Ernawati Ernawati
Deparment Of Obstetrics And Gynecology, Faculty Of Medicine, Universitas Airlangga, Dr Soetomo Hospital, Surabaya

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Role of aspirin dose in reducing uterine artery resistance in 16-24 weeks pregnant women with abnormal uterine artery resistance Muhammad Arief Adibrata; Agus Sulistyono; Ernawati Ernawati
Majalah Obstetri dan Ginekologi Vol. 26 No. 3 (2018): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (487.497 KB) | DOI: 10.20473/mog.V26I32018.128-134

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Objectives: To compare the decrease of resistance index (RI) from uterine artery in pregnant woman receiving low dose aspirin therapy between 80 mg/day and 125 mg/day who had abnormal doppler velocimetry (DV) ultrasound examination at 16-24 weeks.Materials and Methods: An experimental study using double blind randomized clinical trial design. Subjects were from Mulyorejo and Kalijudan public health service in Surabaya, that included pregnant women with 16-24 weeks of pregnancy with abnormal uterine artery velocimetry ultrasound. The results of ultrasound Doppler examination were divided into four levels; normal (RI<0.58; (-) diastolic notching), level I (RI> 0.58; (-) diastolic notching), level II (RI<0.58; (+) disatolic notching) and level III (RI> 0.58; (+) diastolic notching). Uterine doppler ultrasound examination was performed at Fetomaternal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Hospital, Surabaya, Indonesia, by fetomaternal consultants before and after the admin-istration of low-dose aspirin of 125 mg/day and 80 mg/day for four weeks.Results: Ninety subjects were obtained and randomized into 2 groups, with 45 subject in each group. Before treatment, in 125 mg/day group those with level I were 34 subjects and level III 11 subjects. In 80 mg/day group, level I 41 subjects, level II 2 subjects and level III 2 subjects. After 4 weeks of treatment, a second DV USG was performed in Aspirin 125 mg/day group. Normal were 40 subjects, level I 4 subjects, and level III 1 subject. In aspirin group 80 mg/day, normal 22 subjects, level I 19 subjects and level III 4 subjects. The analysis was performed with Wilcoxon test before and after treatment in both aspirin treatment group 125 mg/day and 80 mg/day with p value respectively, p=0.001 and p=0.005.Conclusion: Compared with aspirin of 80 mg/day, aspirin of 125 mg/day is more superior to decrease uterine arterial resistance in pregnant women with ultrasound uterine arterial doppler velocimetry at 16-24 weeks gestational age.
Length of marriage to pregnancy and the risk of preeclampsia Khusnul Putri Maharani; Atika Atika; Ernawati Ernawati
Majalah Obstetri dan Ginekologi Vol. 27 No. 3 (2019): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V27I32019.94-98

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Objective: to analyze the relationship between the length of marriage to pregnancy with the incidence of preeclampsia.Materials and Methods: This study was an observational analytic study with case control approach. Samples were 33 respondents with preeclampsia and 66 respondents with normal pregnancy, all were primigravida with age of 20-35 years old in Dr. M. Soewandhie Hospital, Surabaya, Indonesia, in January-June 2017. Data were taken from medical record.Results: This study found that the length of marriage until pregnancy was 0-4 months with percentage of 39.4% and 77.3% for case and control group respectively. Chi-square test resulted in p = 0.00 and contingency coefficient = 0.366, which meant there was relationship between the length of marriage to pregnancy and the incidence of preeclampsia in primigravida in Dr. M. Soewandhie Hospital Surabaya from January to June 2017 despite being in low level. The value of odd ratio (OR) was 0.191 (95% CI 0.077-0.473), which means there was a risk of protection for the length of marriage to pregnancy <4 months against the incidence of preeclampsia.Conclusion: The shorter the length from early marriage to pregnancy in primigravida, the lower the risk for developing preeclampsia.
Correlation between mother's knowledge and husband's support for the success of the Lactational Amenorrhea Method (LAM) Wahyunnisa Indrarosiana; Ernawati Ernawati; Ivon Diah Wittiarika
Majalah Obstetri dan Ginekologi Vol. 29 No. 3 (2021): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V29I32021.91-95

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HIGHLIGHTS 1. Lactational Amenorrhea Method (LAM) is one of the natural contraception methods of postpartum women.2. Mothers' knowledge and husband's support for LAM contraceptive method was suggested to contribute to its success.3. Research and statistical instruments used found that the success of LAM contraceptive was related to mothers' knowledge, but not related to husband's support. ABSTRACTObjectives: This study aimed to analyze the relationship between mother's knowledge and husband's support for the success of LAM contraception in Brengkok Village, Brondong District, Lamongan Regency, East Java, Indonesia.Materials and Methods: This study was an analytic observational study with a sample of 46 mothers who gave exclusive breastfeeding to their babies who met the inclusion criteria. The research instrument used a questionnaire to determine the level of mother's knowledge and husband's support about exclusive breastfeeding. Spearman Rank Correlation Test was used for data analysis with a significance level of 0.05.Results: More than 50% of the respondents (25 respondents) successfully used the LAM method to prevent pregnancy. Statistical test showed that there was a relationship between mother's knowledge and success of LAM contraception with p value of 0.000, with a correlation coefficient of 0.523. Meanwhile, husband's support was not related to the success of LAM contraception with p value of 0.461 with a correlation coefficient of 0.111.Conclusion: Mother's knowledge is related to the success of LAM contraception, and there is no relationship between husband's support and the success of LAM contraception.
Maternal and perinatal outcomes of pre-referral magnesium sulfate treatment in severe preeclampsia patients Rizki Amalia Sari; Sulistiawati Sulistiawati; Ernawati Ernawati
Majalah Obstetri dan Ginekologi Vol. 30 No. 1 (2022): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V30I12022.17-23

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HIGHLIGHTS 1. Consumption of magnesium sulfate is recommended for prevention against eclampsia. 2. Magnesium sulfate administration to preeclamptic mothers is effective in reducing the risk of eclampsia.3. Pre-referral magnesium sulfate administration and maternal and perinatal outcomes in severe preeclampsia patients was analyzed.4. Magnesium sulfate did reduce eclampsia risk, but not ICU and NICU care rates, maternal mortality, perinatal asphyxia, and perinatal mortality.   ABSTRACT Objectives: This study analyzed the association between pre- referral magnesium sulfate administration and maternal and perinatal outcomes in severe preeclampsia patients. Materials and Methods: This was a retrospective observational analytic study using cross-sectional design. Samples were 132 pregnant women with preeclampsia referred to dr. Saiful Anwar, Hospital Malang, Indonesia in 2019. Data were taken from the patients’ medical records. Maternal outcomes measured in this study were the incidence of eclampsia, ICU care, and maternal mortality, while the perinatal outcomes included the incidence of asphyxia, NICU care, and perinatal mortality. Results: Patients’ history of magnesium sulphate administration significantly associated with the incidence of eclampsia with p-value 0.035 and odds ratio (OR) 2.413, thus consumption of magnesium sulphate could reduce the risk of seizures. However, it did not associate with either maternal ICU care outcomes (p-value 0.087, OR 2.028), or maternal mortality (p-value 0.573). No relationship was found neither between history of magnesium sulphate administration in pregnant women with severe preeclampsia and perinatal outcomes nor with the incidence of asphyxia (p-value 0. 577, OR 0.795), with NICU treatment (p-value 0.205, OR 0.579), and with perinatal mortality (p-value 0.153, OR 3.259). Conclusion: Magnesium sulfate reduced the risk of eclampsia, yet it did not affect either the rate of ICU care, maternal mortality, incidence rate of perinatal asphyxia, the rate of NICU care, or perinatal mortality.
Analysis of Sociodemographic and Information Factors on Family Behaviour in Early Detection of High-Risk Pregnancy Ika Mardiyanti; Shrimarti Rukmini Devy; Ernawati Ernawati
Jurnal Ners Vol. 14 No. 2 (2019): OCTOBER 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.303 KB) | DOI: 10.20473/jn.v14i2.16561

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Introduction: Pregnancy and childbirth are physiological processes experienced by women, but they sometimes have risky conditions. There are still many pregnant women and their families who are unable to detect a high-risk of pregnancy early. This study aims to determine family behaviour in conducting early detection of a high-risk of pregnancy in terms of sociodemographic and information factors.Methods: This study uses an explanatory survey design with a cross sectional design. The sample size of this study was 146, with simple random sampling. The independent variables were sociodemographic factors (age, gender, ethnicity, education, income and religion) and information factors (experience, and media exposure) while the dependent variable is family behaviour. The instrument with the questionnaire used the Likert scale. The data was analysed using partial least square.Results: The results showed that Structural Equation Modelling-Partial least square (SEM-PLS) statistical analysis, through Confirmatory Factor Analysis (CFA), obtained sociodemographic factors on family behaviour of 1,999, and information factors on family behaviour of 13,78. The value of the influence of sociodemographic factors (0.102) and the value of the influence of information factors (0.754). R2 (0.63) and Q2 value of 0.65.Conclusion: Sociodemographic  factors and information factors significantly influenced family behaviour factors in early detection of high-risk of pregnancy. Information factors have a greater effect on family behaviour than sociodemographic factors. Midwives as health service providers at the health care centre need to optimize family empowerment through health information efforts in health promotion efforts. Further research requires the involvement of other factors to improve family behaviour, especially in the ability of families to detect early high-risk pregnancies. 
The Effect of Antenatal Corticosteroid Therapy to Respiratory Distress Syndrome Event on Preterm Infants in Surabaya Devy Putri Zenita; Martono Tri Utomo; Ernawati Darmawan
Biomolecular and Health Science Journal Vol. 1 No. 1 (2018): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (911.807 KB) | DOI: 10.20473/bhsj.v1i1.8217

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ABSTARCTIntroductions: One of the most common cause of morbidity and mortality in premature infants is respiratory distress syndrome (RDS). Several studies have shown that a single dose administration of antenatal corticosteroid therapy in women who are at high risk for premature delivery was associated with decreased incidence of RDS. The study aims to determine the effect of antenatal corticosteroid therapy on the incidence of RDS in prematurity in the Department of Child Health Hospital Dr. Soetomo.Methods: Analytic observational case-control design study was used for this research. Samples were taken from the medical records of RDS patients in premature baby and non-RDS with 36 samples in each group.Results: Antenatal corticosteroid therapy has effect in RDS incidence (p = 0.016). While the results of the odds ratio was 0.298 (with 95% CI 0.110 to 0.810), it means that premature infants with antenatal corticosteroid therapy has 0.298 times lower risk than those who were not given antenatal corticosteroid therapy.Conclusion: Antenatal corticosteroid therapy did not provide a direct relathionship to the incidence of respiratory distress syndrome in premature infants, but it a protective factor that can reduce the incidence of RDS in prematurity.
Correlation between Maternal Infection and Infant Cholestasis Liofelita Christi Adhi Mulia; I Gusti Made Reza Gunadi Ranuh; Ernawati Ernawati
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 12 No. 1 (2021): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V12I12021.38-41

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Introduction: Infant cholestasis has been associated to viral infection. Cytomegalovirus in the pathogenesis of neonatal hepatitis has been already known and it is one of the possible etiological of biliary atresia. The aim of this study was to outline the correlation between maternal infection and infant cholestasis (aged 0-1 year old) in Department of Pediatrics Dr. Soetomo General Hospital, Surabaya. Methods: A case-control study of pregnant women who gave birth in Dr. Soetomo General Hospital from June 2016 to June 2017. The data were taken from medical records. The cases were defined as pregnant women with babies who had cholestasis, and the control was pregnant women who gave birth to a baby without cholestasis within the age of 0-1 year old. Sample cases in this study were drawn from the total population, with the inclusion criteria babies who had cholestasis, and exclusion criteria that include complications of pregnancy and a history of infant’s parent with genetic disorders. The control variable studied was maternal infection history and sex. Samples were taken by purposive control. The data were obtained then summarized and analyzed by univariate and bivariate, using the chi-square table analysis. Results: The number of cases that met the inclusion criteria were 68 patients, and the amount of control taken was 110 patients. The total number of patients studied was 178 patients. Univariate analysis found the cholestasis was more common in mother with infection during pregnancy (73.53% from the total of  cholestasis). Bivariate analyzes found relationship between pregnancy infection and cholestasis (p = <0.001, or = 20.726). Conclusion:The maternal infection is significantly associated with cholestasis in infants. 
Neonatal External Description in Undiagnosed Placenta Accreta Referral Patients Stivany Ilvira; Ernawati Ernawati; Pudji Lestari
Jurnal KESANS : Kesehatan dan Sains Vol 1 No 5 (2022): KESANS : International Journal of Health and Science
Publisher : Rifa'Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54543/kesans.v1i5.60

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Background: Cases of placenta accreta are increasing every year. Placenta accreta has an impact on maternal and neonatal externals. There are cases of placenta accreta that go undiagnosed during pregnancy called undiagnosed. This study aims to find out the neonatal exterior in undiagnosed placenta accreta referral patients at dr. Soetomo Hospital in 2016-2020. Method: This research method is descriptive with an observational approach. The study sample was the entire infant of a patient with a referral case of undiagnosed placenta accreta using the total samplingtechnique. The variable studied was the neonatal exterior. Results: Samples that met the inclusion criteria of 27 infants. The termination age of preterm pregnancy was 8 (29.6%) patients, BBLR as many as 6 (22.2%) infants, female sex (55.6%), babies with SGA as many as 2 (7.4%) babies and LGA as many as 1 (3.7%) babies. APGAR scores less than 7 as many as 6 (22.2%) babies in the first minute and 2 (7.4%) babies in the fifth minute. Nicu resuscitation and care measures were 14 (51.9%) infants and 2 (7.4%) deaths. Conclusion: Neonatal discharge in patients undiagnosed placenta accreta includes potential premature birth, BBLR, resuscitation measures, NICU care, neonate mortality rate of 7.4%. There needs to be an improvement in the quality of ANC, especially in early detection of risk factors so that undiagnosed cases are reduced and betteroutcomes are obtained.
Clinical Characteristic of Congenital Fetal Anomaly In Tertiary Referral Hospital in East Java, Indonesia Fariska Zata Amani; Wardhana M. P; Cininta N. I; Aryananda R. A; Gumilar K. E; Aldika M. I; Wicaksono B; Ernawati Ernawati; Sulistyono A; Aditiawarman Aditiawarman; Hermanto T. J; Abdullah N; Dachlan E G
Jurnal Medis Islam Internasional Vol 2 No 2 (2021): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v2i2.1624

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Background: Congenital fetal anomalies were defined as any structural defect present at birth. Congenital fetal anomalies are an important causes of neonatal morbidity and mortality in developed and developing countries that affect health care system. Reliable data on these congenital anomalies are still lacking, especially in Indonesia. Objective: This study aims to determine the characteristic profile of congenital fetal anomaly in single tertiary hospital in East Java, Indonesia. Methods: Retrospective cross-sectional by using medical record data of dr. Soetomo General Hospital on January – December 2017. Results: There were 58 cases (4,3%) with fetal congenital anomaly from 1360 deliveries in 2017. The majority of cases were referral cases (51 cases; 88%) and only seven cases were booked cases in obstetric outpatient dr. Soetomo General Hospital. Most of these congenital fetal anomaly cases ( 25 cases / 43,1%) were born from mother with ages 20 – 30 years old. Most cases (34 cases; 58,64%) were diagnosed first at third trimester (gestational age > 28 weeks). There were 36 cases (62%) had active termination of pregnancy. Thirty eight percent (22 cases) were born at 37-42 weeks and majority were born section caesaria. The three highest proportion of organ systems involved in fetal congenital anomalies were those of abdomen (22 cases; 37,9%); head (20 cases; 34,5%); thorax and muskuloskeletal (each 12 cases; 20,7%). Conclusion: The incidence of congenital fetal anomaly in dr. Soetomo Hospital at 2017 was 4,3%. Omphalocele and CTEV were two most common types of congenital fetal anomaly found. Most cases of congenital fetal anomalies have a poor prognosis, 67% cases born died. Further research about  risk factors and comprehensive database are needed on cases of congenital anomaly to establish appropriate prevention and management.
Plasma Level of Umbilical Cord Hemeoxygenase-1 (HO-1) and Neonatal Outcome in Early Onset and Late Onset Severe Preeclampsia Muhammad Ilham Aldika Akbar; Indah Mayang Sari; Ernawati Ernawati; Aditiawarman Aditiawarman
Molecular and Cellular Biomedical Sciences Vol 3, No 1 (2019)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1056.632 KB) | DOI: 10.21705/mcbs.v3i1.57

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Background: Many studies had discovered that early onset severe preeclampsia (EO-PE) has worst maternal and neonatal outcome compared to late-onset type (LO-PE), related to its placental involvement. Severe preeclampsia was defined as newly onset severe hypertension developed after 20 weeks gestation in previously normal blood pressure women, with coexistence of proteinuria, or maternal organ or uteroplacental dysfunction. Hemeoxygenase-1 (HO-1) is an enzyme with multiple effect which is protective to pregnancy.Materials and Methods: The total study subjects were 40 pregnant women consisted of 10 EO-PE, 10 normal early onset pregnancy (EO-NP), 10 LO-PE, and 10 normal late onset pregnancy (LO-NP). As much as 5 cc of plasma from umbilical cord was taken as soon as the baby was born, and the HO-1 level was examined by enzyme-linked immunosorbent assay (ELISA). The primary outcome were umbilical cord HO-1 level and neonatal composite morbidity (low Apgar score, low birthweight, length of stay >5 day, respiratory distress syndrome, jaundice and neonatal death).Results: The plasma level of HO-1 in EO-PE subjects were lower than EO-NP (0.96±0.37 ng/mL vs. 2.43±0.58 ng/mL, p<0.001). There were no significant differences in the level of HO-1 in LO-PE and LO-NP (2.18±1.07 ng/mL vs. 3.02±0.64 ng/mL, p=0.277). Plasma level of umbilical cord HO-1 of EO-PE patients was lower compared to LO-PE (0.96±0.37 ng/mL vs. 2.18±1.07 ng/mL, p=0.034). Neonatal outcome of EO-PE was worse than EO-NP (p=0.033), and LO-PE (p=0.003), while in LO-PE did not different with LO-NP (p=0.211).Conclusion: EO-PE is associated with lower plasma umbilical cord level of HO-1 and worse neonatal outcome compared to LO-PE. This indicating abnormal placental blood vessel development, placental ischemia in EO-PE, lead to reduced uteroplacental perfusion and significantly worse neonatal outcome compared to LO-PE.Keywords: severe preeclampsia, early onset preeclampsia, late onset preeclampsia, hemeoxygenase-1