Cokorda Istri Mirayani Pemayun
Outpatient Clinic Sanglah General Hospital, Denpasar, Bali, Indonesia

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Early detection of Fetal Acrania on first-trimester sonography: a case report I Nyoman Hariyasa Sanjaya; Cokorda Istri Mirayani Pemayun; Ni Komang Anik Pirgantari; Made Diah Vendita Sakuntari; Ni Wayan Dewi Purwanti; NI Putu Nining Gianni; Ni Luh Made Diah Mas Cahyani Putri; Ni Luh Md Dwi Laxmi Satriani; Firsta Sesarina Mintariani; Ni Luh Putu Yulia Padmawati; Anak Agung Wahyu Putri Agustini
Indonesian Journal of Perinatology Vol. 2 No. 1 (2021): Available Online: 1 June 2021
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (589.639 KB) | DOI: 10.51559/inajperinatol.v2i1.8

Abstract

Introduction. Fetal Acrania is a rare fetal malformation characterized by the complete or partial absence of a skull covering the fetal brain. In the absence of a hard covering of the soft brain tissue, Acrania is known as a universally lethal malformation. Here we present a Fetal Acrania case detected by sonographic examination at our Center. Case Description. A 36 years old female was referred to the obstetric department to undergo an in-depth sonographic evaluation as a previous examination reveals a potential congenital fetal anomaly. Our sonographic evaluation revealed a singleton, live fetus, 12 weeks gestational age in cephalic presentation and longitudinal lie. One obvious malformation was a well-formed fetal brain without the surrounding cranium (Acrania). The absence of cranium was the main and only malformation. The absence of cranium was evident as the fetal brain was easily compressed on probe pressure, and the brain appeared like floating in the amniotic fluid over the base of the skull. Therapeutic abortion was carried out. The termination was conducted by administering four tablets of 200 mcg misoprostol sublingually and repeated 24 hours later. No adverse reaction or complication on termination. The aborted fetal examination confirmed the lack of fetal cranium. Conclusion. Although seemingly obvious, the first-trimester diagnosis of fetal Acrania must be made with caution as the fetal cranium is not fully calcified before 10- 11 weeks. As Acrania is a universally lethal malformation, therapeutic abortion is indicated.
The impact of the COVID-19 pandemic on the frequency of routine visits and breastfeeding plans on Kasih Medika Clinic I Nyoman Hariyasa Sanjaya; Cokorda Istri Mirayani Pemayun; Firsta Sesarina Mintariani; Made Diah Vendita Sakuntari; Ni Wayan Dewi Purwanti; NI Putu Nining Gianni; Ni Luh Made Diah Mas Cahyani Putri; Ni Luh Md Dwi Laxmi Satriani; Ni Komang Anik Pirgantari; Ni Luh Putu Yulia Padmawati; Anak Agung Wahyu Putri Agustini
Indonesian Journal of Perinatology Vol. 2 No. 1 (2021): Available Online: 1 June 2021
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (318.526 KB) | DOI: 10.51559/inajperinatol.v2i1.9

Abstract

Introduction. The SARS-CoV-2 pandemic has affected every part of the population, including pregnant mothers, breastfeeding mothers, and infants. There is an inadequate comprehension of SARS-CoV-2 transmission potential as of now. As expected, it will result in anxiety among the public, including a specific issue such as breastfeeding practice for the suspected or confirmed novel coronavirus infection. This study aimed to assess whether such anxiety was present in a population of patients that routinely visit Kasih Medika clinic. Methods. This is a simple study conducted on August 5-10, 2020. This study used a questionnaire instrument with samples of pregnant and postpartum mothers. The questionnaire includes a question regarding the anxiety surrounding breastfeeding, visiting the clinic and their everyday activity. Results. We reported that COVID-19 has an impact on the breastfeeding plans from the respondent's questionnaire. All respondents felt anxious about COVID-19, although only 18% of patients reduce their routine visits to Kasih Medika, while the rest keep visiting as scheduled. Eighty-six percent of respondents restricted their outdoor activities during the COVID-19 pandemic. The COVID-19 pandemic causes 27% of the respondents to feel afraid of their breastfeeding plans. However, in the primigravida population, 45.45% of respondents were afraid of their breastfeeding plans. Meanwhile, in the multigravida and postpartum respondents, 90.90% were not afraid about their breastfeeding plans during the COVID-19 period. Conclusion. COVID-19 pandemic brings a certain degree of anxiety to the mothers, including anxiety of safety during breastfeeding practice. Despite the risk of transmission, breastfeeding has more benefits than disadvantages. Breastfeeding makes the infant have a good immune system, which prevents any disease, including COVID-19. Breastfeeding during the COVID-19 is still recommended under health protocol.