HighlightsWe report a rare case of pelvic pain in adult.The pelvic pain was caused by Herlyn-Werner-Wunderlich Syndrome.The main diagnostic tool was MRI.The problem was overcame with excision of the septum.We report a complete investigation and management of Herlyn-Werner-Wunderlich Syndrome.
Background: Morbidly adherent placenta is a condition which placenta adheres and invades deeply into the myometrium and, in some cases, until uterine serosa, thus contribute to peri-partum hemorrhage and significant maternal mortality.Purpose: To identify prevalence, clinical characteristics and their odds ratio to increasing se-verity of morbidly adherent placenta case in RSUP Persahabatan from 2015 to 2018Methods: Cohort retrospective studyResults: From 2015 to 2018, prevalence of morbidly adherent placenta was around 0.8%. The risk factors which contribute to increasing severity of morbidly adherent placenta were: age above 35 years (OR 1.6, 95% CI 0.41-6.24) and history of Caesarean section more than 2 times (OR 1.63, 95% CI 0.41-6.46). The presence of increasing severity of morbidly adherent placenta were related to volume of blood loss more than 1000 ml during surgery (OR 2.13, 95% CI 0.52-8.76). Conclusion: The prevalence of morbidly adherent placenta at Persahabatan General Hospital in 2015-2018 was 0.8%. Age, history of Caesarean section more than 2 times, volume of blood loss, and duration of surgery were not statistically associated with adherent placenta case.
Background: Multi-drug-resistant Tuberculosis (MDR-TB) remains a public health problem in developing countries such as Indonesia. The extensive parenchymal damage due to MDR-TB could manifest as an irreversible destroyed lung, leading to respiratory and also cardiovascular complication. Its occurrence in pregnancy is uncommon but is highly associated with higher mortality and morbidity for both maternal and fetal. Case Report: We report a case of 24 year old primigravida in National Respiratory Center Hospital, diagnosed with an unilateral destroyed lung due to MDR-TB in pregnancy at 32 weeks of gestational age. On initial presentation, she reported fatigue, nausea, night sweats, chronic dyspnoe and was found to have complete left destroyed lung. Her disease was managed during pregnancy using long-term oxygen therapy despite persistent desaturation. Conlusion: Aside from frequent monitoring, prolonged oxygen therapy might benefit the chronic hypoxia condition in gestational destroyed lung due to previous MDR-TB infection, for preventing maternal-fetal mortality and morbidities, such as respiratory failure and IUGR. Tuberkulosis MDR rekuren dengan Kerusakan paru unilateral dalam kehamilan : Sebuah laporan kasus Abstrak Latar Belakang: Tuberkulosis Multi-drug-resistant (TB-MDR) tetap menjadi masalah kesehatan pada negara berkembang, seperti Indonesia. Kerusakan parenkin luas yang diakibatkan oleh infeksi TB-MDR dapat bermanifestasi sebagai kerusakan paru ireversibel, dengan komplikasi respiratorik dan kardiovaskular. Kejadian kerusakan paru akibat TB-MDR dalam kehamilan jarang terjadi, namun berdampak pada peningkatan mortalitas dan morbiditas pada janin dan ibu. Laporan Kasus: Studi ini melaporkan kasus perempuan primigravida 24 tahun didiagnosa dengan kerusakan paru unilateral akibat infeksi TB-MDR pada kehamilan 32 minggu di RS Pusat Paru Nasional. Pada pemeriksaan awal, didapatkan pasien mengeluhkan kelelahan kronik, nausea, keringat malam, sesak kronik dan didapatkan memiliki kerusakan paru kiri komplit. Keadaan pasien dalam kehamilan ditatalaksana dengan terapi oksigen jangka panjang untuk mengatasi desaturasi persisten Kesimpulan: Di samping pengawasan ketat, terapi oksigen jangka panjang dapat menjadi tatalaksana utama untuk kondisi hipoksia kronik pada kerusakan paru dalam kehamilan akibat infeksi lama TB-MDR untuk mencegah morbiditas dan mortalitas ibu dan janin, seperti gagal napas dan pertumbuhan janin terhambat (PJT).
Background: Multi-drug-resistant Tuberculosis (MDR-TB) remains a public health problem in developing countries such as Indonesia. The extensive parenchymal damage due to MDR-TB could manifest as an irreversible destroyed lung, leading to respiratory and also cardiovascular complication. Its occurrence in pregnancy is uncommon but is highly associated with higher mortality and morbidity for both maternal and fetal. Case Report: We report a case of 24 year old primigravida in National Respiratory Center Hospital, diagnosed with an unilateral destroyed lung due to MDR-TB in pregnancy at 32 weeks of gestational age. On initial presentation, she reported fatigue, nausea, night sweats, chronic dyspnoe and was found to have complete left destroyed lung. Her disease was managed during pregnancy using long-term oxygen therapy despite persistent desaturation. Conlusion: Aside from frequent monitoring, prolonged oxygen therapy might benefit the chronic hypoxia condition in gestational destroyed lung due to previous MDR-TB infection, for preventing maternal-fetal mortality and morbidities, such as respiratory failure and IUGR. Tuberkulosis MDR rekuren dengan Kerusakan paru unilateral dalam kehamilan : Sebuah laporan kasus Abstrak Latar Belakang: Tuberkulosis Multi-drug-resistant (TB-MDR) tetap menjadi masalah kesehatan pada negara berkembang, seperti Indonesia. Kerusakan parenkin luas yang diakibatkan oleh infeksi TB-MDR dapat bermanifestasi sebagai kerusakan paru ireversibel, dengan komplikasi respiratorik dan kardiovaskular. Kejadian kerusakan paru akibat TB-MDR dalam kehamilan jarang terjadi, namun berdampak pada peningkatan mortalitas dan morbiditas pada janin dan ibu. Laporan Kasus: Studi ini melaporkan kasus perempuan primigravida 24 tahun didiagnosa dengan kerusakan paru unilateral akibat infeksi TB-MDR pada kehamilan 32 minggu di RS Pusat Paru Nasional. Pada pemeriksaan awal, didapatkan pasien mengeluhkan kelelahan kronik, nausea, keringat malam, sesak kronik dan didapatkan memiliki kerusakan paru kiri komplit. Keadaan pasien dalam kehamilan ditatalaksana dengan terapi oksigen jangka panjang untuk mengatasi desaturasi persisten Kesimpulan: Di samping pengawasan ketat, terapi oksigen jangka panjang dapat menjadi tatalaksana utama untuk kondisi hipoksia kronik pada kerusakan paru dalam kehamilan akibat infeksi lama TB-MDR untuk mencegah morbiditas dan mortalitas ibu dan janin, seperti gagal napas dan pertumbuhan janin terhambat (PJT).
Asthma in pregnancy can influence clinical status of an asthma patient. Study showed that one third of asthma patients were worsening, one third stable and one third improving. During pregnancy, lung function, ventilation pattern and gas diffusion are influenced by biochemistry (hormonal) and mechanic. Mechanism in pregnancy with asthma including hypoxia, inflammation, corticosteroids therapy, history of exacerbation, smoking mother and changes in placenta function. Hormonal status during pregnancy is different with non-pregnancy woman which hormonal level changes through the pregnancy time. Those changes can influence lung function in pregnancy. Treatment of asthma in pregnancy is giving optimal asthma therapy, therefore it can improve asthma control, also the quality of life of a mother and her fetus during pregnancy.
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