Indonesian Journal of Obstetrics and Gynecology

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ISSN / EISSN : 2338-6401 / 2338-7335
Total articles ≅ 456
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Chaerannisa Akmelia, Patiyus Agustiansyah, Agustria Z. Saleh, Theodorus
Indonesian Journal of Obstetrics and Gynecology pp 149-152; https://doi.org/10.32771/inajog.v9i3.1207

Abstract:
Objective: To determine the efficacy of Channa striata extract on serum albumin level and wound healing after radical hysterectomy in cervical cancer patients in Mohammad Hoesin Hospital Palembang.Methods: A clinical trial was conducted in Mohammad Hoesin Hospital Palembang during period of January – September 2019. Samples were cervical cancer patients undergoing radical hysterectomy. Serum albumin level was measured before surgery, after surgery, and after the administration of Channa striata extract capsule. Efficacy of the supplement was analyzed with SPSS version 20 using paired t-test.Result: Twenty-eight cervical cancer patients undergoing radical hysterectomy who fulfilled inclusion criteria were obtained. Majority of patients were aged between 40-49 years old (89.3%), normoweight (39.3%), and lived in rural area. Mean duration of surgery was 154.46 ± 40.47 minutes. Serum albumin level before surgery, after surgery and after the administration of Channa striatus extract were 3.4 ± 0.61 g/dL, 2.91 ± 0.42 g/dL, and 3.11 ± 0.49 g/dL, respectively. There was a statistically significant difference between serum albumin level before and after the surgery (p=0.000). However, no statistically significant difference was found between serum albumin level after surgery and after administration of Channa striata extract capsule (p=0.750).Conclusions: There was no significant difference between serum albumin level after surgery and after administration of Channa striata extract capsule.Keywords: cervical cancer , channa striatus extract , radical hysterectomy, serum albumin level. Abstrak Tujuan: Untuk mengetahui efikasi ekstrak Channa striata terhadap kadar albumin serum dan penyembuhan luka pasca histerektomi radikal pada pasien kanker serviks di RS Mohammad Hoesin Palembang.Metode: Uji klinis dilakukan di RS Mohammad Hoesin Palembang selama periode Januari – September 2019. Sampel adalah pasien kanker serviks yang menjalani histerektomi radikal. Kadar albumin serum diukur sebelum operasi, setelah operasi, dan setelah pemberian kapsul ekstrak Channa striata. Khasiat suplemen dianalisis dengan SPSS versi 20 menggunakan uji-t berpasangan.Hasil: Didapatkan 28 pasien kanker serviks yang menjalani histerektomi radikal yang memenuhi kriteria inklusi. Mayoritas pasien berusia antara 40-49 tahun (89,3%), normoweight (39,3%), dan tinggal di daerah pedesaan. Durasi rata-rata operasi adalah 154,46 ± 40,47 menit. Kadar albumin serum sebelum operasi, setelah operasi dan setelah pemberian ekstrak Channa striatus berturut-turut adalah 3,4 ± 0,61 g/dL, 2,91 ± 0,42 g/dL, dan 3,11 ± 0,49 g/dL. Ada perbedaan yang signifikan secara statistik antara kadar albumin serum sebelum dan sesudah operasi (p=0,000). Namun, tidak ditemukan perbedaan yang signifikan secara statistik antara kadar albumin serum setelah operasi dan setelah pemberian kapsul ekstrak Channa striata (p=0,750).Kesimpulan: Tidak terdapat perbedaan yang bermakna antara kadar albumin serum setelah pembedahan dan setelah pemberian kapsul ekstrak Channa striata.Kata kunci: ekstrak Channa striatus, histerektomi radikal, kadar albumin serum, kanker serviks.
Andrijono, Heru Prasetyo, Eka R Gunardi, Gatot Purwoto, Hariyono Winarto
Indonesian Journal of Obstetrics and Gynecology pp 153-156; https://doi.org/10.32771/inajog.v9i3.1275

Abstract:
Objective: To determine whether thrombocytosis is a prognostic factor for epithelial ovarian cancer and its relationship with 3-year overall survival in epithelial ovarian cancer patients.Methods: This study is a retrospective cohort study using medical record of patients with epithelial ovarian cancer registered in cancer registry of Oncology Division in Obstetrics and Gynecology Department, Dr. Cipto Mangunkusumo National General Hospital from January 2014 - July 2016. Data were collected when subjects were first until diseases outcomes identified in 3 years.Results: : Out of 220 subjects, 132 (60%) were patients with advanced stage epithelial ovarian cancer (stage II/III/IV). 94 (42.7%) subjects had thrombocytosis. Patients with advanced stage of disease had higher risk of having thrombocytosis than the ones with earlier stage (p=0.005; OR=2.329). Correlation between thrombocytosis and 3-year overall survival was known to be insignificant (p=0.555). There was shorter mean time survival between patients with thrombocytosis and the ones without but the there was no significant difference in hazard ratio between the two groups (p = 0.399).Conclusion :Thrombocytosis is not a prognostic factor in patients with epithelial ovarian cancer. There is also no significant difference of 3-year overall survival between patients with or without thrombocytosis.Keywords: epithelial ovarian carcinoma, prognosis, thrombocytosis. Abstrak Tujuan: Membuktikan bahwa trombositosis sebagai faktor prognosis kesintasan pada pasien kanker ovarium jenis epitelial dan hubungannya terhadap kesintasan 3 tahun pasien kanker ovarium jenis epitelial.Metode: Penelitian ini merupakan studi kohort retrospektif menggunakan data rekam medis pasien kanker ovarium epitelial yang terdaftar pada cancer registry Departemen Obstetri dan Ginekologi Divisi Onkologi Rumah Sakit Cipto Mangunkusumo pada tahun Januari 2014-Juli 2016. Pengamatan dilakukan saat subjek pertama kali didiagnosis akhir pengamatan selama 3 tahun.Hasil: Didapatkan 220 subjek penelitian yang merupakan populasi terjangkau dan memenuhi kriteria inklusi dan eksklusi. Dari 220 subjek penelitian, 132 (60%) dari 220 subjek penelitian merupakan pasien dengan kanker ovarium stadium lanjut (Stadium II/III/IV). Trombositosis didapatkan pada 94 orang subjek penelitian (42,7%). Pasien dengan kanker stadium lanjut memiliki risiko trombositosis yang lebih tinggi dibandingkan subjek pada stadium awal (p=0,005;OR=2,329). Trombositosis secara statistik tidak bermakna pada kesintasan 3 tahun (p=0,555). Terdapat mean time survival yang lebih rendah pada pasien dengan trombositosis tetapi tidak ada perbedaan hazard ratio yang bermakna antara subjek dengan atau tanpa trombositosis (p=0,399).Kesimpulan : Trombositosis bukan merupakan faktor prognostik pada pasien kanker ovarium jenis epitelial dan tidak terdapat hubungan antara trombositosis dan 3 tahun pada pasien dengan kanker ovarium jenis epithelial.Kata kunci: karsinoma ovarium epithelial, prognosis, trombositosis
Herbert Situmorang, Raymond Surya, Tantri Hellyanti
Indonesian Journal of Obstetrics and Gynecology pp 162-168; https://doi.org/10.32771/inajog.v9i3.1362

Abstract:
Background: Ascites could be caused by many underlying diseases, mainly portal hypertension, malignancy, and heart failure. Other etiologies include tuberculosis and pancreatitis. Difficulties in confirming the cause of ascites have been seen in many clinical settings. Ambulatory laparoscopy is one of powerful tools to rule out many etiologies of ascites despite being invasive in its nature. This case report would like to show one case of peritoneal TB presenting with ascites. Patient has undergone many laboratory workups in search of ascites origin. Literature study is done to look for evidence about timing and role of laparoscopy in ascites work-up. Case illustration: A-26-year-old P2 woman came to hospital with a history of vaginal delivery 22 days before admission presenting with massive ascites. No obstetric complication was found. Transvaginal ultrasound revealed normal postpartum uterus and ovaries, surrounded with ascites. Both the liver and kidneys were found normal on ultrasound. Abdominal CT scan with contrast showed massive ascites with thickened omentum. ADA was 36 IU/L. We decided to perform diagnostic laparoscopy and biopsy for histopathology. We found massive yellowish ascites and hyperaemic tubal enlargement with thickening of the peritoneum. Pathology examination proved the appearance of chronic salpingitis and granulomatous peritonitis consistent with tuberculosis peritonitis. Conclusion: Laparoscopy as a minimal invasive tool can diagnose ascites with unknown etiology patients after failure to prove diagnosis from clinical laboratory and radiological examination. It is one best alternative to diagnose peritoneal TB presenting with ascites with its superiority in visualizing abdominal cavity and obtaining specimens for histology with lower risk of morbidity.
Luay Abu Atileh, Nouf Khalifeh
Indonesian Journal of Obstetrics and Gynecology pp 169-172; https://doi.org/10.32771/inajog.v9i3.1492

Abstract:
Objectives: To identify the underlying etiology of dermoid cysts in the pouch of Douglas. Case presentation: A 44-year-old woman presented to our clinic complaining of chronic, dull-aching lower abdominal pain of one-month duration. Pelvic ultrasound examination showed an eight-centimeter cystic appearing lesion in the right adnexa. Computed tomography (CT) suggested the diagnosis of dermoid cyst. Laparoscopy revealed a residual ovarian tissue on the right side and an eight-centimeter cystic mass occupying the pouch of Douglas. The entire specimen was removed en bloc through the umbilicus incision inside a bag with no spillage. Histopathologic examination confirmed the diagnosis of a mature cystic teratoma. Conclusion: Parasitic dermoid cysts are extremely rare entity especially those located in the pouch of Douglas. Autoamputation and reimplantation is the most accepted etiology to explain this phenomenon. Key-words: Autoamputation, dermoid cyst, Douglas, Laparoscopy, Mature cystic teratoma
Yuyun Lisnawati, Jimmy Sakti, Rima Irwinda, Kindy Agustin, Nadia Nurfauziah
Indonesian Journal of Obstetrics and Gynecology pp 144-148; https://doi.org/10.32771/inajog.v9i3.1491

Abstract:
Objective: To asses the relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes.Methods: A cross sectional study was conducted at Persahabatan Hospital from January 2014 to December 2018. Subject were pregnant women with hypertensive disorder. Serum uric acid levels were taken from a venous blood sample at the time the patient came for delivery. The severity of hypertensive disorders in pregnancy were grouped into chronic hypertension, gestational hypertension, preeclampsia without severe feature, preeclampsia with severe feature, and preeclampsia with severe feature and organ involvement. The perinatal outcomes were the gestational age at birth, birth weight, and the first minute APGAR score. The relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes were analyzed using Mann Whitney and Kruskall Wallis test.Result: A total of 704 out of 880 pregnant women with hypertensive disorder have met the criteria as research subjects. Maternal uric acid levels were found to increase significantly (p <0.001) with increasing severity of hypertensive disorders in pregnancy. Maternal who experienced preterm delivery had significantly higher blood uric acid levels (p <0.001) than those who experienced a term delivery. Maternal blood uric acid levels of infants with small birth weight for gestational age and first minute Apgar score 7.Conclusions: Maternal blood uric acid levels increased significantly accompanying the severity of hypertensive disorders in pregnancy. Blood uric acid levels tend to be higher in maternal who have poor perinatal outcomes.Keywords: APGAR score, hypertensive disorders in pregnancy, preeclampsia, uric acid. AbstrakTujuan: Untuk menilai hubungan antara kadar asam urat serum ibu dan keparahan gangguan hipertensi pada kehamilan dan luaran perinatal.Metode: Studi potong lintang dilakukan Rumah Sakit Persahabatan periode Januari 2014 sampai Desember 2018. Subjek penelitian adalah ibu hamil dengan gangguan hipertensi. Kadar asam urat darah diambil dari sampel darah vena pada saat ibu hamil datang untuk melahirkan. Tingkat keparahan gangguan hipertensi pada kehamilan dikelompokkan menjadi hipertensi kronik, hipertensi gestasional, preeklamsia tanpa gejala berat, preeklamsia dengan gejaka berat, dan preeklamsia dengan gejala berat dan keterlibatan organ. Luaran perinatal adalah usia kehamilan saat lahir, berat badan bayi lahir, dan skor APGAR menit pertama. Hubungan antara kadar asam urat darah ibu dan tingkat keparahan gangguan hipertensi pada kehamilan dan luaran perinatal dianalisis menggunakan uji Mann Whitney atau uji Kruskall Wallis.Hasil: Sebanyak 704 dari 880 ibu hamil penderita hipertensi telah memenuhi kriteria sebagai subjek penelitian. Kadar asam urat darah ibu meningkat secara signifikan (p <0,001) dengan meningkatnya keparahan gangguan hipertensi pada kehamilan. Ibu yang melahirkan preterm memiliki kadar asam urat darah yang lebih tinggi secara bermakna (p < 0,001) dibandingkan ibu yang melahirkan aterm. Kadar asam urat darah ibu dari bayi dengan berat lahir kecil untuk usia kehamilan dan skor Apgar menit pertama < 7, sedikit lebih tinggi tetapi tidak signifikan, dibandingkan kadar asam urat darah ibu dari bayi berat lahir normal dan skor Apgar menit pertama pertama > 7.Kesimpulan: Kadar asam urat darah ibu meningkat secara signifikan menyertai beratnya gangguan hipertensi pada kehamilan. Kadar asam urat darah cenderung lebih tinggi pada ibu yang memiliki luaran perinatal kurang baik.Kata kunci: APGAR, asam urat, hipertensi dalam kehamilan, preeklamsia.
Brigita Renata, Dharmady Agus
Indonesian Journal of Obstetrics and Gynecology pp 140-143; https://doi.org/10.32771/inajog.v9i3.1467

Abstract:
Objective: To determine the association of husband support and postpartum blues in postpartum women. Methods: This was a cross-sectional study. Respondents are collected from postnatal women at the Pontianak St. Antonius Hospital, with random sampling. Retrieval of data use a research questionnaire. Data were analysed univariately and bivariate using the Chi-Square test method. Result: Of the 96 respondents, 5.2% were 30 years old . For parity data, 38.5% were primiparous women and 61.5% were multiparous women. As for employment status, 68.8% are in the unemployed group, and 31.2% are in the working group. 47.9% of respondents received inadequate husband support, and 52.1% respondents received adequate husband support. While 44.8% of respondents experienced postpartum blues, 55.2% did not. The results of the bivariate analysis showed a significant relationship between husband support and postpartum blues with p=0.042 and OR=2.331. Conclusion: We found a significant relationship between husband support and postpartum blues disorder. Keyword: family, husband support, postpartum blues. Abstrak Tujuan : Untuk mengetahui hubungan dukungan suami dengan gangguan postpartum blues pada perempuan pascamelahirkan. Metode: Penelitian ini adalah penelitian analitik observasional dengan studi potong lintang, yang dilakukan di Rumah Sakit Santo Antonius Pontianak pada perempuan pascamelahirkan dengan metode pengambilan sampel acak sederhana. Dukungan suami diukur dengan menggunakan kuesioner Dukungan Suami dan PPB diukur dengan menggunakan kuesioner Edinburgh Postnatal Depression Scale (EPDS). Data dianalisis dengan menggunakan uji kai kuadrat. Hasil: Dari 96 responden, sebanyak 5,2 % berada pada usia 30 tahun. Untuk data paritas, 38,5% adalah perempuan primipara dan 61,5% adalah perempuan multipara. Sementara untuk status pekerjaan, 68.8% adalah kelompok tidak bekerja dan 31,2% adalah kelompok bekerja. Responden yang mendapat tingkat dukungan suami yang kurang ada sebanyak 47,9% dan dukungan suami yang baik ada 52.1%. Responden yang mengalami PPB ada sebanyak 44,8% dan yang tidak mengalami PPB ada sebanyak 55,2%. Terdapat hubungan yang bermakna antara dukungan suami PPB dengan nilai p=0,042 dan OR sebesar 2,331. Kesimpulan: Terdapat hubungan yang bermakna antara dukungan suami dan PPB. Kata kunci: dukungan suami, gangguan postpartum blues, keluarga.
Made Ariyana, Diah R. Hadiati, Irwan T. Rachman, Dewajani Purnomosari
Indonesian Journal of Obstetrics and Gynecology pp 126-129; https://doi.org/10.32771/inajog.v9i3.1430

Abstract:
Objective: To compare Bax protein expression in throphoblast cells of early and late onset PE. Methods: A cross sectional study involving 36 cases of early onset PE and 36 cases of late onset PE was conducted. Bax protein expression was evaluated from sample of placental tissue collected from the study population and calculated using H-Score. Data on age, number of parity, gestational age, body mass index was collected from the medical records. Expression of Bax was compared using Mann-Whitney test. Results: There was no difference in the clinical characteristics (age, number of parity, BMI, SBP, DBP, and MAP) between the two groups. There was no difference in the expression of Bax protein between the early and late onset PE (mean H-score early vs. late onset PE: 1.48 vs 1.46, p=0.814, Mann Whitney U test). Clinical characteristics of the study population also did not correlate with the Bax expression (R for number of parity: 0.052, age: 0.009, gestational age: -0.014, BMI: 0.063, all p values were >0.05, linear regresion). Conclusion: There is no difference in the expression of Bax protein of throphoblast cells between early and late onset PE. Keyword: apoptosis, BAX, early onset, late onset, preeclampsia Abstrak Tujuan: Untuk membandingkan ekspresi protein Bax dalam sel trofoblas pada preeklamsia (PE) onset dini dan lambat. Metode: Sebuah studi potong lintang yang melibatkan 36 kasus PE onset dini dan 36 kasus PE onset lambat dilakukan. Ekspresi protein Bax dievaluasi dari sampel jaringan plasenta yang dikumpulkan dari populasi studi dan dihitung menggunakan skor-H. Data usia, jumlah paritas, usia kehamilan, indeks massa tubuh dikumpulkan dari rekam medis. Ekspresi Bax dibandingkan menggunakan uji Mann-Whitney. Results: Tidak terdapat perbedaan pada karakteristik klinis (usia, jumlah paritas, IMT, TDS, TDD, dan MAP) antara kedua kelompok. Tidak terdapat perbedaan dalam ekspresi protein Bax antara PE onset dini dan lambat (rata-rata H-skor PE onset dini dan lambat: 1.48 vs 1.46, p = 0.814, uji Mann Whitney U). Karakteristik klinis populasi studi juga tidak berkorelasi dengan ekspresi Bax (R untuk jumlah paritas: 0,052, usia: 0,009, usia kehamilan: -0,014, BMI: 0,063, nilai p dari semua variable tersebut adalah sebesar >0,05, dengan menggunakan regresi linier). Kesimpulan: Tidak terdapat perbedaan dalam ekspresi protein Bax pada sel trofoblas antara PE onset dini dan lambat. Kata kunci: apoptosis, BAX, onset dini, onset lambat, preeklamsia
Hermie M.M. Tendean, Juneke J. Kaeng, Astrina Supandy
Indonesian Journal of Obstetrics and Gynecology pp 134-139; https://doi.org/10.32771/inajog.v9i3.1403

Abstract:
Objective : To determine the difference adiponectin serum levels in pregnant patient with severe preeclampsia and normotency in Manado. Methods : This study is a cross sectional study which the number of samples obtained was 52 samples in which the sample was divided into 26 pregnant samples with severe preeclampsia and 26 control samples. Samples were taken from Prof. dr. R. D. Kandou Manado Hospital and network hospitals around Manado within the inclusion and exclusion criteria. All patients were explained about the research procedure and singning the informed consent and take a blood sample by using the ELIZA method. After the data is collected, it is entered into the SPSS version 23.0 program for data analysis. Results : There was a significant relationship between adiponection serum levels with the incidency of severe preeclampsia and normotency. But for body mass index variables there were no significant differences by using T test (independent sample) in each severe preeclampsia and normotency pregnancy group where p=0.903. Body mass index, height, weight, and weight gain during pregnancy showed that there is no difference between cases and controls (p>0.05) which means that body mass index is not related to the stete of the severe preeclampsia and normotency. Conclusions : There was no relationship between BMI, age, parity, smoking, baby outcomes, delivery method and gestational age with the incidence of severe preeclampsia and normotency against adiponectin in this study. Keywords: adiponectin, obstetrics, preeclampsia. Abstrak Tujuan : Untuk mengetahui perbedaan kadar adiponektin serum pada pasien hamil preeklamsia berat dengan hamil normal di Kota Manado. Metode : Studi ini merupakan studi potong lintang. Jumlah Sampel yang didapatkan sebesar 52 sampel dimana sampel dibagi menjadi 26 sampel hamil dengan preeklamsia berat dan 26 sampel kontrol. Sampel diambil dari RSUP Prof. dr. R. D. Kandou Manado dan rumah sakit jejaring sekitar manado yang memenuhi kriteria inklusi dan eksklusi. Semua pasien dijelaskan mengenai prosedur penelitian dan penandatanganan inform consent baru dilakukan pengambilan sampel darah untuk dilakukan pemeriksaan laboratorium dengan menggunakan metode ELISA. Setelah data dikumpulkan, maka dimasukkan ke dalam program SPSS versi 23.0 untuk data analisis. Hasil : Perhitungan dengan menggunakan uji statistik Mann - Whitney menunjukkan bahwa terdapat perbedaan bermakna nilai rata-rata kadar adiponektin pada pasien hamil normal dengan pasien PEB (p = 0,000). Adanya hubungan bermakna kadar adiponektin dengan kejadian preeklamsia berat. Namun untuk variabel IMT yang dilakukan secara uji t (sampel independen) didapatkan kesimpulan tidak terdapat perbedaan bermakna pada masing-masing kelompok normotensi dan kelompok preeklamsia berat di mana p= 0,903, indeks massa tubuh, tinggi badan, berat badan, serta pertambahan berat badan selama kehamilan tidak berbeda antara kasus dan kontrol (p>0,5). Ini berarti bahwa IMT tidak berhubungan dengan keadaan terjadinya preeklamsia berat. Kesimpulan: Tidak didapatkan hubungan antara IMT, usia, paritas, merokok, luaran bayi, cara persalinan dan usia kehamilan dengan kejadian preeklamsia berat dan normotensi terhadap adiponektin pada penelitian ini. Kata kunci : adiponektin, obstetri, preeklamsia.
Amilya Pradita, Abkar Raden, Farida Kartini
Indonesian Journal of Obstetrics and Gynecology pp 130-133; https://doi.org/10.32771/inajog.v9i3.1449

Abstract:
Objective: The purpose of this study was to compare the use of polyglactin 910 (vicryrapide) and chromic catgut to perineal pain and healing wounds on postpartum. Method: This research is true experiment with a randomized controlled trial (RCT) and single-blind. The number of respondents pad this study of 40 respondents were divided into 20 respondents to the intervention group (vicrylrapide) and 20 respondents for the control group (chromic catgut). Data analysis using independent t-test. Results: Statistical test results using independent t-test for pain showed p = 0.035 <0.05 and for wound healing showed p = 0.000 <0.05 of a second can mean the results are there differences in the use of threads polyglactin 910 (vicrylrapide) and chromic catgut thread to perineal pain and healing wounds in the mother postpartum perineum. Conclusion: The use rapidevicryl thread to repair perineal perineum or stitches can reduce perineal pain and healing wounds better than the use of the chromic catgut thread. Keywords: chromic catgut, pain, polyglactin 910, rapide vicryl, wound healing of the perineum. Abstrak Tujuan: Untuk mengetahui perbandingan penggunaan polyglactin 910 (vicry rapide) dan chromic catgut terhadap nyeri dan penyembuhan luka perineum pada postpartum. Metode: Penelitian ini merupakan penelitian true experiment dengan randomized controlled trial (RCT) dansingle blind. Jumlah responden pada penelitian ini sebanyak 40 responden yang di bagi menjadi 20 responden untuk kelompok intervensi (vicryl rapide) dan 20 responden untuk kelompok kontrol (chromic catgut ). Analisis data menggunakan independent t-test. Hasil: Uji statistik menggunakan independent t-test untuk nyeri didapatkan hasil p=0,035<0,05 dan untuk penyembuhan luka didapatkan hasil p=0,000<0,05 dari kedua hasil tersebut dapat diartikan ada perbedaan penggunaan benang polyglactin 910 (vicryl rapide) dan benang chromic catgutterhadapnyeri perineum dan penyembuhan luka perineum pada ibu postpartum. Kesimpulan: Penggunaan benang vicryl rapide untuk perbaikan perineum atau penjahitan luka perineum dapat mengurangi nyeri perineum dan penyembuhan luka yang lebih baik dibandingkan dengan penggunaan pada benang chromic catgut. Kata kunci: chromic catgut, nyeri, penyembuhan luka perineum, polyglactin 910, vicryl rapide.
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