HIGHLIGHTS1. Uterus couvelaire, also known as uteroplacental apoplexy, is one of the causative post-partum haemorrhage and peripartum hysterectomy.2. The pathophysiology of uterus couvelaire are bleeding in the layer between the decidua-placenta, which then develops and infiltrates into the uterine wall.3. The uterine couvelaire is associated with placental abruption, placenta previa, coagulopathy, pre-eclampsia, uterine rupture, and amniotic fluid embolism.4. This case report shows the unknown of causative during delivery which can lead to maternal morbidity even mortality if there is no proper maternal monitoring during delivery.ABSTRACTObjectives: To discuss the discovery of uterine couvelaire events after the cesarean section without accompanying placental abruption.Case Report: Uterus Couvelaire is a rare occurrence. The incidence of this case is difficult to ascertain and its estimated incidence is as much as 20% and others’ estimatation is as low as 5%. It occurs mainly due to complications from placental abruption. When a vascular injury occurs in the placenta, it causes bleeding that infiltrates the wall of the uterus. This case is usually diagnosed accidentally because it is diagnosed only by direct visualization or biopsy. In this case, uterine couvelaire was found in a woman after a cesarean section that had been performed previously. Uterine couvelaire events are usually seen due to complications from placental abruption, but in this case, there was none.Conclusion: It was not known for sure what caused the emergence of the uterine couvelaire in this case. Hysterectomy was performed in this case due to the patient's unstable hemodynamic state.

Aim and objective: Preeclampsia is part of the hypertension spectrum that occurs during the pregnancy period, especially when the gestational age is 20 weeks or more. Preeclampsia has a broad impact not only on pregnant women but also on the fetus they contain. It is said that in preeclampsia, there is an increase in inflammatory stimulation and an abnormal immune response so that routine blood values increase. Neutrophil-lymphocyte ratio (NLR) values reported in several studies have risen notably in the incidence of preeclampsia. Materials and methods: A cross-sectional observational analysis study was conducted on 924 pregnant respondents from January to December 2019 at Cimacan District Hospital, Cianjur. Statistical analysis test of the average difference between the two groups and the prediction test of NLR values was conducted between the healthy pregnant women group of 838 respondents and the group of 86 pregnant women with preeclampsia. Results: In statistical tests regarding the differences in the mean of the two groups, a significant NLR value was obtained (p = 0.004). Then the NLR value was tested again by the receiver-operating characteristic (ROC) curve method, and the results of the area under the curve (AUC) on the variable values were obtained in the form of AUC: 0.595/p-value: 0.035. Conclusion and clinical significance: Despite the differences in the mean NLR in the two groups, however, the NLR of women in predicting the incidence of pregnancy with preeclampsia is very low.

Abstract Introduction:  Hypertension in pregnancy is a common complication that affects maternal and fetal morbidity and mortality. Comprehensive handling is needed to overcome the incidence of hypertension in pregnancy so that it does not get worse. The use of inflammatory markers is widely used as a predictor of the incidence of hypertension in pregnancy, especially preeclampsia. Neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) values are believed to predict the incidence of hypertension in pregnancy. Aim of study: The purpose of this study was to determine the ability of both the NLR and MPV values to predict the incidence of hypertension in pregnancy. Methods: This research is an analytic observational study using secondary data from medical records. The data were taken from the Cimacan Regional Hospital from January to December 2019. The variables were then tested statistically to see the difference in the mean. If there are significant results, the predictor's ability will be tested again with the ROC curve test. Results: The results of statistical tests between the normotensive pregnancy group and pregnancy with hypertension showed that the mean difference was significant in the NLR variable with P-value of 0.004 and MPV with a P-value of 0.005. Then the NLR and MPV values were tested again by the ROC Curve method. The AUC results on the NLR variable (AUC: 0.562 / p-value: 0.022) and MPV (AUC: 0.560 / p-value: 0.022). Conclusion: Although NLR and MPV had differences mean between the two groups, their ability to predict pregnancy with hypertension was very low.   Keywords: Pregnancy; Hypertension; Preeclampsia; NLR; MPV.

Okronosis eksogen merupakan salah satu penyakit kulit dengan gambaran deposisi pigmen kebiruan pada wajah yang disebabkan oleh penggunaan hidrokuinon dalam krim pemutih topical yang terjadi dalam waktu yang cukup lama. Tujuan: Memperoleh data prevalensi penderita okronosis eksogen. Metode: Penelitian ini merupakan studi observasional deskriptif dengan desain cross sectional yang menggunakan data sekunder berupa rekam medis pasien. Sampel penelitian didapatkan sebanyak 88 pasien yang didiagnosis okronosis eksogen di satu rumah sakit dan dua klinik kesehatan dan kecantikan kulit dengan jumlah empat dokter spesialis kulit dan kelamin yang mendiagnosis okronosis eksogen pada periode Januari 2014 sampai Januari 2019. Hasil:  Sebagian besar pasien adalah wanita yaitu dari 88 orang dengan jumlah penderita 81 orang (92,04%) dan laki-laki 7 orang (7,95%). Kelompok umur terbanyak didapatkan pada usia 40-49 tahun sebanyak 43 orang (48,8%) dan diikuti antara 30-39 tahun sebanyak 20 orang (22,7%) penderita. Simpulan: Pasien paling banyak ditemukan berjenis kelamin perempuan dengan rentang usia tertinggi antara dekade ketiga dan keempat.Kata kunci: hidrokuinon, krim pemutih, okronosis eksogen