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Hang-up IUD, New Technique for Suturing CuT-380A IUD to Uterine Fundus in Immediate Postplacental Insertion during Cesarean Delivery: Twelve Months Follow up Tjahjanto, Hary
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 3, July 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (19.045 KB)

Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at 12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. [Indones J Obstet Gynecol 2014; 2-31: 132-139] Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion

Hang-up IUD, New Technique for Suturing CuT-380A IUD to Uterine Fundus in Immediate Postplacental Insertion during Cesarean Delivery: Twelve Months Follow up Tjahjanto, Hary; Haryuni, Indah T
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 3, July 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at 12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. [Indones J Obstet Gynecol 2014; 2-31: 132-139] Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion

Modification of Immediate Postplacenta CuT-380A IUD Insertion Using Ring Forceps and Standard Inserter: Twelve Months Follow-up Tjahjanto, Hary; Hadiningrat, Wijoyo
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the outcome of CuT-380A IUD postplacental insertion in vaginal delivery using new modification insertion technique. Method: We carried out a prospective cohort study of postplacental IUD insertion by means of ’push and push’ technique, using ring forceps and standard inserter (inserter tube and plunger rod). We included women who underwent vaginal delivery from 1st June 2009 until 31st March 2011 and had postplacental IUD insertion. Followup was conducted for 12 months, including history, physical examination, ultrasound and questionnaires during evaluation, through home visits and by phone. The first monitoring is before 6 weeks after delivery, the second monitoring was after 6 weeks up to 3 months, the third is after 3 months up to 6 months, the fourth is after 6 months up to 12 months, the fifth is after 12 months up to 24 months and the sixth is after 24 months up to 32 months after insertion. Result: On the second monitoring, 2 acceptors experienced expulsion. At the third monitoring period, one acceptor requested for IUD removal. At 9 months up to 12 months post-insertion, one expulsion was encountered, and one acceptor requested removal of device. At ≥12 months there was one acceptor who had IUD removal. We did not find any report of unintended pregnancy or perforation. Conclusion: Immediate post-placental insertion of CuT-380A IUD after vaginal delivery using ’push and push’ technique is safe and effective. The pregnancy rate at typical use is 0%, continuation rate is 94.1% and low expulsion rate (2.86%). Loss of follow up was 5.6% and no perforation was reported. Keywords: continuation rate, immediate post-placental IUD insertion, ’push and push’ technique, typical use, vaginal delivery

Postplacental IUD Insertion Using Ring Forceps versus Push and Push Technique Tjahjanto, Hary; Rizal, Rahmad
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare IUD-endometrium (ED) distance and the incident of malposition postplacental CuT-380A IUD insertion in vaginal delivery between ring forceps technique and push and push technique. Method: This study was a double-blind randomized control trial, performed in September 2014 until March 2015 at Dr. Kariadi Hospital. Ring forceps and push and push insertion technique groups consisted of 25 subjects in each group. Follow-up was performed at 1-2 weeks, 6-8 weeks and >12 weeks after insertion. Result: The mean of IUD-ED distance in push and push group was shorter (but not statistically significant) than ring forceps group. The IUD-ED distance was at 1-2-week follow-up 4.1 (2.2) vs. 4.9 (3.4) mm; p=0.208, at 6-8-week follow-up: 2.6 (1.8) vs. 3.2 (3.7) mm; p=0.452, and at > 12-week follow-up: 0.9 (0.8) vs. 1.0 (0.9) mm; p=0.427, respectively. Malposition was found in 1-2-week follow-up, but the IUD was changed to the normal position (sagital position in uterine fundus) at 6-8-week and >12-week follow-up. Up to 3 months of follow-up, there was no occurrence of perforation, expulsion or pregnancy in both groups. Most of subjects (56% in the ring forceps, 68% in push and push groups) did not feel painful during IUD insertion. Conclusion: Push and push insertion technique clinically tends to produce IUD-ED distance shorter than ring forceps technique. Both techniques are comfortable, safe and effective. [Indones J Obstet Gynecol 2016; 4-2: 78-87] Keywords: immediate postplacental IUD insertion technique, IUDendometrium distance, IUD malposition, push and push technique, ring forceps technique

Hang-up IUD, New Technique for Suturing CuT-380A IUD to Uterine Fundus in Immediate Postplacental Insertion during Cesarean Delivery: Twelve Months Follow up Tjahjanto, Hary; Haryuni, Indah T
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 3, July 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at 12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. [Indones J Obstet Gynecol 2014; 2-31: 132-139] Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion

Modification of Immediate Postplacenta CuT-380A IUD Insertion Using Ring Forceps and Standard Inserter: Twelve Months Follow-up Tjahjanto, Hary; Hadiningrat, Wijoyo
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the outcome of CuT-380A IUD postplacental insertion in vaginal delivery using new modification insertion technique. Method: We carried out a prospective cohort study of postplacental IUD insertion by means of ’push and push’ technique, using ring forceps and standard inserter (inserter tube and plunger rod). We included women who underwent vaginal delivery from 1st June 2009 until 31st March 2011 and had postplacental IUD insertion. Followup was conducted for 12 months, including history, physical examination, ultrasound and questionnaires during evaluation, through home visits and by phone. The first monitoring is before 6 weeks after delivery, the second monitoring was after 6 weeks up to 3 months, the third is after 3 months up to 6 months, the fourth is after 6 months up to 12 months, the fifth is after 12 months up to 24 months and the sixth is after 24 months up to 32 months after insertion. Result: On the second monitoring, 2 acceptors experienced expulsion. At the third monitoring period, one acceptor requested for IUD removal. At 9 months up to 12 months post-insertion, one expulsion was encountered, and one acceptor requested removal of device. At ≥12 months there was one acceptor who had IUD removal. We did not find any report of unintended pregnancy or perforation. Conclusion: Immediate post-placental insertion of CuT-380A IUD after vaginal delivery using ’push and push’ technique is safe and effective. The pregnancy rate at typical use is 0%, continuation rate is 94.1% and low expulsion rate (2.86%). Loss of follow up was 5.6% and no perforation was reported. Keywords: continuation rate, immediate post-placental IUD insertion, ’push and push’ technique, typical use, vaginal delivery

Postplacental IUD Insertion Using Ring Forceps versus Push and Push Technique Tjahjanto, Hary; Rizal, Rahmad
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare IUD-endometrium (ED) distance and the incident of malposition postplacental CuT-380A IUD insertion in vaginal delivery between ring forceps technique and push and push technique. Method: This study was a double-blind randomized control trial, performed in September 2014 until March 2015 at Dr. Kariadi Hospital. Ring forceps and push and push insertion technique groups consisted of 25 subjects in each group. Follow-up was performed at 1-2 weeks, 6-8 weeks and >12 weeks after insertion. Result: The mean of IUD-ED distance in push and push group was shorter (but not statistically significant) than ring forceps group. The IUD-ED distance was at 1-2-week follow-up 4.1 (2.2) vs. 4.9 (3.4) mm; p=0.208, at 6-8-week follow-up: 2.6 (1.8) vs. 3.2 (3.7) mm; p=0.452, and at > 12-week follow-up: 0.9 (0.8) vs. 1.0 (0.9) mm; p=0.427, respectively. Malposition was found in 1-2-week follow-up, but the IUD was changed to the normal position (sagital position in uterine fundus) at 6-8-week and >12-week follow-up. Up to 3 months of follow-up, there was no occurrence of perforation, expulsion or pregnancy in both groups. Most of subjects (56% in the ring forceps, 68% in push and push groups) did not feel painful during IUD insertion. Conclusion: Push and push insertion technique clinically tends to produce IUD-ED distance shorter than ring forceps technique. Both techniques are comfortable, safe and effective. [Indones J Obstet Gynecol 2016; 4-2: 78-87] Keywords: immediate postplacental IUD insertion technique, IUDendometrium distance, IUD malposition, push and push technique, ring forceps technique

Correlation between referral type (emergency vs scheduled) and maternal perinatal outcome in suspected placenta accreta spectrum : a retrospective cohort study in Dr.Kariadi hospital Semarang 2020-2023 Umami, Hayyina Maslikhatul; Cahyanti , Ratnasari Dwi; Tjahjanto, Hary; Hadijono, Soerjo; Dewantiningrum, Julian; Putra, Very Great Eka
Medica Hospitalia : Journal of Clinical Medicine Vol. 13 No. 1 (2026): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v13i1.1366

BACKGROUND : Maternal Mortality Rate (MMR) in Indonesia at 2023 was 189 over 100.000 live births. The most popular reason for maternal death was obstetrics hemorrhage. Obstetric hemorrhage can be caused by abnormal placentation. Abdominal delivery by cesarean section has increased recently in Indonesia. Cesarean section will increase the risk for placenta accreta spectrum, which raises maternal morbidity and mortality. AIM : To analyze the correlation of emergency and scheduled referral with maternal and perinatal outcomes of suspected placenta accreta spectrum patients in Dr.Kariadi Hospital Semarang 2020 – 2023.METHODS : A cohort retrospective study performed in May 2024, involved 153 women with suspected placenta accreta spectrum were referred to Dr.Kariadi Hospital Semarang in 2020 – 2023, divided by emergency referral and scheduled referral groups. We use Placenta Accreta Index (PAI) Score and all patients who fulfilled the criteria of the placenta accreta spectrum based on FIGO to predict suspicious placenta accreta spectrum. Descriptive analysis included the base characteristics of the patients. Correlation analysis with maternal and perinatal outcomes using Chi Square analyze of SPSS 25.00 version.RESULTS : A total of 69 patients with emergency referrals and 84 patients with scheduled referrals. Mean age was 32.97, median 32(24-44), median of gestation was 3(1-6) and 3(1-9), median of gestational age was 35(22-41) and 36(32-39). The emergency referral had a higher risk for cesarean hysterectomy with OR (95%CI) 2.92 (1.51–5.67), for maternal hemorrhage with OR (95%CI) 2.34 (1.22–4.49), for blood transfusion with OR (95%CI) 6.02 (2.46–14.76), for intensive care admission with OR (95%CI) 4.39 (1.5–12.79), for prematurity with OR (95%CI) 2.56(1.32–4.92), for asphyxia with OR (95%CI) 3.41(1.56–7.47). There were significant differences between emergency and scheduled referrals for vaginal delivery (p=0.03), and perinatal mortality (p=0.04). Estimated blood loss was 1453.7± 1253.6 ml in emergency referral and 878.3 ± 823.7 ml in scheduled referral.CONCLUSION : Emergency referrals had worse maternal and perinatal outcomes than scheduled referrals for suspicious placenta accreta spectrum patients.

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