Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Overview of Women's Reproductive Health Problems among Foreign Tourists in Health Services in Bali
Full text linkObjectives: To understand the overview of women's reproductive health problems among foreign tourists in several health services in Bali in 2022-2023.
Methods: The research design used is descriptive research with a cross-sectional method. The study sample consists of 103 samples selected through purposive sampling. Data from the research results will be analyzed univariately and processed using SPSS version 27. The research locations to be used are two private hospital in Bali
Results: The research results on foreign tourists with women's reproductive health problems revealed that the age group was predominantly 20-35 years, with 31 (60.8%) in 2022 and 34 (65.4%) in 2023. Most foreign tourists who visited did not have insurance, amounting to 32 (62.7%) in 2022 and 36 (69.2%) in 2023. The most common diagnosis was prolonged labor, with 20 (39.2%) in 2022 and 11 (21.2%) in 2023. The most frequent complaint was abdominal pain, experienced by 30 (58.8%) in 2022 and 19 (36.5%) in 2023. For the treatment of foreign patients with reproductive health issues, non-pharmacological treatment was predominant, with 34 (66.7%) in 2022 and 31 (59.6%) in 2023.
Conclusion: Based on the research conducted, the overview of women's reproductive health problems among foreign tourists in several health services in Bali in 2022-2023 is dominated by the age group 20-35 years, most of whom have health insurance. The most common diagnosis is prolonged labor, with the majority experiencing complaints of lower abdominal pain, and treatment predominantly involving non-pharmacological methods
Inflammatory Marker and their Association with COVID-19 Severity in Pregnant Women
Full text linkAbstract :
Objective: 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 with confirmed COVID-19 who met the inclusion criteria were included in the study. Laboratory markers, including CRP, D-Dimer, and NLR, were analyzed and categorized as normal or elevated. Data were analyzed using the Chi-square test, and correlations were evaluated using Spearman’s rank correlation coefficient.
Result :The results showed that elevated biomarkers were significantly correlated with increased disease severity. CRP (>10 mg/L), D-Dimer (>3333 mg/L), and NLR (?5.8) were all associated with moderate to severe disease. All biomarkers demonstrated a significant correlation with disease severity (p < 0.005).
Conclusion: Elevated CRP, D-Dimer, and NLR levels are associated with increased disease severity in pregnant women with COVID-19, suggesting their potential role as practical indicators for disease severity assessment.
Keywords : Covid 19, CRP, D-Dimer, NLR, Pregnant
Papaya Fruit (Carica papaya L.) and Its Effectiveness on Menstrual Patterns in Women Using Depo Medroxyprogesterone Acetate (DMPA): A Quasi-Experimental Study
Full text linkObjective: This study aims to determine the effectiveness of administering papaya ( Carica Papaya L) in Medroxy Depo Acceptor Progesterone Acetate (DMPA) on Menstrual Patterns in PMB Patmawati .
Method: Research was conducted at PMB Fatmawati. This research is a Quasy-Experiment research with a Posttest Only Control Group Design research design where this research was carried out by providing treatment (intervention) in the form of Papaya fruit ( Carica Papaya L) then observing the Menstrual Cycle Pattern. Next, the measurement results were compared with the measurement results in the control group who did not receive treatment (intervention) consuming papaya fruit ( Carica Papaya L).
Results: There was a significant effect between changes in menstrual patterns between groups that consumed papaya and those who did not consume papaya (p = 0.000) and thare was a significant difference before and after consuming papaya on changes in menstrual patterns (p=0.001).
Conclusion: Consuming papaya fruit regularly and consistently ( carica Papaya L) as an acceptor of Medroxy Depo Progesterone Acetate (DMPA) shows a good effect on changing menstrual patterns from previously irregular to regular
Keywords: DMPA, Papaya Fruit, Menstrual Cycl
Age at Sexual Debut as a Determinant of HPV Infection in Women with Clinically Normal Cervix in Indonesia
Full text linkObjectives: This study examined the association between sexual debut and HPV infection in Indonesian women with a clinically normal cervix, contextualized within the Sustainable Development Goals (SDGs).
Methods: This prospective cohort study utilized primary data from structured interviews and gynecological exams conducted by the Female Cancer Program (FCP) team across public and private health providers in Jakarta (January 2012–July 2018). Cervical cancer risk factors, including early sexual debut, were analyzed using odds ratios (ORs).
Results: A total of 1,390 women with a clinically normal cervix were enrolled in this study, with 52 (3.7%) testing positive for HPV-DNA. Statistical analysis indicated an odds ratio (OR) of 1.176 (95% CI: 0.598–2.316, p = 0.601) for early sexual debut.
Conclusion: This study showed that there was an insignificant association between sexual debut and HPV infection in clinically normal cervix. According to the SDGs, early sexual debut and cervical cancer are highly associated. In order to meet the SDGs by 2030, more research is required to validate this finding and assess additional co-factors connected to cervical cancer
Analysis of Causes, Maternal And Perinatal Outcomes In Third Trimester Pregnant Women With Normocytic Anemia
Full text linkAbstract
Objective : Analyzing the causes, maternal and perinatal outcomes in third trimester pregnant women.
Method :This research is a hybrid study which combines 2 research designs, namely descriptive analytical and observational with a cross sectional study approach to assess laboratory examinations of anemic pregnant women and a cohort to assess maternal & perinatal outcomes in third trimester pregnant women with normocytic anemia. Bivariate analysis was carried out using the chi square test to measure the strength of the relationship between variables. A complete blood count, ferritin, TIBC, serum Fe, reticulocyte and peripheral blood smear were carried out. This research was conducted on third trimester pregnant women with anemia.
Results :Of the 50 pregnant women who experienced normocytic anemia, there were (92,0%) mild anemia, (8,0%) moderate anemia and no severe anemia was found. Maternal and perinatal outcomes have a p value <0.05. Most pregnant women in the third trimester have low serum Fe < 37 µ/dL (52,2%) in mild anemia and normal serum Fe 37-148 µ/dL (75%) in moderate anemia, most have low ferritin < 13 ng/ dL in mild anemia (82,6%) and (100%) in moderate anemia, most high TIBC ? 389 µ/dL in mild anemia (87%) and (100%) in moderate anemia, all reticulocyte values ??are high (> 1,50%) in mild and moderate anemia.
Conclusion :Chronic diseases and infections were the biggest causes of normocytic anemia in third trimester pregnant women in this study, howeverNormocytic anemia in this study had a picture of serum ferritin and iron that almost resembled microcytic anemia, which was probably caused by iron deficiency, so it was necessary to examine C-Reactive Protein (CRP) as a biomarker/sign of infectious disease.The higher the degree of anemia, the greater the risk of birth problems, which will affect the birth process. Likewise with perinatal outcomes, the higher the degree of anemia, the greater the incidence of LBW and asphyxia in babies.
Keywords: Normocytic anemia, pregnancy, maternal and perinatal outcomes, serum Fe, ferritin, TIBC, reticulocyte
A Spontaneous Uterine Rupture in Placenta Accreta Spectrum: a case series
No full textObjectives: Diagnosing uterine rupture in placenta accreta spectrum (PAS) can be challenging, often confirmed only during surgery after the rupture has occurred. This poses significant risks of morbidity and mortality for both the mother and neonates. Therefore, it is crucial for obstetricians to understand the clinical signs of uterine rupture in PAS cases. We aim to present four cases of grade 3a PAS and their associated maternal and neonatal outcomes related to spontaneous uterine rupture.
Case management: Four cases of spontaneous uterine rupture attributed to FIGO grading 3A PAS occurred at Wahidin Sudirohusodo Hospital, a tertiary healthcare center in Makassar, South Sulawesi, Indonesia. All patients were multigravida with prior cesarean sections, presented at preterm gestational ages, and had histologically confirmed PAS. They were referred from secondary healthcare facilities. In two cases, spontaneous uterine rupture was identified prior to surgery, with the patients presenting in hypovolemic shock and intrauterine fetal demise. In the other two cases, the rupture occurred during laparotomy before any uterine procedure, and the neonates were delivered alive. During the emergency laparotomy, uterine ruptures were identified at the sites of placental attachment. In one case, an additional rupture was observed on the posterior uterine wall. Management included emergency classical cesarean section followed by supracervical hysterectomy, postoperative ICU admission, and massive blood transfusion. All mothers were discharged in stable condition.
Conclusion: Spontaneous uterine rupture in PAS cases is associated with increased maternal morbidity as well as neonatal mortality and morbidity.
Keywords: caesarean section, placenta accreta spectrum, spontaneous uterine rupture, classical cesarean section, supracervical hysterectom
Drospirenone–Ethinyl Estradiol and Cyproterone Acetate in Moderate Severe Acne with Hyperandrogenism: A Randomized Double-Blind Trial
Full text linkABSTRACT
Background: Acne vulgaris is a health problem experienced by 85% of people in Indonesia. The highest prevalence is in women, who attempt to treat acne vulgaris. Unsuccessful acne vulgaris therapy is associated with hormonal influences, the stimulation of the sebaceous glands by androgen hormones. Hyperandrogenism is experienced by 10% of women in Indonesia. The main therapy for hyperandrogens is ciproterone acetate. Drospirenone combined with ethinyl estradiol, apart from sparing pregnancy, is also thought to be effective in treating clinical symptoms of hyperandrogenism. Currently, there is no study on drospirenone for acne and hyperandrogen therapy in Indonesia.
Objective: Determine the efficacy of treatment combination 3-mg drospirenone and 20-microgram ethinyl estradiol as management of choice for moderate-severe acne vulgaris and symptoms of hyperandrogenism (hirsutism, secondary amenorrhea, and oligomenorrhea) for 3 cycles.
Method: A randomized clinical trial with a double-blind study was done. Consecutive sampling is based on a random allocation table. A total of 42 subjects were diagnosed with moderate-severe acne vulgaris with hirsutism, secondary amenorrhea and/or oligomenorrhea at RSCM, divided into 2 groups, 21 subjects using drospirenone 3 mg combined with 0.030 mg ethinyl estradiol (DRSP/EE) and 21 subjects using 2 mg ciproterone acetate and 0.035 mg ethinyl estradiol (CRPN/EE), followed with examination of free testosterone check in laboratory. There was 1 subject who dropped out (Cyproterone group). The duration of therapy was 3 months then evaluation of acne lesions, Ferriman Gallwey score (FG score), and menstrual period.
Results: Characteristics of study subjects with the majority of subjects aged 25-35 years, 51,3%. The education level of most subjects about 57,1%, was a bachelor's degree. Testosterone levels at the start of the study were 1,41±0,64 for the DRSP/EE group and 1,32±0,48 for the CRPN/EE group. For the degree of acne, 85.7% of subjects using DRPS/EE and 85% of subjects using CPRN/EE had reduced acne lesions with a P value of 0.645. For hirsutism by calculating the FG score, 61.9% of the subjects using DRSP/EE and 50% of the subjects consumed CPRN/EE had a decreased FG score with a value of P value 0.443, and their menstrual period became regular for 85.7% of the subjects using DRSP/EE and 90% of the subjects using CPRN/EE with P value 0.645.
Conclusion: Drospirenone and ethinyl estradiol are as effective as cyproterone acetate combined with ethyl estradiol as treatment of moderate to severe acne vulgaris, hirsutism, secondary amenorrhea, and oligomenorrhea.
Keywords: acne vulgaris, cyproterone acetate, drospirenone, hirsutism, secondary amenorrhe
Characteristics and treatment in patient with Vaginismus in East Java Indonesia
No full textBackground - Vaginismus is still an under-researched case of women's health despite its universal prevalence.
Aim -This study aims to explore the characteristics of vaginismus in East Java Indonesia.
Methods- The subjects in this study were all new female patients with Vaginismus was found in a single hospital - East Java Indonesia in 2022. The data used in this study are secondary data obtained from the medical records. Descriptive data are presented as numbers and percentages for categorical data.
Results – Vaginismus was found in a single hospital - East Java Indonesia. Based on medical record data, throughout 2022 there will be 60 patients with a diagnosis of Genito Pelvic Pain Penetration Disorder (GPPPD). The results of the assessment of patient characteristics showed that almost all patients were of reproductive age. Most of the respondents have been married for more than 1 year. Management is carried out independently and collaboratively. A total of 60 patients underwent anamnesis and physical examination. Complaints experienced by patients are failure to penetrate. Treatment was done using Botox injections, dilatation, hymenectomy, and consultation to psychiatrist and andrologist.
Conclusion - Management in cases of Vaginismus requires cross-professional collaboration such as psychiatrists and andrology. The treatment given also tends to be complex
Integrating Herbal Remedies in Indonesian Obstetric and Gynecologic Care: Bridging Tradition with Modern Medicines
Full text linkN/
Neonatal Asphyxia Risk in Cesarean Birth among National Health Insurance Beneficiaries: A Cross-Sectional Analysis
Full text linkOnly english abstract for Indonesian Journal of Obstetrics and Gynecology (INAJOG). Abstract concise description of the background, purpose, methods, results and conclusions required. No more than 250 words. Abstract is written using Arial 8 pt. Written with the following rules:
Objectives: To analyze the correlation between the time of cesarean section and the outcome of neonatal asphyxia in the National Health Insurance participants at Referral Hospitals in Kendari.
Methods: This was an analytical observational study using a cross-sectional method. The population was cases of cesarean delivery in the National Health Insurance participants at Dr. Ismoyo Hospital in 2019. The total sample was 183 obtained using a simple random sampling technique. Data was collected from medical records. Data were analyzed using the Chi-Square test with a significance value of 0.05.
Results: There were 47.5% cases of emergency cesarean section and 52.5% of elective cesarean section. Neonatal asphyxia occurs in 9.4% of elective cesarean sections and 6.9% in emergencies. There was no correlation between the time of cesarean section and the outcome of neonatal asphyxia (p=0.542).
Conclusion: The neonatal asphyxia is not related to the time of cesarean delivery in the National Health Insurance participants. Appropriate and good treatment can reduce the risk of neonatal asphyxia.
Keywords: cesarean section, elective, emergency, neonatal asphyxi