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All Journal Althea Medical Journal Global Medical and Health Communication Majalah Kedokteran Majalah Obstetri dan Ginekologi Journal of Medicine and Health Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Teknologi Sistem Informasi dan Aplikasi Jurnal Teknologi Informatika dan Komputer Jurnal Mekanik Terapan MEDICINUS Journal of Medicine and Health
Adhi Pribadi
Department Of Obstetric And Gynecology, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Automotive Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Electrical & Electronics Engineering Energy Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Materials Science & Nanotechnology Mechanical Engineering Medicine & Pharmacology Neuroscience Nursing Public Health

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The Analysis of Premature Rupture of Membrane Outcomes: Comparison Between 34-36 Weeks and Term Gestation Yordian, Kendry Savira; Pribadi, Adhi; Syam, Hanom Husni; Nugrahani, Annisa Dewi; Handono, Budi; Susiarno, Hadi; Suardi, Dodi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.710

Abstract

Introduction: This study analysed the maternal and neonatal outcomes in premature rupture of membrane at 34-36 weeks of gestation compared to term gestation to provide an overview of the current protocol’s efficacy which is currently widely varied. Method: This was a cross-sectional study using a simple random sampling technique. The subject of this study consisted of a total of 450 pregnant women diagnosed with PPROM at 34-36 weeks and term gestation during the period January 2019-December 2021. P<0.05 was considered statistically significant. Results: That women with premature rupture of membrane (PROM) at term gestation had a higher risk of 1.13 times (OR= 1.13, CI 95%) for neonatal asphyxia, 1.34 times for early neonatal death (OR= 1.34, CI 95%), and 4.03 times for developing clinical chorioamnionitis (OR= 4.03, CI 95%) compared to the 34-36 weeks of gestation group. There was no statistically significant difference between gestational age and the incidence of early neonatal death (P= 0.70). There were no maternal deaths in this study. Conclusion: the management protocol applied for both groups had the same efficacy. The incidence of clinical chorioamnionitis was higher in the term gestation group, which may be associated with risk factors such as COVID-19 and hepatitis B.Analisis Hasil Ketuban Pecah Dini: Perbandingan Antara Usia Kehamilan 34-36 Minggu dan Masa Kehamilan Cukup BulanAbstrakPendahuluan: Penelitian ini menganalisis hasil maternal dan neonatal pada ketuban pecah dini pada usia kehamilan 34 - 36 minggu dibandingkan dengan kehamilan jangka panjang untuk memberikan gambaran tentang kemanjuran protokol saat ini yang sangat bervariasi. Metode: Penelitian ini adalah studi cross-sectional menggunakan teknik simple random sampling. Subjek penelitian ini terdiri atas total 450 wanita hamil yang didiagnosis dengan PROM pada 34 - 36 minggu dan kehamilan jangka panjang selama periode Januari 2019 - Desember 2021. P<0,05 dianggap signifikan secara statistik. Hasil: hasil analisis menunjukan bahwa wanita dengan ketuban pecah dini pada usia kehamilan memiliki risiko lebih tinggi 1,13 kali (OR= 1,13, CI 95%) untuk asfiksia neonatal, 1,34 kali untuk kematian neonatal dini (OR= 1,34, CI 95%), dan 4,03 kali untuk mengembangkan chorioamnionitis klinis (OR= 4,03, CI 95%) dibandingkan dengan kelompok kehamilan 34 - 36 minggu. Tidak ada perbedaan yang signifikan secara statistik antara usia kehamilan dan kejadian kematian neonatal dini (P = 0,70). Tidak ada kematian ibu dalam penelitian ini. Kesimpulan: Protokol manajemen yang diterapkan untuk kedua kelompok memiliki kemanjuran yang sama. Insiden chorioamnionitis klinis lebih tinggi pada kelompok kehamilan, yang mungkin terkait dengan faktor risiko seperti COVID-19 dan hepatitis B.Kata kunci: Ketuban pecah dini, asfiksia, kematian neonatal
Outcome of Fetuses with Anterior Abdominal Wall Defects in A Tertiary Referral Hospital Alifa, Dhara; Aziz, Muhammad Alamsyah; Ritonga, Mulyanusa Amarullah; Pribadi, Adhi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.691

Abstract

Introduction: The most common abdominal wall defects are gastroschisis and omphalocele. Gastroschisis is a case of intraabdominal herniation caused by an abdominal wall defect from exposure to amniotic fluid during pregnancy. Omphalocele is a case of intraabdominal herniation covered with a membranous sac on the umbilical cord’s base. Gastroschisis occurred in 1/4000 of the of the global birth rate. Prevalence of omphalocele in between 1/3000 and 1/5000 cases of pregnancy. The purpose of the purpose of the research  is to present an overview of patients with congenital defects such as Gastroschisis and Omphalocele.Method: Research design is observational and descriptive. Data obtained from medical records in Hasan Sadikin tertiary referral hospital Bandung. Sample size was obtained by total sampling and conducted in April 2020–April 2023. Results: The demographics of gastroschisis include male (50%), female (50%), preterm (20%), stillbirth (30%), severe asphyxia (14.29%), moderate asphyxia (57.14%), normal asphyxia (8.57%), newborn mortality (14.29%), and other congenital anomalies (40%). In comparison, the demographics of omphalocele are male (66.67%), female (33.33%), preterm (58.33%), stillbirth (16.67%), severe asphyxia (40%), moderate asphyxia (40%), normal asphyxia (20%), newborn mortality (50%), and other congenital abnormalities (25%). Abdominal wall defects are seldom related with gender.Conclusion: Abdominal wall defect is a very rare congenital abnormality. This abnormality will require primary abdomen closure surgery to enhance the baby’s prognosis. The more other risk factors exist within abdominal wall defect babies, the worse their following prognosis will be. The prognosis for omphalocele is more severe than gastroschisis due to the presence of asphyxia and prematurity.Luaran Janin dengan Defek Dinding Abdominal Anterior di Rumah Sakit Rujukan TersierAbstrakPendahuluan: Cacat dinding depan abdomen yang paling banyak terjadi adalah gastroschisis dan omphalocele. Gastroschisis adalah kasus herniasi intraabdomen yang disebabkan oleh cacat dinding perut akibat paparan cairan ketuban selama kehamilan. Omphalocele adalah kasus herniasi intraabdomen yang ditutupi kantung membran di dasar tali pusat. Gastroschisis terjadi pada 1/4000 angka kelahiran global. Prevalensi omfalokel antara 1/3000 dan 1/5000 kasus kehamilan. Tujuan dari penelitian ini adalah untuk menyajikan gambaran pasien dengan kelainan bawaan seperti Gastroschisis dan Omphalocele.Metode: Desain penelitian adalah observasional dan deskriptif. Data diperoleh dari rekam medis di rumah sakit rujukan tersier Hasan Sadikin Bandung. Besar sampel diperoleh dengan cara total sampling dan dilakukan pada bulan April 2020–April 2023.Hasil: Demografi gastroschisis meliputi laki-laki (50%), perempuan (50%), prematur (20%), lahir mati (30%), asfiksia berat (14,29%), asfiksia sedang (57,14%), asfiksia normal (8,57%). ), kematian bayi baru lahir (14,29%), dan kelainan kongenital lainnya (40%). Sebagai perbandingan, demografi omfalokel adalah laki-laki (66,67%), perempuan (33,33%), prematur (58,33%), lahir mati (16,67%), asfiksia berat (40%), asfiksia sedang (40%), asfiksia normal (20). %), kematian bayi baru lahir (50%), dan kelainan bawaan lainnya (25%). Cacat dinding perut jarang berhubungan dengan jenis kelamin.Kesimpulan: Cacat dinding perut merupakan kelainan bawaan yang sangat tidak biasa. Kelainan ini memerlukan operasi penutupan perut utama untuk meningkatkan peluang hidup bayi. Adanya faktor risiko tambahan pada bayi baru lahir dengan kelainan dinding perut memperburuk prognosisnya. Omphalocele sering menyebabkan asfiksia dan prematur, sehingga prognosisnya lebih buruk dibandingkan gastroschisis.Kata Kunci : Cacat dinding depan abdomen, Gastroschisis, Omphalocele 
A Case Report: MRI versus Ultrasonography in Abdominal Pregnancy, Which One is Better? Rahman, Luthfi; Reswari, Arnova; Pribadi, Adhi
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.v6i3.485

Abstract

Abdominal pregnancy is a rare potentially life-threatening form of ectopic pregnancy. First trimester sonography is very useful to identify an abdominal pregnancy earlier. However, cases of undiagnosed abdominal pregnancy at second and third trimesters are still reported in obstetric practice. Abdominal pregnancy is often missed during routine ultrasound examination that has classical findings such as the absence of myometrial tissue between the maternal bladder and the pregnancy, an empty uterus, poor visualization of the placenta, oligohydramnios, and abnormality of fetal lie. Magnetic Resonance Imaging (MRI) has been reported as the best abdominal pregnancy detection modality in a later gestational age due to its ability in detailing vascular and placental organ invasion.The reporting of a case of a patient with an abdominal pregnancy involves a diagnosis using abdominal ultrasound in the second trimester.  A 38-year-old woman was admitted to RSUP Dr. Hasan Sadikin Bandung with suspected abdominal pregnancy at gestational age of 28 weeks. Due to unclear clinical manifestation, the diagnosis of abdominal pregnancy was not detected and there was a plan for vaginal termination of pregnancy by misoprostol induction in the hospital before. The patient complained about progressive abdominal pain and difficult of defecation for 2 months before and this condition worsened in the last 4 days. Ultrasound examination in RSHS revealed that there were one living fetus, extra-uterine pregnancy with estimated fetal weight of 664 grams, fetal heart rate (+), and transverse breech presentation. Congenital abnormality was difficult to assess due to oligohydramnios. MRI was performed and showed intra-abdomen pregnancy with one living fetus, breech presentation, and intact amniotic membrane with oligohydramnios which was superior to the uterus and attached along the anterior aspect of uterus. The placenta had the size os 11.52 x 7.02 x 13.07 cm, was diffusely heterogenous in shape, on the right superoanterolateral wall of the gestational sac, and seemed to be attached to the right anterior abdominal wall and part of the intestine in the superior part while no placental adherence was seen. The patient was successfully treated with exploratory laparotomy with complete removal of the fetus and placenta. This case was reported to compare the advantage of MRI and ultrasound examination in detecting abdominal pregnancy, especially in late gestational age.Laporan Kasus: MRI dan Ultrasonografi pada Kehamilan Abdomen, Manakah yang Lebih Baik?AbstrakKehamilan abdomen adalah bentuk kehamilan ektopik yang jarang terjadi dan memiliki potensi mengancam jiwa. Pemeriksaan ultrasonografi (USG) pada trimester pertama berguna untuk mengidentifikasi kehamilan abdominal lebih awal. Namun, kehamilan abdomen yang tidak terdiagnosis masih sering dijumpai pada trimester kedua dan ketiga. Tanda klasik kehamilan abdomen sering terlewatkan oleh operator pada saat pemeriksaan USG rutin. Magnetic Resonance Imaging (MRI) merupakan modalitas terbaik untuk mendeteksi kehamilan abdomen pada usia kehamilan yang lebih tua karena mampu melihat invasi pembuluh darah dan organ plasenta secara lebih detail.Kami melaporkan sebuah kasus mengenai seorang wanita 38 tahun yang terdeteksi memiliki kehamilan abdominal pada usia kehamilan 28 minggu pada pemeriksaan USG saat perawatan di RSHS. Manifestasi klinis pada pasien tidak spesifik sehingga diagnosis kehamilan abdominal terlewati dan sempat diberikan rencana terminasi kehamilan pervaginam di rumah sakit sebelumnya. Pemeriksaan USG menunjukkan terdapat satu janin hidup dan terletak luar rahim. Kemudian pasien diputuskan menjalani pemeriksaan MRI, ditemukan adanya kehamilan intra abdomen dengan satu janin hidup, presentasi bokong, dan plasenta berbentuk heterogen difus, di dinding superoanterolateral kanan kantung kehamilan, melekat pada dinding abdomen anterior kanan dan bagian usus di bagian superior, dan tanpa adanya perlengketan plasenta. Pasien ditangani dengan laparotomi eksplorasi dengan pengangkatan janin dan plasenta secara lengkap. Kasus ini bertujuan membandingkan keunggulan pemeriksaan MRI dan USG dalam mendeteksi kehamilan abdominal, terutama pada usia kehamilan lanjut.Kata kunci: ultrasonografi, MRI, kehamilan abdominal
Neonatal Outcome in Relation to Cardiotocography Interpretation During Pregnancy Megantoro, Izzati Faustina; Pribadi, Adhi; Nurdiawan, Windi; Hidayat, Dini; Ritonga, Mulyanusa
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.718

Abstract

Introduction: The aim of this study is to evaluate the interrelation between neonatal outcome (neonatal asphyxia status) and cardiotocography interpretation during pregnancy.Methods: This is an observational analytical study employing a cross-sectional approach involving patients delivering at Hasan Sadikin General Hospital in 2023. The inclusion criteria were patients who gave birth with cardiotocography interpretation and neonatal outcome recording at 32-37 weeks of gestation. The exclusion criteria were fetal with congenital anomalies and multiple pregnancy. This study utilized secondary data from patient case notes. This study employed non-probability consecutive sampling. Descriptive and analytical statistics were performed.Result: The result of this study indicates abnormal cardiotocography patterns are significantly associated with higher incidences of asphyxia (p=0.0001). No significant difference was found between incidence of asphyxia with the type of delivery and birth weight. There was also no significant difference between Cardiotocography category II and III based on the maternal and neonatal factors.Conclusion: This study concluded that the significant relationship between CTG results, and neonatal asphyxia underscores the importance of CTG monitoring in predicting and managing fetal distress.Luaran Neonatus berdasarkan Pemeriksaan Kardiotokografi pada KehamilanAbstrakPendahuluan: Tujuan penelitian ini adalah untuk mengevaluasi hubungan antara hasil neonatal (status asfiksia neonatal) dan interpretasi kardiotokografi selama kehamilan.Metode: Metode penelitian ini adalah analitik observasional dengan pendekatan cross-sectional yang melibatkan pasien yang melahirkan di Rumah Sakit Umum Hasan Sadikin pada tahun 2023. Kriteria inklusi adalah pasien yang melahirkan dengan interpretasi kardiotokografi dan pencatatan hasil neonatal pada usia kehamilan 32 – 37 minggu. Kriteria eksklusi adalah janin dengan anomali kongenital dan kehamilan ganda. Penelitian ini menggunakan data sekunder dari catatan kasus pasien. Penelitian ini menggunakan metode sampling konsekutif non-probabilitas. Statistik deskriptif dan analitik dilakukan.Hasil: Hasil penelitian ini menunjukkan bahwa pola kardiotokografi abnormal secara signifikan terkait dengan insiden asfiksia yang lebih tinggi (p=0.0001). Tidak ditemukan perbedaan signifikan antara insiden asfiksia dengan jenis persalinan dan berat lahir. Tidak ada perbedaan signifikan antara kategori Kardiotokografi II dan III berdasarkan faktor maternal dan neonatal.Kesimpulan: Penelitian ini menyimpulkan bahwa hubungan signifikan antara hasil CTG dan asfiksia neonatal menekankan pentingnya pemantauan CTG dalam memprediksi dan mengelola distress janin.Kata kunci: Kardiotokografi, Neonatal, Distress janin, APGAR
Comparison of Maternal and Perinatal Outcomes between Severe Preeclampsia without Complications and with HELLP Syndrome Riva, Salma Nisrina; Pribadi, Adhi; Siddiq, Amillia
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.719

Abstract

Introduction: Maternal and perinatal outcomes in severe preeclampsia conditions, without or accompanied by HELLP syndrome, are variable. There is currently a lack of research data in Indonesia comparing maternal and perinatal outcomes in both conditions. This study compares pregnancy outcomes between severe preeclampsia with no complications and severe preeclampsia with HELLP syndrome.Methods: This study employs an observational analytical approach, utilizing a retrospective cross-sectional design. The samplings contain 92 patients from the medical records of patients who were diagnosed with preeclampsia without complications and severe preeclampsia with HELLP syndrome at Hasan Sadikin Hospital Bandung from January 2021 to December 2023.Results: It was found that maternal with HELLP syndrome are five times more at risk for eclampsia compared to maternal with preeclampsia without complications. Maternal who have severe preeclampsia accompanied by HELLP are two times more at risk of having labor under 34 weeks or preterm compared to maternal with preeclampsia without complications. Other outcomes, including maternal mortality, DIC, acute renal failure, pulmonary edema, antepartum hemorrhage, as well as perinatal mortality, FGR, IUFD, and perinatal asphyxia, did not show a statistically significant difference in proportion (p > 0.05).Conclusion: There is a relationship between maternal and perinatal outcomes in severe preeclampsia without complications or with HELLP syndrome.Perbandingan Luaran Maternal dan Perinatal antara Preeklamsia Berat Tanpa Penyulit dan dengan Sindrom HELLPAbstrakPendahuluan: Luaran maternal dan perinatal pada kondisi preeklamsia berat, tanpa dan dengan sindrom HELLP, tergolong bervariasi. Saat ini masih minim data penelitian di Indonesia yang membandingkan hasil luaran maternal dan perinatal pada kedua kondisi tersebut. Penelitian ini bertujuan untuk mengetahui perbandingan luaran kehamilan antara preeklamsia berat tanpa komplikasi dan preeklamsia berat dengan Sindrom HELLP. Metode: Metode yang digunakan dalam penelitian ini adalah analitik observasional dengan desain potong lintang retrospektif. Sampel penelitian ini adalah 92 pasien dari rekam medis pasien yang didiagnosis preeklamsia tanpa komplikasi dan preeklamsia berat dengan Sindrom HELLP di Rumah Sakit Hasan Sadikin Bandung pada periode Januari 2021 hingga Desember 2023.Hasil: Hasil penelitian menunjukkan bahwa ibu dengan sindrom HELLP berisiko lima kali lebih besar untuk mengalami eklampsia dibandingkan dengan ibu dengan preeklampsia tanpa komplikasi. Ibu yang mengalami preeklampsia berat disertai HELLP berisiko dua kali lebih besar untuk mengalami persalinan di bawah 34 minggu atau prematur dibandingkan dengan ibu yang mengalami preeklampsia tanpa komplikasi. Luaran lain seperti kematian ibu, DIC, gagal ginjal akut, edema paru, perdarahan antepartum dan juga kematian perinatal, FGR, IUFD, asfiksia perinatal tidak ada perbedaan proporsi yang bermakna secara statistik (p>0,05).Kesimpulan: Terdapat hubungan luaran maternal dan perinatal antara preeklamsia berat tanpa komplikasi atau dengan sindrom HELLP.Kata kunci: Luaran Maternal, Perinatal, Sindrom HELLP
Expression of Ki-67 has Correlation with the Degree and Size of Endometriosis Cysts Ruswana Anwar; Muhammad Alif; Adhi Pribadi
Journal of Medicine and Health Vol 1 No 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i1.496

Abstract

Endometriosis is one of the most common gynecological problem. Cells resulted in chronic inflammation and progressive, proliferative, invasive and even infiltrating an area that resembles the character of the malignancy. Ki-67 is an antigen on the cell nucleus that is found only in actively dividing cells. Expression of Ki-67 are associated with an aggressive tumor and metastasis. This study aims to determine the level of Ki-67 expression correlation with stage and size of the endometriosis cyst. Methods research is observational analytic cross cut method on 56 paraffin blocks of patients who have been diagnosed with endometriosis and had performed a laparotomy or laparoscopic surgery in Dr Hasan Sadikin Hospital. The results showed a significant relationship between the level of expression of Ki-67 with endometriosis cyst size (p <0.001) with a fairly strong relationship (0.55) according to statistics based on criteria Guilford. Moreover the results also showed a significant relationship between the level of expression of Ki-67 with endometriosis stage (p <0.001) with a fairly close relationship (0.564) according to statistics based on criteria Guilford. It can be concluded that the expression of Ki-67 associated with cyst size and stage of endometriosis. Keywords: Ki-67, endometriosis stage, endometriosis cyst
Blood Cadmium and Preterm Birth: A Systems Toxicology Review of Molecular Mechanisms, Placental Disruption, and Translational Obstetric Implications Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Pribadi, Adhi; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
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.v8i2.949

Abstract

Objectives: Preterm birth (PTB) remains a leading global cause of neonatal morbidity and mortality, with multifactorial origins including inflammation, endocrine disruption, and placental dysfunction. Recent evidence identifies cadmium (Cd), a persistent environmental toxicant, as a modifiable contributor to PTB. This review aims to integrate the mechanistic, molecular, and clinical literature on maternal blood cadmium exposure and its role in the pathogenesis of PTB.Methods: A systematic and integrative review was conducted following PRISMA 2020 guidelines. Literature from 2000 to 2025 was retrieved using PubMed, Scopus, Embase, and Web of Science. Eligible studies included molecular toxicology, animal models, human epidemiological data, and placental mechanistic research addressing cadmium exposure and preterm birth. Inclusion criteria emphasized mechanistic clarity, gestational outcome relevance, and measurable cadmium biomarkers. Figures, tables, and mechanistic diagrams were used to illustrate toxicological convergence pathways.Results: Cadmium disrupts placental homeostasis via oxidative stress, endothelial dysfunction, impaired trophoblast invasion, progesterone suppression, and activation of inflammatory cascades such as the NLRP3 inflammasome. Consistent associations between maternal cadmium burden and PTB risk were found across animal, cellular, and human population studies. However, heterogeneity in exposure assessment, absence of unified risk thresholds, and confounding from co-exposures challenge causal inference. Literature remains fragmented, lacking integration between mechanistic insights and clinical risk models.Conclusions: Cadmium should be reclassified as a central agent in the pathophysiology of PTB. We propose a precision obstetrics framework that includes environmental cadmium screening in high-risk pregnancies, implementation of exposome-informed policies, and prospective multicenter studies with molecular endpoints. Obstetric care must evolve to include toxicological risk profiling as standard practice in the prevention of PTB.Kadmium dalam Darah dan Kelahiran Prematur: Tinjauan Toksikologi Sistemik terhadap Mekanisme Molekuler, Disrupsi Plasenta, dan Implikasi Obstetri TranslasiAbstrakTujuan: Kelahiran Prematur (preterm birth/PTB) tetap menjadi penyebab utama morbiditas dan mortalitas neonatal di seluruh dunia dengan etiologi multifaktorial yang mencakup inflamasi, gangguan endokrin, dan disfungsi plasenta. Bukti terbaru mengidentifikasi kadmium (Cd), suatu toksikan lingkungan persisten, sebagai faktor kontribusi yang dapat dimodifikasi terhadap PTB. Tinjauan ini bertujuan untuk mengintegrasikan literatur mekanistik, molekuler, dan klinis mengenai paparan kadmium dalam darah maternal dan perannya dalam patogenesis PTB.Metode: Tinjauan sistematis dan integratif dilakukan sesuai pedoman PRISMA 2020. Literatur dari tahun 2000 hingga 2025 dikumpulkan melalui database PubMed, Scopus, Embase, dan Web of Science. Studi yang memenuhi syarat mencakup toksikologi molekuler, model hewan, data epidemiologi manusia, dan penelitian mekanistik plasenta yang mengevaluasi hubungan antara paparan kadmium dan kelahiran prematur. Kriteria inklusi menekankan kejelasan mekanistik, relevansi terhadap hasil kehamilan, serta penggunaan biomarker kadmium yang terukur. Gambar, tabel, dan diagram mekanistik digunakan untuk mengilustrasikan jalur konvergensi toksikologis.Hasil: Kadmium mengganggu homeostasis plasenta melalui stres oksidatif, disfungsi endotel, gangguan invasi trofoblas, supresi progesteron, dan aktivasi jalur inflamasi seperti inflammasom NLRP3. Hubungan konsisten antara beban kadmium maternal dan risiko PTB ditemukan dalam studi hewan, seluler, dan populasi manusia. Namun, adanya heterogenitas dalam penilaian paparan, belum adanya ambang risiko yang seragam, serta pengaruh faktor pajanan lainnya menjadi tantangan dalam penarikan kesimpulan kausal. Literatur masih terfragmentasi dan belum mengintegrasikan temuan mekanistik dengan model risiko klinis secara menyeluruh.Kesimpulan: Kadmium seharusnya diklasifikasikan ulang sebagai agen sentral dalam patofisiologi PTB. Kami mengusulkan suatu kerangka kerja obstetri presisi yang mencakup skrining lingkungan terhadap kadmium pada kehamilan berisiko tinggi, menerapkan kebijakan berbasis exposome, serta studi prospektif multisentra dengan titik akhir molekuler. Pelayanan kebidanan harus berkembang dengan mengadopsi profil risiko toksikologis sebagai bagian dari praktik standar dalam pencegahan kelahiran prematur.Kata kunci: Disrupsi Plasenta; Interaksi Endokrin-Inflamasi; Kesehatan Reproduksi Lingkungan; Mekanisme Kelahiran Prematur; Toksisitas Kadmium,
Urinary Bladder Injury Among Patients with Placenta Accreta Spectrum: Comparison Between Wedge Resection and Total Hysterectomy Ismayadi, Tedi; Pribadi, Adhi; Kurniadi, Andi
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.v8i2.877

Abstract

Objective: This study aims to assess the incidence of urinary bladder injury among pregnant women with placenta accreta spectrum (PAS) who underwent total hysterectomy and wedge resection.Methods: This study employed a cross-sectional design by reviewing secondary data of all pregnant women with PAS who underwent total hysterectomy or wedge resection at Hasan Sadikin General Hospital from January 2021 to December 2023. Statistical analysis for categorical data used the Chi-square test or Fisher’s exact test, and numerical data were analyzed using the unpaired T-test or Mann-Whitney test.Results: The sample consists of 116 patients. A total of 84 patients underwent total hysterectomy, and 32 patients underwent wedge resection. There was no significant difference in mean age between the two groups (p = 0.129). The results showed a significant difference between the two groups for birth weight (p = 0.007) and the incidence of urinary bladder injury (p = 0.018). No urinary bladder injury occurred in the wedge resection group, while 13 (15.50%) patients experienced urinary bladder injury in the total hysterectomy group.Conclusion: Total hysterectomy is associated with a higher incidence of urinary bladder injury compared to wedge resection.Cedera Vesika Urinaria pada Pasien dengan Spektrum Plasenta Akreta:Perbandingan antara Wedge Resection dan Total HisterektomiAbstrak Tujuan: Penelitian ini bertujuan untuk menilai angka kejadian cedera vesika urinaria antara wanita hamil dengan spektrum plasenta akreta (SPA) yang menjalani histerektomi totalis dan wedge resection.Metode: Metode yang digunakan dalam penelitian ini adalah metode potong lintang dengan meninjau data sekunder semua ibu hamil dengan SPA yang menjalani histerektomi totalis atau wedge resection di Rumah Sakit Umum Pusat Hasan Sadikin periode Januari 2021 - Desember 2023. Analisis statistik untuk data kategorik menggunakan uji Chi-square atau uji Fisher dan data numerik diuji menggunakan uji T-tidak berpasangan atau uji Mann-Whitney.Hasil: Sampel penelitian ini terdiri atas 116 pasien. Sebanyak 84 pasien menjalani histerektomi totalis dan 32 pasien menjalani wedge resection. Tidak ada perbedaan rata-rata usia yang bermakna antar kedua kelompok (p = 0,129). Hasil penelitian menunjukkan perbedaan yang signifikan antara kedua kelompok untuk berat badan lahir (p = 0,007) dan kejadian cedera vesika urinaria (p = 0,018). Tidak ada yang mengalami cedera vesika urinaria pada kelompok wedge resection, sedangkan 13 (15,50%) pasien mengalami cedera vesika urinaria pada kelompok histerektomi totalis.Kesimpulan: Histerektomi totalis berhubungan dengan tingkat kejadian cedera vesika urinaria yang lebih tinggi dibandingkan dengan wedge resection.
Rare Case: Tetra-Amelia Syndrome Alifa, Dhara; Aziz, Muhammad Alamsyah; Ritonga, Mulyanusa Amarullah; Pribadi, Adhi
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.v7i3.694

Abstract

Introduction: Congenital abnormalities are anomalies that become a fear for a family, when a mother experiences pregnancy. Some abnormalities are temporary and can be corrected, while some are permanent and cannot be corrected, so screening at antenatal time is very important.Objective: To explain and analyze a rare case of Tetra-amelia syndrome and how to diagnose it.Case: A 32-year-old woman with a 32-week-old G3P0A2 pregnancy visited the maternal-fetal clinic. According to ultrasound data, a single fetus with a gestational age of 31-32 weeks and a fetal weight of 1837 grams is in breech presentation. Only the proximal components of the arm and leg are formed, leaving the radius bones, ulna, tibia, and fibula unformed. The femur has a length that corresponds to 16 weeks, while the humerus has a length that corresponds to 20 weeks. These findings also revealed a discrepancy in pregnancy age. A tetra-amelia abnormality was discovered at the end of the ultrasound scan. Caesarean section performed on August 6, 2021, at the age of 39 weeks, a baby girl has been born baby girl a baby girl weighing 2300 grams, a body length of 31 cm, with mild asphyxia.Conclusion: During antenatal care, ultrasound on the unidentified distal part of the entire extremity can detect Tetra-amelia syndrome.Kasus Langka: Sindrom Tetra-ameliaAbstrak Pendahuluan: Kelainan bawaan adalah anomali yang menjadi trauma bagi keluarga, ketika seorang ibu mengalami kehamilan. Beberapa kelainan bersifat sementara dan dapat diobati, sementara beberapa bersifat permanen dan tidak dapat diperbaiki sehingga skrining pada waktu antenatal sangat penting.Tujuan: Artikel ini untuk menjelaskan dan menganalisis kasus langka sindrom Tetra-amelia dan cara mendiagnosisnya.Kasus: Seorang wanita berusia 32 tahun dengan kehamilan G3P0A2 berusia 32 minggu mengunjungi klinik fetomaternal. Hasil pemeriksaan ultrasonografi menunjukan janin tunggal dengan usia kehamilan 31 - 32 minggu dan berat janin 1837 gram dalam letak sungsang. Hanya komponen proksimal lengan dan kaki yang terbentuk, sedangkan tulang jari-jari, ulna, tibia, dan fibula tidak terbentuk. Femur memiliki panjang yang sesuai dengan 16 minggu, sedangkan humerus memiliki panjang yang sesuai dengan 20 minggu. Kelainan tetra-amelia dapat dideteksi dengan pemindaian ultrasonografi. Pada tanggal 6 Agustus 2021 presentasi sungsang, dilakukan operasi caesar, lahir bayi perempuan pada usia 39 minggu, berat 2300 gram, panjang 31 cm, disertai asfiksia ringan.Kesimpulan: Pemeriksaan ultrasonografi pada perawatan antenatal dapat mendeteksi sindrom Tetra-amelia, bila bagian distal ekstremitas tidak teridentifikasi.Kata kunci:Sindrom Tetra-amelia, Ultrasonografi, Kelainan Kongenital
Comparison of Pregnancy Outcomes with Autoimmune Rheumatic Disease and Without Autoimmune Rheumatic Disease Sulaiman, Aina Zakia; Pribadi, Adhi; Hamijoyo, Laniyati; Irianti, Setyorini; Rahmadi, Andri Reza
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.v7i3.724

Abstract

Introduction: It is known that pregnancies with autoimmunity have a higher risk of complications in the mother and fetus compared to pregnancies without autoimmunity. The purpose of this study was to determine the comparison between pregnancy outcomes with autoimmune rheumatic disease and without autoimmune rheumatic disease.Methods: This study is an observational analytic with a retrospective cross-sectional design. Data were obtained from all patients with pregnancy outcomes with autoimmune rheumatic disease and without autoimmune rheumatic disease at Hasan Sadikin Hospital Bandung 1 January - 31 December 2021-2023.Results: During this period, 71 pregnant women were found to be accompanied by autoimmune rheumatic diseases and then data on pregnant women without autoimmune rheumatic diseases were randomly taken as controls. In this study, it was found that pregnant women with autoimmune diseases experienced more neonatal outcomes of stunted fetal growth, namely 11(15.5%) compared to pregnant women without autoimmune rheumatic diseases, namely 2(2.8%) with a p-value of 0.009.Conclusion: This study found that pregnant women with autoimmune rheumatic disease experienced more neonatal outcomes of FGR compared to pregnant women without autoimmune rheumatism.Perbandingan Antara Luaran Kehamilan Dengan Penyakit Rhematik Autoimun Dan Tanpa Penyakit Rematik AutoimunAbstrakPendahuluan: Diketahui bahwa kehamilan dengan autoimun memiliki risiko komplikasi pada ibu maupun janin lebih tinggi dibandingkan dengan kehamilan tanpa autoimun. Tujuan penelitian ini untuk mengetahui perbandingan antara luaran kehamilan dengan penyakit rematik autoimun dan tanpa penyakit rematik autoimunMetode: Penelitian ini bersifat analitik observasional dengan desain potong lintang retrospektif. Data diperoleh dari seluruh pasien luaran kehamilan dengan penyakit rematik autoimun dan tanpa penyakit rematik autoimun di Rumah Sakit Hasan Sadikin Bandung 1 Januari – 31 Desember 2021-2023Hasil: Dalam periode tersebut ditemukan 71 orang ibu hamil yang disertai dengan penyakit rematik autoimun kemudian diambil data ibu hamil tanpa penyakit rematik autoimun secara random sebagai kontrol. Pada penelitian ini didapatkan ibu hamil dengan penyakit autoimun lebih banyak mengalami luaran neonatal pertumbuhan janin terhambat yaitu 11(15.5%) dibandingkan ibu hamil tanpa penyakit rematik autoimun yaitu 2(2.8%) dengan p- value0.009.Kesimpulan : Penelitian ini menemukan bahwa ibu hamil dengan penyakit rematik autoimun lebih banyak mengalami luaran neonatal pertumbuhan janin terhambat dibandingkan dengan ibu hamil tanpa rematik autoimun.Kata kunci : Luaran Maternal, Luaran Neonatal, Autoimun 
Co-Authors AA Sudharmawan, AA Achmad Fauzan, Achmad Adisti Erlina Sutomo Adisti Erlina Sutomo, Adisti Erlina Akhmad Yogi Pramatirta, Akhmad Yogi Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Alifa, Dhara Amillia Siddiq, Amillia Andi Kurniadi, Andi Andi Rinaldi Andonotopo, Wiku Andri Reza Rahmadi Aqilah, Nurjihan Syarifah Arnova Reswari, Arnova ASTRI ASTUTI Aziz, Muhammad Alamsyah Bachnas, Muhammad Adrianes Budi Handono Cool, Charlotte Johanna Cut Meurah Yeni Dany Hilmanto Dewi, Sawitri Dida Akhmad Gurnida Dodi Suardi Elsa Pudji Setiawati Evert Solomon Pangkahila Evicenna Naftuchah Riani, Evicenna Naftuchah Firmansyah, Silva Elifa Hadyana Sukandar Hanom Husni Syam Herry Herman Hidayat, Dini I Nyoman Hariyasa Sanjaya Ismayadi, Tedi Jeffry Iman Gurnadi, Jeffry Iman Johanes C. Mose Julian Dewantiningrum Kurjak, Asim Laniyati Hamijoyo, Laniyati Luthfi Rahman, Luthfi Megantoro, Izzati Faustina Melsa Sagita Imaniar Muhammad Alif Nugrahani, Annisa Dewi Nuswil Bernolian Pramono, Mochammad Besari Adi Pramudyo, Miftah Pratiwi, Erlina Lutfiayu Putra, Ridwan Abdullah Rachmawati, Anita Ritonga, Mulyanusa Ritonga, Mulyanusa Amarullah Riva, Salma Nisrina Ruswana Anwar Ryan Saktika Mulyana Setyorini Irianti Solly Aryza Sri Sulistyowati Stanojevic, Milan Sulaiman, Aina Zakia Suri, Mulhamatus Latifatus Susiarno, Hadi Syahdony, Farrel Nolan Trully D. Sitorus Trully D. Sitorus Utami, Hasri Larasati Wilis Dwi Pangesti Windi Nurdiawan Wiradnyana, Anak Agung Gede Putra Yordian, Kendry Savira