OBGYNIA - Indonesian Journal of Obstetrics & Gynecology Science
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Characteristics of Patients with Morbidly Adherent Placenta at Dr. Hasan Sadikin Hospital Bandung
Get PDFAbstractObjective: Morbidly adherent placenta (MAP) is one of the causes of postpartum haemorrhage that impacts morbidity, hysterectomy, and mortality. This study reviewed patient characteristics and disease features in tertiary referral hospital patients with MAP.Methods: This is a quantitative descriptive study conducted on patients with MAP in September 2019–September 2020. Patient data were sourced from medical records. The characteristics described in this study include sociodemographic characteristics, obstetric history (gestation, parity, and abortion), history of caesarean section (CS), history of curettage, comorbidities, and current disease description and outcomes (bleeding, infant outcome, length of stay, death).Result: A total of 24 patients were diagnosed post-operatively as MAP in this study. Most of the patients were multi-parity, had a history of CS or curettage, and had comorbid placenta previa. Most of the patients came for CS plans or went with the chief complaint of bleeding. All patients were managed by hysterectomy. There was one case of maternal death and one case of fetal death.Conclusion: The characteristics of the patients in this study reflect the risk factors and general features of MAP.Karakteristik Pasien MAP di RSUP Dr. Hasan Sadikin BandungAbstrakTujuan: Morbidly adherent placenta (MAP) merupakan salah satu penyebab perdarahan pasca-salin yang berdampak pada morbiditas, tindakan histerektomi, dan mortalitas. Penelitian ini dilakukan untuk meninjau karakteristik pasien dan gambaran penyakit pada pasien dengan MAP di rumah sakit rujukan tersier.Metode: Penelitian ini merupakan deskriptif kuantitatif yang dilakukan pada pasien dengan MAP pada September 2019–September 2020. Data pasien bersumber dari rekam medik. Karakteristik yang dideskripsikan pada penelitian ini meliputi karakteristik sosiodemografi, riwayat obstetrik (gestasi, paritas, dan abortus), riwayat seksio caesarea (SC), riwayat kuretase, komorbid, dan gambaran penyakit terkini serta luarannya (perdarahan, luaran bayi, lama perawatan, kematian).Hasil: Sebanyak 24 pasien yang terdiagnosis pasca-bedah sebagai MAP pada penelitian ini. Sebagian besar pasien multi paritas, memiliki riwayat SC ataupun kuretase, dan memiliki komorbid plasenta previa. Sebagian besar pasien datang untuk rencana SC ataupun datang dengan keluhan utama perdarahan. Semua pasien ditatalaksana dengan histerektomi. Kematian pada ibu terjadi sebanyak satu kasus dan anak terjadi sebanyak satu kasus.Kesimpulan: Karakteristik pasien pada penelitian ini merefleksikan faktor risiko dan gambaran umum MAP. Kata kunci: morbidly adherent placenta, plasenta akreta, plasenta inkreta, plasenta perkreta
Clinical Profile of Menopause Women in Batam, Makassar, and Surabaya
Get PDFObjective:This study aimed to find out the clinical profile of menopause women aged 45-65 years old in Batam, Makassar, and Surabaya.Methods: This study was an observational descriptive study using total sampling. This research was obtained from primary data, which obtained from women aged 45-65 years using an instrument in the form of a questionnaire. During the data collection period from February to July 2022 with a total of 75 menopause sample. The clinical changes data collected was menopause symptoms which assessed using Menopause Rating Scale (MRS). The data analyzed using Microsoft® Excel 2021 and presented in a form of table and diagram.Result: The most prevalent symptoms experienced by the sample of menopause women in Batam, Makassar, and Surabaya were physical and mental exhaustion as much as 63 samples (84%), followed by joint and muscular discomfort as much as 61 samples (81,33%), and sexual problems with a total of 52 samples (69,33%).Conclusions: The starting age of menopause of most of the sample were 45-55 years old. Most of the sample experienced physical and mental exhaustion and they experienced mild symptoms due to sociodemographic factors. Based on this research, it was found that education plays an important role to increase the awareness of menopause women regarding the symptoms and how to cope with it.Profil Klinis Wanita Menopause di Batam, Makassar, dan SurabayaAbstrakTujuan: Penelitian ini bertujuan untuk mengetahui profil klinis dari wanita perimenopause dan menopause berumur 45-65 tahun di Batam, Makassar, dan Surabaya.Metode: Penelitian ini merupakan penelitian deskriptif observasional dengan menggunakan total sampling. Penelitian ini diperoleh dari data primer yang diperoleh dari wanita usia 45-65 tahun dengan menggunakan kuesioner. Selama periode pengumpulan data dari Februari sampai Juli 2022, terdapat 75 sampel menopause. Data perubahan klinis yang digunakan adalah gejala menopause yang dinilai menggunakan Menopause Rating Scale (MRS). Data dianalisis menggunakan Microsoft® Excel 2021 dan disajikan dalam bentuk tabel dan diagram.Hasil: Gejala yang paling banyak dialami sampel wanita menopause di Batam, Makassar, dan Surabaya adalah kelelahan fisik dan mental sebanyak 63 sampel (84%), diikuti ketidaknyamanan sendi dan otot sebanyak 61 sampel (81,33%), dan masalah seksual sebanyak 52 (69,33%) sampel. Kesimpulan: Usia dimulainya menopause pada sebagian besar sampel adalah 45-55 tahun. Sebagian besar sampel mengalami gejala kelelahan fisik dan mental dan gejala yang dialami ringan karena faktor sosiodemografi. Berdasarkan penelitian ini ditemukan bahwa pendidikan berperan penting dalam meningkatkan kesadaran wanita menopause terkait gejala yang muncul dan cara mengatasinya.Kata kunci: Menopause, Kualitas hidup menopause, Skala Penilaian Menopause, Gejala menopause, Perimenopaus
A Case Report: MRI versus Ultrasonography in Abdominal Pregnancy, Which One is Better?
Get PDFAbdominal pregnancy is a rare potentially life-threatening form of ectopic pregnancy. First trimester sonography is very useful to identify an abdominal pregnancy earlier. However, cases of undiagnosed abdominal pregnancy at second and third trimesters are still reported in obstetric practice. Abdominal pregnancy is often missed during routine ultrasound examination that has classical findings such as the absence of myometrial tissue between the maternal bladder and the pregnancy, an empty uterus, poor visualization of the placenta, oligohydramnios, and abnormality of fetal lie. Magnetic Resonance Imaging (MRI) has been reported as the best abdominal pregnancy detection modality in a later gestational age due to its ability in detailing vascular and placental organ invasion.The reporting of a case of a patient with an abdominal pregnancy involves a diagnosis using abdominal ultrasound in the second trimester. A 38-year-old woman was admitted to RSUP Dr. Hasan Sadikin Bandung with suspected abdominal pregnancy at gestational age of 28 weeks. Due to unclear clinical manifestation, the diagnosis of abdominal pregnancy was not detected and there was a plan for vaginal termination of pregnancy by misoprostol induction in the hospital before. The patient complained about progressive abdominal pain and difficult of defecation for 2 months before and this condition worsened in the last 4 days. Ultrasound examination in RSHS revealed that there were one living fetus, extra-uterine pregnancy with estimated fetal weight of 664 grams, fetal heart rate (+), and transverse breech presentation. Congenital abnormality was difficult to assess due to oligohydramnios. MRI was performed and showed intra-abdomen pregnancy with one living fetus, breech presentation, and intact amniotic membrane with oligohydramnios which was superior to the uterus and attached along the anterior aspect of uterus. The placenta had the size os 11.52 x 7.02 x 13.07 cm, was diffusely heterogenous in shape, on the right superoanterolateral wall of the gestational sac, and seemed to be attached to the right anterior abdominal wall and part of the intestine in the superior part while no placental adherence was seen. The patient was successfully treated with exploratory laparotomy with complete removal of the fetus and placenta. This case was reported to compare the advantage of MRI and ultrasound examination in detecting abdominal pregnancy, especially in late gestational age.Laporan Kasus: MRI dan Ultrasonografi pada Kehamilan Abdomen, Manakah yang Lebih Baik?AbstrakKehamilan abdomen adalah bentuk kehamilan ektopik yang jarang terjadi dan memiliki potensi mengancam jiwa. Pemeriksaan ultrasonografi (USG) pada trimester pertama berguna untuk mengidentifikasi kehamilan abdominal lebih awal. Namun, kehamilan abdomen yang tidak terdiagnosis masih sering dijumpai pada trimester kedua dan ketiga. Tanda klasik kehamilan abdomen sering terlewatkan oleh operator pada saat pemeriksaan USG rutin. Magnetic Resonance Imaging (MRI) merupakan modalitas terbaik untuk mendeteksi kehamilan abdomen pada usia kehamilan yang lebih tua karena mampu melihat invasi pembuluh darah dan organ plasenta secara lebih detail.Kami melaporkan sebuah kasus mengenai seorang wanita 38 tahun yang terdeteksi memiliki kehamilan abdominal pada usia kehamilan 28 minggu pada pemeriksaan USG saat perawatan di RSHS. Manifestasi klinis pada pasien tidak spesifik sehingga diagnosis kehamilan abdominal terlewati dan sempat diberikan rencana terminasi kehamilan pervaginam di rumah sakit sebelumnya. Pemeriksaan USG menunjukkan terdapat satu janin hidup dan terletak luar rahim. Kemudian pasien diputuskan menjalani pemeriksaan MRI, ditemukan adanya kehamilan intra abdomen dengan satu janin hidup, presentasi bokong, dan plasenta berbentuk heterogen difus, di dinding superoanterolateral kanan kantung kehamilan, melekat pada dinding abdomen anterior kanan dan bagian usus di bagian superior, dan tanpa adanya perlengketan plasenta. Pasien ditangani dengan laparotomi eksplorasi dengan pengangkatan janin dan plasenta secara lengkap. Kasus ini bertujuan membandingkan keunggulan pemeriksaan MRI dan USG dalam mendeteksi kehamilan abdominal, terutama pada usia kehamilan lanjut.Kata kunci: ultrasonografi, MRI, kehamilan abdomina
Hubungan antara Kisspeptin-10 dan Preeklamsia Berat
Get PDFTujuan: Menganalisis perbandingan ekspresi KISSPEPTIN-10 antara pasien tidak preeklamsia, preeklamsia berat, dan preeklamsia berat dengan komplikasi.Metode: Penelitian ini menggunakan desain kontrol kasus yang dilakukan pada ibu hamil preeklamsia berat dengan dan tanpa komplikasi sebagai kelompok kasus dan ibu hamil tidak preeklamsia berat sebagai kontrol di RSUP dr. Wahidin Sudirohusodo dan rumah sakit jejaring Fakultas Kedokteran Universitas Hasanuddin. Pengambilan sampel dilakukan dengan consecutive sampling. Kriteria inklusi yaitu ibu hamil dengan preeklamsia berat dan preeklamsia berat dengan komplikasi. Kriteria eksklusi yaitu pasien dengan hipertensi kronik, penyakit tiroid, dan penyakit ginjal sebelum kehamilan dan plasenta previa. Ekspresi KISSPEPTIN-10 diukur secara imunohistokimia dari plasenta saat melahirkan. Data dianalisis dengan uji chi square dan uji Kruskal Wallis. Data dianalisis dengan program SPSS.Hasil: Hasil ini diperoleh 88 subyek penelitian yang terdiri atas 30 pasien kelompok tidak preeklamsia, 30 pasien kelompok preeklamsia berat dan 28 pasien kelompok preeklamsia berat dengan komplikasi. Ekspresi KISSPEPTIN-10 berbeda signifikan antara kelompok tidak preeklamsia berat, preeklamsia berat, dan preeklamsia berat dengan komplikasi (p<0,05).Kesimpulan: Semakin tinggi ekspresi KISSPEPTIN-10 sejalan dengan semakin beratnya derajat preeklamsia berat. Relationship between Kisspeptin-10 and Severe PreeclampsiaAbstractObjective: To analyze the comparison of KISSPEPTIN-10 expression between severe preeclampsia and severe preeclampsia with complications.Method: This study used a case control design which was carried out in pregnant women with severe preeclampsia with and without complications as the case group and pregnant women without severe preeclampsia as a control at Dr. Wahidin Sudirohusodo and the Hasanuddin University Faculty of Medicine network hospital. Sampling was done by consecutive sampling. The inclusion criteria were pregnant women with severe preeclampsia and severe preeclampsia with complications. Exclusion criteria were patients with chronic hypertension, thyroid disease and kidney disease before pregnancy and placenta previa. KISSPEPTIN-10 expression was measured immunohistochemically from the placenta at delivery. Data were analyzed with the chi square test and the Kruskal Wallis test. Data were analyzed with the SPSS program.Results: This result founded 88 subjects consisting of 30 patients in the non-preeclampsia group, 30 patients in the severe preeclampsia group and 28 patients in the severe preeclampsia group with complications. KISSPEPTIN-10 expression differed significantly between groups without severe preeclampsia, severe preeclampsia and severe preeclampsia with complications (p<0.05). Conclusion: The higher the KISSPEPTIN-10 expression is in line with the more severe the degree of preeclampsia. Key words: Complications, KISSPEPTIN, Severe Preeclampsi
Prevalensi dan Luaran Pasien dengan Spekrtum Plasenta Akreta
Get PDFTujuan: Plasenta akreta mengakibatkan risiko perdarahan ibu dan morbiditas anak akibat prematuritas. Prevalensi dan luaran pasien dengan spekrum plasenta akreta di Indonesia masih rendah. Penelitian ini bertujuan mencari tingkat prevalensi serta membandingkan luaran pada ibu dengan plasenta akreta.Metode: Desain penelitian merupakan penelitian deskriptif observasional yang diperoleh dari rekam medis tahun 2015–2019 di RSUP Dr. Hasan Sadikin Bandung periode Februari-April 2020.Hasil: Pada 39 pasien dengan plasenta akreta didapatkan wanita berusia >35 tahun sebanyak 22 orang (56,4%). Kondisi yang banyak ditemui pada pasien plasenta akreta meliputi multipara sebanyak 26 orang (66,7%) dan riwayat seksio sesarea >1x sebanyak 20 orang (51.3%). Sebanyak 30 pasien (76,9%) membutuhkan 3 unit 200 mL Packed Red Cell (PRC). Sebanyak 31 bayi (83,7%) yang lahir dari ibu dengan plasenta akreta lahir kurang bulan atau prematur dan 26 bayi (70,2%) mengalami berat badan lahir rendah (BBLR), serta dari 17 bayi prematur, 8 (52,9%) bayi mengalami stunting.Kesimpulan: Pasien dengan plasenta akreta di RSUP Dr. Hasan Sadikin Bandung mayoritas berusia tua, merupakan multipara dan memiliki riwayat seksio sesarea >1x. Pasien dengan plasenta akreta cenderung mengalami pendarahan yang banyak serta terdapat banyak bayi BBLR dan stunting. Prevalence and Outcome of Placenta Spectrum Accreta AbstractObjective: Placenta accreta carries a risk of maternal bleeding and child morbidity due to prematurity. The prevalence and outcomes of patients with spectrum placenta accreta in Indonesia are still limited. This study aims to evaluate the prevalence and outcomes in mothers with placenta accreta.Method: This is an observational descriptive study obtained from medical records for 2015–2019 at Dr. Hasan Sadikin Bandung from February–April 2020.Results: In 39 patients with placenta accreta, there were 22 women aged >35 years (56.4%). Conditions that were often found in patients with placenta accreta included multiparas in 26 people (66.7%) and history of cesarean section > 1x in 20 people (51.3%). A total of 30 patients (76.9%) required 3 units of 200 mL Packed Red Cell (PRC). A total of 31 babies (83.7%) born to mothers with placenta accreta were born preterm or premature and 26 babies (70.2%) had low birth weight (LBW), and of 17 premature babies, 8 (52.9%) babies are stunted.Conclusion: Patients with placenta accreta at Dr. Hasan Sadikin Bandung are mostly old, multiparous, and have history of more than 1 cesarean section. Patients with placenta accreta tend to experience heavy bleeding and there are many LBW and stunted babies.Key words: placenta accreta, placenta accreta spectrum, LBW, stuntin
Perbandingan Faktor Risiko antara Pertumbuhan Janin Terhambat Onset Dini dan Lambat di RSUD Dr. Moewardi
Get PDFTujuan: Mengetahui perbandingan faktor risiko antara pertumbuhan janin terhambat onset dini dan lambat di RSUD Dr. Moewardi.Metode: Penelitian observasional analitik dengan pendekatan cross sectional menggunakan data sekunder rekam medis ibu dengan pertumbuhan janin terhambat di RSUD Dr. Moewardi mulai 1 Januari 2020–31 Desember 2021. Pengambilan data menggunakan teknik total sampling, Data diolah menggunakan SPSS dan dianalisis menggunakan uji univariat, kemudia bivariat yaitu uji Chi Square.Hasil: Hasil analisis bivariat menunjukkan bahwa tidak terdapat perbedaan bermakna pada variabel usia, paritas, Indeks Massa Tubuh (IMT), pekerjaan ibu, hipertensi, preeklamsi, diabetes melitus, anemia, asma antara pertumbuhan janin terhambat onset dini dan onset lambat (p>0,05).Kesimpulan: Tidak terdapat perbedaan yang bermakna pada usia ibu, paritas, Indeks Massa Tubuh (IMT), pekerjaan ibu, preeklamsi, hipertensi, diabetes melitus, anemia, asma antara kejadian pertumbuhan janin terhambat onset dini dan lambat di RSUD Dr. Moewardi.Comparison of Risk Factor For Early and Late Onset Intrauterine Growth Restriction in RSUD Dr. MoewardiAbstract Objective: To find out the comparison of risk factors between early-onset and late onset intrauterine growth restriction at RSUD Dr. Moewardi.Method: This research is an analytical observational with a cross sectional approach was done by using medical records of pregnant woman with intrauterine growth restriction at RSUD Dr. Moewardi from January 1, 2020– December 31, 2021. Data was collected using a total sampling technique. And processed by SPSS then analyzed using univariate test, and Chi Square test.Results: The results of bivariate analysis showed that there was no significant differences of age, maternal employment, parity, Body Mass Index (BMI), maternal employment, hypertension, preeclampsia, diabetes mellitus, anemia, asthma between early-onset and late-onset with intrauterine growth restriction (p>0,05).Conclusion: There were no significant differences of maternal age, parity, Body Mass Index (BMI), preeclampsia, maternal employment, hypertension, diabetes mellitus, anemia, asthma between early and late onset intrauterine growth restriction at RSUD Dr. Moewardi.Key words: Risk Factor, Intrauterine Growth Restriction, Early Onset, Late Onse
Current Evidence of Platelet-Rich Blood Plasma for Pelvic Organ Prolapse: A Review
Get PDFObjective: To review the current evidence of the potential use of Platelet-Rich Plasma (PRP) in the field of urogynecology, especially in POP cases.Method: This review used several databases (Google Scholar, Pubmed, and Science Direct) and searched for English and Indonesian articles in the last ten years. Articles were received in the form of case reports, observational studies and clinical trials that discussed the use of Platelet-Rich Plasma in cases of Pelvic Organ Prolapse (POP).Results: A total of three articles were included in this review.Discussion: There were two patient studies and one in vitro study. The POP patient study showed favorable results with low recurrence rates in patients who received Platelet Rich-Plasma compared to those who did not and another study that conducted a one-year evaluation found no recurrences after the patients received Platelet Rich Plasma at the surgical site. The in vitro study showed good cell attachment and proliferation in vaginal tissue biopsies with Platelet-Rich Plasma applied to the tissue.Conclusion: Platelet-Rich Plasma may promote tissue regeneration, hence potentially reduce recurrency after reconstruction.Bukti Terkini Plasma Darah Kaya Trombosit untuk Prolaps Organ Panggul: Sebuah KajianTujuan: Untuk meninjau bukti terkini mengenai potensi penggunaan Platelet-Rich Plasma di bidang uroginekologi, khususnya pada kasus POP.Metode:Tinjauan ini menggunakan beberapa database Google Scholar, Pubmed, dan Science Direct) dan mencari artikel berbahasa Inggris dan Indonesia dalam sepuluh tahun terakhir. Artikel yang diterima berupa laporan kasus, studi observasional, dan uji klinis yang membahas penggunaan Platelet-Rich Plasma pada kasus Prolaps Organ Panggul (POP).Hasil: Sebanyak tiga artikel termasuk dalam tinjauan ini.Diskusi: Terdapat dua studi pasien dan satu studi in vitro. Studi pasien POP menunjukkan hasil yang baik dengan tingkat kekambuhan yang rendah pada pasien yang menerima PRP dibandingkan dengan mereka yang tidak menerima Platelet-Rich Plasma dan studi lain yang melakukan evaluasi satu tahun tidak menemukan adanya kekambuhan setelah pasien menerima Platelet-Rich Plasma di tempat pembedahan. Studi in vitro menunjukkan perlekatan dan proliferasi sel yang baik pada biopsi jaringan vagina dengan Platelet-Rich Plasma yang diaplikasikan pada jaringan tersebut.Kesimpulan: Platelet-Rich Plasma dapat meningkatkan regenerasi jaringan, sehingga berpotensi mengurangi kekambuhan setelah rekonstruksi.Kata kunci: Platelet-Rich Blood Plasma, Prolaps Organ Panggul, Uroginekolog
Profil Pasien Kanker Ovarium yang Dilakukan Fertility Sparing Surgery di RSUP Dr. Hasan Sadikin Bandung Tahun 2017-2020
Get PDFTujuan: Tujuan penelitian ini untuk menggambarkan karakteristik pasien kanker ovarium yang dilakukan tindakan fertility sparing surgery.Metode: Penelitian deskriptif menggunakan data rekam medis pasien kanker ovarium yang dilakukan tindakan fertility sparing surgery di RSUP Dr. Hasan Sadikin Bandung pada tahun 2017-2020. Sampel yang digunakan sebanyak 35 data rekam medis menggunakan metode total sampling. Hasil: Dari 35 pasien, sebagian besar berusia 20-29 tahun (37%),belum menikah (54%), dan nulipara (71%), Tindakan fertility sparing surgery dilakukan pada stadium I-II untuk tipe sel epitel, stadium I-III untuk tipe sel germinal, dan hanya pada stadium I untuk tipe sel sex cord stromal. Pasien usia 20 tahun mayoritas dilakukan tindakan pada stadium I dengan tipe histopatologi terbanyak adalah tipe sel epitel.Kesimpulan: Tindakan fertility sparing surgery bertujuan untuk mempertahankan organ reproduksi. Karakteristik pasien kanker ovarium yang dapat dilakukan tindakan fertility sparing surgery berusia 20-29 tahun dan nulipara. Tindakan fertility sparing surgery pada tipe sel epitel dan tipe sex cord stromal hanya dilakukan pada stadium dini, sementara pada tipe sel germinal dapat dilakukan hingga stadium III. Ovarian Cancer Patient Profile Undergoing Fertility Sparing Surgery at Dr. Hasan Sadikin General Hospital Bandung From 2017 Until 2020Abstract Objective: Aimed to describe the characteristics of ovarian cancer patients underwent fertility sparing surgery between 2017-2020 at Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive study that used medical records of ovarian cancer patients that underwent fertility sparing surgery at Dr. Hasan Sadikin General Hospital from 2017-2020. The sample used was 35 data, using the total sampling methods. Result: From a total of 35 patients, most were aged 20-29 years (37%), unmarried (54%), and nulliparous (71%). Fertility sparing surgery was performed at stage I-II for epithelial cell, stage I-III for germ cells, and stage I for sex-cord stromal cells. Patients 20 years underwent fertility sparing surgery at stage I with the histopathology type is surface epithelial cells.Conclusion: Fertility sparing surgery aimed to maintain the reproductive organs. Characteristics of patients who underwent fertility sparing surgery are aged 20-29 years and nulliparous. Fertility sparing surgery can be performed at an early stage for epithelial cell and sex-cord stromal cells, while germ cell can be performed up to stage III.Key words: ovarian cancer, fertility sparing surgery, characteristic
Caesarean Delivery Rates According to Pregnancy Characteristics and Robson Classification in Hypertension Related Pregnancy
Get PDFObjective: The study aimed to investigate the pregnancy characteristics of patients with hypertension related pregnancy and the rate of caesarean section in hypertension related pregnancy categorized into Robson Classification system at the Mother and Children Hospital.Methods: This cross-sectional study design was conducted from December 1st 2018 to November 30th 2019 in one of the private Mother and Children Hospital in Makassar. Total of 156 women with hypertension related pregnancy delivered. Demographics, clinical manifestation, pregnancy outcomes were collected and analyzed using the Chi-square test.Result: Caesarean delivery was 87.8% in our study and birth weight is significantly related to method of delivery (p=0,018). The risk of developing asphyxia of newborn was found 5.8% with higher values for HELLP syndrome (OR=9.667), severe preeclampsia (OR=7.077) and birth weight (OR=4.154). According to Robson classification, size of group 8 (5.8%), group 10 (9%) and number of caesarean delivery in group 5 (90%) were higher (should be 1.5-2%; <5%; and 50-60% in general population, respectively). All the caesarean group rate were above the general population.Conclusion: Clinical considerations about method of delivery need to be tailored to each individual in order to avoid maternal morbidity in later date. The Robson Classification could be one of the guiding tool to assess specific subgroups of women.Kejadian Seksio Sesaria Menurut Karakteristik Kehamilan dan Klasifikasi Robson Pada Hipertensi Dalam KehamilanAbstrakTujuan: Penelitian ini bertujuan untuk mengetahui karakteristik kehamilan pada pasien dan rasio seksio sesaria dengan hipertensi dalam kehamilan yang dikategorikan dalam sistem Klasifikasi Robson di Rumah Sakit Ibu dan Anak.Metode: Desain potong lintang dilakukan pada 1 Desember 2018 hingga 30 November 2019 pada salah satu Rumah Sakit Ibu dan Anak swasta di Makassar. Total 156 perempuan dengan hipertensi dalam kehamilan mengalami persalinan. Demografi, manifestasi klinis dan luaran kehamilan dikumpulkan dan dianalisis. Rasio seksio sesaria secara umum pada tiap grup Robson dihitung, demikian pula dengan kontribusi tiap grup terhadap rasio seksio sesaria secara umum.Hasil: Seksio sesaria ditemukan pada 87% pasien dan berat badan lahir secara signifikan terkait dengan metode persalinan (p=0,018). Asfiksia bayi baru lahir ditemukan 5,8% pada penelitian dengan risiko yang meningkat pada sindrom HELLP (OR=9,667), preeklampsia berat (OR=7,077) dan berat badan lahir (OR=4,154). Menurut klasifikasi Robson, ukuran grup 8 (5.8%), grup 10 (9%) dan rasio seksio sesaria di grup 5 (90%) lebih tinggi dibandingkan populasi umum. Seluruh rasio seksio sesaria lebih tinggi dibandingkan populasi umum.Kesimpulan: Pertimbangan klinis mengenai metode persalinan perlu dikhususkan pada masing-masing individual untuk menghindari morbiditas maternal di kemudian hari. Klasifikasi Robson dapat menjadi alat kontrol untuk melakukan evaluasi pada tiap grup.Kata kunci: Hipertensi; Kehamilan; Seksio sesaria; Klasifikasi Robson
Evaluation of Pelvic Floor Muscle Strength and Anal Spinchter Defects in Women Post Repair Obstetric Anal Spinchter Injuries
No full textTujuan: penelitian ini bertujuan untuk mengevaluasi defek sfingter ani dan disfungsi otot dasar panggul pada perempuan pasca repair trauma sfingter ani obstetri.Metode: Analitik observasional yang dikembangkan dengan desain kohort prospektif. Perempuan yang mengalami Repair Trauma Sfingter Ani Obstetri pada Bulan Januari 2020-Juni 2021 di beberapa RS jejaring Makassar dinilai defek pasca repair dan keluhan subjektif menggunakan USG Transperineal (Alpinion cube 5 dengan probe transvaginal), Skor Wexner, Numeric Pain Rating Scale dan Perineometer (Peritron 9300 V) yang dilakukan dalam 3 kali pengukuran yaitu pada bulan 1, 3 dan 6 pasca repair. Data diuji menggunakan Mann-Whitney test, Cochrane dan Independent T test. Data diolah menggunakan SPSS 24.Hasil: Dari 51 sampel yang dilakukan pemeriksaan, didapatkan rata-rata usia 27.82±4.04 tahun dengan rerata IMT 24.52±4.31 kg/m2. Sampel didominasi oleh primipara sebanyak 41(80,4%). Rerata berat bayi 3312.75±424.24 gram. Terdapat 5 (9,8%) Pasien yang mengalami defek pasca repair, rerata skor wexner pada sampel dengan defek sfingter ani 1.60±1.14 pada bulan pertama, terdapat perbedaan yang signifikan pada dispareunia (p<0.05) dengan rerata 3.33±1.15 pada sampel dengan defek sfingter ani pada bulan keenam. Tampak peningkatan rerata skor kekuatan otot panggul pada perempuan tanpa defek sfingter ani. Kesimpulan: Gejala subjektif dapat ditemukan pada perempuan tanpa defek sfingter ani. Peningkatan kekuatan otot dasar panggul dapat terjadi seiring bertambahnya waktu pasca repair.Evaluation of Pelvic Floor Muscle Strength and Anal Sphincter Defects in Post Obstetric Anal Sphincter Injuries Repair WomenAbstractObjectives: The goal of this study was to look at anal sphincter deficiencies and pelvic floor muscle dysfunction in women who had obstetric anal sphincter injuries and had them repaired.Methods: Analytical was created as an observational study with a cohort prospective design. Women who underwent OASIS Repair in multiple Makassar hospitals between January 2020 and June 2021 were assessed subjectively using Transperineal Ultrasound (Alpinion cube 5 ultrasound with transvaginal probe), Wexner Score, Numeric Pain Rating Scale, and Perineometer (Peritron 9300 V) at 1, 3, and 6 months after repairs. The data was analyzed using the Mann-Whitney test, Cochran test, and Independent T test in SPSS 24. Result: The average age of the 51 samples that underwent the assessment was 27.82.04 years, with a mean BMI of 24.524.31 kg/m2. Up to 41 percent of the sample was dominated by primiparas (80.4 percent ). The average infant weighs 3312.75424.24 grams. There were 5 (9.8%) patients who had a defect after repair, with an average score of 1.601.14 on the first month and a significant difference in dyspareunia (p0.05) with a mean of 3.331.15 on the sixth month in the sample with anal sphincter defect. In women who do not have an anal sphincter dysfunction, there is an average increase in look strength of the pelvic muscle.Conclusion: Women without an anal sphincter abnormality had subjective complaints. With more time passed after surgery, the pelvic floor muscle may improve.Key words: pelvic floor, OASIS, Wexner score, Anal Sphincter defect, Transperineal ultrasoun