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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Published by Perkumpulan Obstetri dan Ginekologi Indonesia
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published quarterly.
Arjuna Subject : -
Articles 1,731 Documents
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Increased Levels of Umbilical Cord Blood Interleukin-6 (IL-6) and Serum C-Reactive Protein (CRP) in Premature Infants of Vitamin D Deficient Mothers: Peningkatan Kadar Interleukin-6 (IL-6) Darah Tali Pusat dan Serum C-Reactive Protein (CRP) pada Bayi Prematur dari Ibu dengan Defisiensi Vitamin D Yuyun Lisnawati; Marianna Yesy; Rinawati Rohsiswatmo
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1397

Abstract

Objective: Increased levels of inflammatory factors in newborns are often associated with lower maternal vitamin D levels. This study aimed to find out the relationship between maternal and umbilical cord vitamin D serum levels on umbilical cord Interleukin-6 (IL-6) and serum C-Reactive Protein (CRP) levels in premature infants.Methods: The study was an observational analytic, cross-sectional design in mothers who underwent preterm birth at 28-34 weeks' gestation due to premature rupture of membranes (PROM) and their infants at Dr. Cipto Mangunkusumo General Hospital (RSCM), Jakarta and Persahabatan General Hospital, Jakarta, from January 2017 to August 2018. Levels of serum vitamin D of the maternal and umbilical cord, umbilical cord IL-6 and serum CRP in premature infants were recorded. Vitamin D level was divided into deficiency (<10 ng/mL), insufficiency (10–29 ng/mL), and normal (>30 ng/mL) groups. The relationship of vitamin D levels with IL-6 and CRP was carried out using Kruskal Wallis test.Results: A total of 70 subjects met the research criteria. Umbilical cord IL-6 and serum CRP levels in premature infants of vitamin D deficient mothers were higher (20.31 pg/mL and 0.50 mg/L) compared to insufficient (3.34 pg/mL and 0.45 mg/L) and normal mothers (3.29 pg/mL and 0.30 mg/L), although not statistically significant (IL-6 p = 0.665, CRP p = 0.89). Referring to the umbilical cord blood vitamin D levels, the results were different and not as expected, in which the umbilical cord IL-6 and serum CRP levels of preterm infants in the deficiency (3.76 pg/mL and 0.35 mg/L) and insufficiency (3.37 pg/mL and 0.40 mg/L) groups were lower (IL-6) and not different (CRP) than the normal group (9.41 pg/mL and 0.40 mg/L).Conclusion: There were an increasing tendency for umbilical cord IL-6 and serum CRP levels in premature infants of vitamin D deficient mothers although these were not statistically significant. Based on the levels of vitamin D umbilical cord blood, the CRP levels in the serum of premature infants were not different, while the IL-6 levels in the deficiency and insufficiency group were lower than in the normal group.Keywords: CRP, IL-6, maternal vitamin D, umbilical cord vitamin D. Abstrak Tujuan: Peningkatan kadar faktor inflamasi pada bayi baru lahir sering dikaitkan dengan rendahnya kadar vitamin D ibu. Penelitian ini bertujuan untuk mengetahui hubungan kadar serum vitamin D ibu dan tali pusat, dengan kadar IL-6 tali pusat dan serum C-Reactive Protein (CRP) bayi prematur.Metode: Studi observasional analitik dengan desain potong lintang pada subjek ibu yang mengalami kelahiran prematur di usia 28–34 minggu kehamilan disebabkan ketuban pecah dan bayi yang dilahirkannya, di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM) dan Rumah Sakit Umum Pusat Persahabatan, Jakarta, pada bulan Januari 2017 sampai Agustus 2018. Variabel data adalah kadar serum vitamin D ibu dan tali pusat, kadar serum IL-6 tali pusat dan kadar CRP darah bayi. Kadar vitamin D (25(OH)D) dibagi menjadi defisiensi (<10 ng/mL), insufisiensi (10–29 ng/mL) dan normal (>30 ng/mL) dan dicari hubungannya dengan kadar IL-6 tali pusat dan serum CRP bayi prematur, menggunakan uji Kruskal Wallis. Hasil: Sebanyak 70 subjek telah memenuhi kriteria penelitian. Kadar IL-6 tali pusat dan serum CRP bayi prematur dari kelompok ibu defisiensi vitamin D (20,31 pg/ml dan 0,50 mg/L) lebih tinggi dibandingkan kelompok ibu insufisiensi vitamin D (3,34 pg/mL dan 0,45 mg/L) maupun kelompok ibu normal vitamin D (3,29 pg/mL dan 0,30 mg/L) tetapi perbedaan tersebut tidak bermakna (IL-6 p=0,665 dan CRP p = 0,899). Mengacu pada kadar vitamin D darah tali pusat didapatkan hasil yang berbeda dan tidak sesuai harapan, dimana tali pusat IL-6 dan serum CRP bayi prematur mengalami defisiensi (3,76 pg / mL dan 0,35 mg / L) dan insufisiensi. (3,37 pg / mL dan 0,40 mg / L) kelompok lebih rendah (IL-6) dan tidak berbeda (CRP) dibandingkan kelompok normal (9,41 pg / mL dan 0,40 mg / L).Kesimpulan: Didapat kecenderungan peningkatan kadar IL-6 darah tali pusat dan serum CRP bayi prematur dari ibu dengan defisiensi kadar vitamin D walaupun secara statistik tidak signifikan. Berdasarkan kelompok vitamin D darah tali pusat, kadar CRP serum bayi prematur tidak berbeda, sedangkan kadar IL-6 pada kelompok defisiensi dan insufisiensi lebih rendah dibandingkan pada kelompok normal.Kata kunci: CRP, IL-6, vitamin D ibu, vitamin D tali pusat.
The Role of Intrapartum Ultrasound to Predict Outcome of Delivery: Penggunaan Ultrasonografi Intrapartum untuk Memprediksi Luaran Persalinan Yakob Togar Simatupang; Yongki Wenas; Januar Simatupang
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1413

Abstract

Objective: To predict outcome of delivery by using ultrasound measurements consisting angle of progression, and head perineum distance.Methods: Sixtytwo parturients assigned in cohort prospective study. Ultrasound examination begin with identifying the cephalic position by placement of transducer on suprapubic region. The angle of progression is obtained trans-labially, head perineum distance and cervical dilation trans-perineally. Ultrasound findings of Nuchal cord, caput, moulding, occiput posterior position then compared with conventional findings. Labour is observed, outcomes are grouped into vaginal delivery and cesarean section.Results: Thirty-six women went for vaginal delivery, 26 underwent cesarean section. Independent T-test showed significant differences of the angle of progression (121.11o vs 88.85o) and head perineum distance (5.15 cm vs 7.26 cm) between the two groups. Linear regression test found a negative correlation on how the angle of progression affecting head perineum distance p-value <0.05 , R2 0.684, (r) – 0.827. Cervical dilation measurements both ultrasound and digital examination were assessed with the Bland-Altman reliability test with level of agreement (-1.0 cm) – (1.2 cm). Receiver Operating Characteristic curve showed cut-off value >101o angle of progression predicts vaginal delivery, area under curve 0.902 and positive likelihood ratio 4.4. Kappa reliability testing for nuchal cord, caput, moulding, and occiput posterior are 0.919, 0.938, 0.384, 0.681 respectively.Conclusion: Intrapartum ultrasound able to predict the outcome of delivery, digital examination of cervical dilation is the mainstay of measurement. Ultrasound able to rule out the presence of nuchal cord, caput, and occiput posterior. Keywords: angle of progression, head perineum distance, intrapartum ultrasound. Abstrak Tujuan: Mengetahui besar sudut penurunan kepala dan jarak kepala ke perineum dengan ultrasonografi intrapartum dalam memprediksi luaran persalinan. Metode: Enam puluh dua ibu bersalin dilakukan pemeriksaan ultrasonografi intrapartum. Identifikasi posisi kepala dengan meletakan transduser di suprapubik, sudut penurunan kepala secara translabial, jarak kepala ke perineum dan nilai dilatasi serviks secara transperineal. Lilitan tali pusat, kaput, molase, dan oksiput posterior pada temuan ulstrasonografi dibandingkan dengan hasil pemeriksaan konvensional. Observasi persalinan dilakukan, di kelompokan untuk persalinan pervaginam dan seksio sesarea.Hasil: Didapatkan 36 persalinan pervaginam dan 26 seksio sesarea. Uji – t secara signifikan berbeda, nilai sudut penurunan kepala (121,11o vs 88,85o), jarak kepala ke perineum (5,15 cm vs 7,26 cm) pada kedua kelompok. Uji regresi linier sudut penurunan kepala dan pengaruhnya terhadap jarak kepala ke perineum berkorelasi negatif p <0.05, R2 0.684, (r) – 0.827. Batas kesepakatan nilai dilatasi serviks kedua metode diuji dengan uji reliabilitas Bland-Altman dengan batas kesepakatan sebesar (-1.0) cm – (1.2) cm. Sudut penurunan kepala memprediksi persalinan pervaginam sebesar >101o, uji diagnostik dengan kurva Receiver Operating Characteristic didapatkan area dibawah kurva 0.902, rasio kemungkinan positif 4,4. Uji reliabilitas Kappa lilitan tali pusat, kaput ,molase, dan oksiput posterior berturut-turut (k) = 0.919, 0.938, 0.384, dan 0.681. Kesimpulan: Penggunaan ultrasonografi intrapartum dapat memprediksi luaran persalinan, pemriksaan dalam tetap menjadi pemeriksaan utama dalam menilai dilatasi serviks, ultrasnografi mampu mendeteksi lilitan tali pusat, kaput, dan posisi oksiput posterior.Kata kunci: Jarak kepala ke perineum, sudut penurunan kepala, Ultrasonografi intrapartum.
Role of Lifestyle Modification through Dietary Changes to Endometrial Receptivity on Infertility Women and Obesity with Polycystic Ovary Syndrome Julianto Witjaksono; Fiastuti Witjaksono; Andhika A. Perdana
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1415

Abstract

Abstract Objective: To investigate the effect of lifestyle modification on endometrial receptivity of obese women with polycystic ovary syndrome using ultrasonography.Methods: This observational study was conducted at Dr. Cipto Mangunkusumo General Hospital Jakarta from August 2019 to May 2020. A total of 14 subjects were participated in this study. The subjects were advised to get nutrition counseling by nutritionist and then followed up the endometrial profiles for 6 months by ultrasonography.Results: A total 19 subjects were received nutrition counseling by Clinical nutritionist, but then, only 14 subjects were evaluated the endometrial study by Ultrasonography. There were several significant result between before and after treatment some subjects such as calories, body weight, body mass index, waist circumference (p<0.05) and type of the endometrial vascular zone, endometrium volume, and vascular flow index by ultrasonography (p<0.05). In this study, no significant results have been found on the correlation between dietary changes and changes in endometrial receptivity profiles.Conclusion: No significant correlation was observed between changes in anthropometrics and daily calorie intake with changes in endometrial vascular zones.Keywords: endometrial receptivity, obese, polycystic ovary syndrome, ultrasonography. Abstrak Tujuan : Untuk mengetahui pengaruh modifikasi gaya hidup pada reseptivitas endometrium perempuan obesitas dengan sindrom ovarium polikistik menggunakan ultrasonografi.Metode: Penelitian observasional ini dilakukan di Rumah Sakit Umum Cipto Mangunkusumo Jakarta dari Agustus 2019 hingga Mei 2020. Sebanyak 14 subjek berpartisipasi dalam penelitian ini. Semua subyek disarankan untuk mendapatkan konseling gizi oleh ahli gizi dan dilakukan observasi profil endometrium selama 6 bulan dengan ultrasonografi.Hasil: Sebanyak 19 subjek menerima konseling gizi oleh ahli gizi klinis, tetapi kemudian, hanya 14 subjek yang dievaluasi profil endometrium dengan Ultrasonografi. Ada beberapa hasil yang signifikan antara sebelum dan sesudah perawatan beberapa subjek seperti kalori, berat badan, indeks massa tubuh, lingkar pinggang (p<0,05) dan tipe zona vaskular endometrium, volume endometrium, dan indeks aliran vaskular dengan ultrasonografi (p <0,05). Dalam penelitian ini, tidak ditemukan hasil yang signifikan pada korelasi antara perubahan pola makan dan perubahan dalam profil reseptivitas endometrium.Kesimpulan: Tidak ada korelasi yang signifikan antara perubahan antropometrik dan asupan kalori harian dengan perubahan zona vaskular endometrium.Kata kunci: endometrium, obesitas, reseptivitas, sindrom ovarium polikistik, ultrasonografi
Visceral Adipose Tissue was Associated with Increased Risk of Insulin Resistance in Lean Polycystic Ovarian Syndrome, Independent with Retinol Binding Protein-4: Jaringan Adiposa Viseral berkaitan dengan Peningkatan Risiko Resistensi Insulin pada Sindrom Ovarium Polikistik dengan Indeks Masa Tubuh Normal, Independen terhadap Retinol Binding Protein-4 Vita Silvana; Andon Hestiantoro; Muharam Natadisastra; Kanadi Sumapraja; Budi Wiweko
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 3 July 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i3.1417

Abstract

Objective: To determine whether visceral adipose tissue or serum RBP-4 were related with the risk increment of insulin resistance in normal BMI PCOS patients. Methods: This was a cross-sectional study conducted in normal body mass index PCOS patients at Yasmin Clinic, RSCM, Jakarta from July 2014 until March 2015. Diagnosis of PCOS was established using Rotterrdam (2003) criteria. Insulin resistance was confirmed by using ratio of HOMA-IR >1.4. Results: Among 40 subjects, 20 subjects (50%) belong insulin resistance group. Serum RBP-4 level was higher in insulin resistance group (p=0.06). After ROC analysis was conducted, area under curve for of serum RBP-4 was 69.9% (CI 95% -3754.77 - (186.60-7696.14, p=0.061)). Cut-off level of serum RBP-4 was 23814.5 ng/mL yielded sensitivity and specificity to a level of 60% and 60%, respectively. After logistic regression were analyzed, visceral adipose tissue demonstrated substantial association with the risk increment of insulin resistance in normal BMI PCOS patients. Conclusions: Visceral adipose tissue demonstrated substantial association with the risk increment of insulin resistance in normal BMI PCOS patients, independent with serum RBP-4 levels. Key words: body mass index, diagnosis, insulin resistance, PCOS, retinol binding protein-4 Abstrak Tujuan: Untuk menentukan apakah jaringan adiposa viseral atau serum RBP-4 berhubungan dengan peningkatan risiko resistensi insulin pada Sindrom Ovarium Polikistik dengan indeks masa tubuh normal. Metode: Studi potong lintang dilakukan pada subjek SOPK dengan IMT normal di Klinik Yasmin, RSCM, Jakarta sejak Juli 2014 sampai dengan Maret 2015. Penegakan diagnosis SOPK dilakukan dengan kriteria Rotterdam (2003). Resistensi insulin dikonfirmasi dengan pemeriksaan rasio HOMA-IR > 1.4 Hasil: Diantara 40 subjek, sebanyak 20 subjek (50%) mengalami resistensi insulin. Kadar serum RBP-4 lebih tinggi pada kelompok resistensi insulin (p=0.06). Setelah dilakukan analisis Receiver Operating Curve (ROC), serum RBP-4 memiliki Area Under the Curve (AUC) sebesar 69.9% (IK 95% -3754.77 - (186.60-7696.14, p=0,061)). Titik potong kadar serum RBP-4 adalah 23814.5 ng/mL dengan sensitivitas dan spesifisitas masing-masing 60% dan 60%. Setelah dilakukan analisis regresi logistik, jaringan adiposa viseral menunjukan asosiasi yang kuat dengan terjadinya resistensi insulin pada pasien SOPK dengan IMT normal. Kesimpulan: Jaringan adiposa viseral menunjukan asosiasi yang kuat dengan terjadinya resistensi insulin pada SOPK dengan IMT normal, independen terhadap kadar serum RBP-4. Kata kunci: diagnosis, indeks masa tubuh, resistensi insulin, retinol binding protein-4, SOPK
High-Sensitivity Cardiac Troponin I Level and Left Ventricular Diastolic Dysfunction on Severe Preeclampsia: Kadar High Sensitivity Cardiac Troponin I dan Disfungsi Diastolik Ventrikel Kiri pada Preeklamsia Berat Rahmad R. B. Wicaksono; Julian Dewantiningrum; Herman Kristanto
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1429

Abstract

Abstract Objective: To know the relationship between high-sensitivity cardiac Troponin I (hscTnI) level with left ventricular dysfunction on severe preeclampsia.Methods: An observational analytics study with a cross-sectional approach of ten pregnant women with severe preeclampsia who underwent delivery or termination pregnancy and then performed a transthoracic echocardiography examination and serum levels of hscTnI.Results: There is a significant relationship between hscTnI levels and left ventricular diastolic dysfunction (p <0.05)Conclusion: These findings of this study have significant implications that severe preeclampsia is associated with heart remodelling and significant change in cardiac function especially left ventricular dilatation and elevation of hscTnI. Early identification and intervention may ameliorate subsequent cardiovascular disease so this requires regular and close follow-up of this target group.Keywords: high-sensitivity cardiac Troponin I, left ventricular diastolic dysfunction, severe preeclampsia. Abstrak Tujuan: Untuk mengetahui hubungan antara kadar high-sensitivity cardiac Troponin I (hscTnI) dengan disfungsi ventrikel kiri pada preeklamsia berat.Metode: Studi observasional dengan pendekatan potong lintang terhadap sepuluh ibu hamil dengan preeklamsia berat yang menjalani persalinan atau terminasi kehamilan kemudian dilakukan pemeriksaan ekokardiografi dan kadar hscTnI serum.Hasil: Ada hubungan yang bermakna antara kadar hscTnI dengan disfungsi diastolik ventrikel kiri (p <0,05).Kesimpulan: Temuan penelitian awal ini memiliki implikasi yang signifikan bahwa preeklamsia berat berhubungan dengan remodeling jantung dan perubahan signifikan pada fungsi jantung terutama dilatasi ventrikel kiri disertai peningkatan kadar hscTnI. Identifikasi dan intervensi dini dapat memperbaiki perjalanan penyakit kardiovaskular sehingga diperlukan pengawasan lanjut pada kelompok pasien ini.Kata kunci: disfungsi diastolik ventrikel, high-sensitivity cardiac troponin I jantung sensitivitas tinggi, kiri, preeklamsia berat
Identification of Bacteria on Postcesarean Section Patient’s Wound Operation: Identifikasi Bakteri pada Luka Operasi Pasien Pascaseksio Sesarea Renny Aditya; Risa Dirgagita
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1433

Abstract

Abstract Objective: To determine the type of bacteria in post-cesarean surgical patient wounds obtained through the patient's surgical wound swab in the Ward Obstetrics and Gynecology RSUD Ulin Banjarmasin in the period August-October 2019.Methods: This study was a descriptive study with a cross-sectional approach. A total of 36 samples were taken using a purposive sampling method, but only 32 bacterial isolates were obtained. Samples in the form of clean operating wound contaminated post-cesarean patients were planted on growth media and identified microscopically to be further classified based on responses to biochemical tests.Results: Descriptive analysis shows that there are three types of bacteria, namely Staphylococcus aureus as much as 59.3%, Staphylococcus epidermidis as much as 25.0%, and Escherichia coli as much as 15.6%.Conclusion: Obtained 3 types of bacteria in the results of surgical wound swab in post-cesarean section patients who were hospitalized in the Ward and Obstetrics Hospital of Ulin Hospital Banjarmasin, namely Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli.Keywords: cesarean section, contaminant bacteria, surgery wound swab. Abstrak Tujuan: Mengetahui gambaran jenis bakteri pada luka operasi pasien pascaseksio sesarea yang didapat melalui swab luka operasi pasien di Bangsal Kandungan dan Kebidanan RSUD Ulin Banjarmasin dalam periode Agustus-Oktober 2019.Metode: Penelitian ini merupakan studi dekskriptif dengan pendekatan potong lintang. Sebanyak 36 sampel diambil menggunakan metode purposive sampling, tetapi hanya didapatkan 32 isolat bakteri. Sampel swab luka operasi bersih terkontaminasi pasien paska seksio sesarea ditanam pada media pertumbuhan dan diidentifikasi secara mikroskopis untuk selanjutnya diklasifikasikan berdasarkan respon terhadap uji biokimia.Hasil : Analisis secara deksriptif menunjukkan bahwa terdapat tiga jenis bakteri, yaitu Staphylococcus aureus sebanyak 59,3%, Staphylococcus epidermidis sebanyak 25,0%, dan Escherichia coli sebanyak 15,6%.Kesimpulan : Didapatkan 3 jenis bakteri pada hasil swab luka operasi pasien pascaseksio sesarea yang dirawat inap di Bangsal Kandungan dan Kebidanan RSUD Ulin Banjarmasin, yaitu Staphylococcus aureus, Staphylococcus epidermidis, dan Escherichia coli.Kata kunci: seksio sesarea, bakteri kontaminan, swab luka operasi.
Maternal Deaths due to Obstetric Hemorrhage in Padang, Indonesia: A Case-Control Study: Kematian Maternal Akibat Perdarahan Obstetri di Kota Padang: Sebuah Studi Kasus-Kontrol Dini F. Omari; Yusrawati; Satya W. Yenny
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 2 April 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i2.1434

Abstract

Abstract Objective: To analyse the association between determinants of maternal deaths and obstetric haemorrhage in Padang, Indonesia.Methods: A retrospective case-control study was conducted in Padang, Indonesia from 2015 to 2019. Maternal deaths that occurred due to obstetric hemorrhage in Padang Health Department was compared to three mothers who survived from obstetric hemorrhage (controls) in Dr. M. Djamil General Hospital, Padang, Indonesia.Results: There were 20 deaths caused by obstetric hemorrhage during 2015 to 2019. Death records could only be found in 16 cases. The most common etiology of obstetric hemorrhage was uterine atony (62.5%). Determinants associated with maternal deaths due to obstetric hemorrhage were interval between pregnancies (p=0.045; OR:10.846), history of previous labour (p=0.003; OR:8.556), and antenatal care (p=0.003; OR:21.364). Age, parity, birth attendant, and mother’s educational level were not significantly associated with maternal deaths due to obstetric hemorrhage.Conclusion: Uterine atony was the most frequent etiology of maternal deaths due to obstetric hemorrhage. There was a significant association between pregnancy intervals, history of previous labour, and antenatal care with maternal deaths due to obstetric hemorrhage.Keywords: determinant, obstetric hemorrhage, maternal death. Abstrak Tujuan: Menganalisis hubungan determinan kematian maternal akibat perdarahan obstetri di Kota Padang.Metode: Sebuah studi retrospektif case-control dilakukan di Kota Padang dari tahun 2015–2019. Setiap kasus kematian ibu akibat perdarahan obstetri dari tahun 2015–2019 yang dilaporkan oleh Dinas Kesehatan Kota Padang dibandingkan dengan tiga kasus perdarahan obstetri yang tidak berakibat kematian di RSUP Dr. M. Djamil Padang. Analisis data menggunakan uji Chi-square.Hasil: Ada 20 kasus kematian akibat perdarahan obstetri selama tahun 2015–2019. Catatan kematian hanya dapat diperoleh pada 16 kasus. Etiologi terbanyak kematian akibat perdarahan obstetri ialah atonia uteri. Determinan yang berhubungan dengan kematian akibat perdarahan obstetri ialah jarak kehamilan (p=0.045; OR:10.846), riwayat persalinan sebelumnya (p=0.003; OR:8.556), dan antenatal care (p=0.003; OR:21.364). Tidak terdapat hubungan yang signifikan antara usia, paritas, penolong persalinan, dan tingkat pendidikan ibu dengan kematian maternal akibat perdarahan obstetri.Kesimpulan: Atonia uteri merupakan etiologi tertinggi kematian maternal akibat perdarahan obstetri. Ada hubungan yang signifikan antara jarak kehamilan, riwayat persalinan sebelumnya, dan antenatal care dengan kematian maternal akibat perdarahan obstetri.Kata kunci: determinan, kematian maternal, perdarahan obstetri.
Postradiotherapy Outcome on Cervical Cancer Stage IIIB Patients with and without Paraaortic Lymph Nodes Enlargement: Hasil Pascadiadioterapi pada Pasien Kanker Serviks Stadium IIIB dengan dan tanpa Pembesaran Nodus Paraaorta Fitriyadi Kusuma; Sahat B. Matondang; Laila Nuranna; Gatot Purwoto; Oni Khonsa; Purnomo Hyaswicaksono
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1438

Abstract

Objective : To determine whether there are differences in clinical response after radiotherapy and 1 year survival in patients with advanced cervical cancer with and without enlargement of PALN.Method : An observational analytic study using a retrospective cohort method was done using consecutive sampling. The subjects of this study were all women with a primary diagnosis of stages IIB to IVB cervical cancer who came to the gynecological oncology clinic of Dr. Cipto Mangunkusumo National General Hospital and underwent MRI examination before undergoing treatment in January 2016 to May 2017Results: Among 76 subjects studied, there were 4 (5.1%) subjects who had enlarged PALN. There were no significant differences between the enlargement status of PALN and age (p = 0.829), age of first sexual intercourse (p = 0.33), parity (p = 0.642), mass diameter (p = 0.777). Patients with PALN enlargement have 2.13 times risk of having negative radiotherapy outcome (p = 0.02, OR 2.13, CI95% 1.12 – 4.07). There was no difference in 1-year survival between patients with and without enlargement of PALN (median 201 vs. 293, p = 0.072).Conclusion: Patients with PALN enlargement have increased risk of having negative radiotherapy outcome (p < 0.05). There were no differences in 1 year survival between patients with advanced cervical cancer with enlargement PALN.Keywords : cervical cancer, lymph node enlargement, paraaortic, radiotherapy. Abstrak Tujuan: Mengetahui adakah perbedaan respon klinis pascaradioterapi dan kesintasan 1 tahun pada pasien kanker serviks stadium lanjut dengan pembesaran KGB paraaorta dibandingkan tanpa pembesaran KGB paraaorta.Metode: Penelitian ini merupakan penelitian analitik observasional dengan menggunakan metode kohort retrospektif. Pengambilan sampel dilakukan dengan cara pengambilan sampel berturut-turut. Subyek penelitian ini adalah semua perempuan dengan diagnosis primer kanker serviks stadium IIB hingga IVB yang datang ke poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan menjalani pemeriksaan MRI sebelum dilakukan terapi pada bulan Januari 2016 hingga Mei 2017.Hasil: Dari 76 subjek yang diteliti, didapatkan sebanyak 4 (5,1%) subyek yang mengalami pembesaran KGB paraaorta. Tidak didapatkan perbedaan yang bermakna antara status pembesaran KGB paraaorta dan usia (p = 0,829), usia hubungan seksual pertama (p = 0,333), paritas (p = 0,642), dan diameter massa (p = 0,777). Pasien dengan pembesaran KGB paraaorta memiliki risiko 2,13 kali lipat (p = 0,02, OR 2,13, IK95% 1,12-4,07) memiliki risiko respon terapi negatif. Tidak terdapat perbedaan kesintasan 1 tahun antara pembesaran KGB paraaorta dan tidak (median 201 vs. 293, p = 0,072).Kesimpulan Pasien dengan pembesaran KGB paraaorta memiliki risiko lebih tinggi mengalami respon radioterapi negatif. (p < 0,05). Tidak terdapat kesintasan 1 tahun antara pasien kanker serviks stadium lanjut dengan dan tanpa pembesaran KGB.Kata kunci: kanker serviks, paraaorta, pembesaran KGB, radioterapi.
The Role of Obstetrician Gynecologist in Ovarian Cancer Management Laila Nuranna
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.v8i4.1447

Abstract

Association of Obstetric Risk Factors with Postpartum Urine Retention in Spontaneous Labor: Hubungan Faktor Risiko Obstetrik dengan Retensio Urin Postpartum pada Persalinan Spontan Pribakti Budinurdjaja; Ihya R. Nizomy; Hermin Sabaruddin
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 2 April 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i2.1462

Abstract

Objective: To determine the relationship between obstetric risk factors and the incidence of postpartum urinary retention in spontaneous labour at RSUD Ulin Banjarmasin.Methods: This clinical study used an analytical observational design with a cross-sectional approach. The population of this study was patients with a diagnosis of postpartum urinary retention in spontaneous labour in the delivery ward and postpartum ward of Ulin Banjarmasin Hospital between January 2018-January 2020. The sample for this study was a part of the target population selected by purposive sampling, which fulfilled the inclusion and exclusion criteria. Data were analyzed using the Chi square test and multivariate analysis using binary logistics.Results: The results showed 35 samples of patients diagnosed with postpartum urinary retention in spontaneous labour and had met the inclusion and exclusion criteria. Characteristic data of the study samples found that most of the study subjects were more than 35 years old, 27 patients (77%), 21 patients (60%) of cases with primigravida parity, 26 patients (76%) with the duration of second stage labour more than equal to 1 hour. Episiotomy was performed in 30 patients (86%), 34 patients (97%) had a newborn birthweight of less than 4000 grams. There was a significant association between the risk factors for parity in primigravida (p-value 0.02), second stage labour duration in primigravida (p-value 0.01), and episiotomy (p-value 0.01), with postpartum urinary retention in spontaneous labour. In contrast, age (p-value 0.19), and birthweight (p-value 0.10) were not significantly associated with postpartum urinary retention in spontaneous labour.Conclusions: There were significant associations between obstetric risk factors (parity, duration of second stage labour, and episiotomy) with postpartum urinary retention in spontaneous labour. Whereas age and birth weight were not significantly associated with postpartum urinary retention in spontaneous labour.Keywords: obstetric risk, postpartum retention, spontaneous delivery. Abstrak Tujuan: Mengetahui hubungan faktor risiko obstetrik dengan kejadian retensio urin postpartum pada persalinan spontan di RSUD Ulin Banjarmasin.Metode: Penelitian ini merupakan penelitian klinis dengan rancangan observasional analitik dengan pendekatan potong lintang. Populasi dari penelitian ini adalah ibu postpartum yang didiagnosis dengan retensio urin postpartum pada persalinan spontan di kamar bersalin dan di ruangan nifas RSUD Ulin Banjarmasin periode Januari 2018-Agustus 2020. Data dianalisis bivariat menggunakan uji Chi square dan analisis multivariate dengan menggunakan binary logistik.Hasil: Didapati 35 sampel yang didiagnosis retensio urin postpartum pada persalinan spontan dan memenuhi kriteria inkulusi dan eksklusi. Data karakteristik sampel penelitian ditemukan usia terbanyak subyek penelitian berusia lebih dari 35 tahun sebanyak 27 pasien (77,14%), kasus dengan paritas primigravida sebanyak 21 pasien (60%), lama kala dua primigravida lebih dari sama dengan 1 jam sebanyak 26 pasien (76%). Tindakan episiotomi sebanyak 30 pasien (86%), berat bayi lahir terbanyak pada berat kurang dari 4.000 gram yaitu sebnyak 34 pasien (97%). Terdapat hubungan yang bermakna pada faktor risiko paritas pada primigravida dengan p value 0,02, lama kala dua dengan p value 0,01, dan tindakan episotomi dengan p value 0.01 dengan kejadian retensio urin postpartum sedangkan didapatkan hasil yang tidak bermakna pada risiko obstetrik usia dengan p value 0.19 dan berat bayi lahir dengan p value 0.10 pada kejadian retensio urin postpartum.Kesimpulan: Terdapat hubungan signifikan antara faktor risiko obstetrik (paritas, lama kala dua dan tindakan episotomi) dengan retensio urin postpartum persalinan spontan. Sedangkan umur dan berat badan lahir tidak berhubungan dengan retensio urin postpartum pada persalinan spontanKata kunci: persalinan spontan, risiko obstetrik, retensio postpartum.

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