Background Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory condition with multi-organ involvement predominantly affecting young women. There are very limited studies in pregnancy in Asian SLE patients and therefore we embarked on this study to identify pregnancy outcomes of Malaysian women with SLE. Materials and methods We performed a retrospective study of pregnancy outcomes in SLE patients in our institution from January 2007 to December 2014. A total of 71 pregnancies from 44 women were analysed. Results The mean age of our cohort was 30.5 ± 3.9 years. The rate of active disease at conception, antiphospholipid syndrome and lupus nephritis were 22.5%, 32.4% and 57.7% respectively. SLE flare occurred in 33 out of 71 pregnancies whereas 19 pregnancies were complicated with preeclampsia. The livebirth rate for our cohort was 78.9%, whilst preterm delivery was 42.9%. On univariate analysis, active disease and flare in pregnancy were both strongly associated with foetal loss and preterm delivery. Lupus nephritis (p = 0.011), SLE flare (p = 0.008) and antiphospholipid syndrome (p = 0.032) significantly increased the risk of preeclampsia. Aspirin and hydroxychloroquine were protective against foetal loss [odds ratio (OR) 0.12] and preeclampsia (OR 0.25), respectively. On multivariate analysis, active disease was a predictor of SLE flare (p = 0.002) and foetal loss (p = 0.018) and SLE flare was the main predictor of preterm delivery (p = 0.006). Conclusions Pregnancies in women with SLE should be planned and aspirin and HCQ use were beneficial in reducing adverse pregnancy outcomes.
Background: Worldwide, the population explosion and unintended pregnancies pose serious health issues. The family planning program is a vital element due to reducing population growth. Demographic data and family planning in Indonesia report that contraceptive use rates are 93.66% for women and 6.34% for men. Men's participation in family planning programs remains low, with options limited to vasectomy and condoms. Limited contraceptive options may explain the low participation rate. WHO recommends traditional medicine as a cost-effective substitute for manufactured medicines. The primary ingredient in turmeric, Curcumin, has antiviral, antibacterial, anti-inflammatory, and anticancer activities. In both animal and human clinical trials, it has demonstrated a lack of toxicity. Little research has been done on how it affects the male reproductive. Objective: This article reviews the literature regarding the effects of Curcumin in Curcuma Longa on male fertility. Conclusion: Curcumin in Curcuma Longa causes noticeable changes in the male reproductive system that reverse when treatment is discontinued. Therefore, Curcumin may potentially control male fertility as a male contraceptive.
Background: The common location of Endometriosis is in genitalia organs, for instance, the ovary, uterus, fallopian tube, and sometimes even in the intestine, bladder, and in rare locations such as the navel, lungs, or brain. Umbilical Endometriosis is the most irregular form of Endometriosis and the most common cutaneous form of Endometriosis. Primary umbilical endometriosis diagnosis is often biased and delayed; the exact etiopathology remains unclear. Our case report discusses the diagnosis and management options for this rare disease. Case presentation: We reported a Primary Umbilical Endometriosis case, confirmed by a history of the nodule with pain, swelling, and bleeding at the umbilicus, which occurs during menstruation. The nodule was surgically removed, and histopathological analysis shows fibromycsoid tissue with multiple forms of subepithelial endometrial glands and surrounding stroma, confirmed as Endometriosis. Conclusion: The definitive treatment for umbilical Endometriosis is surgical excision with total removal of the umbilicus. The prognosis is good, and the recurrence rate is meager if complete excision is successfully performed.
Objective: To determine the relationship between the history of cesarean section and the incidence of placenta accreta in Dr. Zainoel Abidin Hospital Banda Aceh. Methods: The data collection method used was secondary data collection which was assessed through retrospective medical records. Sampling in this study using total sampling method. The results of the study were processed using the chi square statistical test on 781 research samples that were collected from period April 2019 - April 2020. Results: The results obtained were 22 respondents (2.8%) experienced placenta accreta where 18 respondents (2.30%) had placenta accreta with a history of CS and 4 respondents (0.51%) placenta accreta without a history of CS. The p value obtained was 0.000 (p value <0.05). In this study, the value of the Risk Estimate (RE) was 6.483 with a Confident Interval (CI) of 95% being (2.21-18.97). Conclusions: There is a very significant relationship between the history of cesarean section and the incidence of placenta accreta at RSUDZA Banda Aceh and mothers with a history of CS have a 6 times greater risk of experiencing placenta accreta. Keywords: cesarean section, placenta accrete. Abstrak Tujuan: Untuk mengetahui hubungan riwayat seksio sesarea dengan kejadian plasenta akreta di Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh. Metode: Jenis penelitian ini adalah penelitian analitik dengan desain potong lintang. Metode pengambilan data yang digunakan adalah pengambilan data sekunder yang dinilai melalui rekam medik secara retrospektif. Pengambilan sampel pada penelitian ini menggunakan metode total sampling. Hasil penelitian diolah menggunakan uji statistik chi square terhadap 781 sampel penelitian yang telah dikumpulkan dari data periode April 2019 – April 2020. Hasil: Hasil yang didapatkan sebanyak 22 responden (2,8%) mengalami plasenta akreta dimana 18 responden (2,30%) plasenta akreta dengan riwayat SC dan 4 responden (0,51%) plasenta akreta tanpa riwayat SC. Nilai p value yang didapatkan adalah 0.000 (p value <0,05). Pada penelitian ini didapatkan nilai Risk Estimate (RE) 6,483 dengan Confident Interval (CI) 95% berada (2,21- 18,97). Kesimpulan: Hasil ini menunjukkan terdapat hubungan yang sangat signifikan antara riwayat seksio sesarea dengan kejadian plasenta akreta di RSUDZA Banda Aceh dan ibu dengan riwayat SC memiliki risiko 6 kali lebih besar untuk mengalami plasenta akreta. Kata kunci: plasenta akreta, seksio sesarea.
Introduction: A trial of labor after a cesarean (TOLAC) section is a maternal choice with previous caesarian section. However, for those with 2 previous scars, there are pros and cons to allowing the patient for vaginal birth after caesarian section (VBAC) in view of increasing complications. The incidence of SC in Indonesia has been increasing over the year. In addition, several studies have shown an increased risk of problems in subsequent pregnancies in mothers with a history of cesarean section. Thus VBAC in 2 previous scars becomes a alternative choice for a certain patient. Case Illustration: We reported 3 cases of TOLAC; Three of the cases were planned for vaginal birth after caesarian section (VBAC) since prenatal periode Case 1: A 30-year-old woman, G3P2, 39 weeks with two times previous cesarean section. Cardiotocography was normal. The patient was closely monitoring the signs of uterine rupture during labor, and after 7 hours, she had a successful VBAC without complication. Born female baby with body weight 4000 with a good, mother and baby were in good condition. Case 2: A 38-year-old woman, G6P4A1, 41 weeks pregnant with two previous vaginal deliveries and had two previous CS before the current pregnancy. The patient was closely monitored of vital signs and signs of uterine rupture. Cardiotocography is normal. After 8 hours later, she had a successful VBAC without complication, born a male baby with a body weight of 3500gr, with good APGAR score. Case 3: A 35-year-old woman, G3P2A0, had two previous CS admitted at 39 in the latent phase of labor with a cervical dilatation of 2 cm. The labor progressed to second stage after 9 hours. After a hour attempted to conduct delivery, the fetus was still not delivered. Catheterization was performed and found haematuria and proceded with emergency CS due to suspect a uterine rupture. Intraoperatively, the uterine rupture was noted at lower anterior of uterine corpus size 2x1 cm and a repair was performed Conclusion: VBAC can be considered in patients with two previous c-sections with after proper selection, close monitoring and adequate counseling. Prenatal care is a concern for pregnant women to prevent complications and reduce maternal and fetal morbidity and mortality. The VBAC decision returned to personalization and adequate assessment and counseling are mandatory.
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