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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Cermin Dunia Kedokteran

Herbert Situmorang Herbert Situmorang

Department Of Obstetrics And Gynecology Faculty Of Medicine Universitas Indonesia Dr. Cipto Mangunkusumo General Hospital

Author-ID : 921552

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 12 Documents Claim Missing Document

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Articles

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Postplacental IUCD CuT380A: Acceptability, Effectivity and Side Effects Situmorang, Herbert; Setijanto, Ivanna T; Affandi, Biran
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the acceptability, effectivity and side effects of Postplacental IUCD after vaginal delivery at Dr. Cipto Mangunkusumo Hospital (RSCM) after 6 month of insertion. Methods: A prospective study was conducted at RSCM Jakarta during the period of August to October 2012. Postplacental IUCD was inserted into the subjects’ uterus until it reached the fundus. Follow up was done at 40-42 days and 6 months after delivery.  Results: A total of 234 women were recruited in this study, with 19.2% loss of follow up. No significant difference on subjects characteristics who came and loss of follow up in this study. Expulsion was experienced by 5.1% subjects (total expulsion 4.1% and partial 1%) at the first visit on 40-42 days and 7.5% subjects (total expulsion 0.6% and partial 6.9%) at the second visit, after 6 months. 9.3% subjects had the IUCD removed at the first and second visit. Among all of the subjects who had the IUCD removed by request or had the expulsion, 61% were willing to do reinsertion. The effectivity of IUCD was 100%, with 68.9% subjects was still breastfeeding. The side effects were vaginal discharge (23%), dysmenorrhea (4-21%), and spotting (2-10%).  Conclusion: The acceptability and effectivity of postplacental IUCD after 6 months were 86.8% and 100%. Cummulative expulsion rate were 12.6%, and the most common side effects were vaginal discharge, dysmenorea, and spotting. Keywords: acceptability, effectivity, expulsion rate, IUD, postplacenta

Pregnancy Outcome in Infertility Patient with Endometriosis Cyst after Laparoscopic Cystectomy Gunardi, Eka R; Tritama, Duta A; Satria, Luky; Situmorang, Herbert
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 1. January 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate about the rate of pregnancy in womenwho had undergone laparoscopic cystectomy.Methods: This was a retrospective study. Data were taken from themedical records of patients with infertility in Fatmawati Hospital,Jakarta, Indonesia. Data then analyze to know is there anyassociation between age, infertility duration, bilaterality of the cyst,tubal patensy, r-AFS stage with pregnancy rate.Results: A total of 64 subjects were recruited in this study. Therewere 23 subjects (35.9%) that got pregnant within one year afterundergoing laparoscopic procedure. Those who were 35 years oldor less had a greater chance to get pregnant (p = 0.01, OR = 6.75),duration of infertility  3 years had a greater chance to getpregnant with OR = 3.2 and p value = 0.032, r-AFS stage II and IIIhad a greater chance to get pregnant to with (p = 0.04, OR = 3.25and 4.25).Conclusion: The pregnancy rate after laparoscopic procedure is35.9% in this study. There are correlation between age, durationof infertility, and r-AFS staging with pregnancy rate.[Indones J Obstet Gynecol 2018; 6-1: 34-38]Keywords: endometriosis, infertility, laparoscopy, pregnancy

The Outcome on Conservative Surgical Treatment of Adenomyosis Wiweko, Budi; Legiantuko, Ario; Kemal, Achmad; Pratama, Gita; Situmorang, Herbert; Sumapraja, Kanadi; Natadisastra, Muharam; Hestiantoro, Andon
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To understand the outcome on conservative surgical treatment of adenomyosis. Methods: A retrospective cohort study followed for 2 years from 2010 to 2012 of women with adenomyosis were diagnosed by transvaginal sonography and confirmed histologically. Subjects divided into women who were treated by adenomyosis resection (with/without Osada’s technique) and who were underwent hysterectomy. Results: After the surgery, as many as 40 patients (81.63%) did not feel any pain (VAS 0), and 9 patients (18.37%) still felt pain. For the fertility outcome, we had 8 patients (20.51%) getting pregnant naturally without any fertility intervention. Two patients (5.13%) had successfully conceived by IVF. According to the type of surgery, from 8 natural pregnancy, 7 patients (87.50%) was underwent conventional resection of adenomyosis and 1 patients (12.50%) underwent Osada’s procedures. Two patients who were conceived by IVF, both of them were underwent Osada’s resection. Conclusion: Adenomyosis resection both conservative or Osada’s procedures actually has a better outcome for relieving pain; therefore, some patients can still have a child. Keywords: adenomyosis resection, conventional resection, infertility, Osada’s procedure

External Validation of Endometriosis Fertility Index (EFI) in an Indonesian Population: A TwoCentre Prospective Study Situmorang, Herbert; Radityo, Dimas
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To externally validate EFI in an Indonesian population. Methods: A prospective study was performed in 59 reproductive aged women diagnosed with both endometriosis and infertility who underwent laparoscopic surgery in Dr. Cipto Mangunkusumo and Carolus Hospital during the period of December 2012 to June 2016. Subjects were followed up for two years. Results: Statistical analyses suggested that younger age, infertility duration  3 years, higher LF score, and AFS score below 71 were significantly associated with pregnancy (p<0.001, p<0.001, p=0.035, p<0.001, respectively). Pregnant subjects had significantly higher median EFI score compared to the not pregnant group [EFI score 7 (5-9) vs 4 (1-8), p<0.001)]. Conclusion: Higher EFI score was significantly associated with higher pregnancy rate. [Indones J Obstet Gynecol 2017; 5-3: 160-163] Keywords: endometriosis, fertility, index, infertility, laparoscopy, pregnancy

The Association between Endometriosis Appearance during Laparoscopic Surgery and Pain Characteristic in Pelvic Endometriosis Situmorang, Herbert; Lestari, Renny; Gunardi, Eka R
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To evaluate the correlation between the American Society of Reproductive Medicine (ASRM) score in endometriosis and severity pelvic pain in a group of women with endometriosis. Method: A total of 131 patients with pelvic pain who: conduct laparoscopy for diagnosis and therapy of endometriosis, have pain symptoms>3 months, and absence of pelvic anomalies. Dysmenorrhea, deep dyspareunia, dyschezia, dysuria, and chronic pelvic pain were evaluated using a 10-point visual analogue scale. The data was collected by assessing the medical record, and retrospective analysis was performed. Disease stage according to the American Society of Reproductive Medicine, the presence of adhesion, lesion type (Deep Infiltrating Endometriosis (DIE) or without DIE), and severity of pain symptoms were analysed by Spearman analysis. Different VAS between DIE vs non DIE group was analysed by Mann-Whitney analysis. Result: Stage IV endometriosis accounts for 79.4%. Based on the macroscopic appearance, ovarian endometriosis accounts for 92.4%, peritoneal endometriosis 82.4%, DIE was 40.5%, and adenomyosis was 19.1%. There was significant correlation between total ASRM, ovarian endometriosis, peritoneal lesion, Douglas pouch obliteration, adnexal adhesion score and VAS dysmenorrhea (r=0.303; 0,187; 0,203; 0,278; 0,266, p<0.05). There was significant VAS difference of DIE vs non DIE group; the difference was on dyspareunia (5.18±2.4 and 4.58±1.0, p<0.001] and dyschezia [5.28±2.2 and 4.86±0.7,p<0.001] Conclusion: There was a positive correlation between ovarian endometriosis score and severity of dysmenorrhea. There was also a difference in the degree of endometriosis-associated pain between DIE and non DIE group. Keywords: endometriosis, deep infiltrating endometriosis, dysmenorrhea, dyspareunia, dyschezia   Abstrak Tujuan: untuk mencari hubungan antara skor endometriosis ASRM dan karakteristik nyeri pelvik pada pasien endometriosis Metode: Sebanyak 131 pasien dengan nyeri pelvik yang menjalani laparoskopi untuk diagnosis dan terapi endometriosis, memiliki nyeri > 3 bulan, dan tidak mengalami kelainan organ pelvis. Dilakukan evaluasi terhadap dismenorea, dyspareunia dalam, diskezia, dysuria, dan nyeri pelvic kronik dengan menggunakan nilai 1-10 dari skala analog visual. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Rujukan Nasional Dr. Cipto Mangunkusumo, Jakarta. Stadium endometriosis berdasarkan American Society of Reproductive Medicine, kejadian adhesi, jenis lesi (ada Endometriosis Susukan Dalam/ESD atau tanpa ESD), dan derajat keparahan nyeri dianalisis dengan analisis Spearman. Perbedaan skala nyeri antara ESD dan non ESD dianalisis dengan metode Mann-Whitney. Hasil: Sebanyak 79,4% pasien tergolong ke dalam endometriosis stadium IV. Berdasarkan tampilan makroskopik, endometriosis ovarium terdapat pada 92,4%, endometriosis peritoneal 82,4%, ESD 40,5%, dan adenomiosis pada 19,1%. Terdapat korelasi positif bermakna antara skor ASRM total, sub-skorkista endometriosis, endometriosis superfisial, obliterasi kavum douglas, dan adhesia dneksa dengan VAS dismenorea  (r=0,303; 0,187; 0,203; 0,278; 0,266, p<0,05). Pada kelompok ESD dan tanpa ESD, didapatkan perbedaan VAS dismenorea, dispareunia dalam, diskezia, dan nyeri pelvic kronik yang bermakna (6,13±1.7 dan 5,95±1,7, p = 0,560 ; 5,18±2.4 dan 4,58±1,0, p < 0,001; 5,28±2,2 dan 4,86±0,7 , p < 0,001; 2,20±2,8 dan 0,60±1,8, p <0,001) Kesimpulan:Terdapat korelasi positif bermakna antara skor ASRM dengan VAS dismenorea. Terdapat perbedaan VAS dismenorea, dyspareunia dalam, diskezia, dan nyeri pelvic kronik pada kelompok ESD dan tanpa ESD Kata kunci: endometriosis, endometriosis susukan dalam, dismenorea, dispareunia dalam, diskezia  

Terapi laparoskopi niche dan asimptomatik niche: laporan dua kasus Akbar, Taufik; Situmorang, Herbert; Ardhana Iswari, Wulan; Uli Pardede, Tiarma; Darus, Febriansyah; -, Bintari Puspitasari; Santana, Sanny; Abidin, Finekri; J Endjun, Judi
Cermin Dunia Kedokteran Vol 44, No 8 (2017): Obstetri-Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Niche adalah gambaran hipoekoik di antara myometrium segmen bawah uterus yang menggambarkan diskontuinitas myometrium di tempat bekas operasi sesar. Angka kejadian niche meningkat seiring meningkatnya angka seksio sesarea, menimbulkan gejala ginekologi seperti perdarahan, chronic pain, dismenorea, dan disparenea. Niche dapat diterapi secara konservatif maupun operatif. Kami melaporkan dua kasus niche dengan gejala berbeda. Kasus pertama dengan gejala perdarahan pasca menstruasi selama 3 tahun dan kasus kedua terdeteksi tanpa gejala. Pada kasus pertama dilakukan perbaikan dengan laparoskopi sedangkan pada kasus kedua tidak dilakukan intervensi. Tidak semua niche harus menjalani tindakan intervensi.A niche is a hypoechoic image between the myometrium in the lower uterine segment, illustrating myometrial discontinuity after a caesarean section. Niche incidence increases along with increasing caesarean section procedure, causing gynecological symptoms such as hemorrhage, chronic pain, dysmenorrhea, and dyspareunia. Niche is treatable, conservatively or surgery. We report two niche cases with different symptoms. The first was a woman with post-menstrual bleeding for three years, the second presented without any symptoms. The first patient was treated with laparoscopic surgery whereas the second did not receive any interventions. Not all niche cases need intervention.

Postplacental IUCD CuT380A: Acceptability, Effectivity and Side Effects: AKDR Cu T380A Pasca plasenta: Penerimaan, Efektivitas dan Efek Samping Herbert Situmorang; Ivanna T Setijanto; Biran Affandi
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the acceptability, effectivity and side effects of Postplacental IUCD after vaginal delivery at Dr. Cipto Mangunkusumo Hospital (RSCM) after 6 month of insertion. Methods: A prospective study was conducted at RSCM Jakarta during the period of August to October 2012. Postplacental IUCD was inserted into the subjectsâ€™ uterus until it reached the fundus. Follow up was done at 40-42 days and 6 months after delivery. Results: A total of 234 women were recruited in this study, with 19.2% loss of follow up. No significant difference on subjects characteristics who came and loss of follow up in this study. Expulsion was experienced by 5.1% subjects (total expulsion 4.1% and partial 1%) at the first visit on 40-42 days and 7.5% subjects (total expulsion 0.6% and partial 6.9%) at the second visit, after 6 months. 9.3% subjects had the IUCD removed at the first and second visit. Among all of the subjects who had the IUCD removed by request or had the expulsion, 61% were willing to do reinsertion. The effectivity of IUCD was 100%, with 68.9% subjects was still breastfeeding. The side effects were vaginal discharge (23%), dysmenorrhea (4-21%), and spotting (2-10%). Conclusion: The acceptability and effectivity of postplacental IUCD after 6 months were 86.8% and 100%. Cummulative expulsion rate were 12.6%, and the most common side effects were vaginal discharge, dysmenorea, and spotting. Keywords: acceptability, effectivity, expulsion rate, IUD, postplacenta

Basal Temperature, Cervical Mucous, and Both Combination as Diagnostic Tools to Detect Ovulation: Akurasi Suhu Basal Tubuh, Lendir Serviks, dan Kombinasi Keduanya sebagai Alat Pendeteksi Ovulasi Eka R Gunardi; Alexander Mukti; Â Herbert Situmorang
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To make basal body temperature examination andcervical mucus as an alternative examination in detectingovulation, especially in health facilities that do not have ultrasound. Methods: This cross-sectional study was conducted at the outpatientclinic of RSUPN Dr. Cipto Mangunkusumo in the year2016-2017. A total of 49 infertile female patients who had normalmenstrual cycles were asked to participate and performedbasal body temperature measurements, cervical mucussampling and transvaginal ultrasound examination, the dataare subsequently grouped into 3 Days Estimated Ovulation(DEO); DEO-2 days, DEO and DEO+ 2 days. Diagnostic testswere performed and accurate comparison between basal bodytemperature, cervical mucus and a combination of both werelater assessed. Results: The best accuracy was found on cervical mucus andcombination of both with 65% in detecting ovulation, whilstthe lowest was basal body temperature (59%) with sensitivity46.7%, and specificity 78.9%. Cervical mucus in diagnosingovulation has a sensitivity of 70% and specificity 57.8%. Thecombination of temperature-cervical mucus in diagnosing ovulationhas sensitivity of 46.67% and specificity of 94.73%. Conclusion: Cervical mucus examination has better accuracy comparedwith basal body temperature examination in detecting ovulation.Further research for validating these diagnostic tools to thewider community and not only in patients with infertility is needed. Keywords: basal body temperature, cervical mucus, infertility, ovulationdetection, ultrasound

Double Approach (Laparoscopy and Hysteroscopy) Repair of Istmochele (Niche): Pendekatan Ganda (Laparoskopi dan Histeroskopi) untuk Memperbaiki Istmochele (Niche) Herbert Situmorang; Ribkhi A. Putri; Cepi T. Pramayadi; Riyan H. Kurniawan; Muhammad D. Priangga; Eka R. Gunardi
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 4 October 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i4.1268

Objectives: Reported a case demonstrate the double approach repair of niche treatment through the hysteroscopy and laparoscopy technique.Methods: Case report. We reported a case starting from the patient admission untill 3 months postoperative condition.Case: A 33 years old woman came with abnormal uterine bleeding, already got medication and combine oral contraception pill, but the bleeding never stopped. We found a cavity (niche) filled by menstrual blood with thin lower uterine segment (just serous layer) from transvaginal ultrasound. We did hysteroscopy and laparoscopy approach. We illuminated the niche by hysteroscopy, then resected it by laparoscopy. Patient had a day hospital admission and no symptoms anymore after the procedure.Conclusion: Many treatment methods have been described for repair of niche with varies effectivities. Double approach (hysteroscopy and laparoscopy) technique was a minimal access, but optimal approach of niche resection with up to 100% effectivity.Keywords: abnormal uterine bleeding, caesarean scar defect, hysteroscopy, istmochele laparoscopy, niche Abstrak Tujuan: Melaporkan sebuah kasus yang menggambarkan pendekatan ganda dalam memperbaiki niche dengan histeroskopi dan laparoskopi.Metode: Laporan kasus. Kami melaporkan sebuah kasus dimulai dari pasien masuk sampai dengan 3 bulan pascaoperasi.Kasus: Perempuan 33 tahun datang dengan perdarahan uterus abnormal, telah diberikan terapi obat dan pil kombinasi, namun perdarahan tidak berhenti. Dari ultrasonografi ditemukan rongga berisi darah menstrusasi dengan segmen bawah uterus yang tipis (hanya lapisan serosa). Kami melakukan pendekatan histeroskopi dan laparoskopi. Dilakukan iluminasi dengan histeroskopi, kemudian reseksi dengan laparoskopi. Perawatan pasien di rumah sakit selama satu hari, dan tidak terdapat keluhan pada pasien setelah tindakan.Kesimpulan: Terdapat banyak metode dalam tata laksana niche dengan efektivitas yang beragam. Pendekatan ganda dengan histeroskopi dan laparoskopi merupakan tehnik dengan akses minimal namun hasil optimal, dengan efektivitas hingga 100%.Kata Kunci: perdarahan uterus abnormal, defek skar sesar, histeroskopi, istmpchele, laparoskopi, niche

Role of Ambulatory Laparoscopy in Diagnosis of Ascites with Unknown Etiology Herbert Situmorang; Raymond Surya; Tantri Hellyanti
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1362

Background: Ascites could be caused by many underlying diseases, mainly portal hypertension, malignancy, and heart failure. Other etiologies include tuberculosis and pancreatitis. Difficulties in confirming the cause of ascites have been seen in many clinical settings. Ambulatory laparoscopy is one of powerful tools to rule out many etiologies of ascites despite being invasive in its nature. This case report would like to show one case of peritoneal TB presenting with ascites. Patient has undergone many laboratory workups in search of ascites origin. Literature study is done to look for evidence about timing and role of laparoscopy in ascites work-up. Case illustration: A-26-year-old P2 woman came to hospital with a history of vaginal delivery 22 days before admission presenting with massive ascites. No obstetric complication was found. Transvaginal ultrasound revealed normal postpartum uterus and ovaries, surrounded with ascites. Both the liver and kidneys were found normal on ultrasound. Abdominal CT scan with contrast showed massive ascites with thickened omentum. ADA was 36 IU/L. We decided to perform diagnostic laparoscopy and biopsy for histopathology. We found massive yellowish ascites and hyperaemic tubal enlargement with thickening of the peritoneum. Pathology examination proved the appearance of chronic salpingitis and granulomatous peritonitis consistent with tuberculosis peritonitis. Conclusion: Laparoscopy as a minimal invasive tool can diagnose ascites with unknown etiology patients after failure to prove diagnosis from clinical laboratory and radiological examination. It is one best alternative to diagnose peritoneal TB presenting with ascites with its superiority in visualizing abdominal cavity and obtaining specimens for histology with lower risk of morbidity.

Co-Authors -, Bintari Puspitasari Abidin, Finekri Achmad K. Harzif Alexander Mukti Andon Hestiantoro Ardhana Iswari, Wulan Biran Affandi Biran Affandi Budi Wiweko Caroline G. Puspita Cepi T. Pramayadi Cepi Teguh Pramayadi Darus, Febriansyah Eka R Gunardi Eka R Gunardi Eka R. Gunardi Eka Rusdianto Gunardi Gita Pratama Ilham Utama Surya Ivanna T Setijanto J Endjun, Judi Kanadi Sumapradja Kemal, Achmad Legiantuko, Ario Lestari, Renny Muhammad D. Priangga Muhammad Dwi Priangga Muhammad Syauqi Mirza Muharam Natadisastra Radityo, Dimas Raymond R. Tjandrawinata Raymond Surya Ribkhi A. Putri Riyan H. Kurniawan Riyan Hari Kurniawan Santana, Sanny Satria, Luky Setijanto, Ivanna T Tantri Hellyanti Taufik Akbar Tritama, Duta A Uli Pardede, Tiarma

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