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THE EVALUATION OF EARLY INITIATION BREASTFEEDING PRACTICE in Dr. mohammad hoesin hospital palembang Bernolian, Nuswil; Sjaaf, Amal C.
Proceedings of the International Conference on Applied Science and Health No 1 (2017)
Publisher : Proceedings of the International Conference on Applied Science and Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (559.693 KB)

Background: Compared to other countries, the rate of EIB in Indonesia remains low (34,5%). During our practice, particulary in delivery room, we often find practices which delayed EIB. The recent finding that early initiation of breastfeeding (EIB) could substantially reduce neonatal mortality should result in more comprehensive efforts to increase the number of infants breast-fed within an hour of birth. Such efforts can only be effective if policies and guidelines are based on a solid knowledge of the barriers and facilitators for EIB. Aims: To evaluate EIB practice in Dr. Moh. Hoesin hospital. Methods: This was an analytic observational study, using cross sectional design. Our populations were all of afterbirth mothers (spontaneous or abdominal delivery), doctors, midwifes, as well as managerial policy holder. Samples were selected by purposive sampling. Data was obtained from the questionnaire which have been tested for validity and reliability. This study included 29 doctors and 14 midwifes as EIB implementers; also 12 managerial staffs. Results: During the periodNovember to December 2016, there were 19 (51.3%) patients with post spontaneous or abdominal deliverypracticed EIB and 18 (48.6%) patients did not practice EIB. Most of patients in âno EIB groupâ had abdominal delivery (p = 0,003). Most of patients complained that no EIB policy in operating room. Most of implementers stated that EIB already done well. The EIB implementers complained that there was lack of support about EIB practice from hospital manager and maternal level of knowledge was low. Our study found the disintegration between the managerial and executive staff, causing ambiguity in the practice of the EIB. Conclusion: The opportunitiy of EIB practice was affected by medical condition ofmother and fetus,method of delivery, hospital support, EIB policy socialization, and patientâs knowledge. There were so many challenges for our hospital to practice EIB, such as no EIB policy in operating room,the mothers condition wasnot possible to practice EIB, knowledge of the managerial about EIB differ greatly, low socialization about regulations and other elements of the EIB implementation. Thereis also disintegration between the managerand executive staff causing ambiguity in the practice ofEIBand the lack of supervision of EIB practice in the field.Â

Different Doses of Intraumbilical Oxytocin on the Third Stage of Labor Islamy, Nurul; Bernolian, Nuswil; BasiR, Firmansyah; Theodorus, Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

  Objective: To compare the dose of oxytocin injected intraumbilicalltowards the duration of the third stage, blood loss volume, hemoglobinand hematocrit.   Methods: This study is a prospective randomised study with acontrol. The control group was given an intramuscular injection of10 IU oxytocin. The intervention of the three groups intraumbilicaloxytocin treatment dose of 10 IU, 20 IU and 30 IU diluted in 50 ml ofnormal saline solution and administered intraumbilically. Thesample selection by purposive sampling and the distribution groupbased on systematic random sampling (10 samples each). Data weretaken from the period April 2016-January 2017 with the inclusionand exclusion criteria. Data were analysed using Chi-square, T-test,ANOVA and Post hoc tests.   Results: Characteristics study for variables of age, occupation,parity, education, episiotomy and neonates weight showed homogeneouscharacteristics. The mean duration of the third stage forall groups was between 366.7  159.0 seconds and 440.1  244.99seconds. While the average number of postpartum haemorrhage forall group 61.894  226.3ml and 309.5  110.26 ml. There were nodifferences in the dose of oxytocin on the duration of the thirdstage (p> 0.05) and the amount of bleeding (p> 0.005). There was adifference of haemoglobin between intervention group of oxytocindose of 10 IU and 30 IU intraumbilical (p = 0.031). There was nodifference between the mean hematocrit levels between the groups(p> 0.005).   Conclusion: There were no differences in the dose of oxytocinintraumbilical towards the duration of the third stage, the amountof bleeding and hematocrit levels. The decrease of haemoglobingreater in 30 IU intraumbilical significantly. Keywords: duration of the third stage, haemoglobin and hematocrit,oxytocin intraumbilical, the amount of bleeding

The Association of Bladder Wall Thickness with Severity of Symptoms in Patients with Overactive Bladder Adrian, Ronny; Bernolian, Nuswil; Fauzi, Amir; Saleh, Irsan
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the association of bladder wall thickness (BWT) with severity of symptoms in overactive bladder patients in Obstetrics and Gynecology Department Dr. Mohammad Hoesin general hospital Palembang. Methods: An analytical observational study was conducted at Gynecology clinic Dr. Mohammad Hoesin General Hospital Palembang from November 2015 to August 2016. Data were analyzed with SPSS 16.0 for Windows. Bivariate analysis with the Chi square and association Rank-Spearman test was used to assess the association between BWT and visual analog scale (VAS). Results: Fourty subjects were included in the study. The mean BWT in the overactive bladder group was thicker compared to those without overactive bladder (5.8522  0.5783 vs 5.2176  0.67937). There was significant association between BWT and overactive bladder complaints. Abnormal group (5mm) had 12 times risk of overactive bladder compared to normal sample (5mm) (p = 0.029, RR = 12). Conclusion: Thus, the thickness of the urinary bladder wall measured with ultrasound examination (USG) can be used to assess the status and degree of urinary disorders in women with complaints of painful urinate and urinary disorders.  Keywords: bladder wall thickness, detrusor overactivity, overactive bladder, visual analog scale

Oral versus Vaginal Misoprostol for Labour Induction : A Comparative Study Mahacakri, Eke P; Bernolian, Nuswil; Pangemanan, Wim T; Theodorus, Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the efficacy and safety of hourly titrated oralmisoprostol in solution (OMS) with vaginal misoprostol (PV) forlabor induction.Methods: Randomized Controlled Trial (RCT), double blind-add onthe study was conducted from January-November 2016 in deliveryward of Moh. Hoesin general hospital. Women 30 weeks of gestationwith an unfavorable cervix (Bishop score 6) and an indicationfor labor induction were randomly assigned to receive titrated oralor vaginal misoprostol. The OMS group received a basal unit of20 ml misoprostol solution (1 g/ml) every 1 hour for four dosesand then were titrated against individual uterine response. In theabsence of regular uterine contractions, the dose was increased to40 ml hourly for four doses and then 60 ml for four doses. Thevaginal group received 25 g every 4 hours until attaining a morefavorable cervix for three doses. All the subjects received amylumplacebo. In labor within 12 hours was the primary outcome.Results: A total of 30 women were enrolled in this study. One subjectin the OMS group was dropped out due to eclamptic seizure. Theaverage interval from induction until in labour in OMS group was5.753.14 hour and 6.604.46 hour in PV group (p = 0.56). In labourstage was achieved within 12 hours in 14 women (100%) in OMSgroup and 14 women (93.3%) in PV group (p = 1.00). Vaginaldelivery was achieved within 24 hours in 13 women (92.9%) inOMS group and 15 women (100%) in PV group. The incidence ofuterine hyperstimulation/ tachysystolic was 7.1% in OMS groupcompared with 13.3% in PV group. Fetal distress was found only 1case (7.1%) in OMS group. There was no difference in the maternaland neonatal outcome of labor in both the groups.Conclusion: Oral titrated in solution, and vaginal route ofadministration of misoprostol for induction of labour areequally effective and safe.[Indones J Obstet Gynecol 2018; 6-2: 89-97]Keywords: hourly titrated oral misoprostol in solution, oral misoprostol,randomized controlled trial, vaginal misoprostol

The evaluation of early initiation breastfeeding implementation in dr. Mohammad Hoesin Hospital of Palembang, Indonesia: Complaints and barriers Bernolian, Nuswil
Global Health Management Journal Vol 1, No 2 (2017)
Publisher : Yayasan Aliansi Cendekiawan Indonesia Thailand (Indonesian Scholars' Alliance)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (35.26 KB)

Abstract Background: Early Initiation of Breastfeeding (EIB) is a worldwide health demand of both mother and child. EIB programme implementation is the duty and responsibility of all health care practitioners, ranging from executive staff and manager, which haven’t runs well in Dr. Moh. Hoesin hospital. Objective: To identify opportunities and challenges in running the EIB programme in Obstetric Department of Dr. Moh. Hoesin hospital. Method: In this cross sectional study, all of birth mothers and health professionals were included. Samples were selected by purposive sampling. Secondary data were obtained from the questionnaire respondents which have been tested for validity and reliability. Results: During November to December 2016 period, there were 19 (51.3%) patients did EIB while 18 (48.6%) others did not. Most patients in no EIB group had abdominal delivery (p = 0,003) and complained that no EIB policy in operating room. Most of EIB implementers (29 doctors and 14 midwives) stated that EIB were already done well but complained of low level of maternal EIB knowledge and lack of EIB practice support from hospital manager. While managerial staff (n = 12) blaming the EIB implementers worked attitude for this issue. Our study found disintegration EIB implementation between the managerial and implementer staff. Conclusion: Our hospital EIB implementation faces challenges, such no EIB policy in operating room, majority of patients are obstetric referral case with complication and unfit for EIB, managerial staff knowledge of EIB differ greatly, low socialization of EIB regulations and other elements of implementation, patient’s level of knowledge, disintegration between the manager and executive staff causing ambiguity in the implementation of the EIB, and the lack of supervision of EIB implementation in the field. Key words: early initiation of breastfeeding, challenge.

The Association of Bladder Wall Thickness with Severity of Symptoms in Patients with Overactive Bladder Adrian, Ronny; Bernolian, Nuswil; Fauzi, Amir; Saleh, Irsan
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the association of bladder wall thickness (BWT) with severity of symptoms in overactive bladder patients in Obstetrics and Gynecology Department Dr. Mohammad Hoesin general hospital Palembang. Methods: An analytical observational study was conducted at Gynecology clinic Dr. Mohammad Hoesin General Hospital Palembang from November 2015 to August 2016. Data were analyzed with SPSS 16.0 for Windows. Bivariate analysis with the Chi square and association Rank-Spearman test was used to assess the association between BWT and visual analog scale (VAS). Results: Fourty subjects were included in the study. The mean BWT in the overactive bladder group was thicker compared to those without overactive bladder (5.8522  0.5783 vs 5.2176  0.67937). There was significant association between BWT and overactive bladder complaints. Abnormal group (5mm) had 12 times risk of overactive bladder compared to normal sample (5mm) (p = 0.029, RR = 12). Conclusion: Thus, the thickness of the urinary bladder wall measured with ultrasound examination (USG) can be used to assess the status and degree of urinary disorders in women with complaints of painful urinate and urinary disorders.  Keywords: bladder wall thickness, detrusor overactivity, overactive bladder, visual analog scale

Oral versus Vaginal Misoprostol for Labour Induction : A Comparative Study Mahacakri, Eke P; Bernolian, Nuswil; Pangemanan, Wim T; Theodorus, Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the efficacy and safety of hourly titrated oralmisoprostol in solution (OMS) with vaginal misoprostol (PV) forlabor induction.Methods: Randomized Controlled Trial (RCT), double blind-add onthe study was conducted from January-November 2016 in deliveryward of Moh. Hoesin general hospital. Women 30 weeks of gestationwith an unfavorable cervix (Bishop score 6) and an indicationfor labor induction were randomly assigned to receive titrated oralor vaginal misoprostol. The OMS group received a basal unit of20 ml misoprostol solution (1 g/ml) every 1 hour for four dosesand then were titrated against individual uterine response. In theabsence of regular uterine contractions, the dose was increased to40 ml hourly for four doses and then 60 ml for four doses. Thevaginal group received 25 g every 4 hours until attaining a morefavorable cervix for three doses. All the subjects received amylumplacebo. In labor within 12 hours was the primary outcome.Results: A total of 30 women were enrolled in this study. One subjectin the OMS group was dropped out due to eclamptic seizure. Theaverage interval from induction until in labour in OMS group was5.753.14 hour and 6.604.46 hour in PV group (p = 0.56). In labourstage was achieved within 12 hours in 14 women (100%) in OMSgroup and 14 women (93.3%) in PV group (p = 1.00). Vaginaldelivery was achieved within 24 hours in 13 women (92.9%) inOMS group and 15 women (100%) in PV group. The incidence ofuterine hyperstimulation/ tachysystolic was 7.1% in OMS groupcompared with 13.3% in PV group. Fetal distress was found only 1case (7.1%) in OMS group. There was no difference in the maternaland neonatal outcome of labor in both the groups.Conclusion: Oral titrated in solution, and vaginal route ofadministration of misoprostol for induction of labour areequally effective and safe.[Indones J Obstet Gynecol 2018; 6-2: 89-97]Keywords: hourly titrated oral misoprostol in solution, oral misoprostol,randomized controlled trial, vaginal misoprostol

Different Doses of Intraumbilical Oxytocin on the Third Stage of Labor Islamy, Nurul; Bernolian, Nuswil; BasiR, Firmansyah; Theodorus, Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

  Objective: To compare the dose of oxytocin injected intraumbilicalltowards the duration of the third stage, blood loss volume, hemoglobinand hematocrit.   Methods: This study is a prospective randomised study with acontrol. The control group was given an intramuscular injection of10 IU oxytocin. The intervention of the three groups intraumbilicaloxytocin treatment dose of 10 IU, 20 IU and 30 IU diluted in 50 ml ofnormal saline solution and administered intraumbilically. Thesample selection by purposive sampling and the distribution groupbased on systematic random sampling (10 samples each). Data weretaken from the period April 2016-January 2017 with the inclusionand exclusion criteria. Data were analysed using Chi-square, T-test,ANOVA and Post hoc tests.   Results: Characteristics study for variables of age, occupation,parity, education, episiotomy and neonates weight showed homogeneouscharacteristics. The mean duration of the third stage forall groups was between 366.7  159.0 seconds and 440.1  244.99seconds. While the average number of postpartum haemorrhage forall group 61.894  226.3ml and 309.5  110.26 ml. There were nodifferences in the dose of oxytocin on the duration of the thirdstage (p> 0.05) and the amount of bleeding (p> 0.005). There was adifference of haemoglobin between intervention group of oxytocindose of 10 IU and 30 IU intraumbilical (p = 0.031). There was nodifference between the mean hematocrit levels between the groups(p> 0.005).   Conclusion: There were no differences in the dose of oxytocinintraumbilical towards the duration of the third stage, the amountof bleeding and hematocrit levels. The decrease of haemoglobingreater in 30 IU intraumbilical significantly. Keywords: duration of the third stage, haemoglobin and hematocrit,oxytocin intraumbilical, the amount of bleeding

Comparison between Leukocyte Esterase Activity (LEA) and Histopathology Examination in Identifying Chorioamnionitis Cases Novianesari, Putri H; Bernolian, Nuswil; Maulani, Henni; Ramadanti, Afifa; Theodorus, Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare sensitivity and specificity of LEA to histopathology examination in diagnosing chorioamnionitis. Methods: We compared diagnostic tests in dr. Mohammad Hoesin hospital, Palembang, from September 2015 to April 2016. Ninety-one pregnant women were included. LEA and histopathology examination were carried out with neonatal sepsis as main outcome. Data were analysed by SPSS version 21.0 and Med-calc statistic. Results: Chorioamnionitis was detected in 54 (77.1%) patients with gestational period ≥37 weeks and in 16 (22.9%) patients with gestational period <37 weeks. Duration of membrane rupture was significantly associated with chorioamnionitis (p = 0.001 and p = 0.011). Neonatal sepsis was also significantly associated with chorioamnionitis in both groups (p = 0.014 and p = 0.036). LEA value with cut-off point >0.5 was able to significantly predict chorioamnionitis with 98.6% sensitivity and 95.2% specificity, providing better accuracy in diagnosing chorioamnionitis in preterm pregnancy group. Conclusion: LEA had a very good predictive value for chorioamnionitis with better accuracy in diagnosing chorioamnionitis in preterm pregnancy. Keywords: Chorioamnionitis, Histopathology, Leukocyte esterase activity, Neonatal sepsis, Salafia criteria       Tujuan: Membandingkan sensitifitas dan spesifisitas diagnosis korioamnionitis antara pemeriksaan Leukocyte esterase activity (LEA) terhadap histopatologi. Metode: Penelitian uji diagnostik dilakukan di RSUP dr. Mohammad Hoesin Palembang selama periode September 2015 – April 2016,  91 wanita hamil yang memenuhi kriteria inklusi selanjutnya dilakukan pemeriksaan LEA, Histopatologi dan luaran sepsis neonatorum. Data kemudian dianalisis dengan menggunakan software SPSS versi 21.0 dan Med-calc statistic. Hasil: Korioamnionitis terdeteksi pada 54 (77,1%) pasien dengan usia gestasi ≥37 minggu dan 16 (22,9%) pada usia gestasi <37 minggu. Durasi lamanya pecah ketuban akan berpengaruh secara signifikan terhadap kejadian korioamnionitis (p = 0,001 dan p = 0,011), Sepsis neonatorum juga secara signifikan berhubungan dengan kejadian korioamnionitis pada kedua kelompok (p = 0,014 dan p = 0,036). Kadar LEA dengan cut off point >0,5 secara signifikan mampu memprediksi kejadian korioamnionitis dengan sensitivitas 98,6%, spesifisitas 95,2% dan nilai akurasi yang lebih baik ditemukan dalam penegakan diagnosis korioamnionitis pada kelompok kehamilan preterm. Kesimpulan: Pemeriksaan LEA memiliki kekuatan prediksi yang sangat baik terhadap kejadian korioamnionitis dengan akurasi yang lebih baik dalam mendiagnosis korioamnionitis pada kehamilan preterm. Kata kunci: Korioamnionitis, Histopatologi, Leukocyte Esterase Activity,Sepsis Neonatorum, Kriteria Salafia

Preterm Labor Predictors: Maternal Characteristics, Ultrasound Findings, Biomarker, and Artificial Intelligence Nuswil Bernolian; Chairil Anwar; Cindy Kesty
Majalah Kedokteran Sriwijaya Vol 52, No 1 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i1.11429

The identification of risk factors for preterm labor is an important predictor. The risk factors for preterm labor can be maternal characteristics, namely maternal obstetric history, maternal body mass index and weight gain, multiple pregnancy, maternal infections, periodontal disease, maternal vitamin D deficiency, and lifestyle. Nowadays, various accurate diagnostic methods have been developed to diagnose preterm labor, namely ultrasound (cervical length, cervical consistency, uterocervical angle, and fetal adrenal gland) and biomarkers (IL-6 and IL-8 in cervicovaginal fluid, Placental Alpha Microglobulin-1 (PAMG-1), and Insulin-Like Growth Factor Binding Protein-1 (IGFBP-1), Vascular Endothelial Growth Factor (VEGF), Placental Growth Factor (PGF), Soluble VEGF Receptor-1 (sFlt-1), High Mobility Group Box-1 (HMGB1), and calponin. Artificial Intelligence was developed to predict preterm labor, namely in the form of ultrasound software which is capable of detecting cervical funneling processes ranging from resembling the T, Y, V, and U-shaped. This software is expected to be easily used by general practitioners and obstetricians and gynecologists, especially those who work in rural areas.

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