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How Long is the Safest InterDelivery Interval in Women with Previous History of Cesarean Delivery? Santoso, Budi I; Surya, Raymond; Firdaus, Karina K; Hakim, Surahman
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

  Objective: To investigate the association between interdelivery interval and uterine rupture in women with previous CD.   Methods: The formulation question was how long is the safest interdeliveryinterval to minimalize the risk of uterine rupture. Theauthors investigated in three databases including Pubmed,Cochrane, and Embase database. Inclusion criteria wereabstract answering the clinical question, written in Englishlanguage, and full-text paper availability.   Results: One systematic review, six cohort studies, and 1 casecontrolstudy were collected to compare the inter-pregnancyinterval to the risk of uterine rupture. The author retrievedseven articles suitable to the inclusion criteria after excluding tenarticles screened by the abstract and language. Then, the authoradded one article used in the systematic review. Hence, the criticalappraisal based on Validity, Importance, and Applicability (VIA)was performed for eight articles.   Conclusion: The inter-delivery interval 18 months is the safest time to avoid uterine rupture. Prostaglandin analogue induction should be avoided and for patients with a history of past cesarean using a single-layer closure to be educated about the increased risk. Keywords: cesarean delivery, inter-delivery interval, uterine rupture,vaginal birth after cesarean delivery

How Long is the Safest InterDelivery Interval in Women with Previous History of Cesarean Delivery? Santoso, Budi I; Surya, Raymond; Firdaus, Karina K; Hakim, Surahman
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

  Objective: To investigate the association between interdelivery interval and uterine rupture in women with previous CD.   Methods: The formulation question was how long is the safest interdeliveryinterval to minimalize the risk of uterine rupture. Theauthors investigated in three databases including Pubmed,Cochrane, and Embase database. Inclusion criteria wereabstract answering the clinical question, written in Englishlanguage, and full-text paper availability.   Results: One systematic review, six cohort studies, and 1 casecontrolstudy were collected to compare the inter-pregnancyinterval to the risk of uterine rupture. The author retrievedseven articles suitable to the inclusion criteria after excluding tenarticles screened by the abstract and language. Then, the authoradded one article used in the systematic review. Hence, the criticalappraisal based on Validity, Importance, and Applicability (VIA)was performed for eight articles.   Conclusion: The inter-delivery interval 18 months is the safest time to avoid uterine rupture. Prostaglandin analogue induction should be avoided and for patients with a history of past cesarean using a single-layer closure to be educated about the increased risk. Keywords: cesarean delivery, inter-delivery interval, uterine rupture,vaginal birth after cesarean delivery

Antenatal Care for High Risk Pregnancy Sungkar, Ali; Surya, Raymond
Cermin Dunia Kedokteran Vol 47, No 10 (2020): Optalmologi
Publisher : PT. Kalbe Farma Tbk.

Despite 38% gradual fall since 2000, there was still approximately 295,000 women died during and following pregnancy and childbirth in 2017. Factors that lead to high maternal mortality include inequality access to health service, severe bleeding (mostly postpartum hemorrhage), infection, high blood pressure during pregnancy, complication from delivery, and unsafe abortion. These deaths are correlated to delay in decision to seek care, delay in reaching care, delay in receiving adequate health care. Improvement of antenatal care was the solution to this problem. Indonesia has not updated to the newest model of WHO antenatal care in 2016. Defining high-risk and updating the model can help Indonesia provides excellent care for mothers and reduce maternal deaths.Meskipun terdapat penurunan angka kematian ibu (AKI) sebesar 38% sejak tahun 2000, 295.000 wanita meninggal peripartum pada tahun 2017. Faktor yang menyebabkan AKI di antaranya tidak meratanya akses pelayanan kesehatan, perdarahan berat, infeksi, tekanan darah tinggi selama kehamilan, komplikasi persalinan, dan aborsi tidak aman. Kematian ini terkait dengan keterlambatan keputusan untuk merujuk, keterlambatan untuk mencapai tempat rujukan, dan keterlambatan mendapatkan tatalaksana yang baik. Hingga saat ini, Indonesia belum mengikuti panduan kunjungan antenatal terbaru dari WHO tahun 2016. Mendefinisikan kehamilan risiko tinggi dan penyesuaian model kunjungan antenatal diharapkan dapat memberikan perawatan yang baik bagi ibu dan menurunkan kematian maternal.Â

Skoring Prognosis Tetanus Generalisata pada Pasien Dewasa Surya, Raymond
Cermin Dunia Kedokteran Vol 43, No 3 (2016): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Latar Belakang: Tetanus merupakan penyakit toksemia akut yang disebabkan oleh tetanospasmin bakteri Clostridium tetani. Luaran tetanus dinilai berdasarkan Phillips score ataupun Dakar score. Pada laporan kasus ini akan dilakukan perbandingan skoring prognosis yang lebih baru, yaitu Tetanus Severity Score (TTS), dengan yang telah diakui sebelumnya. Laporan kasus: Seorang laki-laki 65 tahun datang dengan keluhan mulut terasa kaku, tidak dapat dibuka, nyeri tenggorokan, sulit menelan, perut terasa tegang, nyeri punggung dan pinggang, sulit berjalan serta lemas sejak 2 hari sebelum masuk rumah sakit (RS). Pasien memiliki riwayat tertusuk kayu yang diobati secara tradisional. Tidak ada riwayat imunisasi tetanus dalam 10 tahun terakhir. Pada pemeriksaan fisik didapat luka berbentuk garis pada telapak kaki kiri. Didapatkan meningismus, risus sardonikus, trismus Â½ cm, rigiditas otot perut (perut papan), opistotonus, serta uji spatula positif. Pasien ditatalaksana dengan infus NaCl 0,9%, D5%, diazepam drip, imunoglobulin, ceftriaxone, metronidazole, serta rawat luka. Prognosis pasien berdasarkan Phillips score ialah 16 sesuai dengan severitas sedang, Dakar score 1 sesuai dengan severitas ringan (mortalitas 10%). Pada TSS didapatkan skor 2 dengan mortalitas risiko rendah (6,3%). Skoring prognosis TSS memberikan hasil serupa dengan dua skoring sebelumnya. Simpulan: Skoring prognosis TSS dapat diaplikasikan pada pusat layanan kesehatan dengan fasilitas terbatas.

Pengaruh Infeksi Malaria Vivax pada Kehamilan Surya, Raymond
Cermin Dunia Kedokteran Vol 43, No 12 (2016): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Latar Belakang: Malaria merupakan salah satu masalah kesehatan masyarakat yang menyebabkan kematian terutama pada kelompok risiko tinggi yaitu bayi, anak balita, ibu hamil. Malaria pada kehamilan meningkatkan risiko kematian janin karena restriksi pertumbuhan fetus, prematuritas, berat badan lahir rendah (BBLR), dan anemia maternal. Laporan kasus ini akan membahas kontribusi infeksi malaria vivax pada kehamilan terhadap luaran neonatus. Laporan kasus: Wanita 30 tahun, G2P0A1 usia kehamilan 39-40 minggu dengan keluhan keluar darah pervaginam, riwayat anemia sepanjang kehamilan. Pasien dua kali menderita malaria vivax dan mendapat dihidroartemisin-piperakuin. Lahir bayi perempuan, spontan, Apgar Score (AS) 8/9/10, dengan berat badan 2100 g, panjang badan 49 cm, lingkar kepala 31 cm, lingkar dada 30 cm. Simpulan: Berat badan lahir rendah (BBLR) dikaitkan dengan infeksi malaria vivax saat kehamilan yang diperparah oleh anemia. Profilaksis intermiten sulfadoksin pirimetamin pada kehamilan sebaiknya dianjurkan pada daerah endemis malaria.Background: Malaria is one of the public health problems which contributes to mortality especially in high risk groups. Malaria in pregnancy increases fetal death risk due to fetal growth restriction (FGR), prematurity, low birth weight, and maternal anemia. This report discusses the impact of P.vivax infection in pregnancy to neonates outcome. Case : A 30 year-old woman, G2P0A1 39-40 weeks of gestation, came with vaginal bleeding. During pregnancy, she had malaria vivax infection twice and got dihydroartemisinin-piperaquine regimen. She was anemic. She delivered spontaneously a female baby with birthweight 2100 g, length 49 cm, head circumference 31 cm, chest circumference 30 cm, and APGAR score 8/9/10. Conclusion: Factors contributed to low birth weight are malaria during pregnancy and maternal anemia. Intermittent preventive treatment with sulfadoxin-pirimetamine should be implemented for pregnant women in malaria-endemic areas.

Kontroversi Persalinan Spontan pada Miopia Tinggi Iskandar, Ferdy; Surya, Raymond; Sungkar, Ali; Debby Anggriany, Friska
Cermin Dunia Kedokteran Vol 47, No 12 (2020): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Gangguan refraksi khususnya miopia tinggi pada wanita hamil sering dikaitkan dengan kejadian ablasio retina pasca-persalinan, sehingga persalinan per abdominam atau bantuan instrumen cenderung direkomendasikan pada wanita hamil dengan miopia tinggi. Padahal, indikasi persalinan per abdominam pada miopia tinggi adalah adanya neovaskularisasi koroid dan subretinal (dengan bintik Fuchs). Hingga saat ini belum didapatkan bukti bahwa miopia tinggi dan riwayat operasi retina sebelumnya meningkatkan risiko ablasio retina saat persalinan per vaginam.Refractive disorders, especially high myopia in pregnant women are often associated with postpartum retinal detachment, thus there is a tendency to recommend cesarean section or instrument-assisted labor in pregnant women with high myopia. In fact, the indications for cesarean section in patients with high myopia are choroidal and subretinal neovascularization (with Fuchs spots). There is no evidence of increased risk of retinal detachment during vaginal delivery in high myopia and previous history of retinal surgery.

Obesity and Endometrial Cancer: Mechanism and How to Deal with? Dewi Anggraeni, Tricia; Surya, Raymond; Pratama Kurniawan, Andrew
Cermin Dunia Kedokteran Vol 48, No 6 (2021): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Obesity is strongly associated with development of endometrial cancer more than any other cancer type. The relationship between obesity and endometrial cancer risk is combination of inflammation, insulin resistance, and increased bioavailability of estrogen. Obesity can increase risk to develop endometrial cancer as exogenous estrogen has impact for tumorigenesis. The best method to reduce the risk of endometrial cancer in obese women is through progesterone medication and lifestyle intervention.Obesitas erat kaitannya dengan terjadinya kanker endometrium lebih dari jenis kanker lainnya. Hubungan antara obesitas dan risiko kanker endometrium adalah kombinasi antara inflamasi, resistensi insulin, dan peningkatan bioavailabilitas estrogen. Obesitas dapat meningkatkan risiko terjadinya kanker endometrium karena estrogen eksogen berdampak pada tumorigenesis. Metode terbaik untuk mengurangi risiko kanker endometrium pada wanita yang obese adalah melalui pengobatan progesteron dan intervensi gaya hidup. Tricia

Preeklamsia: Pencegahan hingga Pengelolaan Berbasis Bukti Surya, Raymond; Irwinda, Rima; Sungkar, Ali
Cermin Dunia Kedokteran Vol 46, No 1 (2019): Obstetri - Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Mekanisme pasti preeklamsia masih tidak diketahui, sering dikaitkan dengan faktor imunologi, genetik, kerentanan terhadap sindrom metabolik, inflamasi/infeksi kronik, hipertensi sebelumnya, penyakit ginjal kronik. Uji prediksi preeklamsia dapat dilakukan dengan melihat faktor risiko demografi, penemuan biofisik, ataupun kombinasi keduanya. Pencegahan preeklamsia di antaranya aspirin dosis rendah pada populasi risiko tinggi dan suplementasi kalsium pada populasi rendah asupan kalsium. Penatalaksanaan preeklamsia yang baik terdiri dari antihipertensi, magnesium sulfat, kortikosteroid, penentuan saat terminasi kehamilan, hingga metode persalinan.The exact mechanism of preeclampsia is unknown; it is associated with immunological, genetic factor, susceptibility to metabolic syndrome, chronic inflammation/infection, history of previous hypertension, and chronic renal disease. Preeclampsia prediction test can be conducted through demographic risk factors, biophysical findings, or both. The prevention measures include low dose aspirin in high risk population and calcium supplementation in low calcium intake population. Good management of preeclampsia consists of antihypertensive, magnesium sulphate, corticosteroid, pregnancy termination, and delivery methods.

Trace elements in maternal serum and their relationships with preterm birth and fetal growth restriction Irwinda, Rima; Sungkar, Ali; Surya, Raymond; Guinto, Valerie Tiempo
Makara Journal of Health Research Vol. 24, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Preterm birth (PTB) and fetal growth restriction (FGR) contribute to high hospital costs. An imbalance in the concentration of the four trace elements (i.e., copper, zinc, iron, and calcium) was shown to be associated with complications during pregnancy. This study aimed to analyze the role of these trace elements in the occurrence of PTB and FGR. Methods: A search was conducted in PubMed, Cochrane Library, and Ovid. The articles were filtered based on the inclusion and exclusion criteria, and further screening was based on the association of articles with the clinical question. The risk of bias in each of the studies was assessed using the Cochrane risk of bias table. Forrest plots were created and analyzed using Review Manager 5.3e. Results: Three studies were included in the risk of bias assessment and meta-analysis. Maternal serum levels of copper and iron were lower in the FGR group (p < 0.05), while copper, zinc, iron, and calcium were lower in the PTB group (p < 0.05). The included studies had a low degree of homogeneity (I2 < 50%). Conclusion: Maternal iron deficiency was associated with FGR, while low levels of the trace elements copper, zinc, iron, and calcium were associated with PTB.

Complicated vivax malaria in pregnancy: A case report in rural area of Indonesia Surya, Raymond; Manurung, Edward Sugito; Saroyo, Yudianto Budi
Majalah Obstetri & Ginekologi Vol. 31 No. 3 (2023): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V31I32023.162-166

HIGHLIGHTS In malaria endemic area, pregnant women are highly prone to suffer from malaria infection. Vivax malaria in pregnancy can contribute to anemia and preterm delivery. ABSTRACT Objective: This study aimed to report a preterm delivery and anemia as part of P. vivax malaria infection complications in a pregnant woman in Timor Tengah Selatan regency, East Nusa Tenggara, Indonesia. Case report: A 42-year-old pregnant woman, gravida 6 para 5,36-week of gestational age pregnant woman came with complaints of water breaking since one day before admission. She had fever with chills for three days, especially at night along with muscle, headache, joint soreness, dizziness, and palpitations. Rapid diagnostic test for malaria showed positive result. Peripheral blood smear examination revealed microcytic hypochromic due to iron deficiency or chronic infection and presence of trophozoites-ring form of P. vivax with 4,235 parasitemia. A baby boy was born with weight of 2,470 grams (percentile 28%), fetal head 31 cm (percentile 13%), birth length 43 cm (percentile 4%), and Apgar Score (AS) 8 and 9 at 1 and 5 minutes, respectively. The treatment was provided according to anti-malarial guideline in Indonesia using dihydroartemisin 120 mg and piperaquine phosphate 960 mg fixed dose as DHP for 3 days and primaquine 15 mg for 14 days. Conclusion: Anemia as part of vivax malaria complication in pregnancy contributes to preterm delivery.

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