Penugasan Jurnal

Management of Severe
Epistaxis during Pregnancy:
A Case Report and Review of
the Literature
Yudhistira Rizky R
Pendahuluan

Pengetahuan
Epitaxis merupakan
Pada wanita hamil, mengenai
hal yang umum
prevalensi 30,2% penanganan epitaxis
pada n/ kehamilan
masih kurang
Laporan kasus

Seorang wanita berusia 33 tahun, status kehamilan primigravida dengan

usia kehamilan 38 minggu mengalami epistaksis pada hidung kiri

Diberikan asam tranexamat

Endoskopi

Pemasangan tampon anterior

Transfusi darah
Pelaksanaan cito
sc

Endoskopi dan
kauterisasi
Diskusi

Penanganan epitaksis
Epitaksis merupakan
harus memperhatikan
kasus yang sering
lini pertama dan radikal
terjadi pada kehamilan
pada pasien hamil
NO Appraisal questions
1. Did the study address a clearly focused Yes, “Epistaxis is a common problem during
question/issue? pregnancy, due to an increased nasal
mucosa vascularity. Te prevalence in
pregnant women is 20.3% compared with
6.2% in nonpregnant ones [1]. Large volume
epistaxis is rare for patients without
preexisting risk factors or conditions, such
as the use of anticoagulants or blood
clotting disorders...”
1. Is the study design appropriate for answering Yes, “A 33-year-old primigravida, who was
the research question? Yes 38 weeks pregnant, presented with
spontaneous severe lef-sided epistaxis. Her
blood pressure was into normal ranges.
Clotting disorders and nasal lesions were
excluded. Te patient clinical worsening, due
to severe anemia, and the failure of
conservative treatment have imposed an
emergency caesarean section”
1. Was the study well defined protocol?
4 Are both the setting and the subject’s representative with regard to the Yes “A 33-year-old primigravida,
population to which the findings will be referred? who was 38 weeks pregnant,
presented with spontaneous severe
lef-sided epistaxis. Her blood
pressure was into normal ranges.
Clotting disorders and nasal lesions
were excluded. Te patient clinical
worsening, due to severe anemia,
and the failure of conservative
treatment have imposed an
emergency caesarean section.”

5 Is the researcher’s perspective clearly described and taken into account? No

6 Are the methods for collecting data clearly described? Yes “. Her frst episode had started
the previous week, with about
seveneight episodes a day. Her
medical history was unremarkable.
She had no personal or family
history of bleeding tendencies, and
she was not taking any regular
medications. Her blood pressure was
into normal ranges. She reported no
previous episodes of epistaxis in her
life. Routine blood tests were
normal during the pregnancy”
1. Are the methods for analysing Yes
the data likely to be valid and
reliable? Are quality control
measures used?
1. Was the analysis repeated by Yes
more than one researcher to
ensure reliability?
1. Are the results credible, and if Don’t know
so, are they relevant for
practice? Are results easy to
understand?
1. It was clinically relevant Yes
outcomes?
1. Are the conclusions drawn Yes “conservative measures frst-line, like IV
justified by the results? tranexamic acid administration, anterior packing and
bipolar cautery. If conservative treatment fails, two
radical treatments have to be considered: the one is
surgical, in the form of vessel ligation, and the other
is obstetrical and is termination of the pregnancy”