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Raymond Surya
Department of Obstetrics and Gynecology RSCM/FKUI
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Obstetric and Perinatal Characteristics of Teenage Pregnancies: an Analysis of Five Year Period in dr. Cipto Mangunkusumo Hospital, Jakarta Junita Indarti; David Eka Prasetya; Hari Sandi; Imam Rahmadi; Raymond Surya
eJournal Kedokteran Indonesia Vol 9, No. 1 - April 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.595 KB) | DOI: 10.23886/ejki.9.6.18

Abstract

Abstract Teenage pregnancy leads to higher rates of maternal and perinatal complication and has been amajor challenge globally. This study aims to evaluate the obstetric and perinatal characteristics of teenagepregnancies in Indonesian population. A cross-sectional study through medical records was performed attertiary cared dr. Cipto Mangunkusumo Hospital, Jakarta, from 2014 to 2018. We recruited average maternalage of women and teenagers who carried singleton live pregnancies and delivered at tertiary care. Obstetricalcomplications include anemia at labor, preeclampsia/eclampsia, postpartum hemorrhage, preterm rupture ofmembrane, induction of labor, cesarean section delivery and perinatal outcomes include small-for-gestationalage, stillbirth, intrauterine growth restriction, preterm birth, low birth weight, 5th minimum APGAR score wereassessed. Statistical analysis was done using SPSS 20. There were 4265 eligible subjects during 5-yearperiod. The prevalence of teenage pregnancy (11-19 years old) was 543/4265 (12.7%). Teenage pregnancyhad a higher incidence of preterm deliveries (OR 2.047, 95%CI 1.660–2.524, p<0.001) and anemia at labor(OR 1.433, 95%CI 1.113-1.843, p=0.005). Low birth weight babies (OR 1.520, 95%CI 1.229–1.879, p<0.01)were associated with teenage pregnancy. Teenage pregnancy contributes to higher incidence of pretermdeliveries, anemia at labor, and low birth weight. Keywords: teenage, pregnancy, outcome, maternal, perinatal.   Karakteristik Obstetrik dan Perinatal pada Kehamilan Remaja: Analisis Lima Tahun di RSUPN Dr. Cipto Mangunkusumo, Jakarta Abstrak Kehamilan remaja meningkatkan komplikasi maternal dan perinatal serta merupakan tantangan global.Studi ini bertujuan untuk mengevaluasi karakteristik obstetrik dan perinatal kehamilan remaja di Indonesia.Studi potong lintang melalui rekam medis dilakukan di RSCM, Jakarta, pada tahun 2014 hingga 2018. Kriteriainklusi ialah kehamilan remaja dan usia reproduksi pasien yang melahirkan di RSCM. Komplikasi obstetrikyang dinilai adalah anemia saat persalinan, preeklamsia/eklamsia, perdarahan pascasalin, ketuban pecahdini, induksi persalinan, seksio sesarea, dan luaran perinatal yaitu janin kecil, lahir mati, pertumbuhan janinterhambat, persalinan prematur, berat lahir rendah, dan skor APGAR 5 menit. Analisis statistik menggunakanSPSS 20. Terdapat 4265 subjek selama 5 tahun dengan prevalensi kehamilan remaja (11-19 tahun) 543/4265(12,7%). Kehamilan remaja meningkatkan insidens persalinan prematur yang lebih tinggi (OR 2,047, 95%CI1,660–2,524, p<0,001) dan anemia saat persalinan (OR 1,433, 95%CI 1,113-1,843, p=0,005). Berat badan lahirrendah berhubungan dengan kehamilan remaja (OR 1,520, 95%CI 1,229–1,879, p<0,01). Kehamilan remajamemiliki dampak lebih tinggi terhadap persalinan prematur, anemia saat persalinan, dan berat lahir rendah. Kata kunci: remaja, kehamilan, luaran, maternal, perinatal.
Maternal Characteristics, Pregnancy, and Neonatal Outome in Preeclampsia and HELLP Syndrome: a Comparative Study Ali Sungkar; Rima Irwinda; Raymond Surya; Andrew Pratama Kurniawan
eJournal Kedokteran Indonesia Vol 9, No. 1 - April 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (369.037 KB) | DOI: 10.23886/ejki.9.15.7

Abstract

HELLP syndrome is a complication in pregnancy which may increase maternal morbidity and mortality risk. This study aims to compare maternal characteristics, pregnancy and neonatal outcome between preeclampsia and HELLP syndrome. All preeclampsia without or with severe features and HELLP syndrome using ACOG criteria coming to dr. Cipto Mangunkusumo Hospital from January 2015 to December 2017 were recruited into this cross-sectional study. Demographic, clinical, laboratories parameters, and neonatal outcomes were compared between HELLP and preeclampsia patients. The SPSS 20 for Windows was used for all analyses. There were 676 deliveries which was complicated by preeclampsia without or with severe features and 113 patients with HELLP syndrome. Gestational age, history of hypertension systolic and diastolic blood pressure, hemoglobin, hematocrit, urea, creatinine, uric acid, and albumin are different significantly between HELLP and preeclampsia patients. History of hypertension in previous pregnancy is considered as a significant risk factor for HELLP syndrome (p=0.001); RR 2.33 (95% CI 1.41–3.9). Based on data of gestational age at delivery which lower in HELLP syndrome, it showed lower median birth weight in HELLP syndrome (1442.5 g) compared with preeclampsia (1442.5 g vs 2400 g, p=; 95%CI There is significant difference in gestational age at delivery, nullipara, blood pressure, and laboratory findings (urea, creatinine, uric acid, albumin) between preeclampsia and HELLP syndrome group. History of hypertension in previous pregnancy is a significant risk factor for HELLP syndrome. Regarding neonatal outcome, baby born from HELLP syndrome has lower median birth weight. Keywords: HELLP syndrome, preeclampsia, risk factor, neonatal outcome.   Karakteristik Maternal, Luaran Kehamilan, dan Neonatal pada Preeklamsia dan Sindrom HELLP: Studi Komparatif Abstrak Sindrom HELLP merupakan komplikasi kehamilan yang meningkatkan morbiditas dan mortalitas maternal. Studi ini bertujuan untuk mengetahui perbedaan karakteristik antara sindrom HELLP dan preeklamsia serta luaran neonatus. Studi potong lintang ini melibatkan seluruh pasien preeklamsia dengan atau tanpa perburukan dan sindrom HELLP berdasarkan kriteria ACOG yang datang ke RS dr. Cipto Mangunkusumo pada bulan Januari 2015 sampai Desember 2017. Analisis bivariat digunakan untuk mengetahui hubungan karakteristik demografi, klinis, laboratorium antara pasien HELLP dan preeklamsia sedangkan analisis multivariat untuk mengetahui karakteristik yang memengaruhi sindrom HELLP. Data dianalisis menggunakan SPSS 20. Terdapat 676 persalinan pada kelompok preeklamsia dengan atau tanpa perburukan dan 113 pasien dengan sindrom HELLP. Usia kehamilan, tekanan darah sistolik dan diastolik, hemoglobin, hematokrit, ureum, kreatinin, asam urat, dan albumin berbeda bermakna antara pasien sindrom HELLP dan preeklamsia. Riwayat hipertensi pada kehamilan sebelumnya dianggap sebagai faktor risiko terhadap sindrom HELLP (p=0,001); RR 2,33 (IK 95% 1,41-3,9). Berdasarkan usia kehamilan saat persalinan yang lebih awal dan bayi lahir lebih rendah pada sindrom HELLP (1442,5 g) dibandingkan preeklamsia (2400 g). Terdapat perbedaan bermakna pada usia kehamilan saat persalinan, tekanan darah, dan parameter laboratorium (ureum, kreatinin, asam urat, albumin) antara kelompok preeklamsia dan sindrom HELLP. Berdasarkan luaran neonatus, bayi dari sindrom HELLP lebih rendah berat lahirnya. Kata kunci: sindrom HELLP, preeklamsia, faktor risiko, luaran neonatus
Kontrasepsi Hormonal Berbasis Progestin pada Perempuan dengan Riwayat Tumor Jinak Payudara Omo Abdul Madjid; Raymond Surya; Harry Prawiro Tantry; Dwiana Ocviyanti
eJournal Kedokteran Indonesia Vol. 10 No. 2 - Agustus 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.10.96.162-7

Abstract

Seorang perempuan berusia 38 tahun dengan G5P1A3 (AH1) dan riwayat abortus habitualis, memiliki riwayat tumor jinak payudara 12 tahun lalu dan sudah dilakukan eksisi dengan hasil patologi dinyatakan jinak. Saat ingin menggunakan kontrasepsi hormonal, tenaga kesehatan menolak karena pasien memiliki riwayat tumor jinak payudara. Evidence based case report ini bertujuan untuk menelaah pengaruh kontrasepsi hormonal berbasis progestin pada perempuan dengan riwayat tumor payudara. Dilakukan pencarian melalui Pubmed®, Cochrane Library®, dan Google Scholar® menggunakan kata kunci atau Medical Subject Headings (MeSH). Didapatkan 3 buah artikel ulasan sistematik dan meta analisis berdasarkan penilaian validity, importance, and applicability (VIA). Sebuah ulasan sistematik dan meta analisis memperlihatkan tidak ada hubungan antara penggunaan progestin dengan risiko kanker payudara. Hanya ada satu ulasan sistematik yang memperlihatkan hubungan penggunaan progestin dengan risiko kanker payudara, namun studi tersebut memiliki heterogenitas tinggi. Kontrasepsi hormonal berbasis progestin tidak memiliki pengaruh terhadap peningkatan kejadian kanker payudara dan tidak berhubungan dengan kejadian tumor jinak payudara. Kata kunci: kontrasepsi berbasis progestin, tumor jinak payudara, kanker payudara.   Influence of Progestin Contraception in Women with Breast Tumor History Abstract A 38-year-old women with G5P1A3 and recurrent pregnancy loss coming with history of benign breast tumor 12 years ago and it had been excised with the result of benign. When patient would like to apply hormonal contraception, health care provider refused due to history of benign breast tumor. Searching was conducted through Pubmed®, Cochrane Library®, and Google Scholar® with keyword or medical subject headings (MeSH). There were three systematic review and meta-analysis articles reviewed based on validity, importance, and applicability (VIA). A systematic review and meta-analysis showed that there was no relationship between progestin use and breast cancer risk. Only a systematic review stated the relationship between both of them; however, it showed high heterogeneity. Progestin based contraception does not have an effect to the incidence of breast cancer and there is no relationship with benign breast tumor. Keywords: progestin based contraception, benign breast tumor, breast cancer.
Co-Authors Ali Sungkar Andrew Pratama Kurniawan David Eka Prasetya Dwiana Ocviyanti Hari Sandi Harry Prawiro Tantry Imam Rahmadi Junita Indarti Omo Abdul Madjid Rima Irwinda Rima Irwinda