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All Journal Jurnal Kedokteran Diponegoro Majalah Obstetri dan Ginekologi Universa Medicina Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Indonesian Journal of Medicine Medica Hospitalia Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Herman Kristanto
Department Of Obstetric And Gynecology, Faculty Of Medicine, Diponegoro University, Semarang
Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Serum 8-isoprostane increased in pre-eclampsia Pramono, Besari Adi; Kristanto, Herman
Universa Medicina Vol 31, No 1 (2012)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2012.v31.43-51

Abstract

Background The main causes of maternal mortality in Indonesia are pre-eclampsia, hemorrhage, and infection. Oxidative stress has a primary role in pre-eclampsia and one of its parameters is 8-isoprostane serum level. The objective of this study is to measure 8-isoprostane and to analyze the relationship between 8-isoprostane level and birth weight in pre-eclampsia.Methods A cross-sectional study involving 23 pre-eclampsia and 29 normotensive pregnant women with normal or cesarean delivery at Dr. Kariadi Hospital Semarang from January to May 2011. Collected maternal blood samples were assessed for 8-Isoprostane levels by means of a specific ELISA kit. Neonatal birth weight was measured immediately after delivery by means of calibrated baby scales. Differences in 8-isoprostane levels between pre-eclampsia and normotensive women were assessed using independent t-test for normal distributed data, and the Mann-Whitney test for non-normally distributed data. ResultsMean 8-isoprostane level was significantly higher in women with pre-eclampsia than in normotensive women (62.52 ± 12.19 pg/mL vs 28.64 ± 8.81 pg/mL) (p<0.05). Low birth weight was twice as frequent in pre-eclampsia than in normotensives. There was no correlation between 8-isoprostane serum level and neonatal birth weight in pre-eclampsia.Conclusion The level of 8-isoprostane was higher in pre-eclampsia than in normotensives. It is recommended to conduct further studies to determine whether 8-isoprostane may be used as a predictive marker of pre-eclampsia.
Effect of L- Arginin on Placental Hipoxia Inducible Factor -1-Alpha (HIF-1-A) Expression at Preeclampsia Mice Models Anggraini, Nutria Widya Purna; Sulistyowati, Sri; Pramono, Besari Adi; Kristanto, Herman
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.436 KB)

Abstract

Background: Placental hypoxia is one of the theories that cause preeclampsia. In placental hypoxia of preeclampsia, there is an increase of Hipoxia Inducible Factor 1 Alpha (HIF-1-A) expression as a response to hypoxia. L-Arginine administration through the L-Arginine-Nitric Oxide pathway is expected to improve placental hypoxia. This study aimed to examine the effect of L- Arginin on placental HIF-1-A expression at preeclampsia mice models.Subjects and Method: Experimental study with parallel group post-test only design. The study was carried out at the Veterinary Medicine Faculty of Airlangga University. Thirty six preeclampsia mice models were made with intravenous injection 10ng anti-Qa-2 on day 1-4 of pregnancy. They were divided into 2 groups: (1)18 mice without treatment (control) and (2) 18 mice were given L-Arginin 200 mg/kgBW/day on day 7-15 of pregnancy. They were terminated on day 16 then immunohistochemistry examination of HIF-1-A expression was done on the placental samples. The dependent variable was placental Hipoxia Inducible Factor-1-Alpha (HIF-1-A) expression. The independent variables were L-Arginin administration. HIF-1-A expression was measured by H-Score method. The data were analyzed by t-test. Results: The mean of placental HIF-1-A expressions of treatment group was lower (Mean= 7.98; SD=9.35) than control group (Mean=41.95; SD= 32.20), and it was statistically significant (p <0.001).Conclusion: L-Arginin reduces the Placental Hypoxia Inducible Factor Alpha (HIF-1-A) expression on preeclampsia mice model.Keywords: L-Arginine, HIF-1-A, PreeclampsiaCorrespondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java, Indonesia. Email: nutria_dr@staff.uns.ac.id. Mobile: 08122651819.Indonesian Journal of Medicine (2020), 05(03): 191-199https://doi.org/10.26911/theijmed.2020.05.03.03 
BREAST CANCER IN PREGNANCY AT DR. KARIADI GENERAL HOSPITAL: A SERIAL CASE Ireneus Vanessa Martono; M. Besari Adi Pramono; Herman Kristanto; Albertus Ari Adrianto
JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL) Vol 10, No 2 (2021): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v10i2.29172

Abstract

Background Each year 2.1 million women were diagnosed with breast cancer, being the most common type of cancer found and cancer-related cause of death in women worldwide. In Indonesia, especially in Middle Java, more than 80% women diagnosed were already in the late stage. Physiological changes in pregnancy contributes to the delay in diagnosis in pregnant women and pregnancy also resulted in a more complicated approach of therapy. Regarding only few studies were done involving pregnancy with breast cancer, the aim of the study is to provide further knowledge associated with it.Methods Medical records of pregnant women with breast cancer in year 2014-2018 at Dr. Kariadi General Hospital were studied.Results Based on the 3 cases be studied, patients were referred from class B and C hospitals outside of Semarang city showing stage III (33.33%) and IV (66.67%) breast cancers. Two-third of the patients underwent mastectomy previously and one of them also underwent chemotherapy program prior her pregnancy. Comorbidities varied between patients and therapies were adjusted individually and multidisciplinary. Two of the cases went through transperitoneal caesarean section for delivery and one patient with twin pregnancy died by complications and intrauterine foetal death was also determined.Conclusion Overall, all patients were > 35 years old and the breast cancers were diagnosed at late stage. Complications by comorbidities such as anaemia, severe malnutrition, and infection, were found. Two pregnancies which were already in third trimester was terminated and a case of maternal mortality was found.Keywords Breast cancer, pregnancy
High-Sensitivity Cardiac Troponin I Level and Left Ventricular Diastolic Dysfunction on Severe Preeclampsia: Kadar High Sensitivity Cardiac Troponin I dan Disfungsi Diastolik Ventrikel Kiri pada Preeklamsia Berat Rahmad R. B. Wicaksono; Julian Dewantiningrum; Herman Kristanto
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1429

Abstract

Abstract Objective: To know the relationship between high-sensitivity cardiac Troponin I (hscTnI) level with left ventricular dysfunction on severe preeclampsia.Methods: An observational analytics study with a cross-sectional approach of ten pregnant women with severe preeclampsia who underwent delivery or termination pregnancy and then performed a transthoracic echocardiography examination and serum levels of hscTnI.Results: There is a significant relationship between hscTnI levels and left ventricular diastolic dysfunction (p <0.05)Conclusion: These findings of this study have significant implications that severe preeclampsia is associated with heart remodelling and significant change in cardiac function especially left ventricular dilatation and elevation of hscTnI. Early identification and intervention may ameliorate subsequent cardiovascular disease so this requires regular and close follow-up of this target group.Keywords: high-sensitivity cardiac Troponin I, left ventricular diastolic dysfunction, severe preeclampsia. Abstrak Tujuan: Untuk mengetahui hubungan antara kadar high-sensitivity cardiac Troponin I (hscTnI) dengan disfungsi ventrikel kiri pada preeklamsia berat.Metode: Studi observasional dengan pendekatan potong lintang terhadap sepuluh ibu hamil dengan preeklamsia berat yang menjalani persalinan atau terminasi kehamilan kemudian dilakukan pemeriksaan ekokardiografi dan kadar hscTnI serum.Hasil: Ada hubungan yang bermakna antara kadar hscTnI dengan disfungsi diastolik ventrikel kiri (p <0,05).Kesimpulan: Temuan penelitian awal ini memiliki implikasi yang signifikan bahwa preeklamsia berat berhubungan dengan remodeling jantung dan perubahan signifikan pada fungsi jantung terutama dilatasi ventrikel kiri disertai peningkatan kadar hscTnI. Identifikasi dan intervensi dini dapat memperbaiki perjalanan penyakit kardiovaskular sehingga diperlukan pengawasan lanjut pada kelompok pasien ini.Kata kunci: disfungsi diastolik ventrikel, high-sensitivity cardiac troponin I jantung sensitivitas tinggi, kiri, preeklamsia berat
Fetal Growth Cut-Off Point To Predict Neonatal Outcome In Pregnancy With Normal And Deficient Vitamin D Levels: Intergrowth-21, World Health Organization Fetal Growth Curve, And Hadlock’s Estimated Fetal Weight Dewantiningrum, Julian; Kristanto, Herman; Pudjonarko, Dwi; Mexitalia, Maria; Ediati, Annastasia; Soejoenoes, Ariawan; Hadisaputro, Suharyo
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.877

Abstract

Purpose : Analyze the cut-off point of fetal growth based on the Intergrowth-21, World Health Organization (WHO), and Hadlock’s estimated fetal weight (EFW) in pregnant women with normal or deficient vitamin D levels to predict neonatal outcomes. Method: This cross sectional study to develop a diagnostic test, included 120 of pregnant women who completed follow up until children aged 2 years, divided into normal and deficient vitamin D group. Ultrasound and maternal vitamin D level examined during the second trimester of pregnancy. EFW was calculated using Hadlock’s formula and plotted on the Intergrowth-21 and WHO curves. The reference standards were the neonatal outcome, LBW, stunting, and neurocognitive impairment. Significant odds ratio (OR) value and area under the curve (AUC) of 0.6 are used to determine the cut-off point to be used. Result: Fetal growth curve was based on the WHO at the 5th percentile to predict LBW to have an AUC of 0.6 and OR of 6, 95% confidence interval (CI) of 1.36–26.45. The AUC for predicting LBW based on Intergrowth and Hadlock were 0.45 and OR not significant. As well as the AUC estimated stunting based on Hadlock, the Intergrowth-21 and the WHO fetal growth curves is <0.6 with OR not statistically significant. The AUC predicted neurocognitive impairment based on WHO’s chart was 0.6 but OR not statistically significant. Conclusion: The WHO fetal growth curve can be used to predict LBW. The cut-off point of the fetal growth curve and which percentile is determined by the neonatal outcome.
Differences of Dyspareunia in Primipara with 2nd Degree Perineal Laceration Sutured with Rapide Polyglactin 910 and Chromic Catgut Threads Wibowo, Satrio Arief; Trisetiyono, Yuli; Kristanto, Herman; Wiyati, Putri Sekar; Tjahjanto, Hary; Erwinanto, Erwinanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.968

Abstract

BACKGROUND: Dyspareunia is persistent or recurrent pain during sexual intercourse. Perineal laceration, spontaneous or episiotomy, is one of the most common causes. Perineal lacerations that occur must be treated through suturing. Chromic catgut is a natural thread that is often used in medical practice, but this thread have a higher inflammatory response compared to Rapide Polyglactin 910. AIMS: To analyze the difference in the incidence of dyspareunia in primipara with 2nd degree perineal lacerations sutured with Rapide Polyglactin 910 and Chromic catgut threads METHOD: True experimental research with randomized controlled trial-single blinded method. The research was conducted at dr. Kariadi Semarang, RA Kartini Hospital and dr. Soeselo from August 2022 to February 2023. The research subjects were primipara with 2nd degree perineal lacerations which were divided into 2 groups, namely 45 subjects in the Chromic catgut group and 45 subjects in the Rapide Polyglactin 910 group. Evaluation of dyspareunia after 3 months was carried out using the Female Sexual Function Index (FSFI) RESULT:  Subjects sutured using Chromic catgut had a 2.7 times greater risk of experiencing dyspareunia when compared to using Rapide Polyglactin 910 (OR=2.7; 95% CI=1.1-6.6). A significant confounding factor was found, namely the act of episiotomy (p=0.047; OR=9.56; 95% CI=1.86 - 48.97). After controlling for these variables, the subjects who were sewn using Chromic had a significant risk (p=0.002, OR=5.39; 95% CI=1.76-16.50) CONCLUSION: Subjects with Chromic catgut have a higher risk of experiencing dyspareunia than using Rapide Polyglactin 910 threads after 3 months of suturing.
Pregnancy Associated Plasma Protein-A (PAPP-A) as a Marker to Distinguish Normotensive with Early 2nd Trimester and Late 3rd Trimester Onset of Preeclampsia Simangunsong, Ragam Pesona; Kristanto, Herman; Iskandar, Mirza; Thaufik, Syarief; Pramono, Besari Adi; Mochtar, Arufiadi Anityo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.979

Abstract

Introduction: Preeclampsia is a hypertensive condition that occurs after 20 weeks of gestation accompanied by target organ damage. Complications of preeclampsia can cause intrauterine fetal growth retardation, and placental hypoperfusion, even in the most serious situations, namely termination of pregnancy and death of the fetus and/or mother. Pregnancy-associated plasma protein-A (PAPP-A) is a high molecular weight glycoprotein that is produced in the placenta and secreted into the maternal bloodstream. However, based on several studies that have been conducted, there is uncertainty in the results of assessing PAPP-A levels obtained in pregnant women in the second and third trimesters. Aim: Proving differences in PAPP-A levels in the second and third trimesters in the incidence of early-onset preeclampsia and normotensive pregnancy. Methods: An analytic observational study with a cross-sectional approach was carried out in the delivery room of RSUP Dr. Kariadi Semarang, Halmahera Health Center, Ngesrep Health Center, Bulu Health Center, and private midwife practice in Semarang City. The subjects of the study were six 2nd-trimester preeclampsia patients, fourteen 3rd-trimester preeclampsia patients, and twenty normotensive pregnancy patients who met the inclusion and exclusion criteria. Data were analyzed using Mann Whitney with a significance of p<0.05 Results: There was a significant difference in PAPP-A levels (p<0.001) between the preeclampsia and normotensive pregnancy groups, whereas PAPP-A levels were higher in the preeclampsia group. There were significant differences in PAPP-A levels (p<0.001) between the 2nd-trimester preeclampsia, 3rd-trimester preeclampsia, and normotensive pregnancies, where the highest PAPP-A levels were found in the 2nd-trimester preeclampsia group. Conclusion: There was a significant difference in PAPP-A levels between the second and third trimesters of early-onset preeclampsia compared to normotensive pregnancies, where PAPP-A levels were higher in the second and third trimesters of early-onset preeclampsia. Elevated PAPP-A levels in the second and third trimesters are associated with an increased risk of early-onset preeclampsia.
Effectiveness of Kelly Plication Method on Clinical Improvement in Stress Urinary Incontinence Patients Notohatmodjo, Puspitasari; Pramono, Besari Adi; Mulyantoro, Inu; Kristanto, Herman; Purnaningtyas, Dewi Astri; Mochtar, Arufiadi Anityo; Mulyantoro, Erwinanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1032

Abstract

BACKGROUND: Patients with pelvic organ prolapse (POP) usually present with POP, but stress urinary incontinence (SUI) is also found during history taking and physical examination. As a result, the complaint of SUI is persistent despite POP surgery. Therefore, SUI found along with POP and undergoing surgery can be performed Kelly plication method. OBJECTIVES: To examine the effectiveness of Kelly's plication method on clinical changes and quality of life of patients suffering from SUI. METHODS: A single cohort prospective one-group pretest-posttest design conducted at RSUP Dr. Kariadi Teaching Hospital Semarang involving 31 research subjects. All subjects were measured preoperative IIQ-7 questionnaire and pad test. Then, all subjects will undergo Kelly method surgery. Postoperative evaluation will be conducted 3 months later, including measurement of the IIQ-7 questionnaire and pad test. All data will be analyzed with univariate and bivariate analysis using paired t-test and Wilcoxon test. RESULTS:  The effectiveness rate of Kelly's plication method was 58.06% in this study. Most of the subjects were aged 50-59 (38.7%) years and had experienced menopause (87.1%). Correlation analysis of baseline data on the degree of preoperative SUI showed that the degree of POP correlated SUI. The Pad test and IIQ-7 questionnaire test showed a significant decrease in postoperative measurements in the treatment group (p: <0.001 & p: <0.001). CONCLUSIONS: Kelly's plication method is effective in treating SUI.
Endothelin-1 Level In Early Onset Preeclampsia Riantyoko, Yoshi; Hadijono, Raden Soerjo; Iskandar, Teuku Mirza; Trisetiyono, Yuli; Pramono, Besari Adi; Suhartono, Suhartono; Kristanto, Herman
DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN Vol 14, No 1 (2023): Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Publisher : Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33859/dksm.v14i1.917

Abstract

Introductions: Preeclampsia is a specific syndrome in pregnancy as a result of abnormal placental invasion leading to placental hypoperfusion. Persistent hypoxia of the placenta causes the release of various inflammatory mediators into the circulation and results in local endothelial dysfunction. Increased endothelin-1 (ET-1) secretion and increased inflammatory mediators occur in preeclampsia.Aims: To analyze the relationship between endothelin-1 and early onset preeclampsia.Methods: This crosssectional study included 50 pregnant women with early onset preeclampsia (n=25) and normal pregnancies (n=25). Pregnant women aged 20-35 years with single intrauterine fetus, primigravida and multigravida who experienced early onset preeclampsia 34 weeks of gestation were included in this study. Endothelin-1 levels was measured using the Enzyme Linked Immunosorbant Assay (ELISA) method. The analysis was performed using the Mann-Whitney test. Receiving Operator Characteristic (ROC) curve analysis was used to find the cut-off value and diagnostic accuracy of endothelin-1 levels.Results: The mean of ET-1 level was significantly higher in early onset preeclampsia (0.732 ± 0.56 pg/mL) compared to normal pregnancy (0.318 ± 0.09 pg/mL) with value of p = 0.000. The ROC analysis showed the AUC value of 87.8% (p = 0.000, 95% CI 78.6%-97.1%). The cut-off value for ET-1 was 0.385 pg/mL, with 80% sensitivity and 68% specificity (PR=3.14; 95% CI 1.40-7.03).Conclusion: Increased levels of endothelin-1 (ET-1) significantly associated with early onset preeclampsia. ET-1 level ≥ 0.385 pg/mL in pregnant women with 34 weeks of gestation is potential biomarkers to predict the occurrence of early onset preeclampsia with a risk up to 3.14 times.
Effect Of Vitamin D Administration On Interleukin 6 (IL-6) Levels In Peritoneal Fluid In Endometrioma Patients Setyasworo, Singgeh; Mochtar, Arufiadi Anityo; Erwinanto, Erwinanto; Kristanto, Herman; Tjahjanto, Hary; Trisetiyono, Yuli
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1031

Abstract

BACKGROUND: An endometrioma is a cyst that occurs when endometrial tissue grows on the epithelium of the ovary. Vitamin D is a steroid hormone that can be extracted from commonly available foods and can be synthesized by humans when exposed to sunlight. Vitamin D deficiency has been reported to be associated with various pathologies, including endometrioma. Vitamin D has been reported to have anti-angiogenic effects that may inhibit the growth of endometriotic implants.   AIM: Proving the effect of vitamin D administration on interleukin 6 (IL-6) levels in peritoneal fluid in patients with endometrioma. METHOD:  Experimental research with two group, post-test only design with single blind that carried out at Central General Hospital (RSUP) Dr. Kariadi Semarang. The research subject was 50 patients with endometrioma on ovary. The definite diagnosis of endometrioma is made based on histopathological examination of tissue samples after the patient undergoes surgery. Patients will be divided into 2 groups, namely the vitamin D3 supplementation group and placebo. The intervention was carried out by providing vitamin D3 50,000 IU/week for a month. Evaluation of serum vitamin D levels were obtained using venous blood samples immediately when the patient was undergoing surgery. Interlukin-6 levels were obtained using peritoneal fluid samples obtained when the patient underwent surgery. Statistical analysis was carried out using the Independent T Test, Mann-Whitney U, Dependent T Test and Wilcoxon. Results are significant if p <0.05. Statistical analysis was carried out using SPSS edition 26. RESULT:  Peritoneal fluid interleukin-6 (IL-6) levels between the vitamin D supplementation group and the placebo group did not show a significant difference (p=0.554). CONCLUSION: Vitamin D supplementation in endometrioma patients is not associated with peritoneal fluid interleukin-6 (IL-6) levels.
Co-Authors AA Sudharmawan, AA Agoes Oerip Poerwoko Albertus Ari Adrianto Annastasia Ediati Bachrudin, Rizky Aditya Bangun T. Purwaka, Bangun T. Besari Adi Pramono Besari Adi Pramono Budi Irawan Damar Prasmusinto Dewi Astri Purnaningtyas Dwi Pudjonarko Erwinanto, Erwinanto Hadijono, Raden Soerjo Hary Tjahjanto Ireneus Vanessa Martono Johanes C. Mose Julian Dewantiningrum Juneke J. Kaeng Made K. Karkata, Made K. Maisuri T. Chalid, Maisuri T. Makmur Sitepu, Makmur Maria Mexitalia MIRZA ISKANDAR, MIRZA Mochtar, Arufiadi Anityo Mulyantoro, Erwinanto Mulyantoro, Inu Noroyono Wibowo Notohatmodjo, Puspitasari Nuswil Bernolian Nutria Widya Purna Anggraini Putri Sekar Wiyati Rahmad R. B. Wicaksono Riantyoko, Yoshi Rima Irwinda, Rima Setyasworo, Singgeh Simangunsong, Ragam Pesona Soejoenoes, Ariawan Sri Sulistyowati Suharyo Hadisaputro Syarief Thaufik, Syarief Teuku Mirza Iskandar, Teuku Mirza Udjaja, Claudio Wibowo, Satrio Arief Yuli Trisetiyono, Yuli Yusrawati Yusrawati