Article Per Year (5 Year)
p-Index From 2021 - 2026
1.235
P-Index
This Author published in this journals
All Journal e-CliniC JURNAL BIOMEDIK Jurnal Kedokteran Klinik Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Medical Scope Journal (MSJ) Jurnal Impresi Indonesia Health & Medical Sciences
Erna Suparman
Universitas Sam Ratulangi Manado
Religion Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences

Published : 23 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 7 Documents
Search
Journal : JURNAL BIOMEDIK

 1 
PEMBERIAN PROGESTERON PADA KEGUGURAN BERULANG Suparman, Erna; Suparman, Eddy
Jurnal Biomedik : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2588

Abstract

Abstract: Recurrent pregnancy loss (RPL) occurs in 0.5-1% of partners. The pathophysiology of this RPL is complex. The causes include anatomical, genetic and molecular abnormalities, endocrine disorders, thrombophilia, and the anti-phospholipid syndrome, meanwhile in 50% of cases no cause can be identified. Progesterone is needed to create a suitable environment for the implantation. Low progesterone level during early pregnancy may reflect corpus luteum defects or abnormal products of conception. Besides that, low progesterone is a sign of a coming miscarriage; an administration of progesterone can only delay the onset of bleeding.. Even with a normal plasma progesterone levels, endometrial progesterone deficiency can still result from receptor defects; this finding supports the existence of absolute or relative progessterone deficiency as a cause of spontaneous abortion. Women who suffer from relative progesterone deficiency probably will not get any benefit from progesterone therapy. Almost all current research states that there is no difference in the rates of miscarriages in women treated and not treated with progesterone. Therefore, all medical organizations do not recommend progesterone supplementation to recurrent miscarriage, except in women who use reproductive technologies such as in vitro fertilization (IVF). Keywords: recurrent pregnancy loss, progesterone.     Abstrak: Keguguran berulang terjadi pada 0,5-1% pasangan dengan patofisiologi yang kompleks. Sebagai penyebab ialah kelainan anatomi, genetik dan molekuler, gangguan endokrin, thrombofilia, dan sindrom anti-fosfolipid, tetapi pada 50% kasus tidak jelas. Progesteron sangat diperlukan dalam menciptakan lingkungan yang cocok untuk implantasi endometrium. Konsentrasi progesteron yang rendah selama awal kehamilan mencerminkan defek korpus luteum atau hasil konsepsi yang abnormal. Progesteron yang rendah merupakan tanda dari keguguran akan datang namun pemberian progesteron hanya dapat menunda timbulnya perdarahan. Walaupun tingkat progesteron plasma normal, endometrium masih dapat mengalami kekurangan progesteron akibat defek reseptor. Temuan ini mendukung adanya defisiensi progesteron absolut atau relatif sebagai penyebab keguguran spontan. Wanita yang menderita kekurangan progesteron relatif tidak akan mendapatkan keuntungan dari pemberian progesteron. Hampir semua penelitian saat ini menyatakan bahwa tidak terdapat perbedaan tingkat keguguran pada wanita yang diberikan progesteron dan yang tidak; oleh karena itu semua organisasi medis tidak menganjurkan pemberian progesteron pada keguguran berulang, kecuali pada wanita yang menggunakan teknologi reproduksi seperti IVF. Kata kunci: keguguran berulang, progesteron.
TOKSOPLASMOSIS DALAM KEHAMILAN Suparman, Erna
Jurnal Biomedik : JBM Vol 4, No 1 (2012): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.4.1.2012.744

Abstract

Abstract: Toxoplasmosis in pregnancy causes the Toxoplasma gondii infection in the fetus via the uteroplacental route. There is a very significant positive correlation between the isolation of Toxoplasma from placental tissues and neonatal infection. Laboratory tests commonly performed are anti-Toxoplasma IgG and IgM, and anti-Toxoplasma IgG avidity. Examination should be done in women who are suspected of being infected of Toxoplasma gondii before or during pregnancy, as well as in newborns of mothers infected with Toxoplasma gondii. Food and Drug Administration (FDA) recommends interpreting the results of an anti-Toxoplasma IgM serology test carefully. Doctors can not confirm the diagnosis based solely on one type of toxoplasmosis test. The use of spiramycin during pregnancy causes a decrease in the frequency of vertical transmission. Spiramycin is given to women who are suspected of having acute Toxoplasma infection in the first trimester or in the early second trimester until labor. Spiramycin should not be used as a monotherapy in suspected cases of fetal infection. In pregnant women who have a high likelihood of infection of Toxoplasma gondii or in cases of fetal infection, treatment with spiramycin should include pyrimethamine, sulfadiazine, and folic acid after 18 weeks of gestation.Key words: Toxoplasmosis, pregnancy, fetal infection. Abstrak: Toksoplasmosis dalam kehamilan menyebabkan transmisi Toxoplama gondii melalui sirkulasi uteroplasenta ke janin. Terdapat korelasi positif yang sangat bermakna antara isolasi toksoplasma dari jaringan plasenta dan infeksi neonatus. Pemeriksaan laboratorium yang lazim dilakukan ialah anti toksoplasma IgG dan IgM, serta aviditas anti-Toksoplasma IgG. Pemeriksaan tersebut perlu dilakukan pada ibu yang diduga terinfeksi Toxoplasma gondii sebelum atau selama masa kehamilan, serta pada bayi baru lahir dari ibu yang terinfeksi Toxoplasma gondii. Food and Drug Administration (FDA) merekomendasikan untuk menginterpretasikan hasil tes serologi IgM anti toksoplasma dengan cermat. Para dokter tidak boleh menegakkan diagnosis toksoplasmosis hanya berdasarkan satu jenis pemeriksaan. Penggunaan spiramisin selama kehamilan menyebabkan penurunan frekuensi transmisi vertikal. Spiramisin diberikan pada wanita yang diduga mengalami infeksi toksoplasma akut pada trimester pertama atau awal trimester kedua, dan akan diberikan hingga persalinan. Sebaiknya spiramisin tidak digunakan sebagai menoterapi pada kasus yang diduga terjadi infeksi pada janin. Untuk ibu hamil yang memiliki kemungkinan infeksi yang tinggi atau telah terjadi infeksi janin, pengobatan dengan spiramisin harus dibantu setelah usia kehamilan 18 minggu dengan pirimetamin, sulfadiazin, dan asam folat. Kata kunci: Toksoplasmosis, kehamilan, infeksi fetal.
PERAN ESTROGEN DAN PROGESTERON TERHADAP KANKER PAYUDARA Suparman, Erna; Suparman, Eddy
JURNAL BIOMEDIK : JBM Vol 6, No 3 (2014): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.6.3.2014.6319

Abstract

Abstract: Sex steroid hormones estrogen and progesterone are the main compounds in hormone replacement therapy (HRT). Due to the Woman’s Health Initiative report 2002, the use of these compounds was controversial. It was reported that these hormones increased the risks of stroke, coronary heart disease, venous thromboembolism, and breast cancer, especially if they were used for a long period of time. The role of sex steroid hormones in inducing or promoting breast malignancy is still not clearly understood. Hypothetically, the polymorphism in receptors and steroidogenesis in breast tissues are involved in promoting the proliferation of breast cells that may trigger carcinogenesis. Although there is a significant benefit in administration of HRT for the menopausal women, there are also probable risks due to this therapy. After prolonged debates and controversies about HRT, it is accepted that there is a significant increase in breast cancers due to the use of combined HRT after 3-4 years. Due to the adverse outcome, the use of hormone therapy must start from the lowest dose and for the shortest period of time.Keywords: hormone replacement therapy, estrogen, progesterone, breast cancerAbstrak: Hormon seks steroid estrogen dan progesteron merupakan kandungan utama dari terapi sulih hormone (TSH). Penggunaan kedua hormon tersebut mendatangkan kontroversi setelah Woman’s Health Initiative pada tahun 2002 melaporkan peningkatan risiko stroke, penyakit jantung koroner, venous thromboembolism dan kanker payudara terutama pada penggunaan jangka panjang. Peran hormon steroid seks dalam meningkatkan keganasan payudara belum jelas dipahami. Secara hipotetik, polimorfisme pada reseptor dan kemampuan steroidogenesis dari jaringan payudara berperan dalam meningkatkan proliferasi sel-sel payudara dan memicu karsinogenesis. Meskipun terdapat keuntungan bermakna dari penggunaan TSH pada wanita menopause, namun terdapat juga kemungkinan risiko yang perlu dipertimbangkan. Setelah melalui berbagai perdebatan dan kontroversi mengenai TSH, disepakati bahwa terdapat peningkatan bermakna dari keganasan payudara setelah 3-4 tahun menggunakan TSH kombinasi. Oleh karena efek samping tersebut maka penggunaan TSH harus dimulai dengan dosis yang serendah mungkin dengan durasi pemakaian yang sesingkat-singkatnya.Kata kunci: terapi sulih hormon, estrogen, progesteron, kanker payudara
Amenorea Sekunder: Tinjauan dan Diagnosis Suparman, Erna; Suparman, Eddy
Jurnal Biomedik : JBM Vol 9, No 3 (2017): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.9.3.2017.17335

Abstract

Abstract: Secondary amenorrhea occurs when a woman in reproductive age who has experienced menstruation, at a sudden stops menstruating for at least three consecutive months. The basic principle underlying the physiology of menstrual function is composed of multiple organ systems with their appropriate compartments in which the menstrual cycle depends on, as follows: compartment I, disorders of the uterus; compartment II, disorders of the ovary; compartment III, disorders of the anterior pituitary; and compartment IV, disorders of the central nervous system (hypothalamus). Finding the cause of secondary amenorrhoea can be done by doing some tests or trials. Determination of the location of the specific anatomical defect is useful to obtain appropriate treatment according to the cause of amenorrhea.Keywords: secondary amenorrhoeaAbstrak: Dikatakan amenorea sekunder bila seorang wanita usia reproduktif yang pernah mengalami haid, tiba-tiba haidnya berhenti untuk sedikitnya 3 bulan berturut-turut. Prinsip dasar yang mendasari fisiologi dari fungsi menstruasi memungkinkan penyusunan beberapa sistem kompartemen yang tepat di mana siklus menstruasi bergantung, yaitu: kompartemen I gangguan pada uterus, kompartemen II gangguan pada ovarium, kompartemen III gangguan pada hipofisis anterior, dan kompartemen IV gangguan pada sistem saraf pusat (hipotalamus). Gangguan ini sering berhubungan dengan keadaan stres (wanita pengungsi, dipenjara, hidup dalam ketakutan), atlit wanita, atau anoreksia nervosa dan bulimia. Mencari penyebab amenorea dapat diperoleh dengan melakukan beberapa uji atau percobaan. Penentuan lokasi defek anatomis spesifik sangat bermanfaat untuk mendapatkan penanganan yang sesuai dengan penyebab amenore.Kata kunci: amenorea sekunder
Peran GnRH agonis Suparman, Erna; Suparman, Eddy
Jurnal Biomedik : JBM Vol 8, No 1 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.1.2016.12329

Abstract

Abstract: Gonadotropin Releasing Hormone (GnRH) agonists have a higher biological potential than endogenous GnRH. Administration of a GnRH agonist triggers FSH and LH secretion from the pituitary (flare-up effect), however, after several days pituitary sensitivity continues to decrease which causes decreases of LH, FSH, estrogen, and progesterone (down-regulation). Preoperative administration of GnRH agonists is recommended in uterine fibroid with severe anemia to reduce blood loss before, during, and after surgery. Due to shrinking of fibroid, laparoscopy or laparotomy with Pfannenstiel incision can be performed. Moreover, myomectomy will not require extensive incision, damaged myometrium and adhesion are minimum, therefore, those conditions will increase the success of fertility; facilitate the removal of submucosal fibroid with histeroscopy; and enable the vaginal hysterectomy more easily. In patients with polycystic ovarial syndrome, GnRH agonists will suppress the high levels of LH and testosterone. GnRH agonists halt the growth and reduce the size of an endometriosis, therefore, they can be used in patients with precocious puberty and premenstrual syndrome. The combination of exogenous gonadotropin plus a GnRH agonist used in vitro fertilization is associated with increased pregnancy rate as compared with the use of gonadotropins without a GnRH agonist. The administration of GnRH agonists trigger hypoestrogen that causes osteoporosis and other complaints such as hot flushes, vaginal dryness, headache, and sleep disturbance. GnRH agonists can be combined with low-dose estrogen and progestin (add-back therapy) to reduce these side effects. Addback provision of therapy is started 12 weeks after administration of GnRH agonists.Keywords: GnRH agonist, exogenous gonadotropinAbstrak: GnRH (Gonadotropin Releasing Hormone) agonis memiliki potensi biologis yang lebih tinggi daripada GnRH endogen. Permulaan pemberian GnRH agonis memicu pengeluaran FSH dan LH dari hipofisis (flare-up effect). Setelah beberapa hari sensitivitas hipofisis terhadap rangsangan GnRH agonis terus berkurang yang menyebabkan penurunan LH, FSH, estrogen, dan progesteron (down regulation). Pemberian GnRH agonis preoperatif dianjurkan pada mioma uteri dengan anemia berat untuk mengurangi kehilangan darah sebelum, selama dan setelah operasi. Dengan mengecilnya mioma maka dapat dilakukan tindakan laparoskopi atau laparatomi dengan insisi Pfannenstiel, juga saat miomektomi tidak diperlukan insisi luas, kerusakan miometrium dan perlekatan menjadi minimal sehingga akan meningkatkan keberhasilan fertilitas; mempermudah pengangkatan mioma submukosum dengan histeroskopi; dan mempermudah melakukan vaginal histerektomi. GnRH agonis pada pasien sindroma ovarium polikistik akan menekan tingginya kadar LH dan produksi testosteron. GnRH agonis menghentikan pertumbuhan dan mengurangi ukuran endometriosis, selain itu GnRH agonis dapat digunakan pada pasien dengan pubertas prekok dan sindroma premenstrual. Pada fertilisasi in vitro penggunaan kombinasi gonadotropin eksogen ditambah GnRH agonis berhubungan dengan peningkatan keberhasilan kehamilan dibandingkan dengan penggunaan gonadotropin tanpa GnRH agonis. Pemberian GnRH agonis memicu keadaan hipoestrogen yang menyebabkan osteoporosis dan keluhan lain seperti hot flushes, vagina yang kering, sakit kepala, dan gangguan tidur. GnRH agonis dapat dikombinasi dengan estrogen dosis rendah dan progestin (add-back therapy) untuk mengurangi efek samping tersebut. Pemberian addback therapy ini dimulai 12 minggu setelah pemberian GnRH agonis.Kata kunci: GnRH agonis, gonadotropin eksogen
PENATALAKSANAAN ENDOMETRIOSIS Suparman, Erna
Jurnal Biomedik : JBM Vol 4, No 2 (2012): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.4.2.2012.754

Abstract

Abstract: Endometriosis is characterized by the occurence of endometrial cells outside the uterine cavity. Endometrial tissue in the pelvic cavity increases the activity of macrophages to phagocyte endometrial tissue debris and influences intrauterine implantation. Bleeding, arising from endometriosis lesions, will lead to adhesions with surrounding tissues, resulting in changes of tubal motility, pain, and infertility. Laparoscopy examination is necessary for confirming the diagnosis. While transvaginal ultrasound is famous for its accuracy, it provides just a little help for finding cystic masses in the parametrium. Nowadays, the treatment of endometriosis with estrogen is begining to be abandoned because it may cause endometrial hyperplasia that can develop into endometrial cancer. Albeit, danazol treatment succeeds due to its hormonal and immunologic effects. The first-line of therapy given for reducing pelvic pain is NSAIDs or oral contraceptives. If this fails, a GnRH agonist is given in combination with estrogen and progestin as an add-back therapy, otherwise an operative laparoscopy has to be done. Concerning the degree of severe and extensive endometriosis, atraumatic surgery is the main option. The induction of ovulation shows a satisfactory result. Randomized trials using the GnRH agonist administration associated with the hormones (FSH and LH), clomiphene citrate, and intrauterine insemination, showed an increased incidence of pregnancy compared to those without therapy.Key words: endometriosis, hormones, pain, infertilityAbstrak: Endometriosis ditandai adanya sel-sel endometrium di luar kavum uteri. Jaringan endometrium di dalam rongga pelvis akan meningkatkan aktifitas makrofag untuk memfagositosis debris jaringan endometriosis serta mempengaruhi nidasi intrauterin. Perdarahan yang timbul dari lesi endometriosis akan menyebabkan perlekatan dengan jaringan sekitarnya, yang berakibat perubahan motilitas tuba, nyeri, dan infertilitas. Laparoskopi sangat diperlukan untuk diagnosis endometriosis. USG transvaginal yang tersohor karena akurasinya hanya sedikit membantu menemukan lesi di daerah parametrium. Dewasa ini, pengobatan endometriosis dengan estrogen mulai ditinggalkan karena mengakibatkan hiperplasia endometrium yang dapat berkembang menjadi kanker endometrium. Keberhasilan pengobatan dengan danazol disebabkan karena efek hormonal dan imunologiknya. Terapi lini pertama pada nyeri pelvis ialah NSAID atau kontrasepsi oral. Bila gagal, diberikan agonis GnRH dikombinasi dengan estrogen dan progestin add-back therapy, atau laparoskopi operatif. Pada endometriosis derajat berat dan luas, pembedahan atraumatik merupakan pilihan utama. Induksi ovulasi memberikan hasil yang cukup memuaskan. Randomized trials pada pemberian GnRH agonis dengan hormon FSH dan LH, clomifen sitrat, serta inseminasi intrauterin, memperlihatkan peningkatan angka kehamilan dibandingkan pada yang tanpa terapi.Kata kunci: endometriosis, hormon, nyeri, infertilitas
Bicornuate Uterus with Previous C-Section: A Case Report Suparman, Erna
Jurnal Biomedik : JBM Vol 13, No 3 (2021): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.v13i3.36695

Abstract

Abstract: Bicornuate uterus is a type of Mullerian duct malformation caused by incomplete fusion of fundal uterine cornu that leads to two connected uterine cavities and one cervix. The incidence of bicornuate uterus is estimated to be 0.1-0.6% and it is believed to account for 10% of all uterine anomalies. We reported a case of bicornuate uterus with previous cesarean sections in an expecting mother presented in labor during her 38-39 weeks of pregnancy. She had a history of two previous cesarean sections. Based on physical examination and transabdominal USG, the fetus was found in breech presentation. She was managed with another cesarean section. During the operation it was found that she had a bicornuate uterus. The main problems for this case were pregnancy with bad obstetric history, previous cesarean sections, breech presentation, and complications that could occur in future pregnancy. The patient was presented already in labor, so she was managed with emergency cesarean section to reduce the risk of uterine rupture. During the operation, she was found to have a bicornuate uterus. This proved that the cause of repeated breech presentation was one of the complications that could occur in pregnancy with bicornuate uterus. The most ideal management for this patient was elective cesarean section. In conclusion, uterine abnormalities are accompanied with uneventful outcomes such as preterm labour, fetal malpresentations, and even perinatal mortality. However, these anomalies may not be suspected before the occurrence of abortion or its complications. A high index of suspicion is needed to diagnose uterine abnormalities before the occurence of its complicationsKeywords: bicornuate uterus; breech presentation; pregnancy; Mullerian duct anomalies
Co-Authors Ar-Rakhimi, Lintang Eddy Suparman Edwin Lasut Frank M. M. Wagey, Frank M. M. Freddy W. Wagey Hermie M. M. Tendean John J. E. Wantania, John J. E. Juneke J. Kaeng Kaeng, Juneke J Laihad, Joel Bismarck Larumpaa, Florensia S. Matricia Delaros G. Silinaung, Matricia Delaros G. Max Rarung Maya Mewengkang Palinoan, Meynita Patricia C. Warouw, Patricia C. Pawa, Alif F. Potes, Velisitas Ana Maria Prasetyo, Ananto Rudy Lengkong Tiara Faradita Rahim, Tiara Faradita Togu, Maulana Wantania, John J E Wongkaren, Brenda