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Pardede, Tiarma Uli
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Membedakan Acute Fatty Liver of Pregnancy dan HELLP Syndrome Hutauruk, Nicholas Marco AH; Iswari, Wulan Ardhana; Pardede, Tiarma Uli; Darus, Febriansyah; Puspitasari, Bintari; Santana, Sanny; Abidin, Finekri; Endjun, Judi J
Cermin Dunia Kedokteran Vol 44, No 8 (2017): Obstetri-Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.218 KB) | DOI: 10.55175/cdk.v44i8.739

Abstract

Sindrom HELLP dan Acute Fatty Liver of Pregnancy (AFLP) merupakan komplikasi berat kehamilan. Kedua kondisi ini dapat mengancam jiwa dan diagnosis awal amat penting untuk mencegah kematian. Gejala sindrom HELLP dan AFLP sekilas nampak sama, namun etio-patogenesis serta penanganan keduanya berbeda. Pembahasan kasus ini bermaksud mengingatkan klinisi agar mempertajam diagnosis dan penanganan untuk hasil yang lebih baik. Penanganan yang cepat dan tepat menjadi tantangan bagi dokter umum dan spesialis kebidanan di negara-negara berkembang, di mana kehamilan dengan komplikasi sering kurang tertangani.HELLP syndrome and Acute Fatty Liver of Pregnancy (AFLP) are very serious complications in pregnancy. These conditions are life threatening and early diagnosis is the most important step to prevent mortality. HELLP syndrome and AFLP have similarities in symptoms and clinical appearance but different in etio-pathogenesis and treatment. Even though AFLP is rare, it is associated with high maternal and neonatal mortality. This case serves as a reminder to early diagnosis and treatment for a better outcome. This will be a challenge for general practitioners and obstetrician in developing countries, where pregnancies with complications often remain undersupervised.
Tatalaksana Retensio Urin Pasca Persalinan Anugerah, Iqra; Ardhana Iswari, Wulan; Pardede, Tiarma Uli; Darus, Febriansyah; Puspitasari, Bintari; Santana, Sanny; Abidin, Finekri; Endjun, Judi J
Cermin Dunia Kedokteran Vol 44, No 8 (2017): Obstetri-Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.204 KB) | DOI: 10.55175/cdk.v44i8.735

Abstract

Retensio urin pasca persalinan (RUPP) adalah tidak adanya proses berkemih spontan atau tidak dapat berkemih spontan yang dimulai 6 jam pasca persalinan dengan residu urin sebanyak > 200 ml. Insidensi RUPP 1,7-17,9%; di Indonesia insidensi RUPP 14,8% pada tahun 1996 dan 26,7% pada tahun 2004. RUPP dapat disebabkan oleh berbagai faktor neurologis, farmakologis, inflamasi, obstruksi, gangguan medis, overdistensi kandung kemih, psikogenik, dan gangguan pasca operasi. Diagnosis ditegakkan melalui kateterisasi dan ultrasonografi. Tatalaksana RUPP ialah penanganan nyeri, kateterisasi intermiten atau selama 24 jam, antibiotik, dan prostaglandin.Postpartum urinary retention is defined as the abrupt inability to spontaneously micturate or micturition after 6 hours post-partum with more than 200 mlresidual urine. Its incidence is 1,7-17,9%; in Indonesia, the incidence was 14,8% in 1996 and 26,7% in 2004. Various factors contribute to the development of postpartum urinary retention: neurological, pharmacological, medical disorders, psychogenic, postoperative factors. Diagnosis is made through catheterization and ultrasonography. Current management involves pain management, intermittent or 24-hour catheterization, antibiotics, and prostaglandin. 
Miomektomi saat Seksio Sesaria - Safe Procedure Yuniati, Alfi Rustina; Pardede, Tiarma Uli; Santana, Sanny
Cermin Dunia Kedokteran Vol 44, No 2 (2017): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.057 KB) | DOI: 10.55175/cdk.v44i2.822

Abstract

Kehamilan pada mioma berhubungan dengan komplikasi kebidanan seperti gangguan pertumbuhan janin, gangguan letak, kontraksi prematur sampai perdarahan potpartum. Tindakan miomektomi saat seksio sesarea masih sering dikhawatirkan karena menimbulkan risiko perdarahan dan ganguan involusi uterus. Dilaporkan tiga kasus kehamilan dengan mioma uteri multipel di RS Kepresidenan Gatot Soebroto, pada ketiganya dilakukan seksio sesarea elektif atas indikasi gangguan letak dilanjutkan dengan miomektomi secara aman. Hal tersebut dimungkinkan karena mioma sudah dideteksi selama antenatal care, kemudian dilakukan persiapan perioperatif, tim operator, dengan teknik operasi yang tepat.Pregnancy with myoma are associated with obstetric complications such as impaired fetal growth, fetal position disorders, premature contractions and postpartum haemorrhage. Myomectomy during cesarean section raises the risk of bleeding and uterine involution disorders. This is the report of three cases of multiple myoma in pregnancy in Gatot Soebroto Presidency Hospital. Caesarean sections were performed electively due to fetal position disorder and directly followed with myomectomy. The procedure was safely done because the myoma was detected during antenatal care, and with good perioperative preparation, team work, and proper techniques.
Tatalaksana Neoplasma Ovarium pada Kehamilan Lestari Avriyani, Renny; Ardhana Iswari, Wulan; Pardede, Tiarma Uli; Darus, Febriansyah; Puspitasari, Bintari; Santana, Sanny; Abidin, Finekri; J Endjun, Judi
Cermin Dunia Kedokteran Vol 44, No 8 (2017): Obstetri-Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (238.928 KB) | DOI: 10.55175/cdk.v44i8.743

Abstract

Insidens massa adneksa pada kehamilan diperkirakan 0,2-2% tergantung usia kehamilan; kebanyakan bersifat jinak. Angka keganasan adalah 1-6%. Massa adneksa pada kehamilan sering didiagnosis saat pemeriksaan fisik pada wanita yang bergejala, seperti nyeri abdomen/nyeri pelvik atau terdapat massa pada perabaan. Diagnosis akurat penting untuk identifikasi pasien yang benar-benar membutuhkan pembedahan. Sejak penggunaan ultrasonografi (USG) pada kehamilan, massa adneksa lebih sering ditemukan. Tulisan ini memaparkan etiologi massa adneksa pada kehamilan, metode diagnostik pilihan, serta pilihan terapi.Overall incidence of adnexal mass in pregnancy is estimated to be 0.2-2.0% depending on gestational age; most are benign, only 1-6% are malignant. Adnexal mass were diagnosed in women presenting with abdominal or pelvic pain or with palpable mass. Accurate diagnosis is necessary to identify patients who truly need surgical interventions. Routine ultrasonography made an easier detection of adnexal mass in pregnancy.
Co-Authors Abidin, Finekri Anugerah, Iqra Ardhana Iswari, Wulan Darus, Febriansyah Endjun, Judi J Hutauruk, Nicholas Marco AH J Endjun, Judi Lestari Avriyani, Renny Puspitasari, Bintari Santana, Sanny Wulan Ardhana Iswari, Wulan Ardhana Yuniati, Alfi Rustina