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All Journal Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan E-Journal Obstetric & Gynecology Udayana WMJ (Warmadewa Medical Journal) Majalah Obstetri dan Ginekologi The Indonesian Biomedical Journal Indonesian Journal of Obstetrics & Gynecology Science ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Babali Nursing Research Jurnal Syntax Transformation Jurnal Health Sains Bioscientia Medicina : Journal of Biomedicine and Translational Research International Journal of Social Service and Research Cermin Dunia Kedokteran Indonesian Journal of Perinatology Cermin Dunia Kedokteran
I Gde Sastra Winata
Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Udayana
Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Step-by-step bleeding management in cesarean section Winata, I Gede Sastra; Wibawa, I Gusti Ngurah Agung Satria
Indonesian Journal of Perinatology Vol. 4 No. 2 (2023): Available online : 1 December 2023
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v4i2.38

Abstract

Cesarean sections have recently increased dramatically worldwide in the last 50 years. Unfortunately, the post-cesarean section maternal morbidity rate is reported to be relatively high, which is as high as 36%. Some of the most common complications of cesarean section are fever (25%), bleeding (4%), hematoma (4%), and urinary tract infection (3%). Among these complications, obstetric hemorrhage is one of the most common causes of maternal death worldwide. Excessive hemorrhage associated with a cesarean section is defined as blood loss above 1000 ml is frequently underestimated, but is documented as occurring in more than 5–10% of cesarean sections. In most cases, this can be treated with conservative treatment such as vaginal packing and administration of uterotonic drugs. However, some persistent bleeding cases require specific treatment and techniques during the operation. Therefore it is essential to understand the steps and procedures for handling bleeding during cesarean section to reduce maternal mortality. This article review aims to summarize some techniques that can be used to control bleeding during cesarean section.
Evaluation of Abortion Measures in Government Regulation No. 28 of 2024 on The Right to Life of the Fetus From a Human Rights Perspective Florencia Desiree; I Gusti Ayu Putri Kartika; I Gede Sastra Winata; Piers Andreas Noak
Jurnal Syntax Transformation Vol 5 No 11 (2024): Jurnal Syntax Transformation
Publisher : CV. Syntax Corporation Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46799/jst.v5i11.1023

Abstract

Indonesia has legalized abortion under certain conditions, such as pregnancy resulting from rape, through Government Regulation No. 28/2004. This policy has sparked heated debate because it contradicts the principle of protecting the right to life of the fetus. This study aims to provide a complex overview of the issue of abortion in Indonesia and its implications for human rights. The method used is normative legal research. This research is conducted by examining library materials or secondary data. The two approaches used are a statutory approach related to the legal issue of abortion and a conceptual approach to examine the medical legal understanding of abortion due to rape. Cases of sexual violence and rape in Indonesia are still high. In 2023, Komnas Perempuan recorded 2,078 cases of sexual violence, of which 143 were rapes. Abortion, in this context, is often used as a solution to address unwanted pregnancies. This research shows that while Government Regulation No. 28 of 2024 provides legitimacy to abortion, it is still contrary to the right to life of the fetus guaranteed by law. While abortion is considered a violation of the right to life, this policy is also considered a protection for women victims of sexual violence. Despite arguments to protect women's rights, the right to life of the fetus as a non-derogable right should not be ignored. Therefore, there needs to be a review of this regulation to ensure that all human rights, including the right to life of the fetus, are optimally protected.
p16 expression in patient with Loop Electrosurgical Excision Procedure (LEEP) Paskarani, Putu Erika; Winata, I Gede Sastra; Sitohang, Elisa Laura Oktrinita; Felyanto, Felyanto; Yuliantini, Sang Ayu Putu
Majalah Obstetri & Ginekologi Vol. 32 No. 3 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I32024.161-167

Abstract

HIGHLIGHTS Clinicopathologic characteristic of patient with LEEP procedures dominated by women above 35 years old, with total parity less than 3 and without history of contraceptive usage. The p16 expression analyzed by immunohistochemistry technique. The positive and negative reactivity of p16 ratio was 3:5 on LEEP specimen which microscopically appear as chronic cervicitis, low-grade and high-grade squamous intraepithelial lesion.   ABSTRACT Objective: The aim of this study was to reveal p16 expression with the clinicopathological characteristics of patients who underwent cervical biopsy using the Loop electrosurgical excision procedure (LEEP) at Udayana University Hospital, Bali, Indonesia, for the period 2020 – 2023. Materials and Methods: The research was conducted at Anatomic Pathology Laboratory of Udayana University Hospital, Denpasar, Bali, Indonesia. The samples were selected based on inclusion criteria such as the formalin fixed paraffin embedded (FFPE) sample from positive IVA patient and continue for LEEP procedure. Otherwise, the exclusion criteria were moldy FFPE sample and incomplete clinical data. Then, p16 immunostaining procedure was carried out manually. The interpretation of p16 results was analyzed using SPSS software, version 25 by International Business Machines (IBM) Corporation. Results: The positive p16 expression was revealed in 12 samples (38.7%), in contrast the negative staining appeared in 19 samples (61.3%). Unfortunately, p16 expression was not significant statistically based on age, parity, and contraceptive history, with p-values of 1.00, 0.45, and 0.65, respectively. Meanwhile, a statistically significant association was found between p16 expression and histopathologic diagnosis (p = 0.02, 95% CI 1.4 – 38.3). In addition, 22.2% of the variation of p16 expression based on multivariate analysis demonstrating a significant correlation (p = 0.01). Conclusion: p16 expression with histopathology diagnostic characteristic in patient who underwent Loop electrosurgical excision procedure (LEEP) was found statistically significant. Moreover, clinical application of p16 in daily practice should be performed with consideration especially for pre-cancer lesion in LEEP biopsy specimen procedure and clinicopathological approach is essential.
Procedures to Reduce Haemorrhage during Myomectomy for Fibroids I Gede Sastra Winata; Nicholas Renata Lazarosony
Cermin Dunia Kedokteran Vol 49 No 10 (2022): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i10.312

Abstract

Uterine fibroids are the most common solid tumors in the female pelvis. Myomectomy is the first choice of treatment for woman who want to keep their uterus. Haemorrhage, uterine perforation, cervical injury, and metabolic problems from excessive absorption of the distension medium, such as glycine, are risks of hysteroscopic myomectomy. There are several procedures and techniques to reduce haemorrhage during myomectomy for fibroids. Some research demonstrated excellent outcomes with uterine artery ligation. Mioma uteri adalah tumor jinak yang paling sering dijumpai pada wanita. Tindakan miomektomi adalah salah satu pilihan terapi padawanita yang tetap ingin mempertahankan rahim. Perdarahan, perforasi uterus, cedera serviks, dan masalah metabolisme akibat penyerapan berlebihan media distensi, seperti glisin, adalah risiko prosedur histeroskopi miomektomi. Beberapa prosedur dan teknik dapat mengurangi perdarahan saat miomektomi pada kasus mioma uteri. Beberapa penelitian menunjukkan hasil yang sangat baik dengan ligasi arteri uterina.
Legal Analysis of the Implementation of the Ten Steps to Successful Breastfeeding in Government Regulation Number 28 of 2024 to Support the Exclusive Breastfeeding Program in Indonesia Dolesgit, Ni Made Garnis; Parsa, I Wayan; Astuti, Ika Widi; Winata, I Gede Sastra
Babali Nursing Research Vol. 6 No. 3 (2025): July
Publisher : Babali Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37363/bnr.2025.63471

Abstract

Introduction: Efforts to advance the welfare of Indonesian society require the development of quality human resources. However, health issues such as stunting and obesity in children can hinder these aspirations, partly due to suboptimal breastfeeding from birth. Although there has been a significant increase in exclusive breastfeeding, there are still obstacles in its implementation, such as a lack of family support and violations of the International Code of Marketing of Breastmilk Substitutes. This study aims to analyze the implementation of the Ten Steps to Successful Breastfeeding (TSSB) advocated by WHO and UNICEF in Government Regulation Number 28 of 2024 to support the Exclusive Breastfeeding program in Indonesia.Method: This study used a descriptive-analytical method with a normative juridical approach, referring to Government Regulation Number 28 of 2024 concerning the Implementation Regulation of Law Number 17 of 2023 concerning health.Result: Almost all TSSB and all the rules of the International Code of Marketing of Breastmilk Substitutes have been included in the articles to subsequently serve as protection against inappropriate promotion of formula milk for infants and to achieve Exclusive Breastfeeding.Conclusion: It is necessary to immediately create specific follow-up regulations regarding the safe provision and administration of donor breast milk for infants in healthcare institutions and a sustainable data monitoring and management system.
Retrograde Hysterectomy Approaches in Difficult Gynaecology Surgery I Gde Sastra Winata; Ongko, Eric Gradiyanto; I Nyoman Gede Budiana; I Nyoman Bayu Mahendra; Kade Yudi Saspriyana; Pande Kadek Aditya Prayudi; Arlando Martino Anapaku; Florencia
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.70

Abstract

Hysterectomy remains one of the most frequently performed gynecological surgeries worldwide. While extra-fascial hysterectomy is the standard abdominal approach, complex cases involving large fibroids, severe endometriosis, adhesions, or malignancy often require alternative techniques such as the Aldridge method or retrograde hysterectomy. These challenging situations are associated with distorted pelvic anatomy, fibrosis, and adhesions, increasing the risk of complications, including injury to adjacent organs. This article reviews strategies and operative steps in managing complex abdominal hysterectomies, with emphasis on retrograde hysterectomy as a valuable approach when the cervicovaginal junction cannot be clearly identified or when extensive adhesions are present. The surgical technique is described step by step, supported by imaging and intraoperative findings, and highlights methods such as hydrodissection and careful dissection around critical structures to minimize morbidity. Preoperative imaging, intraoperative decision-making, and technical modifications are emphasized as key factors for optimizing patient outcomes. Although this study provides a detailed description of techniques under challenging hysterectomies, its limitation lies in the reliance on schematic illustrations rather than comprehensive intraoperative photographic documentation.
Procedures to Reduce Haemorrhage during Myomectomy for Fibroids Winata, I Gede Sastra; Lazarosony, Nicholas Renata
Cermin Dunia Kedokteran Vol 49 No 10 (2022): Oftalmologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i10.312

Abstract

Uterine fibroids are the most common solid tumors in the female pelvis. Myomectomy is the first choice of treatment for woman who want to keep their uterus. Haemorrhage, uterine perforation, cervical injury, and metabolic problems from excessive absorption of the distension medium, such as glycine, are risks of hysteroscopic myomectomy. There are several procedures and techniques to reduce haemorrhage during myomectomy for fibroids. Some research demonstrated excellent outcomes with uterine artery ligation. Mioma uteri adalah tumor jinak yang paling sering dijumpai pada wanita. Tindakan miomektomi adalah salah satu pilihan terapi padawanita yang tetap ingin mempertahankan rahim. Perdarahan, perforasi uterus, cedera serviks, dan masalah metabolisme akibat penyerapan berlebihan media distensi, seperti glisin, adalah risiko prosedur histeroskopi miomektomi. Beberapa prosedur dan teknik dapat mengurangi perdarahan saat miomektomi pada kasus mioma uteri. Beberapa penelitian menunjukkan hasil yang sangat baik dengan ligasi arteri uterina.
Passive Smoking as a Significant Risk Factor of Cervical Dysplasia: A Novel Findings in Single Center Study in Denpasar, Bali, Indonesia Pradnyana, I Wayan Agus Surya; Mirani Ulfa Yusrika; I Gusti Bagus Mulia Agung Pradnyaandara; I Gde Sastra Winata
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1126

Abstract

Background: Colposcopy is a diagnostic procedure evaluating the cervix following an abnormal screening test. It aims to identify and treat cervical cancer precursors. Risk stratification at the end of colposcopy helps differentiate those who can return to regular screening from those needing more frequent screening or surveillance. The study examined the characteristics and risk factors of patients undergoing colposcopy for cervical dysplasia in Denpasar, Bali, Indonesia. Methods: This was a cross-sectional study of women who underwent colposcopy at BaliMed Hospital, Denpasar, Bali, Indonesia, from January 2021-December 2022. Data were derived from medical records. The gynecology oncologist performed a colposcopy examination with a biopsy sample, which was later checked by the pathologist. Bivariate and multivariate analyses were used to identify the risk factors associated with cervical dysplasia. Results: 142 patients underwent colposcopy with a mean age of 37.28+10.1 years. Seventy-eight patients (54.9%) had a low-grade cervical lesion, and 9 (6.3%) had a high-grade cervical lesion. After adjusting the employment status and education level, factors associated with cervical dysplasia were age at first intercourse <20 years (aOR [adjusted odd ratio] 2.44, 95% CI [1.04-5.69]) and history of smoking, either actively or passively (aOR 8.91, 95% CI [3.52-22.54]). From the biopsy result, patients with abnormal cervical lesions were associated with evidence of CIN (aOR 9.03, 95% CI [2.49-32.77]). Conclusion: Early age first sexual intercourse and history of smoking have been identified as significant risk factors for cervical dysplasia. Additionally, passive smoking has been shown to increase the risk. This research provides a foundational reference for future studies in this area.
Co-Authors A.A.N. Anantasika Anak Agung Gede Putra Wiradnyana Anak Agung Ngurah Anantasika Anthony Stephen Halim Arlando Martino Anapaku Charles Richard Thene Clara Amanda Daniel Hadinata Susanto Desak Putu Oki Lestari Dewi, Putu Pradnya Paramitha Dolesgit, Ni Made Garnis DPG Jananuraga Maharddhika Endang Sri Widiyanti Eric Gradiyanto Ongko Ernest T. B. Sianturi Ernest TB Sianturi Felyanto, Felyanto Fenyta Christyani FLORENCIA Florencia Desiree I Gede Indra Kumara I Gede Mahendra Adiguna Dira I Gede Mega Putra I Gusti Ayu Putri Kartika, I Gusti Ayu I Gusti Bagus Mulia Agung Pradnyaandara I Ketut Surya Negara I Ketut Suwiyoga I Made Darmayasa I Nyoman Bayu Mahendra I Nyoman Gede Budiana I Nyoman Gede Budiana I Nyoman Hariyasa Sanjaya I Wayan Agus Surya Pradnyana I Wayan Artana Putra I Wayan Megadhana I Wayan Parsa Ida Bagus Arjuna Ida Bagus Gde Fajar Manuaba IGN. Wiranta Permadi Ika Widi Astuti, Ika Widi Ines Kurniaty Hartono Johan Qalaba Kade Yudi Saspriyana Kade Yudi Saspriyana Ketut Suwiyoga Kevin Agastya Duarsa Lazarosony, Nicholas Renata Made Ayu Prabawaty Indraswari Made Bagus Dwi Aryana Made Yudha Ganesa Wikantyas Widia Maria Septiana Parmonang Aroean Mirani Ulfa Yusrika Musa Taufiq Musa Taufiq Ngakan Ketut Darmawan Ni Luh Wita Astari Widhusadi Ni Wayan Armerinayanti Nicholas Renata Lazarosony Nicholas Renata Lazarosony Nyoman Bayu Mahendra Ongko, Eric Gradiyanto Pande Kadek Aditya Prayudi Pande Kadek Aditya Prayudi Pande Made Suwanpramana Paskarani, Putu Erika Piere Emanuel Yoltuwu Piers Andreas Noak Pradnyana, I Wayan Agus Surya Putu Bagus Darmayasa Putu Doster Mahayasa Putu Harrista Indra Pramana Rayvany Uil Ryan Saktika Mulyana Sitohang, Elisa Laura Oktrinita Sucitawati, Putu Devita Tjokorda Gde Agung Suwardewa Wibawa, I Gusti Ngurah Agung Satria William Alexander Setiawan Yuliantini, Sang Ayu Putu