Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Surgical Wound Dehiscence Treatment: Tata Laksana Dehisensi Luka Operasi
Full text linkObjective: This article describes management of surgicalwound dehiscence. in a cesarean section.Method: Case report.Case: A 39 years-old woman, P4, presented with reddish puscoming out from open surgical wound on day 4 following acaesarean section. Laboratory fi ndings revealed a conditionof Hypoalbuminemia, leukocytosis, and a Staphylococcusaureus was detected on pus from the wound base. Upon theresuturing, the wound was dressed with antimicrobial wounddressings and pad and changed every 12 hours. After 3 days,the wound was dressed with modern antimicrobial wounddressings gel and pad, changed every 3 days and plannedfor necrotomy afterwards. A presence of dry, granulationtissue was observed before the resuturing.Conclusion: Selection of dressing regimen shouldbe individualized according to the wounds. Modernantimicrobial wound dressing can be a good therapy optionfor surgical wound dehiscence after caesarean section.Keywords: surgical site infection, surgical wound, wounddehiscence.Tujuan: Artikel ini melaporkan tata laksana dehisensi lukaoperasi seksio sesarea.Metode: Laporan kasus.Kasus: Seorang perempuan 39 tahun, P4, datang dengankeluhan nanah kemerahan keluar dari luka operasi terbukapostoperasi seksio sesarea hari ke-4. Temuan laboratorium:Hipoalbuminemia, leukositosis, dan Staphylococcusaureus dari kultur dasar luka. Sebelum operasi penjahitankembali, luka dibalut dengan pembalut dan bantalan lukaantimikroba modern yang diresapi dengan hidrogel, digantisetiap 12 jam. Setelah 3 hari, luka dibalut dengan gel danpembalut luka antimikroba modern yang diresapi denganhidrogel, diganti setiap 3 hari dan direncanakan untuknekrotomi. Sebelum operasi dilakukan kembali, luka tampakkering dengan dasar jaringan granulasi.Kesimpulan: Regimen pembalutan harus disesuaikandengan kebutuhan masing-masing luka. Pembalut lukaantimikroba modern dapat menjadi pilihan terapi yang baikuntuk dehisensi luka bedah setelah operasi seksio sesarea.Kata kunci: dehisensi luka, infeksi luka operasi, luka operasi
Qualitative Study on Maternal and Perinatal Health Services in Primary Health Care Facility in Banten Province: Kajian Mutu Pelayanan Kesehatan Maternal Perinatal Fasilitas Kesehatan Tingkat Primer di Provinsi Banten
Full text linkObjective: To determine the effect of clinical governance in PHCs on maternal and perinatal health in Banten Province, Indonesia.Methods: This was an observational analytic study with cross sectional method performed on the PHCs on Banten Province, Indonesia. All PHCs in Banten Province having maternal and perinatal health services were included in the study. Clinical governance and services were measured using a self-made questionnaire filled by the representative of the PHC. Characteristics analyzed in this study were age, education level, completed training, and occupation. Clinical governance aspects analyzed in this study were leadership, culture, competence, governance, and readiness. The services analyzed in this study were antenatal, pathology, and emergency service. Results: There were 117 PHC representatives who were recruited to the study. The PHC which were categorized as “outstanding” for leadership, culture, competence, governance, and readiness were 23.1%, 41%, 98%, 81.2%, and 83.8%, respectively. The PHC which were categorized as having “good” antenatal, pathology, and emergency services were 92.3%, 51.3%, and 90.6%, respectively. The PHCs with better clinical governance aspects delivered better antenatal, pathology, and emergency services for maternal and perinatal care.Conclusions: Primary health cares with better clinical governance aspects delivered better antenatal, pathology, and emergency services for maternal and perinatal care. Therefore, improving clinical governance is essential to improve maternal and perinatal health services quality in Banten Province, IndonesiaKeywords: clinical governance, health service, maternal health, quality assurance.AbstrakTujuan: Untuk mengetahui pengaruh tata kelola klinik di Puskesmas terhadap kesehatan ibu dan perinatal di Provinsi Banten, Indonesia.Metode: Penelitian observasional analitik dengan metode potong lintang yang dilakukan di Puskesmas di Provinsi Banten, Indonesia. Semua Puskesmas di Provinsi Banten yang memiliki layanan kesehatan ibu dan perinatal diikutsertakan dalam penelitian ini. Tata kelola dan layanan klinis diukur menggunakan kuesioner buatan sendiri yang diisi oleh perwakilan Puskesmas. Karakteristik yang dianalisis dalam penelitian ini adalah usia, tingkat pendidikan, pelatihan yang diselesaikan, dan pekerjaan. Aspek tata kelola klinis yang dianalisis dalam penelitian ini adalah kepemimpinan, budaya, kompetensi, tata kelola, dan kesiapan. Pelayanan yang dianalisis dalam penelitian ini adalah pelayanan antenatal, patologi, dan gawat darurat.Hasil: Terdapat 117 perwakilan Puskesmas yang direkrut untuk penelitian. Puskesmas yang dikategorikan “sangat baik” untuk kepemimpinan, budaya, kompetensi, tata kelola, dan kesiapan masing-masing adalah 23,1%, 41%, 98%, 81,2%, dan 83,8%. Puskesmas yang memiliki pelayanan antenatal, patologi, dan gawat darurat yang tergolong “baik” berturut-turut adalah 92,3%, 51,3%, dan 90,6%. Puskesmas dengan aspek tata kelola klinis yang lebih baik memberikan layanan antenatal, patologi, dan darurat yang lebih baik untuk perawatan ibu dan perinatal.Kesimpulan: Pelayanan kesehatan primer dengan aspek tata kelola klinis yang lebih baik menghasilkan pelayanan antenatal, patologi, dan kegawatdaruratan yang lebih baik untuk pelayanan ibu dan perinatal. Oleh karena itu, peningkatan tata kelola klinis sangat penting untuk meningkatkan kualitas pelayanan kesehatan maternal dan perinatal di Provinsi Banten, IndonesiaKata kunci: kesehatan ibu, pelayanan kesehatan, penjaminan mutu, tata kelola klinik
The Low Level of Serum 1,25-Dihydroxyvitamin D3 and Calcium in Preeclampsia Women and Its Impact on Maternal Outcomes: Kadar Serum 1,25-Dihidroksivitamin D3 dan Kalsium yang Rendah pada Perempuan Preeklamsia dan Dampaknya terhadap Luaran Maternal
No full textObjective: To investigate the association of serum 1,25-dihydroxyvitamin D3 (1,25[OH]2D3) and calcium levels in pregnancy with the risk of preeclampsia and its impact on maternal outcomes.
Methods: This cross-sectional observational study was conducted in the Obstetrics and Gynecology Department at Dr. M. Djamil Padang General Hospital from May 2021 to April 2022. Patients with normal pregnancy, diagnosed with preeclampsia, and willing to sign the informed consent were included in this study. Blood serum samples from patients were collected and examined with an ELISA kit. The collected data were then statistically analyzed with univariate and bivariate analysis.
Results: The serum 1,25(OH)2D3 levels strongly correlate with maternal outcomes (systolic and diastolic blood pressure) among preeclampsia patients, with p-value = <0.0001. The serum 1,25(OH)2D3 levels in preeclampsia were significantly lower than in normal pregnancy (88,73 ± 42,22 vs. 111,11 ± 52,49 pg/ml), with p-value = 0,033. The serum calcium levels in preeclampsia patients were significantly lower compared to normal pregnant women's (8,67 ± 0,49 vs. 9,55 ± 0,93 mg/dL), with p-value = <0.0001. However, there was no association between serum 1,25(OH)2D3 and serum calcium levels in pregnancy.
Conclusion: Serum levels of 1,25-dihydroxyvitamin D3 and calcium in preeclampsia were significantly lower than in normal pregnancy. Serum 1,25-dihydroxyvitamin D3 levels were also found to have a significant correlation with systolic and diastolic blood pressure in preeclamptic patients. These findings reinforce the suggestion of the importance of vitamin D and calcium supplementation during pregnancy to reduce the risk of preeclampsia and to achieve better maternal outcomes.
Keywords: 1,25-Dihydroxyvitamin D3, calcium, hypertension, pregnancy, preeclampsia
Abstrak
Tujuan: Mengetahui hubungan antara kadar serum 1,25-dihidroksivitamin D3 (1,25[OH]2D3) dan kalsium pada kehamilan dengan risiko preeklamsia dan pengaruhnya terhadap luaran maternal
Metode: Studi observasional potong lintang ini dilakukan di Departemen Obstetri dan Ginekologi RSUP Dr. M. Djamil Padang dari Mei 2021 hingga April 2022. Pasien dengan kehamilan normal, terdiagnosis preeklampsia, dan bersedia menandatangani informed consent diinklusi dalam penelitian ini. Sampel serum darah dari pasien dikumpulkan dan diperiksa dengan ELISA-kit. Data yang terkumpul kemudian dianalisis secara statistik dengan analisis univariat dan bivariat.
Hasil: Kadar serum 1,25(OH)2D3 memiliki hubungan yang kuat dengan luaran maternal (tekanan darah sistolik dan diastolik) pada pasien preeklamsia, dengan nilai p = <0,0001. Kadar serum 1,25(OH)2D3 pada preeklampsia lebih rendah secara signifikan dibandingkan kehamilan normal (88,73 ± 42,22 vs 111,11 ± 52,49 pg/ml), dengan p-value = 0,033. Kadar kalsium serum pada pasien preeklampsia juga secara signifikan lebih rendah dibandingkan ibu hamil normal (8,67 ± 0,49 vs 9,55 ± 0,93 mg/dL), dengan p-value = <0,0001. Namun, tidak ada hubungan antara kadar serum 1,25(OH)2D3 serum dengan kadar serum kalsium pada kehamilan.
Kesimpulan: Kadar serum 1,25-dihidroksivitamin D3 dan kalsium pada preeklamsia lebih rendah secara signifikan dibandingkan kehamilan normal. Kadar serum 1,25-dihidroksivitamin D3 juga ditemukan memiliki korelasi yang signifikan dengan tekanan darah sistolik dan diastolik pada pasien preeklamsia. Temuan ini memperkuat saran akan pentingnya suplementasi vitamin D dan kalsium selama kehamilan untuk menurunkan risiko preeklampsia dan untuk mendapatkan luaran maternal yang lebih baik.
Kata kunci: 1,25-Dihydroxyvitamin D3, kalsium, hipertensi, kehamilan, preeklamsi
Expansion Grade and Morphokinetic Parameters Associated with Aneuploidy Status of Embryo Fifth Day: Tingkat Ekspansi dan Parameter Morfokinetik yang Diasosiasikan dengan Status Aneuploid pada Hari k Lima Sebuah Embrio
Full text linkObjective: To determine the potential of examining embryo morphology, and morphokinetic parameters in predicting the chromosomal status of embryos.
Methods: This study is a cross-sectional that requires patients undergoing IVF followed by chromosome examination with NGS that was conducted at the IVF Center at Pondok Indah Hospital and Morula IVF Center at Bunda Hospital from December 2021 to December 2022. Each embryo that reaches the blastocyst stage on day 5 or 6 will be washed and put into a PCR tube for a week; then, embryologists annotate them to determine morphological assessment and morphokinetic parameters using Time-Lapse Microscopy. The chi-square test was used to analyse bivariate variables.
Results: One hundred twenty-four samples were collected on day 5 of patients undergoing the IVF procedure. 50.8% of the samples were aneuploid chromosomes, and 49.2% were euploid. The morphokinetic characteristics median was 3.86 fold. It was found that expansion grade, time to pro-nuclear fading, and time to the synchrony of the third cell cycle were significantly associated with euploid status (p = 0.000; 0.041 and 0.036).
Conclusion: The expansion grade has been proven as the most influential component for accurately predicting the ploidy status of embryos.
Keyword: blastocyst, embryo, euploid status, expansion grade, morphokinetics
Abstrak
Tujuan: Untuk mengetahui potensi pemeriksaan morfologi embrio, dan parameter morfokinetik dalam memprediksi status kromosom embrio.
Metode: Penelitian ini merupakan penelitian potong lintang yang memerlukan pasien yang sedang menjalani program bayi tabung yang dilanjutkan dengan pemeriksaan kromosom dengan NGS yang dilakukan di Pusat IVF RS Pondok Indah dan Pusat IVF Morula RS Bunda pada bulan Desember 2021 hingga Desember 2022. Setiap embrio yang mencapai tahap blastokista pada hari ke 5 atau 6 akan dicuci dan dimasukkan ke dalam tabung PCR selama seminggu; kemudian, ahli embriologi membuat anotasi untuk menentukan penilaian morfologi dan parameter morfokinetik menggunakan Mikroskop Time-Lapse. Uji chi-square digunakan untuk menganalisis variabel bivariat.
Hasil: Seratus dua puluh empat sampel dikumpulkan pada hari ke 5 dari pasien yang menjalani prosedur IVF. 50,8% sampel adalah kromosom aneuploid, dan 49,2% adalah euploid. Median karakteristik morfokinetik sebesar 3,86 kali lipat. Ditemukan bahwa tingkat ekspansi, waktu menuju pemudaran pro-nuklir, dan waktu hingga sinkronisasi siklus sel ketiga berhubungan secara signifikan dengan status euploid (p = 0,000; 0,041 dan 0,036).
Kesimpulan: Tingkat ekspansi telah terbukti sebagai komponen yang paling berpengaruh dalam memprediksi status ploidi embrio secara akurat.
Kata kunci: blastosist, embrio, status euploid, tingkat ekspansi, morfokineti
Preoperative Platelet-Lymphocyte Ratio as a Prognostic Factor of Epithelial Ovarian Cancer
Full text linkObjective: To determine whether platelet-lymphocyte ratio can be a prognostic factor for epithelial ovarian cancer. Methods: This study was a retrospective cohort with analytical design, conducted in the Department of Obstetrics and Gynecology of Prof. Dr. R.D. Kandou Manado General Hospital from January – November 2020. The subjects were all patients with epithelial ovarian cancer who met the inclusion and exclusion criteria. Data analysis was conducted with Chi-square test.Results: 35 subjects were included in this study. Most subjects were 40-50 years and had a platelet-lymphocyte ratio of above 200. The mean platelet-lymphocyte ratio of the subjects with epithelial ovarian cancer was 244.663 +- 130.0234. Chi-square test showed a significant association between platelet-lymphocyte ratio and the ovarian cancer relapse (X2 = 14.464 p = 0.000) with RR=4.0Conclusion: There was a significant difference between platelet-lymphocyte ratio and the ovarian cancer relapse.Keywords: epithelial ovarian cancer, inflammatory marker, platelet-lymphocyte ratio, prognosis
In Utero Ultrasonography Parameters as a Children Growth Prediction at Age 2 – 3 : Parameter Ultrasonografi in Utero sebagai Prediksi Pertumbuhan Anak Usia 2-3 Tahun
Full text linkltrasound parameters during pregnancy and the growth of children aged 2 – 3 years.Methods: This was an analytic observational study with a longitudinal approach using data from the first 1,000 days of life. Study conducted at the Faculty of Medicine, Diponegoro University. The research subjects were children aged 2 – 3 years old with good nutritional status and democratic parenting from 14 City Health Centers in Semarang. The ultrasound parameters obtained were Biparietal Diameter (BPD), Abdomen Circumference (AC), Head Circumference (HC), Femur Length (FL) at 20 – 24 weeks of gestation. Data were obtained during the second trimester. Data on the growth of children at the age of 2 years obtained are height, weight, and HC. Statistical test using Pearson correlation test, with p<0.1 is considered significant.Results: The level of confidence used in this study was 90% and obtained 45 research subjects with a female gender of 26 children (57.8%) and 19 male children (42.2%). The Pearson test showed that there was no significant relationship between BPD and height (p=0.18; r=-0.20), AC and height (p=0.12; r=-0.23), and FL and height (p=0.17; r=-0.20). There was a significant relationship between HC and height (p=0.04; r=-0.29), BPD and weight (p=0.06; r=-0.28), HC and weight (p=0.01; r=-0,.5), AC and weight (p=0.08; r=-0.26), FL and weight (p=0.05; r=-0.29) and prenatal HC and postnatal HC (p=0.03; r=-0.32).Conclusion: There is a significant relationship between ultrasound parameters during pregnancy and the growth of children aged 2 – 3 years.Keywords: abdominal circumference, biparietal diameter, child growth, femur length, head circumference, pregnancy.AbstrakTujuan: Untuk mengetahui hubungan antara parameter ultrasonografi saat kehamilan dengan pertumbuhan anak usia 2-3 tahun.Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan longitudinal menggunakan data penelitian 1.000 hari pertama kehidupan yang dilakukan di Fakultas Kedokteran Universitas Diponegoro. Subjek penelitian adalah anak usia 2 – 3 tahun dengan gizi baik dan pola asuh demokratis dari 14 Puskesmas Kota Semarang. Parameter USG yang diperoleh adalah diameter biparietal (BPD), lingkar abdomen (AC), lingkar kepala (HC), dan panjang femur (FL) pada usia kehamilan 20 – 24 minggu. Data diperoleh selama trimester kedua. Data tumbuh kembang anak usia 2 tahun yang diperoleh adalah tinggi badan, berat badan, dan lingkar kepala. Uji statistik menggunakan uji korelasi Pearson, dengan p<0,1 dianggap signifikan.Hasil: Tingkat kepercayaan yang digunakan dalam penelitian ini adalah 90% dan diperoleh 45 subjek penelitian dengan jenis kelamin perempuan 26 anak (57,8%) dan 19 anak laki-laki (42,2%). Uji Pearson menunjukkan bahwa tidak ada hubungan yang signifikan antara BPD dengan tinggi badan (p=0,18; r=-0,20), AC dan tinggi badan (p=0,12; r=-0,23), dan FL dan tinggi (p=0,17; r=-0,20). Terdapat hubungan yang signifikan antara HC dengan tinggi badan (p=0,04; r=-0,29), BPD dan berat badan (p=0,06; r=-0,28), HC dengan berat badan (p=0, 01; r=-0,35), AC dan berat badan (p=0,08; r=-0,26), FL dan berat badan (p=0,05; r=-0,29) dan HC prenatal dan postnatal HC (p=0,03; r=-0,32).Kesimpulan: Terdapat hubungan yang signifikan antara parameter ultrasonografi saat kehamilan dan pertumbuhan anak usia 2 – 3 tahun.Kata kunci: diameter biparietal, kehamilan, lingkar abdomen, lingkar kepala, panjang femur, pertumbuhan anak
Mode of Delivery and Neonatal Outcomes in Preterm Pregnancy: Metode Persalinan dan Luaran Neonatus pada Kehamilan Prematur
Full text linkObjectives: To explain that mode of delivery has a correlation with neonatal outcomes in preterm pregnancies.Methods: This study is a retrospective cohort conducted at Dr. Moewardi Surakarta Hospital, with total sampling of 484 cases divided into early preterm and late preterm from 2019 to 2021. Bivariate analysis was carried out to determine the correlation between Mode of Delivery (MOD) and neonatal outcomes.Results: In the early preterm group, mode of delivery had a significant correlation (p<0.05) with birth weight, APGAR score, and neonatal mortality, however a significant correlation (p<0.05) in the late preterm group was only found in the APGAR score and neonatal mortality outcomes. Cesarean delivery, in both early and late preterm births had a lower rate of asphyxia and neonatal death (p<0.05).Conclusion: There is a significant correlation between mode of delivery and neonatal outcomes in preterm birth. Caesarean delivery by indication can significantly reduce the risk of asphyxia, and neonatal mortality due to premature birth.Keywords: mode of delivery, neonatal outcome, preterm.AbstrakTujuan: Menjelaskan bahwa metode persalinan sangat berkorelasi dengan luaran neonatus pada kehamilan prematur, oleh karena itu penelitian ini dapat menjadi bahan pertimbangan untuk memilih metode persalinan.Metode: Penelitian ini merupakan penelitian kohort retrospektif yang dilakukan di RSUD Dr. Moewardi Surakarta, dengan total sampling sebanyak 484 kasus yang terbagi menjadi early preterm dan late preterm dari tahun 2019 hingga 2021. Analisis bivariat dilakukan dengan menggunakan analisis Chi-square dan Kruskal-Wallis untuk melihat korelasi antara metode persalinan (MOD) dan luaran neonatusHasil: Pada kelompok early preterm, metode persalinan memiliki hubungan yang signifikan (p<0,05) dengan luaran neonatus baik berat lahir, skor APGAR, dan kematian neonatus. Pada kelompok late preterm, hubungan yang signifikan (p<0,05) hanya didapatkan pada luaran skor APGAR dan kematian neonatus. Persalinan Caesar baik early maupun late preterm memiliki angka yang lebih rendah terhadap asfiksia dan kematian neonatus (p<0,05).Kata kunci: metode persalinan, luaran neonatus, preterm
Factors Influencing Word-of-Mouth Behaviour at Outpatient Department YPK Mandiri Hospital, Jakarta
No full textThe purpose of this study was to determine the factors that influence the word-of-mouth behavior of patients seeking treatment at YPK Mandiri Hospital, Jakarta. The factors studied were doctor's expertise, doctor's communication, nursing, ancillary, and administration services, hospital reputation, and the physical structure and facilities of the hospital. Data were collected by a questionnaire distributed to patients receiving outpatient treatment. The number of samples obtained is 162 samples. A convenience sampling technique was used in this study. Data analysis was performed using the Partial Least Square-Structural Equation Modelling (PLS-SEM) approach using SmartPLS software. The results showed that doctors’ expertise, doctors’ communication, hospital reputation, and the physical structure and facilities of the hospital are related to word-of-mouth behavior. Nursing, ancillary, and administrative services are not related to word-of-mouth behavior
Treatment Approach for A Rare Case of Cervical Cancer in Pregnancy : Pendekatan Terapi pada Kanker Serviks dalam Kehamilan
Full text linkAbstract
Objective: To add a new overview of cervical cancer in pregnancy and to review several treatment approaches using available guidelines.
Methods: Case report.
Case: A 29 years old woman, gravida 3 para 2 in 10 weeks of pregnancy, was presented with vaginal bleeding and bloody vaginal discharge. Ultrasound examination showed a 10 weeks single live intrauterine fetus and a mass on the cervix. The histopathological report revealed a poorly differentiated cervical adenocarcinoma without invasion of lymphovascular space. Patient was diagnosed with cervical carcinoma FIGO stage IB3 in 10 weeks of pregnancy. The patient opted to unpreserved the pregnancy. Radical hysterectomy with fetus in situ and bilateral pelvic lymphadenectomy was performed. Patient was referred to undergo adjuvant radiation therapy.
Conclusion: Cervical cancer in pregnancy is a rare and special condition that requires individual planning for the diagnostic and treatment approaches.
Keywords: cervical cancer, cervical cancer in pregnancy, fetus in situ hysterectomy, pregnancy, radical hysterectomy.
Abstrak
Tujuan: Untuk menambah gambaran kasus mengenai kanker serviks dalam kehamilan serta membahas pendekatan terapi menggunakan pedoman – pedoman yang ada.
Metode: Laporan kasus.
Kasus: Seorang perempuan berusia 29 tahun dengan G3P2 usia kehamilan 10 minggu datang dengan keluhan perdarahan pervaginam dan keputihan bercampur darah. Hasil dari USG menunjukkan adanya janin berusia 10 minggu serta massa pada serviks. Hasil pemeriksaan histopatologi menunjukkan adanya adenokarsinoma serviks berdiferensiasi buruk tanpa invasi limfovaskuler. Pasien didiagnosis dengan kanker serviks stadium FIGO IB3 dalam kehamilan 10 minggu. Pasien setuju untuk dilakukan terminasi kehamilan. Pada pasien kemudian dilakukan laparotomi histerektomi radikal dengan fetus in situ serta limfadenektomi pelvik bilateral. Pasien kemudian dirujuk untuk dilakukan terapi ajuvan dengan radiasi.
Kesimpulan: Kanker serviks pada kehamilan merupakan suatu kondisi khusus sehingga perencanaan diagnostik dan manajemen terapi membutuhkan perencanaan secara individual di setiap kasusnya.
Kata kunci: Kanker, kanker serviks, kanker serviks dalam kehamilan, kehamilan, , histerektomi radikal, histerektomi dengan fetus in situ
Effect of Early versus Delayed Cord Clamping on Hematological Parameters of Term Neonates: Pengaruh Penjepitan Tali Pusat Dini Dibandingkan dengan Tertunda pada Parameter Hematologi Neonatus Aterm
Full text linkObjectives : To compare the serum bilirubin, hemoglobin, and hematocrit in term infants undergoing delayed cord clamping with early cord clamping after normal and caesarean delivery.Methods : This is a prospective observational study. The neonates in which cord clamping was done within 15 seconds were considered in early cord clamping (ECC) group and where cord clamping was done after 1 minute was considered in delayed cord clamping (DCC) group. The PCV, Hb, serum bilirubin were observed after 48 hours in both the groups and compared.Results : There was statistically significant difference in means of Hb level (p = 0.001) and PCV level (p = 0.001) between DCC and ECC group whereas no statistically significant difference was present in total serum bilirubin level (p = 0.359).Conclusion: There was no significant increase in risk of polycythaemia and hyperbilirubinemia between delayed cord clamping and early cord clamping group rather has beneficial effects in increasing the haemoglobin and haematocrit in the infants.Keywords : delayed cord clamping, early cord clamping, hematocrit, hemoglobin, serum bilirubin, hyperbilirubinemia.
Abstrak
Tujuan: Untuk membandingkan bilirubin serum, hemoglobin, dan hematoklit pada bayi aterm yang dilakukan delayed cord clamping dan early cord clamping setelah persalinan normal dan seksio sesarea.Metode: Studi ini merupakan studi prospektif. Neonatus yang dilakukan cord clamping dalam 15 detik dikelompokkan pada delayed cord clamping (DCC). PCV, Hb, bilirubin serum diobservasi dalam 48 jam pada kedua kelompok, kemudian dibandingkan.Hasil: Terdapat perbedaan signifikan antara kadar Hb (p = 0,001) dan PCV (p = 0,0010 antara kelompok DCC dan ECC, sedangkan tidak terdapat perbedaan signifikan pada kadar bilirubin serum total (p = 0,3590Kesimpulan: Tidak terdapat peningkatan signifikan polisitemia dan hyperbilirubinemia antara DCC dan ECC.Kata kunci: delayed cord clamping, early cord clapming, hematokrit, hemoglobin, serum bilirubin, hyperbilirubinemi