Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Cortisol Levels in Chronic Primary Dysmenorrhoea Patients and Non-Dysmenorrhoea : A Cross- Sectional Study: Kadar Kortisol antara Pasien Dismenorea Primer Kronis: Sebuah Studi Potong Lintang
Get PDFObjective: To investigate whether chronic primary dysmenorrhoea will significantly increase cortisol levels in the body. This study can provide an overview of the importance of handling primary dysmenorrhoea so that it does not continue to become menstrual disorders.Method: This study used a cross-sectional comparative study method with a total sample of 26 subjects with 13 subjects included in the dysmenorrhea group and 13 other subjects belonging to the non-dysmenorrhea group. The study was conducted at Department of Obstetrics and Gynecology Faculty of Medicine Universitas Andalas network primary healthcare and Dr. M. Djamil Padang Central General Hospital. Data were analyzed using computational calculation of SPSS program with bivariate test using X2 test or chi-square test with a significance degree of 0.05.Results: Twenty six subjects (13 each group) have been sampled in this study, the mean age of the dysmenorrhea group was 26.23 ± 3.92 while the mean age of the non-dysmenorrhea group was 28.62 ± 7.10. The age difference between groups was not statistically significant with a value of p = 0.30 (p> 0.05). In the comparison of cortisol levels between the two groups, it was found that the dysmenorrhea group had a higher cortisol level of 72.3077 (7.2 µg / dL) compared to the non-dysmenorrhoea group of 60.3846 (6 µg / dL). Based on the results of the bivariate analysis using the chi-square test, the value of p = 0.148 (P> 0.05) showed that there was no significant difference between the cortisol levels of the group with chronic primary dysmenorrhea compared with the non-dysmenorrhea group.Conclusion: Chronic primary dysmenorrhea can not significantly increase cortisol levels in the body.Keywords: comparative study, chronic primary dysmenorrhea, cortisol levels, non-dysmenorrhea, menstrual disorders
Abstrak
Tujuan :Mengetahui apakah dismenorea primer kronis akan meningkatkan kadar kortisol dalam tubuh secara signifikan. Penelitian ini dapat memberikan gambaran pentingnya penanganan dismenorea primer agar tidak berlanjut menjadi gangguan menstruasi.Metode :Penelitian ini merupakan penelitian dengan desain potong lintang studi banding dengan jumlah total sampel sebanyak 26 subjek dengan rincian 13 subjek termasuk ke dalam kelompok dismenore dan 13 subjek lainnya termasuk ke dalam kelompok non-dismenore. Penelitian dilakukan di Puskesmas jejaring PPDS Obgyn FK Unand dan RSUP Dr. M. Djamil Padang. Data dianalisis menggunakan perhitungan komputasi program SPSS dengan uji bivariat menggunakan ujiX2 atau uji chi-square dengan derajat kemaknaan 0,05. Hasil : Dari 26 subjek (masing-masing 13 subjek) yang dijadikan sampel dalam penelitian ini, didapatkan usia rerata kelompok dismenore ialah 26,23 ± 3,92 sedangkan usia rerata kelompok non-dismenore ialah 28,62 ± 7,10. Perbedaan rerata usia antar kelompok ini tidak signifikan secara statistik dengan nilai p = 0,30 (p > 0,05). Pada perbandingan kadar kortisol antar kedua kelompok, didapatkan kelompok dismenore memiliki kadar kortisol yang lebih tinggi yaitu 72,3077 (7.2 µg/dL) dibandingkan dengan kelompok non-dismenorea yaitu 60,3846 (6 µg/dL). Berdasarkan hasil analisis bivariat menggunakan uji chi-square, didapatkan nilai p = 0,148 (P > 0,05) yang menunjukkan tidak adanya perbedaan yang signifikan antara kadar kortisol kelompok dengan dismenore primer kronis dibandingkan dengan kelompok non-dismenore.Kesimpulan : Dismenore primer kronis dapat meningkatkan kadar kortisol dalam tubuh secara signifikan.Kata kunci : dismenore primer, gangguan menstruasi, kadar kortisol, kronis, tidak dismenore, studi perbandinga
Management of Aplastic Anemia in Pregnancy: A Case Report: Manajemen Anemia Aplastic Pada Kehamilan: Laporan Kasus
No full textAplastic anemia was first recognized by Ehrlich in 1888, although the pathogenesis of aplastic anemia has remained elusive. Aplastic anemia is a subtype of anemia characterized by pancytopenia and a hypocellular bone marrow which are the risk factor can be due to chemicals, drugs, infections, irradiation, leukemia, and inherited disorders. There is universal agreement that pregnancy complicated by aplastic anemia is a serious condition. The risk to the mother is mainly in the form of hemorrhage meanwhile the fetus may suffer from growth restriction and even intrauterine death. Most of the fetal complications are due to maternal anemia. We here present one cases of pregnancy complicated by aplastic anemia, which were seen within 3 months at our hospital. This high incidence is because the hospital is a top national care referral unit with good hematology and blood bank support.
Keyword: aplastic anemia, pregnancy, pancytopenia
Abstrak
Anemia aplastik pertama kali dikenali oleh Ehrlich pada tahun 1888, walaupun patogenesis anemia aplastik masih sulit dipahami. Anemia aplastik adalah subtipe anemia yang ditandai dengan pansitopenia dan hiposeluler sumsum tulang yang merupakan faktor risiko yang dapat disebabkan oleh bahan kimia, obat-obatan, infeksi, iradiasi, leukemia, dan kelainan bawaan. Terdapat kesepakatan universal bahwa komplikasi kehamilan berupa anemia aplastik merupakan kondisi serius. Risiko kepada ibu hamil terutama dalam bentuk perdarahan sementara janin dapat mengalami hambatan dalam pertumbuhan dan bahkan kematian dalam kandungan. Sebagian besar komplikasi janin disebabkan oleh anemia pada maternal. Kami di sini menyajikan satu kasus komplikasi kehamilan berupa anemia aplastik, yang ditemukan dalam waktu 3 bulan di rumah sakit kami. Kejadian yang tinggi ini karena rumah sakit adalah unit rujukan perawatan nasional teratas dengan hematologi yang baik dan dukungan bank darah
Quality of Life Assessment in Patient who Underwent Chemotherapy in Gynaecologic Oncology Division: Penilaian Kualitas Hidup pada Pasien yang menjalani Kemoterapi di Divisi Onkologi Ginekologi
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Objective: To determine the quality of life in cancer patients who underwent chemotherapy treatment.Methods: A cross-sectional study was conducted from June to August 2019. Patients with cancer, who had undergone chemotherapy and willing to participate were included in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ–30) questionnaire was used as the measurement tool. The patients were grouped into three groups based on the cycles of chemotherapy.Results: Sixty three responders participated in the study. As the treatment progressed, there was a signifi cant decrease in Global Health Status (GHS) and social function. In symptom scales, there was a signifi cant increase in nausea and vomiting, pain, and insomnia.Conclusions: There was a decrease in the quality of life in patients with gynecological cancer who underwent chemotherapy in dr. Cipto Mangunkusumo National General Hospital. This result should be an evaluation for the healthcare provider to implement a holistic approach in managing cancer patients.Keywords: chemotherapy, gynaecological cancer, quality of life.
Abstrak
Tujuan: Untuk menilai kualitas hidup pasien kanker yang menjalani kemoterapi.Metode: Penelitian dilakukan dengan metode potong lintang, dilakukan dari Juni hingga Agustus 2019. Semua pasien dengan kanker yang menjalani kemoterapi dan bersedia mengikuti penelitian diikutsertakan dalam penelitian ini. Penilaian dilakukan menggunakan kuisioner dari The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ- 30) digunakan. Pasien dikelompokkan menjadi 3 kelompok berdasarkan siklus kemoterapinya.Hasil: Terdapat 63 pasien yang berpartisipasi dalam penelitian ini. Seiring pengobatan, terdapat penurunan signifikan pada global health status (GHS) dan fungsi sosial. Gejala yang meningkat secara signifi kan antara lain mual dan muntah, nyeri, dan insomnia.Kesimpulan: Terdapat penurunan kualitas hidup pada pasien kanker ginekologi yang menjalani kemoterapi di Rumah Sakit Dr. Cipto Mangunkusumo. Hasil penelitian ini menjadi evaluasi untuk penyedia layanan kesehatan agar dapat menangani pasien kanker secara holistik.Kata kunci: kanker ginekologi, kemoterapi, kualitas hidup
Profile of Cesarean Sections Since the BPJS Era: Profil Seksio Sesarea pada Era BPJS
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Objective: to find out the profile of caesarean section in dr. Zainoel Abidin Hospital since the BPJS era.
Methods: This study was a descriptive-observational with retrospective design. The data were obtained in March-April 2017. We collected 3656 data from medical record period January 1st, 2014- December 31st, 2016.
Results: The finding showed there were 1669 vaginal deliveries (45,65%) and 1987 caesarean sections (54,35%). The most frequent causes to caesarean sections were induction failure (49,77%), cephalopelvic disproportion (14,33%), pregnancy induced hypertension (11,21%), malpresentation (8,91), and antepartum haemorrhage (4,33%).
Conclusion: The incidence of caesarean sections in dr. Zainoel Abidin Hospital since the BPJS era was 54,35%, increased by 13,29% than the year of 2011-2013 (41,06%) with the most frequent cause is induction failure (49,77%).
Keywords: Antepartum haemorrhage, BPJS, Caesarean section, Induction failure, Pregnancy induced hypertension, Tertiary referral hospital.
Abstrak
Tujuan: Mengetahui profil persalinan seksio sesarea di RSUD dr. Zainoel Abidin Banda Aceh pada era BPJS.
Metode: Penelitian deskriptif-observasional dengan desain studi retrospektif. Pengambilan data dimulai dari bulan Maret-April 2017. Sebanyak 3656 data dikumpulkan dari rekam medik periode 1 Januari 2014- 31 Desember 2016.
Hasil: Terdapat 1669 kasus persalinan pervaginam (45,65%) dan 1987 kasus seksio sesarea (54,35%). Indikasi terbanyak yang menyertai seksio sesarea adalah gagal induksi (49,77%), cephalopelvic disproportion (14,33%), hipertensi dalam kehamilan (11,21%), malpresentasi (8,91%), dan perdarahan antepartum (4,33%).
Kesimpulan: Angka seksio sesarea di RSUD dr. Zainoel Abidin meningkat 13,29% sejak berlakunya BPJS (1 Januari 2014-31 Desember 2016) mencapai 54,35% dibandingkan tahun 2011-2013 (41,07%) dengan indikasi terbanyak gagal induksi (49,77%).
Kata kunci: Perdarahan Antepartum, BPJS, Seksio sesarea, Gagal Induksi, Hipertensi dalam kehamilan, RS Rujukan Tersier.
 
Side Effects of Misoprostol Per Rectal for Treating Postpartum Hemorrhage in Vaginal Delivery versus Cesarean Section: What Do We Know So Far? Efek Samping Misoprostol Per Rektal untuk Pengobatan Perdarahan Pascasalin
Get PDFObjective: To compare the incidence and profiles of misoprostol’ side effects given per rectal for treating postpartum haemorrhage in vaginal delivery versus cesarean section.Methods: A prospective observational study involving 40 women delivered by vaginal birth (VD) and 40 by cesarean section (CS) was undertaken in a gynecology ward of a hospital in West Java. The incidence of misoprostol’s side effects was identified through patient observation and medical note review. The side effect probability was rated by the panellists of healthcare providers. Patient characteristics and side effect data were summarized descriptively. The incidence rates of misoprostol’s side effect between the two groups were compared using Z-test.Results: Thirty-four patients (85.0%) in the VD group experienced side effects, whilst all CS patients reported at least one side effect. There was no significant difference in the proportion of patients having side effects in the two groups (p=0.366). There were 135 and 164 side effects in the VD group and CS group, respectively. There was no discernible difference in side effect profile between the two groups. Gastrointestinal side effects accounted for the most frequent side effects. Regarding the side effect probability, the panellists rated all side effects in VD patients as probable. Meanwhile, around70% of side effects in CS patients were regarded as probable leaving the remaining as definite.Conclusion: High incidence of misoprostol’s side effects was documented both in VD and CS patients. The incidence rates and side effect profile between the two delivery modes were quite similar.Keywords: cesarean section, misoprostol, postpartum haemorrhage, side effect, vaginal delivery
Abstrak
Tujuan:Membandingkan insiden dan profil efek samping misoprostol per rektal untuk pengobatan perdarahan pascasalin pada persalinan pervaginam versus seksio sesarea.Metode: Penelitian observasional prospektif melibatkan 40 perempuan yang melahirkan melalui persalinan pervaginan (VD) versus 40 pasien melalui seksio sesarea (CS) dilakukan di bangsal ginekologi sebuah rumah sakit di Jawa Barat. Insiden efek samping misoprostol diidentifikasi melalui pengamatan pasien dan kajian rekam medis. Probabilitas efek samping dinilai oleh panel tenaga kesehatan. Karakteristik pasien dan profil efek samping dianalisis secara deskriptif. Proporsi insiden efek samping misoprostol antara dua metode persalinan dibandingkan menggunakan uji Z.Hasil :Tiga puluh empat pasien (85,0%) pasien di kelompok VD mengalami efek samping, sementara semua pasien CS melaporkan setidaknya satu efek samping. Tidak ada perbedaan yang signifikan terkait proporsi pasien yang mengalami efek samping di kedua kelompok (p=0,366). Secara keseluruhan terdapat 135 dan 164 efek samping pada kelompok VD dan CS secara berurutan. Tidak ada perbedaan yang nyata dalam profil efek samping kedua kelompok. Efek samping terkait saluran cerna merupakan efek samping yang palings sering ditemukan. Terkait probabilitas kejadian efek samping, panelis menilai semua efek samping pada kelompok VD sebagai “mungkin”. Sementara itu, sekitar 70% efek samping pada pasien CS dikategorikan “mungkin” dan selebihnya “sangat mungkin”.Kesimpulan :Insiden tinggi efek samping misoprostol ditemukan baik pada pasien VD maupun CS. Proporsi insiden dan profil efek samping cukup seragam pada dua kelompok tersebut.Kata kunci: efek samping, misoprostol, perdarahan pascasalin, persalinan pervaginam, persalinan seksio sesare
Low Vitamin D Levels Increase the Risk of Early Onset Neonatal Sepsis: Kadar vitamin D yang Rendah Meningkatkan Risiko Sepsis Neonatal Awitan Dini
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Objective: To identify the association between maternal and umbilical cord vitamin D levels with suspects of early-onset of neonatal sepsis (EONS) in newborns from mothers with preterm premature rupture of membranes (PPROM).Methods: This is a retrospective cohort study conducted from January 2017 to Augusts 2018. Data was taken consecutively from medical records and previous study data at Dr. Cipto Mangunkusumo and Persahabatan Hospital, Jakarta.Results: From total of 72 infants from mothers with PPROM, 22 infants (31%) were EONS-suspected and 50 infants (69%) were not EONS-suspected. There was a significant association between maternal and umbilical cord vitamin D levels with EONS.Conclusion: There was a significant association between maternal and umbilical cord vitamin D levels with EONS.Keywords: early-onset neonatal sepsis, preterm premature rupture of membrane, vitamin D,
Abstrak
Tujuan: Untuk mengetahui hubungan antara kadar vitamin D maternal dan tali pusat dengan risiko tejadinya Sepsis Neonatal Awitan Dini (SNAD) pada bayi dari ibu dengan Ketuban Pecah Dini (KPD).Metode: Desain penelitian kohort retrospektif secara consecutive sampling. Data diambil dari rekam medis dan data penelitian sebelumnya di Rumah Sakit Umum Pusat Nasional (RSUPN) Dr. Cipto Mangunkusumo dan Rumah Sakit Umum Pusat (RSUP) Persahabatan, Jakarta. Hasil: Dari 72 bayi yang dilahirkan dari ibu dengan KPD, 22 bayi (31%) diantaranya diduga mengalami SNAD, sedangkan 50 bayi lainnya tidak mengalami SNAD. Terdapat hubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD. Kesimpulan:Terdapathubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD.Kata kunci: ketuban pecah dini, sepsis neonatal awitan dini, vitamin
Purse String Double Layer Closure in Cesarean Section (Turan Technique) : a Novel Approach to Reduce Cesarean Scar Defect : Teknik Turan (Penjahitan Dua Lapis Purse String): Pendekatan Terkini untuk Menurunkan Defek Jaringan Parut Bekas Seksio Sesarea
Get PDFObjective : To compare cesarean scar defect incidence and other parameters between Turan technique and Conventional techniqueMethod : Literature ReviewResult : The Turan technique uses a purse-string double-layer closure method, which can shorten the incision length and reduce the incidence of postpartum cesarean scar defect that can be detected by ultrasound. Uterine incisional defects are etiologic factor of postoperative pelvic adhesion, placenta previa and accreta, uterine rupture, abnormal uterine bleeding and dysmenorrhea. This means that decrease in the incidence of uterine incisional defects is essential to prevent cesarean-related complications. In 51 patients in the study group (closure the uterine incision with Turan technique) and 65 patients in the control group collected within 6 weeks postoperative for transvaginal ultrasound, the length of the uterine incision closure in the study group shorter than control group (p= 0.0001, 95% IK = 2,854-6,876). Significantly, the number of patients with cesarean scar defect was 12 (23.5%) in the study group and 39 in the control group (76.5%) with P = 0.0001.Conclusion : Turan technique is new uterine closure method technique on CS. This technique can reduce the incidence of cesarean scar defect.Keyword : Turan Technique, Cesarean Section, uterine incision
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Tujuan : Untuk membandingkan angka kejadian defek jaringan parut uterus dan parameter lain antara teknik Turan dan teknik konvensionalMetode : Kajian PustakaHasil : Teknik Turan menggunakan metode penutupan purse-string double layer, dimana dapat memperpendek insisi dan mengurangi insidensi defek jaringan parut uterus postpartum yang dapat dideteksi dengan ultrasonografi. Defek insisional uterus merupakan faktor etiologi dari adhesi pelvis paska operasi, plasenta previa dan akreta, ruptur uteri, kehamilan ektopik pada parut uterus, perdarahan uterus abnormal dan dismenore. Ini berarti penurunan kejadian defek insisional uterus sangat penting untuk mencegah terjadinya komplikasi terkait seksio sesarea. Pada 51 pasien kelompok studi (teknik Turan) dan 65 pasien pada kelompok kontrol yang dilakukan pemeriksaan ultrasonografi transvaginal 6 minggu paska operasi didapatkan data bahwa panjang insisi uterus lebih pendek pada kelompok studi (P = 0.0001, 95% IK = 2.854–6.876). Secara signifikan, jumlah pasien dengan defek parut bekas operasi (Cesarean Scar Defect) adalah 12 orang (23.5%) pada kelompok studi dan 39 orang pada kelompok kontrol (76.5%) dengan nilai P = 0.0001Kesimpulan : Teknik Turan adalah teknik baru mengenai metode penjahitan pada insisi operasi SC. Secara signifikan tehnik ini mampu menurunkan insidensi defek parut bekas operasi.Kata kunci : Teknik Turan, Seksio Sesarea, Insisi uterus
 
A Preliminary Study: The Effectiveness of CO2 Laser Therapy for Stress Urinary Incontinence: Sebuah Studi Awal: Efektivitas Terapi Laser CO2 sebagai Terapi Inkontinensia Urin Tipe Tekanan
Get PDFObjective: To evaluate the role of fractioned CO2 laser intravaginal as a non-invasive treatment for relieving stress urinary incontinence (SUI) symptoms.Methods: This was a prospective, quasi-experimental study in patients with SUI. The patients were treated through three different sessions in a month apart by the fractioned CO2 laser Femilift©, produced by Alma Lasers. The patients fi lled and completed questionnaires about continence assessment, quality of life, and sexuality before and after therapy based on PISQ-12 and ICIQ-UI questionnaire. Perineometry was performed to prove the outcome.Results: Twenty women were enrolled. At 4 weeks following the third treatment, there was a signifi cant improvement for continence assessment (7.70 ± 4.38 to 4.50 ± 2.88; p < 0.001), quality of life and sexuality (28.13 ± 7.06 to 33.13 ±7.80; p < 0.001), and vaginal perineometer results (37.20 ± 17.24 to 48.80 ± 16.72; p = 0.009).Conclusions: Fractioned CO2 intravaginal laser has a role in improving SUI symptoms.Keywords: fractioned CO2 laser, stress urinary incontinence, vaginal rejuvenation.
AbstrakTujuan: Untuk mengetahui efektivitas terapi laser CO2 terfraksi intravaginal sebagai terapi non-invasif untuk mengurangi gejala inkontinensia urine (IU) tipe tekanan.Metode: Penelitian ini merupakan studi prospektif, quasieksperimental pada pasien dengan inkontinensia urin (IU) tipe tekanan yang mengikuti terapi laser CO2 terfraksi intravaginal tiga sesi berbeda, dengan jarak satu bulan menggunakan laser CO2 terfraksi Femilift© dari Alma Lasers. Subjek mengisi kuesioner mengenai penilaian kontinensia, kualitas hidup dan kehidupan seksual sebelum dan sesudah terapi (kuesioner PISQ-12 dan ICIQ-UI). Selain kuesioner, pemeriksaan perineometri juga dilakukan pada beberapa subjek penelitian untuk membuktikan efektivitas terapi.Hasil: Dua puluh subjek ikut dalam penelitian ini. Penilaian pada minggu keempat setelah sesi terapi ketiga, menunjukkan peningkatan yang signifi kan pada penilaian kontinensia (7.70 ± 4.38 ke 4.50 ± 2.88; p < 0.001), pada kualitas hidup dan kehidupan seksual (28.13 ± 7.06 ke 33.13 ±7.80; p < 0.001), dan pada hasil perineometri (37.20 ± 17.24 ke 48.80 ± 16.72; p = 0.009).Kesimpulan: Terapi laser CO2 terfraksi intravaginal menunjukkan kecenderungan untuk mengurangi gejalainkontinensia urine (IU) tipe tekanan.Kata kunci: inkontinensia urin tipe tekanan, terapi laser CO2 terfraksi intravaginal, vaginal rejuvenation
Serum Vascular Endothelial Growth Factor Levels and Uterine Fibroid Volume: Hubungan Kadar Serum Vascular Endothelial Growth Factor dengan Volume Mioma Uteri
Get PDFBackground: Tumor size is related to variations associated with molecular markers. In recent years, it has been reported that investigation of tumor volume has become very popular. Measurement of uterine fibroids volume is very important for treatment response.
Objective: The aims of this study is to find the correlation of VEGF levels and uterine fibroids volume.
Methods: Observational analytic study was carried out on 80 patients with uterine fibroids indicated myomectomy. Each sample was examined for VEGF levels and volume of myoma tissue post myomectomy was measured by using Archimedes' law. Correlation test using the Spearman test.
Results: A total of 80 samples of patients were examined for VEGF levels and uterine fibroids volume. The median VEGF is 360 pg/mL, the median uterine fibroids volume is 325 ml. The Spearman’s test shows p values ​​(<0.01) and r (0.999).
Conclusion: There is a significant correlation between VEGF levels and uterine fibroids volume. The higher the VEGF level, the greater the volume of uterine fibroids.
Keywords: VEGF, uterine fibroids volume, Archimedes law
*Corresponding author: Rajuddin e-mail: [email protected] dan [email protected]
 
Double Approach (Laparoscopy and Hysteroscopy) Repair of Istmochele (Niche): Pendekatan Ganda (Laparoskopi dan Histeroskopi) untuk Memperbaiki Istmochele (Niche)
Get PDFObjectives: Reported a case demonstrate the double approach repair of niche treatment through the hysteroscopy and laparoscopy technique.Methods: Case report. We reported a case starting from the patient admission untill 3 months postoperative condition.Case: A 33 years old woman came with abnormal uterine bleeding, already got medication and combine oral contraception pill, but the bleeding never stopped. We found a cavity (niche) filled by menstrual blood with thin lower uterine segment (just serous layer) from transvaginal ultrasound. We did hysteroscopy and laparoscopy approach. We illuminated the niche by hysteroscopy, then resected it by laparoscopy. Patient had a day hospital admission and no symptoms anymore after the procedure.Conclusion: Many treatment methods have been described for repair of niche with varies effectivities. Double approach (hysteroscopy and laparoscopy) technique was a minimal access, but optimal approach of niche resection with up to 100% effectivity.Keywords: abnormal uterine bleeding, caesarean scar defect, hysteroscopy, istmochele laparoscopy, niche
Abstrak
Tujuan: Melaporkan sebuah kasus yang menggambarkan pendekatan ganda dalam memperbaiki niche dengan histeroskopi dan laparoskopi.Metode: Laporan kasus. Kami melaporkan sebuah kasus dimulai dari pasien masuk sampai dengan 3 bulan pascaoperasi.Kasus: Perempuan 33 tahun datang dengan perdarahan uterus abnormal, telah diberikan terapi obat dan pil kombinasi, namun perdarahan tidak berhenti. Dari ultrasonografi ditemukan rongga berisi darah menstrusasi dengan segmen bawah uterus yang tipis (hanya lapisan serosa). Kami melakukan pendekatan histeroskopi dan laparoskopi. Dilakukan iluminasi dengan histeroskopi, kemudian reseksi dengan laparoskopi. Perawatan pasien di rumah sakit selama satu hari, dan tidak terdapat keluhan pada pasien setelah tindakan.Kesimpulan: Terdapat banyak metode dalam tata laksana niche dengan efektivitas yang beragam. Pendekatan ganda dengan histeroskopi dan laparoskopi merupakan tehnik dengan akses minimal namun hasil optimal, dengan efektivitas hingga 100%.Kata Kunci: perdarahan uterus abnormal, defek skar sesar, histeroskopi, istmpchele, laparoskopi, niche