukuran menggunakan FertiQoL menunjukkan bahwa responden memiliki kualitas hidup yang bervariasi. Kesimpulan: Hasil penelitian menunjukkan bahwa sebagian besar wanita infertil yang sedang menjalani program kehamilan memiliki kualitas hidup tinggi (60%), dengan proporsi tertinggi pada kelompok Fertilisasi In Vitro (58,7%).

Management of Incompletely Staged Endometrial Carcinoma: A Case-Based Review Fakhmi, Muhammad; Kurniadi, Andi
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.v9i1.959

Introduction: Endometrial carcinoma is the most common gynecologic malignancy in developed countries, driven by risk factors such as obesity and unopposed estrogen exposure. Early-stage detection is common due to early symptom onset. Surgical management remains the cornerstone of therapy and serves a dual role in staging the disease. This report presents the initial management of atypical endometrial hyperplasia, evaluation strategies, and treatment planning in a case of advanced-stage endometrial carcinoma with incomplete surgical staging.Case Illustration: A 50-year-old woman presented with persistent vaginal discharge one week following a supracervical hysterectomy and bilateral salpingo-oophorectomy was referred to Hasan Sadikin Hospital Bandung performed for presumed benign disease. Histopathological and immunohistochemical evaluations confirmed the diagnosis of endometrioid adenocarcinoma of endometrial origin. Although chest imaging was negative for distant metastases, further evaluation suggested local extension consistent with FIGO Stage IIIB. Given the incomplete surgical staging and advanced local disease, the patient was referred for multimodal adjuvant therapy consisting of External Beam Radiotherapy (EBRT) and vaginal brachytherapy.Conclusion: Total hysterectomy with bilateral salpingo-oophorectomy and appropriate surgical staging per FIGO guidelines represents the standard treatment for endometrial carcinoma. This case highlights that tailored adjuvant radiotherapy (EBRT and brachytherapy) is critical for effective disease management in incompletely staged high-grade or advanced-stage patients. AbstrakPendahuluan: Karsinoma endometrium merupakan kanker ginekologi yang paling sering terjadi di negara-negara maju, dengan angka kejadian yang terus meningkat secara global. Faktor risiko utama meliputi obesitas, gangguan metabolik, serta paparan estrogen tanpa antagonis progesteron. Deteksi dini sering terjadi karena gejala muncul pada tahap awal penyakit. Penanganan bedah tetap menjadi pilar utama terapi dan sekaligus berperan dalam penentuan stadium penyakit. Laporan ini memaparkan tata laksana awal hiperplasia endometrium atipikal, strategi evaluasi, serta perencanaan terapi pada kasus karsinoma endometrium stadium lanjut dengan staging bedah yang tidak lengkap.Ilustrasi Kasus: Seorang wanita berusia 50 tahun dengan diagnosis karsinoma endometrium dan riwayat histerektomi supraservikal serta salpingoovarektomi bilateral dirujuk ke Rumah Sakit Hasan Sadikin Bandung dengan keluhan keluarnya lendir berwarna kecokelatan dari vagina yang menetap satu minggu pascaoperasi. Pemeriksaan histopatologi dan imunohistokimia mengonfirmasi diagnosis adenokarsinoma endometrioid yang berasal dari endometrium. Tidak ditemukan metastasis pulmonal pada pemeriksaan radiologi. Pemeriksaan laboratorium menunjukkan anemia ringan, leukositosis, dan trombositosis. Diagnosis akhir yang ditegakkan adalah karsinoma endometrium suspek stadium IIIB menurut FIGO. Pasien kemudian dirujuk untuk menjalani radioterapi eksternal (EBRT) dan brakiterapi vagina sebagai terapi adjuvan.Kesimpulan: Histerektomi total disertai salpingoovarektomi bilateral dan staging bedah yang sesuai dengan pedoman FIGO merupakan standar penatalaksanaan karsinoma endometrium. Terapi adjuvan seperti brakiterapi vagina dan EBRT berperan penting dalam penanganan kasus dengan staging yang tidak lengkap, seperti yang dijumpai pada pasien ini.

Unopposed Estrogen and Endometrial Carcinogenesis: Current Concepts Salima, Siti
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.v9i1.1105

Endometrial carcinoma represents the sixth most frequently diagnosed malignancy affecting the female genital tract globally.1 In 2020, approximately 417,000 new cases were identified worldwide, accompanied by an estimated 97,000 related deaths.2 Across Europe, the burden of disease remains substantial, with projections indicating 124,874 newly diagnosed cases and 30,272 deaths in 2022.3-5 The incidence of endometrial cancer continues to increase, largely driven by demographic aging and the rising prevalence of obesity. Over a woman’s lifetime, the risk of developing endometrial cancer is estimated at around 3%, with a median age at diagnosis of 61 years.6 Notably, the global incidence has risen by approximately 132% during the past three decades, underscoring the expanding impact of key risk factors, particularly obesity and population aging.

Uncommon Metastatic Spread of Endometrial Carcinoma to the Posterior Thoracic Wall and Genital Tract in a Young Adult: A Case Report Mawardinata, Phindo; Suardi, Dodi; Harsono, Ali Budi; Homenta, Christian; Sinaga, Ferry Iskandar Kharisma; Susilo, Sulaeman Andrianto; Hernowo, Bethy S.; Harahap, Reza Rinaldy; Lubis, Munawar Adhar
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.v9i1.984

Introduction: Endometrial carcinoma is a common gynecologic malignancy that predominantly affects postmenopausal women. Approximately 15% of cases occur in premenopausal patients, and more than 1% are diagnosed in women younger than 40 years. Distant metastases are uncommon and typically involve lymph nodes, lungs, or liver, whereas cutaneous and genital metastases are exceptionally rare. The micropapillary growth pattern, initially described in breast carcinoma, has also been identified in various organs and is associated with aggressive biological behavior, including frequent lymphovascular invasion and widespread dissemination. Case Report: A case of a 24-year-old woman with a prior history of micropapillary carcinoma excised from the posterior thoracic wall is reported. The patient presented with palpable vulvar and cervical masses. Pelvic MRI and PET-CT revealed stage IV C endometrial carcinoma with extensive dissemination involving the cervix, vulva, vagina, peritoneum, thoracic wall, and pleural cavity. Histopathological and immunohistochemical analyses confirmed endometrioid carcinoma with micropapillary features. Conclusion: This study demonstrates that the rare presentation of micropapillary endometrial carcinoma in a young patient highlights the importance of comprehensive diagnostic evaluation when unusual metastatic sites are encountered, to guide treatment and multidisciplinary management. Abstrak Pendahuluan: Karsinoma endometrium merupakan keganasan ginekologi yang umum dan terutama mengenai wanita pascamenopause. Sekitar 15% kasus terjadi pada pasien pramenopause dan lebih dari 1% pada wanita berusia di bawah 40 tahun. Metastasis jauh jarang terjadi dan biasanya melibatkan kelenjar getah bening, paru, atau hati, sedangkan metastasis ke kulit dan traktus genital sangat jarang dilaporkan. Pola pertumbuhan mikropapiler, yang awalnya dideskripsikan pada karsinoma payudara, juga ditemukan pada berbagai organ dan dikaitkan dengan perilaku biologis agresif, termasuk invasi limfovaskular dan penyebaran luas. Laporan Kasus: Dilaporkan kasus wanita berusia 24 tahun dengan riwayat karsinoma mikropapiler yang sebelumnya dieksisi dari dinding toraks posterior, datang dengan massa vulva dan serviks yang teraba. MRI pelvis dan PET-CT menunjukkan karsinoma endometrium stadium IV C dengan penyebaran luas ke serviks, vulva, vagina, peritoneum, dinding toraks, dan rongga pleura. Pemeriksaan histopatologi dan imunohistokimia menegakkan diagnosis karsinoma endometrioid dengan gambaran mikropapiler.Kesimpulan: Penelitian ini menunjukkan bahwa presentasi langka karsinoma endometrium dengan pola mikropapiler pada pasien usia muda menekankan pentingnya evaluasi diagnostik komprehensif pada lokasi metastasis tidak lazim untuk menentukan terapi dan tata laksana multidisiplin.

The Surgical Approach for Adenomyosis in Nulligravid Women: A Case Report Diputri, Marlina Jaya; Triastuti, Prastika Candra; Priyanto, Edy
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.v9i1.913

Introduction: Adenomyosis is a benign uterine condition characterized by endometrial tissue invasion into the myometrium. This often leading to chronic pelvic pain, dysmenorrhea, and infertility. A meta-analysis in 2025 reported prevalence ranging from 5.9% to 46.0%, with a mean of 20.7%. The Osada triple-flap technique was developed to remove adenomyotic tissue while preserving uterine function, serving as an alternative to total hysterectomy. However, intraoperative findings may require surgical adjustment.Case Report: A 32-year-old woman presented with severe abnormal uterine bleeding. Married for 11 years without children, she had a history of recurrent bleeding, multiple hospitalizations, blood transfusions, and myomectomy. Ultrasound showed an enlarged, globular, and heterogenous uterus with asymmetrical thickening. An exploratory laparotomy was performed with the intention of using the Osada technique, but, due to deep cul-de-sac adhesions and suspected malignancy, the surgery proceeded to total abdominal hysterectomy.Conclusions: Adenomyosis significantlyaffects fertility and uterus-preserving techniques like the Osada method may benefit selected patients. However, in cases with extensive adhesions, distorted anatomy, or suspected malignancy, hysterectomy remains the safest and most definitive treatment. AbstrakPendahuluan: Adenomiosis adalah kelainan jinak pada uterus akibat invasi endometrium ke miometrium. Kondisi ini sering menimbulkan nyeri panggul, dismenore, dan infertilitas. Meta-analisis tahun 2025 melaporkan bahwa prevalensi 5,9% hingga 46,0% (rata-rata 20,7%). Teknik Osada triple-flap dikembangkan untuk mengangkat jaringan adenomyosis sambil mempertahankan fungsi uterus, sebagai alternatif histerektomi total. Namun, temuan intra-operatif dapat mengubah rencana tindakan. Laporan Kasus: Perempuan 32 tahun datang dengan perdarahan uterus abnormal berat. Menikah 11 tahun tanpa anak, riwayat perdarahan berulang, beberapa kali rawat inap, transfusi darah, dan miomektomi. Ultrasonografi menunjukkan uterus membesar dan heterogen. Laparatomi eksplorasi direncanakan dengan teknik Osada (triple-flap), namun karena adanya adhesi dalam dan kecurigaan keganasan, dilakukan histerektomi total. Kesimpulan: Adenomiosis dapat mengganggu kesuburan. Metode preservasi uterus seperti metode Osada bermanfaat pada kasus terpilih, tetapi histerektomi total tetap menjadi pilihan paling aman dan efektif pada kasus kompleks dengan adhesi dan kecurigaan keganasan.

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Wiryawan Permadi

Contact Email obgyniajurnal@gmail.com

Phone -

Journal Mail Official obgyniajurnal@gmail.com

Editorial Address -

Location Kota bandung, Jawa barat INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Wiryawan Permadi

Contact Email
obgyniajurnal@gmail.com

Phone
-

Journal Mail Official
obgyniajurnal@gmail.com

Editorial Address
-

Location
Kota bandung,

Jawa barat

INDONESIA