Case Report of a Successful Delivery in a 29-Year-Old Female with History of Purandare Hysteropexy Surgery

BACKGROUND: Pelvic organ prolapse (POP) generally does not contribute to mortality but can worsen the quality of life, because it can cause abnormal bladder, gastrointestinal system, and sexual function disorders which indirectly cause psychosocial stress and emotional disorders such as depression, isolation, and anxiety. The main purpose of surgical action in young women with POP is to reduce complaints such as fecal and urinary incontinence and also sexual disorders, restore normal anatomy structures, prevent recurrence POP, and maintain the ability of pregnancy, labor, and normal menstrual function. Purandare hysteropexy surgery is one of the conservative surgical procedures for POP in productive women with few operative complication, shorter operating time, and minimal bleeding. At present, there is no literature of pregnant women with the mode of delivery that is effective in patients with history of purandare hysteropexy surgery. This case aims to report delivery in patient with a history of purandare hysteropexy surgery. Pregnancy can be maintained up to gestational term age, healthy baby, and no adhesion during surgery. CASE REPORT: A 29-year-old woman in full-term gestational age of her second pregnancy with a history of purandare hysteropexy surgery 1 year ago. During antenatal care patient, an evaluation of fascia sheath with ultrasonography was performed. The method of delivery was through cesarean section. During surgery, there was no intra-abdominal adhesion, the fascia sheath is well-maintained, and lower segment of uterine is covered by anterior fascia sheath. The operation outcome was a healthy baby boy, weighted 2900 g, body length 49 cm with good Apgar score. CONCLUSION: Purandare hysteropexy surgery is one of the conservative surgical management for conservative treatment of uterovaginal prolapse in women of reproductive age group who wish to retain their capacity for childbearing. Pregnancy up to term gestational age, during cesarean section, surgery seen no intra-abdominal adhesion, all sides of fascia sheath are well-maintained and the outcome was a baby with healthy condition

DIAGNOSIS AND MANAGEMENT OF HYPEREMESIS GRAVIDARUM

Hyperemesis gravidarum is excessive nausea and vomiting in pregnant women to interfere with everyday activities because of poor patient's general condition due to dehydration. Studies estimate that nausea and vomiting occurred in 50-90% of pregnancies. Nausea and vomiting occurred in 60-80% of primi gravida and 40-60% of multi gravida. The cause of hyperemesis gravidarum is not known. Hyperemesis gravidarum, according to the severity of symptoms can be divided into three levels. The diagnosis of hyperemesis gravidarum is made through history, physical examination, and laboratory and USG finding. In patients with hyperemesis gravidarum levels II and III must be hospitalization with the provision of medical treatment, nutrition, parenteral fluids, and alternatives medicine. With a good treatment, the prognosis of hyperemesis gravidarum will be satisfying.</p

THE MANAGEMENT OF HIV INFECTION IN PREGNANCY

The Human Immunodeficiency Virus (HIV) is a RNA retrovirus which causes the clinical disease termed the acquired immunodeficiency syndrome (AIDS). Mother-to-child transmission is the main source of spreading HIV infection to the child with frequency is as high as 25-30%. This may occurred because of the intrapartum maternal blood exposure, infected genital tract secretions and during breastfeeding. The right combination of ARV treatment and elective section caesarean delivery has been proved to reduce the mother-to-child transmission of HIV infection prevalence and preventing obstetric complications significantly. Consultation and follow up with specialists is highly recommended.</p

MISOPROSTOL FOR INDUCTION OF LABOR IN TERM PREGNANCY

Induction of labor refers to the process whereby uterine contractions are initiated bymedical or surgical means before the onset of spontaneous labor. Several studies haveshown that continuous intravenous infusion of oxytocin is less efficient, particularlywhen there are unfavorable cervical conditions, leading frequently to a cesarean section,because of induction failure. Misoprostol is a cervical modifying agent and laborinductor. The typical effect of a single dose of oral misoprostol is an increase in uterinetonus. Sustained plasma level of misoprostol is required for the development of regularcontractions appear. The bioavailability of vaginal misoprostol also greater compared tooral, sublingual and rectal administration. Using misoprostol for cervical ripening andlabor induction represented a 47% reduction in the risk of having a cesarean section(risk ratio = 0.53). In cases of unfavorable cervix condition, the use of misoprostolcould produce several beneficial effects compared to other inductor such as oxytocin<br /

ABDOMINAL BLUNT INJURY AMONG PREGNANCY

Pregnancy is an important event that blissful for pregnant women, but it can be changed when bad things happen on the pregnancy. Trauma to the pregnant women is one of the most cause of the non-obstetic tresulting in morbidity and mortality in pregnancy by 6-7% on the whole pregnancy. The death of the fetus even more happened many compared with mortality pregnant at gets reinjured because trauma, which reached 65 %. Unique changes in anatomy and Physiology during pregnancy change the pathophysiology and the location of trauma to pregnant women. For doctors, this poses challenges because care must be devoted to two patients, the mother and fetus that it contains. This can be resolved more easily if the doctors understand the changes in anatomy, Physiology, mechanisms of injury and trauma assessment in pregnant women.  </p

Purandare Hysteropexy in A 32 Years Old Woman with Stage III Pelvic Organ Prolapse and Cesarean History: Case Report

Background: In reproductive age and low-parity women, pelvic organ prolapse is an uncommon case. Although this condition isn’t harmful, giving an appropriate treatment is important while considering women needs. This case report covers about the management of Purandare hysteropexy in a 32 years old woman with stage III pelvic organ prolapse and cesarean section history.Case: Conservative surgical therapy, Purandare hysteropexy, was performed on a reproductive age woman with stage III pelvic organ prolapse who wish to conserve her uterus.Result: Purandare hysteropexy was successfully performed on the patient, and she has better quality of life and minimal complaint after surgery.Conclusion: Purandare hysteropexy is an appropriate conservative surgical therapy, comparable to mesh using surgery, for women of reproductive age with pelvic organ prolapse.Histeropexi Purandare pada Wanita Usia 32 Tahun dengan Prolaps Organ Panggul Derajat III dan Riwayat Seksio Cesarea: Laporan KasusAbstrakLatar Belakang: Prolaps organ panggul adalah kasus yang jarang terjadi pada wanita usia reproduktif atau riwayat paritas rendah. Walaupun kondisi ini tidak berbahaya, terapi yang diberikan harus sesuai dengan keperluan dari wanita. Laporan kasus ini menggambarkan proses manajemen histeropexi purandare pada wanita usia 32 tahun dengan prolaps organ panggul wanita derajat III dan riwayat seksio cesarea.  Kasus: Terapi bedah konservatif, histeropexi purandare, dilakukan pada wanita usia reproduktif dengan prolaps organ panggul derajat III yang masih ingin mempertahankan uterusnya. Hasil: Purandare histeropeksi berhasil dilakukan pada pasien. Pasien mempunyai kualitas hidup dan keluhan yang minimal setelah prolaps organ panggul Kesimpulan: Histeropexi Purandare adalah terapi bedah konservatif, yang sesuai, setara dengan pembedahan yang menggunakan mesh, untuk dilakukan pada wanita usia reproduktif dengan prolaps organ panggul. Kata kunci: prolaps organ panggul, wanita usia reproduktif, purandare, histeropexi

PENUNDAAN PENJEPITAN TALI PUSAT SEBAGAI STRATEGI YANG EFEKTIF UNTUK MENURUNKAN INSIDEN ANEMIA DEFISIENSI BESI PADA BAYI BARU LAHIR

Normal 0 false false false EN-US X-NONE X-NONE Iron Deficiency Anemia in infants is a health problem that is almost in the entire developed world. Iron Deficiency Anemia is an anemia that is common in babies with the highest incidence in 6 to 24 months. The high prevalence of anemia in infants aged 6-9 months is associated with insufficient backup storage of iron in the baby so that it can lead to impaired growth and development within the first 6 months of life. Time of Cord Clamping play an important role in determining the adequacy of iron in the newborn. Cord Clamping is one of active management of the third stage. Delayed Cord Clamping about 2-3 minutes can give the redistribution of blood between the placenta and the baby, giving assistance placental transfusion acquired by infants as much as 35-40 ml/kg and contains 75 mg of iron as sufficient hemoglobin, that fulfill the needs iron newborn babies in first three monthsof his life. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} <![endif]--