Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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An internal iliac artery ligation technique for bleeding control in the placenta accreta spectrum disorder
Full text linkObjective: To assess the contribution of internal iliac artery ligation to bleeding control during surgery.
Methods: This retrospective study used secondary data from medical records. All patients diagnosed with PASD from January 2019 – to December 2022 were included in this study. Participants were grouped based on operation technique, and the blood loss and operative duration were evaluated. The tests used were the Kruskal-Wallis and the Mann-Whitney U tests.
Results: 108 PAS patients were discovered. The most age group was between 20-35 years with parity of more than or equal to 4, history of Cesarean section once, gestational age at termination 34-36 weeks, and maternal death in 7 out of 101 cases. There were 49 resections, 13 resections with internal iliac artery ligation, 34 hysterectomies, and 12 hysterectomies with internal iliac artery ligation. There was no difference in bleeding and operative duration between resection vs. resection with internal iliac artery ligation (p: 0.113; p: 0.639), hysterectomy vs. a hysterectomy with internal iliac artery ligation ((p:0.052; P:0.723), and resection with ligation vs hystetectomy with the internal iliac artery ligation (p:0.052; p:0.723). Bleeding and operative duration differed significantly between resection vs. hysterectomy (p:0.002; p:0.013). All patients underwent tourniquet placement.
Conclusion An Internal iliac artery ligation was not shown to reduce bleeding in treating PASD.
Keywords: accreta, internal iliac artery, placenta
The Effect of Mannihot Esculenta on Prolactin Hormone Levels and Breast Milk Production in Breastfeeding Mothers: Efek Mannihot Esculenta pada Tingkat Hormon Prolaktin dan Produksi Susu Ibu pada Ibu Menyusui
No full textObjective: To prove the effect of cassava leaves jerky(Mannihot Esculennta) on prolactin hormone levels andbreast milk production in breastfeeding mothers in theWorking Area of the Rejosari Health Center of PekanbaruCity.Methods: This study used True Experiment Design with apretest and posttest design with the control group, usinga simple random sampling with a total of 28 breastfeedingmothers, 14 intervention group respondents, and 14 controlgroup respondents. The intervention group was givencassava leaves jerky 60 gr/day, and the control group wasgiven jerky without cassava leaves 20 gr/day for 2 weeks.Both groups were observed 3 times by weighing the baby'sweight and checking the level of the hormone prolactin afteradministering the intervention using the ELISA method. Dataanalysis using Mann-Whitney, TIndependent, RepeatedANOVA test.Results: There was a difference in the average differenceof prolactin hormone levels in the intervention group andcontrol group with a p-value of 0.000 (<0.05)Conclusion: Giving jerky cassava leaves breast milk boosteraffects the hormone prolactin and breast milk production inbreastfeeding mothers.Keywords: breast milk production, cassava leaves, mannihotesculenta, prolactin.Abstrak Tujuan: Untuk Membuktikan dendeng daun singkong(Mannihot Esculennta) terhadap kadar hormon prolaktindan produksi ASI pada ibu menyusui di Wilayah KerjaPuskesmas Rejosari Kota Pekanbaru.Metode: Penelitian ini menggunakan rancangan percobaanyang sebenarnya dengan desain pretest and posttest onlywith control group, sampling menggunakan sampel acaksederhana dengan jumlah 28 responden ibu menyusui,14 responden kelompok intervensi, dan 14 respondenkelompok kontrol. Kelompok intervensi diberi dendeng daunsingkong 60 gr/hari, dan kelompok kontrol diberi dendengtanpa daun singkong 20 gr/hari selama 2 minggu. Keduakelompok diamati sebanyak 3 kali dengan menimbangberat badan bayi dan pemeriksaan kadar hormon prolaktinsetelah pemberian intervensi dengan metode ELISA. Analisisdata menggunakan uji Mann-Whitney, TIndependent,Repeated ANOVA.Hasil: Terdapat perbedaan rata-rata selisih kadar hormonprolaktin pada kelompok intervensi 376,5 ng/ml, kelompokkontrol 103,5 ng/ml dengan p-value 0,000 (<0,05)Kesimpulan: Pemberian dendeng penambah ASI daunsingkong berpengaruh terhadap hormon prolaktin danproduksi ASI pada ibu menyusui.Kata kunci: daun singkong, mannihot esculenta, produksiASI, prolaktin
Roma Index and Adnex Model: which is more Superior in Predicting Epithelial Ovarian Malignancy? Index Roma dan Model Adnex: Manakah yang Lebih Unggul dalam Memprediksi Keganasan Ovarium Epitelial?
No full textObjective: To compare the accuracy of ROMA index andADNEX model in predicting the risk of malignancy in ovariantumour.Methods: This was a prospective analytic study. A total of 37samples were acquired from women of all ages diagnosedwith an ovarian cystic tumour in the Central General HospitalProf. Dr. R. D. Kandou. A CA-125 marker, HE4 marker,menopausal status and ultrasonography (USG) examinationwere obtained, and subsequently compared with the fi nalhistopathological results. The data were analysed by usingthe SPSS statistics software.Results: Thirty-seven women participated in this study. Themean age of participants was 43 years old. The Area UnderCurve (AUC) of the ADNEX was 0.979 with a sensitivity of90.0%, specifi city of 88.2%, negative predictive value of89.8%, and positive predictive value of 80.5%. The AUC ofthe ROMA model was 0.734 with the sensitivity, specifi city,negative predictive value, and positive predictive value of65.0%, 64.7%, 64.8%, and 64.8%, respectively. Both modelsshowed AUC values > 0.50 (p-value < 0.05).Conclusions: The IOTA ADNEX had better accuracy than theROMA model in predicting ovarian epithelial malignancy.The ADNEX model had higher sensitivity and specifi city thanthe ROMA model.Keywords: ADNEX, CA-125, HE4, Ovarian tumour, ROMAAbstrakTujuan: Untuk membandingkan akurasi indeks ROMAdan ADNEX model dalam memprediksi keganasan tumorovariumMetode: Penelitian ini merupakan studi analitik prospektif.Total 37 sampel penelitian didapatkan dari wanita yangdidiagnosa tumor ovarium kistik di RSUP Prof. Dr. R. D.Kandou. CA-125, HE4, status menopause dan pemeriksaanUSG dilakukan, dan dibandingkan dengan hasil histopatologi.Data kemudian dianalisa menggunakan program statistikSPSS.Hasil: Tiga puluh tujuh perempuan yang berpartisipasidalam penelitian ini. Dengan rerata usia 43 tahun. TotalArea Under Curve (AUC) dari IOTA ADNEX adalah 0,979dengan sensitivitas 90,0%, spesifi sitas 88,2%, nilai prediksinegatif 89,8%, dan nilai prediksi positif 80,5%. AUC darimodel ROMA adalah 0,734 dengan sensitivitas, spesifi sitas,nilai prediktif negatif dan nilai predikitif positif 65.0%, 64.7%,64.8%, dan 64.8% berturut-turut. Kedua model menunjukkannilai AUC > 0,50 (nilai p <0,05).Kesimpulan: IOTA ADNEX memiliki akurasi yang lebih baikdibandingkan model ROMA dalam memprediksi keganasanovarium epithelial. ADNEX model memiliki sensitivitas danspesifi sitas lebih tinggi dibandingkan model ROMAKata kunci: ADNEX, CA-125, HE4, ROMA, Tumor Ovarium
Leiomyoma Ablation with Transvaginal Ultrasonography-Guided Radiofrequency: A Report of Four Cases : Ablasi Mioma dengan Radiofrekuensi Terpandu Ultrasonografi Transvaginal: Laporan Empat Kasus
No full textAbstract
Objective : To perform transvaginal ultrasound-guided radiofrequency ablation (RFA) to four women with symptomatic subserous and intramural leiomyomas using standard protocols.
Methods : A report of four cases.
Case : This article reports three of four women with leiomyomas had heavy menstruation bleeding. The first case was a premenopausal woman with pelvic discomfort. In the second case, the patient underwent curettage after being diagnosed with a blighted ovum, the third case with non-cyclic pain and irregular cycles, and the fourth case with 14-year-old infertility and repeated IVF failure. No significant side effects or complications occurred after treatment and during observation. Monitoring uterine leiomyoma size for one week and three months showed an average reduction of 56.9%, indicating a significant reduction in myoma volume. The reported symptoms also improved.
Conclusion : Transvaginal ultrasound-guided radiofrequency ablation is an effective, non-invasive therapy with minimal side effects, so it may be the primary choice for leiomyoma therapy.
Keywords : Leiomyoma, RFA, transvaginal ultrasonography
Abstrak
Objektif : Untuk melakukan radiofrekuensi ablasi (RFA) terpandu ultrasonografi transvaginal pada empat wanita dengan mioma intramural dan suberosa bergejala dengan menggunakan protokol yang standar.
Metode : Laporan empat kasus.
Kasus : Melaporkan tigas dari empat wanita dengan mioma uteri mengalami perdarahan menstruasi yang banyak. Kasus pertama adalah seorang wanita premenopause dengan keluhan rasa tidak nyaman pada panggul. Pada kasus kedua, pasien menjalani kuretase setelah didiagnosis dengan blighted ovum, kasus ketiga dengan nyeri non-siklus dan siklus tidak teratur, dan kasus keempat adalah infertilitas 14 tahun dan kegagalan IVF berulang. Tidak ada efek samping yang berarti atau komplikasi yang terjadi setelah tindakan dan selama pemantauan. Pemantauan ukuran mioma uteri selama satu minggu dan tiga bulan menunjukkan penurunan rata-rata sebesar 56,9%, menunjukkan penurunan volume mioma yang signifikan. Gejala-gejala yang dilaporkan juga mengalami perbaikan.
Kesimpulan : Radiofrekuensi ablasi terpandu ultrasonografi transvaginal merupakan terapi non-invasif yang efektif dengan efek samping minimal, sehingga dapat menjadi pilihan utama untuk terapi mioma uteri.
Kata kunci : Mioma, RFA, ultrasonografi transvagina
The Anxiety Level and Premature Rupture of Membrane Incidence during COVID-19 Pandemic
Full text linkAbstract
Objective: To determine the association between anxiety level and premature rupture of membrane incidence during COVID-19 pandemic.
Methods: This study was a case-control study. The subjects of this study were patients giving birth at RSUD Dr. Moewardi Surakarta Hospital and UNS Sukoharjo Hospital in June - October 2021. Sampling was done by the purposive sampling technique on 70 samples. Data were analyzed using the chi-square test and logistic regression test.
Results: Characteristic data of the study samples found that most of the study samples was severe anxiety (40%). There was a significant association between the level of anxiety with PROM incident (p = 0.00), and pregnant women with severe anxiety had a risk of PROM of 3.761 times compared to pregnant women who were not anxious (OR=3.761). In multivariate analysis, it was found that the most influential variable on the incidence of premature rupture of membranes was the level of anxiety (p=0.001) compared to parity (p=0.155), employment status (0.193), and education level (0.576).
Conclusion: There was a significant association between anxiety level and premature rupture of membranes incidence during the COVID-19 pandemic, and there was an increased risk of premature rupture of membranes in pregnant women with severe anxiety levels during the COVID-19 pandemic.
Keywords: anxiety level; premature rupture of membrane; COVID-19 pandemic
Effect of Nanocurcumin in Combination with Methotrexate on Telomerase Activity, NF-kb Expression, and Proliferation Index of Bewo Choriocarcinoma Cells: Pengaruh Kombinasi Nanokurkumin dengan Methotrexate terhadap Aktivitas Telomerase, Ekspresi NF-kb, dan Indeks Proliferasi Sel Koriokarsinoma Bewo
Full text linkOverview of S-RBD Antibody Levels After Covid-19 Vaccination in Premenopausal and Menopausal Women
Full text linkObjective: To determine the levels of S-RBD antibodies in premenopausal and postmenopausal women who received the COVID-19 vaccine.
Methods: This study involved 21 premenopausal and postmenopausal women who received two doses of CoronaVac at 28 days intervals. The duration of vaccination was 4-24 weeks. This study was conducted on May–October 2021 in Kendari City, Indonesia. Blood samples were taken at a health care facility and examined at the Prodia Clinical Laboratory. Participants were healthy women, willing to participate, and signed informed consent. Participants were excluded if they had a history of COVID-19, had taken antibiotics or immunomodulators in the last 24 hours, had a history of acute/chronic inflammatory disease and malignancy, were traumatized and received monoclonal antibody therapy.
Results: Participants were 52.95±7.61 years old. The duration of the second vaccination was 13.67±5.26 weeks. The lowest level of S-RBD antibody was menopause with vaccination duration <=12 weeks (185.59±112.34 U/mL), and the highest was premenopause with vaccination duration >12 weeks (257.5±3.54 U/mL). The S-RBD antibody level in premenopausal women was higher than in menopausal women at the duration of vaccination <=12 weeks (223.37±63.45 vs 185.59±112.34 U/mL) and >12 weeks (257.5±3.54 vs. 225.55±91.14 U/mL). There was no significant difference in S-RBD antibody levels between two or more groups (p>0.05).
Conclusion: S-RBD antibody levels in postmenopausal women after receiving two doses of COVID-19 vaccine were lower than in premenopausal women, but the difference was not significant. S-RBD antibody levels in postmenopausal women increased with increasing duration of vaccine administration.
Keywords: menopause, immune response, COVID-19 vaccine, S-RBD antibod
COVID-19 Infection and the Preeclampsia in Pregnant Women : Infeksi COVID-19 dengan Preeklamsia pada Ibu Hamil
No full textObjective: To determine the relationship between COVID-19 infection and preeclampsia in pregnant women at RSD dr. Soebandi Jember.
Methods: This study used cross-sctional study with simple random sampling. The data is secondary data from medical records of 118 pregnant women who checked their pregnancies from March 2020 to December 2021 at RSD dr. Soebandi Jember and analyzed with chi-square test and logistic regression test.
Results: Multivariate analysis showed that there were a relationship between COVID-19 infection with preeclampsia. COVID-19 is the most risky variable with an OR of 4.045 (95% CI 1.595 – 10.259). This condition happens because COVID-19 infection triggers down-regulation of RAS which make the failure of spiral artery remodelling and preeclampsia.
Conclusion: There is a relationship between COVID-19 infection and the incidence of preeclampsia in RSD dr. Soebandi Jember.
Keywords: COVID-19, preeclampsia, renin-angiotensin system (RAS), SARS-CoV-2
Abstrak
Tujuan: Untuk mengetahui hubungan antara infeksi COVID-19 dengan kejadian preeklamsia pada ibu hamil di RSD dr. Soebandi Jember.
Metode: Penelitian ini merupakan studi potong lintang dengan pengambilan sampel menggunakan simple random sampling. Penelitian ini menggunakan data sekunder rekam medis 118 ibu hamil yang memeriksakan kehamilannya mulai Maret 2020 hingga Desember 2021 di RSD dr. Soebandi Jember dan dianalisa dengan uji statistik Chi-square dan uji regresi logistik.
Hasil: Analisis statistik menunjukkan terdapat hubungan antara infeksi COVID-19, usia, dan obesitas dengan kejadian preeklamsia di RSD dr. Soebandi Jember. Variabel COVID-19 merupakan variabel yang paling berisiko terhadap terjadinya preeklampsia dengan OR 4,045 (95% CI 1,595 – 10,259). Hal ini terjadi karena infeksi COVID-19 memicu down-regulasi pada RAS yang mengakibatkan kegagalan remodelling arteri spiralis dan preeklamsia
Kesimpulan: Terdapat hubungan antara infeksi COVID-19 dengan kejadian preeklamsia di RSD dr. Soebandi Jember.
Kata kunci: COVID-19, preeklamsia, renin-angiotensin system (RAS), SARS-CoV-
Hospital Cost vs INA-CBGs Claim for Obstetrics Procedure In Soe Rural General Hospital, East Nusa Tenggara: Tarif Rumah Sakit vs Klaim INA-CBGs untuk Prosedur Obstetrik di Rumah Sakit Umum Daerah SoE, Nusa Tenggara Timur
No full textObjective: To depict the discrepancy and analyze the difference between hospital cost and INA-CBGs claim in obstetrics’ cases in SoE Rural General Hospital, Timor Tengah Selatan regent, East Nusa Tenggara.
Methods: This is an observational descriptive study using medical record documents of spontaneous vaginal, assisted vaginal, and cesarean delivery cases from the period of October to December 2022. We included all completed billing documents on that period. Cases paid by fee-for-service and local government were excluded. Data analysis was conducted using IBM SPSS Statistic 23.0
Results: From the total of 323 delivery cases recorded in SoE Rural General Hospital, only 245 cases were included. Most subjects were patients aged around 30 years old, referred from primary healthcare facility in the district, were in term pregnancy, and in 3rd class inpatient rooms. The median of length of stay (LOS) in vaginal delivery (spontaneous and assisted) and cesarean delivery were 2 days and 3 days, respectively. Mean difference between hospital cost to INA-CBGs claim was 67% to 158% for either vaginal or cesarean delivery based on class inpatient room. We found that hospital cost was always higher than claim cost based on INA-CBGs claim.
Conclusion: There is a significant discrepancy between hospital cost and INA-CBGs claim (from 67% to 158%) for obstetric services in SoE Rural General Hospital.
Keywords: hospital cost, INA-CBGs claim, obstetric.
Abstrak
Tujuan: Untuk memberikan gambaran perbedaan dan menganalisis perbedaan antara tarif RS dengan klaim INA-CBGs pada kasus obstetrik di RSUD SoE, Timor Tengah Selatan, Nusa Tenggara Timur.
Metode: Studi deskriptif observasional menggunakan dokumen rekam medis dari kasus persalinan pervaginam spontan, persalinan pervaginam dengan alat, dan seksio sesarea dari Oktober hinga Desember 2022. Kami memasukkan seluruh dokumen billing yang lengkap. Dokumen biling yang dibayarkan mandiri dan oleh pemerintah lokal dieskslusi. Analisis data dengan menggunakan IBM SPSS Statistik 23.0.
Hasil: Dari 323 persalinan yang terekam di RSUD SoE, hanya 245 kasus diinklusikan. Kebanyakan subjek berusia 30 tahun, dirujuk dari puskesmas, kehamilan cukup bulan, dan ruang perawatan kelas 3. Angka median dari lama rawat pervaginam (baik spontan maupun dengan alat) adalah 2 hari dan seksio sesarea 3 hari. Rerata perbedaan tarif RS dengan klaim INA-CBGs ialah 67% hingga 158% baik persalinan pervaginam maupun seksio sesarea berdasarkan ruang kelas perawatan. Kami menemukan angka tarif RS selalu lebih tinggi cukup jauh dari klaim INA-CBGs.
Kesimpulan: Terdapat perbedaan antara tarif RS dan klaim INA-CBGs (antara 67 hingga 158%) untuk prosedur obstetrik di RSUD SoE.
Kata kunci: tarif RS, klaim INA-CBGs, obstetrik