Risanto Siswosudarmo
Departemen Obstetri dan Ginekologi, FK-KMK, UGM

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The Accuracy of Risanto's Formula and Ultrasound Measurement in Estimating Fetal Weight Elsina Krisnawati Pietersz; Irwan Taufiqur Rachman; Risanto Siswosudarmo
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.37942

Abstract

Background: Accurate estimated fetal weight (EFW) is crucial in determining delivery management. Several methods to estimate fetal weight were used such as abdominal palpation, measurement of symphisis fundal height (SFH), and ultrasound examination. Risanto’s formula based on Indonesian population had been already proven to be more accurate than Johnson’s formula. The formula was as follows: Y = 125 X - 880 where Y was EFW in grams, X was SFH in cm, and 125 was the constanta.Objective: To compare the accuracy of Risanto’s formula and ultrasound examination in estimating fetal weight.Method: A cross sectional study was carried out in Sardjito hospital, Faculty of Medicine Universitas Gadjah Mada, from March 2013 to March 2014. A total of 400 pregnant women meeting the inclusion criteria at 37 – 42 weeks of gestation were recruited. The estimated fetal weight using Risanto’s formula (R_EFW) was compared to the estimated fetal weight using ultrasound measurement (U_EFW). The U_EFW was done by obstetricians on duty or senior residents using Hadlock’s formula. Actual birth weight (ABW) was measured using the same calibrated baby scale. Accuracy was determined by comparing the mean difference between the R_EFW minus ABW (ΔR_EFW) and the U_EFW minus ABW (ΔU_EFW). Paired t-test was used for statistical analysis.Result and Discussion: The mean ABW was 3025.3 ± 414.6 gram and the mean R_EFW was 2972.7 ± 365.4 grams, while the mean U_EFW was 3058.7 ± 423.2 grams. The mean ΔR_EFW was lower than the mean ΔU_EFW (178.2 ± 147.6 grams vs 197.5 ± 155.4 grams; 95% CI 1.24 – 36.68; p = 0.04).Conclusion: Risanto’s formula was more accurate than ultrasound measurement in estimating fetal weight.Keywords: Estimated fetal weight, Risanto’s formula, Ultrasonography, Fundal height
Hubungan antara Ekspresi P53 Mutan terhadap Operabilitas Kanker Serviks Stadium IIB Pasca Kemoterapi Neoajuvan Nur Rohmah Arsyad; Risanto Siswosudarmo; Ardhanu Kusumanto
JURNAL KESEHATAN REPRODUKSI Vol 7, No 1 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (606.603 KB) | DOI: 10.22146/jkr.53838

Abstract

Background: The therapy for stage IIB cervical cancer according to FIGO is concurrent chemoradiation. The neoadjuvant chemotherapy followed by radical hysterectomy is an alternative therapy to improve the survival rate of cancer patients. Cervical cancer is mainly caused by the infection of Human Papilloma Virus (HPV), which contains protein E6 and E7 that downregulate the apoptotic function of p53. The absent of p53 wild-type and the present of p53 mutation play roles on the cervical cancer pathogenesis.Objective: To analyze the association between the expression of mutant p53 to the stage IIB cervical cancer operability after neoadjuvant chemotherapyMethod: This study was a prospective cohort, using 40 of 67 patient who met eligibility criteria. The parafin block from cervical tissue were processed for immunohistochemical staining of p53 using Anti-mutant p53 antibody [Y5] ab32049, Abcam, USA. Two study groups were assessed as: 1) weak and 2) strong expression of mutant p53 expression after neoadjuvant chemotherapy based on H-score. Both group (weak and strong) were comparable in term of mutant p53 expression. In this study, the evaluation of operability was performed clinically. Age, BMI, histopathology, grade of differentiation, and regiment were also evaluated as the external variables. Chi square test, and logistic regression analysis were used for statistical analysis.Results and Discussion: The rate of cervical cancer operability after chemotherapy was 19 out of 40 (47.5%). The strong expression of mutant p53 was observed in 6 subjects (15%). There was no significant association between weak vs strong expression of mutant p53 to the operability of the cancer (RR 1.5, CI 95% 0.46-4.88, p 0.45). Multivariate analysis showed that combination (50 mg/m2 dan 5 fluorourasil 450 mg/m2) was significantly correlated the operability (OR 7.02, CI 95% 1.27-40.07,  p 0.03).  Conclusion: The expression of mutant p53 not correlate with operability after neoadjuvant chemotherapy, but combination  regiment was.Keywords: expression of mutant p53, stage IIB of cervical cancer, neoadjuvant chemotherapy, operability