Threatened Preterm Labor: Which are become Preterm Labor? Ancaman Persalinan Preterm: Mana yang menjadi Persalinan Preterm?

Objective: The research was aimed to show about characteristics of subject, fetal fibronectin, vaginal pH, cervical length of women with threatened preterm labor, and which are become preterm labor? Preterm labor is occurs most often in 20 weeks gestation to less than 37 weeks gestation. This condition is concerned about Obstetric problem and associated with significant neonatal morbidity and mortality.Methods: This study used the design of case control where preterm pregnant women who become research subjects divided into two groups with threat and without the threat of pre-term labor. Fetal fibronectin , vaginal pHand cervical length than in both groups were evaluated as a risk factor for preterm labor. Mann-Whitney test , Wilcoxon test and Chi-squared test were used as statistical tests with a confidence level of 95%.Results: A total of 86 preterm pregnant women involved in this study with an average age 30 , 5 ± 6.25 (group threat) 32.16 ± 5.25 (non-threatening). Comparison of fetal fibronectin (p = 0.005), vaginal PH(p <0.001) and length of the cervix (p <0.001) between the two groups showed a significant difference. A total of 8 subjects of the 43 in the group of pregnant women with the threat pretem labor experiencing preterm labor .Conclusion: The size of a short cervical length, an increase in the pH of the vaginal secretions and increased levels of fetal fibronectin  is a clinical indicator for screening during pregnancy to assess the risk of a preterm labor .Keywords: cervical length, fetal fibronectin, pretermlabor , vaginal pH of the secretions. Abstrak Tujuan: Persalinan preterm adalah persalinan yang terjadi padausia kehamilan 20 hingga kurang dari37 minggu. Kondisi inimerupakanpermasalahan yang sangat mengkhawatirkan dalam bidang kebidanan dan dikaitkan dengan morbiditas dan kematian neonatal yang signifikan. Evaluasi dan skrining terhadap berbagai faktor resiko terjadinya ancaman persalinan preterm adalah hal terpenting dalam mencegah berbagai komplikasi yang mungkin timbul.Metode: Penelitian ini menggunakan desain case control dimana wanita hamil preterm yang menjadi subjek penelitian terbagi menjadi dua yakni kelompok dengan ancaman dan tanpa ancaman persalinan preterm. Fetal fibronectin, pH sekret vagina dan panjang serviks dibandingkan diatara kedua kelompok sebagai faktor resiko ancaman persalinan preterm. Mann-Whitney test, Wilcoxon test dan Chi – squared digunakan sebagai uji statistik dengan tingkat kepercayaan 95%.Hasil: Sebanyak 86 wanita hamil preterm terlibat dalam penelitian ini dengan rerata usia 30,5 ± 6,25 (kelompok ancaman) 32,16 ± 5,25 (tanpa ancaman). Perbandingan Fetal fibronectin (p=0,005), pH sekret vagina (p<0,001) dan panjang serviks (p<0,001) antar kedua kelompok menunjukkan adanya perbedaan yang bermakna. Sebanyak 8 subjek dari 43 pada kelompok wanita hamil pretem dengan ancaman persalinan preterm yang mengalami persalinan pretermKesimpulan:Ukuran panjang serviks yang pendek, peningkatan pH sekret vagina dan peningkatan kadar fetal fibronectin merupakan indikator klinis untuk skrining selama kehamilan guna menilai resiko terjadinya persalinan pretermKata kunci: fetal fibronectin, persalinan preterm, Ph vagina, panjang cerviks &nbsp

Glioblastoma In Pregnancy: A Case Report

Incidence of primary intracranial tumour in pregnancy is very rare. This rare association is becoming more common because women in developed societies defer childbearing to the third or fourth decade of life. We presented A case of a 33- year-old, gravida 2 para 1, Indonesian Acehnese women presented with pregnancy and recurrent Glioblastoma. Her chief complaint was headache that is worsening since 1 month ago. She is a patient of Neurosurgery Department since 7 months earlier with complaints of major headache, vomitting, seizure and weakness of the left part of her body when she was 12 weeks pregnant. Patients was diagnosed with brain tumor on right temporoparietal region. Her CT scan result are midline shift to the left of falx cerebri with obliterated right ventricle and hypodens mass on right region size 5,04x 5,17 cm x 5,79 cm. Craniotomy was performed with no regards of the pregnancy but the patient refuse to terminate the pregnancy. Post craniotomy patient was supposed to undergo series of radiotherapy but decided not to since it may complicate her pregnancy. After 5 month went untreated, patient then had another CT scan due to her recurring complaint and the result was there\u27s an area of hypo and hyperdens in fronto parietal dextra and sinistra with brain edema. The patient was treated for a week when her condition was worsening with loss of consciousness. We then perfomed joint operation with Neurosurgery dept consist of Cesarean section that was continued with craniotomy where we delivered a heathy 1900 gram baby boy. The patient was then treated for 2 days in the intensive care unit and another 4 days in the ward then discharged home in good condition. Every brain tumours in pregnancy bring dilemmas with no standard treatment in medicine. Its diagnosis is challenging because of the need to treat the mother and minimizing the effects of cancer treatment on the fetus. The treatment intention is to minimise mortality and morbidity for both maternal and fetal which can be achieved by prolonging pregnancy while alleviating complications from the brain tumour. The management have to be individualised from a multi-disciplinary team and the consideration of a multitude of factors, including nature and location of the tumour, associated signs and symptoms, fetal gestation and the patient\u27s wishes

Systemic Lupus Erythematosus and Worsening Severe Preeclampsia: Does IT Have Correlation?

Acute exacerbation of systemic lupus erythematosus in pregnancy complicated by severe preeclampsia was difficult to diagnose and treat. This is the case of Mrs Y, 26 years old in 24 weeks gestational age with severe preeclampsia with active exacerbation of systemic lupus erythematosus. She had suffered from systemic lupus eryhtematosus for three years before she got pregnant. When she came the blood pressure was 180/110 mmHg, protein urine +3. There was complaint of stiffness on muscle joints, facial flares, general weakness, and photosensitivity. She was hospitalized for seven days before she was discharged. Her blood pressure was controlled and lupus symptoms were controlled by antihypertensive agents and antiinflamation agent metil prednisolone. A week later she came back to our hospital. Her blood pressure was 190/110 mmHg despite having antihypertensive. She also complaint of joints ache, general weakness, facial flares, and no fetal movement. On ultrasound examination there was intra uterine fetal death. From this case, we would like to assess the patophysiology of systemic lupus erythematosus and worsening symptoms of severe preeclampsia which cause the mortality and morbidity of mother and bab

Fetomaternal Outcome of Aterm Labor with Pregnant Thrombocytopenia: Luaran Fetomaternal pada Ibu Hamil Aterm dengan Trombositopenia

Objective : To determine the relationship between term pregnant women and the incidence of post-partum haemorrhage, duration of healing of incision/perineorhaphy wounds, fetal thrombocytopenia, APGAR value and birth weight of infants in dr. Zainal Abidin Hospital Banda Aceh.Methods: Design of research is observational analytic with a cross sectional approach. The research sample was taken by the total sampling method. The population in this study were all pregnant patients at term who came to the dr. Zainoel Abidin Hospital Banda Aceh and experienced thrombocytopenia at a predetermined time, met the inclusion and exclusion criteria. Analysis data with the Pearson correlation test formula to assess the strength of the relationship between two variables.Results: The prevalence of aterm pregnant women with thrombocytopenia who visited and gave birth at Dr. Zainoel Abidin General Hospital during the study period was 1.62% from 1850 visited pregnant women. A total of 30 samples in this study, obtained a maternal outcome were postpartum haemorrhage as much as 60% (p-value 0.000). The duration of wound healing was 26.70%, (p-value 0.008). While the fetal outcomes were the incidence of neonatal thrombocytopenia 50% (p-value 0,000), nenonatal asphyxia with an APGAR value of 4-6 as much as 43.30% (p-value 0.003) and low birth weight of the baby at 36.70% (p-value 0.033). The five variables obtained a positive correlation with varying strengths of the relationship.Conclusion: There is a close relationship between the incidence of thrombocytopenia at term pregnant women at delivery and fetomaternal outcomes in dr. Zainoel Abidin Hospital Banda AcehKeywords: fetal outcome, maternal outcome, Score APGAR, thrombocytopenia. Abstrak Tujuan : Untuk mengetahui hubungan ibu hamil aterm dengan kejadian perdarahan post-partum, lamanya penyembuhan luka insisi/perineorafi, trombositopenia janin, nilai APGAR dan berat badan lahir bayi di Rumah Sakit Umum dr. Zainal Abidin Banda Aceh.  Metode: Jenis penelitian ini adalah analitik observasional dengan pendekatan cross sectional. Sampel penelitian diambil dengan metode total Sampling. Populasi pada penelitian ini adalah semua pasien hamil aterm yang datang ke RSUD dr. Zainoel Abidin Banda Aceh dan mengalami trombositopenia pada rentang waktu yang telah ditentukan, memenuhi kriteria inklusi dan eksklusi. Analisa data dengan melakukan uji korelasi Pearson untuk menilai kekuatan hubungan dua variabel.Hasil: Prevalensi ibu hamil aterm dengan trombositopenia pada penelitian adalah 1,62% dari 1850 ibu hamil yang berkunjung. Sebanyak 30 sampel pada penelitian didapatkan luaran maternal yaitu perdarahan postpartum sebanyak 60% (p-value 0,000). Lama penyembuhan luka didapatkan26,70%, (p-value 0,008). Sedangkan luaran fetal yaitu kejadian trombositopenia neonatus 50% (p-value 0,000), asifiksia nenonatus dengan nilai APGAR 4-6 sebanyak 43,30% (p-value 0,003) dan berat badan bayi lahir rendah 36,70% (p-value 0,033). Kelima variabel didapatkan korelasi positif dengan kekuatan hubungan yang bervariasi.Kesimpulan: Terdapat hubungan erat antara kejadian trombositopenia ibu hamil aterm saat persalinan terhadap luaran fetomaternal di RSUD dr. Zainoel Abidin Banda Aceh.Kata kunci : luaran fetal, luaran maternal, nilai APGAR, trombositopenia

The effect of serum magnesium, calcium, and potassium levels on the event of calf muscle cramps, according to the perspective of pregnant women in the third-trimester of pregnancy

 Objective: To determine the effect of magnesium, calcium, and potassium levels on calf muscle cramps in third-trimester pregnant women at Dr. Zainoel Abidin Banda Aceh. Methods: This research is an observational analytic study with a case-control method by taking samples using a total sampling technique. The research sample was third-trimester pregnant women (28-40 weeks of gestation) who were treated in the maternity ward for the period September to December 2020. Results: A total of 263 samples were involved in this study where 105 patients (40%) were obese, 229 patients (87%) were housewives, 161 patients (61%) did not experience muscle cramps and samples had magnesium levels below normal as much as 82 people, calcium levels below normal as many as 127 people and potassium levels below normal as many as 2 people. The mean levels of magnesium, calcium, and potassium were 1.8 mg/dL, 8.69 mg/dL, and 4.25 mmol/L, respectively. The results of this study are magnesium levels affect muscle cramps in pregnant women (p-value=0.000), while calcium levels (p-value=0.373) and potassium (p-value=0.062) do not affect muscle cramps in pregnant women. Conclusion: There is a significant effect between magnesium levels on the incidence of calf muscle cramps in third-trimester pregnant women, while calcium and potassium levels do not affect them. Keywords: Muscle Cramps, Magnesium, Calcium, Potassium

Glycated Albumin as an Outcome Predictor in Pregnant Women with Diabetes Mellitus: Glycated Albumin sebagai Prediksi Hasil pada Perempuan Hamil dengan Diabetes Melitus

Abstract Objective: To determine the correlation between Glycated Albumin concentrations with the outcome of pregnant women with Type 2 Diabetes Mellitus in Zainoel Abidin Hospital, Banda Aceh. Methods: This was an observational correlational study using a cross-sectional design. Subjects include pregnant women with a history of Type 2 Diabetes Mellitus who are examined for serum GA levels using colorimetric enzymatic methods and the outcomes will be assessed during pregnancy. Data analysis was performed using the ETA test and Receiver Operating Characteristic (ROC) curve. Results: A total of 29 subjects with a mean age of 33.25 years had normal maternal outcome and those with a mean age of 34.92 years had abnormal maternal outcome. Statistically there was a significant correlation between GA levels and the maternal outcome of pregnant women with Type 2 Diabetes Mellitus (p = 0.009) with a moderate degree of negative correlation (r = 0.477). The GA cut-off for pregnancy outcome is 16.77% with a sensitivity and specificity of 76% and 75% respectively. Conclusion: Examination of GA concentration can be used as a predictor to assess maternal outcomes during pregnancy with moderate correlation and a cutoff point of 16.77%. Keywords: diabetes mellitus, glycated albumin, maternal outcome, pregnancy.   Abstrak Tujuan: Untuk mengetahui korelasi kadar Glycated Albumin terhadap outcome pada ibu hamil yang menderita diabetes melitus tipe I dan untuk mengetahui berapa kadar Glycated Albumin yang dapat memberikan hasil buruk pada ibu hamil yang menderita diabetes melitus tipe II di RSUD dr. Zainoel Abidin Banda Aceh. Metode: Penelitian ini merupakan studi korelatif observasional menggunakan desain potong lintang. Perempuan hamil dengan riwayat DMT2 akan diperiksan kadar GA serum menggunakan metode enzimatik kolorimetri serta akan dinilai outcome selama kehamilan. Analisis data dilakukan menggunakan uji Eta dan kurva Receiver Operating Characteristic (ROC) dengan tingkat kepercayaan 95%. Hasil: Sebanyak 29 subjek dengan rerata usia 33,25 tahun (hasil normal) dan 34,92 tahun (hasil kelainan). Secara statistik terdapat korelasi yang bermakna antara kadar GA dan outcome ibu penderita DMT2 (p = 0,009) dengan derajat korelasi sedang (r = 0,477) dengan arah korelasi negatif. Titik potong GA terhadap outcome kehamilan adalah 16,77% dengan sensitifitas dan spesisitas secara berurutan 76% dan 75%. Kesimpulan: Pemeriksaan GA dapat dijadikan sebagai prediktor untuk menilai outcome ibu selama kehamilan dengan tingkat korelasi sedang dan titik potong 16,77%. Kata kunci: diabetes melitus, glikasi albumin, hamil, luaran ibu

Success of Vaginal Deliveries Among Women in Labor with Previous Cesarean Section: Analysis of 50 Cases

This study was purposed to evaluate the success of vaginal deliveries after cesarean (VBAC). This case-series-study was conducted in Zainoel Abidin and Ibu dan Anak Hospital, as referral and teaching Hospitals, Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, from January until October 2011 with descriptive analytic method. The outcomes were the success of VBAC. There were 50 subjects attempted VBAC. From 50 subjects who attempted VBAC, 45 subjects (90%) were succeed in vaginal delivery, 5 subjects (10%) were unsuccessful and had to undergo emergency C-Section. The parameters which were likely to contribute to the success of vaginal delivery in subjects who attempted VBAC were gestational age less than 40 weeks, the progress of cervical dilatation of less than 1 cm in 60 minutes, more ripened cervix on the labor. Parameters such as lower baby's weight and history of vaginal delivery also result in the success of VBAC. Gestational age, Bishop score, and the progress of cervical dilatation contributed to higher success of VBAC

The Association betweeen Cesarean Section and Placenta Accreta: Hubungan antara Seksio Sesarea dan Plasenta Akreta

Objective: To determine the relationship between the history of cesarean section and the incidence of placenta accreta in Dr. Zainoel Abidin Hospital Banda Aceh. Methods: The data collection method used was secondary data collection which was assessed through retrospective medical records. Sampling in this study using total sampling method. The results of the study were processed using the chi square statistical test on 781 research samples that were collected from period April 2019 - April 2020. Results: The results obtained were 22 respondents (2.8%) experienced placenta accreta where 18 respondents (2.30%) had placenta accreta with a history of CS and 4 respondents (0.51%) placenta accreta without a history of CS. The p value obtained was 0.000 (p value <0.05). In this study, the value of the Risk Estimate (RE) was 6.483 with a Confident Interval (CI) of 95% being (2.21-18.97). Conclusions: There is a very significant relationship between the history of cesarean section and the incidence of placenta accreta at RSUDZA Banda Aceh and mothers with a history of CS have a 6 times greater risk of experiencing placenta accreta. Keywords: cesarean section, placenta accrete.   Abstrak Tujuan: Untuk mengetahui hubungan riwayat seksio sesarea dengan kejadian plasenta akreta di Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh. Metode: Jenis penelitian ini adalah penelitian analitik dengan desain potong lintang. Metode pengambilan data yang digunakan adalah pengambilan data sekunder yang dinilai melalui rekam medik secara retrospektif. Pengambilan sampel pada penelitian ini menggunakan metode total sampling. Hasil penelitian diolah menggunakan uji statistik chi square terhadap 781 sampel penelitian yang telah dikumpulkan dari data periode April 2019 – April 2020. Hasil: Hasil yang didapatkan sebanyak 22 responden (2,8%) mengalami plasenta akreta dimana 18 responden (2,30%) plasenta akreta dengan riwayat SC dan 4 responden (0,51%) plasenta akreta tanpa riwayat SC. Nilai p value yang didapatkan adalah 0.000 (p value <0,05). Pada penelitian ini didapatkan nilai Risk Estimate (RE) 6,483 dengan Confident Interval (CI) 95% berada (2,21- 18,97). Kesimpulan: Hasil ini menunjukkan terdapat hubungan yang sangat signifikan antara riwayat seksio sesarea dengan kejadian plasenta akreta di RSUDZA Banda Aceh dan ibu dengan riwayat SC memiliki risiko 6 kali lebih besar untuk mengalami plasenta akreta. Kata kunci: plasenta akreta, seksio sesarea