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All Journal Medical Journal of Indonesia Majalah Obstetri dan Ginekologi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Djusad, Suskhan
Department Of Obstetrics And Gynecology, Faculty Of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology Public Health

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Use of 2D and multislice transperineal ultrasonography to describe the degree of perineal laceration following vaginal delivery Santoso, Budi I.; Djusad, Suskhan; Hakim, Surahman; Moegni, Fernandi; Meutia, Alfa P.; Priyantini, Tyas
Medical Journal of Indonesia Vol 27, No 2 (2018): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.855 KB) | DOI: 10.13181/mji.v27i2.1908

Abstract

Introduction: Perineal tear is the most common complication after vaginal delivery. Pill-rolling test is a widely used clinical evaluation method to determine the degree of perineal tear. However, the evaluation results of anal sphincter complex (ASC) differ between clinical examination and 2D/multislice transperineal ultrasonography (TPUS). This study aims to describe measurement variation between these modalities.Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2015 to May 2016. Subjects were primiparous women after vaginal delivery. Clinical examination using pill-rolling test was performed to determine the degree of perineal laceration. Suture was conducted accordingly. The subjects were subjected to 2D/multislice TPUS 72 hours after delivery to evaluate the integrity of internal and external anal sphincters. Data were collected and analyzed to determine compatibility between these examinations.Results: Among 70 prospective primiparous women, five were excluded due to unavailability to undergo 2D/multislice TPUS 72 hours after delivery. The mean duration to perform 2D/multislice TPUS was 4.5 minutes, and pain was tolerable during the examination. The compatibility values of clinical examination with 2D and multislice TPUS were 0.98 and 0.93, respectively, with Cohen’s kappa of 0.92 (95% CI 0.81–1.00) and 0.79 (95% CI 0.58–0.99), respectively.Conclusion: Clinical examination is compatible with 2D/multislice TPUS for determining the degree of perineal tear after vaginal delivery.
Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women Fakhrizal, Edy; Priyatini, Tyas; Santoso, Budi I.; Junizaf, Junizaf; Moegni, Fernandi; Djusad, Suskhan; Hakim, Surahman; Maryuni, Sri W.
Medical Journal of Indonesia Vol 25, No 3 (2016): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (435.805 KB) | DOI: 10.13181/mji.v25i3.1407

Abstract

Background: Mode of delivery and some certain risk factors have a relationship to postpartum stress urinary incontinence (SUI). For that reason, the objective of this study was to assess the prevalence of postpartum stress urinary incontinence (SUI), the relationship between postpartum SUI and mode of delivery; and the association between SUI and other demographic and obstetric factors.Methods: In this prospective observational cohort study, all primiparous women who were under postpartum care in obstetric and gynecologic ward were recruited. Four hundreds primiparous women with no history of urinary incontinence (UI) who fulfilled the criteria and would like to participate in this study were followed up for three months after delivery. The analysis was done using Stata 12. Bivariate analysis using Chi-square test and multivariate analysis using logistic regression test were done to obtain associated risk factors to postpartum SUI.Results: The prevalence of postpartum SUI was 8.8%. The mode of delivery was significantly associated with postpartum SUI, there were more women who got vaginal delivery that had stress urinary incontinence (14.1%) compared to women caesarean section (7.1%) with OR=2.1 (95% CI=1.05-4.31), this risk increased when vaginal delivery was assisted with vacuum instrument (OR=9.1, 95% CI=3.9-21.6). There was no statistical difference of stress urinary incontinence incidences in patients with emergency or elective caesarean section with OR=0.84 (95% CI=0.28-2.57). Based on multivariate analysis BMI ≥30 kg/m2 at labor, vacuum assisted delivery, birth weight more than 3,360 g, and second stage labor more than 60 minutes appeared to be associated with an increased rate of postpartum SUI.Conclusion: Stress urinary incontinence increased in the early postpartum period of a primiparous woman. Although vaginal delivery increased the risk of postpartum SUI, elective nor emergency caesarean delivery without vaginal delivery id not appear to increase the risk of stress urinary incontinence.
Prevention of vaginal vault prolapse occurrences post vaginal and abdominal hysterectomy. An evidence based case report. Suskhan Djusad
Majalah Obstetri dan Ginekologi Vol. 29 No. 1 (2021): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V29I12021.28-35

Abstract

Objectives: To determine efficacy of the procedures which were performed during hysterectomy in preventing any complication, in the form of vaginal vault prolapse.Materials and Methods: Articles were searched through the databases, such as PubMed, Scopus, EBSCO-host, and Cochrane Library; resulting in three full text articles which were relevant to be critically reviewed. Those articles then were critically reviewed based on validity, importance, and applicability based on critical review tools from University of Oxford Centre-for Evidence Based Medicine (CEBM) 2011.Results: Findings from the articles showed that prevention procedures during hysterectomy such as McCall culdoplasty, Shull suspension, laparoscopic USP and ULS were effective in preventing future vaginal vault prolapse in women who underwent hysterectomy. Among the four procedures; McCall culdoplasty and Shull suspension provide the highest efficacy as prevention procedures. Other than that, both methods were capable to increase quality of life and sexual function post hysterectomy.Conclusion: Vaginal vault prolapse prevention procedures such as McCall culdoplasty, Shull suspension, laparoscopic USP and ULS were effective in preventing a vaginal vault prolapse. However, additional literatures are needed to support the utilization of these methods in clinical setting.
Characteristics of Patients with Obstetric and Gynecologic Fistula in Jakarta Suskhan Djusad; Ambalagen Sonia; Anthonyus Natanael
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (103.699 KB) | DOI: 10.32771/inajog.v4i4.451

Abstract

Objective: To know the characteristics of patients with obstetrics and gynecologic fistula in Dr. Cipto Mangunkusumo Hospital, Jakarta. Method: This study was a descriptive design using secondary data from medical records and patient database during 2011-2016. Result: There were 68 subjects with fistula. From 2011-2016, there were 5 cases (7.4%), 19 cases (27.9%), 16 cases (23.5%), 11 cases (16.2%), 8 cases (11.8%), and 9 cases (13.2%) of fistula; respectively. The average age of subjects was 38 years old and only 34 subjects have complete data. Gynecologic and obstetric fistula were 17 cases each. As total 28% of fistula cases were vesicovagina fistula, 12% were rectovaginal fistula, 9% were anovagina fistula, and the other types of fistula were 2%. Among 34 subjects, there were 21% of vesicovagina fistula and 3% of rectovagina fistula, which were caused by iatrogenic. There were 7% of vesicovagina and rectovagina fistula each and 9% of anovagina fistula were caused by obstetric problems. The iatrogenic procedures found from this study were total abdominal hysterectomy (16%), vaginal hysterectomy (3%), and neovagina (3%). Conclusion: The trend of cases is decreasing during the present years (2011-2016). Gynecologic fistula cases caused by iatrogenic are the major problems, but the obstetrics fistula cases decreasing following the labor monitoring is much better nowadays. [Indones J Obstet Gynecol 2016; 4-4: 212-217] Keywords: gynecologic fistula, iatrogenic, obstetric fistula
Postoperative Catheterization after Total Vaginal Hysterectomy: Six versus Twenty Four Hours. A Randomized Controlled Trial: Kateterisasi Pascaoperasi Total Vaginal Histerektomi: Enam Jam versus Dua Puluh Empat Jam. Sebuah Penelitian Randomisasi Terkontrol Suskhan Djusad; Abraham A.L. Maukar; Surahman Hakim; Tyas Priyatini; Budi I. Santoso; Leonardo Leonardo
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (51.599 KB) | DOI: 10.32771/inajog.v7i4.677

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Abstracts Objective: To find out whether urinary bladder catheterization after total vaginal hysterectomy is more advantageous.Methods: Forty-six subjects were included. Subjects were divided into two groups. In one group (n = 24), a transurethral catheter was removed after six hours post-surgery. In the other group (n = 24), the catheter was removed after twenty-four hours. A few hours after removal of the catheter, patients were asked to urinate. Then residual volumes were measured by measuring cylinder, using 12F catheter. Pain was measured using visual analogue scale (VAS) score. Patients’ length of stay was also compared. Data were analyzed using Student T-test if distributed normally or Mann-Whitney Rank if data was abnormal.Results: Mean age for each group was 63,21 ± 8,73 and 62,38 ± 7,52 (6 hours, 24 hours respectively). Median score for 6 hours group was 50,00 (range 5 - 80) and for 24 hours was 100 (range 30 - 250) (P = 0,000). Pain perception and hospital stay were not statistically different in both group (P = 0,134 and P = 0,377)Conclusion:In this study, difference in postoperative catheterization time is associated with residual volume. Keywords: bladder catheterization, postoperative catheterization, residual volume, total vaginal hysterectomy. Abstrak Tujuan: Untuk membandingkan lama waktu pemasangan kateter paskaoperasi total vaginal histerektomi yang lebih menguntungkan.Metode: Empat puluh enam pasien ikut serta dalam penelitian. Secara acak dibagi menjadi 2 kelompok. Pada grup I (n = 24), pelepasan kateter dilakukan setelah enam jam pascaoperasi. Pada grup II (n = 24), kateter dilepas setelah dua puluh empat jam. Beberapa jam setelah pelepasan kateter, pasien diminta untuk buang air kecil. Lalu residu urin diukur setelahnya menggunakan gelas ukur, memakai kateter no. 12 F. Skor nyeri menggunakan skor Visual Analogue Scale (VAS). Lama rawat inap juga dibandingkan. Analisis data menggunakan student's T-test. Jika terdistribusi tidak normal, analisis memakai Mann-Whitney Rank.Hasil: Rerata usia untuk tiap grup adalah 63,21 ± 8,73 dan 62,38 ± 7,52 (6 jam, 24 jam, secara berurutan). Skor median untuk grup 6 jam adalah 50,00 (range 5 – 80) dan grup 24 jam adalah 100 (range 30 – 250) (P = 0,000). Tidak ada perbedaan signifikan secara statistic pada rasa skor nyeri dan lama rawat inap (P = 0,134 dan P = 0,377).Kesimpulan: Pada penelitian ini, perbedaan waktu pemasangan kateter pascaoperasi memiliki hubungan dengan volume sisa urine.Kata kunci: kateterisasi urine, kateterisasi pascaoperasi, volume sisa urine, total vaginal histerektomi.
The Outcome of Percutaneous Mitral Balloon Commissurotomy (PMBC) in Pregnant Women with Mitral Stenosis: An Evidence Based Study: Luaran Komisurotomi Balon Mitral Perkutan pada Perempuan Hamil Suskhan Djusad; Surahman Hakim; Raymond Surya; Hansens Yansah; Ali Sungkar
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (211.18 KB) | DOI: 10.32771/inajog.v7i4.768

Abstract

Abstract Objective: To review the outcome of percutaneous mitral balloon commissurotomy (PMBC) both to maternal and neonatal. Methods: The search was conducted on Pubmed®, Cochrane Library®, and Ovid® using MeSH. Critical appraisal determining the validity, importance, and applicability (VIA) was conducted by two independent authors. Results: Several studies showed that performing the PMBC had good outcome for pregnant women functional class based on NYHA. Most of them decreased from NYHA III/IV to I/II. For delivery outcome, all studies concluded that more than 80% pregnant women with mitral stenosis undergoing PMBC delivered at term, and no congenital anomalies found. Conclusion: Percutaneous mitral balloon commissurotomy for pregnant women with severe MS is safe during pregnancy. Keywords: mitral stenosis, outcome, percutaneous mitral balloon commissurotomy, pregnancy, Abstrak Tujuan: Mengulas luaran komisurotomi balon mitral perkutan (KBMP) baik pada maternal maupun neonatus. Metode: Pencarian dilakukan melalui Pubmed®, Cochrane Library®, dan Ovid® menggunakan MeSH. Telaah kristis dilakukan oleh 2 penulis independen berdasarkan validitas, kepentingan, dan aplikabilitas. Hasil: Beberapa studi memperlihatkan KBMP memiliki luaran yang baik di kalangan perempuan hamil berdasarkan kelas fungsional NYHA. Kebanyakan mereka mengalami penurunan NYHA dari III/IV menjadi I/II. Untuk luaran persalinan, seluruh studi menyimpulkan lebih dari 80% perempuan dengan mitral stenosis yang menjalani pembedahan KBMP melahirkan pada usia term dan tidak ditemukan kelainan. Kesimpulan: KBMP aman dilakukan pada perempuan hamil dengan mitral stenosis berat. Kata kunci: kehamilan, komisurotomibalon mitral perkutan, luaran, stenosis mitral
Co-Authors Abraham A.L. Maukar Alfa P. Meutia Ali Sungkar Ambalagen Sonia Anthonyus Natanael Budi I. Santoso Budi I. Santoso Fakhrizal, Edy Fernandi Moegni Hansens Yansah Junizaf Junizaf Leonardo Leonardo Maryuni, Sri W. Meutia, Alfa P. Priyantini, Tyas Raymond Surya Sulaeman A. Susilo Surahman Hakim Surahman Hakim Tyas Priyatini Tyas Priyatini