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Korelasi Akurasi antara Kateter dengan Ultrasonografi Transabdominal untuk Mengukur Volume Kandung Kemih DEWI, T. I.; Santoso, Budi I; KARSONO, B.; JUNIZAF, JUNIZAF
Indonesian Journal of Obstetrics and Gynecology Volume. 30, No. 2, April 2006
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Tujuan: Mencari korelasi antara kateterisasi dengan USG transabdominal untuk mengukur volume KK dan volume urin sisa dan menentukan nilai diagnostik USG transabdominal untuk mendiagnosa retensio urin. Rancangan penelitian: Penelitian ini merupakan studi observasional analitik dengan rancangan potong lintang (cross sectional) untuk menilai korelasi dan menentukan nilai diagnostik. Tempat penelitian: (1) Klinik Anggrek Divisi Fetomaternal Departemen Obstetri dan Ginekologi RS Dr. Cipto Mangunkusumo (RSCM), (2) IGD Lt. III RSCM. Bahan dan cara kerja: Selama kurun Oktober 2003 sampai Agustus 2004, dilakukan pengukuran volume KK dan volume urin sisa pada 90 pasien postpartum nifas hari pertama, kedua dan ketiga. Volume KK dan volume urin sisa diukur secara USG transabdominal dibandingkan dengan hasil pengukuran secara kateterisasi yang merupakan baku emas. Volume KK dianggap merupakan kapasitas KK dan volume urin sisa ialah urin yang masih terdapat dalam KK segera setelah pasien berkemih. USG transabdomina1 digunakan untuk mendiagnosa adanya retensio urin dengan titik potong urin sisa 200 ml dan kateterisasi sebagai baku emas. Dilakukan 3 formula USG (formula 1, 2 dan 3). Hasil: Untuk pengukuran volume KK didapatkan korelasi yang kuat antara USG formula 1, 2 dan 3 dengan tindakan kateterisasi, masingmasing dengan R 0,84, 0,87 dan 0,80, tapi hanya formula 2 USG yang menghasilkan pengukuran volume KK yang tidak berbeda bermakna dengan tindakan kateterisasi. Pada pengukuran volume urin sisa didapatkan korelasi yang kuat antara USG formula 1, 2 dan 3 dengan kateterisasi masing-masing R 0,85, 0,87 dan 0,85, juga hanya formula 2 yang menghasilkan pengukuran urin sisa yang tidak berbeda bermakna dengan tindakan kateterisasi. USG formula 2 dapat mendiagnosa kondisi retensio urin dengan Se 87%, Sp 95,5%, NDP (nilai duga positif) 87% dan NDN (nilai duga negatif) 96%. Kesimpulan: Pengukuran volume KK dan volume urin sisa secara ultrasonografi transabdominal mempunyai korelasi yang kuat dengan tindakan kateterisasi. Sehingga USG transabdominal dapat dijadikan sebagai alternatif dari penggunaan kateter. Hal ini akan membuat tindakan kateterisasi menjadi lebih selektif. Terutama dalam hal diagnostik seperti kondisi retensio urin, sehingga penggunaan USG transabdominal akan mengurangi efek samping berupa infeksi dan trauma akibat penggunaan kateter yang bersifat invasif. [Maj Obstet Ginekol Indones 2006; 30-2: 104-11] Kata kunci: vo1ume KK, volume urin sisa. USG transabdominal, kateterisasi.

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.713 KB)

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

Laceration Extension in Median and Mediolateral Episiotomy Utama, Bobby I; Junizaf, Junizaf; Santoso, Budi I; Ermawati, Ermawati; Hakim, Surahman
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 1, January 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the laceration extension between median and mediolateral episiotomy in women with perineal body sized more than 2.5 cm. Method: A single‐blind RCT study was conducted on 104 women receiving median episiotomy and 104 women receiving mediolateral episiotomy at Dr. M. Djamil Hospital Padang and Reksodiwiryo Military Hospital Padang. Result: There was no difference in laceration extension in both groups, but pain in the first 24 hours and pain after day 14 was higher on mediolateral group than the median group (p=0.005 and p=0.008, respectively). Conclusion: There is no difference in terms of laceration extension between median and mediolateral episiotomy, but the pain is higher in the mediolateral group. [Indones J Obstet Gynecol 2015; 1: 38‐43] Keywords: laceration extension, median episiotomy, mediolateral episiotomy

How Long is the Safest InterDelivery Interval in Women with Previous History of Cesarean Delivery? Santoso, Budi I; Surya, Raymond; Firdaus, Karina K; Hakim, Surahman
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

  Objective: To investigate the association between interdelivery interval and uterine rupture in women with previous CD.   Methods: The formulation question was how long is the safest interdeliveryinterval to minimalize the risk of uterine rupture. Theauthors investigated in three databases including Pubmed,Cochrane, and Embase database. Inclusion criteria wereabstract answering the clinical question, written in Englishlanguage, and full-text paper availability.   Results: One systematic review, six cohort studies, and 1 casecontrolstudy were collected to compare the inter-pregnancyinterval to the risk of uterine rupture. The author retrievedseven articles suitable to the inclusion criteria after excluding tenarticles screened by the abstract and language. Then, the authoradded one article used in the systematic review. Hence, the criticalappraisal based on Validity, Importance, and Applicability (VIA)was performed for eight articles.   Conclusion: The inter-delivery interval 18 months is the safest time to avoid uterine rupture. Prostaglandin analogue induction should be avoided and for patients with a history of past cesarean using a single-layer closure to be educated about the increased risk. Keywords: cesarean delivery, inter-delivery interval, uterine rupture,vaginal birth after cesarean delivery

Prevalence and Characteristics of Pelvic Floor Dysfunction in a Tertiary Care Center in Indonesia Santoso, Budi I; Fauziah, Nur R
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the prevalence and characteristics of pelvic floor dysfunction (PFD) in Jakarta, Indonesia. Methods: A cross sectional study was conducted at gynecology, endocrinology, and urogynecology clinic of Dr. Cipto Mangunkusumo Hospital during the period from January 2016 to April 2016. Subjects were selected using consecutive sampling. Data were taken using research and POP-Q form. Results: A total of 197 subjects were recruited. The prevalence of patients with PFD was 33%. The prevalence of POP, UI, and FI were 26.4%, 15.3% and 2.5%; respectively. Association between individual characteristics and PFD was found on women aged ≥ 60 and aged 40-59 years old with 69 and 14 times probability to be PFD. The probability of developing PFD was 76 and 14.2 times in multiparity and primiparity. Woman with vaginal delivery had a change to develop PFD 1.9 times and postmenopausal woman had a probability 18 times. The infuencing risk factor in PFD were age parity, race, mode of delivery, and menopausal status. Conclusion: Pelvic floor dysfunction affects a substantial of women and increases with age, parity and aging. [Indones J Obstet Gynecol 2017; 5-3: 168-172] Keywords: fecal incontinence, pelvic floor dysfunction, pelvic organ prolapse, urinary incontinence

IIIB-IV Degree Perineal Rupture Repair Using Overlapping and End-to-End Techniques with Pudendal Block Anesthesia Pangastuti, Nuring; Junizaf, Junizaf; Pranoto, Ibnu; Santoso, Budi I; Priyatini, Tyas
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the incidence of persistent sonographic anal sphincter defect, fecal urgency, anal and fecal incontinence after IIIb- IV degree perineal rupture repair using overlapping and end-to-end technique. Method: An open clinical trial with randomization was carried out in July 2010-April 2012. The population consisted of the patients who underwent vaginal delivery in Dr. Sardjito Central General Hospital, Sleman District General Hospital, as well as Tegalrejo, Jetis and Mergangsan Community Health Centers who did no have complaints of fecal urgency, anal incontinence, and/or fecal incontinence, and suffered IIIb-IV degree perineal rupture repaired within less than 24 hours of rupture. The exclusion criteria included conditions in which patients could not undergo repair at the moment (shock, uncooperative patient). Fourty-eight research samples were divided into 2 groups, 24 samples for each of the treatment group (overlapping repair) and the control group (end-to-end repair). Local anesthesia was performed in a pudendal-block manner. Result: Success of the repair was assessed based on the presence of persistent sonographic anal sphincter defects in the 6-week evaluation after repair. Successful repair was higher in the overlapping group than that of the end-to-end group (94.74% vs 81.25%, p=0.31). Clinically and based on the Fecal Continence Scoring Scale (FCSS), evaluation at weeks II and VI indicated successful repair in both groups. Conclusion: There was no difference in the incidence of persistent sonographic anal sphincter defects, fecal urgency, anal incontinence, and fecal incontinence, after IIIb-IV degree perineal rupture repair using overlapping technique in comparison with end-to-end technique. Keywords: end-to-end technique, III-IV degree perineal rupture, obstetric perineal rupture, overlapping technique

Laceration Extension in Median and Mediolateral Episiotomy Utama, Bobby I; Junizaf, Junizaf; Santoso, Budi I; Ermawati, Ermawati; Hakim, Surahman
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 1, January 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the laceration extension between median and mediolateral episiotomy in women with perineal body sized more than 2.5 cm. Method: A single‐blind RCT study was conducted on 104 women receiving median episiotomy and 104 women receiving mediolateral episiotomy at Dr. M. Djamil Hospital Padang and Reksodiwiryo Military Hospital Padang. Result: There was no difference in laceration extension in both groups, but pain in the first 24 hours and pain after day 14 was higher on mediolateral group than the median group (p=0.005 and p=0.008, respectively). Conclusion: There is no difference in terms of laceration extension between median and mediolateral episiotomy, but the pain is higher in the mediolateral group. [Indones J Obstet Gynecol 2015; 1: 38‐43] Keywords: laceration extension, median episiotomy, mediolateral episiotomy

IIIB-IV Degree Perineal Rupture Repair Using Overlapping and End-to-End Techniques with Pudendal Block Anesthesia Pangastuti, Nuring; Junizaf, Junizaf; Pranoto, Ibnu; Santoso, Budi I; Priyatini, Tyas
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the incidence of persistent sonographic anal sphincter defect, fecal urgency, anal and fecal incontinence after IIIb- IV degree perineal rupture repair using overlapping and end-to-end technique. Method: An open clinical trial with randomization was carried out in July 2010-April 2012. The population consisted of the patients who underwent vaginal delivery in Dr. Sardjito Central General Hospital, Sleman District General Hospital, as well as Tegalrejo, Jetis and Mergangsan Community Health Centers who did no have complaints of fecal urgency, anal incontinence, and/or fecal incontinence, and suffered IIIb-IV degree perineal rupture repaired within less than 24 hours of rupture. The exclusion criteria included conditions in which patients could not undergo repair at the moment (shock, uncooperative patient). Fourty-eight research samples were divided into 2 groups, 24 samples for each of the treatment group (overlapping repair) and the control group (end-to-end repair). Local anesthesia was performed in a pudendal-block manner. Result: Success of the repair was assessed based on the presence of persistent sonographic anal sphincter defects in the 6-week evaluation after repair. Successful repair was higher in the overlapping group than that of the end-to-end group (94.74% vs 81.25%, p=0.31). Clinically and based on the Fecal Continence Scoring Scale (FCSS), evaluation at weeks II and VI indicated successful repair in both groups. Conclusion: There was no difference in the incidence of persistent sonographic anal sphincter defects, fecal urgency, anal incontinence, and fecal incontinence, after IIIb-IV degree perineal rupture repair using overlapping technique in comparison with end-to-end technique. Keywords: end-to-end technique, III-IV degree perineal rupture, obstetric perineal rupture, overlapping technique

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

Prevention of Recurrent Urinary Tract Infections in Postmenopausal Women Fernando, Darrell; Santoso, Budi I
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 1, January 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the most effective and applicable methods to reduce recurrence of urinary tract infections in postmenopausal women. Method: A search was conducted on Pubmed, NEJM, BMJ, and Google. After screening and selection, six articles were considered useful; comprising of two original research articles, one systematic review, and three society guidelines. Result: Society guidelines recommended continuous antimicrobial prophylaxis, with postcoital antimicrobial prophylaxis as an alternative. The first research article found similar results in continous antimicrobial prophylaxis group and intermittent antimicrobial prophylaxis group. The second research article found no significant difference in cranberry and trimethoprim group. The systematic review revealed vaginal estrogens are effective in preventing recurrent UTI, but the type of estrogen is less clear. Oral estrogens are not effective. Conclusion: Prevention of recurrent urinary tract infections in postmenopausal women include risk factor identification, non-antimicrobial prophylaxis with cranberry and vaginal estrogen preparations, and antimicrobial prophylaxis (continuous or intermittent). Keywords: postmenopausal, prevention, recurrent urinary tract infection.

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