Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Administration Oral Misoprostol after Radical Hysterectomy Due to Cervical Cancer in the Early Stage Decrease Urinary Retention Incident: Pemberian Misoprostol Per Oral Pasca Histerektomi Radikal Pada Karsinoma Serviks Stadium Awal Untuk Menurunkan Insiden Retensio Urine
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Objective: to determine the effect of oral Misoprostol after Radical Hysterectomy in the early stage Cervical Cancer to reduce the incidence of urinary retention.Methods: The study was conducted with a prospective cohort method, randomized control trial and double blind to the patients with early stage cervical cancer who performed Radical Hysterectomy in Dr. Zainoel Abidin hospital, Banda Aceh. There are 34 research subjects who had agreed to participate in the study. The research subject divided into 2 groups. The first group who received Misoprostol orally as the intervention group and the other group that received placebo as the control group.Results: The incidence of urinary retention after Radical Hysterectomy in Dr. Zainoel Abidin hospital, Banda Aceh, decreased significantly in the intervention group compared to the control group (P 0,049). In the intervention group Misoprostol reduce residual urine. Ability to void spontaneously and urine volume were increase. The duration of catheterization and length of hospital stay for the patients were shorter.Conclusion: Administration of Misoprostol orally reduce the incidence of urinary retention after Radical Hysterectomy. Oral Misoprostol can be recommended as an additional procedure to reduce urinary retention.Keywords: cervical cancer, misoprostol , radical hysterectomy, urinary retention.
Abstrak
Tujuan: untuk mengetahui pengaruh pemberian Misoprostol per oral pasca operasi Histerektomi Radikal pada pasien Karsinoma Serviks stadium awal terhadap insidensi retensio urin.Metode: Penelitian dilakukan dengan metode kohort prospektif, randomized control trial dan double blind, pada pasien karsinoma serviks stadium awal yang dilakukan Histerektomi Radikal di RS dr. Zainoel Abidin, Banda Aceh. Terdapat 34 pasien yang telah menyetujui mengikuti penelitian, yang dibagi ke dalam 2 kelompok yaitu kelompok yang mendapat Misoprostol tablet per oral sebagai kelompok perlakuan dan kelompok yang mendapat plasebo sebagai kelompok kontrol. Residu urin pada kedua kelompok diukur dan faktor-faktor lain yang terkait dilakukan pendataan untuk dilakukan analisis. Hasil: Kejadian retensio urin pasca Histerektomi Radikal di RS dr. Zainoel Abidin, Banda Aceh, menurun secara bermakna pada kelompok perlakuan dibandingkan kelompok kontrol (P0,049). Pada kelompok perlakuan Misoprostol menurunkan residu urin.Peningkatan kemampuan berkemih spontan dan volume urin .lama pemakaian kateter transuretra dan lama perawatan menjadi lebih singkat.Kesimpulan: Pemberian Misoprostol per oral mengurangi insiden retensio urin pasca Histerektomi Radikal. Saran : Misoprostol per oral dapat direkomendasikan sebagai prosedur tambahan untuk mengurangi retensio urin.Kata kunci: karsinoma serviks, histerektomi radikal, misoprostol, retensio uri
Evaluation of the Accuracy of Implementation of Obstetric Referral Cases to the Emergency in the JKN Era: Evaluasi Ketepatan Pelaksanaan Rujukan Kasus Gawat Darurat Obstetri ke Instalasi Gawat Darurat dalam Era Jaminan Kesehatan Nasional
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Objective: To investigate the circumstances of the obstetric referral case at the emergency department of the Dr.Cipto Mangunkusumo Hospital as well as the accuracy of the referral implementation.
Method: We used cross-sectional study. Medical records of obstetric patients at Emergency department in RSCM in January 2013-July 2014 were obtained, then information about patients and their characteristic were collected. The accuracy of referral cases is based on emergency obstetric criteria by BPJS rules.
Results: Primary Health Care became the leading referrer. Inappropriate diagnostic referral cases amounted to 21.2%when JKN first began to be implemented in 2014. Cases with improper diagnoses were more referred when JKN was implemented which amounted to 16.8% and non-emergency referral cases of 6.9% in 2014.
Conclusion: Referral implementation has not been efficient and effective, the number of obstetric referral cases to emergency department of RSCM that can actually be handled in the secondary advanced health services after the application of JKN is still high. Monitoring and evaluation is needed by the Local Health Office to improve the quality of the referral system that applied in the newly JKN era.
Keywords:accuracy of referrals,BPJS, JKN, obstetric emergencies, referral system.
Abstrak
Tujuan: Mengetahui gambaran kasus rujukan obstetri di IGD RSCM dan ketepatan pelaksanaan rujukan.
Metode: Deskriptif desain studi potong lintang. Data diambil dari rekam medis pasien obstetri di IGD RSCMpada bulan Januari 2013 hingga Desember 2014, kemudian informasi mengenai data dan karakteristik pasien dikumpulkan. Ketepatan pelaksanaan rujukan kasus gaat daraurat obstetri berdasarkan Krietria gawatdarurat bagian kebidanan menurut ketentuan BPJS Kesehatan.
Hasil: Perujuk terbanyak adalah Puskesmas (FKTP). Kasus rujukan dengan ketidaksesuaian diagnosa lebih banyakjumlahnya pada saat JKN mulai diterapkan pada tahun 2014 sebesar 21.2%. Kasus dengan diagnosa yang tidak tepat rujuk lebih banyak pada saat JKN di laksanakan yaitu sebesar 16.8% dan kasus rujukan yang bukan gawatdarurat sebesar 6.9% pada tahun 2014.
Kesimpulan: Pelaksanaan rujukan belum efisien dan efektif, jumlah rujukan obstetri ke IGD RSCM yangsebenarnya dapat ditangani di fasilitas kesehatan tingkat lanjutan sekunder setelah penerapan JKN masih tinggi. Dibutuhkan monitoring dan evaluasi oleh Dinas Kesehatan setempat untuk meningkatkan kualitas sistem rujukan yang berlaku di era JKN yang baru diterapkan.
Kata kunci : BPJS, gawat darurat obstetri, JKN, ketepatan rujukan, sistem rujukan
How Long is the Safest InterDelivery Interval in Women with Previous History of Cesarean Delivery?
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Objective: To investigate the association between interdelivery interval and uterine rupture in women with previous CD.
Methods: The formulation question was how long is the safest interdeliveryinterval to minimalize the risk of uterine rupture. Theauthors investigated in three databases including Pubmed,Cochrane, and Embase database. Inclusion criteria wereabstract answering the clinical question, written in Englishlanguage, and full-text paper availability.
Results: One systematic review, six cohort studies, and 1 casecontrolstudy were collected to compare the inter-pregnancyinterval to the risk of uterine rupture. The author retrievedseven articles suitable to the inclusion criteria after excluding tenarticles screened by the abstract and language. Then, the authoradded one article used in the systematic review. Hence, the criticalappraisal based on Validity, Importance, and Applicability (VIA)was performed for eight articles.
Conclusion: The inter-delivery interval 18 months is the safest time to avoid uterine rupture. Prostaglandin analogue induction should be avoided and for patients with a history of past cesarean using a single-layer closure to be educated about the increased risk.
Keywords: cesarean delivery, inter-delivery interval, uterine rupture,vaginal birth after cesarean deliver
Internet Based Infertility Information in Bahasa Indonesia Quality Survey
Get PDFObjective: To assess the quality of websites providing informationon infertility and its management in Bahasa.Methods: Differences between website types and affiliates wereassessed for the credibility, accuracy and ease of navigation usingpredefined criteria. We used Google search engine with the keyword"infertilitas" and we assessed 50 websites in Bahasa that relates withinfertility.Results: The content credibility for most of the sites has adequatescore with range of score 60 to 80 for 68% sites. Content accuracyfor most of the sites have scores more than 60, with 24% or 12sites with scores 60 to 80 and 44% or 22 sites have scores above80. The ease of navigation for most of the sites, 47 sites or 94%has scores more than 60.Conclusion: The quality of internet based infertility information inBahasa is adequate for category credibility, accuracy and ease ofnavigation.[Indones J Obstet Gynecol 2018; 6-1: 28-33]Keywords: bahasa, infertility, information, internet, qualit
Relationship between Knowledge, Attitude and Behavior of Postnatal Woman Toward Participation in Permanent Contraception
Get PDFObjective: To investigate the association between knowledge,attitude, and behavior towards participation in permanentcontraception and describe factors that could affectparticipation of permanent contraception in women inRSMH Palembang.Methods: This case control study was conducted at the Departmentof Obstetrics and Gynecology, Dr. Mohammad Hoesin Hospital/Faculty of Medicine, Universitas Sriwijaya, Palembang, during theperiod of June 2016 to December 2016. Sample of the cases groupwas woman who agreed to use permanent contraception whilecontrol sample was women who refuse to use permanent contraception.Data were collected using a questionnaire. Statisticalanalysis was performed using SPSS.Results: There was a significant association between attitude,behavior, husband support, and disease complications withparticipation of permanent contraception. Factors that influencedparticipation of permanent contraception in woman in RSMHPalembang include husband support and behavior.Conclusion: Factors that influence the participation of women inRSMH safe contraception Palembang include support for herhusband and behavior.[Indones J Obstet Gynecol 2018; 6-1: 39-44]Keywords: family planning, participation, permanent contraceptio
Obstetric Risk Factors and Anal Incontinence among Women with Previous History of Vaginal Delivery
Get PDFObjective: To investigate the obstetric risk factors of the analincontinence in mothers with previous history of vaginaldelivery.Methods: The was a case-control study conducted in the Obstetricsand Gynecology Department of Dr.Wahidin Sudirohusodo Hospital,Faculty of Medicine, Universitas Hasanuddin, Makassar, during theperiod of February 2015 through January 2016. The researchinstruments were used to evaluate obstetric risk factors and theanal incontinence was the self-administered questionnaire and FecalIncontinence Severity Index. The data were analyzed statisticallyusing the Chi-square test with the significant value of p<0.05.Results: A total of 300 subjects were recruited in this study. Theresearch results indicated that the parity of  3, the assisted vaginaldelivery history (vacuum extraction), and the prolong secondstage of labor had a significant correlation with the anal incontinencewith p value=0.026, OR (95% CI) = 1.8 (1.07-3.03), p=0.018with OR (95% CI) =3.65 (1.2-10.7) and p=0.006 with OR (95% CI)= 2.9 (1.2-6.7).The history of episiotomy and the delivery of thebaby  4000 gram had no correlation with the anal incontinence.Conclusion: Parity, vacuum delivery and prolong second stage oflabor have an association with anal incontinence among womenwho has history of vaginal delivery.Keywords: anal incontinence, obstetric risk factors, vaginal deliver
The Effect of Cyclophosphamide Chemotherapy on Ovarian AntiMüllerian Hormone Levels in Breast Cancer Patients
Get PDFObjective: To evaluate cyclophosphamide effects on Anti-Müllerian hormone (AMH) levels in breast cancer patientstreated with cyclophosphamide chemotherapy.Methods: This cohort prospective study was conducted inDr. Wahidin Sudirohusodo Hospital in the Department of Obstetricsand Gynecology in collaboration with Department of Surgery,Faculty of Medicice, Universitas Hasanuddin between September2015 and June 2016. Serum levels of AMH from forty breast cancerpatients received three series of cyclophosphamide chemotherapydetermined by Enzyme Linked Immuno Sorbent Assay (ELISA).Results: Serum AMH levels decreased significant in the first series(from 2.092.04 ïg/ml to o.651.06 ïg/ml; p<0.05) through thethird series (from 1.531.34 ïg/ml to 0.50.65 ïg/ml; p<0.05) ofcyclophosphamide chemotherapy.Conclusion: AMH levels decreased significant after cyclophosphamideindicated that cyclosphosphamide decrease ovarianreserve.[Indones J Obstet Gynecol 2018; 6-1: 64-67]Keywords: anti-müllerian hormone, breast cancer, cyclophosphamide,ovarian reserveObjective: To evaluate cyclophosphamide effects on Anti-Müllerian hormone (AMH) levels in breast cancer patientstreated with cyclophosphamide chemotherapy.Methods: This cohort prospective study was conducted inDr. Wahidin Sudirohusodo Hospital in the Department of Obstetricsand Gynecology in collaboration with Department of Surgery,Faculty of Medicice, Universitas Hasanuddin between September2015 and June 2016. Serum levels of AMH from forty breast cancerpatients received three series of cyclophosphamide chemotherapydetermined by Enzyme Linked Immuno Sorbent Assay (ELISA).Results: Serum AMH levels decreased significant in the first series(from 2.092.04 ïg/ml to o.651.06 ïg/ml; p<0.05) through thethird series (from 1.531.34 ïg/ml to 0.50.65 ïg/ml; p<0.05) ofcyclophosphamide chemotherapy.Conclusion: AMH levels decreased significant after cyclophosphamideindicated that cyclosphosphamide decrease ovarianreserve.Keywords: anti-müllerian hormone, breast cancer, cyclophosphamide,ovarian reserv
Endoglin Expression (CD105) in Ephithelial Ovarian Cancer: Ekspresi Endoglin (cd105) Pada kanker Ovarium Tipe Epitelial
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Objective: Endoglin ( CD105 ) is one of the factors that play a role in vascular development , angiogenesis and vascular homeostasis. The aim of this research is to address the endoglin expression (CD105) in primary tumor and metastasis tumor (omentum) and their relation with clinicopathological factor: stadium, differentiation level, and histological epithelial ovarian cancer.
Method: The research was performed at Public Service Hall of Dr. Wahidin Sudirohusodo Hospital and educational networking hospital of Obstetrics and Gynecology Departement of Medical Faculty Hasanuddin University Makassar. The research design is cross sectional with 55 samples consisting of 55 samples of primary tumor and 55 matastasis tumor. Imunohistochemistry examination was performed to all samples.
Result:The results show a significant relation between endoglin (CD105) at omentum metastasis tumor and stadium and cell differentiation level of epithelial ovarian cancer. There is no significant relation between endoglin (CD105) expression at primary tumor of ovarian cancer and stadium and differentiation and type of histopathological cell. In addition, there is no significant relation between endoglin expression (CD105) at omentum metastasis tumor and type of histophatological cell of ovarian cancer. There is a significant correlation (strong category) between endoglin expression at omentum metastasis tumor and endoglin expression at primary tumor of epithelial ovarian cancer.
Conclusion: Endoglin expression in ovarian cancer metastatic tumor to omentum is correlated to clinical stage and differentiation level of ovarian cancer. And endoglin is one of the pro angiogenic and pro metastasis factors.
Keywords:epithelial ovarian cancer, endoglin expression, CD105, immunohistochemistry