Garuda - Garba Rujukan Digital

Sandhy Prayudhana

Faculty of Medicine University of Indonesia/ Dr. Cipto Mangunkusumo National General Hospital Jakarta

Author-ID : 346865

Health Professions Medicine & Pharmacology Public Health

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Articles

Maternal and Fetal Outcome on Pregnancy in Advanced Maternal Age Dewi, Sianty; Ferry, Ferry; Toynbee, Eddy; Prayudhana, Sandhy
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: Pregnancy in advanced maternal age (AMA) was classified as high risk. The study aims to provide a better description of pregnancy outcome in AMA. Method: The cross sectional study was to review the demography, medical and obstetrics problems, mode of delivery, maternal and fetal outcome in Tangerang General Hospital as a referral center in Banten. The data were taken from medical records of 35-year-old and above women age who delivered on the period of January to December 2014. Result: The total number of delivery and live birth was 6,107 and 5,926 respectively, including 1,548 (25.36%) pregnancies in AMA. The prevalence of grandmultiparities was 11.4%. The average education level was mostly elementary. The prevalence of hypertension in pregnancy was 34.6%. There was increasing trend of miscarriages from 10.8% in 35-40-year-old group to 25% in above 45- year-old group. Pregnancy complications were higher consisting of 3.2% multifetal, 16.6% malpresentation, and 7.1% placenta previa. Cesarean section rate was 33.6%. Maternal near-missed cases were 56 of 1000 and the maternal mortality rate (MMR) was 932 of 100,000 live births. The prevalence of stillbirth and perinatal mortality were 5.3% and 12.9%; respectively. Conclusion: Adverse maternal and fetal outcome were higher in AMA as it takes special attention and multidiscipline-approached care started from preconception, antenatal, preparation of delivery, and also postpartum care. Keywords: advanced maternal age (AMA), fetal outcome, maternal outcome, pregnancy

Serum biomarker profiles of interleukin-6, tumor necrosis factor alpha, matrix-metalloproteinase-2, and vascular endothelial growth factor in endometriosis staging Hadisaputra, Wachyu; Prayudhana, Sandhy
Medical Journal of Indonesia Vol 22, No 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Background: The focus of this study was to compare serum biomarkers: interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), matrix-metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in endometriosis stage I-II and stage III-IV. Methods: This is a cross-sectional study. Forty endometriosis patients were diagnosed using laparoscopy procedure. Serum sample was taken before the surgery. The serum biomarkers (IL-6, TNF-α, MMP-2, and VEGF) were analyzed with ELISA method at the end of research. Mean of serum biomarkers in endometrosis stage I-II and stage III-IV were compared using unpaired t-test. Variables that show significant mean difference were tested using ROC measurement and the optimal cut-off point was determined. Results: There was no significant difference in mean serum biomarkers level of IL-6, TNF-α, and MMP-2 between endometriosis stage I-II and stage III-IV (1.58 ± 0.78 vs 1.55 ± 0.98 pg/mL, 1.5 ± 0.47 vs 1.49 ± 0.29 pg/mL, and 152.04 ± 27.32 vs 140.98 ± 28.08 ng/mL, respectively). On the other hand, the comparison of VEGF level in endometriosis stage I-II and stage III-IV demonstrated significant difference (289.76 ± 188.13 vs 581.29 ± 512.85 pg/mL (p < 0.05)). Mean difference of VEGF had AUC of 74.5%. Optimal cut-off point for VEGF was ≥ 314.75 pg/mL with sensitivity 78.6% and specificity 69.2%. Conclusion: This study showed that serum biomarkers of VEGF level (but not IL-6, TNF-α, and MMP-2) can be used to measure the degree of severity in endometriosis. VEGF level of 314.75 pg/mL represents the cut-off point between lower and higher stage of severity. (Med J Indones. 2013;22:76-82)Keywords: Endometriosis, interleukin-6, matrix-metalloproteinase-2, TNF-α, vascular endhothelial growth factor

Maternal and Fetal Outcome on Pregnancy in Advanced Maternal Age Dewi, Sianty; Ferry, Ferry; Toynbee, Eddy; Prayudhana, Sandhy
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: Pregnancy in advanced maternal age (AMA) was classified as high risk. The study aims to provide a better description of pregnancy outcome in AMA. Method: The cross sectional study was to review the demography, medical and obstetrics problems, mode of delivery, maternal and fetal outcome in Tangerang General Hospital as a referral center in Banten. The data were taken from medical records of 35-year-old and above women age who delivered on the period of January to December 2014. Result: The total number of delivery and live birth was 6,107 and 5,926 respectively, including 1,548 (25.36%) pregnancies in AMA. The prevalence of grandmultiparities was 11.4%. The average education level was mostly elementary. The prevalence of hypertension in pregnancy was 34.6%. There was increasing trend of miscarriages from 10.8% in 35-40-year-old group to 25% in above 45- year-old group. Pregnancy complications were higher consisting of 3.2% multifetal, 16.6% malpresentation, and 7.1% placenta previa. Cesarean section rate was 33.6%. Maternal near-missed cases were 56 of 1000 and the maternal mortality rate (MMR) was 932 of 100,000 live births. The prevalence of stillbirth and perinatal mortality were 5.3% and 12.9%; respectively. Conclusion: Adverse maternal and fetal outcome were higher in AMA as it takes special attention and multidiscipline-approached care started from preconception, antenatal, preparation of delivery, and also postpartum care. Keywords: advanced maternal age (AMA), fetal outcome, maternal outcome, pregnancy

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