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Ketepatan Rumus Risanto untuk Memprediksi Berat Lahir Janin pada Ibu dengan Berat Badan Berlebih Nadia Mutiara Zahra; Shinta Prawitasari; Vicky Admiral Aprizano; Muhammad Nurhadi Rahman; Risanto Siswosudarmo
JURNAL KESEHATAN REPRODUKSI Vol 9, No 1 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.64595

AbstrakLatar Belakang: Pengukuran taksiran berat janin (TBJ) harus dilakukan seakurat mungkin agar dapat mencerminkan keadaan janin yang sesungguhnya guna merencanakan manajemen persalinan. Rumus Risanto adalah salah satu rumus TBJ yang yang praktis digunakan dengan memanfaatkan komponen tinggi fundus uteri (TFU). Namun, sering kali, penentuan TFU pada ibu hamil dengan berat badan berlebih sulit dilakukan secara teliti, akibat dari tingginya ketebalan lemak subkutan abdomen. Sehingga, terdapat kemungkinan penurunan ketepatan pengukuran TBJ menggunakan TFU pada ibu dengan berat badan berlebih.Tujuan: Untuk menilai ketepatan rumus Risanto dalam memprediksi berat lahir janin pada ibu dengan berat badan berlebih.Metode: Desain penelitian nested cross sectional, yang bersarang pada penelitian induk oleh author pada tahun 2018. Subjek yang terlibat yakni ibu hamil aterm dengan indeks massa tubuh (IMT) ≥25 kg/m2 di RSUP dr Sardjito dan beberapa RS jejaring. Selisih antara rata-rata taksiran berat janin rumus Risanto (TBJR) dan berat bayi lahir (BBL) dianalisis menggunakan paired t-test. Kemudian, TBJR dinilai ketepatannya menggunakan rata-rata persentase kesalahan absolut, serta proporsi kasus yang berada pada persentase kesalahan absolut ≤5%, ≤10%, ≤15%, dan ≤20%. TBJ dikatakan akurat apabila rata-rata persentase kesalahan absolut ≤10% dan/atau jumlah kasus dengan TBJ yang berada pada rentang ± 10% dari BBL sebanyak >75%.Hasil dan Pembahasan: Dari 205 subjek penelitian didapatkan rata-rata TBJR sebesar 3050,49 ± 421,96 gram (rentang 1995-4745 gram). Sedangkan, rata-rata BBL sebesar 3129,29 ± 406,67 gram (rentang 1800-4880 gram). TBJR cenderung memberikan hasil taksiran yang lebih kecil daripada BBL, dengan selisih rerata diantara keduanya (∆mean) sebesar 78,8 gram (95% CI: 50,031-107,569 dan nilai P=0,000). Artinya terdapat perbedaan yang bermakna secara statistik. Namun, apabila ∆mean diubah kedalam persentase maka akan didapatkan selisih rata-rata sebesar 2,52%. Selain itu, didapatkan rata-rata persentase kesalahan absolut sebesar 5,8 ± 4,11 %. Apabila dilihat proporsi data yang berada pada persentase kesalahan absolut ≤5%, ≤10%, ≤15%, dan ≤20%, maka berturut turut didapatkan cakupan sebesar 47,3%, 85,9%, 96,6%, dan 100% dari keseluruhan data.Kesimpulan: Rumus Risanto dapat dikatakan akurat dalam memperkirakan BBL pada ibu dengan berat badan berlebih berdasarkan indikator rata-rata persentase kesalahan absolut ≤10% dan jumlah kasus dengan TBJR yang berada pada rentang ±10% dari BBL sebanyak >75%. AbstractBackground: Estimated Fetal Weight (EFW) needs to be as accurate as possible to reflect the actual condition of the fetus for labor-management planning. Risanto’s formula is one of the easy to use formula to estimate fetal weight using fundal height (FH). But, oftentimes, the measurement of fundal height in overweight pregnant mothers is hard to be done precisely due to the thickness of the abdominal subcutaneous fat layer. Therefore, there is a possibility of a decrease in EFW’s accuracy in overweight mothers by using FH measurement.Objective: To determine the accuracy of Risanto’s formula in estimating fetal weight in overweight mothers.Method: It was a cross-sectional study nested within research by author in 2018. Mothers at term pregnancies with body mass index (BMI) ≥25 kg/m2 from Sardjito and affiliated hospitals were included in the study. The difference between the mean Risanto’s estimated fetal weight (R_EFW) and the mean actual birth weight (ABW) was analyzed using a paired t-test. Later on, the accuracy of R_EFW was analyzed based on the mean absolute percentage error and the number of cases within ≤5%, ≤10%, ≤15%, and ≤20% absolute percentage error. EFW can be defined as accurate if the mean absolute percentage error is ≤10% and/or the number of EFW within ± 10% from the ABW is >75%.Results and Discussion: From the 205 research subjects, the mean R_EFW was 3050,49 ± 421,96 gram (ranged from 1995 to 4745 gram), while the mean ABW was 3129,29 ± 406,67 gram (ranged from 1800-4880 gram). Risanto’s formula tends to give a smaller estimation compared to the ABW with the mean difference (∆mean) between the two was 78,8 gram (95% CI: 50,031-107,569 and P=0,000). The mean difference was statistically significant. But, if we convert the ∆mean into a percentage, the mean difference was 2,52%. Other than that, the mean absolute percentage error was 5,8 ± 4,11 %. The number of case within the absolute percentage error of ≤5%, ≤10%, ≤15%, and ≤20% was 47,3%, 85,9%, 96,6%, and 100% from the overall data in consecutive order.Conclusion: Risanto’s formula was accurate in estimating fetal birth weight in overweight mothers based on the two indicators, in which the mean absolute percentage error was ≤10% and the number of cases within the ± 10% from the ABW was >75%.

Early detection and primary prevention system in COVID-19 transmission to staff and residents in the department of obstetrics and gynecology Muhammad Nurhadi Rahman; Detty Siti Nurdiati; Nuring Pangastuti; Anis Widyasari; Fauzan Achmad Maliki; Sarah Ayu Andari; Khairina Hashifah
Journal of Community Empowerment for Health Vol 4, No 1 (2021): Special Issue of COVID-19
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.61165

COVID-19 is currently a global pandemic because of its fast transmission in humans. The disease can be symptomatic or asymptomatic. Patients with the disease can transmit the infection to the medical team who are exposed without proper protection. Prevention of transmission is our main focus of attention as well as early recognition of exposed medical teams among obstetrics and gynecology residents and consultants in our hospital. This article aimed to describe the COVID-19 early detection and primary prevention system among staff and residents in the Obstetrics and Gynecology (OBSGYN) Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada and Dr. Sardjito General Hospital from April to June 2020. The data were acquired from the reports of the COVID-19 taskforce from the OBSGYN Department. In order to prevent the transmission of COVID-19 infection, actions taken by the OBSGYN Department are as follows: a) arrangement of staff and residents watch schedules, b) usage of PPE (Personal Protective Equipment) according to protocol, c) contact tracing, and d) early detection. Resident watch schedule arrangement is done by withdrawing residents from affiliated hospitals so that the division of daily duty schedules at Dr. Sardjito General Hospital is divided into 2 shifts of 12 hours each. The PPE usage policy is adjusted according to the risk of COVID-19 exposure in different environments and in accordance with established standards. A total of 65 out of 74 residents (88%) had been exposed to suspected COVID-19 cases, and among the exposed residents, 12 residents (18%) were self-isolated because of the occurrence of symptoms, exposure to patients with positive COVID-19 rapid antibody test, or exposure to patients with positive COVID-19 Polymerase Chain Reaction (PCR) test. The department also conducted early detection of COVID-19 infection among all staff members and residents. As many as 13 out of 27 staff (48%) underwent COVID-19 rapid antibody test with 100% negative results, 66 of the 74 residents (89%) also underwent COVID-19 rapid antibody test with 100% negative results. In conclusion, the OBSGYN Department has implemented several measures to prevent transmission of COVID-19 among its staff and residents with adequate satisfactory results.

Malformasi Genital Perempuan: Kasus di RSUP Dr. Sardjito Yogyakarta Tahun 2019 Anis Widyasari; Muhammad Nurhadi Rahman; Akbar Novan Dwi Saputra; Nuring Pangastuti
JURNAL KESEHATAN REPRODUKSI Vol 9, No 2 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.75774

BackgroundReproductive tract malformations are rare in general population but are commonly encountered in women with infertility and recurrent pregnancy loss. Their true prevalence in the general population is not absolutely known mainly owing to methodological bias. Common uterine anomalies are important owing to their impact on fertility, and certain Mullerian malformations are particularly important because they cause serious clinical symptoms and affect woman’s quality of life. Identification of symptoms and timely diagnosis are an important key to the management of these defects. Although MRI being gold standard in delineating uterine anatomy, recent advances in imaging technology, specifically 3-dimensional ultrasound, achieve accurate diagnosis. Surgical management depend on the type of anomaly and its complexity and also involves multiple specialties; thus, patients should be referred to centres with experience in the treatment of complex genital malformationsObjectiveDetermined the description of cases of female genital malformation at Dr. Sardjito Hospital in 2019.MethodThis is descriptive study. The subject in this study were all new patient with female genital malformation at Obgyn Polyclinic Dr. Sardjito Hospital January-December 2019. Obtained 30 cases of female genital malformation.ResultThere is 30 cases of genital malformation in 2019. They were 4-44 years with mode at group 16-20 years. They consist of vaginal and cervicovaginal agenesis 14 cases, Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrom 6 cases, hematometra of hemiuterine 4 cases, Herlyn-Werner-Wunderlich (HWW) syndrome 3 cases, imperforate hymen, didelphys uterus and genital ambiguous each 1 case. Five cases of cervicovaginal agenesis have been done sigmoid vaginoplasty, all of them have good sexual function after procedure. One case MRKH syndrome has been done sigmoid vaginoplasty with good sexual function after that. Two cases HWW syndrome have been surgical treatment that are vaginal septectomy and vaginal septectomy with laparascopic cystectomy.ConclusionThe correct knowledge of embryology of the genitourinary is essential for the understanding, study, diagnosis and management of genital malformations, especially complex ones and those that lead to reproductive problems. Surgical techniques for correcting genital malformations depend on the type of anomaly and complexity.

Bahasa Inggris Akbar Novan Dwi Saputra; Dicky Moch Rizal; Nandia Septiyorini; Muhammad Nurhadi Rahman
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.675-692.2024

Background : Platelet-rich plasma (PRP) is an autologous, self-blood product, an anticoagulated blood product generated by the centrifugation method of whole blood that primarily contains platelets at amounts up to 5 times those found in physiologic platelet concentrations. The use of PRP in pelvic floor reconstruction surgery is becoming much more common. Objective : To determine the efficacy of PRP on pelvic floor reconstruction surgery, we will synthesize the available research on the use of PRP for pelvic floor disorders.; Methods: This review was conducted on research articles in PubMed, Proquest, EBSCO, and ScienceDirect databases published between January 2010 – December 2023 regarding the use of PRP for pelvic floor reconstruction surgery. All primary research in humans, case reports and case series will be included to evaluate the outcome of PRP as an adjunct to conventional surgery in treating pelvic floor disorders; Results: A total of five articles were chosen for review. Every article makes use of PRP in pelvic floor reconstruction surgery. Conclusions: This review offers actual evidence of PRP's efficacy in pelvic floor reconstruction surgery. This is a new approach, and the findings of this study are expected to inform clinical practice and ongoing research focused on improving the outcome of pelvic floor disorders treatment. Trial registration number: osf.io/gyr72

Effect of Vitamin D Supplementation in Women with Pelvic Floor Dysfunction: A Systematic Review Yanuaristi, Herdifitrianne Saintissa; Idhar, Syauqi Maulana; Rahman, Muhammad Nurhadi
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.v7i2.641

Objective: This review systematically analyzes and summarizes existing studies on the association between vitamin D supplementation and symptoms of Pelvic Floor Dysfunction (PFD) in women. Methods: We conducted a comprehensive literature search based on the Preferred Reporting Items for Systematic Review (PRISMA) Statements’ flow diagram for systematic review. Two independent reviewers searched five online databases using keywords to identify relevant studies from 2018-2023. Excluded were articles with populations other than women, case reports or case series, review papers, and studies that did not report vitamin D supplementation as a means of intervention in the study.Result: After identifying 2392 references, 13 studies were examined. Three studies explored the correlation between vitamin D supplementation and levator ani muscle strength, revealing a positive association. Results on vitamin D’s effect on urinary incontinence varied: five studies reported a negative correlation, while three showed significant improvement. Two studies indicated that vitamin D supplementation improved sexual function in the intervention group compared to the control group.Conclusion: Current evidence suggests that vitamin D supplementation is a potential strategy for the prevention and treatment of PFD in women, but relevant studies are severely available.Efek Suplementasi Vitamin D pada Wanita dengan Disfungsi Dasar Panggul: Tinjauan SistematikAbstrakTujuan: Tinjauan ini bertujuan untuk menganalisis secara sistematis studi yang ada dan meringkas data yang menunjukkan hubungan antara suplementasi vitamin D dan wanita dengan gejala disfungsi dasar panggul.Metode: Pada penelitian ini, dilakukan pencarian literatur yang komprehensif berdasarkan diagram alir Preferred Reporting Items for Systematic Review (PRISMA) untuk tinjauan sistematis. Dua pengulas independen mencari lima basis data daring menggunakan kata kunci untuk mengidentifikasi studi yang relevan dari tahun 2018 – 2023. Artikel dengan populasi selain wanita, laporan kasus atau seri kasus, makalah ulasan, dan studi yang tidak melaporkan suplementasi vitamin D sebagai sarana intervensi dalam studi dikecualikan.Hasil: Setelah mengidentifikasi 2394 referensi dan 13 studi ditinjau. Tiga studi melaporkan korelasi antara suplementasi vitamin D dan kekuatan otot levator ani, mengungkapkan hubungan positif. Namun, hasil mengenai dampak vitamin D pada inkontinensia urin bervariasi: lima studi melaporkan korelasi negatif, sementara tiga menunjukkan perbaikan signifikan. Dua studi menunjukkan bahwa suplementasi vitamin D meningkatkan fungsi seksual pada kelompok intervensi dibandingkan dengan kelompok kontrol.Kesimpulan: Bukti saat ini menunjukkan bahwa suplementasi vitamin D merupakan strategi pencegahan dan pengobatan yang potensial untuk wanita dengan disfungsi dasar panggul, tetapi penelitiannya masih sangat terbatas.Kata kunci: Vitamin D, Disfungsi Dasar Panggul, Prolaps, Inkontinensia

Kejadian Ballooning dan Avulsi Otot Levator Ani Pada Persalinan Spontan Primipara Non OASIS di Fasilitas Kesehatan Tingkat Pertama Rahman, Muhammad Nurhadi; Sukarsa, Mochamad Rizkar Arev; Rinaldi, Andi Rinaldi; Achmad, Eppy Darmadi; Sasotya, Raden Mas Sonny; Armawan3, Edwin
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.639

Pendahuluan: Kerusakan otot levator ani, seperti Ballooning dan Avulsi, sering terjadi pada Obstetric Anal Sphincter Injuries (OASIS) saat persalinan, yang menyebabkan masalah jangka panjang seperti inkontinensia dan prolaps uteri. Namun, hubungan antara kerusakan ini dengan robekan perineum derajat ringan atau Non-OASIS masih kurang dipahami. Penelitian ini bertujuan untuk mengeksplorasi prevalensi Ballooning dan Avulsi pada persalinan spontan primipara Non-OASIS tanpa episiotomi di fasilitas kesehatan tingkat pertamaMetode: Studi cross-sectional dilakukan di Rumah Sakit Umum Pusat Dr. Sardjito Yogyakarta dan praktik mandiri bidan di Sleman, Yogyakarta, melibatkan 69 pasien. Penggunaan USG 3D melalui pendekatan translabial digunakan untuk mengidentifikasi Ballooning dan Avulsi.Hasil: Dari 69 pasien yang mengalami persalinan spontan primipara Non-OASIS tanpa episiotomi yang terlibat dalam penelitian ini, 66,67% pasien mengalami robekan perineum derajat ringan, sementara 33,3% memiliki perineum intak. Prevalensi Ballooning adalah 26,1% dan Avulsi adalah 17,4%. Ballooning lebih umum terjadi pada pasien dengan robekan perineum derajat ringan (32,6%) daripada yang memiliki perineum intak (13,0%). Avulsi juga lebih sering terjadi pada pasien dengan robekan perineum derajat ringan (21,7%) dibandingkan dengan yang memiliki perineum intak (8,7%).Kesimpulan: Avulsi terjadi pada satu dari empat persalinan spontan primipara Non-OASIS tanpa episiotomi, sementara Ballooning terjadi pada satu dari enam persalinan. Studi ini memberikan wawasan tentang karakteristik kerusakan otot levator ani dalam setting praktik kebidanan mandiri yang berjejaring dengan fasilitas kesehatan tingkat pertama.The occurance of Ballooning and Avulsion of The Levator Ani Muscles in First Spontaneous Vaginal Birth Non-OASIS without Episiotomy at Primary Health FacilitiesAbstract Introduction: Damage to the levator ani muscles, such as Ballooning and Avulsion, often occurs during Obstetric Anal Sphincter Injuries (OASIS) during childbirth, leading to long-term issues like incontinence and uterine prolapse. However, the relationship between this damage and mild perineal tears or Non-OASIS is not fully understood. This study aims to explore the prevalence of Ballooning and Avulsion in spontaneous primiparous deliveries without episiotomy in primary healthcare facilities.Method: A cross-sectional study was conducted at Dr. Sardjito General Hospital in Yogyakarta and midwifery practices in Sleman, Yogyakarta, involving 69 patients. 3D ultrasound via translabial approach was used to identify Ballooning and Avulsion.Results: Out of 69 patients undergoing spontaneous primiparous deliveries without episiotomy, 66.67% experienced mild perineal tears, while 33.3% had intact perineum. The prevalence of Ballooning was 26.1% and Avulsion was 17.4%. Ballooning was more common in patients with mild perineal tears (32.6%) compared to those with intact perineum (13.0%). Avulsion also occurred more frequently in patients with mild perineal tears (21.7%) compared to those with intact perineum (8.7%).Conclusion: Avulsion occurs in one out of four spontaneous primiparous deliveries without episiotomy, while Ballooning occurs in one out of six deliveries. This study provides insights into the characteristics of levator ani muscle damage in the setting of primary healthcare facilities connected to independent midwifery practices.Key words: levator ani muscle avulsion, levator ani muscle ballooning, primipara, mild perineal tear.

Bahasa Inggris Saputra, Akbar Novan Dwi; Rizal, Dicky Moch; Septiyorini, Nandia; Rahman, Muhammad Nurhadi
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.675-692.2024

Background : Platelet-rich plasma (PRP) is an autologous, self-blood product, an anticoagulated blood product generated by the centrifugation method of whole blood that primarily contains platelets at amounts up to 5 times those found in physiologic platelet concentrations. The use of PRP in pelvic floor reconstruction surgery is becoming much more common. Objective : To determine the efficacy of PRP on pelvic floor reconstruction surgery, we will synthesize the available research on the use of PRP for pelvic floor disorders.; Methods: This review was conducted on research articles in PubMed, Proquest, EBSCO, and ScienceDirect databases published between January 2010 – December 2023 regarding the use of PRP for pelvic floor reconstruction surgery. All primary research in humans, case reports and case series will be included to evaluate the outcome of PRP as an adjunct to conventional surgery in treating pelvic floor disorders; Results: A total of five articles were chosen for review. Every article makes use of PRP in pelvic floor reconstruction surgery. Conclusions: This review offers actual evidence of PRP's efficacy in pelvic floor reconstruction surgery. This is a new approach, and the findings of this study are expected to inform clinical practice and ongoing research focused on improving the outcome of pelvic floor disorders treatment. Trial registration number: osf.io/gyr72

Pelvic floor exercises to improve low back pain and activities of daily living for the elderly Nurba, Fera Gusmi; Rahman, Muhammad Nurhadi; Rizal, Dicky Moch
Physical Therapy Journal of Indonesia Vol. 6 No. 2 (2025): July-December 2025
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v6i2.248

Background: Lower back pain is a prevalent health concern on a global scale, particularly among female and elderly demographics. The objective of this study was to assess the impact of regular pelvic floor exercises on the severity of low back pain and the enhancement of daily functioning in postmenopausal women. Methods: The present study employs a quasi-experimental design, incorporating a pre-post-test approach and a control group. Based on the extant data, 18 postmenopausal women will be distributed between the control group and the intervention group. The control group will participate in pelvic floor exercises thrice weekly for three weeks, while the intervention group will engage in pelvic floor exercises daily for three consecutive weeks. The collected data will be subjected to a paired sample t-test to make a pre-and post-intervention comparison, while an independent t-test will be employed to compare the groups at a significant level of p<0.05. Results: The average numeric rating scale (NRS) and modified Oswestry low back pain disability index (MODI) values in the control group after performing pelvic floor exercises were recorded as (6.0±1.4) and (20.3±7.3), respectively, while in the intervention group, they were (2.6±1.7) and (9.44±7.9). These data show a significant difference with a p-value < 0.000 (p < 0.05). A comparison between the control and intervention groups after performing pelvic floor exercises with different frequencies also revealed significant differences, with p-values of 0.000 and 0.008 (p<0.05), respectively. However, a larger difference was observed in the intervention group performing pelvic floor exercises daily, showing a much higher delta compared to the group exercising three times a week, with NRS values of (4.4±0.5) and MODI values of (19.7±1.7). Conclusion: In postmenopausal women, the group that performed pelvic floor exercises daily exhibited a significant reduction in NRS and MODI values compared to the group that performed exercises three times a week.

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