G. Hermawan, I. Nym. Gde. D. Mahardhika, Jennie D. Sutantio, Dyana S. Velies
{"title":"Prenatal Differential Diagnosis and Prospective Management of Hydranencephaly","authors":"G. Hermawan, I. Nym. Gde. D. Mahardhika, Jennie D. Sutantio, Dyana S. Velies","doi":"10.32771/inajog.v10i3.1597","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1597","url":null,"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. \u0000 \u0000Methods: Case Report \u0000 \u0000Case: 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. \u0000 \u0000Conclusion: 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. \u0000 \u0000Keywords: Hydranencephaly, Differential Diagnosis, Management. \u0000 \u0000Abstrak \u0000 \u0000Tujuan: 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. \u0000 \u0000Methode: Laporan Kasus \u0000 \u0000Kasus: 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. \u0000 \u0000Kesimpulan: Deteksi dini prenatal hidranen","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46834471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abnormal Trophoblast Invasion: The Culprit of The Major Obstetrics Problems","authors":"S. Sulistyawati","doi":"10.32771/inajog.v10i3.1801","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1801","url":null,"abstract":"Pathogenesis of preeclampsia as the consequences of the interaction failure between trophoblast and womb, mainly in the 1 st trimester leads to a stress response in the placenta. This may cause poor growth and development of the villous tree, deteriorating transfer of oxygen and nutrients to the fetus. 1 In the simultaneous way huge number of placental debris as the result of necrotic-apoptotic process is released into maternal circulation. 1,2 That of phenomenon related to syncytiotrophoblastic stress is triggering endothelial dysregulation and extreme in fl ammation process, and so do the clinical respond related, such as: hypertension, proteinuria, edema, convulsion, cerebral edema, acute renal failure, acute liver dysfunction, thrombocytopenia (which are as the maternal complications) and fetal growth restriction, preterm delivery, still birth (which are as the fetal complications). 3 Fetal growth restriction (FGR) which could be develop solely or as one entity of early-onset preeclampsia is mostly caused by the poor attitude of extravillous trophoblast cells (EVT) in doing its work on maternal spiral artery remodeling process. 4 As we can see clear from the large data of scienti fi c evidence, the only signi fi cant modality to prevent FGR until recent is by giving low-dose aspirin before 16 weeks of gestational age in selected pregnancies with high resistance index of uterine artery shown by doppler velocimetry ultrasound. 5 Beyond that, only timely delivery after series of close monitoring that will give better perinatal outcome. 6 This will often end with preterm delivery, which increases the percentage of preterm birth in general. 6 In the placenta accreta spectrum (PAS) is a condition where the trophoblast invasion is too aggressive. The development of PAS is a complex multifactorial process related to the combination of decidual-myometrial (as the results of previous c-section or other gynecological surgery), absence the basal plate","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41722147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Yeni, Hafni Handayani, Aulia Nasir, Ima Indirayani, Rezania Razali
{"title":"The Association betweeen Cesarean Section and Placenta Accreta","authors":"C. Yeni, Hafni Handayani, Aulia Nasir, Ima Indirayani, Rezania Razali","doi":"10.32771/inajog.v10i3.1572","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1572","url":null,"abstract":"Objective: To determine the relationship between the history of cesarean section and the incidence of placenta accreta in Dr. Zainoel Abidin Hospital Banda Aceh. \u0000Methods: The data collection method used was secondary data collection which was assessed through retrospective medical records. Sampling in this study using total sampling method. The results of the study were processed using the chi square statistical test on 781 research samples that were collected from period April 2019 - April 2020. \u0000Results: The results obtained were 22 respondents (2.8%) experienced placenta accreta where 18 respondents (2.30%) had placenta accreta with a history of CS and 4 respondents (0.51%) placenta accreta without a history of CS. The p value obtained was 0.000 (p value <0.05). In this study, the value of the Risk Estimate (RE) was 6.483 with a Confident Interval (CI) of 95% being (2.21-18.97). \u0000Conclusions: There is a very significant relationship between the history of cesarean section and the incidence of placenta accreta at RSUDZA Banda Aceh and mothers with a history of CS have a 6 times greater risk of experiencing placenta accreta. \u0000Keywords: cesarean section, placenta accrete. \u0000 \u0000Abstrak \u0000Tujuan: Untuk mengetahui hubungan riwayat seksio sesarea dengan kejadian plasenta akreta di Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh. \u0000Metode: Jenis penelitian ini adalah penelitian analitik dengan desain potong lintang. Metode pengambilan data yang digunakan adalah pengambilan data sekunder yang dinilai melalui rekam medik secara retrospektif. Pengambilan sampel pada penelitian ini menggunakan metode total sampling. Hasil penelitian diolah menggunakan uji statistik chi square terhadap 781 sampel penelitian yang telah dikumpulkan dari data periode April 2019 – April 2020. \u0000Hasil: Hasil yang didapatkan sebanyak 22 responden (2,8%) mengalami plasenta akreta dimana 18 responden (2,30%) plasenta akreta dengan riwayat SC dan 4 responden (0,51%) plasenta akreta tanpa riwayat SC. Nilai p value yang didapatkan adalah 0.000 (p value <0,05). Pada penelitian ini didapatkan nilai Risk Estimate (RE) 6,483 dengan Confident Interval (CI) 95% berada (2,21- 18,97). \u0000Kesimpulan: Hasil ini menunjukkan terdapat hubungan yang sangat signifikan antara riwayat seksio sesarea dengan kejadian plasenta akreta di RSUDZA Banda Aceh dan ibu dengan riwayat SC memiliki risiko 6 kali lebih besar untuk mengalami plasenta akreta. \u0000Kata kunci: plasenta akreta, seksio sesarea.","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45205263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does Lifestyle Affect Dysmenorrhea Intensity? A Cross-Sectional Study","authors":"Annisa D. P. Hernanto, A. Polim, Vetinly","doi":"10.32771/inajog.v10i3.1559","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1559","url":null,"abstract":"Objective : To determine whether or not there is a relationship between lifestyle and dysmenorrhea intensity in FKIK Atma Jaya students. \u0000Methods : This research is a cross sectional analytic descriptive study with a minimum sample size of 196 students of the FKIK Atma Jaya class 2017-2019. The degree of pain was assessed using the Verbal Multidimensional Scoring System pain scale. Frequency of fast food consumption were assessed with Food Frequency Questionnaire. Frequency of physical activity were assessed with International Physical Activity Questionnaire. The datas were analyzed using the Kolmogorov-Smirnov normality test, the Mann-Whitney U test, and the Kruskal-Wallis test. \u0000Results : The highest percentage of menstrual pain was at grade 1 (painful menstruation; rarely disturbed activity; no systemic symptoms; rarely required analgesics) for the VMSS scale (46.3%). The percentage of fast food consumption in this study was 86.1%. The highest percentage of physical activity in the category of moderate physical activity was 56.2%. The results of this study indicates a significant relationship between consumption of fast food and the intensity of dysmenorrhea with p = 0.017. There were no significant relationship between physical activity and the intensity of dysmenorrhea with p = 0.225 \u0000Conclusion : Consumption of fast food were related to the intensity of dysmenorrhea, whereas physical activity was not related with the intensity of dysmenorrhea. \u0000Keywords : dysmenorrhea, , fast food consumption, lifestyle, physical activity \u0000 \u0000Abstrak \u0000Tujuan : Untuk mengetahui ada tidaknya hubungan gaya hidup dengan intensitas dismenore pada mahasiswa FKIK Atma Jaya. \u0000Metode : Penelitian ini merupakan penelitian deskriptif analitik cross sectional dengan jumlah sampel minimal 196 mahasiswa FKIK Atma Jaya angkatan 2017-2019. Derajat nyeri dinilai dengan menggunakan skala nyeri Verbal Multidimensional Scoring System. Frekuensi konsumsi makanan cepat saji dinilai dengan Food Frequency Questionnaire. Frekuensi aktivitas fisik dinilai dengan International Physical Activity Questionnaire. Data dianalisis menggunakan uji normalitas Kolmogorov-Smirnov, uji Mann-Whitney U, dan uji Kruskal-Wallis. \u0000Hasil : Persentase nyeri haid tertinggi pada derajat 1 (nyeri haid; aktivitas jarang terganggu; tidak ada gejala sistemik; jarang memerlukan analgesik) untuk skala VMSS (46,3%). Persentase konsumsi fast food dalam penelitian ini adalah 86,1%. Persentase aktivitas fisik tertinggi pada kategori aktivitas fisik sedang adalah 56,2%. Hasil penelitian ini menunjukkan adanya hubungan yang signifikan antara konsumsi fast food dengan intensitas dismenore dengan p = 0,017. Tidak ada hubungan yang bermakna antara aktivitas fisik dengan intensitas dismenore dengan p=0,225 \u0000Kesimpulan : Konsumsi fast food berhubungan dengan intensitas dismenore, sedangkan aktivitas fisik tidak berhubungan dengan intensitas dismenore. \u0000Kata kunci : aktivitas fisik, dismenore, gaya hidup, konsumsi fast f","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48506630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"EMA and EMACO Chemotherapy in High Risk Gestational Trophoblast Disease, which Better?","authors":"I Gde S. Winata, Putra A. E. Aricandana","doi":"10.32771/inajog.v10i3.1595","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1595","url":null,"abstract":"Abstract \u0000Objective: Determine the best effectiveness and efficacy between EMA and EMACO for patients with high-risk GTN. \u0000Results: 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. \u0000Discussion: 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. \u0000Conclusion: 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. \u0000 \u0000Keywords: EMA, EMACO, gestational trophoblastic neoplasia \u0000 \u0000Abstrak: \u0000Tujuan: Mengetahui efektivitas dan efikasi terbaik diantara EMA dan EMACO untuk pasien dengan NTG berisiko tinggi. \u0000Hasil: 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. \u0000Diskusi: 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. \u0000Kesimpulan: 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, \u0000Kata kunci: EMA, EMACO, neoplasia trofoblastik gestasional \u0000 \u0000 ","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43867102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cesarean delivery Characteristics during JKN Implementation","authors":"Sofia Al Farizi, E. Ernawati, Ernawaty Ernawaty","doi":"10.32771/inajog.v10i3.1593","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1593","url":null,"abstract":"Objective: To compare the characteristics of cesarean before and during JKN, also analyzes the factors that influence these differences. \u0000Methods: This was a quantitative study with a longitudinal retrospective design and qualitative research used design case studies. The population were delivery women at the Banyuwangi referral hospital before and during JKN. The quantitative data were analyzed firstly by univariable and then bivariable. The bivariable analysis was performed by comparing the prevalence ratio (PR) between two variables. \u0000Results: The proportion of cesarean delivery had increased significantly during the implementation of JKN. 50% of maternal deaths before JKN gave birth using cesarean delivery, this proportion increased significantly to 60% during JKN. Indications of fraud committed by health workers to be a factor in increasing the proportion of cesarean delivery. Other contributing factors were repeated cesarean delivery, delayed referral, and the number of obstetric complications. \u0000Conclusion: There was an increase in the proportion of cesarean deliveries during the implementation of JKN. BPJS Kesehatan needed to re-evaluate the system they had created so far. The quality of service must be emphasized so that the negative impact on women could be minimized. \u0000Keywords: cesarean section, health insurance, maternal mortality. \u0000 \u0000Abstrak \u0000Tujuan: Membandingkan karakteristik persalinan sesar sebelum dan selama implementasi JKN, selain itu juga menganalisis faktor-faktor yang berpengaruh. \u0000Metode: Studi kuantitatif dengan desain longitudinal retrospective dan studi kualitatif dengan desain case studies. Populasi adalah ibu bersalin di rumah sakit rujukan Kabupaten Banyuwangi sebelum dan selama JKN. Data kuantitatif dianalisis secara univariabel dan bivariabel. Analisis bivariabel dengan membandingkan prevalensi rasio (PR) diantara dua variabel. \u0000Hasil: Proporsi persalinan sesar meningkat secara signifikan selama implementasi JKN. 50% ibu yang meninggal bersalin dengan metode sesar, proporsi ini meningkat selama JKN menjadi 60%. Indikasi kecurangan oleh tenaga kesehatan menjadi salah satu faktor yang menyebabkan peningkatan ini. Faktor lain yang berkontribusi adalah persalinan sesar yang berulang, keterlambatan rujukan dan banyakanya komplikasi obstetrik. \u0000Kesimpulan: Terdapat peningkatan proporsi persalinan sesar selama implementasi JKN. BPJS Kesehatan perlu mengkaji ulang sistem yang dibuat selama ini. Kualitas pelayanan harus tetap dipertahankan, agar tidak berdampak pada kesehatan ibu. \u0000Kata kunci: jaminan kesehatan, kematian ibu, persalinan sesar.","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46383645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How the Type of Surgery and Adherence to the Clinical Pathway Correlate with Quality Control and Cost Control in Endometriosis Surgery","authors":"Muharam Natadisastra, Yohanes Alda, A. Meutia","doi":"10.32771/inajog.v10i3.1682","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1682","url":null,"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. \u0000Methods : 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. \u0000Results : 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. \u0000Conclusions : 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. \u0000Keywords: Laparotomy, Laparoscopy, surgery, endometriosis, national health insurance \u0000Abstrak \u0000Tujuan: Studi ini menguji korelasi jenis operasi dan kepatuhan terhadap jalur klinis yang sesuai dengan pedoman nasional dalam hal kontrol kualitas dan biaya. \u0000Metode: 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. \u0000Hasil: 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. \u0000Kesimpulan: Jenis pembedahan berkorelasi dengan kualitas dan pengendalian biaya, sedangkan kepatuhan terhadap jalur klinis tidak berkorelasi dengan kualitas atau pengendalian biaya. \u0000Kata kunci: Laparotomi, Laparoskopi, pembedahan, endometriosis, jaminan kesehatan nasional","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44531126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Germ Patterns and Antibiotic Susceptibility in Pregnancy and Labor with Risk of Infections","authors":"Reni C. Ibrahim, John Wantania, S. Mongan","doi":"10.32771/inajog.v10i3.1576","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1576","url":null,"abstract":"Objective: To determine the pattern of germs and antibiotic susceptibility tests in pregnant women related to risk factors for infection in preterm PROM cases, the threat of preterm labor, pathological fluor albus, and prolonged labor in Manado city. \u0000Method: This study is a cross-sectional descriptive study. A total of 21 samples were obtained, consisting of six preterm PROM cases, five premature contraction cases, five pathological fluor albus cases, and five prolonged labor cases. The study was conducted in Kandou General Hospital and Affiliated Hospitals, Manado. All patients were informed about the study and signed informed consent. Germ pattern and antibiotics susceptibility data were analyzed. \u0000Results: Of 21 samples, the detected microorganisms included Staphylococcus aureus (12), Coagulase-negative staphylococcus (2), mixed microorganisms (Staphylococcus aureus + Candida sp, Coagulase-negative staphylococcus + Candida sp), Bacillus sp and Candida sp. The susceptible and safe antibiotics for pregnancy were Ampicillin / Sulbactam and Meropenem. The resistant antibiotics were Ceftriaxone, Tetracycline, and Neomycin. \u0000Conclusion: The most common type of bacteria found in pregnant women and women in labor was Staphylococcus aureus. Susceptible and safe antibiotics for pregnancy were Ampicillin / Sulbactam and Meropenem. \u0000Keywords: antibiotic sensitivity test, germ pattern, pregnancy and labor infection. \u0000 \u0000Abstrak \u0000Tujuan: Mengetahui pola kuman dan uji sensitivitas antibiotik pada perempuan hamil terkait faktor risiko infeksi pada kasus KPD preterm, ancaman partus prematurus, fluor albus patologis dan partus lama di kota Manado. \u0000Metode: Studi ini merupakan studi deskriptif potong lintang. Jumlah sampel yang didapatkan sebesar 21 sampel di mana terbagi pada masing-masing kasus KPD preterm 6 sampel, ancaman partus prematurus 5 sampel, fluor albus patologis 5 sampel dan partus lama 5 sampel. Sampel diambil dari RSUP Prof. Dr. R. D. Kandou Manado dan Rumah Sakit Jejaring di kota Manado yang memenuhi kriteria inklusi dan eksklusi. Semua pasien dijelaskan mengenai prosedur penelitian dan penandatanganan inform consent baru dilakukan pengambilan sampel. Data dianalisis dengan cara deskriptif tentang pola kuman dan uji sensitivitas antibiotik pada kehamilan dan persalinan dengan faktor risiko infeksi. \u0000Hasil: Dari 21 sampel, sebaran jenis mikroorganisme diantaranya Staphylococcus areus (12), Staphylococcus non koagulase (2), mikroorganisme campuran (Staphylococcus aureus + Candida sp, Staphylococcus non koagulase + Candida sp), Bacilus sp dan Candida sp. Hasil uji sensitivitas antibiotik yang sensitif dan aman untuk kehamilan di antaranya Ampicillin/Sulbactam dan Meropenem. Hasil uji sensitivitas antibiotik yang resisten adalah Ceftriaxone, Tetracycline dan Neomycin. \u0000Kesimpulan: Jenis mikroorganisme paling banyak adalah Staphylococcus aureus. Hasil uji sensitivitas antibiotik yang sensitif dan aman untuk kehamilan di antaranya Ampicillin/Sulbactam","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42072997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kurniawan, M. Ulfa, Raymond Surya, A. Hestiantoro
{"title":"Clinical Pregnancy Rate in in-Vitro Fertilization (IVF) among Endometrioma Patients Underwent Cystectomy Laparoscopy","authors":"A. Kurniawan, M. Ulfa, Raymond Surya, A. Hestiantoro","doi":"10.32771/inajog.v10i3.1566","DOIUrl":"https://doi.org/10.32771/inajog.v10i3.1566","url":null,"abstract":"Abstract \u0000Objective: to discuss the clinical pregnancy rate and factors influencing fecundity among endometriosis women having cystectomy laparoscopically who underwent IVF. \u0000Methods: The search was conducted on Pubmed®, EBSCOhost®, and Proquest®, Cochrane Library®, ClinicalKey® using MeSH. \u0000Case : A 38-years woman, P0A0 come to the gynecology clinic with a chief complaint of primary infertility for eight years. The patient had undergone a bilateral endometrial cyst resected with laparoscopy and failed for two cycles of IVF. What is the clinical pregnancy rate of women that undergo IVF with a history of ovarian endometrioma cystectomy? \u0000Results:, There were six articles appropriate to the inclusion criteria and further appraised using the Centre for Evidence-Based Medicine, University of Oxford appraisal tools. The studies consisted of five prognostic studies and one meta-analysis. The studies were appraised for their validity, Importance, and Applicability. \u0000Conclusion: The pregnancy rate in patients undergoing IVF after ovarian cystectomy ranges from 14%-45.2%. A prudent consideration and carefulness during cystectomy surgery are essential for patients that wish to be fertile. \u0000Keywords: clinical pregnancy rate, endometrioma, in vitro fertilization, laparoscopy, ovarian cystectomy \u0000 \u0000Abstrak \u0000Tujuan: Untuk menelaah tentang kemungkinan terjadinya kehamilan secara klinis pada perempuan yang menjalani IVF dengan riwayat laparoskopi sistektomi dan faktor-faktor yang mempengaruhi kesuburannya. \u0000Metode: Pencarian jurnal dilakukan dengan menggunakan search engine Pubmed®, EBSCOhost®, dan Proquest®, Cochrane Library®, ClinicalKey® menggunakan MeSH. \u0000Kasus: Perempuan P0A0 berusia 38 tahun datang ke poliklinik dengan keluhan utama infertilitas selama delapan tahun. Pasien memiliki riwayat kista endometrioma bilateral yang sudah di kistektomi dengan laparoskopi dan dua kali gagal menjalani siklus IVF. Berapa kemungkinan terjadinya kehamilan secara klinis pada perempuan yang menjalani IVF dengan riwayat kistektomi endometrioma? \u0000Hasil: Dari hasil pencarian didapatkan enam artikel jurnal yang sesuai dengan kriteria inklusi dan dianalisis lebih lanjut menggunakan telaah kritis Evideence-Based Medicine, University of Oxford. .Terdapat lima jurnal studi prognostic dan satu meta-analisis. Studi-studi tersebut akan ditelaah kritis lebih lanjut berdasarkan validitas, kepentingan, dan aplikabilitasnya \u0000Kesimpulan: Kemungkinan terjadinya kehamilan secara klinis pada pasien yang menjalani IVF setelah kistektomi endometrioma ovarium adalah 14%-45,2%. Pertimbangan yang bijaksana dan hati-hati diperlukan untuk melakukan operasi kistektomi pada pasien yang mengalami endometrioma dan ingin tetap subur. \u0000Kata kunci: endometrioma, fertilisasi in vitro, kehamilan klinis, kistektomi ovarium, laparoskopi","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44808281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Hestiantoro, B. Putri, E. R. Gunardi, Y. B. Saroyo, M. Natadisastra
{"title":"Estradiol on Day Seven is a Good Predictor for Oocyte Maturation Rate in In Vitro Fertilization Program","authors":"A. Hestiantoro, B. Putri, E. R. Gunardi, Y. B. Saroyo, M. Natadisastra","doi":"10.32771/inajog.v10i2.1539","DOIUrl":"https://doi.org/10.32771/inajog.v10i2.1539","url":null,"abstract":"Abstract \u0000Objective: to determine which factors influence the rate of oocyte maturation in In Vitro Fertilization (IVF) program. \u0000Methods: A retrospective cohort study was conducted using secondary data from IVF participants at the Yasmin Fertility Clinic, Dr. RSUP. Cipto Mangunkusumo, Jakarta, Indonesia during the period January 2019 to December 2020, as recorded in the InaRepromed archive. The variables analyzed were age, body mass index, and hormone levels on day 1, day 7, and day hCG, with oocyte maturation rate as the main outcome. Correlation test was performed between several variables and the level of oocyte maturation rate and followed by multivariate analysis to assess the factors that were closely related to oocyte maturation rate. \u0000Results: Data from 52 subjects were collected for the study. Positive correlation was observed between oocyte maturation rate and estradiol on day 7 (r = 0.229), while negative correlation was observed between oocyte maturation rate and progesterone/estradiol ratio on day 7 (r = -0.289) and luteinizing hormone on day 1 (r = -0.265). Multivariate analysis revealed that higher estradiol on day-7 was associated with better oocyte maturation rate (p = 0.047). \u0000Conclusion: Higher estradiol level on day 7 was associated with better oocyte maturation rate in IVF. \u0000Keywords: Assisted reproductive technology (ART), estradiol, in vitro fertilization (IVF), progesterone. \u0000 \u0000Abstrak \u0000Tujuan: untuk menentukan faktor-faktor yang mempengaruhi tingkat pematangan oosit dalam program Fertilisasi InVitro (FIV). \u0000Metode: Desain penelitian adalah kohort retrospektif, menggunakan data sekunder peserta bayi tabung Klinik Fertilitas Yasmin, RSUP Dr. Cipto Mangunkusumo, Jakarta, Indonesia selama periode Januari 2019 hingga Desember 2020, yang tercatat di dalam arsip InaRepromed. Variabel yang dianalisis adalah umur, indeks massa tubuh, dan kadar hormon pada hari ke-1, hari ke-7, dan hari ke-hCG, dengan tingkat maturasi oosit sebagai luaran utama. Dilakukan analisis korelasi antara beberapa variabel dengan tingkat maturasi oosit, dan dilanjutkan dengan analisis multivariat untuk menilai faktor-faktor yang berhubungan kuat dengan tingkat maturasi oosit. \u0000Hasil: Data dari 52 subjek dikumpulkan untuk penelitian ini. Dijumpai korelasi positif antara tingkat maturasi oosit dan estradiol pada hari ke 7 (r = 0,229), sedangkan korelasi negatif diamati pula antara tingkat maturasi oosit dan rasio progesteron/estradiol pada hari ke 7 (r = -0,289) dan hormon luteinisasi pada hari 1 (r = -0,265). Analisis multivariat mengungkapkan bahwa estradiol yang lebih tinggi pada hari ke-7 dikaitkan dengan tingkat maturasi oosit yang lebih baik (p = 0,047). \u0000Kesimpulan: Kadar estradiol yang lebih tinggi pada hari ke 7 dikaitkan dengan tingkat pematangan oosit yang lebih baik pada program FIV. \u0000Kata kunci : Teknologi reproduksi berbantu (TRB), estradiol, fertilisasi in vitro (IVF), progesteron.","PeriodicalId":13477,"journal":{"name":"Indonesian Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42562248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}