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Sulchan Sofoewan Sulchan Sofoewan
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Full term premature rupture of the membrane (PROM): Active management (AM) vs conservative management (CM) Sulchan Sofoewan, Sulchan Sofoewan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 31, No 02 (1999)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (119.963 KB)

Abstract

Background: The management of premature rupture of the membrane (PROM) is one of the most controversial areas in obstetrics. In the case of full term PROM, the obstetrician is often faced with either immediate induction of labor with higher incidence of caesarean section or awaiting spontaneous labor with higher incidence of chorioamnionitis.Objective: To compare pregnancy outcomes between active management (AM) and conservative management (CM) in full term PROM.Methods: The study was carried out in randomized controlled trial at the Department of Obstetrics and Gynecology, Faculty of Medicine, Gadjah Mada University/Sardjito Hospital Yogyakarta. Sixty full term PROM cases admitted to the hospital between July-December 1994 were randomly allocated into AM (n=30) and CM (n=30).Results: Caesarean section rate due to the failure of induction among AM group was significantly higher than those in CM group (p= 0.03). Maternal and perinatal infection were not statistically significant (p>0.50). The total number of newborn babies with asphyxia was higher in AM group but no statistical significant difference was found (p> 0.50).Conclusion: The conservative management of full term PROM was better compared to active management, especially when the outcome is caesarean section rate due to the failure of induction:Key words: PROM - active management - conservative management.
Biophysical vs hormonal assessment in the detection of fetal distress Sulchan Sofoewan, Sulchan Sofoewan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 28, No 04 (1996)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (118.311 KB)

Abstract

Fetal monitoring was carried out in 63 high risk pregnancies at Dr. Sardjito Hospital. Cardiotocographic examination (CTG) was used to evaluate 20 patients, and biochemical fetoplacental test. Urinary estriol (E3) and serum hPL were used to evaluate 43 patients. There were patients with postterm, preeciampsia, eclampsia and prolonged labor. Diagnostic test to predict fetal distress was analyzed for both CTG and biochemical test. CTG had a sensitivity of 87.5%, specificity of 58.3%, and accuracy of 70%. Urinary estriol level had a sensitivity of 25%, specificity of 89.7% and accuracy of 83.7%. The sensitivity, specificity and accuracy of serum hPL level were 25%, 92.3%, and 86%, respectively. There was correlation between relative birth weight and serum hPL level (r-z 0,3363), relative birth weight and urinary estriol (r=0.3427).Biophysical assessment Is more favourable compared to hormonal measurement in the detection of fetal distress.Key words: biophysical - hormonal assessment - fetal distress
Perinatal mortality in breech deliveries at Dr. Said%ito General Hospital, Yogyakarta Sulchan Sofoewan, Sulchan Sofoewan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 29, No 01 (1997)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (116.246 KB)

Abstract

Breech delivery is still of importance to discuss, because perinatal morbidity and mortility are higher than those vertex deliveries. A retrospective study was carried out on 141 cases of breech deliveries in Dr. Sardjito General Hospital during 1989 - 1990. The highest perinatal mortality was due to low birth weight: 17 cases (12%) compared to all cases (4.2%). No perinatal mortality of multiparity cases was found compared with cases of nulliparity i.e. 13 cases (17.0%). The type of breech presentation were frank breech: 85 cases (60.3%); incomplete: 21 cases (14.9%) and complete: 35 cases (24.8%). The highest perinatal mortality was frank breech presentation: 15 cases (17.6%). According to the termination of delivery, breech extraction has the highest perinatal mortality (23.%).Key Words: breech presentation - parity - perinatal - morbidity - mortality
Full term premature rupture of the membrane (PROM): Active management (AM) vs conservative management (CM) Sulchan Sofoewan Sulchan Sofoewan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 31, No 02 (1999)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (119.963 KB)

Abstract

Background: The management of premature rupture of the membrane (PROM) is one of the most controversial areas in obstetrics. In the case of full term PROM, the obstetrician is often faced with either immediate induction of labor with higher incidence of caesarean section or awaiting spontaneous labor with higher incidence of chorioamnionitis.Objective: To compare pregnancy outcomes between active management (AM) and conservative management (CM) in full term PROM.Methods: The study was carried out in randomized controlled trial at the Department of Obstetrics and Gynecology, Faculty of Medicine, Gadjah Mada University/Sardjito Hospital Yogyakarta. Sixty full term PROM cases admitted to the hospital between July-December 1994 were randomly allocated into AM (n=30) and CM (n=30).Results: Caesarean section rate due to the failure of induction among AM group was significantly higher than those in CM group (p= 0.03). Maternal and perinatal infection were not statistically significant (p>0.50). The total number of newborn babies with asphyxia was higher in AM group but no statistical significant difference was found (p> 0.50).Conclusion: The conservative management of full term PROM was better compared to active management, especially when the outcome is caesarean section rate due to the failure of induction:Key words: PROM - active management - conservative management.
Perinatal mortality in breech deliveries at Dr. Said%ito General Hospital, Yogyakarta Sulchan Sofoewan Sulchan Sofoewan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 29, No 01 (1997)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (116.246 KB)

Abstract

Breech delivery is still of importance to discuss, because perinatal morbidity and mortility are higher than those vertex deliveries. A retrospective study was carried out on 141 cases of breech deliveries in Dr. Sardjito General Hospital during 1989 - 1990. The highest perinatal mortality was due to low birth weight: 17 cases (12%) compared to all cases (4.2%). No perinatal mortality of multiparity cases was found compared with cases of nulliparity i.e. 13 cases (17.0%). The type of breech presentation were frank breech: 85 cases (60.3%); incomplete: 21 cases (14.9%) and complete: 35 cases (24.8%). The highest perinatal mortality was frank breech presentation: 15 cases (17.6%). According to the termination of delivery, breech extraction has the highest perinatal mortality (23.%).Key Words: breech presentation - parity - perinatal - morbidity - mortality
Biophysical vs hormonal assessment in the detection of fetal distress Sulchan Sofoewan Sulchan Sofoewan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 28, No 04 (1996)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (118.311 KB)

Abstract

Fetal monitoring was carried out in 63 high risk pregnancies at Dr. Sardjito Hospital. Cardiotocographic examination (CTG) was used to evaluate 20 patients, and biochemical fetoplacental test. Urinary estriol (E3) and serum hPL were used to evaluate 43 patients. There were patients with postterm, preeciampsia, eclampsia and prolonged labor. Diagnostic test to predict fetal distress was analyzed for both CTG and biochemical test. CTG had a sensitivity of 87.5%, specificity of 58.3%, and accuracy of 70%. Urinary estriol level had a sensitivity of 25%, specificity of 89.7% and accuracy of 83.7%. The sensitivity, specificity and accuracy of serum hPL level were 25%, 92.3%, and 86%, respectively. There was correlation between relative birth weight and serum hPL level (r-z 0,3363), relative birth weight and urinary estriol (r=0.3427).Biophysical assessment Is more favourable compared to hormonal measurement in the detection of fetal distress.Key words: biophysical - hormonal assessment - fetal distress
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