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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Jurnal Kesehatan Reproduksi Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Risanto Siswosudarmo
Bagian Obstetri Dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
Health Professions Medicine & Pharmacology Nursing Public Health

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PERBANDINGAN ANTARA PEMBERIAN PROGESTERON VAGINAL DAN ALLYLESTRENOL ORAL PADA PENANGANAN ABORTUS IMINENS Umar Dhani; Ova Emilia; Risanto Siswosudarmo
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (153.909 KB) | DOI: 10.22146/jkr.7120

Abstract

Umar Dhani1, Ova Emilia2, Risanto Siswosudarmo3 ABSTRACTBackground: Abortion is still the most common complication of pregnancy. Inadequate secretion of progesterone in early pregnancy has been associated with one of the cause of miscarriage. Progesterone supplementation has been used to prevent abortion but it is still debatable.Objective: To compare the success rate of vaginal progesterone vs oral allylestrenol in the treatment of threatened abortion and duration of maintaining pregnancy.Method: Randomized Clinical Trial. The study was conducted at four affiliated hospitals of Sardjito hospital Yogyakarta from November 2013 to May 2014. Subjects with the diagnosis threatened abortion meeting the following criteria were included: 8-16 weeks gestational age, hemoglobin content eH 10 g/dL, and live fetus. The following patients were excluded: there was a history of induced abortion, hormonal treatment, associated with IUD use, uterine anomaly and gynecology tumor. A total of 60 patients were recruited to obtain 0.6 times proportion difference and 80% power of study. Eligible subjects consisting of 30 and 29 were randomly allocated into vaginal progesterone and oral allylestrenol groups. Ability to maintain, duration of pregnancy and side effects were outcomes of interest. Chi-square, t-test, Fisher exact test and survival analysis were used for statistical analysis.Result & Discussion: Abortion rate in vaginal progesterone was 23.3% compared 37.9% with oral allylestrenol group (RR=0.61; 95% CI 0.27-1.36). Duration of maintaining pregnancy was 16.57 days vs 9.82 days in vaginal progesterone and oral allylestrenol respectively (mean difference 6.75 days; 95% CI 2.30-11.20). There was no difference in term of gestational age on the abortion rate (p>0.05). One case undergoing nausea was found in oral allylestrenol group.Conclusion: There was no difference between vaginal progesterone and oral allylestrenol in term of abortion rate. Vaginal progesterone could maintain pregnancy longer than oral allylestrenol.Keywords: Threatened abortion, Vaginal progesterone, Oral allylestrenol, Abortion rate, Side effect. ABSTRAKLatar Belakang: Abortus masih merupakan komplikasi kehamilan yang sering terjadi. Sekresi progesteron yang tidak memadai pada awal kehamilan telah dikaitkan dengan salah satu penyebab abortus. Suplementasi progesteron digunakan untuk mencegah keguguran spontan walaupun masih diperdebatkan.Tujuan: Membandingkan keberhasilan terapi progesteron vaginal vs. allylestrenol oral dalam hal kejadian abortus dan lama terjadinya abortus pada kasus abortus iminens.Metode: Randomized Clinical Trial. Penelitian dilakukan dibagian Obstetrika dan Ginekologi di RS Kabupaten yang merupakan afiliasi RS Sardjito dari bulan November 2013 sampai dengan Mei 2014. Subyek yang memenuhi kriteria berikut ini: hamil 8-16 minggu, terdiagnosis abortus iminens, kadar hemoglobin > 10 g/dL, dan janin hidup. Pasien berikut ini tidak dimasukkan dalam penelitian: riwayat abortus provokatus, riwayat penggunaan terapi hormonal, abortus imminens karena kegagalan IUD, anomali uterus dan tumor ginekologis. Sebanyak 60 pasien diikutsertakan dalam penelitian ini untuk mendapatkan beda proporsi kejadian abortus sebesar 0,6 kali dengan kekuatan penelitian sebesar 80%. Subjek dibagi menjadi dua kelompok secara random yaitu kelompok yang mendapat progesteron vaginal dan allylestrenol oral masing-masing sebanyak 30 dan 29. Keberhasilan mempertahankan kehamilan, lama hari bertahan dan efek samping adalah hasil yang dinilai. Uji Chi-square, t-test, uji Fisher dan analisis survival adalah uji statistik yang dipakai.Hasil & Pembahasan: Kejadian abortus pada kelompok progesteron vaginal adalah 23,3% dibanding, 37,9% pada kelompok allylestrenol oral (RR=0,61; 95% CI 0,27-1,36). Lama bertahan pada kelompok progesteron vaginal rata-rata 16,57 hari dibanding rata-rata 9,82 hari pada kelompok allylestrenol oral (beda rata-rata 6,75 hari; 95% CI 2,30-11,20). Tidak ada perbedaan bermakna pengaruh umur kehamilan terhadap kejadian abortus pada kedua kelompok (p>0,05). Efek samping berupa perasaan mual hanya dijumpai pada kelompok allylestrenol oral.Kesimpulan: Tidak terdapat perbedaan kejadian abortus pada kedua kelompok meskipun kemampuan bertahan lebih lama pada kelompok progesteron vaginal.Kata Kunci: Abortus iminens, progesteron vaginal, allylestrenol oral, angka abortus, efek samping. 1,2,3 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada/RS SardjitoYogyakarta
Faktor Risiko Transmisi Virus HIV pada Ibu Hamil di Papua Alberthzon Kris Silo Rabrageri; Risanto Siswosudarmo; Soetrisno Soetrisno
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.35433

Abstract

Background: Human Immunodeficiency Virus (HIV) has been transmitted all over the world and attack people including pregnant women and their fetus. HIV-AIDS has become the main cause of maternal death. The transmission is started from Africa to Indonesia, specifically to Papua Island. In Papua, HIV is a serious threat for pregnant women’s life because of its fast transmission, even faster from other regions in Indonesia. Until present, there has no research about HIV transmission on pregnant women in Papua Island.Objective: To conduct analysis on risk factors related to HIV transmission on pregnant women in Papua Island.Method: Cross sectional continued with retrospective cohort. Data was taken from medical record of all patients delivering in eight state-owned hospitals in Papua and West Papua provinces started from 1 January 2013 to 31 December 2013. Inclusion criteria were all pregnant women who delivered vaginally or by caesarean sections with HIV and non HIV diagnosis and had complete medical record data. Data being taken included mother’s age when delivered the baby, mother’s education, parents’ social economic status, mother’s ethnicity, parents’ domicile, prematurity and infant’s birth weight. The two research groups were HIV (+) and HIV (-) groups. Data were statistically analyzed using Pearson Chi Square for univarian and logistic regression for multivarian.Result and Discussion: In Papua island, prevalence of pregnant women with HIV was 15.3%, and mostly occurred in reproductive age ( 85.1%). The main transmission source was heterosexual (100%). Univarian analysis found that mothers’s age <20 years old when delivered the baby increase 1.12 times compared to > 20 years old but it’s statistically insignificant (p=0.53). Mothers education < 9 years increases the risk of HIV 1.4 times compared to mother’s education > 9 years (p=0.01). The husband’s low socioeconomic status increase the risk of 5.51 times compared with husband’s high socioeconomic status (p<0.01). The wife’s low socioeconomic status increase the risk of 1.22 times, in which statistically insignificant (p=0.14). Native Papuanese pregnant women has significantly 3.05 times higher risk for HIV transmission compared to non Papuanese (p<0.01). Pregnant women’s domicile in villages increase the transmission significantly 2.21 times compared to cities’ domiciles (p<0.00). Premature delivery increased HIV transmission by 1.7 times (p<0.01). Low infant body weight increased the transmission by 1.64 times significantly (p<0.01). Multivarian analysis showed that husband’s low socioeconomic status, Papuanese ethnicity and domicile in villages are the most dominant factors influencing HIV transmission on pregnant women in Papua Island.Conclusion: Varied risk factors on HIV transmission resulted in the occurrence of HIV (+) cases in Papua Island, while the most dominant factors are husband with low socioeconomic status, Papua ethnicity and domicile in villages.Keywords: HIV, risk factors, birthing mothers, Papua Island.
Does Misoprostol for Induction of Labor Increase the Risk of Uterine Rupture? Kiswa Anggreany; Mohammmad Luthfi; Risanto Siswosudarmo
JURNAL KESEHATAN REPRODUKSI Vol 3, No 2 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.35445

Abstract

Background: Misoprostol is a synthetic prostaglandin E1 analogue which is now commonly used for induction of labor. Hyperstimulation is a complication of misoprostol that may lead to uterine rupture.Objective: To find the association between misoprostol exposure for induction of labor with uterine rupture.Methods: Case were all women who delivered in Sardjito and affiliate Hospitals from January 2007 to November 2012 with the diagnosis of uterine rupture. Controls were taken randomly from the same hospital. Chi square test and logistic regression model were used for statistical analysis.Result and Discussion: There were 53 cases of uterine rupture and 199 controls. The incidence of uterine rupture was 53 over 64,244 deliveries or 0,08%. Risk of of uterine rupture associated with misoprostol exposure was 1, 09 (CI 95% 0,52-2,2), while that of oxytocin exposure was 0,80 (CI 95% 0,35-1,85). Logistic regression analysis showed that the highest risk factor associated with uterine rupture was fetal weight > 3500 (OR 3,46; 95% CI 1,48-8,56) followed by parity (OR 2,56;95% CI 1,019-6,465) and vacuum extraction(OR 2,45;95% CI 0,94-6,39).Conclusion: There was no association between misoprostol exposure with uterine rupture. Fetal weight> 3500 gram, Parity more than 3, and vacuum extraction increased the risk of uterine rupture associated with misoprostol use.Keywords: Misoprostol, induction of labor, uterine rupture, fetal weight, parity.
Hubungan antara Saat Penanganan Kegawatdaruratan Maternal di Luar atau Saat Jam Kerja dengan Waktu Tanggap di RSUD LA Temmamala Kabupaten Soppeng, Sulawesi Selatan Fadillah Fadillah; Mohammad Hakimi; Risanto Siswosudarmo; Umar Malinta
JURNAL KESEHATAN REPRODUKSI Vol 4, No 3 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.36479

Abstract

Background: The national maternal mortality rate is still high at 228 per 100.000 live births. Three late allegedly related to high maternal mortality rate, are 1)too late for decision making, 2) too late for access service and 3) too late for get treatment at referral health facility. Response time for maternal emergency treatment in the hospital plays an important role, since it affects the final result.Objective: To determine the relationship between the time of obstetric emergency management and response time.Method: This study used cross sectional design with the population of study was obstetric emergency patients. One hundred and forty-five subjects were divided into two group: group treated outside of working hours as exposed groups and groups treated during working hours as control groups. Delay of response time were observed. Data was processed by statistical program using computer. Chi square test and logistic regression analysis were used to perform statistical tests.Result and Discussion: From September 1st 2015 to April 30th 2016, there were 145 cases with obstetric emergency handled. A total 82 cases among 145 (56,6%) received emergency management outside working hours. It was found that the 1st response time was delayed in handling outside work hours compared to handling during working hours (RR 2,22; 95% CI 164-3,00). The same was obtained at 2nd response time (RR 1,39; 95% CI 1,04-1,86) and 3rd response time (RR 1,65; 95% CI 1,14-2,31). Multivariate analysis was found that time of the emergency handling was the most dominant variable that affect all response time [1st response time (OR 12,61; 95% CI 4,82-32,03), 2nd response time (OR 2,17; 95% CI 1,05-4,47), 3rd response time (OR 7,70; 95% CI 1,91-31,10)]. PONEK with midwife on duty also influence 1st response time (OR 3,28; 95% CI 1,21-8,93).Conclusion: Obstetric emergency management outside of work hours increased the occurence of response time delay.Keywords: Time of management, Obstetric emergency, 1st, 2nd and 3rd response time.
Risanto’s Formulas is more Accurate in Determining Estimated Fetal Weight Based on Maternal Fundal Height Hanifah I Titisar; Risanto Siswosudarmo
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 3, July 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.899 KB) | DOI: 10.32771/inajog.v1i3.355

Abstract

Objectives: To compare the accuracy of Johnson’s and Risanto’s formulas in determining estimated fetal weight based on maternal fundal height (FH). Methods: This was a cross sectional study, consisting of 655 pregnant women from Dr. Sardjito Hospital and affiliated hospital sat 37-42 weeks of gestation. Fundal height was measured from the symphisis to the top of uterine fundus, using inverted unelastic flexible tape. EFW based on Johnson’s and Risanto’s formulas were compared with the actualbirth weight. Wilcox on analysis was used for statistical analysis. Results: Mean EFW of Johnson’s formula was 3136 ± 392.2 grams and EFW of Risanto’s formula was 3056 ± 322.5 grams and mean actual birth weight was 3021 ± 341.1 grams. The mean difference between EFW of Johnson’s formula and the actual birth weight was 156.1 ± 107.3 grams, and mean difference between EFW of Risanto’s formula and the actual birth weight was 100.8 ± 86.1 grams. Those two differences was statistically significant (p=0.001). Conclusion: This study showed that Risanto’s formula was more accurate than Johnson’s in predicting birth weight based on the maternal’s fundal height. [Indones J Obstet Gynecol 2013; 1-3: 149-51] Keywords: actual birth weight, fundal height, Johnson’s formula, Risanto’s formula
Effect of Delay in Postpartum Hemorrhage Management on the Rate of Near-Miss and Maternal Death Cases: Pengaruh Keterlambatan Penanganan Perdarahan Pascapersalinan terhadap Kejadian Hampir Mati dan Kematian Ibu Risanto Siswosudarmo
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.294 KB) | DOI: 10.32771/inajog.v2i4.984

Abstract

Objective: To recognize the effect of delay in the management of postpartum bleeding to the occurrence of near-miss and maternal death cases. Method: Prospective cohort. The study population was patients with postpartum hemorrhage. All PPH cases from thirteen hospitals (Sardjito and 12 affiliated hospitals) were recorded. The study was carried out from January 1st to June 30th 2009. The study group was those who experienced delay and the control group was those without delay. The outcome was measured as the number of near-miss and death cases. Near-miss was defined as those who experienced severe shock, demonstrated by systolic blood pressure 90 mmHg or less. Chi square test, t-test and logistic regressions were used to analyze our data.Result: From January 1st to June 30th 2009 we identified 139 cases of PPH from 8,924 deliveries (1.6%). From the 80 referred cases, as much as 22 cases (27.5%) were delayed, and 12 from 139 (8.6%) experienced delay in the hospital. A total of 30 cases among 139 (21.6%) experienced delay both outside and in the hospital. There were 74 near-miss cases, 9 of which ended in death of the patient. This means the real occurrence of near-miss cases is 65 from 139 cases or 46.8% while the occurrence of maternal death was 9 out of 139, or 6.47%. Case fatality rate was 9 from 139 or 6.47%; maternal near-miss ratio was 6.22; mortality index was 13.84% and maternal mortality ratio is estimated as 103/100.000 live births. Multivariate analysis showed delay in referral increased the risk of near-miss cases as much as 8.37 folds, while bleeding >1500 ml increased risk of near-miss by 12.12 folds. Delay in both referral and management in the hospital increased the risk of maternal death rate as much as 25.34 folds, hemoglobin <6 g/dl and unavailability of blood increase maternal death by 31.58 folds and 13.39 folds, respectively.Conclusion: Delay in referral and delay of in-hospital management ncreased the occurrence of near-miss and maternal mortality cases significantly. Multivariate analysis showed that the amount of bleeding, hemoglobin level and lack of blood availability influenced the occurrence of near-miss and maternal death more than the delay itself.Keywords: delay, maternal death, maternal near-miss, PPH
Comparison of Serum Interleukin-6 (Il-6) Levels Between Patients With HELLP Syndrome Versus Normotensive Pregnant Ganap, Eugenius Phyowai; Sofoewan, Sulchan; Siswosudarmo, Risanto
Sains Medika: Jurnal Kedokteran dan Kesehatan Vol 9, No 2 (2018): December 2018
Publisher : Faculty of Medicine, Universitas Islam Sultan Agung (UNISSULA), Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (727.341 KB) | DOI: 10.30659/sainsmed.v9i2.3630

Abstract

Background: Interleukin-6 (IL-6) has been known associated with oxidative stress and endothelial dysfunction, and also has important roles in pathogenesis of preeclampsia. Several studies have demonstrated that there was a significant increase of serum IL-6 levels in preeclamptic compared to normotensive pregnant women. However, study to evaluate serum IL-6 level in pregnant women with HELLP (hemolysis, elevated liver enzyme, and low platelet) syndrome is not well documented yet. This study aims to evaluate serum IL-6 levels between women with HELLP syndrome compared to normotensive pregnant.Methods: The research design was observational cross-sectional study. Samples were recruited consecutively using inclusion and exclusion criteria from emergency department and inpatient wards at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Serum IL-6 were collected from venous blood sample and measured by enzyme-linked immunoassay (ELISA) method. Independent-samples t-test or Mann-Whitney test was used to compare serum IL-6 values between women with HELLP syndrome and normotensive pregrnancy. A statistical measurement conducted using SPSS IBM Statistics 19® and considered significance when p<0,05.Results: There were 46 subjects, consisted of 23 women with HELLP syndrome and 23 women with normotensive pregnancy. Serum IL-6 level was a mean of 0,11±0,08 pg/mL and 0,15±0,20 pg/mL in women with HELLP syndrome compared to normotensive pregnancy respectively. There was no significant statistical difference between both groups (p=0,17).Conclusion:.The result of this study has shown that no significant difference of serum IL-6 level in HELLP syndrome women compared to normotensive pregnant women. 
Co-Authors Alberthzon Kris Silo Rabrageri Anggreany, Kiswa Apriliani, Happy Dwi Ardhanu Kusumanto Arsyad, Nur Rohmah Dewi, Silvy Kusuma Diah Rumekti Hadiati Fadillah Fadillah Fadillah Fadillah Faris, Abdul Ganap, Eugenius Phyowai Ginting, Erwin Hanifah I Titisar Herdhana Suwartono Herdhana Suwartono Ibnu Pranoto Ibnu Pranoto Ibrahim Rahmat Ifrinda Giantari Ifrinda Giantari Intan Titisari Intan Titisari Irwan Taufiqur Rachman Kadek Kurniawan Kadek Kurniawan Kiswa Anggreany Kurniawan, Andrianto Luthfi, Mohammmad Maria Anggraeni Maria Anggraeni MARIA BINTANG Mohammad Hakimi Mohammad Hakimi Mohammmad Luthfi Muhammad Lutfi Mukhoirotin Mukhoirotin Noviana, Fifi Ova Emilia Pietersz, Elsina Krisnawati Rabrageri, Alberthzon Kris Silo Setiyarini, Wahyu Ikka Soejoenoes, Ariawan Soerjo Hadijono Soetrisno Soetrisno Soetrisno Soetrisno Sulchan Sofoewan, Sulchan Taufik Rahman Alkaff Taufik Rahman Alkaff Titisar, Hanifah I Umar Dhani Umar Dhani, Umar Umar Malinta Umar Malinta Wiwik Widyaningsih