8^th Asia Pacific Gynecology and Obstetrics Congress May 10-11, 2021 Singapore City, Singapore

Biography:

Devita Kurniawati has completed her MD at the age of 22 from Airlangga University in 2010. Then she continued the internship at Caruban General Hospital, Madiun for 1 year after that. After she done with her internship, she had a duty at remote area for 1 year from May 2012 until May 2013 in East Kalimantan. She worked at Laham Public Health Centre in West Kutai District Now she continued her residency in Obstetric and Gynecology at Airlangga University Surabaya - Doctor Soetomo General Hospital.

Abstract:

The world was caught off guard by the outbreak of unknown pneumonia that began in Wuhan, Hubei Province, China in early 2020. It spread rapidly throughout more than 190 countries and territories. This outbreak is named coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The spread of this infection disease in the early time  has had tremendous  impact in our health system.

Pregnancy it elf alter physiologic in her body, thus make immune sistems decrease. In Indonesia, even before pandermic in 2017 maternal mortality rate is high at 177 death in 100.000 labour. Case fatatity rate in Indonesia until December 2020 is 2,98%. In dr soetomo general hospital as a referral hospital in Surabaya there are 15 maternal death since maret to desember 2020 related to COVID- 19. We wAnt to determine the antenatal care, clinical manifestations, prognostic factors, and treatment.We have all the patients with BMI more than 30 in 46 %, with Any Comorbid in 66 %, Age over 35 in 33%. We found that Case Fatality Ratio in maternal with covid is 3,4 %, still lower than all Case Fatality Ratio In maternal case without COVID-19 is 4,5% . In this pandemic situation, all the manpower and resources of health facilities will be consumed, especially as a referral hospital. Preparedness and vigilance from all parties is needed to prepare resources, manpower, policies, budgets and quarantine to face a pandemic.

Biography:

Dewi Setiawati  had born in Makassar in 21th June 1981 and graduated  as a medical doctor in medical Faculty Hasanuddin University 2004. In 2013, she graduated form Faculty Hasanuddin University  2013 as an obstetrian and gynecology specialist  in.  Know work as an obstetrian spesialist  in Paramaount Mother and Child Hospital. She also as the owner and director in Wirahusada Medical Center. 

Abstract:

Asia  has become one of  the epicenter of coronavirus pandemic. It seems that asymptomatic population may contribute importantly to the spread of the disease. Transmission from asymptomatic pregnant woman  needs to be tested in large scale, but  In primary health care without facilities for RT PCR SARS CoV-2, antibodies and the level of Wbc and lymphocytes may become as alternative test.

Objective: To assess the prevalence of SARS CoV-2 infection in matic asymtomatic pregnant woman in primary health care. Methods This was a cross-sectional study was performed. Pregnant women admitted at policlic Obstetrics & Gynecology of  Wirahusada Medical Center for antenatal care, between November 1st  and December 31, 2020. A total of 142 pregnant woman without symproms were tested for  rapid antibody for SARS CoV-2 and checked for routine hematology during the study period. Asymtomatic pregnant woman with rapid antibody positif  then cronfirmed  with RT-PCR for SARS CoV-2.

Results: From 142 pregnant women who underwent screening, there were 11 (7.7%) who were positive (IgG / IgM, while the negative  were 131 (92.3%). 11 asymptomatic  pregnant woman was confirmed positive RT-PCR for SARS CoV-2 in secondary Health center (hospital). There were differences in the mean Wbc levels in the group of asymptomatic  pregnant women with positive SARS CoV-2 antibodies (3742.73) compared to non-reactive  (9122.48), where the mean leukocyte levels were <4000 in subjects with positive SARS CoV-2 (p = 0.001). There was a difference in the mean lymphocyte levels in the group of pregnant women with positive SARS CoV-2 rapid antibody (12.7) compared to non-reactive (24.3), where the mean lymphocyte levels were lower in subjects with positive SARS CoV-2 Rapid IgG / IgM pregnant women ( p = 0.001). There was no difference in the mean lymphocyte levels in the group of pregnant women with positive SARS CoV-2 antibodies (11.06) compared to non-reactive pregnant women (11,36), where the mean Hb levels were not different in subjects with positive SARS CoV-2Rapid IgG / IgM pregnant women (p = 0.551). There was no difference in the mean lymphocyte levels in the group of pregnant women with positive SARS CoV-2 positive antibodies (280,454) compared to non-reactive (300,778), where the mean pletelet levels were not different in subjects with positive SARS CoV-2 Rapid IgG / IgM pregnant women (p = 0.346 ).

Conclusion ; In our study Wbc levels and the percentage of lymphocytes were significantly lower in subjects of asymptomatic pregnant women with positive SARS CoV-2  antibodies than  non-reactive pregnant women. In primary health care without facilities for RT PCR SARS CoV-2, antibodies and the level of Wbc and lymphocytes can be used as alternative for Routine screening in asymptomatic pregnant woman.

Biography:

Khoirunnisa Novitasari, has completed his MD at the age of 24 years from Airlangga University, then worked for one year in Jember, East Java as primary doctor in Secondary Hospital  and now continue her study as the resident of obstetric and gynecologic in Airlangga University,  Soetomo Hospital the tertiary hospital in Indonesia. 

Abstract:

Nowadays, Covid-19 has become our concern, included its impact to pregnant women. The rate of maternal mortality related Covid-19 increased. Early detection of significant factor related to clinical worsening of pregnant women with Covid-19 can be a rationale to do aggressive treatment and closed monitoring. The aim of study is to analyze the risks and predictor factor of maternal death with Covid-19.

Material and method : Case control study, case grup consists of all maternal death related Covid-19 till August 2020 (15 patients) in Soetomo Hospital, tertiary hospital in Indonesia. Control grup consists of all pregnant women survived with Covid-19 confirmed till August 2020 (30 patients). We used bivariat analysis and multivariat using logistic regression.

Result : We found five significant factors of maternal death related Covid-19. They are respiration rate  p=0,04 CI 95% 3,75 (1-14),  D-dimer >2400 with p=0,035 CI 95% 4,12 (1,06-16,03), SpO2 p=0,001 CI 95% 18 (3,61-89,5), CRP >7,15 p=0,003 CI 95% 7,5 (1,86-30,7) Obesity p=0,09 CI 95% 4,5 (0,9-22,3), A simple scoring is made based on probability equation of 5 factors and can predict the probability of level severity cause death from 3,9% (score 1) to 98,3% (score 5) with AUC (ROC) 94,7%.

Conclusion : the risk and predictor factors of maternal death related covid included respiration rate, perifer saturation, CRP, D-dimer and Obesity. This simple prediction score can be used to define pregnant women with Covid-19 that need closed monitoring and aggressive treatment to avoid maternal morbidity and mortality.

Biography:

Margaretha Claudhya Febryanna, has completed her MD at the age of 24 years from Airlangga University, then worked for four years in Bojonegoro, East Java as primary doctor in Public Health Centre and now continue her study as the resident of Obstetric and Gynecology in Airlangga University, Dr. Soetomo Hospital, a tertiary hospital in Surabaya, Indonesia. 

Abstract:

Neural tube defects (NTD) become a concern in developing countries, with rare recurrence risk 2-5%. Folate and cyanocobalamine deficiencies are the common cause of NTD , while other cause are MTHFR enzyme mutation and the presence of Maternal Serum Folate Reseptor Auto-antibodies.; Case Description: A multigravida (GIV P3001), 35 year old mother having anencephalic babies on second and fourth pregnancy with was examined at antenatal clinic Dr. Soetomo Hospital. She was tested negative for TORCH, Ultrasound examination revealed positive Frog sign, cerebellum located outside cranial lobe with cervical spine defect to upper femoral region. Termination of pregnancy was performed, a female 300 gram stillbirth baby was delivered. Open upper cranium was observed with intact brain structure and non closure of cervical spine. After postpartum period, maternal serum folate and cobalamin level were observed within normal values.  Maternal serum homocysteine levels was also observed. MTHFR enzyme has a critical role at converting methylentetrahydrofolate to active tetrahydrofolate, and converting homocysteine serum to methionone used for protein synthesis. The mutant MTHFR C677T have 30% lesser converting function in metilathion chain. The decrease of this conversion in metilathion proccess resulting in increase unconverted homocysteine serum level accumulation. The serum of maternal NTD’s pregnancy contain Folate Reseptor Auto-antibodies that binds to folate receptor and blocking cellular folate uptake.Conclusion : Mother with history of NTD pregnancy should encourage to take routine daily 400-800 mcg folic acid supplementation, routine antental care is mandatory, ealy ultrasound examination should be performed for monitoring and diagnosis.

Biography:

Sathaphone Inthavong, M.D. has completed his Doctor of Medicine at the age of 23 years from Faculty of Medicine, University of Health Sciences, Lao PDR. He is a student majoring in Master of Science in Obstetrics and Gynecology at Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand. 

Abstract:

Background: Adolescent pregnancy is an important issue, which can cause social, educational and health problems to female adolescents. Thai government has launched the free-of-charge for long-acting reversible contraception (LARC) prevention in 2014 for Thai female adolescence. However, the acceptance of this program has not been reported.

Objective(s): The study aims to describe the contraceptive use among reproductive age women before and after the free-of-charge LARC program.

Study design: This retrospective cross-sectional study was conducted among reproductive age women who attended to the family planning clinic at Maharaj Nakorn Chiang Mai Hospital between 2009 and 2018. The data were collected from the medical records. The chi-square test was used to compare the contraceptive methods used before and after the program and the binary logistic regression was used to find the factors associated with implant use after the program.

Results: The data of 9536 women were enrolled in the study. The rates of subdermal implant, progestin-only pills and condom use were increase significantly after the program (2.3% to 9.5%, 27.8% to 30.4% and 9.9% to 12.4%; p<0.005), while the rate of depot medroxyprogesterone acetate injection were decrease significantly after the program (44.0% to 35.3%; p<0.001). The implant users aged under 20 years increased from 7.0% to 34.1%. Factors significantly associated with the implant use after the program included the age group, job, educational level, race, and number of pregnancies. The adjusted odds ratio (aOR) for age < 20 years = 4.36 (CI: 2.02 - 9.43); p<0.001) and nulligravida; = 5.53 (CI: 2.65 - 11.52); p<0.001).

Conclusions: This study showed a significant increase in contraceptive implant use after the free-LARC program, especially among women under 20 years.