Hartanto Bayuaji
Departemen Obstetri & Ginekologi Fakultas Kedokteran Univesitas Padjajaran/ RSUP Dr. Hasan Sadikin Bandung

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Manajemen Jangka Panjang Endometriosis: Dapatkah Progestin Menjadi Andalan? Hartanto Bayuaji
Indonesian Journal of Obstetrics & Gynecology Science Volume 6 Nomor 2 Juli 2023
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v6.n2.527

Abstract

Latar belakang: pada tahun 2014 The Practice Committee of The American Society of Reproductive Medicine menyebutkan bahwa endometriosis merupakan penyakit kronis yang memerlukan penanganan jangka panjang dengan titik berat pada terapi medikamentosa. Progestin merupakan modalitas terapi yang berpotensi digunakan dalam jangka panjang. Dienogest merupakan progestin turunan 19-nortestosteron dengan pengaruh pada endometrium dan antiinflamasi yang kuat merupakan pilihan untuk terapi jangka panjang endometriosis.Metode: telaah pustaka.Hasil: dalam manajemen endometriosis, progestin digunakan dalam terapi jangka panjang serta untuk mencegah rekurensi. Penggunaan dienogest jangka panjang menurunkan skor visual analogue scale secara bermakna dari beberapa penelitian. Analisis efektivitas-biaya menunjukkan profil penghematan biaya yang lebih baik pada dienogest dibandingkan goserelin. Rekurensi endometriosis pasca operasi menurun secara bermakna pada wanita yang mendapat terapi dienogest. Dalam suatu network meta-analysis diketahui bahwa kombinasi agonis GnRH + dienogest diharapkan menjadi pilihan terbaik pencegahan rekurensi. Dari dua penelitian dengan subjek wanita Asia, efek samping dienogest terjadi pada sekitar 13,27% - 31,5% subjek dan umumnya bersifat ringan. Perubahan pola perdarahan uterus merupakan hal yang sering disampaikan subjek. Kepadatan mineral tulang mengalami penurunan pada pemberian dienogest namun mengingat pentingnya pencegahan rekurensi dan menghindari operasi ulang, keputusan penggunaan dienogest sebaiknya tidak hanya didasarkan pada hal ini saja. Simpulan: data menunjukkan bahwa dalam konsep terapi jangka panjang, progestin merupakan modalitas yang amat penting. Dienogest merupakan salah satu pilihan untuk manajemen jangka panjang endometriosis. Pengawasan penggunaan progestin harus selalu diperhatikan untuk mengupayakan diperolehnya hasil yang optimal.The Long Term Management Of Endometriosis: are Progestins the Reliable Choice?AbstractBackground: in 2014, The Practice Committee of The American Society of Reproductive Medicine stated that endometriosis should be viewed as a chronic disease that requires a lifelong management, with focus on progestins. Dienogest, a 19-nortestosterone derivative, is a progestin compound with strong endometrium effects and antiinflammatory property that may become an option in long term management of endometriosis.Method: literature reviewResults: progestins might be applied in both long term management and prevention of recurrence of endometriosis. The significant reduction of visual analogue scale score were found in several study. The cost-effectiveness analysis reveals better cost-saving profile of dienogest when compared with goserelin. Women who received postoperative dienogest treatment have reduced incidence of recurrence. In one network meta-analysis study, the GnRH agonist + dienogest combination revealed the best option for preventing recurrence. The adverse effects of dienogest from 2 Asian studies range from 13.27% - 31.5%, mostly mild cases. Changes in uterine bleeding pattern were the most common reported side effects. The bone mineral density decreased after dienogest treatment, however, considering the benefit of dienogest for preventing recurrence and repeated operation, the use of dienogest should not be solely based on bone mineral density changes.Conclusion: progestin is the important mainstay of long term therapi in endometriosis. Dienogest is an option in long term management of endometriosis. However, monitoring of their usage should be an important aspects to ensure optimal outcomes are achieved.Key words: bleeding pattern, bone mineral density, dienogest, endometriosis, long term management, progestins.
Maternal And Perinatal Outcomes In Adolescent Mothers Referred To A Central Hospital In West Java Indonesia Puspa Sari; Hartanto Bayuaji; Dany Hilmanto
JKM (Jurnal Kebidanan Malahayati) Vol 9, No 3 (2023): Volume 9 No. 3 Juli 2023
Publisher : Program Studi Kebidanan Fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkm.v9i3.10457

Abstract

Latar Belakang: Angka persalinan remaja di dunia masih tinggi. Di Asia Tenggara, sekitar 6 juta remaja melahirkan setiap tahunnya, termasuk di Jawa Barat, Indonesia. Selain itu, beberapa kehamilan remaja dirujuk ke rumah sakit pusat untuk mendapatkan perawatan medis selama persalinan.Tujuan: Penelitian ini bertujuan untuk menganalisis luaran maternal dan perinatal yang merugikan pada remaja yang dirujuk ke rumah sakit pusat di Jawa Barat.Metode: Penelitian ini merupakan penelitian potong lintang dengan data sekunder, dikumpulkan dari remaja yang melahirkan di Rumah Sakit Hasan Sadikin Jawa Barat, Indonesia. Terdapat 517 ibu hamil yang dirujuk antara bulan Januari 2019 hingga Agustus 2020 untuk persalinan. Data dimasukkan, dibersihkan, dan dianalisis dengan menggunakan SPSS versi 27.Hasil: Analisis Chi-square menunjukkan hubungan yang signifikan antara usia dengan preeklampsia, eklampsia, ketuban pecah dini (KPD), plasenta previa, dan komplikasi lainnya. Hasil yang paling umum menunjukkan hubungan yang signifikan pada masa remaja adalah eklampsia (5,15%); KPD (23,18%); kelahiran prematur (23,60%); solusio plasenta (0,34%), dengan metode persalinan pervaginam terbanyak (65,24%).Kesimpulan: Prevalensi eklamsia, KPD, kelahiran prematur, dan solusio plasenta lebih tinggi pada kehamilan remaja. Persalinan remaja menimbulkan banyak risiko dibandingkan dengan wanita dewasa.Saran: Peran berbagai pihak sangat diperlukan untuk mencegah persalinan remaja mulai dari pelayanan kesehatan primer. Kata Kunci: persalinan remaja; luaran ibu dan perinatal ABSTRACT Introduction: The number of adolescent birth in the world is still high. In South-East Asia, about 6 million adolescents give birth each year, including in West Java, Indonesia. Moreover, several adolescent pregnancies are referred to the central hospital to receive medical treatment during delivery.Objective: This study aimed to analyze the adverse maternal and perinatal outcomes of adolescent mother referred to a central hospital in West Java.Methode: This study was a cross sectional study with secondary data, gathered from adolescent who gave birth at Hasan Sadikin Hospital in West Java, Indonesia. There were 517 pregnant women referred between January 2019 to August 2020 for delivery. Data were entered, cleaned, and analyzed by using SPSS version 27.Result: The Chi-square analysis showed a significant relationship between age and preeclampsia, eclampsia, premature rupture of membranes (PROM), placenta previa, and other complications. The most common maternal outcomes showing a significant relationship in adolescence were eclampsia (5.15%); PROM (23.18%); preterm birth (23.60%); placental abruption (0.34%), with the most vaginal delivery method (65.24%).Conclusion: Prevalence of eclampsia, PROM, preterm birth, and placenta abruption were higher in adolescent pregnancy. Adolescent childbirth poses many risks compared to adult women.Suggestions: The role of various parties is needed to prevent adolescent childbirth start with primary healthcare. Keyword: adolescent childbirth; maternal and perinatal outcomes
Expansion Grade and Morphokinetic Parameters Associated with Aneuploidy Status of Embryo Fifth Day: Tingkat Ekspansi dan Parameter Morfokinetik yang Diasosiasikan dengan Status Aneuploid pada Hari k Lima Sebuah Embrio Achmad K. Harzif; Muharam Natadisastra; Dwi A. Suryandari; Retno A. Werdhani; Wisnu Jatmiko; Arief Budiono; Hartanto Bayuaji; Budi Wiweko
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.v11i4.2083

Abstract

Objective: To determine the potential of examining embryo morphology, and morphokinetic parameters in predicting the chromosomal status of embryos. Methods: This study is a cross-sectional that requires patients undergoing IVF followed by chromosome examination with NGS that was conducted at the IVF Center at Pondok Indah Hospital and Morula IVF Center at Bunda Hospital from December 2021 to December 2022. Each embryo that reaches the blastocyst stage on day 5 or 6 will be washed and put into a PCR tube for a week; then, embryologists annotate them to determine morphological assessment and morphokinetic parameters using Time-Lapse Microscopy. The chi-square test was used to analyse bivariate variables. Results: One hundred twenty-four samples were collected on day 5 of patients undergoing the IVF procedure. 50.8% of the samples were aneuploid chromosomes, and 49.2% were euploid. The morphokinetic characteristics median was 3.86 fold. It was found that expansion grade, time to pro-nuclear fading, and time to the synchrony of the third cell cycle were significantly associated with euploid status (p = 0.000; 0.041 and 0.036). Conclusion: The expansion grade has been proven as the most influential component for accurately predicting the ploidy status of embryos. Keyword: blastocyst, embryo, euploid status, expansion grade, morphokinetics Abstrak Tujuan: Untuk mengetahui potensi pemeriksaan morfologi embrio, dan parameter morfokinetik dalam memprediksi status kromosom embrio. Metode: Penelitian ini merupakan penelitian potong lintang yang memerlukan pasien yang sedang menjalani program bayi tabung yang dilanjutkan dengan pemeriksaan kromosom dengan NGS yang dilakukan di Pusat IVF RS Pondok Indah dan Pusat IVF Morula RS Bunda pada bulan Desember 2021 hingga Desember 2022. Setiap embrio yang mencapai tahap blastokista pada hari ke 5 atau 6 akan dicuci dan dimasukkan ke dalam tabung PCR selama seminggu; kemudian, ahli embriologi membuat anotasi untuk menentukan penilaian morfologi dan parameter morfokinetik menggunakan Mikroskop Time-Lapse. Uji chi-square digunakan untuk menganalisis variabel bivariat. Hasil: Seratus dua puluh empat sampel dikumpulkan pada hari ke 5 dari pasien yang menjalani prosedur IVF. 50,8% sampel adalah kromosom aneuploid, dan 49,2% adalah euploid. Median karakteristik morfokinetik sebesar 3,86 kali lipat. Ditemukan bahwa tingkat ekspansi, waktu menuju pemudaran pro-nuklir, dan waktu hingga sinkronisasi siklus sel ketiga berhubungan secara signifikan dengan status euploid (p = 0,000; 0,041 dan 0,036). Kesimpulan: Tingkat ekspansi telah terbukti sebagai komponen yang paling berpengaruh dalam memprediksi status ploidi embrio secara akurat. Kata kunci: blastosist, embrio, status euploid, tingkat ekspansi, morfokinetik
Characteristics of Endometrioma Recurrence Patients Maharani, Chintia Dewi; Bayuaji, Hartanto; Syam, Hanom Husni; Ritonga, Mulyanusa Amarullah; Mantilidewi, Kemala Isnainiasih; Rinaldi, Andi; Pratiwi, Yuni Susanti
Indonesian Journal of Obstetrics & Gynecology Science Volume 6 Nomor 3 November 2023
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v6i3.576

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Objective: To identify the characteristics of endometrioma recurrence cases. Method: This study was a descriptive retrospective, using secondary data taken from all medical records of Clinic Aster and Medical Records Installation in Dr. Hasan Sadikin General Hospital, Bandung, from 1st January 2018 – 31st December 2022. Data were presented in tables.Results: Of the 37 endometrioma recurrences, most of the patients are 20 to 35 in age. None of them has a parity history after the first surgical procedure. Both previous and recent cases are dominantly unilateral endometriomas. The history of postoperative medication is higher (54,1%). Obstetricians/Gynecologists appear to perform the most surgical procedure (67,6%). Mass is the main clinical manifestation of the recurrence. While menstrual and BMI profiles appear to be normal.Conclusions: The characteristic of the recurrence of endometrioma is related parity status after the first surgery, history of the previous medical treatment, and previous form of endometrioma are related to the current characteristic of endometrioma (age, lesion form, clinical manifestation, and recurrence interval).Karakteristik Pasien Endometrioma RekurenAbstrakTujuan: Mengetahui karakteristik dari pasien endometrioma rekuren.Metode: Penelitian ini merupakan penelitian deskripsi retrospektif dengan menggunakan data sekunder yang diambil dari seluruh rekam medis pasien kista endometriosis rekuren di Klinik Aster dan Instalasi Rekam Medis di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dengan periode 1 Januari 2018 – 31 Desember 2022. Kemudian, data-data disajikan dalam bentuk tabel.                                                                                . Hasil: Dari 37 kasus e ndometrioma rekuren, sebagian besar pasien berusia 20 hingga 35 tahun. Seluruh pasien tidak mempunyai riwayat paritas setelah prosedur pembedahan sebelumnya. Baik kasus-kasus kista endometriosis sebelumnya maupun yang kambuh, keduanya dominan dalam bentuk unilateral. Riwayat pengobatan pasca operasi lebih tinggi (54,1%). Dokter Spesialis Obstetri/Ginekologi tampak melakukan tindakan pembedahan terbanyak (67,6%). Massa adalah manifestasi klinis utama dari kekambuhan. Selain itu, profil menstruasi dan BMI tampak normal.Kesimpulan: Karakteristik pada endometrioma rekuren berkaitan dengan status paritas setelah operasi pertama, riwayat pengobatan medis sebelumnya, dan bentuk endometrioma sebelumnya berhubungan dengan karakteristik endometrioma saat ini (usia, bentuk lesi, manifestasi klinis, dan rentang rekurensi)Kata kunci: karakteristik, rekuren, endometrioma
The Indonesian Version of the Chapron’s Screening Method for Endometriosis Diagnosis based on Questionnaire as a Tool for Better Endometriosis Screening in Indonesia Hendrana, Aisyah Riseta Aini; Tjahyadi, Dian; Bayuaji, Hartanto; Rachmawati, Anita; Prasetyo, Nogi Eko; Djuwatono, Tono
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.890

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Objective: This study aims to translate, develop, and assess the validity and reliability of the Indonesian version of Professor Chapron’s screening method for endometriosis diagnosis based on the questionnaire as a tool for better endometriosis screening in Indonesia.Methods: Development of the questionnaire using 5 steps: translation, synthesis, back translation, expert committee review, and pretesting by involving language expert and subject expert. The analysis includes the validity and reliability of the questionnaire.Results: A sample of 30 subjects was enrolled. The questionnaire was consist of 3 sections, including characteristic patient questions, yes or no questions (8 questions), and pain scale questions (5 questions). Of the 8 yes or no questions, 7 were valid (r >0.300), and one question was not valid (r<0.300). The yes or no questions were reliable (Cronbach’s alpha 0.6968). All of the 6 pain scale questions were valid (r>0.300) and reliable (Cronbach’s alpha 0.790).Conclusion: This study represent the Professor Chapron’s questionnaire for endometriosis screening into another language (Bahasa) than the original. It showed that the questionnaire was reliable, and one question was not valid (removed from the questionnaire). The questionnaire can be used in Indonesia for screening method in Indonesia.Versi Indonesia dari Kuesioner Chapron untuk Metode Skrining dalam Diagnosis Endometriosis sebagai Alat Skrining Endometriosis di IndonesiaAbstrak Tujuan: Penelitian ini bertujuan untuk menerjemahkan, mengembangkan, dan menilai validitas dan reliabilitas versi bahasa Indonesia dari metode Skrining Professor Chapron berdasarkan kuesioner, sebagai alat untuk skrining endometriosis yang lebih baik di Indonesia.Metode: Pengembangan kuesioner menggunakan 5 langkah: penerjemahan, sintesis, penerjemahan balik, telaah komite ahli, dan pra-uji dengan melibatkan ahli bahasa dan ahli subjek. Analisis yang dilakukan yaitu uji validitas dan reliabilitas kuesioner.Hasil: Sampel penelitian sebanyak 30 orang. Kuesioner terdiri atas 3 bagian, yaitu pertanyaan karakteristik pasien, pertanyaan ya atau tidak (8 pertanyaan), dan pertanyaan skala nyeri (5 pertanyaan). Sebanyak 7 pertanyaan ya atau tidak, hasilnya valid (r>0,300) dan 1 pertanyaan tidak valid (r<0,300). Pertanyaan ya atau tidak hasilnya reliabel (Cronbach’s alpha 0,6968). Semua pertanyaan skala nyeri hasilnya valid (r>0,300) dan reliabel (Cronbach’s alpha 0,7900).Kesimpulan: Penelitian ini mengembangkan serta menilai validitas dan reliabilitas kuesioner Professor Chapron untuk skrining endometriosis dalam versi bahasa Indonesia. Kuesioner ini reliabel dengan 1 pertanyaan tidak valid (dihilangkan dari kuesioner). Kuesioner ini dapat digunakan di Indonesia untuk metode skrining endometriosis di Indonesia.
Body Composition Parameters, Adiponectin, Leptin and Adiponectin/Leptin Ratio are Correlated with LH/FSH Ratio in Women with PCOS but not in Women without PCOS Gita Pratama; Wiweko, Budi; Asmarinah; Widyahening, Indah Suci; Andraini, Trinovita; Hartanto Bayuaji; Andon Hestiantoro
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 1 January 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i1.2031

Abstract

Objective: To investigate the correlation between body composition parameters, adiponectin, leptin and the adiponectin/leptin ratio and the LH/FSH ratio in women with polycystic ovary syndrome (PCOS). Methods: A cross-sectional study was conducted at Reproductive Cluster Yasmin, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, with sixty women with PCOS and sixty healthy women as controls (matched for age and BMI). Body composition parameters, including body weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), percent body fat (PBF), visceral fat area (VFA), percent subcutaneous fat (PSF) and skeletal muscle mass (SMM), were measured; levels of fasting glucose, fasting insulin, testosterone, and sex hormone binding globulin (SHBG) were measured; and homeostatic model assessment for insulin resistance (HOMA-IR) values, anti-Mullerian hormone (AMH), free androgen index (FAI), Ferriman-Gallwey (FG) score, adiponectin levels, leptin levels, adiponectin/leptin ratio, LH, FSH and LH/FSH ratio were measured. Results: Body composition parameters (body weight, BMI, WC, WHR, PBF, VFA, PSF, SMM) were not significantly different between women with PCOS and controls. Fasting insulin (P<0.05), HOMA-IR (P<0.05), AMH (P<0.01), FAI (P<0.01), FG score (P<0.01) and LH/FSH ratio (P<0.05) were higher in PCOS women. Adiponectin (P<0.01) was lower in PCOS women, while leptin and the adiponectin/leptin ratio were not significantly different between groups. Most of body composition parameters, adiponectin, leptin and adiponectin/leptin ratio were correlated with HOMA-IR in both groups. SMM was positively correlated with the LH/FSH ratio, while body weight, BMI, WC, PBF, VFA, and PSF were inversely correlated with the LH/FSH ratio in PCOS patients but not in controls. WHR was not correlated in either group. Leptin (r=-0.278; P<0.05) was negatively correlated with the LH/FSH ratio only in the PCOS group. Adiponectin (r=0.394; P<0.01) and the adiponectin/leptin ratio (r=0.413; P<0.01) were also positively correlated with the LH/FSH ratio only in the PCOS group. AMH was correlated with the LH/FSH ratio, whereas testosterone level, FAI, FG score, fasting insulin level and HOMA-IR value were not correlated with the LH/FSH ratio in PCOS women. Conclusion: Most of the body composition parameters, leptin, adiponectin and the adiponectin/leptin ratio were significantly correlated with HOMA-IR in both groups. However, correlations of those parameters with LH/FSH ratio were found only in PCOS but not in women without PCOS. Adiponectin and leptin may play a significant role in the mechanism of neuroendocrine disorders in PCOS, which is characterized by an increased LH/FSH ratio. Keywords: adiponectin, adiponectin/leptin ratio, body composition, HOMA-IR, leptin, LH/FSH ratio, PCOS
Correlation between Leukocyte Esterase Levels and Pregnancy Latency Interval in Pregnant Women with a History of Preterm Premature Rupture of Membranes Andayani, Aviasti Pratiwi; Bayuaji, Hartanto; Siddiq, Amillia
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.681

Abstract

Introduction: Bacterial colonization of the vagina and cervix can lead to intra amniotic infections that increase the risk of chorioamnionitis, premature rupture of membranes, and preterm labor. Leukocyte esterase (LE) is an alternative test that is affordable and easy to perform to predict the risk of preterm labor due to urinary tract infection. We examined the correlation between leukocyte esterase levels and gestational latency interval in pregnant women with preterm premature rupture of membranes.Methods: This study is an observational study with a cross-sectional design from the medical records of singleton pregnancy patients with preterm premature rupture of membranes undergoing conservative treatment at Dr. Hasan Sadikin General Hospital, Bandung. Researchers analyzed the difference in mean latency interval and the correlation between leukocyte esterase levels and latency interval. The data processing results regarding the correlation between variables are presented in tables and graphs.Results: Of 101 patients, 76 patients met the inclusion criteria; 26 patients (34%) had negative results for leukocyte esterase examination, while 50 patients (66%) were positive. The average latency period of all patients was 2.16 days. The latency period ≤2 days occurred in 53% of patients, with the shortest latency period found in patients with leukocyte esterase +4 levels (1.5 days). Moreover, the ANOVA test results show that the correlation between the age latency period and leukocyte esterase levels obtained a value of f-ratio =1.44 with a p-value of 0.65, indicating no significant results at p<0.05.Conclusion: This study found no significant correlation between leukocyte esterase levels and the latency interval after preterm premature membrane rupture.Hubungan antara Kadar Leukosit Esterase dan Interval Masa Latensi Kehamilan pada Ibu Hamil dengan Riwayat Ketuban Pecah Dini pada Kehamilan PrematurAbstrakPendahuluan:Penjalaran infeksi bakteri dari kolonisasi bakteri pada vagina dan serviks menyebabkan infeksi intraamniotik yang meningkatkan risiko korioamnionitis, ketuban pecah dini, serta persalinan prematur. Penapisan infeksi saluran kemih (ISK) melalui pemeriksaan kadar leukosit esterase (LE) merupakan alternatif pemeriksaan yang terjangkau dan mudah dilakukan untuk mencegah persalinan prematur. Penelitian ini meneliti hubungan antara kadar leukosit esterase dan masa latensi kehamilan pada ibu hamil dengan ketuban pecah dini <34 minggu.Metode: Penelitian ini merupakan studi observasional dengan desain cross-sectional dari rekam medik pasien hamil tunggal dengan ketuban pecah dini <34 minggu yang menjalani perawatan konservatif di RSUP Dr.Hasan Sadikin Bandung. Kriteria eksklusi pada penelitian ini ialah penyulit lain pada ibu dan janin dan pemberian tokolitik. Peneliti menganalisis perbedaan rerata masa latensi serta hubungan kadar leukosit esterase dengan masa latensi kehamilan pada ketuban pecah dini <34 minggu. Hasil olah data mengenai hubungan antar variabel disajikan dalam bentuk tabel dan grafik.Hasil: Dari 101 pasien, terdapat 76 pasien yang memenuhi kriteria inklusi, didapatkan hasil pemeriksaan leukosit esterase negatif sebanyak 34% (26 pasien), dan positif pada 66% pasien (50 pasien). Rerata masa latensi dari seluruh pasien ialah 2,16 hari. Masa latensi ≤ 2 hari terjadi pada 53% pasien dengan masa latensi paling singkat didapatkan pada pasien dengan kadar leukosit esterase +4 yaitu 1,5 hari. Pada uji Anova hubungan rerata masa latensi dengan kadar leukosit esterase didapatkan nilai rasio-f = 1,44 dengan nilai p 0.65 yang menunjukkan hasil tidak signifikan pada p<0.05.Kesimpulan: Hasil penelitian menunjukkan tidak ada korelasi signifikan antara kadar leukosit esterase dengan lama masa latensi kehamilan setelah ketuban pecah dini <34 minggu.Kata kunci: Infeksi saluran kemih; leukosit esterase; ketuban pecah dini; masa latensi
Outcomes of Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy in Endometrial Carcinoma Viko Duvadilan Wibowo; Febia Erfiandi; Hartanto Bayuaji
Indonesian Journal of Obstetrics & Gynecology Science Volume 9 Number 1 March 2026
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v9i1.1019

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Objective: Management of endometrial carcinoma may involve total hysterectomy with bilateral salpingo-oophorectomy (TH-BSO), performed either laparoscopically or via laparotomy. This evaluation is crucial for assessing recovery and determining appropriate follow-up care in patients with endometrial cancer based on the ECOG Performance Status.Methods: This retrospective cohort study examined data from patients who underwent THBSO at Dr. Hasan Sadikin Hospital in 2024. The primary outcome measured was ECOG performance status at one month and six months post-surgery. The analysis was conducted using the Mann-Whitney U test to compare ECOG scores between the laparoscopic and laparotomy groups. Result: Of the 47 patients (28 laparotomies and 19 laparoscopies), the Mann-Whitney U test results for the ECOG score one month postoperatively showed no significant difference between patients who underwent THBSO with laparoscopic and laparotomy techniques (p = 0.921). However, the results of the 6-month postoperative ECOG score test indicated a significant difference between the two groups (p = 0.026), with better outcomes in the laparoscopic group. Conclusion: ECOG performance status after laparoscopy in endometrial cancer cases was better than after laparotomy. AbstrakTujuan: Penatalaksanaan karsinoma endometrium dapat dilakukan dengan histerektomi total disertai salpingo-ooforektomi bilateral, yang dilakukan baik secara laparoskopi maupun melalui laparotomi. Penilaian ini penting untuk mengevaluasi proses pemulihan dan menentukan tata laksana tindak lanjut yang tepat pada pasien kanker endometrium berdasarkan ECOG Performance Status.Metode: Studi kohort retrospektif ini menganalisis data pasien yang menjalani HTSOB di RSUP Dr. Hasan Sadikin pada tahun 2024. Luaran utama yang dinilai adalah ECOG performance status satu bulan dan enam bulan postoperatif. Analisis dilakukan menggunakan uji Mann-Whitney U untuk membandingkan skor ECOG antara kelompok laparoskopi dan laparotomi.Hasil: Dari 47 pasien (28 laparotomi dan 19 laparoskopi), hasil uji Mann-Whitney U terhadap skor ECOG satu bulan postoperatif menunjukkan bahwa tidak terdapat perbedaan bermakna antara pasien yang menjalani HTSOB dengan teknik laparoskopi dan laparotomi (p = 0.921). Sedangkan hasil uji skor ECOG 6 bulan postoperatif menunjukkan bahwa terdapat perbedaan signifikan antara kedua kelompok (p = 0.026), dengan hasil lebih baik pada kelompok laparoskopi.Kesimpulan: ECOG performance status pasca laparoskopi pada kasus kanker endometrium lebih baik daripada laparotomi.