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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi Indonesian Journal of Biotechnology The Indonesian Biomedical Journal Jurnal Gizi Klinik Indonesia Jurnal Kesehatan Reproduksi Berita Kedokteran Masyarakat Medical and Health Journal

Heru Pradjatmo

Department Of Obstetrics And Gynecology, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Farmako, Sekip Utara, Yogyakarta 55281

Author-ID : 343993

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Perbandingan Kejadian Retensi Urin antara Persalinan dengan Vakum Ekstraksi dan Persalinan Normal Nurul Hikmah Petrana; Ova Emilia; Heru Pradjatmo
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.36185

Background: Urinary retention after vaginal delivery is a common problem with incidence 1.7% - 17.9%. Assissted vaginal delivery is one risk factor for the occurence of urinary retention.Objective: to compare urinary retention between normal vaginal delivery and assissted vaginal delivery using extraction vacum, and evaluate factors related to urinary retention.Method: The study was prospective cohort design, conducted in 3 hospitals and 2 primary health centres during 6 month period since September 2013- February 2014. Subjects were divided into two groups i.e. normal delivery and assissted delivery using extraction vacum, each 118 subjects. Events of urinary retention was assessed and also related factors were identified. Analysis used Chi-Square test, Fisher test and also logistic regression analysis.Result and Discussion: In total 236 subjects were involved, there was no difference in age and parity among the subjects. Incidence of urinary retention among extraction vacum delivery group was higher (32.2%) compare to normal delivery (11.9%). Multivariate analysis using logistic regression showed that extraction vacum (p=0.074; OR 2.71; 95% CI 1.55-4.73), baby weight (p= 0.230; OR 1.95; 95% CI 0.655.84) and perineal injury (p= 0.614; OR 1.35; 95% CI 0.41-4.36) were not significant risk factors for urinary retention. Length of labour (p=0.003; OR 3.71; 95% CI 1.55-8.86) and parity (p= 0.023; OR 2.29; 95% CI 1.2-4.66) were significant risk factors for urinary retention.Conclusion: Urinary retention is higher among vaginal delivery with extraction vacum compare to normal delivery. Length of labour and parity are external factors related to urinary retention.Keywords: Assissted vaginal delivery, extraction vacum, normal delivery, urinary retention, postpartum

Hubungan Response Time Seksio Sesarea Emergensi Kategori 1 dengan Luaran Perinatal di RSUP Dr.Sardjito Tri Gunawan; Ahsanudin Attamimi; Heru Pradjatmo
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.37997

Background: Caesarean section is often applied as a preventif efoort against the continued effects of perinatal asphyxia. The cesarean section (SC) in pregnant woman can be performed in a planned manner with various indications or performed by emergency (emergency) on maternal or fetal indications and or both.Objective: To study the association of response time in category I emergency caesarean section with perinatal outcomes in Dr. Sardjito hospital and the average response time of category 1 emergency cesarean section in Dr. Sardjito hospital.Method: This study uses retrospective cohort. Category 1 CS with an indication of fetal accordance with the inclusion criteria was recorded from 1st January 2012 until 31th July 2016, then we find the response time mean as the cut off point of this study to compare with their perinatal outcomes.Result and Discussion: There were 155 cases out of 386 of emergency CS category 1 met the inclusion criteria during the period 1st January 2012 to 31th July 2016. From the data obtained, the average response time of category 1 emergency CS was 115±52 minutes (35 - 360 minutes). We found no significant differences in perinatal outcomes in the group’s response time ≥115 minutes with a value of p>0.05 on the Apgar score, CPAP, infant mortality, ventilator, NICU care, MAS and HIE than those category 1 emergency CS with a response time <115 minutes. From multivariate analysis, general anaesthesia was statistically significant against perinatal outcomes Apgar score <7 at 5 minutes with (p=0.044). Prematurity in the multivariate analysis was statistically significant against perinatal outcomes Apgar score ≤3 at 1 minute with (p=0.040), Apgar score <7 at 5 minutes with (p=0.025) and the use of CPAP with (p=0.009).Conclusions: Response time category 1 emergency cesarean section in this study did not affect perinatal outcomes. General anesthesia effect on perinatal outcomes Apgar score <7 at 5 minutes, whereas the prematurity effect on perinatal outcomes Apgar score ≤3 at 1 minute, Apgar score <7 at 5 minutes and the use of CPAP.Keywords: category 1 emergency caesarean section, response time, fetal distress

Hubungan Asupan Cairan Ibu Hamil terhadap Indeks Cairan Amnion Eny Fatmawati; Diah Rumekti Hadiati; Heru Pradjatmo
JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.38549

Introduction: Adequate amniotic fluid volume is a requirement for intra uterine fetal development and good pregnancy outputs / neonatal. Adequate intake of fluid in pregnant women can increase both the amniotic fluid index on oligohydramniotic or normoamniotic, but the scientific basis for the adequacy of the recommended daily fluid have not clear yet. Furthermore, the fluid intake counseling in addition to nutrition for pregnant women is neededObjective: To determine the fluid intake in pregnant women and the mean difference of amniotic fluid index on adequate fluid intake compared to less fluid intake.Methods: This research used prospective observational cohort study, conducted against the third semester pregnant women in Puskesmas Mergangsan and Tegalrejo Yogyakarta during July until September 2014. The subjects who met the inclusion criteria were divided into adequate and less fluid intake groups. The correlation between fluid intake and amniotic fluid index was analyzed using t-test and linear regression.Result and Discussion: The total subjects who met the criteria were 27 people, consist of 12 people in adequate fluid intake group and 15 people in less fluid intake group. The mean of subject’s fluid intake 2078 ml (enough), while the mean of amniotic fluid index (AFI) 12,76 cm (normoamniotic).The result showed that there was a significant difference (3,50 cm (IK 95%; 1,5-5,48); P < 0,05) between the mean of AFI from adequate fluid intake group compared to less fluid intake group . Simple linear regression test showed the effect of fluid intake for AFI namely 31,7%; with the amount of predicted AFI = 10,686 + 3,545 x fluid intake – 1,015 x age – 1,317 x education + 0,314 x occupation (ARS= 44,5%). External variables (age, education, and occupation) had no significant effect for AFI .Conclusion : The mean preview of fluid intake in the third semester pregnant women in Yogyakarta was adequate. Moreover, there was a AFI signifficant difference between adequate fluid intake compared to less fluid intake. Keywords: fluid intake; amniotic fluid index; AFI

Kualitas Hidup Satu Tahun Pasien Kanker Serviks yang telah Dilakukan Histerektomi Radikal di RSUP DR. Sardjito Yogyakarta Afif Fuadi; Heru Pradjatmo; Ardhanu Kusumanto
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Latar Belakang: Kanker serviks merupakan kanker paling banyak ketiga yang ditemukan pada seorang wanita. Secara keseluruhan lebih dari 85% terjadi pada negara-negara berkembang. Insidensi rata-rata paling tinggi di wilayah Sub Sahara Afrika, Amerika Latin dan Karibia, Melanesia dan Asia Barat, Australia/Selandia Baru. Variasi geografis yang besar mencerminkan ketersediaan skrining yang memungkinkan untuk mendeteksi lesi prakanker dan prevalensi terjadinya infeksi Human Papillomavirus (HPV). Modalitas skrining dan strategi pengobatan telah berevolusi, dengan kemajuan terapi saat ini yang meliputi tindakan pembedahan, kemoterapi dan radiasi, penderita kanker serviks dihadapkan pada efek samping pasca pengobatan lengkap. Sehingga dapat menyebabkan penurunan kualitas hidup mereka.Tujuan: Mengetahui kualitas hidup satu tahun pasien kanker serviks yang telah dilakukan histerektomi radikal.Metode: Penelitian kuantitatif dengan pendekatan cross sectional dengan cara melakukan wawancara dengan pasien saat periksa di poli onkologi menggunakan instrumen dari EORTC QLQ C30 versi 3.Hasil dan Pembahasan: Rata-rata penderita kanker serviks berusia 45-55 tahun yaitu 21 orang (37,5%), tidak menopause, dengan paritas antara 1-2 dan indeks massa tubuh normal. Jenis histopatologi terbanyak adalah karsinoma sel skuamosa dan grade sedang. Sebagian besar tidak terdapat keterlibatan kelenjar getah bening, lymphovascular space invation (LVSI) dan tidak dilakukan kemoterapi adjuvan. Kualitas hidup pasien kanker serviks termasuk dalam katagori baik dengan nilai rata-rata status kesehatan global >87,5% dan pada domain skala fungsi dan gejala >90%. Hanya saja terdapat hubungan yang bermakna yang ditunjukkan pada variable usia dengan nilai p=0,020 dan RR=0,545 dan keterlibatan kelenjar gertah bening dengan nilai p=0,008.Kesimpulan: Pada penelitian ini kualitas hidup pasien kanker serviks yang telah dilakukan histerektomi radikal di RSUP Dr. Sardjito sangat baik.Kata Kunci: Kanker serviks; Kualitas Hidup; Histerektomi radikal

Perbandingan Angka Ketahanan Hidup Penderita Kanker Ovarium yang Mendapat Terapi Regimen Kemoterapi Paclitaxel-Carboplatin dan Vyclophosphamide-Adriamycin-Cisplatin di RSUP Dr. Sardjito: Studi retrospektif Januari 2014-Desember 2018 Choery Novitasari; Ahsanuddin Attamimi; Heru Pradjatmo
JURNAL KESEHATAN REPRODUKSI Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.57002

Latar Belakang: Kanker merupakan penyebab kematian kedua terbanyak setelah penyakit kardiovaskular dan lebih dari 70% kematian yang disebabkan oleh kanker terjadi di negara berkembang. Kanker ovarium merupakan kanker terbanyak kesembilan pada wanita dan menjadi kanker dengan mortalitas ke-5 terbanyak, yaitu 8,6 per 100.000.Tujuan: Menilai angka ketahanan hidup penderita kanker ovarium yang diberikan kemoterapi dengan regimen Paclitaxel- Carboplatin dibandingkan dengan regimen Cyclophospamide-Adriamicyn-Cisplatin di RSUP Sardjito.Metode: Penelitian ini merupakan penelitian observasional dengan rancangan studi analisis angka ketahanan hidup (survival rate) dari penderita kanker ovarium. Data akan diambil secara retrospektif dari rekam medis pasien kanker ovarium yang berobat ke RSUP dr. Sardjito kemudian ditelusuri riwayat kematiannya.Hasil dan Pembahasan: Terdapat 353 penderita kanker ovarium yang dilakukan kemoterapi, terdiri dari 265 subjek yang diterapi PC dan 88 subjek yang diterapi dengan CAP. Dari analisis bivariat didapatkan bahwa regimen kemoterapi PC dan CAP tidak memengaruhi angka ketahanan hidup (HR=1,15, p=0,64, CI95%=0,64-2,05).Usia <50 tahun (HR=0,42, p=0,01, CI95%=0,23-0,77), stadium klinis awal (HR=0,27, p=0,00, CI95%=0,14-0,49), dan CA125 pasca kemoterapi <70 U/mL (HR=0,21, p=0,00, CI95%=0,11-0,41) merupakan faktor protektif terhadap angka ketahanan hidup penderita kanker ovarium. Analisis multivariat dengan angka ketahanan hidup (cox’s regression) menunjukkan bahwa faktor yang dapat meningkatkan angka ketahanan hidup adalah stadium klinis awal (HR=0,45, p=0,04, CI95%=0,18-0,91) dan CA125 pasca kemoterapi (HR=0,33, p=0,01, CI95%=0,15-0,74).Kesimpulan: Tidak ada perbedaan bermakna antara regimen kemoterapi PC dan CAP dengan angka ketahanan hidup penderita kanker ovarium yang dirawat di RSUP dr. Sardjito selama tahun 2014-2018. Faktor- faktor yang dapat meningkatkan angka ketahanan hidup pasien kanker ovarium adalah stadium klinis awal dan CA125 pasca kemoterapi <70 U/mL. Kata Kunci: Angka ketahanan hidup; kanker ovarium; regimen paclitaxel dan carboplatin; regimen cyclophosphamide, adriamycin, cisplatin

Hubungan antara Modified Glasgow Prognostic Score (mGPS) dengan Stadium dan Derajat Diferensiasi Kanker Ovarium Bob Irsan; Heru Pradjatmo; Muhammad Lutfi
JURNAL KESEHATAN REPRODUKSI Vol 7, No 3 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.63107

Background: Prognostic factors for ovarian cancer include residual tumor and chemotherapy response, but these parameters are not sufficient to predict ovarian cancer prognoses. A new approach such as mGPS that use a combination of CRP and albumin can be used to assess an inflammatory response. With mGPS, an elevated CRP value and hypoalbuminemia are poor prognosis. Objective: To investigate the effect of mGPS on histopathologic staging and grading of ovarian cancer.Method: The study design was a cross sectional study. The population of this study were patients with suspected ovarian cancer who underwent laparotomy surgical staging at RSUP Dr. Sardjito. The samples were patients with suspected ovarian cancer that have examined the hs-CRP level and albumin level preoperative,then underwent laparotomy surgical staging with histopathological results epithelial ovarian cancer. Data were analyzed using Chi Square test and logistic regression.Results and Discussion: there were 57 subjects with epithelial ovarian cancer consisting of 25 subjects (43.86%) with high mGPS and 32 subjects (56.14%) with low mGPS. The value of mGPS is associated with the stage of ovarian cancer (p = 0.000; RP = 4.000 CI 95% = 2.195 – 7.289). The results of the multivariate analysis showed that the most important factor in determining the stage was mGPS (p = 0.000; RP = 3.818 95% CI = 1.544-6.092). While the most important factor in determining histopathologic grading of ovarian cancer was the type of ovarian tumor (p = 0.000; RP = 7.339 95% CI = 4.960-9.718).Conclusion: There was an association between mGPS and the stage of ovarian cancer. The histopathologic grading was not influenced by mGPS, but was influenced by the type of ovarian tumor.Keywords: mGPS; Stage; Histopathologic grading; Ovarian Cancer; Epithelial Type

Status gizi sebagai faktor prognosis penderita karsinoma endometrium Heru Pradjatmo; Deyna Primavita Pahlevi
Jurnal Gizi Klinik Indonesia Vol 10, No 1 (2013): Juli
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.18838

Background: In Indonesia, endometrial cancer is the third gynaecologic cancer after cervical and ovarian cancers. Various factors affect the survival of the patients, however, which factors affect the survival of endometrial carcinoma patients in Dr. Sardjito Hospital remain unclear. A research is therefore needed in order to determine the survival and the prognostic factors.Objective: To investigate the prognostic factors that affect the survival of endometrial carcinoma patients who had been admitted to Dr. Sardjito Hospital.Method: The study design was retrospective cohort. The subjects were patients with endometrial carcinoma who were treated in Dr. Sardjito Hospital from 1st of January 2006 until 31st of December 2011. Kaplan-Meier analysis was performed to analyze several factors that influenced the survival of the patients. The differences of survival were analyzed with log rank test while the prognostic factors influencing the survival were analyzed using Cox regression.Results: 68 endometrial carcinoma patients were recruited as the subjects for the study. The median survival of endometrial carcinoma patients 52 months for those on early stage and 17 months on advanced stage (p≤0.01). The prognostic factors affecting survival that has been found statistically and clinically significant was the stage of the disease (p=0.002; HR=6.175; 95% CI=1.1980 to 19.25). Meanwhile, the nutritional status of patients with low, normal, and high BMIs score showed increased survival rate as indicated by the HR values of 1; 0.768; and 0.311 respectively.Conclusion: The prognostic factor that was clinically and statistically significant influenced the survival was the stage of the disease, while the nutritional status of patients was found clinically significant as the prognostic survival of the patients.

Hubungan kepatuhan bidan puskesmas dalam penerapan antenatal care terpadu berkualitas dengan deteksi komplikasi dan penyakit pada ibu hamil Siti Sholikhah; Heru Pradjatmo; Mohammad Hakimi
Berita Kedokteran Masyarakat (BKM) Vol 32, No 5 (2016)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Compliance of midwife primary health center in implementation of the antenatal care integrated quality, disease detection and complications in pregnant womenPurpose This research aimed to determine the relationship of midwife’s compliance in the implementation of the antenatal care (ANC) integrated quality with disease detection and complications in pregnant women.MethodsThis research was an observational study with a retrospective cohort design. The sample was midwives who serve pregnant women in a primary health center, involving 125 midwives. The place of research was in 21 health centers throughout Kulon Progo. Research instruments used a questionnaire, with total sampling. Data analysis used: univariable analysis to determine the distribution of the data, bivariable with chi-square tests, multivariable with linear regression tests with 95% CI and significance of p=0.05, and a qualitative analysis.ResultsMidwives' compliance to the standard operating procedure has a 35% greater chance of detecting complications and illness in pregnant women than the midwife who did not follow standard operating procedure. Not all midwives in primary health care comply with ANC integrated quality.ConclusionThis study contributes to an understanding that compliance of midwives to ANC integrated quality is important as an effort to detect complications in pregnant women. The health office should establish a team for socialization, supervision, and assistance in the implementation of ANC integrated quality.

The impact of hormonal contraceptives on breast cancer patients hospital Dr. Sardjito Nuratul Awaliyah; Heru Pradjatmo; Hari Kusnanto
Berita Kedokteran Masyarakat (BKM) Vol 33, No 10 (2017)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

The use of hormonal contraceptives relates with the incidence of breast cancer in Dr. Sardjito Yogyakarta Purpose: This study aimed to determine whether women using the contraceptive pill can cause breast cancer.Methods: A case control study was conducted August to October 2016 with 250 patients.Results: Factors that were associated with breast cancer were: type of pill with adjusted OR = 1.66 (95% CI = 1.21 to 2.28; p = 0.001), duration of consumption with adjusted OR = 2.25 (95% CI = 1.04 to 4.84; p = 0.037), and the period of last hormonal contraception with adjusted OR = 2.41 (95% CI = 1. 15 to 5.05; p = 0.020). This study showed that the use of hormonal contraceptives raises the risk of breast cancer.Conclusion: Women should play an active role in breast cancer prevention programs through early detection and treatment. Health services need to explain the potential risks of hormonal contraceptive.

Exosomal miRNAs as Potential Biomarkers for Preeclampsia: miR-1283 Has the Highest Expression, while miR-152-3p Has the Lowest Expression Herman Sumawan; Ifrinda Giantari; Sofia Mubarika; Diah Rumekti Hadiati; Heru Pradjatmo
The Indonesian Biomedical Journal Vol 16, No 4 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i4.3197

BACKGROUND: Preeclampsia management is necessary, as it is one of the leading causes of death during pregnancy. Exosomal microRNAs (miRNAs) can serve as biomarkers for early detection, diagnosis, and prognosis of preeclampsia. NanoStrings is an effective method for identifying exosomal miRNA due to their high sensitivity and ability to work with small amounts of miRNA; however, the analysis using this method for determining preeclampsia biomarker is still limited. Therefore, this study was conducted to utilize the NanoStrings method in identifying preeclampsia biomarkers related to its underlying pathophysiology.METHODS: This study involved 12 pregnant women at 20–40 weeks of gestation, including 6 preeclampsia women and 6 normotension women. The miRNAs from plasma exosomes were processed using NanoStrings method with NanoString nCounter SPRINT Profiler. Enrichment analysis of The Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways were performed to examine the pathophysiological pathways of preeclampsia, using the DIANA–miRPath v3.0.RESULTS: Forty-eight miRNAs were downregulated and 7 were upregulated (miR-1283, miR-613, miR-520a-3p, miR-3185, miR-556-3p, miR-1973, and miR-598-3p) in women with preeclampsia. The highest expression was observed in miR-1283 (log fold-change: 3.69) and the most lowest expression was in miR-152-3p (log fold-change: 1.41). Enrichment analysis showed that the most upregulated miRNAs pathways was estrogen signaling pathway, and the most downregulated was Hippo signaling pathways.CONCLUSION: miR-1283 has the highest expression, while and miR-152-3p has the lowest expression in preeclampsia women. These miRNAs are shown to be linked to specific pathways, shedding light on the pathophysiology of preeclampsia, and may serve as promising biomarkers.KEYWORDS: exosomes, biomarker, miRNAs, pathophysiology, preeclampsia, pregnancy

Co-Authors Addin Trirahmanto Adelina Amelia Adelina Amelia Adintyo Rahman, Muhammad Nur Afif Fuadi Ahsanuddin Attamimi Ahsanudin Attamimi Akbar Satria Fitriawan Alkaff, Muhammad Lutfi Aprilia Indra Kartika Aprivinta, Sherlyana Mega Ardhanu Kusumanto Ardhanu Kusumanto Attamimi, Ahsanuddin Bob Irsan Bob Irsan Choery Novitasari Dewi Sahfitri Tanjung Deyna Primavita Pahlevi Diah Rumekti Hadiati Djaswadi Dasuki Djaswadi Dasuki Djaswadi Dasuki Emilia Theresia Eny Fatmawati Ery Kus Dwianingsih Fatmawati, Eny Geni, Puti Lenggo H.R. Siswosudarmo Hari Kusnanto Herman Sumawan Ifrinda Giantari Ifrinda Giantari Irianiwati Widodo Irsan, Bob Irwan Taufiqur Rachman Ksyatria, Yudhistya Ngudi Insan Laili Chilmawati Laili Chilmawati Mardiana Mardiana Mardiana Mardiana Moh Nailul Fahmi Mohammad Hakimi Muhammad Lutfi Muhammad Lutfi Muhammad Nur Adintyo Rahman Novitasari, Choery Nuratul Awaliyah Nurul Hikmah Petrana Ova Emilia Pahlevi, Deyna Primavita Petrana, Nurul Hikmah Puti Lenggo Geni putra, prayuna Rifqi, Rifqi Shinta Prawitasari Shinta Prawitasari Siti Nur Chasanah Siti Sholikhah Sofia Mubarika Sofia Mubarika Haryana Sumawan, Herman Syamsul Arifin Teguh Aryandono Tri Gunawan Tri Gunawan, Tri Yudhistya Ngudi Insan Ksyatria

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