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Placenta accreta spectrum (PAS) is characterized by abnormal invasion of placental tissue into the underlying uterine muscles and has an incidence of 1/533–1/251. The incidence of complications includes uterine rupture (14–29%), PAS (6–10%), and retained placenta or incomplete placenta removal (4%). Here, we described a rare case of PAS and angular pregnancy, including how to diagnose and manage it preoperatively. A 32-year-old primigravida diagnosed at 24 weeks of gestation with a right angular pregnancy was admitted due to preterm premature rupture of membrane (PPROM) with a singleton fetus. We decided to perform hysterotomy because of the PPROM and intrauterine infection. Intraoperatively, we found PAS in the right angular pregnancy; therefore, we performed uterine conservative management with wedge resection on the right uterine fundus. Intraoperative bleeding was 1,600 cc. Histopathological examination revealed placenta increta. The maternal prognosis was good, while the fetus was poor, with an APGAR score of 1/1/0.

This research aims to shed light into congenital heart diseases, the pathophysiology, and the ultrasonographic findings of congenital heart diseases. Congenital heart diseases are a major health concern, affecting 1.35 million children born every year. Ventricular septal defect, atrial septal defect, and atrioventricular septal defect are found in 57.9% cases of congenital heart diseases. The risk factors include consanguineous marriage, family history of congenital heart diseases, old maternal and paternal age, and exposure to teratogens, and genetic factors. Missteps in cardiac development are the main pathophysiology of congenital heart diseases. Ultrasonography screening in 18–22 weeks gestational age is utilized to screen. Follow-up screening can increase detection rate to 80%. This study has limitation of only discussing most common congenital heart diseases and did not delve into rarer types of congenital heart diseases and did not discuss impacts or burden of congenital heart diseases in adulthood and health comorbidities associated. This literature review is beneficial for general practitioners and obstetricians focusing in maternal fetal medicine.

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Objective: To determine the correlation between risk factors and the incidence of postpartum urinary retention (PUR) at RSUP Dr. Mohammad Hoesin Palembang. Method: Analytical observational study with cross sectional design to find out the correlation between risk factors and incidence of PUR at emergency room, delivery room and ward at dr. Mohammad Hoesin General Hospital Palembang since October 2018 to April 2019. There were 82 samples that met inclusion criteria. The correlation between risk factors and the incidence of urinary retention was analyzed using Chi Square test/ Fisher Exact test, and the most important risk factor was determined using the Logistic Regression test. Data analysis used SPSS version 22.0. Result: In this study, it was found that there was a significant relationship between prolonged second stage of labor (PR=40.75, p=0.000), type of labor (PR=9.028 CI 95% 2.114–38.558; p=0.004 ) and perineal laceration (PR=12.938 CI95% 1.872–89.414; p=0.016) with PUR. However, there was no significant relationship between age, parity, neonatal birth weight, episiotomy, vulvar edema and urinary retention (p>0.05). It was concluded that instrumental delivery had a significant effect on the incidence of urinary retention (PR=13,541 CI95% 2.381–77.018, p value=0.003) by using logistic regression test.Conclusion: The most important risk factor of urinary retention was instrumental delivery.Keywords:   instrumental delivery, perineal laceration, postpartum urinary retention, type of labor   Abstrak Tujuan: Untuk mengetahui hubungan antara faktor risiko dan kejadian retensio urine pascasalin di RSUP Dr. Mohammad Hoesin Palembang.Metode: Penelitian observasional analitik dengan desain potong lintang untuk mengetahui hubungan antara faktor risiko dan kejadian retensio urine pascasalin di IGD, kamar bersalin dan bangsal perawatan RSUP Dr. Mohammad Hoesin Palembang sejak Oktober 2018 sampai April 2019. Didapatkan 82 sampel yang memenuhi kriteria inklusi. Hubungan antara faktor risiko dan kejadian retensio urine dianalisis menggunakan uji Chi Square/Fisher Exact, sedangkan untuk mengetahui faktor risiko yang paling berperan menggunakan uji regresi logistik. Analisis data menggunakan SPSS versi 22.0.Hasil: Pada penelitian ini, didapatkan hubungan yang signifikan antara lama kala II (PR=40,75, p=0,000), jenis persalinan (PR=9,028 IK95% 2,114–38,558; p=0,004), laserasi perineum (PR=12,938 CI95% 1,872–89,414; p=0,016), dan retensio urine pascasalin. Namun, didapatkan hubungan yang tidak signifikan antara usia, paritas, BBL bayi, episiotomi, edema vulva, dan kejadian retensio urin (p>0,05). Dengan uji regresi logistik, didapatkan kesimpulan bahwa jenis persalinan dengan instrumen berpengaruh secara signifikan terhadap kejadian retensio urine (PR = 13,541 IK95% 2,381–77,018, p value = 0,003).Kesimpulan: Faktor risiko yang paling berperan terhadap kejadian retensio urine pascasalin adalah persalinan dengan instrumen.Kata Kunci: jenis persalinan, instrumen, laserasi perineum, retensio urine pascasalin