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Avulsion of the Levator Ani at First Pregnancy Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 1, January 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To investigate whether demographic and obstetric risk factors are associated with avulsion of the levator ani at first pregnancy. Methods: A series of case was undertaken on 4 pregnant nulliparous women seen with a gestational age of more than 37 weeks. We analyzed with 3D/4D translabial ultrasound and digital assessment data of 4 women seen in a tertiary Urogynecological clinic. The use of 3D/4D ultrasound as a means of detection of trauma to the levator ani. Result: We had 4 women who had levator ani avulsion. Diagnosis of levator trauma (avulsion) on tomographic ultrasound was correlated with predelivery demographic variables and ultrasound parameters. Conclusion: With a greater understanding on the function of pelvic floor muscles, risk factors for trauma and damage as a result of pregnancy and birth, healthcare professionals will have better ability to meet the needs of women in the childbearing year. This study utilized a scoring system that can be used to predict the occurrence of levator ani muscle damage. In the end, the decline in quality of life for women, especially after a birth, can be prevented. [Indones J Obstet Gynecol 2013; 37-1: 51-6] Keywords: 3D/4D translabial ultrasound, demographic, levator ani avulsion, obstetric risk factors

Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume. 36, No. 2, April 2012
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age

The Incidence of Anal Sphincter Ruptures and Risk Factors Santoso, Budi I; Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 1, January 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To analyze the incidence of anal sphincter ruptures and to evaluate risk factors of obstetric anal sphincter ruptures in Dr. Cipto Mangunkusumo Hospital. Method: We reviewed 2009 vaginal deliveries based on the analysis of obstetric data base and patient records of our department during 2012. Cases and control subjects were chosen randomly and patientâs records were reviewed for the following variable: maternal age, parity, gestational age, labor induction, duration of 2nd stage labor, use of forceps, use of vacuum, use of episiotomy, birth weight, and presentation of the baby. Result: There were 91 (4.53%) anal sphincter ruptures during period of study (91 of 2009 patients). An univariate analysis of these 91 case and 91 randomly selected control subjects show that primiparity (p = .000), gestational age (p = .016), duration of second-stage labor (p = .000), forceps delivery (p = .000), vacuum delivery (p = .001), episiotomy (p = .000), and birth weight (p = .000) increased the risk for anal sphincter ruptures. In multivariate re-gression models, only 5 of the 10 predictor variables were significantly related to the likelihood of having a severe perineal trauma greater than second degree. Primiparity (p = .023; OR 2.74, 95% [CI], 1.15-6.51), forceps delivery (p = .000; OR 18.18, 95% [CI] 3.84-86.07), vacuum delivery (p = .005; OR 6.83, 95% [CI] 1.77-26.42), episiotomy (p = .015; OR 2.86, 95% [CI] 1.23-6.65), and birth weight (p = .000; OR 0.99, 95% [CI] 0.997-0.999). Conclusion: Damage of the anal sphincter resulting in a third- or fourth- degree perineal tear is a relatively rare but severe complication of vaginal delivery. We found that factors as sociated with anal sphincter ruptures were primiparity, forceps, vacuum, episiotomy and birth weight. [Indones J Obstet Gynecol 2016; 1: 31-36] Keywords: anal sphincter ruptures, third- or fourth- degree perineal tear, vaginal delivery

Vaginal Delivery in Placental Abruption Adjie, JM Seno; Ghazali, M Farid; Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

    Objective: To describe the case of vaginal delivery in placental abruption.   Methods: A case report   Results: In the case of placental abruption, we could perform vaginal delivery.   Conclusion: The treatment of placental abruption can be vaginally or by cesarean section depending on the severity of disease, gestational age, and state of the mother and fetus. Keywords: IUFD, placental abruption, vaginal delivery

The Incidence of Anal Sphincter Ruptures and Risk Factors Santoso, Budi I; Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 1, January 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To analyze the incidence of anal sphincter ruptures and to evaluate risk factors of obstetric anal sphincter ruptures in Dr. Cipto Mangunkusumo Hospital. Method: We reviewed 2009 vaginal deliveries based on the analysis of obstetric data base and patient records of our department during 2012. Cases and control subjects were chosen randomly and patient’s records were reviewed for the following variable: maternal age, parity, gestational age, labor induction, duration of 2nd stage labor, use of forceps, use of vacuum, use of episiotomy, birth weight, and presentation of the baby. Result: There were 91 (4.53%) anal sphincter ruptures during period of study (91 of 2009 patients). An univariate analysis of these 91 case and 91 randomly selected control subjects show that primiparity (p = .000), gestational age (p = .016), duration of second-stage labor (p = .000), forceps delivery (p = .000), vacuum delivery (p = .001), episiotomy (p = .000), and birth weight (p = .000) increased the risk for anal sphincter ruptures. In multivariate re-gression models, only 5 of the 10 predictor variables were significantly related to the likelihood of having a severe perineal trauma greater than second degree. Primiparity (p = .023; OR 2.74, 95% [CI], 1.15-6.51), forceps delivery (p = .000; OR 18.18, 95% [CI] 3.84-86.07), vacuum delivery (p = .005; OR 6.83, 95% [CI] 1.77-26.42), episiotomy (p = .015; OR 2.86, 95% [CI] 1.23-6.65), and birth weight (p = .000; OR 0.99, 95% [CI] 0.997-0.999). Conclusion: Damage of the anal sphincter resulting in a third- or fourth- degree perineal tear is a relatively rare but severe complication of vaginal delivery. We found that factors as sociated with anal sphincter ruptures were primiparity, forceps, vacuum, episiotomy and birth weight. [Indones J Obstet Gynecol 2016; 1: 31-36] Keywords: anal sphincter ruptures, third- or fourth- degree perineal tear, vaginal delivery

Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume. 36, No. 2, April 2012
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age

Avulsion of the Levator Ani at First Pregnancy Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume 37, No. 1, January 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate whether demographic and obstetric risk factors are associated with avulsion of the levator ani at first pregnancy. Methods: A series of case was undertaken on 4 pregnant nulliparous women seen with a gestational age of more than 37 weeks. We analyzed with 3D/4D translabial ultrasound and digital assessment data of 4 women seen in a tertiary Urogynecological clinic. The use of 3D/4D ultrasound as a means of detection of trauma to the levator ani. Result: We had 4 women who had levator ani avulsion. Diagnosis of levator trauma (avulsion) on tomographic ultrasound was correlated with predelivery demographic variables and ultrasound parameters. Conclusion: With a greater understanding on the function of pelvic floor muscles, risk factors for trauma and damage as a result of pregnancy and birth, healthcare professionals will have better ability to meet the needs of women in the childbearing year. This study utilized a scoring system that can be used to predict the occurrence of levator ani muscle damage. In the end, the decline in quality of life for women, especially after a birth, can be prevented. [Indones J Obstet Gynecol 2013; 37-1: 51-6] Keywords: 3D/4D translabial ultrasound, demographic, levator ani avulsion, obstetric risk factors

Vaginal Delivery in Placental Abruption Adjie, JM Seno; Ghazali, M Farid; Khusen, Denny
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 3 July 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

    Objective: To describe the case of vaginal delivery in placental abruption.   Methods: A case report   Results: In the case of placental abruption, we could perform vaginal delivery.   Conclusion: The treatment of placental abruption can be vaginally or by cesarean section depending on the severity of disease, gestational age, and state of the mother and fetus. Keywords: IUFD, placental abruption, vaginal delivery

THE ROLE OF CONTRACEPTION IN THE PAST, PRESENT AND FUTURE Gunardi, Eka Rusdianto; Khusen, Denny; Winston, Kevin
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Contraceptives play an undeniable important role in woman?s lives. It is widely accepted that the availability of both hormonal and non-hormonal modern contraceptives have improved 0 women?s lives worldwide by allowing women to control their own fertility. Indirectly, contraceptives have been shown to reduce maternal mortality, unwanted pregnancy, and overpopulation. However, the contraceptives available today may not be suitable for all users. Furthermore, there is still need to expand available current contraceptives choices especially long-term contraceptives in order to improve acceptability. As a result, several novel products such as implants, contraceptive vaginal rings, and transdermal patches have recently been introduced in family planning programs. Additional issue of contraceptive needed to be addressed is the adverse effects of hormonal contraceptives. Therefore, new combinations with an improved metabolic profile is currently being researched. Generally, the introduction of new methods with additional health benefits and less side effects would help women with their unmet needs to obtain access to a wider range of contraceptives.

PERAN DOKTER DALAM MENANGANI PELECEHAN SEKSUAL PADA ANAK DI INDONESIA Ocviyanti, Dwiana; Budiningsih, Yuli; Khusen, Denny; Dorothea, Maya
Majalah Kedokteran Indonesia Vol 69 No 2 (2019): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Pendahuluan: Kejahatan seksual banyak terjadi di Indonesia. Pada tahun 2010-2014, data dari Komisi Nasional Perlindungan Anak menunjukkan 42-62% dari seluruh kekerasan yang terjadi pada anak merupakan kejahatan seksual. Pelecehan seksual pada anak sering terjadi di tempat-tempat yang seharusnya menjadi tempat teraman bagi anak seperti di rumah atau di sekolah. Pelecehan seksual yang terjadi pada seorang anak dapat berupa verbal, non-verbal, maupun fisik, dan dapat berdampak pada anak secara fisik dan psikis. Peran dokter dalam kasus pelecehan seksual pada anak antara lain untuk pemeriksaan demi kepentingan peradilan serta tata laksana secara medis untuk mencegah dampak buruk jangka panjang yang dapat ditimbulkan dari korban pelecehan seksual.

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