Background: Injectable hormonal contraception demonstrates high efficacy in pregnancy prevention with minimal adverse effects. Nevertheless, undetected pregnancy resulting from contraceptive failure may lead to spontaneous abortion and unplanned pregnancies. Such contraceptive failures present significant clinical challenges, particularly when resulting in unrecognized pregnancies that terminate in miscarriage. Case Presentation: A 34-year-old multiparous woman (G3P2A0) who had consistently used monthly injectable contraception (Cyclofem) for twelve months presented with acute onset heavy vaginal bleeding and severe abdominal cramping. The patient remained unaware of her pregnancy status. Transabdominal ultrasonography revealed no visible fetal structures on examination. During clinical observation, she spontaneously expelled fetal tissue consistent with 14-week gestation. Following expulsion, bleeding continued. Subsequent ultrasonography confirmed presence of retained products of conception. Surgical curettage was undertaken after cervical preparation using misoprostol (PGE-1). Discussion : This case demonstrates the necessity for healthcare providers to maintain elevated clinical suspicion for pregnancy in contraceptive users presenting with abnormal bleeding patterns. Essential preventive measures include regular monitoring, comprehensive patient education regarding contraceptive failure risks, and prompt assessment of menstrual irregularities. Even highly effective contraceptive methods may fail, with injectable methods showing 0.2-1% failure rates despite perfect compliance. Hormonal contraceptives can induce withdrawal bleeding that obscures pregnancy symptoms, resulting in delayed diagnosis. Local institutional research reveals significant biomarker variations during pregnancy complications, emphasizing the need for comprehensive diagnostic approaches when clinical presentations are atypical. Conclusion: This case underscores the critical importance of clinical vigilance, comprehensive reproductive health education, and ensuring access to quality contraceptive services. Healthcare providers must remain alert when evaluating abnormal bleeding in contraceptive users, as pregnancies may remain unrecognized despite compliance, highlighting the vital role of education and monitoring in preventing contraceptive failure.
Background: Exclusive breastfeeding during the first six months of life is recognized as the optimal infant feeding practice and is strongly recommended by the World Health Organization. However, exclusive breastfeeding coverage remains below national and global targets, including in Indonesia, partly due to limited maternal knowledge, misconceptions, and insufficient education during pregnancy at the primary health care level. Objective: This study aimed to assess the effect of exclusive breastfeeding education on improving pregnant women’s knowledge at Puskesmas Lubuk Begalung, Padang, Indonesia. Method: A pre-experimental one-group pretest–posttest design was conducted among pregnant women attending antenatal care. Participants were recruited using convenience sampling. The intervention consisted of structured education and workshop sessions on exclusive breastfeeding. Knowledge was measured before and after the intervention using a validated questionnaire and analyzed using descriptive statistics and the Wilcoxon signed-rank test. Result: Thirty-two respondents completed the study. The mean knowledge score increased from 58.45 before the intervention to 91.03 after the intervention. Statistical analysis showed a significant improvement in knowledge following the education and workshop intervention (p < 0.05). Conclusion: Exclusive breastfeeding education significantly improved pregnant women’s knowledge. Integrating structured education and interactive workshops into routine antenatal care is recommended in primary health care settings locally.
Introduction : This study aims to see the relationship between the level of perineal wound pain and healing using PRP (Platelet Rich Plasma) in Vaginal birth. Perineal wound pain causes fear of movement resulting in subinvolution, unsmooth release of the locea, bleeding, or infection. Method : This type of research is Experimental with chi-quadrath design . The intervention group received PRP injections on perineal wounds on day 1 after delivery, while the control group was the group that was not given PRP. On the 7th day, observation of the degree of pain of perineal wounds was carried out using the VAS scale (Visual Analog Scale) in both groups. Result : The results of the study obtained a value of p=0.016. Then the value of OR = 6.250 was also obtained. Conclusion : there is a significant relationship between the level of perineal wound pain and healing using PRP in Vaginal birth. From the OR score, it is known that patients who receive PRP have a 6.25 times chance of experiencing mild pain compared to patients who are not given PRP. Keywords : pain; perineal wound; PRP; Vaginal birth.
Background: Toxoplasmosis is a globally distributed zoonotic infection caused by the protozoan parasite Toxoplasma gondii. The infection is of particular importance among women of reproductive age because of its potential implications for maternal and fetal health. This study aimed to determine the seroprevalence of T. gondii infection among women in Mukalla City, Hadhramout Governorate, Yemen, and to assess its relationship with selected demographic, reproductive, and hematological factors. Methods: A cross-sectional study was conducted among 192 women aged 17–42 years who attended selected healthcare centers and hospitals in Mukalla City. Blood samples were collected and analyzed for anti-T. gondii IgG and IgM antibodies using an enzyme-linked immunosorbent assay (ELISA). A structured questionnaire was used to collect demographic, reproductive, and exposure-related information, including residence, occupation, cat contact, and abortion history. Hematological parameters were also recorded. Results: Anti-T. gondii IgG antibodies were detected in 140 participants (72.9%), while anti-T. gondii IgM antibodies were detected in 40 participants (20.8%). Both IgG and IgM antibodies were detected in 12 participants (6.25%). A statistically significant association was observed between occupation and anti-T. gondii IgG seropositivity (p = 0.002), whereas no significant association was found between occupation and IgM seropositivity (p = 0.814). No statistically significant associations were observed between T. gondii seropositivity and residence or reported cat contact. Correlation analysis showed very weak positive correlations between age and IgG (r = 0.029) and IgM (r = 0.008), while weak negative correlations were observed between WBC counts, hemoglobin levels, abortion history, and anti-T. gondii antibody seropositivity. Conclusion: The study demonstrated a high seroprevalence of T. gondii among women in Mukalla City, indicating substantial exposure to the parasite within the studied population. The findings highlight the importance of continued awareness and preventive measures against toxoplasmosis among women of reproductive age in Hadhramout Governorate.
Background: Preeclampsia is a major pregnancy complication that significantly contributes to maternal and neonatal morbidity and mortality. Impaired placentation leads to an imbalance between angiogenic and antiangiogenic factors, particularly a reduction in placental growth factor (PlGF) levels, which is believed to play an important role in adverse neonatal outcomes. Objective: To determine the relationship between maternal serum PlGF levels and neonatal outcomes in normal pregnancies, early-onset preeclampsia, and late-onset preeclampsia at Dr. M. Djamil General Hospital, Padang. Methods: This study was an observational analytic study with a cross-sectional design. The study population consisted of pregnant women with normal pregnancies, early-onset preeclampsia, and late-onset preeclampsia who met the inclusion criteria. Maternal serum PlGF levels were measured using the enzyme-linked immunosorbent assay (ELISA) method. Neonatal outcomes assessed included birth weight, birth length, and Apgar scores. Data were analyzed using univariate and bivariate statistical analyses. Results: A total of 48 pregnant women were included in this study, comprising 16 normal pregnancies, 16 cases of early-onset preeclampsia, and 16 cases of late-onset preeclampsia. The mean age of the subjects was within the reproductive age range of 20–35 years. The highest mean PlGF levels were found in the normal pregnancy group, followed by the late-onset preeclampsia group, and the lowest in the early-onset preeclampsia group, with a significant p-value indicating a meaningful difference in PlGF levels among the three groups. Neonatal outcomes showed that the lowest mean birth weight, birth length, and Apgar scores were observed in the early-onset preeclampsia group. Bivariate analysis demonstrated a significant association between PlGF levels and birth weight in the early-onset preeclampsia group (p = 0.0001). Conclusion: There is a significant association between PlGF levels and preeclampsia, suggesting that PlGF has potential as a predictive biomarker for preeclampsia. Regarding neonatal outcomes, a significant association was found with birth weight in early-onset preeclampsia, while no significant association was observed with birth length and Apgar scores across the three groups.
