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All Journal Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Jurnal Kedokteran Brawijaya Majalah Kedokteran Bandung Jurnal Keperawatan Jiwa (JKJ): Persatuan Perawat Nasional Indonesia Majalah Obstetri dan Ginekologi Majalah Kesehatan FKUB Warta Ardhia : Jurnal Perhubungan Udara Medical Laboratory Technology Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Care : Jurnal Ilmiah Ilmu Kesehatan Journal of Issues in Midwifery Heart Science Journal Devotion: Journal of Research and Community Service Narra J Indonesian Journal of Perinatology Asian Journal of Health Research Jurnal Info Kesehatan
Bambang Rahardjo
Faculty Of Medicine Universitas Brawijaya Dr. Saiful Anwar General Hospital Malang
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Transportation Veterinary

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Maternal profiles and outcome of Placenta Accreta Spectrum (PAS) in a retrospective cohort study in Dr. Saiful Anwar General Hospital, Malang, Indonesia Rahardjo, Bambang; Pratama, Harry Dwi; Purbandari, Rosalia; Alim, Fathi Nabila
Majalah Obstetri & Ginekologi Vol. 33 No. 3 (2025): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I32025.204-213

Abstract

HIGHLIGHTS This study compared maternal characteristics and outcomes between PAS and non-PAS patients, including analysis using the Placenta Accreta Index. PAS is associated with significantly higher intraoperative blood loss and postoperative ICU admission rates. Findings underscored the importance of early identification and PAI-based risk stratification to optimize surgical planning and maternal outcomes.   ABSTRACT Objective: This study aimed to investigate maternal risk factors associated with PAS among patients at Dr. Saiful Anwar Regional General Hospital in Malang, Indonesia. Materials and Methods: This retrospective cohort study was conducted at Dr. Saiful Anwar General Hospital, Malang, analyzing medical records of patients diagnosed with Placenta Accreta Spectrum (PAS) from January 2023 to August 2024. Patients were categorized into PAS and non-PAS groups, with further classification of PAS patients based on their Placenta Accreta Index (PAI) score (<5 and ≥5) to compare clinical outcomes. A total of 47 eligible patients were included based on gestational age ≥28 weeks, clinical suspicion of PAS, and histopathological confirmation. Demographic, clinical, intraoperative, and postoperative data were collected and analyzed. Data were analyzed using SPSS 27.0. Ethical approval was obtained from the Dr. Saiful Anwar General Hospital Ethics Committee. Results: Patients with PAI scores ≥5 had higher intraoperative blood loss (3467.50 ± 2520.35 mL) compared to those with PAI scores <5 (2212.50 ± 1055.32 mL, p=0.764). Hysterectomy was the primary surgical approach in both groups (PAI <5: 88.88%, PAI <5: 92.75%, p=0.667). Bladder trauma (AAST grade IV) occurred in 100% of patients with PAI <5, whereas bladder infiltration was observed only in the PAI ≥5 group (p=0.117). NICU admission was more frequent in the PAI ≥5 group (31.25% vs. 0%, p=0.061). ICU admission was required in all PAI <5 patients (100%) and 75% of PAI <5 patients (p=0.102). No statistically significant associations were found. Conclusion: Higher PAI score may indicate a more complex clinical course, further research with larger sample sizes is necessary to validate its predictive value.
Effectivity of Artery Ligation for Bleeding Control in Placenta Accreta Spectrum: A Systematic Review Daniati, Lidya; Rahardjo, Bambang
Jurnal Kedokteran Brawijaya Vol. 34 No. 1 (2026)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2026.034.01.9

Abstract

Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition that causes severe postpartum hemorrhage. This study aimed to evaluate these techniques and their effectiveness in controlling postpartum hemorrhage. This systematic review used four databases: ScienceDirect, PubMed, Embase, and Scopus. We included studies on arterial ligation or occlusion, particularly of the internal iliac, uterine, hypogastric, or abdominal arteries, that compared arterial occlusion with conservative therapy or other interventions in women with PAS. We included eighteen studies with 1,338 patients. A total of 884 patients underwent the arterial ligation technique, whereas 454 underwent the balloon technique. Several studies have shown that arterial ligation or ballooning may be beneficial in controlling bleeding and reducing the need for hysterectomy. In contrast, other studies found that arterial ligation and occlusion did not result in significant differences in terms of intraoperative blood loss, required hysterectomy, and blood transfusion. All studies consistently found that arterial ligation and occlusion led to an increase in overall operative time compared to the control group. In addition, arterial ligation and occlusion are considered safe techniques with few complications. Arterial ligation and occlusion are effective techniques for managing PAS, particularly for controlling blood loss. Arterial ligation and occlusion are safe procedures with minimal complications.
Effectiveness comparison of nifedipine, methyldopa, and labetalol in severe preeclampsia: A systematic review Rahardjo, Bambang; Rahajeng; Nurhaeni, Yohanes Rico
Majalah Obstetri & Ginekologi Vol. 34 No. 1 (2026): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V34I12026.53-60

Abstract

HIGHLIGHTS All three medications (nifedipine, methyldopa, and labetalol) are viable first-line options for treating severe preeclampsia in pregnanc Oral nifedipine may be faster at lowering blood pressure in severe preeclampsia than methyldopa or labetalol.   ABSTRACT Objectives: Nifedipine, methyldopa, and labetalol are commonly used antihypertensive drugs for the management of severe preeclampsia. However, evidence directly comparing their effectiveness remains limited. This systematic review aimed to evaluate and compare the effectiveness of nifedipine, methyldopa, and labetalol in achieving blood pressure control in pregnant women with severe preeclampsia. Materials and Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in MEDLINE (PubMed), ScienceDirect, and the Cochrane Library for studies published between May 2014 and May 2024. Randomized controlled trials evaluating nifedipine, methyldopa, and/or labetalol in pregnant women with severe preeclampsia were included. Eligible studies were screened and assessed using predefined criteria, and relevant data were extracted and analyzed qualitatively. Results: A total of 12 randomized controlled trials met the inclusion criteria and were included in the qualitative synthesis. All participants in the included studies met the diagnostic criteria for severe preeclampsia and received antihypertensive therapy. Overall, nifedipine demonstrated a higher rate of achieving target blood pressure compared with methyldopa and labetalol in most studies. Labetalol also showed good effectiveness in controlling severe hypertension, whereas methyldopa generally had a slower onset of action and lower efficacy in reaching target blood pressure. Conclusion: All three medications remain viable first-line options for the management of severe preeclampsia during pregnancy. However, when only a single antihypertensive agent is available, nifedipine or labetalol may be preferred over methyldopa. Oral nifedipine appears to provide faster blood pressure reduction in severe preeclampsia.
Co-Authors A.A. Santi Dewi Abd. Rasyid Syamsuri Agustina Tri Endharti Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Alim, Fathi Nabila Aloysius Suryawan Amir, Nayla Nabilla Tahta Avwina Andonotopo, Wiku Anggie Diniayuningrum Anggraeni, Yessy Mulyanur Anik Sri Purwanti Anin Indriani Anisa Setyowati Anita Dwi Rahmawati Annisa Jusuf, Annisa Annissa Febriani Astuti, Ludji Auliya, Faiza Fardha Aziz, Ali Bachnas, Muhammad Adrianes Baihaqi, Irfani Cholid Tri Tjahjono Cut Meurah Yeni Daniati, Lidya Dewi Azar Nuria Wardani Dewi, Ratih Frastika Diadjeng Setya Wardani Dinda Oktia Maghfiroh Edy Mustofa Erna Amin Evert Solomon Pangkahila Fauqo Wildatil Jannah Gusti, Kharisma Ciptaning Harumsari, Stefani Hery Setiawan, Hery Hidayat Sujuti Hikmawan Wahyu Sulistomo I Nyoman Hariyasa Sanjaya I Wayan Agung Indrawan I Wayan Subage Ihda Dian Kusuma Ihda Dian Kusuma Indrayanti Indrayanti Indriani, Anin Indriati Dwi Rahayu Irfani Baihaqi Ita Sulistiani Julian Dewantiningrum Kalsumy, Umi Kharisma Ciptaning Gusti Kurjak, Asim Kusworini Handono Lestari, Ni Putu Yunita Sri Lilik Zuhriyah Ludji Astuti Melani Chysti Situmorang Mohammad Saifur Rohman Mosip, Erinus Mukhamad Nooryanto Noviyanti Noviyanti, Noviyanti Nugrahanti Prasetyorini Nur Sophia Matin Nurdiana Nurdiana Nurdiana Nurdiana Nurdiana Nurdiana Nurhaeni, Yohanes Rico Nuswil Bernolian Pande Made Dwijayasa Permatasari, Galuh W. Pramono, Mochammad Besari Adi Pratama, Harry Dwi Purba, Irene Silvia Purbandari, Rosalia Puspita Handayani Putra, Ichsan Setya Rahajeng Regina Ayu Fristiyanti Ryan Saktika Mulyana Sabilla Khaerunissa, Dymphna Safrina Dewi Ratnaningrum Sanarto Santoso Sanggelorang, Margie Cassie Setyowati, Anisa Sirat, Noorhamdani A. Siti Candra Windu Baktiyani Siti Candra Windu Baktiyani Situmorang, Melani Chysti Sri Poeranto, Sri Sri Sulistyowati Sri Winarsih Stanojevic, Milan Subandi Subandi Sugiono, Achmad Sulistiani, Ita Sulistomo, Hikmawan Wahyu Sultanah Zahariah Sumarno . Sumarno Sumarno Sutrisno Sutrisno Talita Nandia Primarintan Tatit Nurseta Tatit Nurseta Theresia Monica Rahardjo Udjianto, Udjianto Wardani, Dewi Azar Nuria Wardani, Widya Kusuma Wati, Linda Ratna Wibisono, Hermawan Widyalaksono, Agung Winasih, Sri Wiradnyana, Anak Agung Gede Putra Wiyasa, I Wayan Arsana Yahya Irwanto Yogibuana, Valerinna Yuyun Yueniwati Zahariah, Sultanah