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A Real-time Optoelectronic Device in Screening of Precancerous Cervical Lesion Rizky Rahmadhany; Junita Indarti
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (108.381 KB) | DOI: 10.32771/inajog.v3i2.38

Abstract

Objective: To obtain the diagnostic values of optoelectronic device for screening of precancerous cervical lesions. Method: We performed a diagnostic study with cross sectional design. Subjects were recruited from Dr. Cipto Mangunkusumo Hospital, from February until December 2013. Subjects were enrolled based on consecutive sampling until the minimum sample was achieved (60 samples). Result: During the study period, 60 patients were enrolled. Sensitivity, specificity, positive predictive value, and negative predictive value of the optoelectronic device were 76%, 95%, 96%, and 64%, respectively. We also investigated diagnostic values of other screening methods, namely citology and colposcopy. Sensitivity and specificity of liquid based cytology were 83% and 63% respectively. The combination of optoelectronic device and liquid based cytology increased the sensitivity to 92.8%. Meanwhile, sensitivity and specificity of colposcopy were 88% and 58%, respectively. Based on Altman criteria, kappa value for optoelectronic device with cytology was 0.35 (fair) and optoelectronic device with colposcopy was 0.45 (moderate). Conclusion: A real-time optoelectronic device might be used as an alternative method in early detection of precancerous cervical lesions, either as a single method or combined with liquid based cytology. Keywords: diagnostic values, optoelectronic device, precancerous cervical lesions
Daily Application of EvidenceBased Medicine Junita Indarti
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (60.511 KB) | DOI: 10.32771/inajog.v3i3.39

Abstract

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Profile of Maternal Referral Cases Junita Indarti; Dwiyana Ocviyanti; Reyhan Aditya
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (78.153 KB) | DOI: 10.32771/inajog.v4i2.76

Abstract

Objective: To explore the demography of maternal referral cases in Dr. Cipto Mangunkusumo Hospital (RSCM) along with the accuracy of referral. We also aim to evaluate the types of referral, origin of referral, referring healthcare facility and quality of referring healthcare facility. Method: The design of this study was a cross sectional design which described the accuracy of obstetrics referred cases in Emergency Unit Dr. Cipto Mangunkusumo Hospital from 2013 to 2014. Result: The total referred obstetric cases in 2013 was 1,645 patients. It was consisted of 1,307 appropriate (79.5%) and 338 inappropriate (20.5%) referred cases. Primary healthcare and general hospital were the most often referring cases to RSCM during two consecutive years. The top three cases referred to RSCM in both 2013 and 2014 were preterm premature rupture of membrane (PPROM), continued by severe preeclampsia and preterm labor. Conclusion: The number of referral cases in Indonesia is considered high, particularly in RSCM as the tertiary healthcare facility. There are still a high number of inappropriate referrals originating from primary healthcare facilities, pointing to the fact that the referral system is not running according to design or plan. To improve the quality of referral system, proper monitoring and evaluation of referral should be performed by local health department. [Indones J Obstet Gynecol 2016; 4-2: 64-66] Keywords: maternal case, referral system
Obstetric Referral System during COVID-19 Pandemic : Tertiary Referral Hospital Perspective: istem Rujukan Obstetri dalam Masa Pandemi COVID-19 : Perspektif Rumah Sakit Rujukan Tersier Arietta R. D. Pusponegoro; Chakti A. Swastika; Junita Indarti
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.v10i2.1651

Abstract

Abstract Objective : To evaluate the effectiveness of obstetric referrals to the dr. Cipto Mangunkusumo National Central General Hospital (RSCM), a tertiary hospital in Indonesian referral system, during the COVID-19 pandemic. Methods : A cross-sectional descriptive-analytic study that compared the effectiveness of referrals before (July-December 2019) and during the COVID-19 pandemic (March-August 2020) at the National Central General Hospital dr. Cipto Mangunkusumo (RSCM). Referral effectiveness is assessed based on two criteria, namely the suitability of the diagnosis and procedural compliance which includes communication through the integrated emergency response system (SPGDT), delivery by ambulance, and attachment of a referral letter. Results: The study found 198 referral cases from 464 obstetric cases (42.67%) before the pandemic and 231 referral cases from 486 obstetric cases (47.53%) during the pandemic. The diagnostic concordance increased from 57.58% before the pandemic to 71.00% during the pandemic (p = 0.004). Referral procedural compliance increased from 28.28% before the pandemic to 45.45% during the pandemic (p < 0.001). Based on these criteria, the effectiveness of referrals at the RSCM during the COVID-19 pandemic era was found to be significantly higher, namely before the pandemic by 21.72% and during the pandemic by 40.26% (p < 0.001). Conclusion : The effectiveness of referral to the RSCM based on the suitability of the diagnosis and the accuracy of the procedure during the COVID-19 pandemic was found to be better than before the pandemic. Keywords: COVID-19, obstetric referral system, pandemic. Abstrak Tujuan : Untuk menilai efektivitas rujukan obstetri ke Rumah Sakit Pusat Nasional dr. Cipto Mangunkusumo, rumah sakit tersier dalam sistem rujukan Indonesia, selama pandemi COVID-19 Metode: Penelitian deskriptif-analitik berdesain potong lintang yang membandingkan efektivitas rujukan sebelum (Juli-Desember 2019) dan saat pandemi COVID-19 (Maret-Agustus 2020) di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM). Efektivitas rujukan dinilai berdasarkan dua kriteria, yakni kesesuaian diagnosis dan kepatuhan prosedur yang meliputi komunikasi melalui sistem penanggulangan gawat darurat terpadu (SPGDT), pengantaran dengan ambulans, dan pelampiran surat rujukan. Hasil: Penelitian menemukan 198 kasus rujukan dari 464 kasus obstetri (42,67%) sebelum pandemi dan 231 kasus rujukan dari 486 kasus obstetri (47,53%) saat pandemi. Kesesuaian diagnosis meningkat dari 57,58% sebelum pandemi menjadi 71,00% saat pandemi (p = 0,004). Kepatuhan prosedur rujukan meningkat dari 28,28% sebelum pandemi menjadi 45,45% saat pandemi (p < 0,001). Berdasarkan kriteria tersebut, efektivitas rujukan di RSCM pada era pandemi COVID-19 ditemukan lebih tinggi secara signifikan, yakni sebelum pandemi sebesar 21,72% dan saat pandemi sebesar 40,26% (p < 0,001). Kesimpulan: Efektivitas rujukan ke RSCM berdasarkan kesesuaian diagnosis dan kepatuhan prosedur saat pandemi COVID-19 ditemukan lebih baik. Kata kunci: COVID-19, pandemi, sistem rujukan obstetri
Obstetric and Perinatal Characteristics of Teenage Pregnancies: an Analysis of Five Year Period in dr. Cipto Mangunkusumo Hospital, Jakarta Junita Indarti; David Eka Prasetya; Hari Sandi; Imam Rahmadi; Raymond Surya
eJournal Kedokteran Indonesia Vol 9, No. 1 - April 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.595 KB) | DOI: 10.23886/ejki.9.6.18

Abstract

Abstract Teenage pregnancy leads to higher rates of maternal and perinatal complication and has been amajor challenge globally. This study aims to evaluate the obstetric and perinatal characteristics of teenagepregnancies in Indonesian population. A cross-sectional study through medical records was performed attertiary cared dr. Cipto Mangunkusumo Hospital, Jakarta, from 2014 to 2018. We recruited average maternalage of women and teenagers who carried singleton live pregnancies and delivered at tertiary care. Obstetricalcomplications include anemia at labor, preeclampsia/eclampsia, postpartum hemorrhage, preterm rupture ofmembrane, induction of labor, cesarean section delivery and perinatal outcomes include small-for-gestationalage, stillbirth, intrauterine growth restriction, preterm birth, low birth weight, 5th minimum APGAR score wereassessed. Statistical analysis was done using SPSS 20. There were 4265 eligible subjects during 5-yearperiod. The prevalence of teenage pregnancy (11-19 years old) was 543/4265 (12.7%). Teenage pregnancyhad a higher incidence of preterm deliveries (OR 2.047, 95%CI 1.660–2.524, p<0.001) and anemia at labor(OR 1.433, 95%CI 1.113-1.843, p=0.005). Low birth weight babies (OR 1.520, 95%CI 1.229–1.879, p<0.01)were associated with teenage pregnancy. Teenage pregnancy contributes to higher incidence of pretermdeliveries, anemia at labor, and low birth weight. Keywords: teenage, pregnancy, outcome, maternal, perinatal.   Karakteristik Obstetrik dan Perinatal pada Kehamilan Remaja: Analisis Lima Tahun di RSUPN Dr. Cipto Mangunkusumo, Jakarta Abstrak Kehamilan remaja meningkatkan komplikasi maternal dan perinatal serta merupakan tantangan global.Studi ini bertujuan untuk mengevaluasi karakteristik obstetrik dan perinatal kehamilan remaja di Indonesia.Studi potong lintang melalui rekam medis dilakukan di RSCM, Jakarta, pada tahun 2014 hingga 2018. Kriteriainklusi ialah kehamilan remaja dan usia reproduksi pasien yang melahirkan di RSCM. Komplikasi obstetrikyang dinilai adalah anemia saat persalinan, preeklamsia/eklamsia, perdarahan pascasalin, ketuban pecahdini, induksi persalinan, seksio sesarea, dan luaran perinatal yaitu janin kecil, lahir mati, pertumbuhan janinterhambat, persalinan prematur, berat lahir rendah, dan skor APGAR 5 menit. Analisis statistik menggunakanSPSS 20. Terdapat 4265 subjek selama 5 tahun dengan prevalensi kehamilan remaja (11-19 tahun) 543/4265(12,7%). Kehamilan remaja meningkatkan insidens persalinan prematur yang lebih tinggi (OR 2,047, 95%CI1,660–2,524, p<0,001) dan anemia saat persalinan (OR 1,433, 95%CI 1,113-1,843, p=0,005). Berat badan lahirrendah berhubungan dengan kehamilan remaja (OR 1,520, 95%CI 1,229–1,879, p<0,01). Kehamilan remajamemiliki dampak lebih tinggi terhadap persalinan prematur, anemia saat persalinan, dan berat lahir rendah. Kata kunci: remaja, kehamilan, luaran, maternal, perinatal.
Three-Delay Model on Maternal Mortality Cases in Tertiary Referral Hospital in Indonesia Junita Indarti; Affan Solihin; Arresta V. Suastika; Dyah P. Wardhani; Muhammad T. Ramadhani; Quamila F. Afdi; Syifa M. Syafitri; Muhammad Ikhsan; Kristian Alda
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (345.671 KB) | DOI: 10.23886/ejki.9.60.99

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Maternal mortality remains a worldwide concern to this day. Three main causes of maternal mortality during 2010–2013 were hemorrhage, hypertension, and infection, which all of them are the direct causes. The high MMR is also due to the presence of 3 delay which is Delay in seeking assistance (type–1), delay in identifying and accessing medical center (type–2) and delay in having prompt treatment (type–3) . Therefore, this study aims to describe maternal mortality cases in tertiary hospital which is Cipto Mangunkusumo Hospital (CMH) so that the root of problems in maternal deaths can be discovered and improvements can be done in the future. This was a descriptive study conducted in the Department of Obstetrics and Gynecology at CMH, Jakarta. Data collection was taken from 2016 – 2018 where subjects were taken from secondary data on maternal mortality. Based on the data that has been collected in CMH total live births in Emergency Department CMH during 2016-2018 which was 4.226 cases. There was 22 maternal death cases (0.52%). Most deaths were occurred in 2017 (50% of all cases). Indirect causes of maternal mortality were the leading cause in this study, including septic shock, hypovolemic shock due to Dengue Shock Syndrome, cardiogenic shock, and acute respiratory failure. Three delay models were three main factors contributing to maternal mortality interrelated and influenced by other factors with delay in looking for assistance and treatment (31,8%) was the upmost factor of maternal mortality. More than half maternal deaths in CMH during 2016 – 2018 caused by indirect causes. Among three delay models, delay in looking for assistance and treatment was the upmost factor of maternal mortality. Keywords: maternal mortality, three-delay model.   Tiga Model Keterlambatan pada Kasus Kematian Ibu di Rumah Sakit Tersier di Indonesia Kematian ibu masih menjadi perhatian dunia hingga saat ini. Tiga penyebab utama angka kematian ibu (AKI) selama 2010-2013 adalah perdarahan, hipertensi, dan infeksi, yang semuanya merupakan penyebab langsung. Tingginya AKI juga disebabkan oleh adanya 3 keterlambatan yaitu keterlambatan dalam mencari pertolongan, keterlambatan dalam mengidentifikasi dan mengakses pusat kesehatan, dan keterlambatan dalam mendapatkan pengobatan yang tepat. Penelitian ini bertujuan untuk mendeskripsikan kasus kematian ibu di rumah sakit tersier yaitu Rumah Sakit Cipto Mangunkusumo (RSCM) sehingga akar permasalahan kematian ibu dapat ditemukan dan dapat dilakukan perbaikan di masa yang akan datang. Penelitian ini merupakan penelitian deskriptif yang dilakukan di Bagian Obstetri dan Ginekologi RSCM, Jakarta. Pengambilan data diambil dari tahun 2016 – 2018, subjek diambil dari data sekunder kematian ibu. Berdasarkan data yang terkumpul di RSCM jumlah kelahiran hidup di Instalasi Gawat Darurat RSCM selama tahun 2016-2018 sebanyak 4.226 kasus. Terdapat 22 kasus kematian ibu (0,52%). Kematian terbanyak terjadi pada tahun 2017 (50% dari seluruh kasus). Penyebab tidak langsung kematian ibu merupakan penyebab utama dalam penelitian ini, antara lain syok septik, syok hipovolemik akibat dengue shock syndrome, syok kardiogenik, dan gagal napas akut. Tiga model keterlambatan merupakan tiga faktor utama penyebab kematian ibu yang saling berkaitan dan dipengaruhi oleh faktor lain dengan keterlambatan mencari pertolongan dan pengobatan (31,8%) merupakan faktor penyebab kematian ibu yang paling tinggi. Lebih dari separuh kematian ibu di RSCM selama tahun 2016 – 2018 disebabkan oleh penyebab tidak langsung. Di antara tiga model keterlambatan, keterlambatan dalam mencari bantuan dan pengobatan merupakan faktor utama kematian ibu. Kata kunci: kematian maternal, model tiga terlambat.
Infections of Chlamydia trachomatis and Mycoplasma hominis as Risk Factors for Abnormal Cervical Cells Mardhia, Mardhia; Effiana, Effiana; Irsan, Abror; Natalia, Diana; Rahmayanti, Sari; Indarti, Junita; Rachmadi, Lisnawati; Yasmon, Andi
Makara Journal of Health Research Vol. 22, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Cervical cancer is the fourth most common cancer among women across the world. Recent studies have shown that cervical cancer is not only caused by persistent infection of human papillomavirus (HPV), but sexually transmitted infections (STIs) also play a role in the pathogenesis of abnormal cervical cells. STIs frequently occur with no specific symptoms, such as the infections caused by Chlamydia trachomatis and Mycoplasma hominis. Asymptomatic STIs could lead to persistent infection. Persistent infections caused by STIs have been hypothesised to increase the access of HPV into the deeper cervical tissue and cause cervical cell abnormalities. Therefore, we conducted this study to assess the association between C. trachomatis and M. hominis infections and abnormal cervical cells. Methods: A cross-sectional study was performed on 58 outpatients at the Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Abnormal cervical cells were detected by a liquid-based cytology Pap smear, and bacterial identification was done by conducting conventional duplex polymerase chain reaction (PCR). Results: 58 patients, 14 (24.1%) showed abnormal cervical cells, whereas 44 (75.9%) patients showed normal cervical cells. The conventional duplex PCR demonstrated a positive result for C. trachomatis and M. hominis bacterial infections in only 1 (7.1%) and 2 (14.3%) patients with abnormal cervical cells, respectively. The statistical analysis revealed no significant association between the bacterial infections and the abnormal cervical cytology in the patients (p > 0.05). Conclusions: Infections caused by C. trachomatis and/or M. hominis were not associated with abnormal cervical cells.
Maternal and Neonatal Characteristics and its Contact Tracing of Covid-19 in Pregnancy in Cipto Mangunkusumo General Hospital Junita Indarti; Handika Zulimartin; Boeyoeng E.A.P Dalimunte; Nova V. Wijaya; Henny S. Wonodihardjo; Ario B. Hanggono; Kristian Alda; Mohammad A.F Dilmy; Siti R.F Harun
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.127.144-50

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Pregnant women might be at greater risk for common pregnancy complications and baby abnormalities if they are infected with COVID-19. This cross-sectional study aims to investigate the characteristics of pregnant women with COVID-19, using secondary data from medical records of subjects treated with COVID-19 at Cipto Mangunkusumo Hospital from January to June 2021. 102 pregnant women with confirmed COVID-19 were enrolled and 77 were delivered during admission. Enrolled subjects mostly consisted of multigravidas 58 (56.8%) between 29-36 weeks gestation 42 (41.1%). No comorbidities were present in the majority of subjects that were enrolled. Most presented with mild symptoms 50 (49%) and 21 (20,6%) with moderate symptoms. Most were delivered by Caesarean section (CS) a total of 58 out of 102 cases (75.4%). A total of 8 (7.9%) of those with severe cases with acute respiratory distress syndrome were admitted to intensive care. Pulmonary consolidation corresponding to pneumonia on chest x-ray were findings in 43 (42.2%) women. The majority of neonates born 36 (37.1%) had a birth weight of 1500-2499 grams. The were no positive COVID-19 findings of neonatal nasopharyngeal swab results. Perinatal complications occurred in 28 (36.3%) neonates that experienced respiratory distress and 22 (28.6%) experienced neonatal sepsis. A total of 44 (57.1%) infants with birth weight <2500 grams. Among these neonates 41 (55.4%) required NICU admission, 10 (13.5%) required ventilators due to respiratory distress. Most of the subjects on contact tracing, contracted COVID-19 from their neighbors or close relatives; 56(54.9%). There was 1 case of maternal death. In addition, we found that most of COVID-19 transmissions originated from asymptomatic close relatives and neighbors.
The Role of Social Obstetrics and Gynecology in the Coverage of Cervical Cancer Screening in the Era of Health Transformation in Indonesia Junita indarti
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.2181

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Concordance and Acceptability of HPV DNA Genotyping Test by Patient’s Self-Sampling Against Clinician Sampling Indarti, Junita; Syaharutsa, Danny Maesadatu; Surya, Ilham Utama; Alda, Kristian
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 2 April 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i2.2402

Abstract

Objectives: To determine the effectiveness of this alternative method, especially during the COVID-19 pandemic and considering Indonesia’s cultural context. Methods: This study utilized a cross-sectional design, and involved patients at the Gynecology and Colposcopy Clinic of Dr. Cipto Mangunkusumo General Hospital. The estimated sample size was 48, determined using a diagnostic test formula. The sample population consisted of female patients with positive VIA or abnormal Pap smear results. Each patient underwent HPV DNA self-sampling and clinician sampling tests using the GenoFlow HPV Array technique and continued with colposcopy. All patients were also administered a questionnaire consisting of eight questions about their perspective on the self-sampling HPV DNA test. The data analysis employed a 2 × 2 table using SPSS version 20, and Cohen’s kappa coefficient was calculated to measure the agreement between the sampling results of patients’ and Clinicians’. Results: Among the examinations conducted by clinicians, there were 33 patients with positive HPV results, whereas through self-sampling, there were 28 patients with positive HPV (p=0.00). High risk HPV was the most commonly observed, with HPV type 16 appearing the most (15%). Based on these data, the self-sampling sensitivity, specificity, positive predictive value, and negative predictive value were 85%, 100%, 100%, and 75%, respectively, with a concordance rate of 89.6%. The Cohen’s Kappa coefficient between samples taken by the clinician and self-sampling resulted in K=0.778, which is considered a good agreement (K=0.61-0.80). All patients concluded that the procedure was easy (100%), and the majority (60.5%) expressed a preference for the self-sampling method. Conclusion: There is a good agreement between the results of self-sampling and clinician sampling for detecting HPV DNA, with patients positively accepting the self-sampling method, indicating its potential as an effective cervical cancer screening method. Keywords: Cervical Cancer Screening, Clinician Sampling, Human Papillomavirus, Self-Sampling.