Nuring Pangastuti
Departemen Obstetri dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan (FKKMK) UGM

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Robekan Perineum pada Persalinan Vaginal di Bidan Praktik Swasta (BPS) Daerah Istimewa Yogyakarta Indonesia Tahun 2014-2016 Nuring Pangastuti
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.36184

Abstract

Background: Vaginal delivery is the most preffered mode of delivery by all women, and the birth attendants. The vaginal delivery assistance was conducted by various health professionals such as midwives, physicians, and obstetricians. Various complaints of pelvic floor dysfunction and complaints related to the perineum as a result of vaginal perineal laceration during childbirth can affect the quality of life of a woman.Objective: To identify and conduct an analysis of maternal factors (maternal age, parity, gestational age), fetal factor (birth weight), and the labor factor (duration of 2nd stage of labor), with the occurrence of perineal rupture in vaginal delivery at the 5 Midwife’s Private Clinic (MPC), Yogyakarta, Indonesia.Method: Retrospective medical record searching, from January 2014 until December 2016.Result and Discussion: There were 1595 obtained samples of data that met the criteria for inclusion and exclusion. Number of perineal laceration reached 1201 (75.3%), with 1.9% of them are grade 3. Perineal rupture occurred in 80.55% of vaginal deliveries at young age, 69.14% in more than 35 years old women, and 85.05% primiparas. There was significant negative correlation (0.186) between parity and perineal rupture (p=0.000). The less the parity, the higher the incidence of perineal rupture (p=0.002). There was significant correlation between baby’s weight less than 2500 gram and perineal rupture but not for the baby’s weight more than 4000grams (p=0.304). The correlation was positive which meant that the heavier the baby’s weight the higher the incidence of perineal rupture. There was significant positive correlation (p=0,018) for the duration of 2nd stage of labor between 30-60 minutes and perineal rupture(0.061). The correlation was positive as well (0.092) for the duration of 2nd stage of labor more than 60 minutes and perineal rupture( p=0.002). The longer the duration of the 2nd stage of labor the higher the incidence of perineal rupture.Conclusion: There was significant relationship between parity, and duration of the 2nd stage of labor and perineal rupture in vaginal delivery.Keywords: perineal rupture, vaginal delivery, parity, duration of the 2nd stage of labor
Komplikasi Bedah, Luaran Fungsi Seksual dan Menstruasi dari Prosedur Vaginoplasti Sigmoid pada Pasien dengan Agenesis Vagina Roy Jansen Sinaga; Nuring Pangastuti; Ova Emilia
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.52149

Abstract

Background:  Vaginal agenesis is one form of abnormality found in the uroginecology with a prevalence of 1: 4000 births. Various reconstruction techniques, both non-surgical and surgical, have been introduced, one of which is sigmoid vaginoplasty. Research on the complications and outcomes of sigmoid vaginoplasty procedure is still limited.Objective: To assess surgical complications, sexual and menstrual function outcomes of sigmoid vaginoplasty procedure.Method: This is a prospective study. A total 11 patients with a variety of genital tract malformations have been performed for sigmoid vaginoplasty during January 2017 to January 2019. Data are described descriptively-analytically. All patients were assessed for surgical complications, menstrual and sexual function after surgery.Results and Discussion: A total of 10 cases (90.9%) were diagnosed with vaginal agenesis and 1 case (9.1%) was diagnosed with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Durante surgery complications are severe bleeding and rectum injury, occurred in 2 cases (18.2%). Postoperative complication is surgical wound dehiscence, occurred in 2 cases (18.2%). All patients who have uterus (100%) showed good menstrual function outcomes. Of the 3 married patients, all patients (100%) showed good postoperative sexual function outcomes (FSFI score 27-30.4). Conclusion: The sigmoid vaginoplasty procedure is an effective procedure for patients with agenesis vaginal. This procedure has low surgical complications with good outcomes of menstrual and sexual function. Keywords: Sigmoid vaginoplasty; vaginal agenesis; menstrual function; sexual function.
Diagnosis and Treatment in patient with Herlyn-Werner-Wunderlich Syndrome: A case causing pelvic pain Norman Aji Triantoro; Nuring Pangastuti
JURNAL KESEHATAN REPRODUKSI Vol 8, No 3 (2021)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.64831

Abstract

ABSTRACTBackground: Herlyn-Werner-Wunderlich (HWW) syndrome is a rare variant of Mullerian duct anomalies. The characteristic triad of this syndrome includes didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis, recently known as Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome. The most common presentation is abdominal and pelvic pain, dysmenorrhea, and abdominal mass secondary to hematocolpos, hematosalping or hematometra.Objective: to determine the diagnosis and operative management of HWW syndrome case with pelvic pain as the chief complaint.Methods: case examination and tracing medical records at Dr Sardjito Hospital Yogyakarta.Results and Discussion: Fourteen-year-old female, presented with pelvic pain. Physical examination revealed a cystic mass in the abdomen inferior, palpable up to 3 cm inferior to the umbilicus. From the Intravenous Pyelography (IVP) examination, it was found normal anatomy and function of the right kidney, but there was no left kidney. On a contrast-enhanced abdominal CT scan, magnetic resonance imaging (MRI) and laparoscopy showing a complete duplication of the uterus from the horn to the cervix with no connection between the two uterine cavities, both ovaries were normal, the right fallopian tube was normal, the left tube was enlarged, attached to the uterus and the left ovary, no left kidney was found. Operative management of the vaginal septectomy procedure was performed.Conclusion: MRI is most accurate for providing details regarding the altered anatomy and for identifying associated hematocolpos,hematosalping or hematometra for HWW syndrome cases. Surgical intervention by vaginal septectomy is performed to relieve symptoms, provide better reproductive and sexual functions.Keywords: Herlyn-Werner-Wunderlich syndrome, Mullerian disgenesis, pelvic pain. ABSTRAKLatar belakang: sindrom Herlyn-Werner-Wunderlich (HWW) adalah varian langka dari kelainan duktus Mullerian. Trias khas dari sindrom ini adalah uterus didelfis, septum hemivagina, dan agenesis ginjal ipsilateral atau sindromObstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA). Gejala paling sering adalah nyeri perut maupun panggul, dismenorea, dan terdapatnya massa pada perut akibat dari hematokolpos, hematosalping atau hematometra.Tujuan: untuk mengetahui penegakan diagnosis dan penatalaksanaan operatif satu kasus sindrom HWW dengan keluhan utama nyeri panggul.Metode: pemeriksaan kasus dan penelusuran rekam medis di RSUP Dr Sardjito Yogyakarta.Hasil dan Diskusi: Perempuan berusia 14 tahun dengan nyeri panggul. Pemeriksaan fisik terdapat massa kistik di perut bagian inferior, teraba hingga 3 cm inferior umbilikus. Dari pemeriksaan Intravenous Pyelografi (IVP) didapatkan anatomi dan fungsi ginjal kanan yang normal namun tidak didapatkan adanya ginjal kiri. Pada CT scan abdomen dengan kontras, Magnetic Resonance Imaging (MRI) dan laparoskopi menunjukkan duplikasi lengkap uterus dari cornu ke serviks tanpa hubungan antara dua rongga uterus, kedua ovarium normal, tuba fallopi kanan normal, tuba kiri membesar, menempel pada uterus dan ovarium kiri. tidak didapatkan ginjal kiri. Selanjutnya dilakukan penatalaksanaan operatif prosedur septektomi vagina.Kesimpulan: MRI paling akurat untuk memberikan rincian mengenai perubahan anatomi dan untuk mengidentifikasi hematocolpos, hematosalping maupun hematometra pada sindrom HWW. Intervensi bedah berupa septektomi vagina dilakukan untuk meredakan gejala serta memberikan harapan fungsi reproduksi dan sexual yang lebih baik.Kata kunci: Sindrom Herlyn-Werner-Wunderlich, disgenesis Mullerian, nyeri panggul.