Muhammad Nurhadi Rahman
Departemen Obstetri Dan Ginekologi, FK-KMK, Universitas Gadjah Mada

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Ketepatan Rumus Risanto untuk Memprediksi Berat Lahir Janin pada Ibu dengan Berat Badan Berlebih Nadia Mutiara Zahra; Shinta Prawitasari; Vicky Admiral Aprizano; Muhammad Nurhadi Rahman; Risanto Siswosudarmo
JURNAL KESEHATAN REPRODUKSI Vol 9, No 1 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.64595

Abstract

AbstrakLatar Belakang: Pengukuran taksiran berat janin (TBJ) harus dilakukan seakurat mungkin agar dapat mencerminkan keadaan janin yang sesungguhnya guna merencanakan manajemen persalinan. Rumus Risanto adalah salah satu rumus TBJ yang yang praktis digunakan dengan memanfaatkan komponen tinggi fundus uteri (TFU). Namun, sering kali, penentuan TFU pada ibu hamil dengan berat badan berlebih sulit dilakukan secara teliti, akibat dari tingginya ketebalan lemak subkutan abdomen. Sehingga, terdapat kemungkinan penurunan ketepatan pengukuran TBJ menggunakan TFU pada ibu dengan berat badan berlebih.Tujuan: Untuk menilai ketepatan rumus Risanto dalam memprediksi berat lahir janin pada ibu dengan berat badan berlebih.Metode: Desain penelitian nested cross sectional, yang bersarang pada penelitian induk oleh author pada tahun 2018. Subjek yang terlibat yakni ibu hamil aterm dengan indeks massa tubuh (IMT) ≥25 kg/m2 di RSUP dr Sardjito dan beberapa RS jejaring. Selisih antara rata-rata taksiran berat janin rumus Risanto (TBJR) dan berat bayi lahir (BBL) dianalisis menggunakan paired t-test. Kemudian, TBJR dinilai ketepatannya menggunakan rata-rata persentase kesalahan absolut, serta proporsi kasus yang berada pada persentase kesalahan absolut ≤5%, ≤10%, ≤15%, dan ≤20%. TBJ dikatakan akurat apabila rata-rata persentase kesalahan absolut ≤10% dan/atau jumlah kasus dengan TBJ yang berada pada rentang ± 10% dari BBL sebanyak >75%.Hasil dan Pembahasan: Dari 205 subjek penelitian didapatkan rata-rata TBJR sebesar 3050,49 ± 421,96 gram (rentang 1995-4745 gram). Sedangkan, rata-rata BBL sebesar 3129,29 ± 406,67 gram (rentang 1800-4880 gram). TBJR cenderung memberikan hasil taksiran yang lebih kecil daripada BBL, dengan selisih rerata diantara keduanya (∆mean) sebesar 78,8 gram (95% CI: 50,031-107,569 dan nilai P=0,000). Artinya terdapat perbedaan yang bermakna secara statistik. Namun, apabila ∆mean diubah kedalam persentase maka akan didapatkan selisih rata-rata sebesar 2,52%. Selain itu, didapatkan rata-rata persentase kesalahan absolut sebesar 5,8 ± 4,11 %. Apabila dilihat proporsi data yang berada pada persentase kesalahan absolut ≤5%, ≤10%, ≤15%, dan ≤20%, maka berturut turut didapatkan cakupan sebesar 47,3%, 85,9%, 96,6%, dan 100% dari keseluruhan data.Kesimpulan: Rumus Risanto dapat dikatakan akurat dalam memperkirakan BBL pada ibu dengan berat badan berlebih berdasarkan indikator rata-rata persentase kesalahan absolut ≤10% dan jumlah kasus dengan TBJR yang berada pada rentang ±10% dari BBL sebanyak >75%. AbstractBackground: Estimated Fetal Weight (EFW) needs to be as accurate as possible to reflect the actual condition of the fetus for labor-management planning. Risanto’s formula is one of the easy to use formula to estimate fetal weight using fundal height (FH). But, oftentimes, the measurement of fundal height in overweight pregnant mothers is hard to be done precisely due to the thickness of the abdominal subcutaneous fat layer. Therefore, there is a possibility of a decrease in EFW’s accuracy in overweight mothers by using FH measurement.Objective: To determine the accuracy of Risanto’s formula in estimating fetal weight in overweight mothers.Method: It was a cross-sectional study nested within research by author in 2018. Mothers at term pregnancies with body mass index (BMI) ≥25 kg/m2 from Sardjito and affiliated hospitals were included in the study. The difference between the mean Risanto’s estimated fetal weight (R_EFW) and the mean actual birth weight (ABW) was analyzed using a paired t-test. Later on, the accuracy of R_EFW was analyzed based on the mean absolute percentage error and the number of cases within ≤5%, ≤10%, ≤15%, and ≤20% absolute percentage error. EFW can be defined as accurate if the mean absolute percentage error is ≤10% and/or the number of EFW within ± 10% from the ABW is >75%.Results and Discussion: From the 205 research subjects, the mean R_EFW was 3050,49 ± 421,96 gram (ranged from 1995 to 4745 gram), while the mean ABW was 3129,29 ± 406,67 gram (ranged from 1800-4880 gram). Risanto’s formula tends to give a smaller estimation compared to the ABW with the mean difference (∆mean) between the two was 78,8 gram (95% CI: 50,031-107,569 and P=0,000). The mean difference was statistically significant. But, if we convert the ∆mean into a percentage, the mean difference was 2,52%. Other than that, the mean absolute percentage error was 5,8 ± 4,11 %. The number of case within the absolute percentage error of ≤5%, ≤10%, ≤15%, and ≤20% was 47,3%, 85,9%, 96,6%, and 100% from the overall data in consecutive order.Conclusion: Risanto’s formula was accurate in estimating fetal birth weight in overweight mothers based on the two indicators, in which the mean absolute percentage error was ≤10% and the number of cases within the ± 10% from the ABW was >75%.
Early detection and primary prevention system in COVID-19 transmission to staff and residents in the department of obstetrics and gynecology Muhammad Nurhadi Rahman; Detty Siti Nurdiati; Nuring Pangastuti; Anis Widyasari; Fauzan Achmad Maliki; Sarah Ayu Andari; Khairina Hashifah
Journal of Community Empowerment for Health Vol 4, No 1 (2021): Special Issue of COVID-19
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.61165

Abstract

COVID-19 is currently a global pandemic because of its fast transmission in humans. The disease can be symptomatic or asymptomatic. Patients with the disease can transmit the infection to the medical team who are exposed without proper protection. Prevention of transmission is our main focus of attention as well as early recognition of exposed medical teams among obstetrics and gynecology residents and consultants in our hospital. This article aimed to describe the COVID-19 early detection and primary prevention system among staff and residents in the Obstetrics and Gynecology (OBSGYN) Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada and Dr. Sardjito General Hospital from April to June 2020. The data were acquired from the reports of the COVID-19 taskforce from the OBSGYN Department. In order to prevent the transmission of COVID-19 infection, actions taken by the OBSGYN Department are as follows: a) arrangement of staff and residents watch schedules, b) usage of PPE (Personal Protective Equipment) according to protocol, c) contact tracing, and d) early detection. Resident watch schedule arrangement is done by withdrawing residents from affiliated hospitals so that the division of daily duty schedules at Dr. Sardjito General Hospital is divided into 2 shifts of 12 hours each. The PPE usage policy is adjusted according to the risk of COVID-19 exposure in different environments and in accordance with established standards. A total of 65 out of 74 residents (88%) had been exposed to suspected COVID-19 cases, and among the exposed residents, 12 residents (18%) were self-isolated because of the occurrence of symptoms, exposure to patients with positive COVID-19 rapid antibody test, or exposure to patients with positive COVID-19 Polymerase Chain Reaction (PCR) test. The department also conducted early detection of COVID-19 infection among all staff members and residents. As many as 13 out of 27 staff (48%) underwent COVID-19 rapid antibody test with 100% negative results, 66 of the 74 residents (89%) also underwent COVID-19 rapid antibody test with 100% negative results. In conclusion, the OBSGYN Department has implemented several measures to prevent transmission of COVID-19 among its staff and residents with adequate satisfactory results.