Trends in cesarean section rates during Covid-19 pandemic based on Robson classification at Sanjiwani Hospital

Sat, 13 May 2023 00:00:00 +0000

Background: The Cesarean section rate in 2017 in Bali Province was 32.7%. The Covid-19 pandemic has raised problems in management pregnant women, especially determining mode of delivery.

Aim: This study was conducted to determine the effect of the pandemic on the rate of cesarean section deliveries by comparing the absolute cesarean section rates in 2019 and 2020 using the Robson Classification. This study was a descriptive retrospective. The subjects were all pregnant mother who gave birth at the RSUD Sanjiwani Gianyar in 2019 and 2020. The data were taken from medical records then analyzed using Robson Classification and further analysis of the causes of caesarean section.

Result: From 396 research subjects, the cesarean section rate in 2020 was 52.8%, increased 123.7% compared to the cesarean section rate in 2019 (23.6%). Based on Robson's classification, the highest cesarean section rate was in group 5 with an absolute rate 10.7%, group 1 (8.6%) and group 4 (7.2%). Further analysis showed the largest indications of the cesarean section were maternal conditions (28.3%) and fetal indications (27.9%).

Conclusion: There was a significant increase of cesarean sections rate in 2020 during covid-19 pandemic. The highest indications for cesarean section are maternal conditions and fetal indications.

Coinfection of typhoid fever and hepatitis B: a case report

Sat, 13 May 2023 00:00:00 +0000

Background: Enteric fever (or more commonly known as typhoid fever) is an infectious disease characterized by systemic manifestations such as fever with a step-ladder pattern and abdominal pain. This disease is mainly caused by gram-negative bacteria Salmonella enterica serovar Typhi (S. typhi) and other Salmonella enterica serovars such as S. paratyphi A, S. paratyphi B and S. paratyphi C. Although there have been great advances in public health and hygiene in developing countries, enteric fever is still endemic in some of these countries with the case fatality rate of enteric fever reaching 2.49%. This study aims to further discuss the coinfection of typhoid fever with acute hepatitis B.

Case: A 40-year-old female patient who presented with the chief complaint of fever at night, nausea, vomiting and abdominal pain. Widal serological examination showed an increase in antibody titers of S. typhi and paratyphi. The results of laboratory tests showed increased levels of SGPT and SGOT. Follow-up immunoserology examination for HBsAg showed a reactive result. During hospitalization, the patient was given antibiotik therapy for typhoid infection and supportive therapy for acute hepatitis B. The occurrence of worsening symptoms, complications and manifestations of hepatitis (such as jaundice) was not observed in this patient.

Conclusion: It can be concluded that the manifestation of viral hepatitis coinfection in enteric fever varies from asymptomatic to fulminant hepatitis. The therapeutic strategy for co-infection of typhoid fever with viral hepatitis follows the therapeutic guidelines for each disease in addition to close monitoring of liver function.

Bali Journal of Anatomy

Trends in cesarean section rates during Covid-19 pandemic based on Robson classification at Sanjiwani Hospital

Coinfection of typhoid fever and hepatitis B: a case report