06 - RSUP Dr. Kariadi - Research Form.xlsx

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1	No	Exam Date	Register Number	Operator	Patient name	Usia (tahun)	Tinggi (m)	Berat badan saat pemeriksaan (kg)	BMI (kg/m2)	Berat badan sebelum hamil (kg)	Usia gestasi (berdasarkan taksiran persalinan)	Jumlah kehamilan	Jumlah abortus	Usia gestasi saat abortus	Komplikasi persalinan (1. Tidak ada; 2. Hipertensi; 3. Diabetes mellitus; 4. Lainnya)	Kontraksi (1. Tidak ada; 2. Ada, ireguler; 3. Reguler)	Perdarahan (1. Tidak ada；2. Ada)	BPD (mm)	HC (mm)	AC (mm)	FL (mm)	EFW (g)	AOP (°)	HPD (mm)	CL (sebelum dilatasi serviks , mm)	CL (setelah dilatasi serviks , mm)	Istirahat (REST)	Urethral angle	Retrovesical angle	Bladder neck symphysis distance (cm)	Bladder distance (cm)	Cervical distance (cm)	Rectal Ampulla Distance (cm)	Anteroposterior diameter of the hiatus (2D) (cm)	Subpubic angle	Area of levator hiatus (cm2)	Perimeter of levator hiatus (cm)	Anteroposterior diameter of levator hiatus(4D) (cm)	Transverse diameter of levator hiatus (cm)	Kontraksi	Anteroposterior diameter of the hiatus (2D) (cm)	Area of levator hiatus (cm2)	Perimeter of levator hiatus (cm)	Anteroposterior diameter of levator hiatus(4D) (cm)	Transverse diameter of levator hiatus (cm)	Levator avulsion (1. Tidak ada, 2. Ada)	Ani sphincter trauma (1. Tidak ada, 2. Ada)	Valsalva (Va)	Urethral rotation angle	Funnelling of the bladder neck (1. Tidak ada, 2. Ada)	Retrovesical angle	Bladder neck symphysis distance (cm)	Bladder neck descend (cm)	Bladder distance (cm)	cervical distance (cm)	rectal ampulla distance (cm)	Anteroposterior diameter of the hiatus (2D) (cm)	Area of levator hiatus (cm2)	Perimeter of levator hiatus (cm)	Anteroposterior diameter of levator hiatus(4D) (cm)	Transverse diameter of levator hiatus (cm)

2	No	Exam Date	YYYYMMDD-00	Doctor's name	Name	Age	Height	Weight	GX/(FX^2)	Weight before pregnant	GA by EDD				Complications of pregnancy	Contractions	Bleeding						Calliper Angle	Calliper DIstance	Transvaginal CL	Lebar Funnel (mm), Panjang Funnel (mm), Sisa panjang cervix (mm)		UTA (R)	RVA (R)	BSD (R)	BPW-SP Dist (R)	Cx-SP Dist (R)	RA-SP Dist (R)	LHAP pada 2D (R) Calliper Distance	Calliper Angle	LH Area (R)	LH Circ (R)	LH AP DIam (R)	LH Lateral Diam (R)		LH AP Calliper DIstance	LH Area (C)	LH Circ (C)	LH AP Diam (C)	LH Lateral Diam (C)				URA(c)		RVA (Va)	BSD (Va)	[BSD (R) - BSD (Va)]	BPW-SP Dist (Va)	Cx-SP Dist (Va)	RA-SP Dist (Va)	Calliper DIstance	LH Area (Va)	LH Circ (Va)	LH AP Diam (Va)	LH Lateral Diam (Va)
4	X	11/11/2022	01-20221111-01	dr Fernandi	Mrs. W	32.00	1.60	76.00	29.69	62.00	34+2	2	0	0	1	1	1	87.60	305.50	31.40	64.20	2530.00	90.00	5.53	43.00			-21.00	113.00	3.19	3.22	4.57	2.74	5.22	58.00	16.04	17.36	5.60	4.40		3.73	11.20	13.48	4.10	3.40	1	1		26.00	1	124.00	1.32	1.87	1.36	3.01	0.06	5.05	16.65	17.02	5.30	4.00
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