Publications by authors named "Yudianto Budi Saroyo"

6 Publications

  • Page 1 of 1

Massive obstetric haemorrhage on post caesarean subtotal hysterectomy due to late detection of occult placenta percreta: A case report.

Int J Surg Case Rep 2021 Aug 22;85:106225. Epub 2021 Jul 22.

Department of Obstetric and Gynecology, Faculty of Medicine Universitas Indonesia, Dr Cipto Mangunkusumo Hospital, Indonesia.

Introduction: Placenta accreta syndrome is a significant cause of maternal mortality and morbidity. Therefore, a multidiscipline approach is essential to overcome this life-threatening disorder for the mother and fetus.

Presentation Of Case: A 32-year-old women gravida 3 parity 2, 34 weeks gestation come due to recurrent antepartum haemorrhage. She had twice prior caesarean section. Ultrasound assessment suggests total placenta previa and elevating suspicion to placenta accreta. However, intraoperatively its sign is unavailable. Although we have done subtotal hysterectomy, massive bleeding still occurring. Therefore, we present management of unexpected placenta percreta.

Discussion: Management of unexpected placenta percreta involves prenatal diagnosis, haemoglobin optimization, surgical management anticipating haemorrhage, dedicated maternal ICU, blood bank providing massive transfusion and blood component.

Conclusion: Close monitoring is important in catastrophe management of Placenta Accreta Syndrome.
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http://dx.doi.org/10.1016/j.ijscr.2021.106225DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326718PMC
August 2021

Thyroid storm in the second stage of labour: a case report.

BMJ Case Rep 2021 Jul 21;14(7). Epub 2021 Jul 21.

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia; Dr. Cipto Mangunkusumo General Hospital, Jakarta Pusat, Indonesia.

A thyroid storm (or thyroid crisis) is an emergency in endocrinology. It is a form of complication of hyperthyroidism that can be life-threatening. Inadequate control of hyperthyroidism in pregnancy could develop into thyroid storm, especially in the peripartum period. We present a woman came in the second stage of labour, with thyroid storm, superimposed pre-eclampsia, acute lung oedema and impending respiratory failure. Treatment for thyroid storm, pre-eclampsia protocol and corticosteroid was delivered. The baby was born uneventfully, while the mother was discharged after 5 days of hospitalisation. Delivery is an important precipitant in the development of thyroid storm in uncontrolled hyperthyroidism in pregnancy. Although very rare, it can cause severe consequences. Diagnosis and treatment guidelines for thyroid storm were available and should be done aggressively and immediately. Uncontrolled hyperthyroidism should be prevented by adequate control in thyroid hormone levels, especially before the peripartum period.
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http://dx.doi.org/10.1136/bcr-2021-243159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296797PMC
July 2021

Long-chain polyunsaturated fatty acid (LC-PUFA) status in severe preeclampsia and preterm birth: a cross sectional study.

Sci Rep 2021 Jul 19;11(1):14701. Epub 2021 Jul 19.

Maternal Fetal Division, Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Indonesia/Cipto-Mangunkusumo Hospital, Jakarta, Indonesia.

Long-Chain Polyunsaturated Fatty Acid (LCPUFA) is essential throughout pregnancy, since deficiency of LPUFA may linked to obstetrical complications. This study aimed to investigate LCPUFA status in severe preeclampsia and preterm birth. A cross sectional study was conducted in 104 pregnant women, which divided into normal pregnancy, severe preeclampsia and preterm birth groups. Serum percentage and concentration of total LCPUFA, omega-3, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-6, linoleic acid (LA), and arachidonic acid (AA) were measured using gas chromatography/mass spectrometry. Receiver operating characteristic (ROC), bivariate and multivariate analysis were performed. Severe preeclampsia showed the highest concentration of total PUFA and the lowest DHA percentage, with significantly higher Omega-6/Omega-3 ratio (p = 0.004) and lower omega-3 index (p < 0.002) compared to control. Preterm birth showed the least omega-3 concentrations, with significantly low omega-6 derivates (LA (p = 0.014) and AA (p = 0.025)) compared to control. LCPUFA parameters have shown to increase the risk in both conditions, particularly ALA ≤ 53 µmol/L in preeclampsia with OR 5.44, 95%CI 1.16-25.42 and preterm birth with OR 4.68, 95%CI 1.52-14.38. These findings suggest that severe preeclampsia and preterm birth have an imbalance in LCPUFA status.
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http://dx.doi.org/10.1038/s41598-021-93846-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289913PMC
July 2021

Oxidative Stress Induced Damage and Early Senescence in Preterm Placenta.

J Pregnancy 2021 24;2021:9923761. Epub 2021 Jun 24.

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Indonesia.

Introduction: Senescent cells have been demonstrated to release High Mobility Group Box 1 (HMGB1) which induces labor through an inflammatory pathway. This research is aimed at demonstrating whether telomere shortening, proinflammatory HMGB1, and oxidative damage marker 8-OHdG play a role in the placenta of preterm birth in comparison to term birth.

Method: A cross-sectional study on 67 full thickness of the placenta obtained from mothers with term and preterm birth. Mothers with clinical signs of infection (fever > 38°C, leukocytosis > 18000/L, or abnormal vaginal discharge) and other pregnancy complications were excluded. Real-time polymerase chain reaction was performed to measure T/S ratio and ELISA quantification to measure the amount of HMGB1 and 8-OHdG.

Result: A total of 34 placentas from preterm and 33 placentas from term birth were examined. Maternal characteristics were comparable between the two groups. There were no statistical difference of T/S ratio ( = 0.181), HMGB1 ( = 0.119), and 8-OHdG ( = 0.144) between the preterm and term groups. HMGB1 was moderately correlated with 8-OHdG ( = 0.314). Telomere T/S ratio of the placenta did not differ between preterm and term labor despite difference in gestational age, suggesting earlier shortening in the preterm group. It is possible that critical telomere length has been achieved in both term and preterm placenta that warrants labor through senescence process. The result of our study also showed that HMGB1 was not correlated to telomere length, due to the fact that HMGB1 is not upregulated until the critical length of telomere for senescence is exhibited.

Conclusion: Similar telomere length might be exhibited due to early telomere shortening in preterm birth that mimics the term placenta. The relationship between placental telomere shortening and HMGB1 release remains to be uncovered. Further research is needed to discover the factors leading to early telomere shortening in the placenta of preterm birth.
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http://dx.doi.org/10.1155/2021/9923761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8249137PMC
June 2021

Remdesivir Treatment for COVID 19 in Pregnant Patients with Moderate to Severe Symptoms: Serial Case Report.

Infect Dis Rep 2021 May 17;13(2):437-443. Epub 2021 May 17.

Obstetric Gynecology Department, Maternal Fetal Medicine Division, Cipto Mangunkusumo General Hospital, Jakarta 10430, Indonesia.

Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection that causes Coronavirus Disease 2019 (COVID-19) has become a major health problem worldwide and been declared a pandemic since March 2020 by WHO. One special population that poses a challenge is pregnant women with COVID-19. There have not been many studies related to COVID-19 in pregnancy. In this study, we present five serial cases of Remdesivir treatment for COVID-19 in pregnant women with moderate to severe symptoms.

Case Illustration: We briefly describe five serial cases being treated with Remdesivir therapy during hospitalization. Four cases were delivered by cesarean section, and one was delivered vaginally in gestation week 37. All cases showed a shortened duration of hospitalization, rapid improvement in clinical symptoms, and no adverse events were observed in mothers, fetuses, and neonates.

Discussion: Remdesivir, an inhibitor RNA Polymerase, has been used in COVID-19 treatment and is known to shorten recovery time in nonpregnant women. Some studies have shown no adverse effects on Remdesivir for pregnant women. Based on randomized control trial (RCT) during the Ebola epidemic, Remdesivir was safe to use for pregnant women. All cases showed reduced hospitalization time and better clinical outcomes without maternal, fetal, or neonatal adverse events.

Conclusion: Remdesivir protocol for pregnant women with moderate to severe symptoms of COVID-19 has resulted in better clinical improvement with a shorter recovery period and no adverse effects during the hospitalization period. Further studies and RCT are warranted to evaluate the biosafety and effects of Remdesivir in pregnant women.
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http://dx.doi.org/10.3390/idr13020042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8162322PMC
May 2021

Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome.

Infect Dis Rep 2020 Nov 2;12(3):51-60. Epub 2020 Nov 2.

Department of Obstetrics and Gynecology Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Diponegoro No. 71, Central Jakarta 10430, Indonesia.

: Dengue fever is a major public health problem in tropical and subtropical areas. There are not many studies concerning the complications of dengue fever in pregnancy. We present four serial cases of dengue fever in pregnancy. : Three of four cases were delivered by caesarean section; two of them died during post-caesarean care. All cases had the lowest platelet level below 50,000/µL and were given platelet transfusion during and after delivery; they also showed abnormal liver function tests. For foetal outcome, none tested positive for dengue. : Complication of dengue infection depends on a combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patients with dengue infection due to an intricate effect on the haemostatic system. The adverse foetal outcome may contribute because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy. : The management of dengue fever in pregnancy at the tertiary hospital is still suboptimal. Dengue fever around peripartum presents a higher risk of morbidity and mortality for the mother and therefore needs a multidiscipline team approach.
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http://dx.doi.org/10.3390/idr12030013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768497PMC
November 2020
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