Nuswil Bernolian
Biomedicine Doctoral Program, Faculty Of Medicine, Universitas Sriwijaya, Palembang, South Sumatera, Indonesia / Division Of Maternal Fetal Medicine, Department Of Obstetrics And Gynecology, Mohammad Hoesin General Hospital/Faculty Of Medicine, Unive

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CURRENT UPDATE ON CONGENITAL HEART DISEASE SCREENING IN PREGNANCY Nuswil Bernolian; Cindy Kesty; Benedictus Wicaksono Widodo
Majalah Kedokteran Sriwijaya Vol 52, No 2 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i2.11976

Abstract

Congenital Heart Disease (CHD) affects 8 births per 1,000 live births; equivalent to 1.35 million children born with CHD each year. Based on global incidence rate, Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), and Atrioventricular Septal Defect (AVSD) are found on 54.5% of CHD cases. Genetic factors are known to involve in CHD. Moreover, it can also be caused by environmental and infectious factors. Ultrasonography has been widely utilized to screen CHD at 18-22 weeks gestational age. Screening aims to measure heart rate, heart size, heart position, four chamber of the heart, pericardium, atrium, ventricles, atrioventricular junctions, and ventriculoatrial junctions. Doppler echocardiography becomes primary diagnostic tools in CHD patients because of its high sensitivity and specificity, safety, and noninvasiveness. Follow-up examination is indicated on a few conditions. Maternal indications include autoimmune antibody, family history of defects, in vitro fertilization, maternal metabolic disease, or teratogenic exposure. Fetal indications include abnormal screening result, family history of CHD, abnormal heart rhythm, chromosomal abnormalities, extracardiac abnormalities, hydrops, or monochorionic twin pregnancy. With increased rate of CHD, better screening and follow-up should be conducted to achieve acceptable detection rate.
Cardiac Disease in Pregnancy: Maternal and Perinatal Outcomes in RSUP Dr. Mohammad Hoesin Palembang Ni Made Dyah Gayatri; Peby Maulina Lestari; Abarham Martadiansyah; Nuswil Bernolian; Hadrians Kesuma Putra; Rizky Agustria; Muwarni Emasrissa Latifah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.448

Abstract

Background: Impaired maternal and uteroplacental perfusion can occur in pregnancy with cardiac disease leading to maternal and perinatal mortality and morbidity due to increased cardiac load and ventricular dysfunction. This research aims to determine maternal and perinatal outcomes of pregnancies with cardiac disease. Method: This research was a descriptive observational study conducted by total sampling method and cross-sectional design. This research used medical records of pregnant women with cardiac disease who gave birth in RSUP Dr. Mohammad Hoesin Palembang in January 2018-December 2020 as study samples. Result: Among 68 pregnancies with cardiac disease, there were 6 cases (0.87%) found in 2018, 38 cases (2.47%) found in 2019, and 24 cases (1.48%) found in 2020. The highest distribution of pregnancies with cardiac disease was found at 64.7% in the range of 20-35 years old age group; 57.4% in the multiparity group; 38.2% in the range of ≥34 – <37 weeks gestational age group; 86.8% in the high school educational level group; 66.2% in the high-risk cardiac functional status group; 54.4% in the peripartum cardiomyopathy group; and 36.8% with preeclampsia/eclampsia as a comorbid. In this study, maternal outcomes found were maternal mortality at 11.8%; cardiac failure at 70.6%; arrhythmia at 1.5%; and stroke at 1.5%, while perinatal outcomes found were prematurity at 60.3%; low birth weight at 64.4%; IUGR at 37.0%; IUFD at 1.4%; stillbirth at 6.8%; neonatal death at 9.6%; and perinatal asphyxia at 42.5%. Conclusion: The prevalence rate of pregnancies with cardiac disease in RSUP Dr. Mohammad Hoesin Palembang was 0.87% in 2018, 2.47% in 2019, and 1.48% in 2020. The most common maternal outcome in this study was cardiac failure, with most in the peripartum cardiomyopathy group, while the most common perinatal outcome was low birth weight, with most in the hypertensive heart disease group.
Kehamilan pada Skar Seksio Sesaria Nuswil Bernolian; Win T. Pangemanan; A. Kurdi Syamsuri; M. Hatta Ansyori; Putri Mirani; Peby Maulina Lestari; Abraham Martadiansyah; Cindy Kesty
Indonesian Journal of Obstetrics & Gynecology Science Volume 3 Nomor 2 September 2020
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v3n2.198

Abstract

Tujuan: Memaparkan klasifikasi, faktor risiko, epidemiologi, cara diagnosis, tatalaksana, dan komplikasi kehamilan pada skar seksio sesareaMetode: Tinjauan pustakaKesimpulan: Kehamilan pada skar SC merupakan kehamilan yang kantung kehamilannya terdapat pada miometrium yang menipis akibat SC sebelumnya. Secara umum, kehamilan pada skar Caesarean Scar Pregnancy (CSP) dapat dibedakan menjadi 2 tipe, yaitu tipe 1 (endogenik) dan tipe 2 (eksogenik). Kejadiannya berkisar antara 1 per 8.000 dan 1 per 2.500 SC dengan risiko rekurensi 3,2-5,0% pada wanita dengan riwayat SC 1 kali yang ditatalaksana dengan dilatasi dan kuretase dengan atau tanpa embolisasi arteri uterina. Adapun faktor risiko CSP adalah tebal Segmen Bawah Rahim (SBR) <5 mm, kantong kehamilan menonjol ke plika vesikouterina, SC di rumah sakit umum daerah, dan riwayat perdarahan melalui vagina ireguler dan nyeri abdomen selama CSP sebelumnya. Pengobatan CSP dapat secara konservatif dengan metotreksat (MTX) maupun operatif termasuk eksisi jaringan kehamilan dengan laparoskopi, histerotomi, atau histerektomi. Pilihan pengobatan lain termasuk dilatasi dan kuretase, reseksi transervikal (TCR) dengan histeroskopi, embolisasi arteri uterina (UEA), kemoembolisasi arteri uterina, atau penempatan kateter balon ganda.Caesarean Scar PregnancyAbstractObjective: To explain about classification, risk factors, epidemiology, diagnostic methods, management, and complications of Caesarean Scar Pregnancy (CSP).Method: Literature review Conclusion: CSP is a pregnancy where the gestational sac is found in the thin myometrium due to previous CS. In general, Caesarean Scar Pregnancy (CSP) can be divided into 2 types, namely type 1 (endogenic) and type 2 (exogenic). Its incidence ranges from 1 per 8,000 and 1 per 2,500 SC with a recurrence risk of 3.2-5.0% in women with a history of 1 time CS who are treated with dilatation and curettage with or without uterine artery embolization. The risk factors for CSP are lower uterine segment thickness <5 mm, gestational sac pouches protruding into the vesicouterine fold, CS in regional public hospitals, and a history of irregular vaginal bleeding and abdominal pain during previous CSP. Caesarean scar pregnancy treatment can be conservative with methotrexate (MTX) or operatively including excision of pregnancy tissue with laparoscopy, hysterotomy, or hysterectomy. Other treatment options include dilatation and curettage, transcervical resection (TCR) with hysteroscopy, uterine artery embolization (UAE), chemoembolization of the uterine arteries, or placement of a double-balloon catheter.Key words: Caesarean scar pregnancy
Primigravida Hamil 12 Minggu dengan Atrial Septal Defect Secundum dan Hipertensi Pulmonal Berat Janin Tunggal Hidup Intrauterin Cindy Kesty; Nuswil Bernolian; Kgs Irawan Satria Arjanggi
Indonesian Journal of Obstetrics & Gynecology Science Special Issue: Case Report
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (603.446 KB)

Abstract

Latar Belakang: Atrial Septal Defect (ASD) apabila disertai hipertensi pulmonal berat harus dikonseling karena tingginya insiden morbiditas dan mortalitas ibu dan janin. Tujuan: Memaparkan sebuah kasus primigravida dengan ASD secundum dan hipertensi pulmonal berat sehingga dapat dilakukan tatalaksana dan pemilihan kontrasepsi yang sesuai.Metode: Laporan kasus seorang wanita berusia 30 tahun, hamil 12 minggu, mengeluh sesak nafas, batuk pada malam hari, dan jantung berdebar-debar. Hasil rontgen thoraks menunjukkan gambaran hipertensi pulmonal disertai peningkatan vaskularisasi paru. Kateterisasi jantung menunjukkan ASD secundum besar, hipertensi pulmonal berat, high flow, high resistance, dan reaktif dengan tes O2. Hasil ekokardiografi (2017) menunjukkan ASD secundum berat, regurgitasi trikuspid dan pulmonal moderat. Ultrasonografi abdomen menunjukkan kesan hamil 12 minggu janin tunggal hidup intrauterin, mioma uteri intramural dan subserosum, perdarahan subamnion dan subkorion. Pada pasien ini, dilakukan abortus provokatus medisinalis melalui pemberian Prostaglandin dilanjutkan dengan dilatasi dan kuretase.Kesimpulan: Kehamilan pada wanita dengan ASD umumnya ditoleransi dengan baik, dengan luaran ibu dan janin yang baik. Pasien dengan penyakit jantung berat sebaiknya tidak hamil dan bila hamil sebaiknya diterminasi. Preparat estrogen merupakan kontraindikasi pada pasien jantung. Pemilihan kontrasepsi harus mempertimbangkan keparahan, tipe anatomis kelainan jantung, dan keinginan ibu untuk mempertahankan fungsi reproduksinya.Kata Kunci: primigravida, ASD secundum, hipertensi pulmonal  AbstractBackground: Atrial Septal Defect (ASD) with severe pulmonary hypertension should be counseled because of the high incidence of maternal and fetal morbidity and mortality. Objective: Describing a case of primigravida with ASD secundum and severe pulmonary hypertension so that appropriate management and contraception can be selected.Method: A 30-year-old woman, 12 weeks pregnant, suffered from shortness of breath, coughing at night, and palpitations. Chest X-ray showed pulmonary hypertension with increased pulmonary vascularity. Cardiac catheterization showed a large ASD secundum, severe pulmonary hypertension, high flow, high resistance, and reactive O2 test. Echocardiography (2017) showed severe ASD secundum, moderate tricuspid, and pulmonary regurgitation. Abdominal ultrasonography showed 12 weeks gestational age single live fetus intrauterine, intramural and subserosal uterine myoma, and also subamniotic and subchorionic bleeding. We did provoked abortion using Prostaglandin continued with dilatation and curettage.Conclusion: Pregnancy in women with ASD is generally well tolerated, with good maternal and fetal outcomes. Patients suffered from severe heart disease should not be pregnant, and if necessary get pregnancy terminated. Estrogen preparations are contraindicated in these patients. The choice of contraception must consider the severity, the anatomy of heart abnormality, and mother's desire to maintain her reproductive function. Key words: primigravida, ASD secundum, pulmonary hypertension.
Maternal Obesity Increases Risk for Adverse Maternal Outcome at RSUP Dr. Mohammad Hoesin Palembang Syifa Alkaf; Optima Fitra Ilhami; Mutiara Budi Azhar; Nuswil Bernolian; Ardesy Melizah
Indonesian Journal of Obstetrics & Gynecology Science Volume 3 Nomor 1 Maret 2020
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1801.879 KB) | DOI: 10.24198/obgynia/v3n1.178

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Objective: To find the relationship between level of obesity and adverse maternal outcomes in pregnant women Method: An observational analytic study with a cross sectional design with secondary data from medical record. Subjects were pregnant women who gave birth at RSUP Dr. Mohammad Hoesin Palembang in January 2015-December 2017. Samples were taken by purposive sampling technique. BMIs  were divided into 5 categories based on WHO criteria, normoweight, overweight, obese level I, II, and III. Underweight was excluded from the study.Result: Of 252 research subjects, 94 (37.3%) were subjects with normal BMI, 102 (40.5%) were overweight, 44 (17.5%) were obese level I, 6 (2.4%) were level II, and 6 (2.4%) were level III. The maternal outcome consisted of 135 cases (53.6%) of preeclampsia, 6 cases of gestational diabetes mellitus (2.4%), 41 cases of uterine inertia (16.3%), 56 cases of preterm labor (22.2%), assisted delivery 111 cases (44%), and healthcare associated infections (HAIs) 6 cases (2.4%). Further analysis showed that increased level of maternal obesity is related significantly with preeclampsia, gestational diabetes mellitus, uterine inertia, and assisted delivery.Conclusion: There are statistically significant association between obesity level and the incidence of preeclamsia, gestational diabetes, uterine inertia and assisted delivery.Obesitas Pada Wanita Hamil Meningkatkan Morbiditas Maternal Di RSUP Dr. Mohammad Hoesin PalembangAbstrakTujuan: Untuk menemukan hubungan antara tingkat obesitas dengan luaran maternal pada wanita hamil. Metode: Studi analitik observasional dengan desain potong lintang menggunakan data sekunder rekam medis. Subjek adalah wanita hamil yang melahirkan di RSUP Dr.Mohammad Hoesin Palembang pada Januari 2015 - Desember 2017. Sampel diambil secara purposive sampling. Indeks massa tubuh (IMT) dibagi menjadi 5 sesuai kriteria WHO, yaitu normal, berat badan lebih, obesitas level I, II, dan III. Berat badan kurang diekslusi dari penelitian. Hasil: Subjek penelitian dari 252 orang, 94 (37.3%) subjek dengan IMT normal, 102 (40.5%) subjek berat badan berlebih,  44 (17.5%) obesitas level I,  6 (2.4%) obesitas level II, dan 6 (2.4%) obesitas level III. Luaran  maternal terdiri dari 135 kasus (53.6%) of preeklampsia, 6 kasus diabetes mellitus gestasional,  41 kasus inertia uteri  (16.3%), 56 kasus persalinan preterm (22.2%), 111 kasus (44%) persalinan pervaginam berbantu, dan infeksi luka 6 kasus (2.4%).  Analisis menunjukkan adanya tingkatan obesitas maternal berkaitan secara signifikan dengan kejadian preeklampsia, diabetes mellitus gestasional, inertia uteri, dan persalinan pervaginam berbantu. Kesimpulan: Terdapat hubungan antara tingkat obesitas pada ibu hamil dengan preeklampsia, diabetes mellitus gestasional, dan persalinan pervaginam berbantu. Kata kunci: Indeks Massa Tubuh, Obesitas, Luaran Maternal, Morbiditas.
Preeklamsia Pascasalin Nuswil Bernolian; Wim T. Pangemanan; A. Kurdi Syamsuri; M. Hatta Ansyori; Putri Mirani; Peby Maulina Lestari; Abarham Martadiansyah; Cindy Kesty
Indonesian Journal of Obstetrics & Gynecology Science Special Issue: Article Review
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v4n2s.196

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AbstrakTujuan: Memaparkan etiologi dan faktor risiko, diagnosis banding, patofisiologi, pemantauan, terapi, komplikasi, rekurensi dan tindakan preventif pada kasus preeklamsia pascasalin.Metode: Tinjauan pustaka dengan berbagai referensi yang diakses melalui mesin pencarian seperti Pubmed dan Sci-Hub dengan menggunakan kata kunci preeclampsia, hypertension, postpartum, management. Sumber referensi yang digunakan yaitu guidelines, jurnal, dan buku teks yang diterbitkan dalam 15 tahun terakhir.Kesimpulan: Insiden preeklamsia di Indonesia yaitu 128.273/tahun atau sekitar 5,3%. Sebanyak 0,3 – 27,5% kasus yang dilaporkan mengalami preeklamsia atau hipertensi pascasalin. Gejala-gejala preeklamsia pascasalin muncul setelah melahirkan. Mayoritas kasus berkembang dalam 48 jam setelah persalinan, walaupun sindrom dapat muncul hingga 6 minggu setelah persalinan. Periode pascasalin merupakan waktu kritis bagi spesialis obstetri dan ginekologi untuk menjamin wanita dengan riwayat preeklamsia untuk dipantau dalam jangka waktu pendek dan panjang. Akan tetapi, pemantauan pascasalin sangatlah rendah, berkisar antara 20-60%. Pemilihan antihipertensi pasca salin yaitu berikatan kuat dengan protein dan solubilitas lipid yang rendah sehingga lebih sedikit yang masuk ke ASI. Selain itu, dipengaruhi juga oleh ionisasi, berat molekul dan konstituen ASI (kandungan lemak, protein, dan air). Agen lini pertama untuk preeklamsia pascasalin adalah labetalol dan hidralazin intravena serta nifedipin. Wanita dengan hipertensi gestasional ataupun preeklamsia biasanya dapat menghentikan antihipertensi dalam 6 minggu pasca salin.Postpartum PreeclampsiaAbstractObjective: To explain about etiologies and risk factors, differential diagnosis, pathophysiology, follow up, treatment, complications, recurrence, and prevention of preeclampsia post delivery discharged.Method: Literature review with several references accessed through search engines such as Pubmed and Sci-Hub by using keywords preeclampsia, hypertension, postpartum, management. Reference sources used are guidelines, journals, and textbooks published in the last 15 years.Conclusion: The incidence of preeclampsia in Indonesia is 128,273/year or around 5.3%. As many as 0.3-27.5% of cases reported postpartum preeclampsia or hypertension. Symptoms of postpartum preeclampsia appear after delivery. The majority of cases develop within 48 hours after delivery, although the syndrome can appear up to 6 weeks after delivery. The postpartum period is a critical time for obstetricians and gynecologists to ensure women with a history of preeclampsia are monitored in the short and long term. However, postpartum monitoring is very low, ranging from 20-60%. The choice of antihypertensive postpartum is that it is strongly bound to protein with low lipid solubility so that fewer enter breast milk. In addition, it is also influenced by ionization, molecular weight and constituents of breast milk (fat content, protein, and water). The first line agent for postpartum preeclampsia is intravenous labetolol and hydralazine and also nifedipine. Women with gestational hypertension or preeclampsia can usually stop antihypertension within 6 weeks postpartum.Key word: postpartum preeclampsia, antihypertension
The Association of Bladder Wall Thickness with Severity of Symptoms in Patients with Overactive Bladder: HubunganantaraKetebalanDindingVesikaUrinaridenganKeparahanGejalapadaPasienOveractiveBladder Ronny Adrian; Nuswil Bernolian; Amir Fauzi; Irsan Saleh
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (209.4 KB) | DOI: 10.32771/inajog.v5i4.564

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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
The risk of sensorineural hearing impairment in preeclampsia: Risiko Gangguan Pendengaran Sensorineural pada Pasien Preeklamsia Achmad Taufan; Nuswil Bernolian; Yusuf Efendi; Alba G.E. Bahar
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (56.948 KB) | DOI: 10.32771/inajog.v7i3.585

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Abstract Objective: To determine the risk of sensorineural hearing impairment in preeclampsia patients and to in Obstetric and Gynecology Department in Dr. Mohammad Hoesin Hospital Palembang. Method: An analytic observational case-control study was held in Dr. Mohammad Hoesin Hospital Palembang from January 1st to December 31st 2016. Subjects were obtained through consecutive sampling. Hypothetical tests used were unpaired t-test, Chi-square test and Fisher test for expected deviation standard <5, significance determined based on p-value if p<0.05. Data progressing and analysis were done using SPSS version 17.0 for windows. Results: Characteristics distribution of the subjects were overall homogenous. With the Chi-square test, no significant difference was found in hearing function examination with OAE and tympanometry in both groups (p>0.05). From unpaired t-test, there was no significant difference between mean Air Conducting (AC) and Bone Conducting (BC) of the right ear in severe preeclampsia group and healthy pregnancy group (p=0.340), as well as mean AC and BC of the left ear in severe preeclampsia group and healthy pregnancy group (p=0.059). Based on the Fisher's Exact test, no significant relation was found between severe preeclampsia and sensorineural hearing impairment (p=0.999). Conclusion:There was no significant relation between severe preeclampsia and sensorineural hearing impairment in Obstetric and Gynecology Department in Dr. Mohammad Hoesin Palembang. Keywords: otoacoustic emission, preeclampsia, sensorineural hearing impairment. Abstrak Tujuan: Mengetahui risiko gangguan pendengaran sensorineural pada pasien dengan preeklamsia di Departemen Obstetri dan Ginekologi RSUP Mohammad Hoesin Palembang. Metode: Penelitian analitik observasional dengan disain kasus kontrol pada wanita hamil di RSMH sejak 1 Januari – 31 Desember 2016. Subjek dipilih secara consecutive sampling. Analisis dengan uji t tak berpasangan, Chi-square, dan uji Fisher untuk ekspektasi sd<5, kemaknaan ditentukan berdasarkan (p) jika p<0.05. Proses mengolah dan analisis data ini dilakukan menggunakan SPSS 17.0 for windows. Hasil: Distribusi karakteristik umum subjek secara keseluruhan adalah homogen. Berdasarkan uji Chi Square, tidak didapatkan perbedaan bermakna hasil pemeriksaan fungsi pendengaran dengan OAE dan Timpanometri pada kedua kelompok (p>0,05). Dengan uji T tidak berpasangan, tidak didapatkan perbedaan bermakna rerata Air Conducting (AC) dan Bone Conducting (BC) telinga kanan kelompok PEB dan kelompok hamil normal (p=0,340), begitu juga dengan rerata Air Conducting (AC) dan Bone Conducting (BC) telinga kiri kelompok PEB dan kelompok hamil normal (p=0,059). Berdasarkan uji statistik Fisher, tidak didapatkan hubungan bermakna antara preeklamsia berat dengan gangguan pendengaran sensorineural (p=0,999). Simpulan:Tidak terdapat hubungan yang bermakna antara preeklamsia berat dengan gangguan pendengaran sensorineural berdasarkan pemeriksaan audiometri di Departemen Obstetrik dan Ginekologi RSUP Dr. Mohammad Hoesin Palembang. Kata kunci: gangguan pendengaran sensorineural, otoacoustic emission, preeklamsia
Oral versus Vaginal Misoprostol for Labour Induction : A Comparative Study Eke P Mahacakri;  Nuswil Bernolian; Wim T Pangemanan; Theodorus Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (126.447 KB) | DOI: 10.32771/inajog.v6i2.767

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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: Berbagai Dosis Oksitosin Intraumbilikal pada Manajemen Aktif Kala III Nurul Islamy; Nuswil Bernolian; Firmansyah BasiR; Theodorus Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.291 KB) | DOI: 10.32771/inajog.v6i3.780

Abstract

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
Co-Authors A. Kurdi Syamsuri Achmad Taufan Adhi Pribadi Adrian, Ronny Afifa Ramadanti Agustria, Rizky Al Farisi Sutrisno, Muhammad Alba G.E. Bahar Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Alia Desmalia Aloysius Suryawan Amal C. Sjaaf Amir Fauzi Amir Fauzi Anang Ansyori Andonotopo, Wiku Ansyori, Muhammad Hatta Ardesy Melizah Arjanggi, Kiagus Irawan Satria Bachnas, Muhammad Adrianes Bambang Rahardjo Bangun T. Purwaka, Bangun T. Benedictus Wicaksono Widodo Chairil Anwar Cindy Kesty Citra Dewi Cut Meurah Yeni Damar Prasmusinto Eddy Roflin Eke P Mahacakri Evert Solomon Pangkahila Firmansyah Basir Firmansyah Basir Henni Maulani Herman Kristanto I Nyoman Hariyasa Sanjaya Jhonatan, Senna Moca Johanes C. Mose Julian Dewantiningrum Juneke J. Kaeng Junita, Nuria Kesty, Cindy Kgs Irawan Satria Arjanggi Kurjak, Asim M. Hatta Ansyori Made K. Karkata, Made K. Mahacakri, Eke P Maharsi, Rahma Maisuri T. Chalid, Maisuri T. Makmur Sitepu, Makmur Martadiansyah, Abarham Maulani, Henni Muhammad Irsan Saleh Mutiara Budi Azhar Muwarni Emasrissa Latifah Muzakkie, Mufida Ni Made Dyah Gayatri Nisfita, Rizania Raudhah Noroyono Wibowo Novianesari, Putri H Nurul Islamy Nurul Islamy Nyimas Aliyah Faizatun Muthmainnah Optima Fitra Ilhami Pangemanan, Wim T Pangemanan, Wim Theodorus Peby Maulina Lestari, Peby Maulina Pramono, Mochammad Besari Adi Puspitasari, Dwi Cahya Putra, Hadrians Kesuma Putri H Novianesari Putri Mirani Putri Mirani Putri Mirani Putri Mirani Putri, Asri Indriyani Rima Irwinda, Rima Rizky Agustria Ronny Adrian Rose Mafiana Ryan Saktika Mulyana Sangjaya, Arif Sentani, Ray Suga Aulia Sjaaf, Amal C. Sjaaf, Amal C. Sri Sulistyowati Stanojevic, Milan Syamsuri, Ahmad Kurdi Syifa Alkaf Theodorus Theodorus Theodorus Theodorus Theodorus Theodorus Theodorus Theodorus Theresia Monica Rahardjo Wim T Pangemanan Wim T. Pangemanan Wim T. Pangemanan Win T. Pangemanan Wiradnyana, Anak Agung Gede Putra Yulianto kusnadi Yusrawati Yusrawati Yusuf Efendi