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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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The Association between Endometriosis Appearance during Laparoscopic Surgery and Pain Characteristic in Pelvic Endometriosis: HubunganTampilan Susukan Endometriosis pada saat Pembedahan Laparoskopik dengan Karakteristik Nyeri pada Endometriosis Pelvik Herbert Situmorang; Renny Lestari; Eka R Gunardi
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 (5.18Â±2.4 and 4.58Â±1.0, p<0.001] and dyschezia [5.28Â±2.2 and 4.86Â±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 (6,13Â±1.7 dan 5,95Â±1,7, p = 0,560 ; 5,18Â±2.4 dan 4,58Â±1,0, p < 0,001; 5,28Â±2,2 dan 4,86Â±0,7 , p < 0,001; 2,20Â±2,8 dan 0,60Â±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: Identifikasi Mikroorganisme pada Swab Vagina dan Cairan Peritoneum pada Wanita dengan Endometriosis Wachyu Hadisaputra; Johny Judio; Eka R Gunardi
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

Profile Changes in Weight and Body Mass Index of Single Rod Levonorgestrel Implant Acceptor (MonoplantÂ®): Profil Perubahan Berat Badan dan Indeks Masssa Tubuh Akseptor Implan Levonorgestrel Satu Batang (MonoplantÂ®) Eka R. Gunardi; Jimmy T. Sitorus
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

AbstractObjective: To finding out the change of weight and body mass index (BMI) of single rodlevonorgestrel implant acceptor (Monoplant®).Methods: A cross-sectional descriptive study was conductedusing data changes of weight and BMI obtained from series of measurement which is recorded in patients’ medical record in three years of Monoplant® placement in Raden Saleh Clinic, Jakarta. This method is the part of a research of a bigger phase two in clinical test.Results: From 21 subjects of this research, the average weight and BMI before and after 3 years of Monoplant® placement is gained, i.e. 53.1 (SD 11,0) kg and 22.4 (SD 4.5) kg/m2, and 54.8 (SD 9.4) kg and 23.1 (SD 3.9) kg/m2. Despite the tendency of increasing, statistically the increasing of weight and BMI, however, is meaningless (p=0.09) and (p=0.08). There is a difference of weight in series of measurement, particularly after the 12th month (Repeated test ANOVA p=0.024). Even though there is no difference in BMI average, there is a difference in subject's proportion based on BMI categories before and after Monoplant® placement (Marginal homogeneity test p=0.046). The increasing of levonorgestrel level occurs in the 6th month and subsequently followed by the increase of BMI in the 12th month.Conclusions: There is a tendency of increasing weight and BMI in Monoplant® users, specifically after one year despite statistically insignificant.Keywords: levonorgestrel, monoplant®, weight, body mass index. AbstrakTujuan: Untuk mengetahui perubahan berat badan dan indeks massa tubuh pada akseptor implan levonorgestrel satu batang (Monoplant®).Metode: Studi deskriptif dengan desain potong lintang mengambil data perubahan BB dan IMT diperoleh dari pengukuran serial yang tercatat dalam rekam medis pasien selama tiga tahun pemasangan Monoplant® di Klinik Raden Saleh, Jakarta. Penelitian ini merupakan bagian dari suatu penelitian uji klinis fase 2 yang lebih besar.Hasil: Dari 21 subjek penelitian ini, didapatkan rerata BB dan IMT sebelum dan setelah 3 tahun pemasangan Monoplant®yakni 53,1 (SB 11,0) kg dan 22,4 (SB 4,5) kg/m2, serta 54,8 (SB 9,4) kg dan 23,1 (SB 3,9) kg/m2. Meskipun ada kecenderungan naik, tetapi secara statistik kenaikan BB dan IMT tersebut tidak bermakna (p=0,09) dan (p=0,08). Terdapat perbedaan berat badan dalam pengukuran serial, terutama setelah bulan ke-12 (Uji repeated ANOVA p=0,024). Walaupun tidak terdapat perbedaan rerata IMT, terdapat perbedaan proporsi subjek berdasarkan kategori IMT sebelum dan setelah pemasangan Monoplant® (Uji Marginal homogeinity p=0,046). Peningkatan kadar levonorgestrel terjadi pada bulan ke-6 yang kemudian diikuti oleh kenaikan IMT pada bulan ke-12.Kesimpulan: Terdapat kecenderungan peningkatan BB dan IMT pengguna Monoplant®, khususnya setelah satu tahunmeskipun secara statistik tidak bermakna.Kata kunci: berat badan, indeks massa tubuh, levonorgestrel, monoplant®.

Patterns of Outpatient Referral Cases before and after Implementation of National Health Coverage Program: Pola Kasus Rujukan Rawat Jalan sebelum dan sesudah Pelaksanaan Program Jaminan Kesehatan Nasional Eka R. Gunardi; Arresta Suastika
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 3 July 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i3.1254

AbstractObjective: To understand the pattern of referral cases (accuracy of referral diagnosis, the accuracy of referral health facility and consistency of referral diagnosis) in obstetrics and gynaecology outpatient clinic before and after the implementation of JKN.Methods: This is an observational cross-sectional study using medical records of patients who were referred to obstetrics and gynaecology outpatient clinic in Dr. Cipto Mangunkusumo General Hospital in 2013 and 2014. Data were analyzed with bivariate analysis with chi-square, consisting of the accuracy of referral cases, accuracy of referral health facility, and consistency of referral cases before and after implementation of JKN.Results: There is a growing number of patients in obstetrics and gynaecology outpatient clinic after the implementation of JKN in 2014, which is 4.311 patients. Subjects were 222 cases, 104 cases from 2013 and 118 cases from 2014. From the analyzed data, the accuracy of referral diagnosis before JKN is 81.7% and after JKN 72.9%. (p=0.118), the accuracy of referral health facility before JKN is 63.5% and after JKN 71.2% (p=0.220), and the consistency of referral diagnosis before JKN is 89.4% and after JKN 84.7% (p=0.302).Conclusion: There is no statistically significant difference between the accuracy of referral diagnosis, the accuracy of referral health facility, and consistency of referral diagnosis before and after the implementation of JKN.Keywords: national health coverage program, obstetrics and gynaecology, outpatient clinic, referral AbstrakTujuan: Untuk memahami pola kasus rujukan (ketepatan diagnosis rujukan, ketepatan asal fasyankes perujuk, dan kesesuaian diagnosis rujukan) di Poliklinik Obstetri dan Ginekologi sebelum dan setelah pelaksanaan JKN.Metode: Penelitian ini adalah observasional potong lintang dengan menggunakan data rekam medis pasien yang dirujuk ke Poliklinik Obstetri dan Ginekologi RSUPN Dr. Cipto Mangunkusumo selama tahun 2013 dan 2014. Analisis dilakukan dengan analisis bivariat dengan chi square untuk membedakan ketepatan diagnosis rujukan, ketepatan asal fasyankes perujuk, dan kesesuaian diagnosis rujukan sebelum dan setelah pelaksanaan JKN.Hasil: Terdapat peningkatan jumlah kunjungan Poliklinik Obstetri dan Ginekologi sejak dilaksanakannya program JKN pada tahun 2014, yaitu sebanyak 4.311 pasien. Jumlah subjek adalah sebanyak 222 subjek, terdiri dari 104 subjek pada tahun 2013 dan 118 subjek pada tahun 2014. Dari analisis data, didapatkan tingkat ketepatan diagnosis sebelum JKN adalah 81,7% dan setelah JKN 72,9% (p=0,118), tingkat ketepatan fasyankes perujuk sebelum JKN adalah 63,5% dan setelah JKN 71,2% (p=0,220), serta tingkat kesesuaian diagnosis sebelum JKN adalah 89,4% dan setelah JKN 84,7% (p=0,302).Kesimpulan: Tidak ada perbedaan yang bermakna secara statistik antara ketepatan diagnosis rujukan, ketepatan fasyankes perujuk, dan kesesuaian diagnosis fasyankes rujukan sebelum dan sesudah pelaksanaan JKN.Kata kunci: jaminan kesehatan nasional, obstetri dan ginekologi, poliklinik, rujukan

Double Approach (Laparoscopy and Hysteroscopy) Repair of Istmochele (Niche): Pendekatan Ganda (Laparoskopi dan Histeroskopi) untuk Memperbaiki Istmochele (Niche) Herbert Situmorang; Ribkhi A. Putri; Cepi T. Pramayadi; Riyan H. Kurniawan; Muhammad D. Priangga; Eka R. Gunardi
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 4 October 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i4.1268

Objectives: Reported a case demonstrate the double approach repair of niche treatment through the hysteroscopy and laparoscopy technique.Methods: Case report. We reported a case starting from the patient admission untill 3 months postoperative condition.Case: A 33 years old woman came with abnormal uterine bleeding, already got medication and combine oral contraception pill, but the bleeding never stopped. We found a cavity (niche) filled by menstrual blood with thin lower uterine segment (just serous layer) from transvaginal ultrasound. We did hysteroscopy and laparoscopy approach. We illuminated the niche by hysteroscopy, then resected it by laparoscopy. Patient had a day hospital admission and no symptoms anymore after the procedure.Conclusion: Many treatment methods have been described for repair of niche with varies effectivities. Double approach (hysteroscopy and laparoscopy) technique was a minimal access, but optimal approach of niche resection with up to 100% effectivity.Keywords: abnormal uterine bleeding, caesarean scar defect, hysteroscopy, istmochele laparoscopy, niche Abstrak Tujuan: Melaporkan sebuah kasus yang menggambarkan pendekatan ganda dalam memperbaiki niche dengan histeroskopi dan laparoskopi.Metode: Laporan kasus. Kami melaporkan sebuah kasus dimulai dari pasien masuk sampai dengan 3 bulan pascaoperasi.Kasus: Perempuan 33 tahun datang dengan perdarahan uterus abnormal, telah diberikan terapi obat dan pil kombinasi, namun perdarahan tidak berhenti. Dari ultrasonografi ditemukan rongga berisi darah menstrusasi dengan segmen bawah uterus yang tipis (hanya lapisan serosa). Kami melakukan pendekatan histeroskopi dan laparoskopi. Dilakukan iluminasi dengan histeroskopi, kemudian reseksi dengan laparoskopi. Perawatan pasien di rumah sakit selama satu hari, dan tidak terdapat keluhan pada pasien setelah tindakan.Kesimpulan: Terdapat banyak metode dalam tata laksana niche dengan efektivitas yang beragam. Pendekatan ganda dengan histeroskopi dan laparoskopi merupakan tehnik dengan akses minimal namun hasil optimal, dengan efektivitas hingga 100%.Kata Kunci: perdarahan uterus abnormal, defek skar sesar, histeroskopi, istmpchele, laparoskopi, niche

The Role of Thrombocytosis as a Prognostic Factor for Epithelial Ovarian Cancer: Peran Trombositosis sebagai Faktor Prognostik pada Kanker Ovarium Jenis Epitelial Andrijono; Heru Prasetyo; Eka R Gunardi; Gatot Purwoto; Hariyono Winarto
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1275

Objective: To determine whether thrombocytosis is a prognostic factor for epithelial ovarian cancer and its relationship with 3-year overall survival in epithelial ovarian cancer patients.Methods: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer registered in cancer registry of Oncology Division in Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo National General Hospital from January 2014 - July 2016. Data were collected when subjects were first until diseases outcomes identified in 3 years.Results: : Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42.7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0.005; OR=2.329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0.555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups (p = 0.399).Conclusion :Thrombocytosis is not a prognostic factor in patients with epithelial ovarian cancer. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis.Keywords: epithelial ovarian carcinoma, prognosis, thrombocytosis. Abstrak Tujuan: Membuktikan bahwa trombositosis sebagai faktor prognosis kesintasan pada pasien kanker ovarium jenis epitelial dan hubungannya terhadap kesintasan 3 tahun pasien kanker ovarium jenis epitelial.Metode: Penelitian ini merupakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014-Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis akhir pengamatan selama 3 tahun.Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Trombositosis secara statistik tidak bermakna pada kesintasan 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399).Kesimpulan : Trombositosis bukan merupakan faktor prognostik pada pasien kanker ovarium jenis epitelial dan tidak terdapat hubungan antara trombositosis dan 3 tahun pada pasien dengan kanker ovarium jenis epithelial.Kata kunci: karsinoma ovarium epithelial, prognosis, trombositosis

Estradiol on Day Seven is a Good Predictor for Oocyte Maturation Rate in In Vitro Fertilization Program: Kadar estradiol hari ketujuh sebagai prediktor tingkat kematangan oosit pada program Fertilisasi In Vitro Andon Hestiantoro; Betaria Putri; Eka R. Gunardi; Yudianto B. Saroyo; Muharam Natadisastra
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 2 April 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i2.1539

Abstract Objective: to determine which factors influence the rate of oocyte maturation in In Vitro Fertilization (IVF) program. Methods: A retrospective cohort study was conducted using secondary data from IVF participants at the Yasmin Fertility Clinic, Dr. RSUP. Cipto Mangunkusumo, Jakarta, Indonesia during the period January 2019 to December 2020, as recorded in the InaRepromed archive. The variables analyzed were age, body mass index, and hormone levels on day 1, day 7, and day hCG, with oocyte maturation rate as the main outcome. Correlation test was performed between several variables and the level of oocyte maturation rate and followed by multivariate analysis to assess the factors that were closely related to oocyte maturation rate. Results: Data from 52 subjects were collected for the study. Positive correlation was observed between oocyte maturation rate and estradiol on day 7 (r = 0.229), while negative correlation was observed between oocyte maturation rate and progesterone/estradiol ratio on day 7 (r = -0.289) and luteinizing hormone on day 1 (r = -0.265). Multivariate analysis revealed that higher estradiol on day-7 was associated with better oocyte maturation rate (p = 0.047). Conclusion: Higher estradiol level on day 7 was associated with better oocyte maturation rate in IVF. Keywords: Assisted reproductive technology (ART), estradiol, in vitro fertilization (IVF), progesterone. Abstrak Tujuan: untuk menentukan faktor-faktor yang mempengaruhi tingkat pematangan oosit dalam program Fertilisasi InVitro (FIV). Metode: Desain penelitian adalah kohort retrospektif, menggunakan data sekunder peserta bayi tabung Klinik Fertilitas Yasmin, RSUP Dr. Cipto Mangunkusumo, Jakarta, Indonesia selama periode Januari 2019 hingga Desember 2020, yang tercatat di dalam arsip InaRepromed. Variabel yang dianalisis adalah umur, indeks massa tubuh, dan kadar hormon pada hari ke-1, hari ke-7, dan hari ke-hCG, dengan tingkat maturasi oosit sebagai luaran utama. Dilakukan analisis korelasi antara beberapa variabel dengan tingkat maturasi oosit, dan dilanjutkan dengan analisis multivariat untuk menilai faktor-faktor yang berhubungan kuat dengan tingkat maturasi oosit. Hasil: Data dari 52 subjek dikumpulkan untuk penelitian ini. Dijumpai korelasi positif antara tingkat maturasi oosit dan estradiol pada hari ke 7 (r = 0,229), sedangkan korelasi negatif diamati pula antara tingkat maturasi oosit dan rasio progesteron/estradiol pada hari ke 7 (r = -0,289) dan hormon luteinisasi pada hari 1 (r = -0,265). Analisis multivariat mengungkapkan bahwa estradiol yang lebih tinggi pada hari ke-7 dikaitkan dengan tingkat maturasi oosit yang lebih baik (p = 0,047). Kesimpulan: Kadar estradiol yang lebih tinggi pada hari ke 7 dikaitkan dengan tingkat pematangan oosit yang lebih baik pada program FIV. Kata kunci : Teknologi reproduksi berbantu (TRB), estradiol, fertilisasi in vitro (IVF), progesteron.

The Role of Long-Term Contraceptive Services in the Covid-19 Pandemic Era Eka R Gunardi
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 2 April 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i2.1558

The Effectiveness of Misoprostol Single Dose Oral for Evacuation of Incomplete Abortion Eka Rusdianto Gunardi; Affan Solihin
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 16 No. 02 Desember 2019
Publisher : Pharmacy Faculty, Universitas Muhammadiyah Purwokerto

This study is aimed to find out the effectiveness of oral 600 mcg single dose misoprostol for the evacuation of conception remnant in cases of incomplete abortion. This research is done by quasi experimental method with one group pretest – posttest design. The population of the study is all women who were diagnosed with incomplete abortion in less than 12 weeks of gestation in Cipto Mangunkusumo National general Hospital and affiliations hospital from June 2018 to June 2019. Women who met the study criteria, was treated with oral misoprostol 600 mcg single dose and then undergo conception evacuation evaluation and side effects evaluation. Effectiveness evaluation was seen after 7 days of single dose 600 mcg of misoprostol by measuring <15 mm endometrial thickness on transvaginal ultrasound. The effectiveness of using single dose oral misoprostol 600 mcg in the study participants was 93.55%, which were 29 out of a total of 31 participants. The side effects experienced after being given misoprostol were bleeding with less than the same amount as menstruation (71.0% and 9.0%), diarrhea (6.5%), and shivering (67.7%), and not found side effects of vomiting. Based on data analysis using paired T test before and 24 hours after administration of misoprostol, there was a significant difference between endometrial thickness (p value <0.001). Misoprostol 600 mcg per oral dose is effective for the evacuation of retained conception tissue of incomplete abortion at less than 12 weeks gestation, so that it can be an alternative non-operative method of evacuating retained conception tissue in incomplete abortion cases other than the operative method. Side effects found were bleeding, diarrhea, and chills. Side effects of vomiting were not found in this study.

National health coverage programs and quality of referral obstetrics and gynaecology clinic in Dr Cipto Mangunkusumo Hospital Jakarta Eka Rusdianto Gunardi; Arresta Vitasatria Suastika; Hanevi Djasri; Adi Utarini
Berita Kedokteran Masyarakat (BKM) Vol 34, No 8 (2018)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Purpose: Implementation of national health coverage contributes to the increasing number of outpatient visits in Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo Hospital. It may be caused by improper referral system or number of government insurance patients called as BPJS patients. Therefore, this study aims to analyse the pattern and quality of referral system in the implementation of national health coverage.Method: The quasi experimental study was conducted using pre and post analysis of the cases pattern and referral quality. It included accuracy of referred case diagnosis, accuracy of referring health facility, and consistency of referred case diagnosis.Results: There was an increasing number of referral visits in the early implementation of national health program; however, it declined overtime. There was reduction of general obstetrics and gynaecology cases and increase of sub-specialistic cases. It was in appropriate to the role of centre referral hospital in Indonesia. Around 98% referral diagnosis was correct to be referred, 82% cases came from correct health facility, and 98% referral diagnosis was consistent to Dr. Cipto Mangunkusumo hospital.Conclusion: The quality referral cases improves with the implementation of national health coverage program.

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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