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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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Perineal Laceration in primipara in Association with Perineal length, Fetal Head Circumference, and Fetal Weight Udjaja, Claudio; Erwinanto, Erwinanto; Kristanto, Herman; Tjahjanto, Hary; Trisetiyono, Yuli; Mochtar, Arufiadi Anityo
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.v11i3.1117

Abstract

BACKGROUND : Perineal laceration is one of the risk and complication of spontaneous labour resulting intervention in short-term and long-term quality of life. Lack of research in Indonesia on perineal length Lack of research on perineal length in Indonesia, fetal birth weight and fetal head circumference and its impact on spontaneous labour and perineal laceration gave rise to the idea of research in order to minimize the occurrence of complications from perineal laceration in spontaneous labour.OBJECTIVES : To know find out the association between perineal length, fetal head circumference, and fetal weight with degree of perineal laceration in primiparous women.METHODS : Observational cross sectional multi-center study conducted between August 2023 until October 2023 in which all subject that delivered vaginally within inclusion criteria was measured. All data will be further analized to determine the significant predictor of perineal tear.RESULTS : Based on this study The result of this study has indicated that there is no significant association of perineal length with the degree of spontaneous primiparous perineal laceration. While there is an association of fetal head circumference and fetal weight with the degree of spontaneous primiparous perineal laceration in aterm pregnancy. Based on further analysis, fetal head circumference greater than 325 mm increases the risk of severe perineal laceration 4.4 times (PR=4,4; 95% CI=1,4-13,9) and Fetal weight greater than 3097.5 grams increases the risk of 2.7 times (PR=2,7; 95% CI=1,1-6,4) the occurrence of severe perineal laceration.CONCLUSION : There is an association of fetal head circumference and fetal weight with the degree of spontaneous primiparous perineal laceration.
Reinterpreting potential biomarker in umbilical cord as a marker of chorioamnionitis and funisitis in prelabor ROM Dewantiningrum, Julian; Pramono, Besari Adi; Poerwoko, Agoes Oerip; Irawan, Budi; Bachrudin, Rizky Aditya; Kristanto, Herman
Majalah Obstetri & Ginekologi Vol. 33 No. 3 (2025): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I32025.221-227

Abstract

HIGHLIGHTS HsCRP and IL-6 levels in umbilical cord blood serve as reliable early biomarkers of chorioamnionitis and funisitis in prelabor ROM, enabling more accurate neonatal sepsis risk assessment and targeted clinical intervention. Early identification of amnionitis and funisitis through hsCRP and IL-6 measurements guides timely clinical decisions, including prompt antibiotics or intensified monitoring, thereby reducing severe neonatal complications.   ABSTRACT Objective: Prelabor rupture of membranes (ROM) occurs in approximately 1% of all pregnancies and 30% of all preterm births, and the etiology remains unclear. Prelabor ROM is associated with a high incidence of funisitis and chorio-amnionitis leading to neonatal sepsis. This study aimed to assess whether hsCRP, procalcitonin, and IL-6 level in umbilical cord as indicators for identifying pregnancies at risk for these complications. Materials and Methods: This research used cross sectional design conducted in dr. Kariadi Hospital. Inclusion criteria were pregnant woman with 28-42 weeks of gestational age, singleton and prelabor ROM. Exclusion criteria included other comorbidities. The participants were divided into two groups: with and without funisitis-chorioamnionitis, which were detected using histopathologic examination. Statistical analysis was performed using the chi-square, t-test/Mann-Whitney between two group, wit statistically significant set at p<0.05. Results: A total of 88 pregnant women were included in the study, consisting of 23 pregnant women with chorioamnionitis-funisitis and 65 pregnant women without funisitis-chorioamnionitis. Procalcitonin levels in the group with and without chorioamnionitis-funisitis were 0.88±0.6 vs 1.06±0.46 ug/mL (p=0.07). IL-6 levels in the chorioamnionitis-funisitis were 54.41(9.34-445.9) vs 2.83(0.09-454.82) pg/mL in without chorioamnionitis-funisitis (p<0.001). HsCRP levels in the funisitis-chorioamnionitis compared to those without chorioamnionitis-funisitis group were 1.39(0.07-10.5) vs 0.17(0.03-10.5) mg/L (p<0.001). Conclusion: Elevated levels of hsCRP and IL-6 in the umbilical cord were found to be significant biomarkers for chorioamnionitis and funisitis in prelabor rupture of membranes. These biomarkers could be useful in identifying pregnant women at high risk for these complications, enabling better clinical management.
Efficacy and Tolerability of Short-Term Hormonal Therapy Following Conservative Surgery for Endometriosis: Efficay and Clinical Tolerability of Short-Term Hormonal Treatment for Endometriosis Pain Trisetiyono, Yuli; Sarastry, Razmaeda; Dewantiningrum, Julian; Anityo Mochtar, Arufiadi; Kristanto, Herman; Thaufik Hidayat, Syarief
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 4 October2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i4.2588

Abstract

AbstractObjective: To compare the efficacy and tolerability of four short-term hormonal therapies; Dienogest (DNG), Depot Medroxyprogesterone Acetate (DMPA), continuous Combined Oral Contraceptive (COC), and Leuprolide Acetate (LA); administered for 12 weeks after conservative endometriosis surgery. Methods: This randomized, prospective, open-label study enrolled reproductive-aged women with surgically confirmed endometriosis. Participants were randomly assigned to receive DNG 2 mg daily, DMPA 150 mg intramuscularly every 12 weeks, continuous COC (ethinyl estradiol 0.03 mg and levonogestrel 0.15 mg) daily, or LA 3.75 mg intramuscularly every 4 weeks. Primary outcomes were changes in pain intensity (visual analog scale, VAS), hormonal markers (estradiol, E2), inflammatory markers (TNF-?), and the Menopause Rating Scale (MRS) as an indicator of tolerability. Data were analyzed using ANOVA with a significance level of p < 0.05. Results: All four regimens resulted in significant reductions in dysmenorrhea, dyspareunia, and chronic pelvic pain after 12 weeks (p < 0.001). E2 and TNF-? levels decreased significantly in all groups, with the greatest decline observed in the LA arm. No significant differences were found among regimens in pain reduction or biomarker changes (p > 0.05). MRS scores increased transiently at week 8, particularly in the LA group, reflecting hypoestrogenic effects, but decreased by week 12 in all groups. Conclusion: Short-term postoperative hormonal therapy with DNG, DMPA, COC, or LA effectively reduces pain and inflammatory markers following endometriosis surgery. Progestin-based therapies achieve comparable clinical efficacy to GnRH agonists with superior tolerability. Individualized selection based on symptom profile, side effects, and accessibility is recommended in accordance with ESHRE guidelines. Keywords: endometriosis-associated pain, Menopause Rating Scale, short-term hormonal therapy.
Co-Authors AA Sudharmawan, AA Agoes Oerip Poerwoko Albertus Ari Adrianto Anityo Mochtar, Arufiadi 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 Sarastry, Razmaeda Setyasworo, Singgeh Simangunsong, Ragam Pesona Soejoenoes, Ariawan Sri Sulistyowati Suharyo Hadisaputro Syarief Thaufik, Syarief Teuku Mirza Iskandar, Teuku Mirza Thaufik Hidayat, Syarief Udjaja, Claudio Wibowo, Satrio Arief Yuli Trisetiyono, Yuli Yusrawati Yusrawati