10 research outputs found
Heterotopic Pregnancy after a Spontaneous Conception: A Case Report
No full textIntroduction: Heterotopic pregnancy (HP) is a rare and potentially life-threatening condition in which an intrauterine pregnancy (IUP) and an ectopic pregnancy (EP) occur simultaneously. Increased awareness and early diagnosis are crucial to preventing complications. This case highlights the importance of timely identification and appropriate management of heterotopic pregnancy.Case report: A 32-year-old G2P1A0 pregnant woman was referred with a suspicion of heterotopic pregnancy. The patient had no prior complaints and had a spontaneous conception, there was no history of in vitro fertilization. At 2 months of gestation, an ultrasound revealed both an intrauterine pregnancy and an ectopic pregnancy. The laparoscopic diagnostic evaluation confirmed an enlarged right horn, requiring a wedge resection of the right horn. The procedure was completed successfully, and the intrauterine pregnancy progressed until term. This resulted in a cesarean section delivery of a healthy female infant weighing 3000 grams.Conclusion: This case underscores the need for a high index of suspicion when diagnosing heterotopic pregnancy, even in asymptomatic patients. Early recognition and surgical intervention significantly improve outcomes. The findings offer valuable insights for clinical practice and highlight the importance of vigilance in the evolving landscape of reproductive medicine.Kehamilan Heterotopik Pasca Konsepsi Spontan: Sebuah Laporan KasusAbstrakPendahuluan: Kehamilan heterotopik (KH) adalah kondisi langka dan berpotensi mengancam jiwa ketika kehamilan intrauterin (KIU) dan kehamilan ektopik (KE) terjadi secara bersamaan. Kesadaran yang lebih tinggi dan diagnosis dini sangat penting untuk mencegah komplikasi. Kasus ini menyoroti pentingnya identifikasi yang tepat waktu dan manajemen yang sesuai dari kehamilan heterotopik.Laporan kasus: Seorang wanita hamil G2P1A0 berusia 32 tahun dirujuk dengan kecurigaan kehamilan heterotopik. Pasien tidak memiliki keluhan sebelumnya dan kehamilan terjadi secara spontan, tanpa riwayat fertilisasi in vitro (IVF). Pada usia kehamilan 2 bulan, pemeriksaan ultrasonografi menunjukkan adanya kehamilan intrauterin dan kehamilan ektopik. Evaluasi diagnostik laparoskopi mengonfirmasi adanya pembesaran tuba kanan sehingga dilakukan reseksi parsial tuba kanan. Prosedur ini berhasil diselesaikan sampai kehamilan intrauterine cukup bulan dan menghasilkan kelahiran bayi Perempuan sehat dengan berat 3000 gram melalui operasi sesar.Kesimpulan: Kasus ini menekankan perlunya tingkat kecurigaan yang tinggi dalam mendiagnosis kehamilan heterotopic termasuk pada pasien yang tidak bergejala. Pengenalan dini dan intervensi bedah secara signifikan meningkatkan hasil klinis. Temuan ini memberikan wawasan berharga untuk praktik klinis dan menyoroti pentingnya kewaspadaan dalam perkembangan ilmu kedokteran reproduksi
Progressivity of Variable Deceleration to Late Deceleration – A Case Report and It’s Implication
No full textIntroduction: Cardiotocography (CTG) records changes in fetal heart rate and their temporal relationship with uterine contractions. This case report specifically highlights the progression of variable deceleration to late deceleration, its implication, and importance of variable deceleration.Case Report: A 42-year-old G4P2A1 patient at 37–38 weeks of gestation presented to our emergency unit with severe preeclampsia (170/110 mmHg) and irregular heart rate (120 – 70 – 110 bpm). We performed CTG and showed baseline 120–130, with no variability and accompanied by deceleration. The first 2 deceleration occur without the same timing as contraction, and the two later occur after contraction. We performed C-section on the patient and healthy female baby.Discussion: This case provides us with a rather unique pattern of CTG where we could see a slight progression from variable deceleration to late deceleration. Deceleration itself represents a reflex response of the fetus to reduce myocardial workload in response to stress; therefore, it can be secondary to cord compression or other causes. As this condition continues, the fetus deceleration progresses to late deceleration, presenting with a more dire condition and severe acidemic condition. Conclusion: Most of the time variable deceleration are classified as “cord compression” decelerations, while most cases of fetal acidemia in labor are due to reduction in uteroplacental perfusion not the compression of cord. Therefore, variable deceleration is an important sign of fetal acidemia, and when such if itis present, we should take the initiative for termination of pregnancy to prevent bad outcomes of the fetus.Progresivitas Deselerasi Variabel ke Deselerasi Lambat–Laporan Kasus dan ImplikasinyaAbstrakPendahuluan:Kardiotokografi merekam perubahan detak jantung janin dan hubungannya dengan kontraksi uterus. Laporan kasus ini hendak menunjukkan perubahan dari deselerasi variabel ke deselerasi lambat serta implikasi dan pentingnya deselerasi variabel.Laporan Kasus: Seorang wanita 42 tahun G4P2A1 gravida 37-38 minggu datang ke IGD dengan preeklamsia berat (170/110 mmHg) dan denyut jantung janin yang irreguler (120 – 70 – 110 x/menit). Setelah dilakukan kardiotokografi didapatkan baseline 120-130, tanpa ada akselerasi dan diikuti deselerasi. Dua deselerasi yang muncul pertama timbul tanpa ada hubungan dengan kontraksi uterus dan dua kontraksi berikut nya terjadi setelah kontraksi. Pasien kemudian dilakukan seksio sesarea dan lahir bayi perempuan sehat.Diskusi: Kasus ini memberikan gambaran kardiotokografi unik dengan adanya progresivitas dari deselerasi variabel ke deselerasi lambat. Deselerasi sendiri merupakan respon fetus terhadap stress dengan menurunkan beban kerja myocardium janin. Hal ini terjadi akibat hipoksia pada janin yang terjadi akibat kompresi tali pusat dan atau penyebab lain. Bila kondisi ini berlanjut menjadi deselerasi lambat maka kondisi fetus akan semakin memburuk dan masuk kedalam asidemia berat. Kesimpulan: Sering kali dalam melihat deselerasi variabel, kita menklasifikasikannya sebagai deselerasi yang disebabkan penekanan tali pusat/cord-compression yang bila dilakukan resusitasi dapat membaik. Akan tetapi mayoritas kasus dari asidemia fetus pada persalinan terjadi akibat penurunan aliran uteroplasental bukan dari kompresi tali pusat. Oleh karena itu deselerasi variabel justru merupakan tanda penting dalam menilai asidemia fetus dan bila ada dalam pemeriksaan karditokografi harus diambil langkah cepat untuk terminasi kehamilan guna mencegah luaran janin yang buruk.Kata kunci : kardiotokografi; deselerasi variabel; asidemia fetu
Pengaruh Masa Pandemi Covid-19 terhadap Operasi Elektif Obstetri dan Ginekologi di RSUP Dr. Hasan Sadikin Tahun 2020-2021
No full textTujuan: Pandemi COVID-19 memengaruhi semua bidang termasuk operasi karena sekitar 19% kematian akibat COVID-19 berhubungan dengan operasi elektif. Studi ini bertujuan untuk melihat pengaruh pandemi COVID-19 terhadap operasi elektif obstetri dan ginekologi (Obgin) di RSUP Dr. Hasan Sadikin (RSHS) Bandung, Indonesia.Metode: Studi ini menyajikan data retrospektif operasi elektif Obgin di RSHS selama dua tahun (Januari 2020 - Desember 2021) kemudian dilakukan analisis. Hasil: Angka pembatalan operasi tahun 2020 adalah 20 (3,6%) dari 561 jadwal operasi: 7 (1,3%) akibat COVID-19 dan 13 (2,3%) penyebab lainnya. Pembatalan operasi tahun 2021 sebanyak 48 (6,5%) dari 737 jadwal operasi: 35 (4,8%) akibat COVID-19 dan 13 (1,7%) penyebab lainnya. Penggunaan ruang rawat intensif (ICU) tahun 2020 (14/541) memiliki angka lebih rendah dibandingkan dengan tahun 2021 (7/689). Tidak ada penjadwalan operasi pada bulan April tahun 2020. Jumlah pembatalan operasi terbanyak terjadi pada periode Mei-Agustus 2021. Pasien yang terdiagnosis COVID-19 dengan komorbid cenderung memiliki nilai CT (cycle threshold) value lebih rendah dan penjadwalan ulang operasi lebih lama. Mortalitas terjadi pada pasien komorbid.Kesimpulan: Jumlah operasi elektif Obgin di RSHS tahun 2021 lebih banyak dibandingkan tahun 2020 meskipun lebih banyak jumlah pembatalan operasi akibat COVID-19. Penggunaan ruang intensif pasca operasi menurun pada tahun 2021. Rekomendasi prioritas operasi dibagi menjadi empat kelompok utama. Edukasi dan konseling mengenai risiko penundaan operasi dibandingkan risiko peningkatan mortalitas dan morbiditas perioperatif akibat COVID-19 perlu disampaikan. Impact Of Covid-19 Pandemic on the Implementation of Elective Obstetrics And Gynecologic Surgery at Dr. Hasan Sadikin Hospital in 2020-2021AbstractObjective: The COVID-19 pandemic affects all fields, including surgery, as 19% of COVID-19 deaths correlate with elective surgery. This study aims to examine the effect of COVID-19 pandemic on obstetrics and gynecology elective surgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia.Methods: This study presented retrospective data on obstetrics and gynecologic surgery at Dr. Hasan Sadikin Hospital for two years (January 2020 - December 2021).Result: The number of surgery cancellations in 2020 was 20 (3.6%) out of 561 scheduled surgeries: 7 (1.3%) due to Covid-19 and 13 (2.3%) other causes. The surgery cancellations in 2021 was 48 (6.5%) of the 737 scheduled surgeries: 35 (4.8%) due to COVID-19 and 13 (1.7%) other causes. Use of intensive care rooms (ICU) in 2020 (14/541) was lower compared to 2021 (7/689). There was no surgery scheduled for April 2020. The highest number of surgery cancellations occurred in the period of May-August 2021. Patients diagnosed with COVID-19 and comorbidities tend to have lower CT (cycle threshold) values and longer surgery rescheduling. Mortality occurs in patients with comorbidities.Conclusion: The number of obstetrics and gynecologic surgery at Dr. Hasan Sadikin Hospital in 2021 was higher than in 2020, although the number of surgery cancellations due to COVID-19 was higher. Use of ICU after elective surgery decreased in 2021. Recommendations for elective surgeries priority during the COVID-19 pandemic were divided into four groups. Education and counseling regarding the risk of surgery delays compared to the risk of increased perioperative mortality and morbidity due to COVID-19 needed to be delivered.Key words: COVID-19, elective surgery, obstetrics, gynecolog
Assessment of Knowledge, Attitude, and Negative Emotions among Gynecologic Oncology Patients during the Coronavirus Disease-19 Pandemic
No full textBACKGROUND: Coronavirus disease-19 (COVID-19) has been declared a world pandemic by World Health Organization (WHO). The ability of COVID-19 to be transmitted quickly causes fear and excessive worry in certain groups of people, such as the elderly and those with chronic diseases, including oncology and gynecology patients and the caregivers around them (family members).
AIM: This study investigates knowledge, attitude, and negative emotions among gynecologic oncology patients and their families during the COVID-19 pandemic at Hasan Sadikin Public Hospital.
METHODS: In this descriptive study, 100 patients with gynecologic malignancies at Hasan Sadikin Hospital, Bandung, Indonesia, were assessed in May 2020–April 2020, who asked for their current knowledge, attitude, as well as negative emotions through Depression Anxiety Stress Scale (DASS-42).
RESULTS: The average age of the respondents in this study was 45.50. There were 31 respondents with low-level knowledge, 36 with moderate-level knowledge, and 33 with a high level of knowledge about COVID-19. Based on the attitude assessment, only 44 respondents (44%) always wore masks, 54 (54%) kept a distance of 1 meter, and 42 (42%) kept away from the crowd. An evaluation using the DASS-42 showed that 3, 4, and 0 subjects experienced severe depression, severe anxiety, and severe stress, respectively.
CONCLUSIONS: All Indonesian citizens must take necessary measures to prevent COVID-19, including wearing masks, maintaining a minimum distance of 1 m, and washing hands. This study found that not all respondents could comply with the health protocols that were carried out to prevent the transmission of COVID-19. Respondents who experienced severe depression and severe anxiety needed further attention to determine whether they required counseling with a psychiatrist
Peran Magnetic Resonance Imaging pada Diagnosis Kanker Serviks yang Menyerupai Kanker Endometrium – Laporan Kasus
No full textPendahuluan: Magnetic resonance imaging (MRI) merupakan modalitas penting dalam diagnosis kanker ginekologi, terutama serviks dan endometrium. Laporan kasus ini bertujuan melihat peranan MRI dalam menentukan asal tumor, keterlibatan parametrium, dan metastasis kelenjar getah bening retroperitoneal.Presentasi Kasus: Pada laporan kasus ini pasien didiagnosis kanker serviks stadium IB3 dengan diagnosis banding kanker endometrium stadium II karena keluhan perdarahan pasca-menopause, massa di serviks bersifat endofitik, dan ukuran uterus membesar. Hasil histopatologi kuretase yaitu endometrioid endometrial carcinoma moderately differentiated Dd/adenocarcinoma cervix. Magnetic resonance imaging (MRI) dilakukan untuk melihat asal tumor dan menetukan stadium. Skor MRI menganalisis tujuh perbedaan fitur: lokasi dan perfusi tumor, penyengatan perifer, massa atau distensi rongga endometrium, invasi miometrium, dan infiltrasi jaringan sekitar; skor 10 didapatkan pada kasus dengan menggunakan sekuens T2WI sagital, DWI-ADC, dan DCE yang menyimpulkan bahwa tumor berasal dari serviks dan telah menginfiltrasi parametrium.Kesimpulan: Skor MRI bisa dijadikan pertimbangan untuk melihat asal tumor (serviks atau endometrium) selain melihat keterlibatan parametrium dan kelenjar getah bening pelvis sehingga diagnosis dan manajemen lebih baik.The Role of Magnetic Resonance Imaging in the Diagnosis of Cervical Cancer Resembling Endometrial Cancer – A Case ReportAbstractObjective: Magnetic resonance imaging (MRI) is an important modality in the diagnosis of gynecological cancer, especially cervical and endometrial cancer. This case report aims to examine the role of MRI in determining tumor origin, parametrial involvement, and retroperitoneal lymph node metastases.Case presentation: In this case report, the patient was diagnosed with stage IB3 cervical cancer Dd/ stage II endometrial cancer due to complaints of postmenopausal bleeding, endophytic cervical mass, and uterine enlargement. The histopathological results of curettage were moderately differentiated endometrioid endometrial carcinoma Dd/adenocarcinoma of the cervix. Magnetic resonance imaging (MRI) is performed to determine the origin of the tumor and its stage. MRI score was analyzed for seven distinct features: tumor location and perfusion, peripheral rim, endometrial cavity mass or distension, invasion of the myometrium, and surrounding organs infiltration; score of 10 was obtained in these cases using sagittal T2WI, DWI-ADC, and DCE sequence which concluded that the tumor was cervical origin and had infiltrated the parametrium.Conclusion: MRI score can be considered to see the origin of the tumor (cervical or endometrial) in addition look for involvement of the parametrium and pelvic lymph nodes so that diagnosis and management will be better.Key words: Magnetic Resonance Imaging, Cervical Cancer, Endometrial Cancer, Gynecological Cancer, Parametrial InfiltrationPendahuluan: Magnetic resonance imaging (MRI) merupakan modalitas penting dalam diagnosis kanker ginekologi, terutama serviks dan endometrium. Laporan kasus ini bertujuan melihat peranan MRI dalam menentukan asal tumor, keterlibatan parametrium, dan metastasis kelenjar getah bening retroperitoneal.Presentasi Kasus: Pada laporan kasus ini pasien didiagnosis kanker serviks stadium IB3 dengan diagnosis banding kanker endometrium stadium II karena keluhan perdarahan pasca-menopause, massa di serviks bersifat endofitik, dan ukuran uterus membesar. Hasil histopatologi kuretase yaitu endometrioid endometrial carcinoma moderately differentiated Dd/adenocarcinoma cervix. Magnetic resonance imaging (MRI) dilakukan untuk melihat asal tumor dan menetukan stadium. Skor MRI menganalisis tujuh perbedaan fitur: lokasi dan perfusi tumor, penyengatan perifer, massa atau distensi rongga endometrium, invasi miometrium, dan infiltrasi jaringan sekitar; skor 10 didapatkan pada kasus dengan menggunakan sekuens T2WI sagital, DWI-ADC, dan DCE yang menyimpulkan bahwa tumor berasal dari serviks dan telah menginfiltrasi parametrium.Kesimpulan: Skor MRI bisa dijadikan pertimbangan untuk melihat asal tumor (serviks atau endometrium) selain melihat keterlibatan parametrium dan kelenjar getah bening pelvis sehingga diagnosis dan manajemen lebih baik.The Role of Magnetic Resonance Imaging in the Diagnosis of Cervical Cancer Resembling Endometrial Cancer – A Case ReportAbstractObjective: Magnetic resonance imaging (MRI) is an important modality in the diagnosis of gynecological cancer, especially cervical and endometrial cancer. This case report aims to examine the role of MRI in determining tumor origin, parametrial involvement, and retroperitoneal lymph node metastases.Case presentation: In this case report, the patient was diagnosed with stage IB3 cervical cancer Dd/ stage II endometrial cancer due to complaints of postmenopausal bleeding, endophytic cervical mass, and uterine enlargement. The histopathological results of curettage were moderately differentiated endometrioid endometrial carcinoma Dd/adenocarcinoma of the cervix. Magnetic resonance imaging (MRI) is performed to determine the origin of the tumor and its stage. MRI score was analyzed for seven distinct features: tumor location and perfusion, peripheral rim, endometrial cavity mass or distension, invasion of the myometrium, and surrounding organs infiltration; score of 10 was obtained in these cases using sagittal T2WI, DWI-ADC, and DCE sequence which concluded that the tumor was cervical origin and had infiltrated the parametrium.Conclusion: MRI score can be considered to see the origin of the tumor (cervical or endometrial) in addition look for involvement of the parametrium and pelvic lymph nodes so that diagnosis and management will be better.Key words: Magnetic Resonance Imaging, Cervical Cancer, Endometrial Cancer, Gynecological Cancer, Parametrial Infiltratio
Wound Dehiscence Following Obstetrics and Gynecology Surgeries: An Observational Study at a Tertiary Hospital in Bandung
No full textIntroduction: Wound dehiscence is a severe postoperative complication that disrupts an abdominal wound closure which can be caused by endogenous or exogenous flora that infect a surgical wound. Many factors are responsible for surgical site infection in obstetric and gynecology patients considering all the basic standards are ideally maintained in tertiary care hospitals. To identify the characteristics of surgical wound dehiscence (SWD) patients who underwent obstetric and gynecological surgeries at Dr. Hasan Sadikin Hospital from 2021 to 2022.Methods: This study utilized a quantitative descriptive approach with a retrospective design. Results: A total of 43 subjects were included in the study and were divided into three groups based on their surgery type: obstetrics (n=11), gynecology (n=7), and gynecological oncology (n=25). The majority of SWD cases were associated with gynecological oncology surgeries. The patients were predominantly aged 18-65 years (88%), had superficial SWD (65%), normal BMI (37%), were non-smokers (67%), had a history of steroid medication usage (63%), received prophylactic antibiotics (63%), underwent elective surgery (58%), had laparotomy surgeries (100%), with a duration of ≥180 minutes (35%), and intraoperative bleeding of ≤1500 cc (63%). The surgical wounds were primarily classified as clean type (47%), and therapeutic antibiotics were administered to the majority of patients (74%).Conclusion: Most of our findings were consistent with existing theories. However, the discrepancies observed in some outcomes can serve as an evaluative tool to assess the adherence of current practices to established guidelines. It is crucial to consider the risk factors for SWD when developing preventive strategies.Dehisensi Luka Pascaoperasi Obstetri dan Ginekologi: Sebuah Studi Observasi di Rumah Sakit Tersier Di BandungAbstrakPendahuluan: Dehisensi luka pascaoperasi merupakan komplikasi serius yang dapat mengganggu penutupan luka di perut yang disebabkan oleh adanya flora bersumber secara endogen atau eksogen yang menginfeksi luka operasi. Banyak faktor yang berperan dalam infeksi daerah operasi walaupun sudah dilakukannya semua standar operasional yang selalu dipertahankan di rumah sakit perawatan tersier. Untuk mengetahui karakteristik pasien dehisensi luka pascaoperasi obstetri dan ginekologi di RSUP Dr. Hasan Sadikin.Metode: Penelitian ini merupakan penelitian deskriptif retrospektif yang menganalisis faktor praoperatif, intraoperatif, dan pascaoperatif dari subjek penelitian. Hasil: Pada studi ini, terdapat 43 subjek yang selanjutnya dikategorikan menjadi tiga kelompok berdasarkan jenis operasinya: obstetri (n=11), ginekologi (n=7), dan onkologi ginekologi (n=25). Sebagian besar kasus berhubungan dengan operasi onkologi ginekologi, berusia 18 - 65 tahun (88%), memiliki dehisensi luka superfisial (65%), indeks massa tubuh normal (37%), bukan perokok. (67%), memiliki riwayat penggunaan obat steroid (63%), menerima antibiotik profilaksis (63%), menjalani operasi elektif (58%), menjalani operasi melalui laparotomi (100%), dengan durasi ≥180 menit (35%), memiliki luka operasi tipe bersih (47%), mengalami perdarahan intraoperative ≤1500 cc (63%), dan mendapatkan antibiotik terapeutik (74%).Kesimpulan: Sebagian besar hasil studi didapatkan sesuai dengan teori yang telah ada. Kesenjangan yang ditemukan pada luaran studi dapat menjadi alat evaluasi untuk menilai ketaatan pada praktik yang dilakukan untuk kemudian dijadikan pedoman praktik. Penting juga untuk mempertimbangkan faktor risiko dari dehisensi luka pascaoperasi ketika akan mengembangkan strategi preventif.Kata kunci: dehisensi luka pasca operasi, faktor risiko, praoperasi, intraoperasi, pascaoperas
Gambaran Karakteristik Klinis dan Histopatologi Kanker Ovarium Anak di RSUP Dr. Hasan Sadikin Bandung
No full textTujuan: Untuk mengetahui gambaran karakteristik klinis dan histopatologi kanker ovarium anak di RSUP Dr. Hasan Sadikin Bandung.Metode: Penelitian ini menggunakan desain penelitian deskriptif. Data dikumpulkan dari rekam medis pasien kanker ovarium anak di RSUP Dr. Hasan Sadikin Bandung tahun 2017–2020.Hasil: Terdapat 22 pasien kanker ovarium anak yang sesuai dengan kriteria inklusi dan eksklusi. Ditemukan pasien kanker ovarium anak paling banyak usia 13–18 tahun sebanyak 13 orang (59,1%), stadium klinis I sebanyak 10 orang (45,4%), histopatologi jenis sel germinal sebanyak 17 orang (77%), dan gejala klinis benjolan pada perut sebanyak 16 orang (33%).Kesimpulan: Kanker ovarium anak di RSUP Dr. Hasan Sadikin Bandung Bandung periode 1 Januari 2017 – 31 Desember 2020 paling sering terjadi pada pasien dengan rentang usia 13–18 tahun, terdiagnosis pada stadium I, karakteristik histopatologi tipe sel germinal, dan memiliki gejala klinis berupa benjolan pada perut.Overview of Clinical Characteristics and Histopathology of Pediatric Ovarian Cancer at RSUP Dr. Hasan Sadikin Bandung AbstractObjective: To determine pediatric ovarian cancer’s clinical characteristics and histopathology at RSUP Dr. Hasan Sadikin Bandung.Methods: This study used a descriptive research design. Data were collected from medical records of pediatric ovarian cancer patients at RSUP Dr. Hasan Sadikin Bandung in 2017 – 2020.Result: 22 pediatric ovarian cancer patients met the inclusion and exclusion criteria. The majority of pediatric ovarian cancer patients were 13-18 years as many as 13 people (59.1%), clinical stage I as many as 10 people (45.4%), histopathological germ cell types as many as 17 people (77%), and clinical symptoms as lumps in the abdomen as many as 16 people (33%).Conclusion: Pediatric ovarian cancer at RSUP Dr. Hasan Sadikin Bandung period 1 January 2017 – 31 December 2020 most occurred in patients aged 13–18 years, diagnosed at stage I, histopathological characteristics of germ cell type, and had clinical symptoms in the form of abdominal lump.Key words: Ovary, Pediatric Ovarian Cancer, Clinical Characteristic, Histopathological Characteristi
Gambaran Faktor Risiko Kanker Endometrium di RSUP Dr. Hasan Sadikin pada Tahun 2020 – 2022
No full textTujuan: Mengetahui faktor risiko pasien kanker endometrium di RSUP Dr. Hasan Sadikin pada Tahun 2020 – 2022.Metode: Penelitian metode deskriptif dengan menggunakan data sekunder. Kriteria inklusi yaitu pasien dengan diagnosis utama kanker endometrium.Hasil: Mayoritas pasien kanker endometrium berusia 50 – 59 tahun (34,8%), multipara (40,9%), Indeks Masa Tubuh ≥25 kg/m2 (33,2%), usia menarche ≥12 tahun (68,8%), tidak memiliki riwayat infertilitas (49,0%), belum menopause (36,4%), tidak memiliki riwayat terapi hormon (74,1%), pasien tidak memiliki riwayat kanker/lynsch syndrome (71,7%), tidak memiliki riwayat keluarga dengan lynch syndrome (75,7%), tidak menggunakan kontrasepsi (42,5%), dan tidak memiliki riwayat hipertensi (72,9%).Kesimpulan: Pasien kanker endometrium di RSUP Dr. Hasan Sadikin Bandung periode tahun 2020 – 2022 ditemukan paling banyak pada rentang usia 50 – 59 tahun, status paritas yaitu multi para (≥2 kelahiran hidup), indeks massa tubuh ≥25 (obesitas), belum menopause, usia menarche ≥12 tahun, tidak memiliki riwayat terapi hormon, tidak terdapat riwayat infertilitas, pasien tanpa riwayat kanker, tidak memiliki riwayat keluarga dengan kanker, tidak menggunakan kontrasepsi, dan tidak memiliki riwayat hipertensi.Overview of Endometrial Cancer Risk Factors at RSUP Dr. Hasan Sadikin in 2020 - 2022AbstractObjective: Indentifying the risk factor of endometrial cancer patients at RSUP Dr. Hasan Sadikin in 2020 - 2022.Method: This research used descriptive method by collecting secondary data. The inclusion criteria was patients with primary diagnosis of endometrial cancerResults: In this research, the majority of endometrial cancer patients were aged 50 - 59 years (34,8%), multiparous (40,9%), with body mass index ≥25 kg/m² (33,2%), menarche age of ≥12 years (68,8%), no history of infertility (49,0%), not menopausal yet (36,4%), no history of hormone therapy (74,1%), no patient history of cancer/Lynch syndrome (71,7%), no family history of lynch syndrome (75,7%), no history of contraceptive use (42,55), and no history of hypertension (72,9%).Conclusion: In 2020 - 2022, endometrial cancer patient in Dr. Hasan Sadikin Central General Hospital Bandung were mostly foung in the aged range 50 - 59 years, multiparous, obesity, not menopausal yet, menarche age of ≥12 years, no history of hormone therapy, no patient and family history of cancer, no history of contraceptive use and hypertension.Key words: Endometrial cancer, risk factor, descriptive stud
Strategies for managing EMA/CO resistant in gestational trophoblastic neoplasia a systematic review and meta analysis
No full textAbstract Objective This systematic review and meta-analysis evaluate the efficacy and safety of salvage regimens in managing EMA/CO-resistant GTN, providing evidence to inform optimal treatment strategies. Methods A literature search was conducted in PubMed, ScienceDirect, Cochrane Library, Google Scholar, and Wiley Online Library until December 27, 2024. Studies on EMA/CO chemoresistance in gestational trophoblastic neoplasia (GTN) were included, and alternative regimens and surgical interventions were also considered. Exclusion applied to non-human studies and those unrelated to EMA/CO chemoresistance. Data extraction and quality assessment followed PRISMA, Cochrane ROB-2, and the Newcastle-Ottawa Scale. A meta-analysis was performed using a random-effects model, with heterogeneity (I²) and publication bias assessed. The study was registered with PROSPERO (CRD42024574582). Results Eight studies met the inclusion criteria, encompassing patients predominantly with advanced-stage (FIGO III-IV) and high-risk GTN. EMA/EP and EP/EMA were the most frequently evaluated salvage regimens, with a pooled complete remission rate of 78.7% (95% CI: 67.4–88.1%) across 84 patients. No significant heterogeneity (I² = 27.05%) or publication bias was detected. Alternative regimens, including BEP, FAEV, and TP/TE, demonstrated favourable remission rates in small cohorts but lacked generalizability. Neutropenia (68%), thrombocytopenia (41%), and anaemia (30%) were the most commonly reported toxicities with EP/EMA. Safety data for other regimens were limited. Conclusion EMA/EP and EP/EMA remain the most effective and well-studied salvage regimens for EMA/CO-resistant GTN, demonstrating high remission rates with manageable toxicity. While alternative regimens such as BEP, FAEV, and TP/TE show encouraging results, their limited evidence base precludes definitive comparison. Further prospective studies are needed to establish optimal salvage strategies and refine toxicity management
Management paradigm for ovarian neuroendocrine carcinoma: a systematic review
No full textAbstract Introduction Neuroendocrine neoplasms (NENs) of the female genital tract are rare, comprising only 1–2% of gynecologic tumors, with ovarian neuroendocrine carcinoma (O-NEC) accounting for less than 1% of all ovarian cancers. Despite its rarity, O-NEC is a highly aggressive tumor with poor prognosis and significant diagnostic complexity, warranting focused clinical attention and demand greater awareness to improve diagnostic and therapeutic strategies. Methods This systematic review analyzed management paradigm for O-NEC through a comprehensive search on the databases PubMed, Science Direct, Wiley, Springer Link, Google Scholar and Cochrane Central Register of Controlled Trials that was performed on August 1st, 2024. Results A comprehensive search on August 1st, 2024, identified 21 eligible studies (6 retrospective cohorts, 12 case reports, 3 case series), encompassing 923 cases of O-NEC. The most common subtypes were small-cell (40%) and large-cell (39.8%) NEC. Most patients presented with advanced-stage (Stage III–IV: 52%). Immunohistochemical markers included synaptophysin (84%), chromogranin A (64.2%), CD56 (69%), and NSE (77.7%). Treatment varied from surgery alone (35%) or surgery plus chemotherapy (32%) being most common. No standardized regimen of chemotherapy was identified with etoposide/cisplatin and paclitaxel/carboplatin were most frequently used. Survival outcomes were poor, with median overall survival ranging from 11 to 23.5 months. The stage at diagnosis was a crucial prognostic factor. Conclusions The O-NEC is a rare, heterogeneous malignancy with diverse histopathology, variable immunohistochemical profiles, and generally poor prognosis. Early-stage disease may be managed with surgery alone, while advanced stages require multimodal treatment including surgery with adjuvant platinum-based chemotherapy. Due to limited cases and predominantly retrospective data, standardized diagnostic and treatment protocols are lacking. Prospective multicenter studies and centralized registries are needed to improve understanding and patient outcomes
