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Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome Kesty, Cindy; Saputra, Hendra S
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the MMR trends, its associated factors, and neonatal outcome at East OKU Regional Public Hospital from 2013 until 2016. Methods: This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East OKU Regional Public Hospital, South Sumatera. Data was collected from medical records. There were 17 maternal deaths, but 1 data was excluded due to lack of data. Results: We recorded 2,191 pregnancies and 17 maternal deaths. Over 4 years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major etiology of maternal deaths were hypertensive disorder (37.5%), followed by hypertensive disorder + hemorrhage and hypertensive disorder + infection in the same proportion. MMR were higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%). Conclusion: MMR trends in our hospital were fluctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays significant role in maternal deaths. In addition, most of neonates were born alive. We hope that this study can be a feedback for hospital to do maternal and perinatal audit. Keywords: Factors, Maternal mortality rate, Neonatal outcome, Regional public hospital, Trends     Tujuan: Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD OKU Timur dari 2013 hingga 2016. Metode: Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD OKU Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap. Hasil: Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui sectio caesaria (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%). Kesimpulan: Pola AKI di RSUD berfluktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifikan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal. Kata kunci: Angka kematian ibu, Faktor, Luaran neonatus, Pola, Rumah sakit umum daerah

Preterm Labor Predictors: Maternal Characteristics, Ultrasound Findings, Biomarker, and Artificial Intelligence Nuswil Bernolian; Chairil Anwar; Cindy Kesty
Majalah Kedokteran Sriwijaya Vol 52, No 1 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i1.11429

The identification of risk factors for preterm labor is an important predictor. The risk factors for preterm labor can be maternal characteristics, namely maternal obstetric history, maternal body mass index and weight gain, multiple pregnancy, maternal infections, periodontal disease, maternal vitamin D deficiency, and lifestyle. Nowadays, various accurate diagnostic methods have been developed to diagnose preterm labor, namely ultrasound (cervical length, cervical consistency, uterocervical angle, and fetal adrenal gland) and biomarkers (IL-6 and IL-8 in cervicovaginal fluid, Placental Alpha Microglobulin-1 (PAMG-1), and Insulin-Like Growth Factor Binding Protein-1 (IGFBP-1), Vascular Endothelial Growth Factor (VEGF), Placental Growth Factor (PGF), Soluble VEGF Receptor-1 (sFlt-1), High Mobility Group Box-1 (HMGB1), and calponin. Artificial Intelligence was developed to predict preterm labor, namely in the form of ultrasound software which is capable of detecting cervical funneling processes ranging from resembling the T, Y, V, and U-shaped. This software is expected to be easily used by general practitioners and obstetricians and gynecologists, especially those who work in rural areas.

CURRENT UPDATE ON CONGENITAL HEART DISEASE SCREENING IN PREGNANCY Nuswil Bernolian; Cindy Kesty; Benedictus Wicaksono Widodo
Majalah Kedokteran Sriwijaya Vol 52, No 2 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i2.11976

Congenital Heart Disease (CHD) affects 8 births per 1,000 live births; equivalent to 1.35 million children born with CHD each year. Based on global incidence rate, Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), and Atrioventricular Septal Defect (AVSD) are found on 54.5% of CHD cases. Genetic factors are known to involve in CHD. Moreover, it can also be caused by environmental and infectious factors. Ultrasonography has been widely utilized to screen CHD at 18-22 weeks gestational age. Screening aims to measure heart rate, heart size, heart position, four chamber of the heart, pericardium, atrium, ventricles, atrioventricular junctions, and ventriculoatrial junctions. Doppler echocardiography becomes primary diagnostic tools in CHD patients because of its high sensitivity and specificity, safety, and noninvasiveness. Follow-up examination is indicated on a few conditions. Maternal indications include autoimmune antibody, family history of defects, in vitro fertilization, maternal metabolic disease, or teratogenic exposure. Fetal indications include abnormal screening result, family history of CHD, abnormal heart rhythm, chromosomal abnormalities, extracardiac abnormalities, hydrops, or monochorionic twin pregnancy. With increased rate of CHD, better screening and follow-up should be conducted to achieve acceptable detection rate.

Clinical Efficacy of the Use of Honey as Wound Treatment in Surgical Site Infection due to Hysterectomy Patient with Type 2 Diabetes Mellitus Hartati; Mufida Muzakkie; Yusuf Effendi; Ferry Yusrizal; Ramzi Amin; Cindy Kesty; Vicela Patricia Virgyna
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 8 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i8.343

Introduction: Honey is believed to be used in the topical treatment of wounds and burns due to its anti-bacterial and wound healing promotion activities. The sugar content in honey is high enough to inhibit microbial growth. This case report reports the clinical efficacy of using honey as a postoperative hysterectomy wound dressing with type 2 diabetes mellitus complications. Case Presentation: A woman, 40 years old, lived in Palembang, housewife, came with complaints of open surgical scars and smelling pus. The patient is a postoperative patient with cesarean section with indications of a prolonged latent phase and macrosomia. The patient also had a history of uncontrolled diabetes mellitus since 8 years ago. Intraoperatively, a wound dehiscence is obtained in the lower uterine segment and adhesions between the anterior uterine body and the omentum and transverse colon. The patient finally underwent a supracervical hysterectomy and the surgical secretions were examined for bacterial culture and antibiotic resistance. During wound care, the patient's surgical wound was treated using honey dressings. Patient experienced improvement after treatment for 12 days post-operation. Conclusion: Honey has antibacterial and tissue regeneration ability which is high enough to heal surgical wounds. Further studies are needed for the application of honey to postoperative wounds more widely

Congenital Heart Diseases in Pregnancy Nuswil Bernolian; Radiyati Umi Partan; Siti Nurmaini; Cindy Kesty; Benedictus Wicaksono Widodo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.376

This research aims to shed light into congenital heart diseases, the pathophysiology, and the ultrasonographic findings of congenital heart diseases. Congenital heart diseases are a major health concern, affecting 1.35 million children born every year. Ventricular septal defect, atrial septal defect, and atrioventricular septal defect are found in 57.9% cases of congenital heart diseases. The risk factors include consanguineous marriage, family history of congenital heart diseases, old maternal and paternal age, and exposure to teratogens, and genetic factors. Missteps in cardiac development are the main pathophysiology of congenital heart diseases. Ultrasonography screening in 18–22 weeks gestational age is utilized to screen. Follow-up screening can increase detection rate to 80%. This study has limitation of only discussing most common congenital heart diseases and did not delve into rarer types of congenital heart diseases and did not discuss impacts or burden of congenital heart diseases in adulthood and health comorbidities associated. This literature review is beneficial for general practitioners and obstetricians focusing in maternal fetal medicine.

Abnormal Uterine Bleeding in Adolescent Kms Yusuf Effendi; Rizani Amran; Iskandar Zulqarnain; Heriyadi Manan; Adnan Abadi; Fatimah Usman; Awan Nurtjahyo; Cindy Kesty; Siti Chodijah; Selly Rizany
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 1 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v6i1.431

Abnormal uterine bleeding (AUB) is defined as the abnormal bleeding from the uterine corpus in term of duration, volume, frequency and/or regularity. This condition occurs in 37% of adolescents and may affect the quality of life and increased hospitalization. Etiology is divided into structural and non-structural causes, known as PALM-COEIN. The most common etiology in adolescents is anovulatory menstruation due to immature hypothalamus-hypophysis axis. Diagnostic evaluation should include investigation in the etiology of AUB, anemia signs, and hemodynamic status. Treatment of AUB consists of hormonal and non-hormonal therapy. Therapy in adolescent is given based on the severity of bleeding, grading of anemia, and hemodynamic stability. Follow-up is required after therapy. Understanding AUB in adolescents can help clinicians deliver appropriate and comprehensive treatment. This review was aimed to explain about definition, epidemiology, etiology, pathophysiology, diagnosis, and treatment of abnormal uterine bleeding in adolescent.

Multigravid Women with Uterine Rupture: A Case Report Firmansyah Basir; Adnan Abadi; Abarham Martadiansyah; Cindy Kesty; Febi Stevi Aryani; Murwani Emasrissa Latifah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.443

Introduction: Uterine rupture is the discontinuation of the uterine scar that creates connection between uterine and peritoneal cavity. The most common etiology for uterine rupture is dehiscence of uterine scar tissue from previous cesarean section. In patient with uterine rupture and fetal expulsion to the peritoneal cavity, fetal survival becomes extremely poor. Therefore, it is important for clinician to understand the uterine rupture and be able to give prompt treatment in order to prevent maternal and fetal morbidity and mortality. Case Presentation: A 34-year-old woman, G3P2A0 38 weeks of gestation complained that she had abdominal pain, couldn’t feel her baby movement, watery discharge since 10 hours before admission. Bloody discharge and trauma were all denied. Patient underwent twice cesarean section before. Patient only had four times antenatal care with obstetrician at 24, 28, 32, and 36 weeks of gestation. She was scheduled for caesarean section at 38 weeks of gestation. Patient looked alert with low blood pressure and tachycardia. On physical examination, we found that she was pale, fundal height could not be determined, and there was no fetal heart rate detected. Speculum examination showed livide portio, closed external orifice of uterus, and inactive blood. There was positive slinger sign and Douglas cavity was bulging. Ultrasound examination showed intrauterine fetal demise, complete uterine rupture on lower segment, and positive sign of free fluid on abdominal cavity. Patient underwent operation and we found the died male neonate was in the peritoneal cavity and the placenta was still attached in the uterine cavity. We delivered the baby and placenta completely. There was uterine rupture on the previous CS scar, the edge of the uterine wound was regular with no necrosis and extended to the right side of uterus. Then, we performed hysterorrhaphy in order to stop the bleeding and repair the uterus, and we also performed tubal ligation. The died neonate had maceration grade I. Conclusion: Uterine rupture causes poor fetal and maternal prognosis. Early diagnosis and prompt treatment is really important in uterine rupture. Prevention of uterine rupture could be done by meticulous antenatal care, especially visiting to obstetrician in order to review maternal and fetal condition and determine mode of delivery.

Relationship Between Vitamin D Supplementation and Improvement in Body for Carcinogenesis: A Literature Review Irawan Sastradinata; Rizal Sanif; Cindy Kesty; Siti Hardianti Harahap
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.447

Vitamins are probably the best-selling dietary supplements in the United States, in which an estimated 35% of the population take multivitamin and mineral supplements. Data relating microconstituents to carcinogenesis are extremely limited, as explained in the first report. A striking feature of many of the compounds in the three groups mentioned above is their capacity to prevent or retard the occurrence of neoplasia. However, there is a paucity of data concerning the conditions under which inhibition occurs, the mechanisms of inhibition, and the precise impact of these microconstituents on humans. A literature review was conducted in the electronic databases PubMed and Google Scholar using the index terms "carcinogenesis" and "cancer" and "vitamin D" All types of studies were included for this study, such as randomized controlled trials, systematic reviews, literature reviews, and pilot studies published between 2010 and 2021. Articles which not written in English were excluded from the study. This search resulted in 10 papers. Many of the mechanisms proposed for vitamin D and cancer prevention have been studied only in the context of one tissue or one type of cancer and so further studies must be conducted to determine if these mechanisms can be generalized. For example, while higher serum (25(OH)D3) is associated with reduced cancer risk, and CYP27B1 is expressed in non-renal cells, there is no evidence that the low-level expression of CYP27B1 in tissues leads to meaningful local production of 1a,25(OH)2D3 or calcitriol, and that this mediates the protection from cancer provided by high vitamin D status. In conclusion, we suggest that vitamin D compounds to be employed in the treatment of, alone or in combination with other anticancer agents. solar UV-B radiation, acting through the production of vitamin D, is a risk reduction factor for over a dozen forms of cancer.

Relationship Between Vitamin D Supplementation and Improvement in Body for Carcinogenesis: A Literature Review Irawan Sastradinata; Rizal Sanif; Cindy Kesty; Siti Hardianti Harahap
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.447

Vitamins are probably the best-selling dietary supplements in the United States, in which an estimated 35% of the population take multivitamin and mineral supplements. Data relating microconstituents to carcinogenesis are extremely limited, as explained in the first report. A striking feature of many of the compounds in the three groups mentioned above is their capacity to prevent or retard the occurrence of neoplasia. However, there is a paucity of data concerning the conditions under which inhibition occurs, the mechanisms of inhibition, and the precise impact of these microconstituents on humans. A literature review was conducted in the electronic databases PubMed and Google Scholar using the index terms "carcinogenesis" and "cancer" and "vitamin D" All types of studies were included for this study, such as randomized controlled trials, systematic reviews, literature reviews, and pilot studies published between 2010 and 2021. Articles which not written in English were excluded from the study. This search resulted in 10 papers. Many of the mechanisms proposed for vitamin D and cancer prevention have been studied only in the context of one tissue or one type of cancer and so further studies must be conducted to determine if these mechanisms can be generalized. For example, while higher serum (25(OH)D3) is associated with reduced cancer risk, and CYP27B1 is expressed in non-renal cells, there is no evidence that the low-level expression of CYP27B1 in tissues leads to meaningful local production of 1a,25(OH)2D3 or calcitriol, and that this mediates the protection from cancer provided by high vitamin D status. In conclusion, we suggest that vitamin D compounds to be employed in the treatment of, alone or in combination with other anticancer agents. solar UV-B radiation, acting through the production of vitamin D, is a risk reduction factor for over a dozen forms of cancer.

Cortisol Level Related to Depression in Women with Endometriosis Adnan Abadi; Aria Indrabrata; Iskandar Zulqarnain; Theodorus; Abdullah Sahab; Kemas Yusuf Effendi; Heriyadi Manan; Fatimah Usman; Awan Nurtjahyo; Cindy Kesty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 6 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i6.537

Background: Several main symptoms of endometriosis can lead to physical and psychological stress and also hormonal disturbances as the result of prolonged stress. Cortisol was associated with the onset of depression. This study aimed to determine the relationship between cortisol levels and depression in women with endometriosis at the Department of Obstetrics and Gynecology at Dr. Mohammad Hoesin General Hospital (RSMH) Palembang. Methods: A cross-sectional study was performed at the Reproductive Endocrinology and Infertility outpatient clinic and inpatient ward, Department of Obstetrics and Gynecology at Dr. Mohammad Hoesin General Hospital Palembang, from January to November 2020. There were 74 samples of endometriosis patients who met the inclusion criteria. The blood cortisol level was examined using the ELISA method. The determination of depression level was performed by filling out the Beck Depression Inventory questionnaire. Data were analyzed using SPSS version 22.0. Results: Seventy-four samples met the inclusion criteria. As many as 44 patients (59.5%) without depression, 20 patients (27%) with mild depression, 8 patients (10.8%) with moderate depression, and only 2 patients (2.7%) with severe depression. There were no differences in age, marital status, parity, menstrual cycle, and duration of treatment between endometriosis patients with and without depression (p > 0.05). There was a significant difference in cortisol levels between endometriosis patients with and without depression (p = 0.017). Endometriosis patients with cortisol levels ≤ 7.4 mg/dl were three times more at risk of depression than endometriosis patients with cortisol levels > 7.4 mg/dl. In addition, there was a significant relationship between cortisol level and depression status (OR = 3.023 (95% CI 1.153–7.942; p = 0.041). This study also found a significantly low negative correlation between cortisol levels and BDI scores (r = -0.249; p = 0.032). Conclusion: There was a significant relationship between serum cortisol levels and depression in women with endometriosis. Endometriosis patients with depression had significantly lower cortisol levels than endometriosis patients without depression.

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