http://localhost:8080/xmlui/handle/123456789/1101 2026-04-09T23:02:26Z http://localhost:8080/xmlui/handle/123456789/2855 Title: Prevention and Treatment of Venous Thromboembolism in Pregnancy Authors: Suparman, Erna Abstract: Prevention and Treatment of Venous Thromboembolism in Pregnancy Pencegahan dan Tatalaksana Tromboemboli Vena pada Kehamilan Erna Suparman Department of Obstetrics and Gynecology Faculty of Medicine Sam Ratulangi University Prof. Dr. R. D. Kandou General Hospital Manado, North Celebes Abstract Abstrak Objective: To determine prevention and treatment of venous thromboembolism in pregnancy. Tujuan: Mengetahui bagaimana pencegahan dan tatalaksana tromboemboli vena pada kehamilan. Methods: Literature Review. Results: The diagnosis of TEV, both deep vein thrombosis (DVT) and pulmonary embolism (PE) was clinical and confi rmed by imaging. D-dimers commonly used in the non-pregnant population are less useful in pregnant women. Prevention needs to be done by assessing the risk of TEV in pregnant women and giving thrombophylaxis according to risk. Treatment of TEV in pregnant women mainly uses heparin, either unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Conclusion: The ASH recommends the use of LMWH compared with UFH for the management of acute VTE in pregnancy, in once-daily or divided doses. The recommended method of delivery for pregnant women receiving anticoagulant therapy should be planned delivery. Keywords: vein thromboemboli, deep vein thrombosis, pulmonary embolism, pregnancy. Metode: Kajian Pusataka. Hasil: Diagnosis TEV, baik Deep vein thrombosis (DVT) dan pulmonary embolism (PE) berdasarkan klinis dan dikonfi rmasi dengan pencitraan. D-dimer yang biasa digunakan pada populasi non-hamil kurang berguna pada ibu hamil. Pencegahan perlu dilakukan dengan menilai risiko TEV pada ibu hamil dan memberikan trombofi laksis sesuai dengan risiko. Tatalaksana TEV pada ibu hamil terutama menggunakan heparin, baik unfractionated heparin (UFH) maupun low molecular weight heparin (LMWH). Kesimpulan: ASH merekomendasikan penggunaan LMWH dibandingkan dengan UFH untuk pengelolaan VTE akut pada kehamilan, dalam dosis sekali sehari atau terbagi. Metode persalinan yang direkomendasikan untuk ibu hamil yang menerima terapi antikoagulan harus direncanakan persalinan. Kata kunci: tromboemboli vena, deep vein thrombosis, pulmonary embolism, kehamilan. 2022-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/2854 Title: Treatment Approach for a Rare Case of Cervical Cancer in Pregnancy Authors: Putri, Yuannita I.; Wiranegara, Gumilang Abstract: Treatment Approach for a Rare Case of Cervical Cancer in Pregnancy Pendekatan Terapi pada Kanker Serviks dalam Kehamilan Yuannita I. Putri, Gumilang Wiranegara Badan Pengusahaan Batam Hospital Batam Abstract Abstrak Objective: To add a new overview of cervical cancer in pregnancy and to review several treatment approaches using available guidelines. Tujuan: Untuk menambah gambaran kasus mengenai kanker serviks dalam kehamilan serta membahas pendekatan terapi menggunakan pedoman – pedoman yang ada. Methods: Case report. Case: A 29 years old woman, gravida 3 para 2 in 10 weeks of pregnancy, was presented with vaginal bleeding and bloody vaginal discharge. Ultrasound examination showed a 10 weeks single live intrauterine fetus and a mass on the cervix. The histopathological report revealed a poorly differentiated cervical adenocarcinoma without invasion of lymphovascular space. Patient was diagnosed with cervical carcinoma FIGO stage IB3 in 10 weeks of pregnancy. The patient opted to unpreserved the pregnancy. Radical hysterectomy with fetus in situ and bilateral pelvic lymphadenectomy was performed. Patient was referred to undergo adjuvant radiation therapy. Conclusion: Cervical cancer in pregnancy is a rare and special condition that requires individual planning for the diagnostic and treatment approaches. Keywords: cervical cancer, cervical cancer in pregnancy, fetus in situ hysterectomy, pregnancy, radical hysterectomy. Metode: Laporan kasus. Kasus: Seorang perempuan berusia 29 tahun dengan G3P2 usia kehamilan 10 minggu datang dengan keluhan perdarahan pervaginam dan keputihan bercampur darah. Hasil dari USG menunjukkan adanya janin berusia 10 minggu serta massa pada serviks. Hasil pemeriksaan histopatologi menunjukkan adanya adenokarsinoma serviks berdiferensiasi buruk tanpa invasi limfovaskuler. Pasien didiagnosis dengan kanker serviks stadium FIGO IB3 dalam kehamilan 10 minggu. Pasien setuju untuk dilakukan terminasi kehamilan. Pada pasien kemudian dilakukan laparotomi histerektomi radikal dengan fetus in situ serta limfadenektomi pelvik bilateral. Pasien kemudian dirujuk untuk dilakukan terapi ajuvan dengan radiasi. Kesimpulan: Kanker serviks pada kehamilan merupakan suatu kondisi khusus sehingga perencanaan diagnostik dan manajemen terapi membutuhkan perencanaan secara individual di setiap kasusnya. Kata kunci: Kanker, kanker serviks, kanker serviks dalam kehamilan, kehamilan, , histerektomi radikal, histerektomi dengan fetus in situ. 2022-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/2851 Title: High Random Blood Glucose Level before Surgery as a Risk Factor for Recurrent Event in Epithelial Ovarian Carcinoma Authors: Hapsari, Anggiyasti V.; Iskandar, Teuku M. Abstract: High Random Blood Glucose Level before Surgery as a Risk Factor for Recurrent Event in Epithelial Ovarian Carcinoma Kadar Gula Darah Sewaktu yang Tinggi sebelum Operasi sebagai Faktor Risiko Kejadian Residif pada Pasien Karsinoma Ovarium Tipe Epitelia Anggiyasti V. Hapsari, Teuku M. Iskandar Department of Obstetrics and Gynecology Faculty of Medicine Universitas Diponegoro Dr. Kariadi General Hospital Semarang Abstract Abstrak Objective: To investigate the high random blood glucose level as a risk factor for recurrent disease in EOC patient at Kariadi General Hospital. Tujuan: Untuk membuktikan kadar glukosa darah sewaktu yang tinggi sebagai faktor risiko kejadian residif pada pasien karsinoma ovarium epitelial di RSUP dr. Kariadi. Methods: Sixty six patients diagnosed as EOC in Kariadi General Hospital were divided into 2 groups: 30 patients with recurrent disease and 30 patients without recurrent disease after completing chemotherapy cycles. We analysed correlation between age of diagnosis, tumour mass location, Ca-125 level, histological subtype and random blood glucose level before surgery with recurrent disease. Metode: Enam puluh pasien yang telah didiagnosis sebagai karsinoma ovarium epitelial di RSUP dr. Kariadi dibagi menjadi 2 kelompok: 30 pasien pada kelompok residif dan 30 pasien pada kelompok non-residif berdasarkan evaluasi setelah menyelesaikan siklus kemoterapi. Data yang dianalisis meliputi usia saat terdiagnosis, lokasi tumor, kadar Ca-125, subtipe histologi, kadar gula darah sewaktu (GDS) sebelum operasi dan hubungannya dengan kejadian residif. Results: There is no signifi cantly difference in age of diagnosis, tumour mass location and histological subtypes between two groups. However, recurrent EOC patients have higher Ca-125 level signifi cantly than non-recurrent patients (327.8±250.5 vs 183.5±212.1 respectively; p = 0,01). Mean of random blood glucose level of recurrent patients is also higher than non-recurrent patients signifi cantly (150.5 ±79 vs 110.8 ± 31.1 respectively; p = 0.006). Patient with random blood glucose level > 110 mg/dl have 3 times more likely to develop recurrence in EOC patient signifi cantly with 95% CI. Hasil: PTidak terdapat perbedaan yang bermakna dalam usia saat diagnosis, lokasi tumor dan subtipe histologis diantara kedua kelompok. Namun, kelompok pasien residif memiliki kadar Ca-125 yang lebih tinggi secara bermakna dibandingkan kelompok pasien non-residif (327,8 ± 250,5 vs 183,5 ± 212,1; p = 0,01). Rerata kadar GDS pada kelompok pasien residif juga lebih tinggi secara bermakna daripada kelompok non-residif (150,5 ± 79 vs 110,8 ± 31,1; p = 0,006). Pasien dengan kadar GDS > 110 mg/dl memiliki risiko 3 kali lipat untuk menjadi residif secara bermakna dengan tingkat kepercayaan 95%. Conclusion: The mean of random blood glucose level in recurrent EOC patients is signifi cantly higher than nonrecurrent EOC patients. Patient with random blood glucose level > 110 mg/dl have 3 times more likely to develop recurrence in EOC patient. Kesimpulan: Rerata kadar GDS pada kelompok pasien residif lebih tinggi secara bermakna dibanding kelompok pasien non-residif. Pasien dengan kadar GDS > 110 mg/dl memiliki risiko 3 kali lipat untuk menjadi residif. Keywords: cepithelial ovarian cancer, random blood glucose level, recurrent. Kata kunci: kadar gula darah sewaktu, karsinoma ovarium epitelial, residif. 2022-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/2849 Title: The Efficacy of Chemotherapy in Advanced-Stage Cervical Cancer on Vitamin A Serum Authors: Nurwany, Raissa; Sanif, Rizal; Noviliani, Amirah; Theodorus, Theodorus Abstract: The Effi cacy of Chemotherapy in Advanced-Stage Cervical Cancer on Vitamin A Serum Efektivitas Kemoterapi pada Karsinoma Serviks Stadium Lanjut terhadap Serum Vitamin A Raissa Nurwany, Rizal Sanif, Amirah Noviliani, Theodorus Department of Obstetrics and Gynecology Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Husein General Hospital Palembang Abstract Abstrak Objective: To determine the effi cacy of neoadjuvant chemotherapy on changes of vitamin A serum in advanced cervical carcinoma patient. Tujuan: Untuk mengetahui efektivitas kemoterapi neoadjuvan terhadap perubahan kadar serum vitamin A pada karsinoma servik stadium lanjut. Methods: A randomized clinical trial was performed in the Oncology Gynecology Polyclinic and Ward of Dr. Mohammad Hoesin General Hospital, Palembang from September 2019 to September 2020. There were 30 subjects of advanced cervical carcinoma. Vitamin A levels and tumor volume subjects were assessed before and 1 month after 3 cycles of NAC and analyzed using the Paired T Test and Wilcoxon test. The correlation between vitamin A levels and tumor volume was analyzed by using Spearman's Rho test. Data analysis was using SPSS version 22.0. Metode: Penelitian uji klinik tanpa pembanding telah dilakukan di Poliklinik dan Bangsal Onkologi Ginekologi RSUP Dr. Muhammad Hoesin Palembang sejak September 2019 hingga September 2020. Didapatkan 30 sampel karsinoma serviks stadium lanjut. Kadar vitamin A dan volume tumor dinilai sebelum dan 1 bulan setelah 3 siklus NAC dan dianalsis menggunakan uji Paired T Test dan Wilcoxon. Korelasi antara Kadar vitamin A dan volume tumor sampel dianalisis menggunakan uji Spearman Rho’s. Analisa data menggunakan SPSS versi 22.0. Results: This study showed statistically not signifi cant increase on vitamin A levels after 3 cycles of NAC chemotherapy (p=0.515). However, there was a signifi cantly decrease in tumor volume after 3 cycles of NAC (p=0.000). In addition, there was a moderate negative correlation between tumor size and vitamin A (r=-0.475; p=0.008). Hasil: Pada penelitian ini terdapat peningkatan tidak signifi kan kadar vitamin A setelah kemoterapi (p = 0,515). Terdapat penurunan secara signifi kan volume tumor sebelum dan sesudah kemoterapi NAC 3 seri (p = 0,000). Selain itu, didapatkan korelasi negatif sedang yang bermakna antara ukuran tumor dan kadar vitamin A ( r = -0,475 ; p = 0,008). Conclusion: It can be concluded that there was signifi cantly decrease in tumor volume after 3 series NAC chemotherapy and the smaller tumor size, the higher level of vitamin A serum. Kesimpulan: Disimpulkan bahwa terdapat penurunan volume tumor setelah kemoterapi NAC 3 series dan semakin kecil ukuran tumor maka semakin tinggi kadar vitamin A dalam serum. Keywords: cervical cancer, neoadjuvant chemotherapy, randomized clinical trial, vitamin A. Kata kunci: kanker serviks, kemoterapi neoadjuvan, uji klinik tanpa pembanding, vitamin A. 2022-04-01T00:00:00Z