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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : 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
EMA and EMACO Chemotherapy in High Risk Gestational Trophoblast Disease, which Better? Kemoterapi EMA dan EMACO dalam Risiko Tinggi Penyakit Trofoblas Gestasional, Mana yang Lebih Baik? I Gde S. Winata; Putra A. E. Aricandana
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 3 July 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i3.1595

Abstract

Abstract Objective: Determine the best effectiveness and efficacy between EMA and EMACO for patients with high-risk GTN. Results: GTN patients who received EMA showed remissions as high as 74.4% - 96.6% of cases. The side effects of anemia in EMA were less toxic than EMACO, but it wasn’t the case in neutropenia. Two studies showed that 57,1% and 87% patients relapse within 2 years, while none in 5 years and 7 years follow-ups. Discussion: With EMACO use, it has been observed to result in increased morbidity and increased health care costs and when patients experience complications while staying overnight in the hospital, they are not monitored by a good specialist team. Patients treated with EMACO had more peripheral neuropathy as result of vincristine than EMA. The use of EMA certainly requires further evaluation. Conclusion: Patients with High-risk GTN who treated first-line with EMA or EMACO have an excellent prognosis. Both regiments are equally effective. There were differences in treatment scheduling, hospitalization requirements, and toxicity between regimens. Keywords: EMA, EMACO, gestational trophoblastic neoplasia Abstrak: Tujuan: Mengetahui efektivitas dan efikasi terbaik diantara EMA dan EMACO untuk pasien dengan NTG berisiko tinggi. Hasil: Pasien dengan NTG yang menerima EMA menunjukkan remisi setinggi 74.4%-96.6% dari kasus. Efek samping anemia dari EMA lebih tidak toksik dibandingkan EMACO, namun tidak dengan neutropenia. Dua studi menunjukkan bahwa 57.1% dan 87% pasien mengalami kekambuhan dalam 2 tahun, namun tidak ada dalam follow up 5 tahun dan 7 tahun. Diskusi: Dengan penggunaan EMACO, dapat diobservasi bahwa terdapat peningkatan morbiditas dan peningkatan biaya pelayanan kesehatan, dan ketika pasien mengalami komplikasi pada saat rawat inap di rumah sakit, mereka tidak dimonitor oleh tim spesialis yang baik. Pasien yang diterapi dengan EMACO memiliki efek samping neuropati perifer lebih tinggi yang disebabkan oleh vinkristin, dibandingkan EMA. Penggunaan EMA membutuhkan evaluasi lebih lanjut. Kesimpulan: Pasien dengan NTG berisiko tinggi yang diterapi dengan lini pertama EMA atau EMACO mempunya prognosis yang baik. Kedua regimen tersebut efektif. Ada perbedaan dalam penjadwalan terapi, kebutuhan rawat inap dan toksisitas antara regimen, Kata kunci: EMA, EMACO, neoplasia trofoblastik gestasional
Prenatal Differential Diagnosis and Prospective Management of Hydranencephaly: Diagnosis Diferensial Prenatal dan Manajemen Prospektif dari Hidranensefali Gezta N. Hermawan; I. Nym. Gde. D. Mahardhika; Jennie D. Sutantio; Dyana S. Velies
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 3 July 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i3.1597

Abstract

Objective: To report a rare case of hydranencephaly that was diagnosed during prenatal period. We also provided further review of differential diagnosis and management performed in Ende District General Hospital, based on appropriate literatures and guidelines available. Methods: Case Report Case: A 27-year old primigravida women was diagnosed with term pregnancy (37 weeks of gestation) and intra-uterine singleton live fetus with hydranencephaly via ultrasonography. In this patient, emergency caesarean section (CS) was performed to prevent complication of cephalo-pelvic disproportion (CPD), involving teamwork between obstetrics and perinatology. A male neonate was born weighing 3000 grams, head circumference of 32 cm, and APGAR score of 2/4/7/8 suggestive of asphyxia and respiratory distress. The newborn was immediately transferred to Neonatal Intensive Care Unit (NICU) for further resuscitative management and observation. The newborn remains in stable condition after resuscitative management was given. Post-natal transcranial sonography (TCS) of the newborn was performed by a pediatrician, and the diagnosis of hydranencephaly was confirmed. The newborn was later referred to facilities with neurosurgery department for further evaluation and intervention. Conclusion: Early prenatal recognition of hydranencephaly and exclusion of similar differential diagnosis, which includes: hydrocephalus, holoproscencephaly, porencephaly and schizencephaly, are fundamental in formulating proper multidisciplinary management with pediatric and neurosurgery department, which may consequently improve the newborn’s life expectancy. Keywords: Hydranencephaly, Differential Diagnosis, Management. Abstrak Tujuan: Melaporkan suatu kasus langka hidranensefali yang kami diagnosa dalam periode prenatal; dan memberikan ulasan lanjut mengenai diagnosis diferensial dan manajemen yang kami kerjakan di Rumah Sakit Umum Ende, berdasarkan literatur dan pedoman ilmiah yang tersedia. Methode: Laporan Kasus Kasus: Seorang perempuan primigravida berusia 27 tahun di diagnosa dengan kehamilan aterm (37 minggu gestasi), janin tunggal hidup intrauterin dengan hidranensefali via ultrasonografi. Pada pasien ini dilakukan Sectio Caesarea (SC) cito untuk mencegah komplikasi dari disproporsi kepala-panggul dengan kerjasama tim kebidanan dan perinatologi. Lahir bayi laki-laki dengan berat badan 3000 gram, lingkar kepala 32 cm, dan skor APGAR 2/4/7/8 dengan kesan asfiksia dan distres pernapasan. Bayi segera dipindahkan ke Neonatal Intensive Care Unit (NICU) untuk penanganan resusitatif lanjut dan observasi. Bayi tetap bertahan dalam kondisi stabil setelah diberikan manajemen resusitatif. Pemeriksaan sonografi transkranial paska natal dilakukan oleh dokter anak, dan diagnosis hidranensefali terkonfirmasi. Bayi kemudian di rujuk ke fasilitas dengan ketersediaan departemen bedah saraf untuk evaluasi dan intervensi lanjut. Kesimpulan: Deteksi dini prenatal hidranensefali dan eksklusi diagnosis diferensial serupa, yang mencakup: hidrosefalus, holoprosensefali, porensefali, dan skizensefali, adalah dasar dari formulasi manajemen multidisiplin yang baik antara departemen pediatrik maupun bedah saraf, sehingga dapat meningkatkan kualitas dan ekspektasi hidup bayi baru lahir. Kata Kunci: Hidranensefali, Diagnosis Diferensial, Manajemen
Calsium Supplementation with Rasbora sp. to Prevent Loss of Bone Mineral Density during Gonadotropin-releasing hormone Agonis Long-term Treatment Enrico Hervianto; Hardyan Sauqi; Farida Heriyani; Juhairina
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1602

Abstract

Background. Gonadotropin-releasing hormone (GnRH) agonist widely used to induce hypoestrogenic climate overcoming any benign gynecologic abnormalities such as endometriosis, adenomyosis, or various cause of abnormal uterine bleeding. Hypoestrogenic cause some of adverse effect mainly loss of bone mineral density (BMD). Suplementation of calcium improve loss in BMD, hence prevent development of osteoporosis. Certain area of Indonesia shows specific biodiversity, for example South Borneo has its wetland biodiversity in swamp and river. Processed food from fishery like Rasbora sp. (locally called Seluang fish) is local favourite due to access and economical reason. Method. Studies included 24 reproductive age (15-49 years old) female on agonist GnRH leuprolide acetate 11,25 mcg regimen given subcutaneously. Measurement of bone mineral density was done twice within 3 months apart, before and after first agonist GnRH treatment. During observation, subject was divided to one of three daily supplementation belows, placebo containing saccharum lactis, grinded powder of 500 mg of calcium, or grinded powder of dried Rasbora sp containing 500 mg of calcium. Measurement pre- and post- supplementation was count using bone quality index with Osteosys of Sonost 3000. Result. Placebo supplementation group in GnRH agonist has bone mineral density loss of -22,7201 greater than 500 mg grinded powder of lactate calcium dan grinded powder of rasbora sp, respectively -4,4570 and -3,3634 after 3 months of trial. Homogeneity test shown p=0.031 level of significancy and ANOVA resulted a significant difference from three classes. Post Hoc resulted calcium lactate supplementation 18,26 + 3,20 greater (p = 0.001) and grinded powder of Seluang 19,36 + 3,20 greater (p = 0.000). Both form of calcium lactate and fish powder supplementation have no significant differences. Conclusion. Calcium supplementation in both of calcium lactate powder and natural resources help maintaining bone mineral density during GnRH agonist treatment. Seluang fish (Rasbora sp.), abundantly found along Indonesia people especially in South Borneo, has similar potency with pharmaceutical calcium lactate product in same weight. Fishery product, has beneficial trace element for bodies, 84 mg of calcium (Ca), 6,81 % of magnesium (Mg), 13,4 mg of iron (Fe), dan 3.97 % of zinc (Zn). Keyword: Bone mineral density, Calcium supplementation, Agonist GnRH, Rasbora Sp.
Successful pregnancy after hCG/hMG treatment in an azoospermic male with idiopathic hypogonadotropic hypogonadism Gyun-Ho Jeon; Cheyon Park
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1604

Abstract

Idiopathic hypogonadotropic hypogonadism (IHH) is one of the correctable causes of male infertility. Although there have been several previous reports about fertility treatment for IHH, there are no established guidelines of therapeutic method yet. We present an azoospermic male of IHH who succeeded in pregnancy and full term live birth after 18 months of treatment with human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG), and then changed his treatment into testosterone replacement therapy to maintain an appropriate male hormone level. This case report shows that a thorough and careful examination of whether it is a reversible cause is necessary and important in the approach to male infertility. In addition, it further proves that, in the case of IHH, a continuous long-term gonadotrophic stimulation therapy contributes to successful pregnancy and may need a testosterone replacement therapy after birth.
Sociodemographic Factors of Elective and Emergency Cesarean Delivery in the Referal Hospital: A cross-sectional study: Faktor Sosiodemografi pada persalinan seksio sesarea elektif dan emergensi di Rumah Sakit Rujukan: sebuah penelitian potong lintang Restuaji B.K. Umam; Nur I. Purnamasari; I Putu Sudayasa; Juminten Saimin
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1613

Abstract

Objectives: To analyze the correlation between sociodemographic factors and cesarean section delivery at Referral Hospital in Kendari. Method: This was a cross-sectional study conducted at dr. Ismoyo Hospital in Kendari. Data were obtained from medical records of cesarean section delivery from January to December 2019. Sampling used simple random sampling techniques. Data were analyzed using the Chi-square test. Result: There were 50.5% emergency cesarean and 49.5% elective cesarean. The maternal age was 18-44 years. Most cases are aged 20-35 years (78.5%), have a higher education level (65.1%), employees (53.2%), and multipara (56.5%). There was a correlation between age and cesarean section (p = 0.027). There was no correlation between education level (p = 0.618), occupation (p = 0.563), and parity (p = 0.365) with cesarean section. Conclusion: There is a correlation between maternal age and cesarean section. Education, counseling, and antenatal care should be done for early detection. Keywords: age, cesarean section, education level, occupation, parity
Level of maternal zinc serum as risk factor of preeclampsia Tian Kaprianti; Putri Mirani; Abarham Martadiansyah; Peby M. Lestari; Theodorus Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1616

Abstract

Objective : To know the relationship of serum zinc levels with preeclampsia (PE) Method: This observational research uses a type of case control research. The population of this study is all pregnant women with a single pregnancy, gestational age of 28-42 weeks who were treated at the Department of Obstetrics and Gynecology of RSUP Dr. Mohammad Hoesin Palembang from August 2020 to November 2020. The study divided into 2 group, a case group of 30 pregnant women with PE and a control group of 60 pregnant women non PE. Serum zinc level examination is performed on all samples that match the research criteria. The data is processed by using SPSS software program version 20.0 Windows. Result: Both case and control groups had no meaningful differences to the general characteristics of the patient. There were significant differences in average zinc levels of maternal serum in both research groups (p=0.013; 43.90 plus-minus 15.79 pg/dL). The value of serum zinc levels that have the best sensitivity and specificity is at 45.5 pg/dL. Conclusion: There is a meaningful relationship between serum zinc levels and PE events. Pregnant women with serum zinc levels greater than or equal to 45.5 pg /dL were significantly at 3.2 times more risk of PE than pregnant women with serum zinc levels less than or equal to 45.5 pg/dL. In this case it is necessary to supplement zinc earlier in pregnancy to reduce the risk of preeclampsia. Keywords: preeclampsia, zinc, case-control studies
Assessment serum zinc levels in pregnancy with COVID-19 compared with normal pregnancy: Penilaian kadar seng serum pada kehamilan dengan COVID-19 dibandingkan dengan kehamilan normal Freddy W. Wagey; Vivi Mamangkey; Frank M.M. Wakey
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1623

Abstract

Abstract Objective: The objective of this study was to assess serum zinc levels in pregnancy with COVID-19 compared with normal pregnancy. Methods: The sampling method used was consecutive sampling. All subjects enrolled must meet eligibility inclusion and exclusion criteria with signed informed consent. The study was conducted from March 2021 to June 2021 in Manado. Pregnant women with COVID-19 and normal pregnant women serum zinc levels were measured. Results:Sixteen pregnant patients with COVID-19 and 16 normal pregnant patients’ serum zinc levels were measured.All pregnant women with COVID-19 have low serum zinc levels (100%), whereas in the normal pregnancy group only 8 subjects (50%) have low serum zinc levels and 8 subjects (50%) have normal serum zinc levels. In the pregnancy with COVID-19 group, the mean±SD value was 40.75±10.440, whereas in the normal pregnancy group the mean±SD value was 60.25±17.407. The analysis using an independent T-test shows a significant difference in serum zinc levels between pregnancies with COVID-19 and normal pregnancies (p=0.001). Conclusion: There is a significant difference in serum zinc levels in pregnancies with COVID-19 and normal pregnancies. Keywords: COVID-19,pregnancy with COVID-19, zinc in pregnancy. Abstrak Tujuan: Untuk mengetahui kadar zinc pada kehamilan dengan COVID-19 dibandingkan pada kehamilan normal. Metode: Pengambilan sampel metode consecutive sampling setiap subjek yang sesuai dengan kriteria inklusi dan eksklusi penelitian dan telah menandatangani surat persetujuan. Penelitiandilakukan bulan Maret 2021 sampai Juni 2021 di Manado. Dilakukan pemeriksaan kadar zinc dalam serum pasien hamil dengan COVID-19 dan pasien hamil normal. Hasil:Enam belas pasien hamil dengan COVID-19 dan 16 pasien hamil normal dilakukan pemeriksaan kadar zinc. Kelompok kehamilan dengan COVID-19, semuanya memiliki kadar zinc rendah (100%). Sedangkan pada kehamilan normal kelompok kadar zinc rendah sebanyak 8 orang (50%) dan kadar zinc normal sebanyak 8 orang (50%). Pada kelompok kehamilan dengan COVID-19 didapatkan nilai mean±SD sebesar 40,75±10,440, sedangkan pada kelompok kehamilan normal nilai mean±SD sebesar 60,25±17,407. Pada analisis uji beda independen menunjukkan bahwa terdapat perbedaan bermakna kadar zinc pada kehamilan dengan COVID-19 dan kehamilan normal (p=0.001). Kesimpulan: Terdapat perbedaan bermakna kadar zinc pada kehamilan dengan COVID-19 dan kehamilan normal Kata kunci : COVID-19,kehamilan dengan COVID-19,zinc pada kehamilan,
Assosiation between Serum Cortisol Levels and Anxiety levels In Elective and Emergency Cesarean Section: Hubungan antara Kadar Kortisol Serum dan Tingkat Kecemasan Pada Operasi Caesar Elektif dan Darurat Nadia O. S. Nurdin; John J. E. Wantania; Ronny A. A. Mewengkang
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1624

Abstract

Objective: To detect anxiety before elective and emergency cesarean section. Methods: This study was a cross-sectional study. The number of research samples was 42 samples consisting of 21 pregnant patients with an elective cesarean section plan and 21 pregnant patients with an emergency cesarean section at Prof. RSUP. Dr. R. D. Kandou Hospital Manado and Network Hospital in Manado from March 2021 to June 2021. Anxiety was assessed by examining serum cortisol and anxiety levels according to the Hamilton questionnaire (HAM-A). The data were then analyzed using SPSS version 23.0 software. Results: Cortisol levels were higher in emergency cesarean section (mean 21.590±11.6392) compared to elective cesarean section (mean 10.586±4.9501). Anxiety levels according to HAM-A scores were higher in emergency cesarean section (mean 15.33±7.722) compared to elective cesarean section (mean 7.19±3.614). Conclusion: There was a significant positive correlation between cortisol levels and anxiety levels based on HAM-A scores. Keywords: cesarean section , cortisol, HAM-A score. anxiety, Abstrak Tujuan: Untuk mendeteksi kecemasan sebelum tindakan seksio sesarea elektif dan emergensi. Metode: Penelitian ini merupakan suatu penelitian cross-sectional. Jumlah sampel penelitian 42 sampel terdiri dari 21 pasien hamil dengan rencana seksio sesarea elektif dan 21 pasien hamil dengan rencana seksio sesarea emergensi di RSUP Prof. Dr. R. D. Kandou Manado dan RS Jejaring di Kota Manado dari bulan Maret 2021 sampai bulan Juni 2021. Kecemasan dinilai melalui pemeriksaan kortisol serum dan tingkat kecemasan menurut kusioner Hamilton (HAM-A). Data kemudian dianalisis dengan menggunakan software SPSS versi 23.0. Hasil: Kadar kortisol secara rata-rata lebih tinggi pada seksio sesarea emergensi (mean 21.590±11.6392) dibandingkan dengan seksio sesarea elektif (mean 10.586±4.9501). Tingkat kecemasan menurut skor HAM-A secara rata-rata lebih tinggi pada seksio sesarea emergensi (mean 15.33±7.722) dibandingkan dengan seksio sesarea elektif (mean 7.19±3.614). Kesimpulan: Terdapat korelasi positif bermakna antara kadar kortisol dan tingkat kecemasan berdasarkan skor HAM-A pada semua subjek penelitian. Kata kunci: kortisol, seksio sesarea, skor HAM-A. kecemasan
The mIRNA519a-3p and NKG2D in endometriosis. Cepi Teguh Pramayadi; Muharam Natadisastra; Kanadi Sumapradja; Aria Kekalih
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1638

Abstract

Background: Natural killer (NK) cells play a role in pathogenesis of endometriosis. Lower expressions of NK cells receptor group 2D (NKG2D) ligands inhibits cytotoxic activity of NK cells; a common immunity avoidance mechanism in neoplasms. Literatures have proven miRNAs regulatory effect on NKG2D expression. There has been no specific biomarker for diagnosing endometriosis. Non-invasive means of diagnosing endometriosis may reduce well-known risks of invasive method of diagnosis and yield better results. Purpose: To investigate the correlation between miRNA-519a-3p expression with NKG2D ligands (MICA, MICB, ULBP 1-6) on endometriosis and non-endometriosis patients. Methods: This was a cross-sectional study held in five centers: dr. Cipto Mangunkusumo General Hospital, Pelni Hospital, Bunda Hospital, YPK Mandiri Hospital, and Primaya Evasari Hospital from October 2020 to July 2021. miRNA and NKG2DL analysis were done in Human Reproduction, Infertility and Family Planning (HRIFP) cluster at IMERI FKUI. Results: We obtained 19 patients in each study groups. NKG2D ligands and miRNA519a-3p relative expressions were not significantly different (p > 0.05). Increased miRNA519a-3p expression negatively affected NKG2D ligands expression. A decrease in ULBP1 and an increase in ULBP2 increased the probability for endometriosis. NKG2D ligands expression may be influenced by infection, pro-inflammatory cytokine production, dan polymorphism. NKG2D ligands expression level can be different depending on the origin of the sample. Lower expression of miRNA519a-3p indirectly inhibits tumor apoptosis by lowering NKG2D ligands, caspase, or mRNA. Conclussion: We did not manage to establish a correlation between NKG2D ligands with miRNA519a-3p in endometriosis and non-endometriosis patients.
How the Type of Surgery and Adherence to the Clinical Pathway Correlate with Quality Control and Cost Control in Endometriosis Surgery: Bagaimana Jenis Pembedahan dan Kepatuhan pada Clinical Pathway Berhubungan dengan Kontrol Kualitas dan Kontrol Biaya pada Operasi Endometriosis Muharam Natadisastra; Yohanes Alda; Alfa P. Meutia
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 3 July 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i3.1682

Abstract

Objective: This study examined the correlation of the type of surgery and adherence to the clinical pathway corresponding to the national guidelines in terms of quality and cost control. Methods : Quantitative economic evaluation was conducted to assess the type of surgery and adherence to clinical pathways in terms of quality and cost control. The data were analyzed using the chi-square or Mann–Whitney test. Results : Of the sample of 82 patients who had undergone laparoscopy or laparotomy, 54.9% had a laparoscopic procedure, while 45.1% had undergone laparotomy ; only 25.6% of the case procedures adhered to the clinical pathway. In general, it can be interpreted that, in a laparoscopy procedure, the potential risk that a mismatch will occur in quality control is up to 32 times that of a laparotomy procedure. Moreover, good adherence to the clinical pathway does not correlate with good cost control. Overall, of the 82 cases, only three (3.7%) showed a good fit for both quality control and cost control. Conclusions : The type of surgery correlates with quality and cost control, whereas adherence to the clinical pathway does not correlate with either quality or cost control. Keywords: Laparotomy, Laparoscopy, surgery, endometriosis, national health insurance Abstrak Tujuan: Studi ini menguji korelasi jenis operasi dan kepatuhan terhadap jalur klinis yang sesuai dengan pedoman nasional dalam hal kontrol kualitas dan biaya. Metode: Evaluasi ekonomi kuantitatif dilakukan untuk menilai jenis operasi dan kepatuhan terhadap jalur klinis dalam hal kualitas dan pengendalian biaya. Data dianalisis menggunakan uji chi-square atau Mann-Whitney. Hasil: Dari sampel 82 pasien yang pernah menjalani laparoskopi atau laparotomi, 54,9% menjalani prosedur laparoskopi, sedangkan 45,1% pernah menjalani laparotomi ; hanya 25,6% dari prosedur kasus yang mengikuti jalur klinis. Secara umum dapat diartikan bahwa, dalam prosedur laparoskopi, potensi risiko terjadinya ketidaksesuaian dalam kontrol kualitas adalah hingga 32 kali lipat dari prosedur laparotomi. Selain itu, kepatuhan yang baik terhadap jalur klinis tidak berkorelasi dengan pengendalian biaya yang baik. Secara keseluruhan, dari 82 kasus, hanya tiga (3,7%) yang menunjukkan kesesuaian yang baik untuk pengendalian kualitas dan pengendalian biaya. Kesimpulan: Jenis pembedahan berkorelasi dengan kualitas dan pengendalian biaya, sedangkan kepatuhan terhadap jalur klinis tidak berkorelasi dengan kualitas atau pengendalian biaya. Kata kunci: Laparotomi, Laparoskopi, pembedahan, endometriosis, jaminan kesehatan nasional

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