Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Threatened Preterm Labor: Which are become Preterm Labor? Ancaman Persalinan Preterm: Mana yang menjadi Persalinan Preterm?
Get PDFObjective: The research was aimed to show about characteristics of subject, fetal fibronectin, vaginal pH, cervical length of women with threatened preterm labor, and which are become preterm labor? Preterm labor is occurs most often in 20 weeks gestation to less than 37 weeks gestation. This condition is concerned about Obstetric problem and associated with significant neonatal morbidity and mortality.Methods: This study used the design of case control where preterm pregnant women who become research subjects divided into two groups with threat and without the threat of pre-term labor. Fetal fibronectin , vaginal pHand cervical length than in both groups were evaluated as a risk factor for preterm labor. Mann-Whitney test , Wilcoxon test and Chi-squared test were used as statistical tests with a confidence level of 95%.Results: A total of 86 preterm pregnant women involved in this study with an average age 30 , 5 ± 6.25 (group threat) 32.16 ± 5.25 (non-threatening). Comparison of fetal fibronectin (p = 0.005), vaginal PH(p <0.001) and length of the cervix (p <0.001) between the two groups showed a significant difference. A total of 8 subjects of the 43 in the group of pregnant women with the threat pretem labor experiencing preterm labor .Conclusion: The size of a short cervical length, an increase in the pH of the vaginal secretions and increased levels of fetal fibronectin is a clinical indicator for screening during pregnancy to assess the risk of a preterm labor .Keywords: cervical length, fetal fibronectin, pretermlabor , vaginal pH of the secretions.
Abstrak
Tujuan: Persalinan preterm adalah persalinan yang terjadi padausia kehamilan 20 hingga kurang dari37 minggu. Kondisi inimerupakanpermasalahan yang sangat mengkhawatirkan dalam bidang kebidanan dan dikaitkan dengan morbiditas dan kematian neonatal yang signifikan. Evaluasi dan skrining terhadap berbagai faktor resiko terjadinya ancaman persalinan preterm adalah hal terpenting dalam mencegah berbagai komplikasi yang mungkin timbul.Metode: Penelitian ini menggunakan desain case control dimana wanita hamil preterm yang menjadi subjek penelitian terbagi menjadi dua yakni kelompok dengan ancaman dan tanpa ancaman persalinan preterm. Fetal fibronectin, pH sekret vagina dan panjang serviks dibandingkan diatara kedua kelompok sebagai faktor resiko ancaman persalinan preterm. Mann-Whitney test, Wilcoxon test dan Chi – squared digunakan sebagai uji statistik dengan tingkat kepercayaan 95%.Hasil: Sebanyak 86 wanita hamil preterm terlibat dalam penelitian ini dengan rerata usia 30,5 ± 6,25 (kelompok ancaman) 32,16 ± 5,25 (tanpa ancaman). Perbandingan Fetal fibronectin (p=0,005), pH sekret vagina (p<0,001) dan panjang serviks (p<0,001) antar kedua kelompok menunjukkan adanya perbedaan yang bermakna. Sebanyak 8 subjek dari 43 pada kelompok wanita hamil pretem dengan ancaman persalinan preterm yang mengalami persalinan pretermKesimpulan:Ukuran panjang serviks yang pendek, peningkatan pH sekret vagina dan peningkatan kadar fetal fibronectin merupakan indikator klinis untuk skrining selama kehamilan guna menilai resiko terjadinya persalinan pretermKata kunci: fetal fibronectin, persalinan preterm, Ph vagina, panjang cerviks
 
Efficacy of Trichloroacetic Acid (TCA) Compared to Cryotherapy in Treating Patients with Positive VIA Result: Efikasi Trichloroacetic Acid (TCA) Dibandingkan Krioterapi sebagai Terapi Pasien dengan IVA Positif
Get PDFObjective: To investigate the effectiveness TCA 85% compared to cryotherapy to treat patients with positive IVA result.Method: This is a non-inferiority randomized controlled trial study. Patients with positive VIA result referred to Jatinegara Primary Health Center were included in this study. Eligible samples were then treated with either TCA 85% or cryotherapy. The treatment was determined using a random block sampling method. Samples were then followed up 3 months after treatment in order to determine VIA result conversion.Result: Thirty-six patients were treated with TCA 85% and 36 others were treated with cryotherapy. 35 (97,2%) patients treated with TCA 85% converted to negative VIA, whereas all of the patients that were treated with cryotherapy converted to negative VIA. Bivariate analysis fisher’s exact test was then conducted with a result P-value of 1.00 (p > 0,05).Conclusion: There was no statistically significant difference of result between TCA 85% and cryotherapy for treating patients with positive VIA result.Keywords: cervical cancer, cryotherapy, TCA 85%, VIA test.
Abstrak
Tujuan: Mengetahui efikasi TCA 85% pada tatalaksana IVA positif dibandingkan dengan krioterapiMetode: Penelitian ini merupakan penelitian randomized control trial menggunakan metode non-inferiority study. Subyek penelitian ini merupakan pasien dengan hasil IVA positif yang dirujuk ke Puskesmas Kecamatan Jatinegara, Jakarta Timur. Tatalaksana yang diberikan ditentukan menggunakan metode random block sampling. Subyek diikuti selama 3 bulan setelah tindakan untuk menentukan hasil konversi pemeriksaan IVA.Hasil: Sbenyak 36 subjek diterapi dengan TCA 85% dan 36 lainnya diterapi dengan krioterapi. Sebanyak 35 (97,2%) pasien yang ditatalaksana dengan TCA 85% mengalami konversi menjadi IVA negatif pada follow-up bulan ke-3, sedangkan seluruh pasien yang ditatalaksana dengan krioterapi menjadi konversi menjadi IVA negatif. Dilakukan analisis bivariat fisher’s exact test dan didapatkan nilai p sebesar 1,00 (p>0,05).Kesimpulan:Tidak ada perbedaan bermakna dari efikasi penggunaan TCA 85 % dibandingkan dengan krioterapi pada terapi IVA positif.Kata kunci: kanker serviks, krioterapi, pemeriksaan IVA, TCA 85%
Accuracy Tests of Serum Vitamin D and Calcium Levels in Chorioamnionitis: Uji Kesesuaian Kadar Serum Vitamin D dan Kalsium pada Korioamnionitis
No full textObjective: To compare the sensitivity and specificity of the diagnosis of chorioamnionitis in preterm labor using serum vitamin D and calcium in Dr.Mohammad Hoesin Hospital Palembang.Method: This diagnostic test was carried out in the Obstetrics and Gynecology Department of Dr. Mohammad Hoesin Hospital Palembang from October 2018 to April 2019. Research subjects were women in preterm labor with chorioamnionitis. We collected 39 samples and 36 of them met the inclusion criteria.Results: Eighteen patients with hypovitaminosis vitamin D had chorioamnionitis with a sensitivity value of 94.74%, specificity 5, 88%, positive predictive value (PPV) 52.9% and negative predictive value (NPV) 50%. Two of the 4 patients with hypocalcemia had chorioamnionitis with sensitivity of 10.53%, specificity 88. 24%, positive predictive value (PPV) 50% and negative predictive value (NPV) 46. 9%.Conclusion: Reliability of diagnosis accuracy of serum vitamin and calcium levels against chorioamnionitis is poor.Keywords: accuracy tests, calcium, chorioamnionitis, vitamin D
Abstrak
Tujuan: Membandingkan sensitivitas dan spesifisitas diagnosis korioamnionitis pada partus prematurus antara serum vitamin D dan kalsium di Rumah Sakit Dr. Mohammad Hoesin Palembang.Metode: Uji diagnostik dilakukan di Departemen Obstetrik dan Ginekologi RSUP Dr. Mohammad Hoesin Palembang. Penelitian dilaksanakan sejak Oktober 2018 hingga April 2019. Subjek penelitian adalah wanita hamil prematur yang didiagnosa korioamnionitis. Terdapat 39 sampel dimana 36 sampel termasuk kriteria inklusi.Hasil: Terdapat 18 pasien dengan hipovitaminosis vitamin D memiliki luaran koriaoamnionitis memiliki nilai sensitivitas 94,74%, spesifisitas 5, 88%, positive predictive value (PPV) 52, 9% dan negative predictive value (NPV) 50%. 2 dari 4 pasien dengan hipokalsemia memiliki luaran korioamnionitis memiliki sensitivitas 10, 53%, spesifisitas 88, 24%, positive predictive value (PPV) 50% dan negative predictive value (NPV) 46, 9%.Kesimpulan: Akurasi diagnosis kadar serum vitamin dan kalsium terhadap luaran korioamnionitis memiliki derajat kesesuaian (realiabilitas) kurang baik.Kata kunci: kalsium, korioamnionitis, uji kesesuaian, vitamin
Maternal Referral at Kalabahi General Hospital : A Descriptive Study: Rujukan Maternal di Rumah Sakit Daerah Kalabahi : Sebuah Studi Deskriptif
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Objective: To find out the profile of cesarean section in dr. Zainoel Abidin Hospital since the BPJS era.Methods: This study was a descriptive-observational with retrospective design. The data were obtained in March-April 2017. We collected 3656 data from medical record period January 1st, 2014 - December 31st, 2016.Results: The finding showed there were 1,669 vaginal deliveries (45.65%) and 1,987 cesarean sections (54.35%). The most frequent causes to cesarean sections were induction failure (49.77%), cephalopelvic disproportion (14.33%), pregnancy-induced hypertension (11.21%), malpresentation (8.91), and antepartum haemorrhage (4.33%).Conclusions: The incidence of cesarean sections in dr. Zainoel Abidin Hospital since the BPJS era was 54.35%, increased by 13.29% than the year of 2011-2013 (41.06%) with the most frequent cause is induction failure (49.77%).Keywords: antepartum haemorrhage, BPJS, cesarean section, induction failure, pregnancy-induced hypertension, tertiary referral hospital.
Abstrak
Tujuan: Mengetahui profil persalinan seksio sesarea di RSUD dr. Zainoel Abidin Banda Aceh pada era BPJS.Metode: Penelitian deskriptif-observasional dengan desain studi retrospektif. Pengambilan data dimulai dari bulan Maret-April 2017. Sebanyak 3656 data dikumpulkan dari rekam medik periode 1 Januari 2014 - 31 Desember 2016.Hasil: Terdapat 1.669 kasus persalinan pervaginam (45,65%) dan 1.987 kasus seksio sesarea (54,35%). Indikasi terbanyak yang menyertai seksio sesarea adalah gagal induksi (49,77%), cephalopelvic disproportion (14,33%), hipertensi dalam kehamilan (11,21%), malpresentasi (8,91%), dan perdarahan antepartum (4,33%).Kesimpulan: Angka seksio sesarea di RSUD dr. Zainoel Abidin meningkat 13,29% sejak berlakunya BPJS (1 Januari 2014-31 Desember 2016) mencapai 54,35% dibandingkan tahun 2011-2013 (41,07%) dengan indikasi terbanyak gagal induksi (49,77%).Kata kunci: BPJS, gagal Induksi, hipertensi dalam kehamilan, perdarahan antepartum, RS rujukan tersier, seksio sesarea
Characteristic of Midwife’s who Refer Complex Obstetrics Cases: Karakteristik Bidan yang Merujuk kasus Kebidanan Komplek
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Objective: To identify reasons for referring and characteristics of midwives who practice independently and its relation with complicated cases referred to RSCM.Method: Descriptive analytic case-control. Medical records of patients referred directly to RSCM in January 2016-July 2017 were obtained, then information about midwives and obstetric cases, along with its complications, were collected. Interview and analysis of six characteristics of midwives were conducted. Characteristics analyzed were age, education, training, duration of practice, number of patients ever treated, also distance and travel time of the referral process.Results: All midwives refer due to inadequate facilities. There is a statistically significant correlation between duration of practice and number of patients, with the complicated cases referred directly to RSCM, with OR 7.036 and 6.032, respectively.Conclusion: Midwives refer due to inadequate facilities, and so patients can be treated immediately. Characteristics that affect midwives to refer complicated cases: duration of practice and number of patients. It is necessary to re-evaluate the position of midwives who practiced independently in BPJS, refresher programs, and monitoring by relevant agencies. Further research is needed with more samples and combining midwives' and patients' characteristics in referral cases. Confounding and external factors are identified first in order to do a thorough analysis.Keywords: complicated cases, midwives' characteristics, midwives who practiced independently, referral, referral system.
Abstrak
Tujuan: Mengetahui alasan rujuk dan karakteristik bidan yang berpraktik mandiri serta hubungannya dengan kasus komplikatif yang dirujuk ke RSCM.Metode: Deskriptif analitik kasus kontrol. Data diambil dari rekam medis pasien yang dirujuk langsung ke RSCM di bulan Januari 2016 hingga Juli 2017, kemudian informasi mengenai data bidan dan kasus obstetri beserta komplikasinya dikumpulkan. Dilakukan wawancara dan analisis enam karakteristik bidan. Karakteristik yang dianalisis yaitu usia, pendidikan, pelatihan, lama waktu berpraktik, jumlah pasien yang pernah ditangani, serta jarak dan waktu tempuh proses merujuk. Hasil: Keseluruhan bidan merujuk karena fasilitas yang tidak memadai. Terdapat hubungan yang bermakna antara waktu praktik dan jumlah pasien yang pernah ditangani, dengan kasus komplikatif yang dirujuk langsung ke RSCM, dengan nilai OR 7.036 dan 6.032.Kesimpulan: Bidan merujuk karena fasilitas tidak memadai dan agar pasien langsung ditangani. Karakteristik bidan yang mempengaruhi dalam merujuk yaitu lama waktu praktik dan jumlah pasien yang ditangani. Perlu dilakukan evaluasi ulang mengenai kedudukan bidan yang berpraktik mandiri di BPJS, program penyegaran bidan, serta monitoring oleh instansi terkait. Perlu penelitian lanjut dengan sampel lebih banyak serta menggabungkan karakteristik bidan dan pasien pada kasus-kasus rujukan. Faktor perancu dan eksternal diidentifikasi terlebih dahulu agar analisis dilakukan menyeluruh.Kata kunci: bidan yang berpraktik mandiri, karakteristik bidan, kasus komplikatif rujukan, sistem rujuka
Effects of Levonorgestrel Implants of One Rod and Two Rod on Lipid Profile, Follicle Stimulating Hormone (FSH), and Estradiol Levels in Acceptors : Efek Implan Levonorgestrel Satu Batang dan Dua Batang terhadap Profil Lipid, Kadar Follicle Stimulating Hormone (FSH), dan Estradiol pada Akseptor
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Objective: To find out the comparison of the effect of one-rod and two-rod levonorgestrel implants on FSH, estradiol levels and increase in acceptor lipid profile after a 3-month evaluation in the Mother Hospital of Rika Amelia Palembang.Methods: This study was a phase III clinical trial, "Open" (Open Randomized Clinical Trial), carried out randomization by comparing two types of implant KB, namely levonorgestrel implants, one rod with two rods. This research was conducted at the RSAB Rika Amelia Palembang. Research time is 6 months from November 2018 - April 2019 or until the number of samples is fulfilled.Results: Based on the installation time, the average installation time using one rods LNG was 1.54 ± 0.11 minutes and the LNG for the two rods was 2.49 ± 0.26 minutes. Majority of patients having a normal blood pressure of 89.5% in one rod LNG and 68.4% in two rod LNG. The mean body mass index (BMI) of respondents using LNG implants one rod was 24.19 ± 3.93 kg / m2 and LNG for two rods was 25.09 ± 6.11 kg / m2. Based on the menstrual pattern, it was found that 84.2% of the subjects had regular menstrual patterns in the one-rod LNG group, while there were 63.2 % of subjects who have irregular menstrual patterns. From the statistical test, it was found that there were no differences in cholesterol levels (p = 0.919), HDL (p = 0.793), LDL (p = 0.851) and triglycerides (p = 0.679). There were no differences in FSH levels between respondents using one rod and two rod LNG implants (p = 0.849) and also on estradiol (p = 0.099)Conclusion: There is no difference between the use of one-rod and two-rodlevonorgestrel implants against FSH, Estradiol levels and increased lipid profile after 3 months of implant installation. The unpleasant effect in this study was the decline in HDL, but this was accompanied by a decrease in body weight, total cholesterol, LDL, HDL due to a decrease in all aspects.Keyword: estradiol, FSH, implant contraception, lenovorgestrel, lipid profile, one-rod, two-rod
Abstrak
Tujuan:Untuk mengetahui perbandingan efek implanlevonorgestrel satu-batang dan dua-batang pada FSH, kadar estradiol dan peningkatan profil lipid akseptor setelah evaluasi 3 bulan di Rumah Sakit Ibu Rika Amelia Palembang.Metode: Penelitian ini adalah uji klinis fase III, "Open" (Open Randomized Clinical Trial), yang dilakukan secara acak dengan membandingkan dua jenis KB implan, yaitu levonorgestrel implan, satu batang dengan dua batang. Penelitian ini dilakukan di RSAB Rika Amelia Palembang. Waktu penelitian adalah 6 bulan dari November 2018 - April 2019 atau hingga jumlah sampel terpenuhi.Hasil :Berdasarkan waktu pemasangan didapatkan rerata waktu pemasangan yang menggunakan LNG satubatangadalah 1,54±0,11 menitdanpada LNG dua batang adalah 2,49±0,26 menit. Mayoritas pasien memiliki tekanan darah yang normal 89.5% pada LNG satu batang dan 68.4% pada LNG dua batang. Rerata indeks massa tubuh (IMT) responden yang menggunakan implan LNG satu batang sebesar 24,19 ± 3,93 kg/m2 dan LNG dua batang sebesar 25,09 ± 6,11 kg/m2. Berdasarkan pola haid, didapatkan sebanyak 84,2% subjek yang memiliki pola haid teratur pada kelompok LNG satu batang, sedangkan terdapat sebanyak 63,2% subjek yang memiliki pola haid tidak teratur. Dari uji statistik didapatkan bahwa tidak terdapat perbedaan kadar kolesterol (p = 0,919), HDL (p = 0,793), LDL (p = 0,851) dan trigliserida (p = 0,679). Tidak terdapat perbedaan kadar FSH antara responden yang menggunakan implan LNG satu batang dan dua batang (p = 0,849) dan juga pada estradiol (p=0.099)Kesimpulan: Tidak terdapat perbedaan antara penggunaan implan levonorgestrel satu batang dan dua batang terhadap kadar FSH, Estradiol serta peningkatan profil lipid setelah 3 bulan pemasangan implan. Efek yang tidak menyenangkan dalam penelitian ini adalah terjaidnya penurunan HDL, namun hal ini disertai dengan penurunan berat badan, kolesterol total, LDL, HDL dikarenakan terjadi penurunan pada seluruh aspek.Kata Kunci: dua batang, estradiol, FSH, kontrasepsi implan, lenovorgestrel, profil lipid, satu batang.
 
Prevalence of Appendical Metastasis in Primary Surgery of Ovarian Epithelial Cancer: Prevalensi Metastasis Apendiks Pada Bedah Primer Kanker Epitel Ovarium
Get PDFObjective: To determine the prevalence of metastasis to appendix from primary surgery of ovarian epithelial cancer at National General Hospital Dr. Cipto Mangunkusumo (RSCM), Indonesia.Methods: A cross sectional study was done using ovarian epithelial cancer patient medical record whose primary ovarian cancer and appendectomy surgery were conducted on July to December 2019 at RSCM. Patients without appendix histopatology result and previous chemotherapy were excluded in this study. Consecutive method and random sampling were used in this study.Results: : A total of 80 subjects were included in this study. Subjects have average age of 48 years old. Out of all samples, 43 samples (53.8%) were defined as stage I patient, 7 subjects (8.8%) as stage II, 30 subjects (37.5%) as stage III, and none as stage IV. Appendectomy were done and eight subjects (10%) experienced metastasis to appendix. A total of 19 subjects (23.8%) had chronic appendicitis and 53 subjects (66.3%) did not have metastasis to the appendix. Among eight subjects having appendix involvement, 4 had mucinous histology, 2 serous, and 2 endometrioid. Six out of eight were diagnosed at clinical stage III and two were diagnosed at stage I.Conclusion: The prevalence of appendix metastases from primary surgery in ovarian epithelial cancer at RSCM was 10%. Based on this research, appendectomy can be considered on ovarian cancer surgeryKeywords: appendix, metastasis, ovarian cancer.
Abstrak
Tujuan: Mengetahui prevalensi metastasis kanker epitelial ovarium ke apendiks pada pembedahan primer kanker epitelial ovarium di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo (RSCM), Indonesia. Metode: Penelitian ini merupakan studi potong lintang menggunakan data rekam medis pasien kanker ovarium epitelial yang menjalani pembedahan primer dan apendiktomi pada bulan Juli hingga Desember 2019 di RSCM Pasien tanpa histopatologi apendiks atau pernah dilakukan kemoterapi sebelumnya dieksklusi dari penelitian. Digunakan metode pengambilan sampel secara acak. Hasil: Didapatkan 80 subjek penelitian yang diikutsertakan dalam penelitian. Dari 80 subjek penelitian, didapatkan rerata usia 48 tahun. Sebanyak 43 subjek (53,8%) didiagnosis dengan stadium I, 7 subjek (8,8%) sebagai stadium II, 30 subjek (37,5%) stadium III. Dari 80 subjek yang menjalani apendiktomi, didapatkan 8 subjek (10%) anak sebar ke apendiks, 19 subjek (23,8 %) apendisitis kronis, 53 subjek (66,3%) tidak terdapat anak sebar. Dari 8 subjek yang terdapat anak sebar ke apendiks dengan temuan histologi 4 musinosum, 2 serosum, 2 endometroid. Sebanyak enam dari delapan subjek terdiagnosis pada stadium klinis stadium III dan dua lainnya pada stadium klinis satu. Kesimpulan: Prevalensi metastasis apendiks pada operasi primer kanker ovarium epitelial di RSCM adalah sebesar 10%. Berdasarkan hasil penelitian ini, apendektomi dapat dipertimbangkan dilakukan pada pembedahan baik stadium awal maupun stadium lanjut.Kata kunci: , apendiks , kanker ovarium, metastati
Antepartum Perineal Massages is Effective to Prevent Intrapartum Perineal Rupture: Pijat Perineum Antepartum Efektif Mencegah Ruptur Perineum Intrapartum
Get PDFObjective: To provide a summary of evidence about the benefi ts and effectiveness of perineal massage in preventing perineal rupture during labour.Methods: Evidence-based review of research articles with an evidence-based level 1a.Results: Intervention of perineal massage not only reduced the incidence of perineal rupture but also reduced the incidence of episiotomy requiring stitches, as well as reducing perineal pain after 3 months of postpartum.Conclusions: Perineal massage intervention is an intervention that is easy to do, effective, inexpensive, and has the potential to benefi t more than the potential harm in preventing perineal rupture.Keywords: intrapartum, perineal massage, perineal rupture.AbstrakTujuan: memberikan ringkasan bukti penelitian tentang manfaat dan efektifi tas dari pijat perineum dalam mencegah ruptur perineum selama persalinan.Metode: evidence-based review dengan level evidence based 1a.Hasil: Intervensi pijat perineum tidak hanya menurunkan insiden ruptur perineum tetapi juga menurunkan insiden episiotomi yang membutuhkanj jahitan, serta mengurangi nyeri perineum setelah 3 bulan postpartum.Kesimpulan: Intervensi pijat perineum merupakan intervensi yang mudah untuk dilakukan, efektif, murah, serta mempunyai potensi menguntungkan lebih banyak daripada potensi merugikan dalam mencegah ruptur perineum.Kata kunci: intrapartum, pijat perineum, ruptur perineum
The Outcome of Percutaneous Mitral Balloon Commissurotomy (PMBC) in Pregnant Women with Mitral Stenosis: An Evidence Based Study: Luaran Komisurotomi Balon Mitral Perkutan pada Perempuan Hamil
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Objective: To review the outcome of percutaneous mitral balloon commissurotomy (PMBC) both to maternal and neonatal.
Methods: The search was conducted on Pubmed®, Cochrane Library®, and Ovid® using MeSH. Critical appraisal determining the validity, importance, and applicability (VIA) was conducted by two independent authors.
Results: Several studies showed that performing the PMBC had good outcome for pregnant women functional class based on NYHA. Most of them decreased from NYHA III/IV to I/II. For delivery outcome, all studies concluded that more than 80% pregnant women with mitral stenosis undergoing PMBC delivered at term, and no congenital anomalies found.
Conclusion: Percutaneous mitral balloon commissurotomy for pregnant women with severe MS is safe during pregnancy.
Keywords: mitral stenosis, outcome, percutaneous mitral balloon commissurotomy, pregnancy,
Abstrak
Tujuan: Mengulas luaran komisurotomi balon mitral perkutan (KBMP) baik pada maternal maupun neonatus.
Metode: Pencarian dilakukan melalui Pubmed®, Cochrane Library®, dan Ovid® menggunakan MeSH. Telaah kristis dilakukan oleh 2 penulis independen berdasarkan validitas, kepentingan, dan aplikabilitas.
Hasil: Beberapa studi memperlihatkan KBMP memiliki luaran yang baik di kalangan perempuan hamil berdasarkan kelas fungsional NYHA. Kebanyakan mereka mengalami penurunan NYHA dari III/IV menjadi I/II. Untuk luaran persalinan, seluruh studi menyimpulkan lebih dari 80% perempuan dengan mitral stenosis yang menjalani pembedahan KBMP melahirkan pada usia term dan tidak ditemukan kelainan.
Kesimpulan: KBMP aman dilakukan pada perempuan hamil dengan mitral stenosis berat.
Kata kunci: kehamilan, komisurotomibalon mitral perkutan, luaran, stenosis mitra
CuT 380A IUD Inserted by R-Inserter and Ring Forceps during Postpartum Period A Randomized Clinical Trial, Twelve Months Follow Up: IUD CuT380A yang Dipasang dengan R-inserter dan Klem Cincin pada Masa Pascasalin Uji Klinis secara Random, Pengamatan Dua Belas Bulan
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Objective: To compare the safety and effectiveness of CuT 380A IUD use inserted by R-inserter compared with those inserted by ring forceps during the postpartum period.Methods: The study was conducted in three puskesmas (community health centre) as affiliated of Sardjito Hospital. Subjects meeting the inclusion and exclusion criteria were recruited to get a 10% proportion expulsion rate difference, type one error 0.05 and type two error 0.20. Insertion using R-inserter was treated while using ring forceps belonged to the control groups. Follow up was carried out one week after the insertion, one month and then monthly for 12months. Rate of the following events i.e.infection, expulsion, pain, bleeding, removal and continuation of use were primary outcomes of interest.Results: A total of 208 eligible subjects were recruited, consisting of 104 subjects using R-inserter and 104 subjects using ring forceps. Cumulative event rates during 12 months follow up were 1%, 4.3%, 3.4%, 10.1% and 4.8% each for infection, expulsion, bleeding, pain, and removal respectively. There was no difference in the rate of infection between the two groups, i.e. 1,0% for each group. There was one pregnancy over 208 subjects giving the overall failure rate of 0.5%. The overall results showed that there were no differences among those events rates (pain, bleeding, removal and continuation) between R-inserter and ring forceps groups. Continuations rate were 93.7%, 93.2%, 90.8%, and 90.8% each for three, six, nine and 12 months follow up respectively.Conclusions: There were no differences in terms of event rates between the use of CuT 380A IUD inserted by R-inserter and ring forceps.Keywords: continuation rate, expulsion, infection, postpartum IUD, R-inserter
AbstrakTujuan: Membandingkan keamanan dan keefektifan pemakaian IUD CuT 380A pascasalin yang dipasang dengan R-inserter vs klem cincin.Metode: Penelitian dilakukan di 3 puskesmas di provinsi DIY. Pasien yang memenuhi kriteria kelayakan dimasukkan dalam penelitian ini untuk memenuhi beda proporsi ekspulsi 10%, kesalahan tipe satu 0,05 dan kesalahan tipe dua 0,20. Kelompok uji adalah mereka yang dipasang IUD dengan R-inserter dan kelompok control adalah mereka yang dipasang dengan klem cincin.Follow up dikerjakan setelah satu minggu, satu bulan dan setiap bulan sampai 12 bulan. Infeksi, ekspulsi, nyeri, perdarahan, pelepasan dan kelangsungan pemakaian adalah hasil utama yang diteliti.Hasil: Sebanyak 208 subyek penelitian memenuhi kriteria kelayakan, terdiri atas 104 subyek dipasang dengan R-inserter dan 104 subyek dengan klem cincin. Kejadian kumulatif pada seluruh kasus selama 12 bulan follow up adalah 1%, 4,3%,3,4%, 10,1%, 4,8% masing-masing untuk infeksi, ekspulsi, perdarahan, nyeri, dan pelepasan. Angka infeksi masing-masing sebesar 1% pada kedua kelompok. Terdapat satu kehamilan (0,5%) dari seluruh kasus. Angka kejadian yang lain (nyeri, perdarahan, pelepasan dan kelangsungan pemakaian) tidak menunjukkan perbedaan yang bermakna. Angka kelangsungan pemakaian kumulatif adalah 93,7%, 93,2% 90,8%, dan 90,8% masing-masing pada follow up tiga, enam, Sembilan dan 12 bulan pascapasang.Kesimpulan: Tidak ada perbedaan dalam hal kejadian efek samping antara pemakaian IUD CuT 380A yang dipasang pada masa pascasalin denganR-inserter dan klem cincin.Kata kunci: Angka kelangsungan, ekspulsi, infeksi, IUD pascasalin, pelepasan, R-inserter