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Besari Adi Pramono
Departement Of Obstetrics And Gynecology, Faculty Of Medicine, Diponegoro University
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Why Infertility Patients Came Late to Infertility Clinics (Study at Kariadi General Hospital) Rahma Khusnul Khotimah; Besari Adi Pramono; Suharto Suharto; Yuli Trisetiyono
JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL) Vol 10, No 6 (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.v10i6.30190

Abstract

Background: Infertility is an inability of a spouse to get pregnant within twelve months seeking pregnancy without using any contraception. The duration of infertility affects the chance to get pregnant.Objective: To identify the factors causing infertility patient came late to Polyclinic Merpati RSUP Dr. KariadiMethods: This study was an observational descriptive with a cross-sectional design. The data were obtained from medical records and questionnaires. Twenty-six respondents were infertility patients who met the inclusion and exclusion criteria and came to Polyclinic Merpati RSUP Dr. Kariadi in September 2020.Results: The number of infertility patients in September 2020 was 76 patients, 72,4% of them came to Polyclinic Merpati late. Most people came after being referred from the previous doctors. Three factors causing infertility patients came late were economic factors, a social factor, and another difficulty.Conclusion: Factors causing the late coming of infertility patients were economic factors, a social factor, and another difficulty
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
Adverse Outcome in a Near Term, High-Risk Twin Pregnancy Complicated by COVID-19: A case report Razmaeda Sarastry; Crismanto Layarta; Ussisti Aladini; Alini Hafiz; Besari Adi Pramono
Diponegoro International Medical Journal Vol 1, No 2 (2020): December
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v1i2.7937

Abstract

Background: COVID-19 affecting the outcome of pregnancy is still under investigation. Here we report a case of primigravida with monochorionic diamniotic twin pregnancy with superimposed preeclampsia who develop symptoms of COVID-19 infection on her near term pregnancy and was confirmed later on as COVID-19 positive after cesarean section. The pregnancy was terminated abdominally due to the intrauterine fetal demise of both twins using COVID-19 standard equipment.Case Presentation: A 29-year-old female, gravida 1, para 0 presented with a twin pregnancy at the gestational age of 36 weeks was referred to our emergency department for further management of intrauterine fetal death of both twins. Six days before admitted to our emergency department, she has been experienced a remittent fever which followed by a mild cough. Four days before admission, she complained of decrease movement of the babies. She went to the Secondary Hospital to check her pregnancy and both fetal heart rates were not found.  The patient is obese (BMI 49.2 kg/m2) and had prior uncontrolled hypertension but no other medical history, including epilepsy, allergies, asthma, heart disease as well as Diabetes Mellitus.Conclusion: A research about placental pathology in pregnancy with confirmed case of COVID-19 infection showed no pathognomonic feature in the histopathologic examination but mostly, there were maternal vascular malperfusion (decidual arteriopathy in particular) and intervillous thrombi. In the end, a further examination is suggested to evaluate the course and causal factors pertaining to this case.
Differences of Ampicillin and Cefazolin Effects in Reducing hs-CRP Level in Premature Rupture of Membranes Ahmad Bukhoeri; Syarief Thaufik Hidayat; Ediwibowo Ambari; Julian Dewantiningrum; Putri Sekar Wiyati; Besari Adi Pramono
Diponegoro International Medical Journal Vol 2, No 1 (2021): July
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v2i1.8428

Abstract

Background: Premature rupture of membranes (PROM) is a rupture of amniotic sac before delivery. PROM is associated with an increased incidence of preterm labor and infection. The use of prophylactic antibiotic may reduce the risks of infection. High-sensitivity C-reactive protein (hs-CRP) is an acute-phase reactant protein that is associated with PROM. How much effect of prophylactic antibiotic to hs-CRP level remains unclear.Objective: To compare the reduction in hs-CRP levels in premature rupture of membranes before and after given ampicillin or cefazolin.Methods: The design of this study was true experimental design (pre and post-test) conducted at Dr. Kariadi General Hospital Medical Center Semarang and Kartini General Hospital Jepara from September 2019 to January 2020. Study samples are pregnant women with premature rupture of membranes that came to the Emergency Department and Maternity Ward Dr. Kariadi General Hospital Medical Center Semarang and Kartini General Hospital Jepara. Samples were divided into two groups, a group treated with ampicillin and the other with cefazolin therapy. All samples were subjected to a hs-CRP examination. Statistical analysis was performed by Mann-Whitney and Wilcoxon.Results: There are no significant differences in the age variable (28.8 ± 6.54 vs 29.1 ± 5.93), gestational age (36.3 ± 2.55 vs 36.3 ± 2.90), and parity (2,2 ± 0.99 vs 2.47 ± 1.19) in the ampicillin and cefazolin groups (p> 0.05). In this study, 37.1% patients have a history of PROM while 62.9%. had no history of PROM. Reduction in hs-CRP levels after administration of ampicillin and cefazolin was significant (4.4 ± 2.65 mg/L vs 6.3 ± 4.43 mg/L, respectively, p = 0.03). The difference in the decrease in hs-CRP levels before and after given ampicillin and cefazolin was significant (p = 0.0001). Conclusion: There is a decrease in hs-CRP levels after the administration of ampicillin or cefazolin in PROM, whereas cefazolin induced higher reduction in hs-CRP levels. Ampicillin can still be used as a first-line prophylactic antibiotic in primary healthcare facilities.
Pregnancy with Hypothyroid Secondary to Treatment of Thyroid Carcinoma: A Case Report Claudio Udjaja; M. Besari Adi Pramono
Diponegoro International Medical Journal Vol 2, No 2 (2021): December
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v2i2.10630

Abstract

Background: Thyroid malignancy is one of the most common malignancies in women of reproductive age. One of the normal physiological change in pregnancy is an increase in total maternal thyroid levels. According to 2015 DATIN information, the prevalence of hypothyroidism in women of reproductive age was 2.2%. Method of delivery in patients with thyroid disorders are mostly by cesarean section due to complications of the mother and/or fetus. Fetal outcome usually associated with low birth weight and poor APGAR Score.Objective : Reporting a case of pregnancy with hypothyroidism secondary to thyroid carcinoma treatmentCase: A 37-year-old woman Gravida 3 Parity 2 Abortion 0 with 18 weeks pregnancy after thyroid ablation treatment with a history of Papillary Thyroid Carcinoma – Follicular Variant, following a complete thyroidectomy in August 2016. The patient was given 6-dose ablation therapy, the last therapy was performed in April 2019. On clinical examination, the patient have no sign and symptoms suggesting hypothyroidism. On laboratory examination, the thyroid stimulating hormone (TSH) level was increased. Levothyroxine dosage was adjusted until the patient in euthyroid status in the early 3rd trimester of pregnancy until the delivery period. The fetal examination suggests that the Bio-Physical Profile was normal according to gestational age. The patient underwent vaginal delivery following 38 weeks of gestation with good maternal outcomes and low birth weight neonatal outcomes, no thyroid nodules, and slightly increased thyroid function.Conclusion : Management of counselling about preconception, contraception, and initial screening of patients with a history of thyroid carcinoma are the initial steps to help a better outcome in pregnancies with thyroid disorders. 
The Association of Cervical Length, Bacterial Vaginosis, Urinary Tract Infection and Premature Rupture of Membranes to The Imminent Preterm Labour Hariyo Wirastomo Prajarto; Besari Adi Pramono
Diponegoro International Medical Journal Vol 1, No 2 (2020): December
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v1i2.9538

Abstract

Background: Research conducted at the Central General Hospital (RSUP) Dr. Kariadi Semarang in 2013 stated that out of 1,719 deliveries, 82 (5%) were preterm labor cases. Although there are many predictors for predicting imminent preterm labour, the complete prediction and prevention have not been established. Prevention of preterm labor through screening is the key to antenatal care. Good early prediction on a premature labor will provide adequate antenatal surveillance and special interventions.Objective: to analyze the relationship between cervical length, bacterial vaginosis, urinary tract infections, and premature rupture of membranes with the incidence of preterm labor.Methods: It is an observational analytic study in the form of the design of cross sectional with subject of pregnant women who experienced imminent preterm labour at gestational age 28-34 weeks and were treated at the ward of Obstetrics Gynecology Hospital Dr. Kariadi Semarang and network hospital during the study period (n=112). Subjects were assessed for the clinical risk (BV, premature rupture of the membrane, urinary tract infection) and sonography (cervical length). Statistical analysis was performed with paired t-test for normally distributed data and Mann Whitney if otherwise. Analysis of the relationship between variables and the incidence of preterm labor was carried out by the X 2 testResults: From 112 subjects, it was found that the Prevalence Ratio (PR) for cervical length, bacterial vaginosis, urinary tract infections and premature rupture of membranes to the incidence of imminent preterm labor was 2.2;2.32;1.99 and 2.36 respectively. From the multivariate analysis, it was found that bacterial vaginosis and premature rupture of membranes were the most influencing factors for the incidence of imminent premature labor with Odd Ratios of 6.497 and 21.362, respectively.Conclusion: There is a relationship between cervical length (≤25 mm ), bacterial vaginosis, urinary tract infections and premature rupture of membranes in the incidence of preterm labor.
Co-Authors Ahmad Bukhoeri Albertus Ari Adrianto Alini Hafiz Claudio Udjaja Crismanto Layarta Ediwibowo Ambari Hariyo Wirastomo Prajarto Herman Kristanto Ireneus Vanessa Martono Julian Dewantiningrum Putri Sekar Wiyati Rahma Khusnul Khotimah Razmaeda Sarastry Suharto Suharto Syarief Thaufik Hidayat Ussisti Aladini Yuli Trisetiyono