Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at 12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. [Indones J Obstet Gynecol 2014; 2-31: 132-139] Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion
Background: Combine Oral Contraceptives (COCs) pills is one of the many popular contraceptives worldwide, with 100 million women who use contraceptive pills. To increase the choice of oral contraceptives, COCs Novadiol® (Pill A) domestic production, which has the same dosage as Microgynon® (Pill B), are still imported drugs. This study aims to determine Pill A's efficacy, safety and acceptance level compared to Pill B for 3 months. Methods: The study was a randomized control clinical trial, an open-label trial in 200 women of childbearing age who met the inclusion and exclusion criteria from July to November 2015. Data were analyzed using SPSS version 20 for Windows. Results: About 300 participants were selected and 200 met the inclusion and exclusion criteria who participated study from the beginning to the end of the study period. In the first month of observation, 1 complaint of dizziness in pill A and 2 from pill B. One nausea complaint was found in the participant from Pill A. These differences were not statistically significant (p>0.05). In the second month of observation, 1 complained of dizziness from pill B and 1 nausea from Pill A. In the third month, observation found no complaints about using Pill A and pill B. There were changes in menstrual patterns in both pills and bleeding outside the cycle during the use of 3 months, but they were not statistically significant (p>0.05). Conclusion: Pills A has the same efficacy, safety and acceptance when compared to the use of birth control pills B for 3 months.
Introductions: Epithelial ovarian cancer accounts for 90% of all ovarian malignancies. More than 70% of patients will experience a relapse even after receiving operative therapy and chemotherapy. There are several prognostic factors that influence the recurrence of ovarian cancer. In Indonesia, especially at Dr. Kariadi Hospital, Semarang, the data as mentioned above is still very limited.objective: Knowing the disease-free survival rate, optimizing surgery and factors related to the incidence of recurrence in epithelial ovarian cancer patients at Dr. Kariadi Hospital SemarangMethods: This study is a retrospective cohort study with survival analysis. Data were collected through medical records, with the study population are patients with a diagnosis of epithelial ovarian cancer who were treated at Dr. Kariadi Hospital Semarang in period January 2018-December 2019. Furthermore, patients who had been remission were observed for signs of disease recurrence for 2 years period.Results: There were 361 patients with epithelial ovarian cancer who underwent primary treatment at Dr. Kariadi Hospital, Semarang in 2018-2019. Furthermore, there were observations of recurrence in 148 patients who achieved remission. Of these 76 patients (51.4%) experienced recurrence, while 72 patients not relapse. From 148 epithelial ovarian cancer patients who underwent cytoreduction surgery at Dr. Kariadi Hospital, Semarang, 113 patients (76.4%) achieved optimal operation with a residu less than 2 cm, while 35 patients (23.6%) were not optimal with a residu more than 2 cm. FIGO stage (HR 2.44) and tumor residu (HR 2.15) were shown to be significant factors associated with the recurrence of epithelial ovarian cancer.Conclusion: Overall disease-free survival in epithelial ovarian cancer at Dr. Kariadi Semarang were 74.8% (6 months), 57.1% (1 year), 42.5% (18 months), and 37.4% (2 years). Tumor residual factors and FIGO stage were shown to be significant prognostic factors influencing the recurrence of epithelial ovarian cancer.
Introduction: Abnormal uterine bleeding (AUB) is bleeding from the uterus that is longer than usual or that occurs at an irregular time, affecting 20% of the adolescent age group, and 50% of women aged 40-50 years in Indonesia. The causes of AUB are pregnancy, anovulatory dysfunction, uterine leiomyoma, endometrial polyps, endometrial hyperplasia, or endometrial carcinoma. This study aims to compare the accuracy of Saline Infusion Sonohysterography (SIS), hysteroscopy and endometrial histopathology in determining pathological abnormalities in women with AUB.Material and Method: This cross sectional diagnostic study was conducted at General Hospital dr. Kariadi Semarang and its network hospitals in June 2020. Samples were determined by consecutive sampling, including married women, not pregnant, had no genital infection and did not present with any malignancy. Histopathological examination of the endometrium is the gold standard for AUB diagnosis. Research data were obtained from secondary data from patient's medical records including demographic characteristics, clinical history, pregnancy history, SIS examination data, hysteroscopy and endometrial histopathology.Result: There were 51 subjects with a mean age of 31.67 ± 5.21 years. The most common complaints were intermenstrual bleeding (37.3%), followed by irregular menstrual bleeding (21.6%), heavy menstrual bleeding (13.7%), and amenorrhea (5.9%). Sensitivity value of SIS examination ranged from 81.5-100% and specificity ranged from 30.77-100%. Hysteroscopy has a sensitivity value range of 87.5-98% and a specificity value of 62.5-100%.Conclusion: SIS examination could be an alternative for endometrial structural abnormalities diagnosis in AUB if hysteroscopy is unavailable.
Objective: To compare IUD-endometrium (ED) distance and the incident of malposition postplacental CuT-380A IUD insertion in vaginal delivery between ring forceps technique and push and push technique. Method: This study was a double-blind randomized control trial, performed in September 2014 until March 2015 at Dr. Kariadi Hospital. Ring forceps and push and push insertion technique groups consisted of 25 subjects in each group. Follow-up was performed at 1-2 weeks, 6-8 weeks and >12 weeks after insertion. Result: The mean of IUD-ED distance in push and push group was shorter (but not statistically significant) than ring forceps group. The IUD-ED distance was at 1-2-week follow-up 4.1 (2.2) vs. 4.9 (3.4) mm; p=0.208, at 6-8-week follow-up: 2.6 (1.8) vs. 3.2 (3.7) mm; p=0.452, and at > 12-week follow-up: 0.9 (0.8) vs. 1.0 (0.9) mm; p=0.427, respectively. Malposition was found in 1-2-week follow-up, but the IUD was changed to the normal position (sagital position in uterine fundus) at 6-8-week and >12-week follow-up. Up to 3 months of follow-up, there was no occurrence of perforation, expulsion or pregnancy in both groups. Most of subjects (56% in the ring forceps, 68% in push and push groups) did not feel painful during IUD insertion. Conclusion: Push and push insertion technique clinically tends to produce IUD-ED distance shorter than ring forceps technique. Both techniques are comfortable, safe and effective. [Indones J Obstet Gynecol 2016; 4-2: 78-87] Keywords: immediate postplacental IUD insertion technique, IUDendometrium distance, IUD malposition, push and push technique, ring forceps technique
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