Adly N.A. Fattah
Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Jakarta

Published : 4 Documents
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Urinary catheterization in gynecological surgery: When should it be removed? Fattah, Adly N.A.; Santoso, Budi I.
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (477.08 KB) | DOI: 10.13181/mji.v22i3.589

Abstract

Background: The aim of this study was to determine the most appropriate time for urinary catheter removal following a gynecological surgery.Methods: Critical appraisal of clinical trial articles were conducted. It was aimed to answer our clinical question whether 24-hour postoperative urinary catheter removal is superior compared to other durations in avoiding postoperative urinary retention (PUR) and urinary tract infection (UTI). The search was conducted on the Cochrane Library® and PubMed® using keywords “postoperative urinary retention”, “postoperative catheterization” and “urinary retention AND catheterization”. Reference lists of relevant articles were searched for other possibly relevant trials.Results: Seven articles were available as full text, then appraisals of six prospective RCTs involving 846 women underwent hysterectomy and vaginal prolapse surgery were performed finding at the re-catheterization and UTI rate. Subjects in earlier-removal groups were 3 to 4 times more likely to have re-catheterization (OR = 3.10-4.0) compared to later-removal groups, while they who have it removed on 5th day were 14 times more likely to develop UTI compared with immediate group (OR = 14.786, 95% CI 3.187- 68.595).Conclusion: The 24-hour catheterization policy in hysterectomy and vaginal prolapse surgery remains most appropriate although associated with an increased risk of re-catheterization. The removal of catheter before 24 hour (6 or 12 hour) could be considered to be used as one of interventions in further RCT(s) to find out the best duration which would result in lowest incidence in both of UTI and  PUR. (Med J Indones. 2013;22:183-8. doi: 10.13181/mji.v22i3.589)Keywords: Catheter, hysterectomy, prolapse, urinary tract infection
Determinants of low APGAR score among preeclamptic deliveries in Cipto Mangunkusumo Hospital: a retrospective cohort study in 2014 Susilo, Sulaeman A.; Pratiwi, Karina N.; Fattah, Adly N.A.; Irwinda, Rima; Wibowo, Noroyono
Medical Journal of Indonesia Vol 24, No 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.651 KB) | DOI: 10.13181/mji.v24i3.1229

Abstract

Background: Preeclampsia has great implication on adverse neonatal outcome. Appearance, pulse, grimace, activity, respiration (APGAR) score at 1 or 5 minutes is one of the indicators of physiologic maturity of the infant. Therefore, the aim of this study was to know the correlation of APGAR score in preeclamptic deliveries with its risk factors. Methods: This study was a retrospective cohort. Data were collected from January to December 2013 including all preeclamptic women with singleton live pregnancies who delivered their babies in Cipto Mangunkusumo Hospital, Jakarta. The primary outcome was APGAR score. There were some determinants conducted in this study. Binary logistic was used as multivariate analysis to analyze the correlation between APGAR score and risk factors of preeclampsia, data were analyzed using chi square test. Results: Out of 450 preeclamptic women, 446 of them met the inclusion criteria. Low APGAR scores at 1 and 5 minutes were found in 19% (86/446) and 5.4% (24/446) of neonates respectively. Early onset of preeclampsia (adjusted OR = 4.577; 95% CI = 2.147 - 9.757), white blood cell ≥ 15,000/μL (adjusted OR = 3.315; 95% CI = 1.738 – 6.324), HELLP syndrome (adjusted OR = 2.00; 95% CI = 1.38 – 2.91) were independent risk factors for having infant with low APGAR score at 1 minute. Meanwhile, there was no significant risk factors at 5 minutes APGAR score after adjustment.Conclusion: Leukocytosis, early onset preeclampsia, preterm birth, and thrombocytopenia, severity of preeclampsia, and HELLP syndrome are independent risks of having infant born with low APGAR score at 1 minute in preeclamptic deliveries.
Indonesian local fetal-weight standard: a better predictive ability for low Apgar score of SGA neonates Fattah, Adly N.A.; Pratiwi, Karina N.; Susilo, Sulaeman A.; Berguna, Jimmy S.N.; Irwinda, Rima; Wibowo, Noroyono; Santoso, Budi I.; Zhang, Jun
Medical Journal of Indonesia Vol 25, No 4 (2016): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (511.187 KB) | DOI: 10.13181/mji.v25i4.1301

Abstract

Background: Accurate assessment of fetal growth is one of crucial components of antenatal care. A generic reference for fetal-weight and birthweight percentiles that can be easily adapted to local populations have been developed by Mikolajczyk and colleagues. This study aimed to validate our own local percentile standard by evaluating the odds ratio (OR) of low 1st and 5th minute Apgar score for small-for-gestational age (SGA) versus those not SGA.Methods: We used the generic reference tools for fetal-weight and birthweight percentiles developed by Mikolajczyk and colleagues to create our own local standard and then defined the SGA neonates. For validation, we used the database of singleton live deliveries (2,139 birth) during January 1st to December 31st 2013 in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. We compared our reference with that of Hadlock and colleagues. For every reference, the OR of Apgar score <7 at 1st and 5th minutes for infants who were SGA versus those not estimated with bivariate and multivariate analyses.Results: SGA found in 35% (748/2,139) and 13% (278/2,139) of neonates using the definition derived from Indonesian standard and Hadlock’s. OR of Apgar score <7 at 1st and 5th minutes were 3.45 (95% CI=2.56–4.65) and 3.05 (95% CI=1.92–4.83) for the Indonesian local fetal-weight standard compared with respectively 2.14 (95% CI=1.65–2.76) and 1.83 (95% CI=1.21–2.77) for Hadlock and collegues’ reference.Conclusion: Indonesian local fetal-weight standard has a better ability to predict low 1st and 5th minutes Apgar scores of SGA neonates than has the Hadlock and collegues’ reference.
High preterm birth at Cipto Mangunkusumo Hospital as a national referral hospital in Indonesia Sungkar, Ali; Fattah, Adly N.A.; Surya, Raymond; Santoso, Budi I.; Zalud, Ivica
Medical Journal of Indonesia Vol 26, No 3 (2017): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (383.934 KB) | DOI: 10.13181/mji.v26i3.1454

Abstract

Background: Preterm birth is the leading direct that causes neonatal death. Indonesia was listed as one of the countries with the greatest number of preterm birth in 2010. This study aims to identify the prevalence and the potential risk factors of preterm birth among women underwent delivery in Cipto Mangunkusumo Hospital, an Indonesian national reference hospital.Methods: This retrospective cohort study involved 2,612 women who delivered between January and December 2013. Any clinical data which related to the potential risk factors and outcomes were recorded. The data were managed using chi-square for bivariate analysis and t-test or Mann-Whitney for numerical data followed by multiple logistic regression for multivariate analysis in SPSS version 20.0.Results: Preterm birth affected 1,020 of 2,616 pregnancies (38.5%). Non-booked patients increased nearly twice risk for preterm delivery (OR 1.89, 95% CI 1.37–2.61). While women with singleton pregnancy (OR 0.17, 95% CI 0.12–0.25), head presentation (OR 0.75, 95% CI 0.63–0.89), and regular ANC (OR 0.67, 95% CI 0.54–0.84) had lower risk for preterm birth. Apgar score, birthweight, and mode of delivery were significantly different between the pre-term group and the full-term group.Conclusion: Prevalence of preterm birth in Cipto Mangunkusumo Hospital was approximately 2.5 times higher compared to the national number. Several factors reducing preterm birth rate include singleton pregnancy, head presentation, and regular ANC.