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All Journal Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Indonesian Journal of Cancer Berita Kedokteran Masyarakat RESLAJ: Religion Education Social Laa Roiba Journal

Eka R Gunardi

Department Of Obstetrics And Gynecology, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Author-ID : 270696

Religion Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Articles

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Family Planning Problem in Indonesia Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

N/A

A Randomized FiveYear Comparative Study of Two LevonorgestrelReleasing Implant Systems: Norplant® Capsules and Jadena® Rods Affandi, Biran; Ridwan, Rusdi S; Hoesni, R Hasan M; Tandjung, Thamrin; Ichsan, TM; Amran, Rizani; Manan, Heriyadi; Gunardi, Eka R; Pramana, Noor; Hadiyono, Suryo; Widohariadi, Widohariadi; Farid, Retno B; Taher, Mardiah
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To provide a randomized comparison between Jadena® and Norplant® in terms of efficacy and acceptability among Indonesian women. Method: This study was a phase IV, open label, randomized, multicenter study throughout Indonesia. Subjects were Indonesian adult women who were randomized to receive Jadena® or Norplant® as their contraceptive method. The subjects were recruited from 6 large cities in Indonesia, such as Medan, Palembang, Jakarta, Semarang, Surabaya, and Makassar. Result: Of 600 subjects, 301 women getting to Jadena® and 299 women to Norplant® were enrolled between August 1998 and February 1999. The mean age was 29.8 (SD 5.3) years old, ranging from 18 to 40 years old. We did not find the pregnancy during the study. Non-pregnancy probability at the end of one year was similar between Jadena® (0.920 (SD 0.016)) and Norplant® users (0.916 (SD 0.084)). The continuation rates of Jadena® at one and three-year were 95.3% and 66.8%; whereas, the continuation rates of Norplant® was 94.3% at year-1 and 70.2% at year-3. Conclusion: The new two rod levonorgestrel subdermal system (Jadena®) showed similar efficacy with the old six capsule levonorgestrel subdermal system (Norplant®) in term of birth control. Both implant systems also have similar tolerability profile. Jadena® is easier to insert and remove than Norplant®. Keywords: birth control, efficacy, implant

Acceptor Comment of PostPlacental Copper T380A Intrauterine Device Gunardi, Eka R; Malik, Adila RA; Oktavianti, Febby; Meria,, Riry; Ardianto, Fachreza; Marian, Christina
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To describe the characteristics of subjective complaints reported by post-placental inserted intrauterine device (IUD) acceptor, especially those who used Copper T380A (CU T380A) type of IUD. Methods: Seventy-two-married women whose age ranged from 19 to 44 years old and received post-placental IUD in Dr. Cipto Mangunkusumo Hospital, Jakarta, were included in this study. Subjective complaints regarding the use of CU T380A IUD were evaluated twice including during the puerperium and six months afterwards by a direct interview. Results: Most respondents were 20-35 years old, 50% of whom were primiparous (n=36). There were 42% respondents reporting pain during insertion, 32% respondents reporting abdominal pain during the use, 22% respondents reporting menstrual disorder, 18% respondents reporting vaginal discharge, and 3% respondents complaining of having IUD repulsion. Conclusion: There are variety of subjective complaints reported after post-placental IUD use. However, most of the respondents does not complain anything. [Indones J Obstet Gynecol 2017; 5-1: 19-22] Keywords: complication, contraception, intrauterine device (IUD) post-placental, postpartum

The Efficacy of Monoplant® and Indoplant® as Contraceptive Methods: A Comparative Study Gunardi, Eka R; Ballo, Frista
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the effectiveness, safety, and time of insertion between Monoplant® with Indoplant® to prevent pregnancy. Methods: Data were collected from November 2015 until May 2016 in Raden Saleh Clinic. A total of 153 patients met the inclusion and exclusion criteria for the study and were divided into 77 patients who received Monoplant® and 76 patients received Indoplant®. The study period was 6 months. Results: The data obtained showed no significant difference in the effectiveness of both contraceptive methods. In addition, side effects such as menstrual disorders and weight gain did not differ significantly in those study groups. However, the time of insertion between Monoplant® and Indoplant® was siginificantly different (162.91 + 197.04 + 49.81 seconds versus 44.96 seconds, p<0.001). For complications such as skin irritation, inflammation, there are no differences between Monoplant® (0.0%) and Indoplant® users (0.0%). Conclusion: There are no significant differences in efficacy and side effects using Monoplant® and Indoplant® during the 6-month follow-up. However, the insertion time of Monoplant® is shorter compared to Indoplant®’s. Monoplant® can be considered for use as contraception with the effectiveness and side effects are almost the same, but with shorter time of insertion compared to Indoplant ®. [Indones J Obstet Gynecol 2017; 5-2: 94-98] Keywords: contraception, implant, indoplant®, monoplant®

Basal Temperature, Cervical Mucous, and Both Combination as Diagnostic Tools to Detect Ovulation Gunardi, Eka R; Mukti, Alexander; Situmorang, Herbert
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

    Objective: To make basal body temperature examination andcervical mucus as an alternative examination in detectingovulation, especially in health facilities that do not have ultrasound.   Methods: This cross-sectional study was conducted at the outpatientclinic of RSUPN Dr. Cipto Mangunkusumo in the year2016-2017. A total of 49 infertile female patients who had normalmenstrual cycles were asked to participate and performedbasal body temperature measurements, cervical mucussampling and transvaginal ultrasound examination, the dataare subsequently grouped into 3 Days Estimated Ovulation(DEO); DEO-2 days, DEO and DEO+ 2 days. Diagnostic testswere performed and accurate comparison between basal bodytemperature, cervical mucus and a combination of both werelater assessed.   Results: The best accuracy was found on cervical mucus andcombination of both with 65% in detecting ovulation, whilstthe lowest was basal body temperature (59%) with sensitivity46.7%, and specificity 78.9%. Cervical mucus in diagnosingovulation has a sensitivity of 70% and specificity 57.8%. Thecombination of temperature-cervical mucus in diagnosing ovulationhas sensitivity of 46.67% and specificity of 94.73%.   Conclusion: Cervical mucus examination has better accuracy comparedwith basal body temperature examination in detecting ovulation.Further research for validating these diagnostic tools to thewider community and not only in patients with infertility is needed.   Keywords: basal body temperature, cervical mucus, infertility, ovulationdetection, ultrasound

The Association between Endometriosis Appearance during Laparoscopic Surgery and Pain Characteristic in Pelvic Endometriosis Situmorang, Herbert; Lestari, Renny; Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To evaluate the correlation between the American Society of Reproductive Medicine (ASRM) score in endometriosis and severity pelvic pain in a group of women with endometriosis. Method: A total of 131 patients with pelvic pain who: conduct laparoscopy for diagnosis and therapy of endometriosis, have pain symptoms>3 months, and absence of pelvic anomalies. Dysmenorrhea, deep dyspareunia, dyschezia, dysuria, and chronic pelvic pain were evaluated using a 10-point visual analogue scale. The data was collected by assessing the medical record, and retrospective analysis was performed. Disease stage according to the American Society of Reproductive Medicine, the presence of adhesion, lesion type (Deep Infiltrating Endometriosis (DIE) or without DIE), and severity of pain symptoms were analysed by Spearman analysis. Different VAS between DIE vs non DIE group was analysed by Mann-Whitney analysis. Result: Stage IV endometriosis accounts for 79.4%. Based on the macroscopic appearance, ovarian endometriosis accounts for 92.4%, peritoneal endometriosis 82.4%, DIE was 40.5%, and adenomyosis was 19.1%. There was significant correlation between total ASRM, ovarian endometriosis, peritoneal lesion, Douglas pouch obliteration, adnexal adhesion score and VAS dysmenorrhea (r=0.303; 0,187; 0,203; 0,278; 0,266, p<0.05). There was significant VAS difference of DIE vs non DIE group; the difference was on dyspareunia (5.18±2.4 and 4.58±1.0, p<0.001] and dyschezia [5.28±2.2 and 4.86±0.7,p<0.001] Conclusion: There was a positive correlation between ovarian endometriosis score and severity of dysmenorrhea. There was also a difference in the degree of endometriosis-associated pain between DIE and non DIE group. Keywords: endometriosis, deep infiltrating endometriosis, dysmenorrhea, dyspareunia, dyschezia   Abstrak Tujuan: untuk mencari hubungan antara skor endometriosis ASRM dan karakteristik nyeri pelvik pada pasien endometriosis Metode: Sebanyak 131 pasien dengan nyeri pelvik yang menjalani laparoskopi untuk diagnosis dan terapi endometriosis, memiliki nyeri > 3 bulan, dan tidak mengalami kelainan organ pelvis. Dilakukan evaluasi terhadap dismenorea, dyspareunia dalam, diskezia, dysuria, dan nyeri pelvic kronik dengan menggunakan nilai 1-10 dari skala analog visual. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Rujukan Nasional Dr. Cipto Mangunkusumo, Jakarta. Stadium endometriosis berdasarkan American Society of Reproductive Medicine, kejadian adhesi, jenis lesi (ada Endometriosis Susukan Dalam/ESD atau tanpa ESD), dan derajat keparahan nyeri dianalisis dengan analisis Spearman. Perbedaan skala nyeri antara ESD dan non ESD dianalisis dengan metode Mann-Whitney. Hasil: Sebanyak 79,4% pasien tergolong ke dalam endometriosis stadium IV. Berdasarkan tampilan makroskopik, endometriosis ovarium terdapat pada 92,4%, endometriosis peritoneal 82,4%, ESD 40,5%, dan adenomiosis pada 19,1%. Terdapat korelasi positif bermakna antara skor ASRM total, sub-skorkista endometriosis, endometriosis superfisial, obliterasi kavum douglas, dan adhesia dneksa dengan VAS dismenorea  (r=0,303; 0,187; 0,203; 0,278; 0,266, p<0,05). Pada kelompok ESD dan tanpa ESD, didapatkan perbedaan VAS dismenorea, dispareunia dalam, diskezia, dan nyeri pelvic kronik yang bermakna (6,13±1.7 dan 5,95±1,7, p = 0,560 ; 5,18±2.4 dan 4,58±1,0, p < 0,001; 5,28±2,2 dan 4,86±0,7 , p < 0,001; 2,20±2,8 dan 0,60±1,8, p <0,001) Kesimpulan:Terdapat korelasi positif bermakna antara skor ASRM dengan VAS dismenorea. Terdapat perbedaan VAS dismenorea, dyspareunia dalam, diskezia, dan nyeri pelvic kronik pada kelompok ESD dan tanpa ESD Kata kunci: endometriosis, endometriosis susukan dalam, dismenorea, dispareunia dalam, diskezia  

Identification of microorganisms in vaginal swab and peritoneal fluid of women with endometriosis Hadisaputra, Wachyu; Judio, Johny; Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: to discover correlation between microorganisms found in vaginal swab culture and in peritoneal fluid culture from laparoscopy in reproductive age women diagnosed with endometriosis. Methods: This cross sectional study was conducted in Bunda Hospital and YPK Hospital, Central Jakarta. Thirty one subjects was includedby consecutive sampling. Data were analyzed using SPSS 20.0 for Windows. Bivariate analysis was used to identify the correlation between independent and dependent variable. Results: From 31 subjects with mean age 34.42+5.056 years old, 87.1% were infertile. Vaginal swab culture was found positive in 83.9% subjects while peritoneal fluid culture was found positive only in 9.6% subjects. There was moderate correlation between chronic pelvic pain and positive vaginal swab culture (r=0.601; p=0.001), but weak correlation between Ca125 and vaginal swab culture (r=0.440; p=0.010). Peritoneal fluid culture had significant inverse correlation with left tubal patency (r=-0.346; p=0.047). There was weak correlation between vaginal swab culture and peritoneum fluid culture with correlation coefficient of 0.13. Conclusion: Most of bacteria found in vaginal swab culture and peritoneal fluid culture were the ones found in gastrointestinal tract. However, vaginal swab and peritoneal fluid culture were not sufficient to prove the hypothesis that infection has a role in pathogenesis of endometriosis. Therefore, advance and more complete examination such as LPS and PCR might be needed to be done in the future research with cohort study, to overcome the limitation of this study. Keywords: endometriosis, ascending bacterial contamination, vaginal swab, peritoneal fluid, culture   Abstrak Tujuan : Membuktikan adanya korelasi antara mikroorganisme yang ditemukan pada hasil kultur bilasan vagina dengan mikroorganisme yang ditemukan pada cairan peritoneum hasil laparoskopi perempuan usia reproduksi yang terdiagnosis endometriosis Metode :Penelitian ini menggunakan desain penelitian analitik poltong lintang yang bertujuan untuk melihat adanya hubungan korelasi serta mengetahui tingkat korelasi antara mikroorganisme kultur bilasan vagina dengan mikroorganisme pada cairan peritoneum pasien endometriosis. Hasil: Hasil kultur bilasan vagina dari 31 subjek penelitian yang diteliti, mikroorganisme terbanyak adalah Enterococcus faecalis (32.3%), Eschericia coli (29.1%), dengan 16.1 % dengan hasil kultur negatif. Sedangkan dari hasil kultur bilasan peritoneum terdapat 3 subjek (9.6%) dengan hasil positif yaitu dengan jenis bakteri Eschericia coli, Enterococcus faecalis, dan Pseudomonas. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum (r 0.13). Terdapat korelasi sedang antara kultur positif bilasan vagina dengan nyeri pelvik kronis, korelasi lemah antara kultur positif bilasan vagina dengan nilai Ca 125, dan korelasi lemah antara kultur positif cairan peritoneum dengan tuba kiri yang non paten. Kesimpulan:          Sebagian besar bakteri dari bilasan vagina dan bilasan peritoneum pada pasien endometriosis memiliki hasil bakteri dari organ pencernaan. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum pada pasien endometriosis. Kata kunci: endometriosis, kontaminasi bakteri asenden, kultur, bilasan vagina, cairan peritoneum

THE ROLE OF CONTRACEPTION IN THE PAST, PRESENT AND FUTURE Gunardi, Eka Rusdianto; Khusen, Denny; Winston, Kevin
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Contraceptives play an undeniable important role in woman?s lives. It is widely accepted that the availability of both hormonal and non-hormonal modern contraceptives have improved 0 women?s lives worldwide by allowing women to control their own fertility. Indirectly, contraceptives have been shown to reduce maternal mortality, unwanted pregnancy, and overpopulation. However, the contraceptives available today may not be suitable for all users. Furthermore, there is still need to expand available current contraceptives choices especially long-term contraceptives in order to improve acceptability. As a result, several novel products such as implants, contraceptive vaginal rings, and transdermal patches have recently been introduced in family planning programs. Additional issue of contraceptive needed to be addressed is the adverse effects of hormonal contraceptives. Therefore, new combinations with an improved metabolic profile is currently being researched. Generally, the introduction of new methods with additional health benefits and less side effects would help women with their unmet needs to obtain access to a wider range of contraceptives.

User Profile and Factors Correlating to Duration of Intrauterine Device Use Eka R Gunardi; Fadli Fadli
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the demographic and clinical profile of intrauterine device (IUD) users and factors correlating to duration of IUD use. Method: We conducted a prospective observational study of 867 patients who underwent IUD insertion in Raden Saleh Outpatient Clinic during the period of January - December 2011. All patients were followed for 1 year to ascertain any complaint of discharge after insertion. Spearman correlation test was conducted to inves- tigate the strength of correlation and significance between age, parity, and discharge, with duration of IUD use. Result: During year 2011, 867 patients (median of age=34 [range=14-49]; median parity=2 [range=0-7]) underwent IUD insertion in Raden Saleh Clinic. The majority of subjects were aged between 31-35 years old and were willing to use IUD for 4 years. Bivariate analysis revealed a significant correlation between age, parity, and vaginal discharge with duration of IUD use. The strongest correlation was identified between age and duration of use (r=0.25, p0.002 for parity and duration of use; r=0.05 p=0.045 for discharge and duration of use). Conclusion: Most IUD users were aged 31-35 years, who were willing to use IUD for 4 years. Factors that correlated with duration of IUD use were age, parity, and vaginal discharge. Keywords: contraceptive, duration of use, family planning, intrauterine device

Promising Male Hormonal Contraceptive are Well Established Soon a Reality Eka R Gunardi; Arnold Soetarso; Putri Addina
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To understand the modalities used for male hormonal contraception. Methods: Literature review Conclusion: Male contraceptive methods are still limited but hormonal contraceptive methods are being developed. The basic mechanism of male hormonal contraception is to inhibit spermatogenesis by suppression of the hypothalamic-pituitary-testicular axis function. Administration of testosterone or androgen derivative that is given in combination with progestin or GnRH antagonist shows that male hormonal contraceptive is reversible, effective, and acceptable as a male contraceptive method. However, no method of male hormonal contraceptive is ready for clinical use and marketed due to limited studies. [Indones J Obstet Gynecol 2015; 3-4: 239-243] Keywords: GnRH antagonist, male hormonal contraceptive, progestin, testosterone

Co-Authors Addina, Putri Adi Utarini Adila RA Malik Affan Solihin Agus Sujono Aldri Frinaldi Alexander Mukti Andon Hestiantoro Andrijono Anita Tobing Ardianto, Fachreza Arnold Soetarso Arresta Suastika Arresta Vitasatria Suastika Astri Noviani Ballo, Frista Betaria Putri Biran Affandi Biran Affandi Cepi T. Pramayadi Cepi Teguh Pramayadi Christina Marian Darrell Fernando Denny Khusen Denny Khusen Dhifa Dwi Putra Duta A Tritama Dwi Retna Lestari Fachreza Ardianto Fadli Fadli Fadli Fadli Farid, Retno B Febby Oktavianti Frista Ballo Gatot Purwoto Hadiyono, Suryo Hanevi Djasri Hariyono Winarto Herbert Situmorang Herbert Situmorang Heriyadi Manan Heru Prasetyo Hoesni, R Hasan M Ichsan, TM Ilham Utama Surya Ilham Utama Surya Irma Bernadette Jimmy T. Sitorus JM Seno Adjie Johny Judio Judio, Johny Kanadi Sumapradja Kartika Mayasari Kartiwa Hadi Nuryanto Kevin Winston Leonanta M. Ginting Lestari, Renny Luky Satria Malik, Adila RA Manan, Heriyadi Manan, Heriyadi Marcel Elian Suwito Mardiah Taher Marian, Christina Meria,, Riry Muhammad D. Priangga Muhammad Dwi Priangga Muhammad Dwi Priangga Muhammad Syauqi Mirza Mukti, Alexander Nabila Budi, Yasmine Syifa Nana Agustina Nessyah Fatahan Noor Pramana Nur Fitri Fadila Oktavianti, Febby Pramana, Noor Pramayadi, Cepi Teguh Putri Addina R Hasan M Hoesni Raden Muharam Natadisastra Rahmi, Trisha Alya Ramadhani Sheba Arifin Renny Lestari Retno B Farid Ribkhi A. Putri Ridwan, Rusdi S Riry Meria, Riyan H. Kurniawan Riyan Hari Kurniawan Rizani Amran Rusdi S Ridwan Satria, Luky Soetarso, Arnold Suryo Hadiyono Syauqi Mirza Taher, Mardiah Tandjung, Thamrin Thamrin Tandjung TM Ichsan Tofan Widya Utami Trisha Alya Rahmi Trisha Alya Rahmi Tritama, Duta A Wachyu Hadisaputra Wachyu Hadisaputra Widohariadi Widohariadi Widohariadi Widohariadi Winston, Kevin Yudianto B Saroyo

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