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All Journal Indonesian Journal of Obstetrics & Gynecology Science Journal of Maternal and Child Health Indonesian Journal of Perinatology Indonesian Basic and Experimental Health Sciences

Bachnas, Muhammad Adrianes

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Author-ID : 2034768

Health Professions Medicine & Pharmacology Nursing Public Health

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Prenatal Diagnosis and Management of Advanced Abdominal Pregnancy in Dr. Moewardi Hospital Surakarta: A Case Series Akbar, Uchti; Anggraini, Nutria Widya Purna; Yuliantara, Eric Edwin; Bachnas, Muhammad Adrianes; Ridwan, Robert; Sulistyowati, Sri
Journal of Maternal and Child Health Vol. 6 No. 5 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: The abdominal pregnancy is a pregnancy anywhere in the abdominal cavity other than the tube, ovary, and broad ligament. Abdominal pregnancy has 7.7 times greater risk than tubal pregnancy and 90 times greater than intrauterine pregnancy. This study aims to reveal the diagnosis and treatment of abdominal pregnancy in Dr. Moewardi Hospital Surakarta. Subjects and Method: This was a case series study conducted at Dr. Moewardi Hospital Surakarta. This study report three cases of advanced abdominal pregnancy at Dr Moewardi Hospital (2019 – 2020), that consisted of two cases of advanced abdominal pregnancy to term, and one advanced abdominal pregnancy with acute abdomen. Case presentation: Case 1 (it was found abdominal pregnancy at 30 weeks), the condition of the mother and the fetus was good, the pregnancy was continued until the gestational age was term. The patient was given corticosteroids for lung maturation and magnesium sulfate for neuroprotection. Case 2 (an abdominal pregnancy was found at term), it was decided to immediately terminate it with good preoperative preparation. Both patients in case 1 and case 2 had good result in both the mother and the fetus. The placenta was left in situ in both cases to prevent massive bleeding and injury to the gastrointestinal organs. Case 3 (advanced abdominal pregnancy with acute abdominal symptoms) decided to undergo an emergency laparotomy and removal of the placenta. Conclusion: Abdominal pregnancy must be diagnosed and managed properly to reduce maternal mortality and morbidity. In advanced abdominal pregnancy, it could be considered to continue the pregnancy until the term. The placenta management of in situ without methotrexate might be considered in cases of abdominal pregnancy.

Enhancing Nutrients Knowledge during Pregnancy through Webinars to Prevent Stunting Bachnas, Muhammad Adrianes; Sulistyowati, Sri; Yuliantara, Eric Edwin; Anggraini, Nutria Widya Purna; Prabowo, Wisnu; Respati, Supriyadi Hari; Nurinasari, Hafi; Ridwan, Robert; Astetri, Lini; Yuliani, Saffana Oka; Carissa, Dinda; Alamsyah, Meuthia
Journal of Maternal and Child Health Vol. 7 No. 5 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Background: Indonesia still has a high stunting rate, 1.2 million out of 5 million births each year result in stunted baby growth. linear growth in utero, the process can be caused by maternal malnutrition, which can result in intrauterine growth inhibition and low birth weight, and result in stunting. This study aims to analyze the effectiveness of the webinar in improving nutrition knowledge during pregnancy to prevent stunting growth. Subjects and Method: This is a cross sectional study conducted in July, 15th 2022 using the Zoom Meeting webinar platform. Target population are all young POGI and POGI Members who took part in webinars and online conversations using the Zoom Meeting program. This study used random sampling, and sample size are 161. The independent variables of this study was learning via webinars while the dependent variable was nutrient knowledge. Data were analyzed by paired t-test statistical test. Results: There was a significant difference score of knowledge in pregnant women after (Mean= 8.60) compared to before webinars (Mean= 6.52). Conclusion: The result of this study indicates that learning method via webinars increased maternal understanding about optimal nutrient during pregnancy. Keywords: stunting, nutrients, webinar, pregnant women Correspondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi General Hospital, Surakarta, Central Java, Indonesia. Jl. Kolonel Sutarto No. 132 Jebres, Surakarta. Email: nutria_dr@staff.uns.ac.id. Mobile: 08122651819.

A Systematic Review of NT-proBNP as Prognostic Biomarker for Preeclampsia Complications Bachnas, Muhammad Adrianes; Asaduddin, Aiman Hilmi; Ali, Agni Shalha; Indarta, Ardhia Fefrine; Anshari, Shafira Yasmine; Febrinasari, Ratih Puspita; Widyaningsih, Vitri
Journal of Maternal and Child Health Vol. 9 No. 2 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejmch.2024.09.02.06

Background: Preeclampsia can lead to maternal and fetal complications due to its ability to cause multiple organ disorders. Interestingly, N-terminal pro-brain-type natriuretic peptide (NT-proBNP) levels were higher in preeclampsia than in non-preeclampsia, representing cardiovascular mal¬function as the potential cause. Moreover, NT-proBNP also has a potential role in predicting complications that will arise in preeclampsia. This systematic review was performed to determine the role of NT-proBNP plasma levels in predicting maternal and fetal complications in preeclampsia.Subjects and Method: This systematic review was conducted based on PRISMA-P by previous observational study from scientific databases, namely Hinari, Cochrane Library, ScienceDirect, Scopus, and grey literature in OCLC’s OAISTER between 2006 and 2021. The search keyword used were ((NTproBNP) OR (NT-proBNP) OR (N-terminal pro-BNP) OR (N-terminal pro-Brain Natriuretic Peptide)) AND ((preeclampsia) OR (pre-eclampsia)) AND (pregnancy complications). Newcastle - Ottawa Quality Assessment Scale (NOS) was used to assess quality of included studies.Results: After study selection, five studies from 156 studies were considered eligible and selected in this systematic review. The results showed that pre-eclampsia complications occurred with NT-proBNP levels above 500 mg/dL, which cardiovascular complications may occurred above 700 mg/dL. NT-proBNP levels were higher in women with maternal complications such as placental abruption, HELLP (Hemolysis, elevated liver enzyme levels, and low platelet levels) syndrome, eclampsia, pulmonary oedema, congestive heart failure, cerebrovascular accident, renal dysfunction, and hypertensive retinopathy. Furthermore, increased NT-proBNP levels were associated with fetal growth restriction, resulting in low birth weight. NT-proBNP was significantly higher in pregnant women due to a combination of pre-existing volume overload and NT-proBNP clearance dysfunction in kidney. Conclusion: NT-proBNP levels were associated with adverse outcomes in preeclampsia. NT-proBNP serum levels could be used to predict maternal-fetal complications in preeclampsia.

Syphilis in Pregnancy: Education to Increase Knowledge in Reproductive Couples Sulistyowati, Sri; Bachnas, Muhammad Adrianes; Yuliantara, Eric Edwin; Anggraini, Nutria Widya Purna; Respati, Supriyadi Hari; Nurinasari, Hafi; Ridwan, Robert; Astetri, Lini; Nuur, Aliffudin; Pradana, Muhammad Denny Gagah; Khoeronisa, Siti; Rahmawati, Oktantia Dyah
Journal of Maternal and Child Health Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejmch.2025.10.04.01

Background: Syphilis is believed to be one of the oldest diseases, first discovered in the late 15th century. Indonesian Ministry of Health reported a total of 76,923 new cases in 2020. WHO has set an ambitious target to reduce the incidence by 90% before 2030, in spite of slow global response. This number is lower than the number obtained in 2019, which was 4,169 people. Syphilis can be transmitted through sexual contact, blood transfusion, and vertical mother-to-child transmission (MTCT). It is estimated that the risk of transplacental infection ranges from 20-80%, depending on various factors, such as the stage of infection in the mother. This study aimed to assess the effect of counseling in increasing patient knowledge of syphilis cases in pregnancy. Subjects and Method: This was a quasi experiment conducted at obstetrics and gynecology department in Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia, in June 2025. A sample of 84 pregnant women was selected for this study. The independent variable was counselling. The dependent variable was knowledge about Syphilis in pregnancy. Knowledge was tested before and after counselling. The data were examined using independent t test. Results: The knowledge score of pregnant women about syphilis after the intervention (Mean= 77.14; SD= 13.85) was higher than before (Mean= 56.43; SD= 15.88), and it was statistically significant (p <0.001). Conclusion: The results of this study indicate that this recovery is effective in improving understanding of syphilis cases in pregnancy in obgyn polyclinic patients at Dr. Moewardi Hospital.

Ethnopharmacological insights and clinical prospects of ten Indonesian medicinal plants for pregnancy, postpartum, and lactation: a systematic review Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Rahardjo, Theresia Monica; Suryawan, Aloysius; Rahardjo, Bambang; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.77

Background: The perinatal period involves significant physiological and metabolic transitions, particularly concerning hypertensive disorders, preeclampsia, hemorrhage, lactation challenges, and oxidative stress. Although pharmacological therapies are available, their safety and accessibility remain inconsistent, especially in resource-limited settings. Indonesia’s extensive biodiversity and deep-rooted ethnomedicinal traditions offer promising yet underutilized botanical alternatives. This study aimed to review the efficacy of Indonesian medicinal plants used in pregnancy, postpartum, and lactation. Methods: This systematic review investigates ten Indonesian medicinal plants traditionally used during pregnancy, postpartum recovery, and lactation: Sauropus androgynus, Curcuma longa, Moringa oleifera, Nigella sativa, Centella asiatica, Orthosiphon aristatus, Syzygium polyanthum, Andrographis paniculata, Solanum nigrum, and Zingiber officinale. Literature from 2000 to 2025 was reviewed using PRISMA guidelines across global and regional databases. Phytochemical composition, mechanisms of action, therapeutic effects (e.g., antihypertensive, antidiabetic, galactagogue, hemostatic, antioxidant), and clinical relevance were critically evaluated. Results: All ten plants demonstrated pharmacological potential relevant to perinatal health challenges. Notably, Zingiber officinale offers antiemetic and anti-inflammatory benefits during early pregnancy, complementing the lactogenic, antihypertensive, and wound-healing properties of other species. However, gaps persist in human trials, dosage standardization, and regulatory oversight. Conclusion: The review highlights the importance of integrating validated traditional botanicals into perinatal care through interdisciplinary research, targeted clinical trials, and culturally responsive health policies. Bridging ethnopharmacology with maternal health systems offers a scalable, sustainable pathway toward maternal wellness and equity in Indonesia and comparable global settings.

Blood Cadmium and Preterm Birth: A Systems Toxicology Review of Molecular Mechanisms, Placental Disruption, and Translational Obstetric Implications Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Pribadi, Adhi; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.949

Objectives: Preterm birth (PTB) remains a leading global cause of neonatal morbidity and mortality, with multifactorial origins including inflammation, endocrine disruption, and placental dysfunction. Recent evidence identifies cadmium (Cd), a persistent environmental toxicant, as a modifiable contributor to PTB. This review aims to integrate the mechanistic, molecular, and clinical literature on maternal blood cadmium exposure and its role in the pathogenesis of PTB.Methods: A systematic and integrative review was conducted following PRISMA 2020 guidelines. Literature from 2000 to 2025 was retrieved using PubMed, Scopus, Embase, and Web of Science. Eligible studies included molecular toxicology, animal models, human epidemiological data, and placental mechanistic research addressing cadmium exposure and preterm birth. Inclusion criteria emphasized mechanistic clarity, gestational outcome relevance, and measurable cadmium biomarkers. Figures, tables, and mechanistic diagrams were used to illustrate toxicological convergence pathways.Results: Cadmium disrupts placental homeostasis via oxidative stress, endothelial dysfunction, impaired trophoblast invasion, progesterone suppression, and activation of inflammatory cascades such as the NLRP3 inflammasome. Consistent associations between maternal cadmium burden and PTB risk were found across animal, cellular, and human population studies. However, heterogeneity in exposure assessment, absence of unified risk thresholds, and confounding from co-exposures challenge causal inference. Literature remains fragmented, lacking integration between mechanistic insights and clinical risk models.Conclusions: Cadmium should be reclassified as a central agent in the pathophysiology of PTB. We propose a precision obstetrics framework that includes environmental cadmium screening in high-risk pregnancies, implementation of exposome-informed policies, and prospective multicenter studies with molecular endpoints. Obstetric care must evolve to include toxicological risk profiling as standard practice in the prevention of PTB.Kadmium dalam Darah dan Kelahiran Prematur: Tinjauan Toksikologi Sistemik terhadap Mekanisme Molekuler, Disrupsi Plasenta, dan Implikasi Obstetri TranslasiAbstrakTujuan: Kelahiran Prematur (preterm birth/PTB) tetap menjadi penyebab utama morbiditas dan mortalitas neonatal di seluruh dunia dengan etiologi multifaktorial yang mencakup inflamasi, gangguan endokrin, dan disfungsi plasenta. Bukti terbaru mengidentifikasi kadmium (Cd), suatu toksikan lingkungan persisten, sebagai faktor kontribusi yang dapat dimodifikasi terhadap PTB. Tinjauan ini bertujuan untuk mengintegrasikan literatur mekanistik, molekuler, dan klinis mengenai paparan kadmium dalam darah maternal dan perannya dalam patogenesis PTB.Metode: Tinjauan sistematis dan integratif dilakukan sesuai pedoman PRISMA 2020. Literatur dari tahun 2000 hingga 2025 dikumpulkan melalui database PubMed, Scopus, Embase, dan Web of Science. Studi yang memenuhi syarat mencakup toksikologi molekuler, model hewan, data epidemiologi manusia, dan penelitian mekanistik plasenta yang mengevaluasi hubungan antara paparan kadmium dan kelahiran prematur. Kriteria inklusi menekankan kejelasan mekanistik, relevansi terhadap hasil kehamilan, serta penggunaan biomarker kadmium yang terukur. Gambar, tabel, dan diagram mekanistik digunakan untuk mengilustrasikan jalur konvergensi toksikologis.Hasil: Kadmium mengganggu homeostasis plasenta melalui stres oksidatif, disfungsi endotel, gangguan invasi trofoblas, supresi progesteron, dan aktivasi jalur inflamasi seperti inflammasom NLRP3. Hubungan konsisten antara beban kadmium maternal dan risiko PTB ditemukan dalam studi hewan, seluler, dan populasi manusia. Namun, adanya heterogenitas dalam penilaian paparan, belum adanya ambang risiko yang seragam, serta pengaruh faktor pajanan lainnya menjadi tantangan dalam penarikan kesimpulan kausal. Literatur masih terfragmentasi dan belum mengintegrasikan temuan mekanistik dengan model risiko klinis secara menyeluruh.Kesimpulan: Kadmium seharusnya diklasifikasikan ulang sebagai agen sentral dalam patofisiologi PTB. Kami mengusulkan suatu kerangka kerja obstetri presisi yang mencakup skrining lingkungan terhadap kadmium pada kehamilan berisiko tinggi, menerapkan kebijakan berbasis exposome, serta studi prospektif multisentra dengan titik akhir molekuler. Pelayanan kebidanan harus berkembang dengan mengadopsi profil risiko toksikologis sebagai bagian dari praktik standar dalam pencegahan kelahiran prematur.Kata kunci: Disrupsi Plasenta; Interaksi Endokrin-Inflamasi; Kesehatan Reproduksi Lingkungan; Mekanisme Kelahiran Prematur; Toksisitas Kadmium,

TWIN TO TWIN TRANSFUSION SYNDROME APA YANG DAPAT KITA LAKUKAN DI PERIFER? Bachnas, Muhammad Adrianes
Indonesian Basic and Experimental Health Sciences Vol. 12 No. 1 (2023): November
Publisher : Rumah Sakit Umum Daerah Dr. Moewardi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ibehs.vol12iss1pp35-40

PENDAHULUAN Twin-Twin transfusion syndrome (TTTS) merupakan tantangan tersendiri bagi perifer. Hingga saat ini Fetoscopic laser photocoagulation (FLP) baru tersedia satu di seluruh Indonesia, yaitu di RSAB Harapan Kita, Jakarta. Sementara menurut perhitungan rasio kejadian TTTS terhadap angka kelahiran di Indonesia, tidak kurang dari 3000 kasus TTTS terjadi pertahunnya. Artinya, 10 kasus perhari membutuhkan tindakan tersebut. Maka bila di satu senter layak mengerjakan maksimal 3 kasus maka dibutuhkan 3-4 senter fetoskopi di Indonesia. Sementara kita menunggu terbitnya senter fetoskopi selain RSAB Harapan Kita Jakarta, maka apa yang mungkin dan bisa kita lakukan? TUJUAN Memberikan gagasan manajemen TTTS untuk daerah perifer berbasis telaah literatur beserta telaah kasus serial yang ditangani. Metode: Serial Kasus HASIL Empat kasus TTTS terdiagnosis rata-rata pada minggu 26.5 kehamilan (dari 23 – 29 minggu). Satu kasus datang sudah dalam persalinan tanpa intervensi. Satu kasus dilakukan amnnioreduksi. Dua kasus dapat dilakukan 50% dilakukan septostomi dan amnioreduksi. Lama waktu dari intervensi sampai dengan bayi lahir 19.6 hari. Didapatkan 100% (8 bayi) lahir hidup, tetapi hanya 37.5% (3 bayi) yang dapat bertahan hidup. Dua bayi lahir dari ibu yang sama dengan usia kehamilan 36 minggu, sayang bayi resipien meninggal beberapa saat setelah dilahirkan. Pada kasus lain Satu bayi donor juga berhasil bertahan hidup pasca tindakan septostomi yang lahir pada usia 32 minggu sementara resipien meninggal pasca salin. Cara persalinan, 50% (2 kasus) pervaginam dan 50% (2 kasus) perabdominam. KESIMPULAN Tindakan pertama terpilih untuk TTTS adalah fetoskopi dan laser ablasi dengan angka keselamatan kedua janin lebih dari 90%, hanya saja dikarenakan fasilitas ini belum tersedia di RSUD Dr. Moewardi maka diambil pilihan kedua, yaitu melakukan septostomi dan amnioreduksi. Tindakan septostomy dapat mencegah kompresi tali pusat pada janin donor akibat oligohidramnion, sehingga mengurangi probabilitas kematian intrauterin. Tindakan amnioreduksi dilakukan simultan setelah septostomy dapat mengurangi dypsnea dan nyeri perut akibat overdistensi serta prematuritas. Timing septostomi dan amnioreduksi ternyata sangat menentukan untuk setidaknya dapat menolong salah satu janin.

Cancer in Pregnancy in Indonesia: A Global Review and 2022–2025 Cohort Analysis of Maternal and Neonatal Outcomes Elita Rahmi; Bachnas, Muhammad Adrianes; Sri Sulistyowati
Journal of Maternal and Child Health Vol. 10 No. 5 (2025)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejmch.2025.10.05.03

Background: Cancer during pregnancy is rare but presents serious challenges, especially in low- and middle-income countries like Indonesia. Limited national data, delayed diagnosis, and lack of standardized care make management difficult. Global awareness is growing, but regional differences in outcomes remain poorly understood. This study aims to provide a comprehensive overview of cancer during pregnancy, including its clinical characteristics and maternal-fetal outcomes both in Indonesian and global data. Subjects and Method: This systematic review was conducted following PRISMA guidelines from databases of PubMed, EMBASE, Scopus, and additional search, published between 2022 and April 2025. The included studies reported the global depiction of pregnancy-associated cancer. Newcastle-Ottawa Quality Assessment Scale (NOS) was used to assess the quality of observational included studies, while the Joanna Briggs Institute checklists for assessment of case reports. Results: A total of 14 studies were included based on the criteria, with a total population of 29,403 pregnant women associated with cancer. From this systematic review, the most found cancers during pregnancy were breast cancer, cervical cancer, and ovarian cancer, both from Indonesian data and global studies. Compared to global studies, obstetric complications were more prevalent in Indonesia, including preterm birth (64% vs 52%, respectively); very preterm birth (22% vs 15%, respectively); caesarean delivery (76% vs 65%, respectively); preeclampsia (18% vs 12%, respectively); and postpartum haemorrhage (15% vs 10%, respectively). Conclusion: The global literature shows wide variation in cancer types, gestational timing, and outcomes. Indonesian cohort data show higher rates of preterm birth, low birth weight, and maternal complications compared to global averages. Delays in diagnosis and limited access to integrated cancer-obstetric care may explain these differences. The findings support the urgent need for national guidelines, early detection programs, and multidisciplinary care models for managing cancer in pregnancy in resource-limited settings.

Co-Authors Adhi Pribadi Akbar, Uchti Alamsyah, Meuthia Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Ali, Agni Shalha Aloysius Suryawan Andonotopo, Wiku Anshari, Shafira Yasmine Asaduddin, Aiman Hilmi Astetri, Lini Bambang Rahardjo Carissa, Dinda Cut Meurah Yeni Elita Rahmi Eric Edwin Yuliantara Evert Solomon Pangkahila I Nyoman Hariyasa Sanjaya Indarta, Ardhia Fefrine Julian Dewantiningrum Khoeronisa, Siti Kurjak, Asim Nurinasari, Hafi Nuswil Bernolian Nutria Widya Purna Anggraini Nuur, Aliffudin Pradana, Muhammad Denny Gagah Pramono, Mochammad Besari Adi Rahmawati, Oktantia Dyah Ratih Puspita Febrinasari Ridwan, Robert Ryan Saktika Mulyana Sri Sulistyowati Sri Sulistyowati Stanojevic, Milan Supriyadi Hari Respati Theresia Monica Rahardjo Vitri Widyaningsih Wiradnyana, Anak Agung Gede Putra WISNU PRABOWO Yuliani, Saffana Oka

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