Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Detection of Uterine Cavity Pathology in Subfertile Women Prior to In Vitro Fertilization Using Transvaginal Sonography and Office Hysteroscopy
Full text linkObjective: To compare transvaginal sonography (TVS) and office hysteroscopy in detecting uterine cavity pathology in subfertile women prior to in vitro fertilization (IVF).Methods: This retrospective cross-sectional study included 104 subfertile women who underwent both TVS and office hysteroscopy at the Yasmin IVF Clinic, Dr. Cipto Mangunkusumo Kencana Hospital, Jakarta. Findings from TVS and hysteroscopy were compared with histopathological results for chronic endometritis, endometrial polyps, submucosal fibroids, and endometrial hyperplasia. Findings of uterine septum and intrauterine synechiae on TVS were compared with hysteroscopy as the reference standard.
Results: Office hysteroscopy detected chronic endometritis in 16.3% of subjects, with a sensitivity of 33% and specificity of 68%, whereas TVS did not identify any cases. Submucosal fibroids were detected by both modalities with identical specificity (100%) and sensitivity (75%). Endometrial polyps were identified in 47.1% of cases by hysteroscopy and 15.4% by TVS. TVS demonstrated higher specificity (88% vs. 35%), although both modalities showed low sensitivity (15% for TVS vs. 50% for hysteroscopy). Both methods accurately detected endometrial hyperplasia, showing high specificity (97%). Uterine septum and intrauterine synechiae were detected exclusively by hysteroscopy.
Conclusion: Both TVS and office hysteroscopy are effective in detecting submucosal fibroids and endometrial hyperplasia. However, only hysteroscopy can identify chronic endometritis, uterine septum, and intrauterine synechiae, while TVS demonstrates higher specificity for detecting endometrial polyps. Histopathology remains the gold standard, and office hysteroscopy provides important complementary diagnostic value prior to IVF.
Keywords: in vitro fertilization, office hysteroscopy, sub-fertility, transvaginal sonograph
Pregnancy Outcomes in Women Aged 20–34 vs. ?35 Years: A Cross-Sectional Study in a Tertiary Referral Center
Full text linkObjective: This study aims to compare pregnancy outcomes between mothers under and over 35 years of age at Dr. Hasan Sadikin General Hospital.
Methods: An observational analytic approach with a cross-sectional design was used. Data from the medical records of 150 patients at Dr. Hasan Sadikin General Hospital in 2022 were analyzed. Patients were divided into two groups: ages 20-34 and greater than or equal to 35. Data analysis was performed using SPSS version 27.0.
Results: Advanced maternal age was significantly associated with mode of delivery [OR 2.16, 95% CI (1.08-4.28), p=0.048], hypertensive disorders of pregnancy [OR 3.99, 95% CI (1.86-8.38), p<0.001], and postpartum hemorrhage [OR 2.93, 95% CI (0.99-8.79), p=0.044].
Conclusion: This study affirmed that advanced maternal age is associated with adverse maternal outcomes, namely hypertensive disorders of pregnancy and postpartum hemorrhage. Moreover, compared to mothers aged 20-34, advanced maternal age is linked with higher rates of cesarean deliveries and forceps deliveries.
Keywords: Advanced maternal age pregnancy, Adverse maternal outcomes, Neonatal outcomes, Peak reproductive years, Complications of pregnanc
Placental Vitamin D, Oxidative Stress, and Senescence Markers in Spontaneous Preterm Birth: A Comparative Cross-Sectional Study
No full textAbstractObjective: To evaluate the associations between vitamin D metabolism markers and biomarkers of oxidative stress and placental senescence among women with spontaneous preterm labor compared with those with term labor.
Methods: We conducted a comparative cross-sectional study between 2017 and 2019 in two hospitals in Jakarta, Indonesia. Maternal serum and placental samples were collected from women with term labor and spontaneous preterm labor. Markers of the vitamin D pathway 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D? (1,25[OH]?D?), vitamin D receptor (VDR), and CYP27B1 along with oxidative stress (8-hydroxy-2--deoxyguanosine [8-OHdG]) and placental senescence markers (GLB1 and HMGB), were measured using ELISA, LC–MS/MS, and ICP–MS. Between-group comparisons were performed using parametric or nonparametric tests, as appropriate, and correlations were assessed using Pearson’s or Spearman’s correlation coefficients.
Results: A total of 67 women were included (term labor, n = 34; spontaneous preterm labor, n = 33), and both groups were vitamin D deficient. Placental 1,25(OH)?D? levels were significantly lower in the preterm group than in the term group (4.58 ± 2.90 vs 5.57 ± 3.50 pg/ng, p = 0.037). Placental VDR levels also differed significantly between groups {21.70 (6.06–73.40) vs 16.48 (1.87–74.67), p = 0.041}. Across all participants, 8-OHdG and placental senescence markers were negatively correlated with placental 25(OH)D and 1,25(OH)?D? levels and positively correlated with placental CYP27B1 and VDR expression.
Conclusion: In this comparative cross-sectional cohort, placental vitamin D metabolites were associated with lower levels of oxidative stress and placental senescence biomarkers, whereas VDR and CYP27B1 showed positive associations with these biomarkers. These patterns may reflect compensatory regulatory mechanisms in the context of maternal vitamin D deficiency. These findings are hypothesis-generating and warrant confirmation in prospective studies and mechanistic investigations.
Keywords: oxidative stress, placental senescence, spontaneous preterm labor, vitamin D
Eliminating Cervical Cancer in Asia–Pacific: From HPV Policy to Real-World Oncology Practice
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Maternal Immunization against Respiratory Syncytial Virus (RSV): Indonesian Consensus 2025
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Risk Factors for Stunting in Children Aged 24–59 Months in Jambi City, Indonesia, 2024
No full textAbstract Objective: To analyze factors associated with stunting among children aged 24–59 months at the Tanjung Pinang Community Health Center, Jambi City, Indonesia, in 2024. Methods: This quantitative cross-sectional study involved all stunted children registered at the Tanjung Pinang Community Health Center (n = 42). Total sampling was applied. The independent variables included child age, maternal age, maternal education, economic status, maternal knowledge, and maternal attitude. Data were collected using structured questionnaires with established validity and reliability. Statistical analysis was performed using the chi-square test, with a significance level set at p < 0.05. Results: The analysis showed no significant associations between stunting and child age (p = 0.509), economic status (p = 0.746), maternal education (p = 0.170), maternal knowledge (p = 0.355), or maternal attitude (p = 0.395). However, maternal age was significantly associated with the incidence of stunting (p = 0.024), with a higher risk observed among mothers aged <20 years and >35 years. Conclusion: Maternal age was the only factor significantly associated with stunting among children aged 24–59 months in this study. These findings highlight the importance of targeted interventions focusing on maternal age as part of stunting prevention strategies. Keywords: attitude, economic status, knowledge, maternal age, maternal education, stuntin
Determining Factors for Discontinuing Hormonal Contraceptive Use in Acceptors at The Kassi Kassi Community Health Center
No full textIntroduction : During the COVID-19 pandemic, several experts have reported the effects of pregnancy accompanied by COVID-19 on both the mother and infant, influenced by the symptoms and signs presented. This study aims to analyze the correlation between blood markers; C-Reactive Protein (CRP), D-Dimer, Neutrophil-to-Lymphocyte Ratio (NLR) and the severity of COVID-19 in pregnant women during the 2020 pandemic at Persahabatan Hospital, Jakarta.
Method : This cross-sectional study was conducted at Persahabatan Hospital, a National Respiratory Referral Center in Jakarta. A total of 525 pregnant women who met the inclusion criteria were evaluated. Laboratory markers, including CRP, D-Dimer, and NLR, were analyzed and categorized as normal or elevated. Data were analyzed using Chi-Square tests, and correlations were evaluated using Spearman’s rank correlation coefficient.
Result : The result of this study found that elevated biomarkers were significantly correlated with increased severity of disease. CRP (>10 mg/L), D-Dimer (>3333 mg/L), and NLR (>5.8) were all associated with moderate to severe disease. Statistical analysis showed significant correlations with p-values <0.005 and a 95% confidence interval.
Conclusion : Elevated CRP, D-Dimer, and NLR levels are associated with increased disease severity in pregnant women with COVID-19. These biomarkers can serve as useful predictors for the severity of the disease.
Keywords : Covid 19, CRP, D-Dimer, NLR , Pregnan
Maternal Risk Factors Associated with Neonatal Stunting: A Case–Control Study
Full text linkAbstractObjective: To identify maternal risk factors associated with neonatal stunting at Wonosari Hospital.
Methods: A case–control study was conducted involving mothers who gave birth at Wonosari Hospital in 2023. Maternal sociodemographic characteristics (age, education, and occupation), nutritional status (body mass index and mid-upper arm circumference), and pregnancy-related factors (gestational age, gestational status, hemoglobin levels, blood pressure, pregnancy complications, and mode of delivery), as well as newborn length at birth, were obtained from medical records. Neonatal stunting was defined as a length-for-age z-score < ?2 SD according to World Health Organization (WHO) standards. Statistical analysis was performed using chi-square tests and multiple logistic regression.
Results: A total of 154 participants were included, equally divided into case (stunted newborns) and control (non-stunted newborns) groups. Mothers with a lower educational level had significantly higher odds of delivering a stunted newborn (p= 0.010; aOR = 2.845; 95% CI = 1.286–6.293). Preterm birth was also associated with an increased risk of neonatal stunting (p= 0.033; aOR = 9.847; 95% CI = 1.210–80.152). In addition, pregnancy complications were significantly associated with higher odds of neonatal stunting (p = 0.020; aOR = 2.728; 95% CI = 1.171–6.352).
Conclusion: Maternal factors, including low educational level, preterm birth, and pregnancy complications, were significantly associated with neonatal stunting at Wonosari Hospital. These findings underscore the importance of maternal education in neonatal health outcomes. Furthermore, close monitoring of fetal growth and nutritional status, along with appropriate management of pregnancy complications, may help reduce the risk of neonatal stunting. However, larger-scale studies are needed to assess the population-level impact of these factors.
Keywords: neonatal, pregnancy complication, stunting
Risk Factors of Intrauterine Growth Restriction: A Case-Control Study
Full text linkAbstract
Objectives: To explore out whether age, rate of delivery, and hypertension are risk factors for IUGR in Bethesda Hospital Yogyakarta
Methods: A case control study was used by evaluating medical record of patient who diagnosed with IUGR in Bethesda Hospital Yogyakarta between January 2015 – December 2021.
Results: The sample size was 62 with a case number of 31 (IUGR) and in control patients without IUGR of 31. Based on bivariate analysis with chi square test, it was found the risk factor for IUGR was hypertension (P = 0,032; OR = 3,906). Risk factor age (P = 0,115) and rate of delivery (P = 0,446; OR = 1,681) were not found to be risk factor for IUGR.
Conclusion: Hypertension is a risk factor for IUGR, whereas age and rate of delivery are not risk factors for IUGR in Bethesda Hospital Yogyakarta.
Keywords: IUGR, age, rate of delivery, hypertension
Assessing Contraceptive Service Training Using the Kirkpatrick Model to Improve Health Worker Competency
Full text linkAbstractObjective: To evaluate contraceptive service training using the Kirkpatrick evaluation model levels 1–3.Methods: This quasi-experimental study was conducted based on the Kirkpatrick evaluation model to assess contraceptive service training in West Nusa Tenggara, Indonesia. Thirty health workers participated after providing informed consent. The competency-based training employed a blended learning approach, consisting of 57 hours of online theoretical instruction followed by 50 hours of face-to-face practical training. The training was evaluated at the reaction, learning, and behavior levels of the Kirkpatrick model. Participants were representatives from districts and municipalities across West Nusa Tenggara Province.Results: Participants reported a high level of satisfaction with the training (86.89%). Knowledge levels improved significantly, with mean scores increasing from 56.33 on the pre-test to 95.73 on the post-test. During the training, participants demonstrated effective counseling skills as well as competency in IUD and implant insertion and removal. However, the mean competency scores showed a decline one year after the training.Conclusion: The improvement in pre-test and post-test scores was statistically significant (p < 0.001). At the behavior level, a slight decrease in competency was observed after one year of follow-up.Keywords: contraceptive services, contraceptive training, evaluation, health worker, kirkpatrick model