Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Compatibility between Menstrual Pictogram Assessment and Haemoglobin Assessment in Abnormal Uterine Bleeding: Uji Kesesuian Pemeriksaan Piktogram Menstruasi dengan Pemeriksaan Hemoglobin pada Pasien Perdarahan Uterus Abnormal
Get PDFObjective: To determine the amount of wasted blood and diagnosedAUB and determine amount of decrease in haemoglobinlevels by adjusting the examination of menstrual pictogramwith haemoglobin.Methods: Diagnostic test was conducted in the DepartmentObstetrics and Gynecology Dr. Mohammad Hoesin/Faculty ofMedicine Universitas Sriwijaya Palembang, start from January 2015through January 2017. Sample was obtained from 39 patients withabnormal uterine bleeding who meet the inclusion and exclusioncriteria. Frequency and distribution of data are described in tablesand cross analyze (cut-off point) to find cut points differencemenstrual pictogram and a decrease in haemoglobin levels usingROC curve. Accuracy is measured by the value of Kappa. Dataanalysis using SPSS version 21.Results: From 39 samples that obtained, majority characteristicsage > 35 years (59%), ideal BMI (59%) and multiparous(48.7%). From statistical analysis, there was significanceassociation between haemoglobin measurement toolsand menstrual pictogram (p = 0.063). Both measuring deviceshave compatibility in predicting the type of AUB (p = 0.047),with the degree of conformity is weak (Kappa = 0.232).Conclusion: Accuracy of menstrual pictogram examination andhaemoglobin has a weak degree of conformity, so menstrualpictogram examination can’t be used to determine a decrease inhaemoglobin levels. Menstrual pictogram menstruation only usedas an evaluation of therapeutic response.[Indones J Obstet Gynecol 2018; 6-3: 172-178]Keywords: abnormal uterine bleeding, haemoglobin, menstrual pictogra
Relationship between Physical Activity of Pregnant Women in the Third Trimester of Pregnancy with Preterm Birth Using Kaiser Physical Activity Survey (KPAS) Questionnaire: Hubungan antara Aktivitas Fisik Perempuan Hamil pada Trimester Ketiga Kehamilan dengan Persalinan Prematur Menggunakan Kuesioner Kaiser Physical Activity Survey (KPAS)
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Objective: To examine the relationship between the intensity of physical activity of pregnant women with preterm birth and to know the relationship between types of physical activity of pregnant women with preterm birth.
Method: This research was a case control study that was conducted at Dr. Cipto Magunkusumo Hospital and Karawang Hospital in January 2017 to June 2017 with KPAS questionnaire which was divided into two groups, preterm birth and term birth. The sample size was 127 subjects for each group. The analysis was done by multivariate analysis of etiologic concept.
Result: In term birth, the most frequent physical activity intensities were: moderate intensity (64.6%, n = 82), light intensity (22%, n = 28), and vigorous intensity (13.4%, n = 17). In preterm birth, the most frequent physical activity intensities were: light intensity (40.1%, n = 51), vigorous intensity (33.9%, n = 43), and moderate intensity (26%, n = 33). Adjusted OR of preterm birth in light intensity versus moderate intensity was OR 5.32 (95% CI, 2.80-10.13;P = < 0.001). While adjusted OR of preterm birth in vigorous intensity compared with moderate intensity was OR 6.29 (95% CI, 3.28- 13.46;P = < 0.001). Work and sport have a significant association with preterm birth with OR 3.19 (95% CI, 1.62 - 6.28;P = 0.001) and OR 1.85 (95% CI,1.11 - 3.09; P= 0.017). Occupational conditions are also associated with preterm birth, including: weight lifting with OR 5.16 (95% CI, 1.10-24.08, P = 0.021), walking with OR 3.57 (95% CI, 1.61-7.92, P = 0.001), sitting with OR 2.79 (95% CI, 1.23-6.31, P = 0.011), and standing with OR 3.04 (95% CI, 1.40-6.59; P = 0.003).
Conclusion: There is a significant relationship between the intensity of physical activity and type of physical activity in pregnant women with preterm birth.
Keywords: intensity of physical activity, KPAS, physical activity, preterm labor
Abstrak
Tujuan: Mengetahui hubungan antara intensitas aktivitas fisik perempuan hamil dengan persalinan prematur dan mengetahui hubungan antara jenis aktivitas fisik perempuan hamil dengan persalinan prematur.
Metode: Penelitian ini merupakan penelitian kasus kontrol yang dilakukan di RS Cipto Magunkusumo dan RS Karawang pada bulan Januari 2017 hingga Juni 2017 dengan kuesioner KPAS yang dikelompokkan menjadi dua, yaitu persalinan prematur dan persalinan cukup bulan. Jumlah sampel adalah 127 subjek untuk masing-masing kelompok. Analisis dilakukan dengan analisis multivariat konsep etiologik.
Hasil: Pada persalinan cukup bulan, secara berurutan intensitas aktivitas fisik yang paling banyak dilakukan, antara lain : intensitas sedang (64.6%, n= 82), intensitas ringan (22 %, n = 28), dan intensitas berat (13.4 %, n = 17). Pada persalinan prematur, secara berurutan intensitas aktivitas fisik yang paling banyak dilakukan, antara lain : intensitas ringan (40.1 %, n = 51), intensitas berat (33.9 %, n = 43), dan intensitas sedang (26 %, n = 33). Hubungan antara intensitas aktivitas fisik ringan dibandingkan intensitas sedang untuk persalinan prematur memiliki OR 5.32 (IK 95% 2.80-10.13;P = < 0.001). Sedangkan hubungan antara intensitas aktivitas fisik berat dibandingkan intensitas sedang untuk persalinan prematur memiliki OR 6.29 (IK 95% 3.28- 13.46;p = < 0.001). Pekerjaan dan olahraga memiliki hubungan bermakna dengan persalinan prematur dengan OR 3.19 (IK 95% 1,62 – 6.28;p = 0.001) dan OR 1.85 (IK 95% 1.11 – 3.09;p= 0.017). Kondisi pekerjaan juga berhubungan dengan persalinan prematur, antara lain : angkat berat (OR 5.16; IK 95% 1.10-24.08; p = 0.021), berjalan (OR 3.57;IK 95% 1.61-7.92;p = 0.001), duduk (OR 2.79;IK 95% 1.23-6.31; p = 0.011 ), dan berdiri (OR 3.04 ;IK 95% 1.40-6.59;p = 0.003)
Secretory Leukocyte Protease Inhibitor in Preterm Labor and Pregnancy: Secretory Leukocyte Protease Inhibitor pada Persalinan dan Kehamilan Prematur
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Objective: To investigate the levels of secretory leukocyteprotease inhibitor (SLPI) in women with preterm labor andpregnancy.
Methods: SLPI level examination conducted to 32 samples ofpregnant women who meet the inclusion and exclusion criteria,consists of 16 preterm labor and 16 preterm pregnancy.Sample analysis carried out in Prodia Laboratory Jakarta. SLPIlevel examination used ELISA method. The obtained dataprocessed by SPSS software version 20.0 and discussed withexisting literature theory.
Results: Mean plasma SLPI level in patients with preterm laboris 30.319 ng/ml and median: 29.950 ng/ml with p value: 0.652,while the mean on preterm pregnancy is 45.975 ng/ml andmedian: 41.600 ng/ml with p value: 0.005.
Conclusion: There are significant differences of SLPI level betweenpreterm labor and preterm pregnancy.
Keywords: preterm labor, preterm pregnancy, SLP
Identification of microorganisms in vaginal swab and peritoneal fluid of women with endometriosis: Identifikasi Mikroorganisme pada Swab Vagina dan Cairan Peritoneum pada Wanita dengan Endometriosis
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Objective: to discover correlation between microorganisms found in vaginal swab culture and in peritoneal fluid culture from laparoscopy in reproductive age women diagnosed with endometriosis.
Methods: This cross sectional study was conducted in Bunda Hospital and YPK Hospital, Central Jakarta. Thirty one subjects was includedby consecutive sampling. Data were analyzed using SPSS 20.0 for Windows. Bivariate analysis was used to identify the correlation between independent and dependent variable.
Results: From 31 subjects with mean age 34.42+5.056 years old, 87.1% were infertile. Vaginal swab culture was found positive in 83.9% subjects while peritoneal fluid culture was found positive only in 9.6% subjects. There was moderate correlation between chronic pelvic pain and positive vaginal swab culture (r=0.601; p=0.001), but weak correlation between Ca125 and vaginal swab culture (r=0.440; p=0.010). Peritoneal fluid culture had significant inverse correlation with left tubal patency (r=-0.346; p=0.047). There was weak correlation between vaginal swab culture and peritoneum fluid culture with correlation coefficient of 0.13.
Conclusion: Most of bacteria found in vaginal swab culture and peritoneal fluid culture were the ones found in gastrointestinal tract. However, vaginal swab and peritoneal fluid culture were not sufficient to prove the hypothesis that infection has a role in pathogenesis of endometriosis. Therefore, advance and more complete examination such as LPS and PCR might be needed to be done in the future research with cohort study, to overcome the limitation of this study.
Keywords: endometriosis, ascending bacterial contamination, vaginal swab, peritoneal fluid, culture
Abstrak
Tujuan : Membuktikan adanya korelasi antara mikroorganisme yang ditemukan pada hasil kultur bilasan vagina dengan mikroorganisme yang ditemukan pada cairan peritoneum hasil laparoskopi perempuan usia reproduksi yang terdiagnosis endometriosis
Metode :Penelitian ini menggunakan desain penelitian analitik poltong lintang yang bertujuan untuk melihat adanya hubungan korelasi serta mengetahui tingkat korelasi antara mikroorganisme kultur bilasan vagina dengan mikroorganisme pada cairan peritoneum pasien endometriosis.
Hasil: Hasil kultur bilasan vagina dari 31 subjek penelitian yang diteliti, mikroorganisme terbanyak adalah Enterococcus faecalis (32.3%), Eschericia coli (29.1%), dengan 16.1 % dengan hasil kultur negatif. Sedangkan dari hasil kultur bilasan peritoneum terdapat 3 subjek (9.6%) dengan hasil positif yaitu dengan jenis bakteri Eschericia coli, Enterococcus faecalis, dan Pseudomonas. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum (r 0.13). Terdapat korelasi sedang antara kultur positif bilasan vagina dengan nyeri pelvik kronis, korelasi lemah antara kultur positif bilasan vagina dengan nilai Ca 125, dan korelasi lemah antara kultur positif cairan peritoneum dengan tuba kiri yang non paten.
Kesimpulan: Sebagian besar bakteri dari bilasan vagina dan bilasan peritoneum pada pasien endometriosis memiliki hasil bakteri dari organ pencernaan. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum pada pasien endometriosis.
Kata kunci: endometriosis, kontaminasi bakteri asenden, kultur, bilasan vagina, cairan peritoneu
Incidence of Pelvic and Paraaortic Lymph Node Metastasis in Epithelial Ovarian Cancer at a Tertiary Care Center
Get PDFObjective: To investigate the incidence of pelvic and paraaorticlymph node metastasis in epithelial ovarian cancer.Methods: This was a cross-sectional study. Data were collectedfrom medical records, and from the cancer registry 1539 medicalrecords were obtained. From there, 863 patients were operatedand 676 were not, and only 401 medical records were foundcomplete, and 306 samples were excluded because they have beentreated with NAC and underwent surgery, patients who underwentsurgery but the results is not the epithelium, and patients whounderwent surgery, but the results were benign or borderline. And95 patients who underwent primary surgery and lymphadenectomyonly 55 patients have results in lymphadenectomy. This study usesa calculation of sample size with categorial descriptions, withprecision of 3% then obtained a minimum sample size of 261patients.Results: According to the characteristics of the study subjectsabove, the results were stage I, II, III respectively 60%, 10.9%, and29%. The metastasized of the lymph node paraaortic 9.1%, andpelvic/paraaortic 20% pelvic/paraaortic23.6%. Based on thedegree of differentiation the results were good differentiation30.9%, moderate differentiation 23.6%, and poor differentiation45.5%. We found that paraaortic lymph node metastasis weremost frequent at stadium III (43.8%). In relationship betweenlymph node metastasis with differentiation of epithelial ovariancancer, the most frequent epithelial ovarian cancer were one withpoor differentiation in pelvic/paraaortic lymph node with the sumof 69.2%. From analysis, there is significant difference betweenserous hystologic subtype with mucinosum subtype in pelviclymph node, significant difference between serous hystologicsubtype and clear cell in paraorta or pelvic lymph node andbetween the serous histology subtype and mucinous as well.Conclusion: Lymph node metastasis incident of ovarian epithelialcancer in paraaorta amounts 20%, pelvic 9.1% and pelvic orparaaortic 23.6%. Higher the stadium, the lymph node involvementswill be higher as well (pelvic and paraaortic). In stadium 1of mucinous subtype with well differentiation has minimal lymphnode involvement so we can be more selective in considering therisk and benefit of lymphadenectomy.[Indones J Obstet Gynecol 2018; 6-1: 60-63]Keywords: lymph node metastasis, ovarian cance
Levels of 25 Hydroxyvitamin D in Normotensive Pregnancy and Severe Preeclampsia
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Objective: To determine the ratio of 25-hydroxyvitamin D levels innormotensive pregnancy and severe preeclampsia.
Methods: This study was an analytic cross-sectional study witht-test. The subject of this study consists of 17 samples normotensivepregnancy and 17 samples severe preeclampsia. This study wasconducted and evaluated from August 2016 until December 2016 atDepartment of Obstetrics and Gynecology Faculty of MedicineUniversitas Sam Ratulangi Prof. Dr. R.D. Kandou Hospital Manadoand satellite hospital in Manado. Samples were taken from serumas much as 5 ccs and were analyzed using CLIA at Prodia clinicallaboratory. Data were analyzed with SPSS version 20.0.
Results: By using the t- test, there were significant differences in25-hydroxyvitamin D levels between normotensive pregnancygroup (24.771  6.9567ng/ml) and severe preeclamptic group(17.712  3.7513ng/ml), p = 0.001.
Conclusion: Levels of 25-hydroxyvitamin D in normotensive pregnancysignificantly higher compared to severe preeclampsia so it canbe concluded that the levels of 25-hydroxyvitamin D were associatedwith preeclampsia.
Keywords: 25-hydroxyvitamin D, normotensive, severe preeclampsi
Human Papilloma Virus16 and 18 Infection and the Cervical Cytology Changes in Combined Hormonal Contraceptive Users: Infeksi Human Papilloma Virus Tipe 16 dan 18 dan Perubahan Sitologi Serviks pada Akseptor Kontrasepsi Hormonal Kombinasi
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Objective: To evaluate the correlation between HPV-16 and 18infection and the cervical cytology changes among combinationhormonal contraceptives users.
Methods: A cross-sectional study involved 40 women usingcombined hormonal contraceptive (oral or injection/DMPA contraceptive)and 40 women of non-hormonal contraceptive users wasconducted in Dr. Wahidin Sudirohusodo hospital, some affiliatedhospitals of Department of Obstetrics and Gynecology Faculty ofMedicine, Universitas Hasanuddin and a private clinic in Makassarfrom November 2015 and April 2016. HPV 16 and 18 genotypingin cervix using PCR method and cervical cytology changes usingliquid-based cytology (LBC) method were performed. HPV infectionand cervical cytology changes were analysis based on Fisher’s testand chi-square test.
Results: A significant difference found only in parity (p<0.05)between users and control of baseline characteristics. Neither usersnor control were significantly associated with HPV-16 and 18infection and changes in cervical cytology.
Conclusion: Combined hormonal contraceptives are not correlatedwith HPV-16 and 18 infection and changes in cervical cytology.
Keywords: cervix, combined hormonal contraceptive, human papillomaviru
How to Recognize, Prevent and Address Complications of Laparoscopic Gynecologic Surgery: Mengenali, Mencegah dan Mengatasi Komplikasi Operasi Ginekologi Laparoskopi
Get PDFAbstractObjective: to highlight the needs of awareness on recognizing, prevent and address complications in laparoscopic gynecologic surgery.Method: Literature reviewDiscussion: The complications of laparoscopic gynecologic surgery mainly can be classified as complications related to anesthesia, entry technique, electrosurgical, postoperative and visceral due to surgical procedure itself. Lam proposed a 6 phase-based classification of laparoscopic surgery complications; patient identification, anesthesia and positioning, abdominal entry and port placement, surgery, postoperative recovery and counselling. The aim of this classification is to promote a culture risk management to improve patient safety and outcome. Each and every phase above should be able to assessed, analyzed and executed properly to prevent complications.
Conclusion: Complication in operative laparoscopy is generally minor and can be handled successfully. However, although very rare, major complications are detrimental to the patient. It also becomes heavy burden for the surgeons. Preventive measures should be implemented not only by the operator but also the anesthesiologist, and theatre practitioners. Systematic drills, which regularly re rehearsed is important in order to maintain team proficiencies.
Keywords: complications, gynecologic laparoscopy, operative Laparoscopy
Abstrak
Tujuan: Untuk menekankan pentingnya mengenali, mencegah dan mengatasi secara dini komplikasi operasi laparoskopi ginekologi.
Metode: Kajian pustaka
Diskusi : Komplikasi operasi ginekologi laparoskopi dapat diklasifikasikan menjadi komplikasi yang berhubungan dengan anestesi, teknik masuknya trokar utama, terkait elektro surgikal, komplikasi pascaoperasi dan komplikasi visera (pembuluh darah, usus, cedera traktus urinarius) terkait tindakan operasi itu sendiri. Lam mengusulkan suatu klasifikasi berbasis fase, antara lain, identifikasi pasien, anestesi dan posisi pasien, akses masuk abdomen dan penempatan trokar, terkait operasi, pemulihan pascaoperasi dan konseling. Tujuan dari klasifikasi ini adalah untuk meningkatkan budaya sadar risiko,guna meningkatkan keselamatan pasien. Setiap tahap harus dapat dilaksanakan, dinilai dan dianalisis dengan baik untuk mencegah terjadinya komplikasi.
Kesimpulan: Komplikasi pada operasi ginekologi laparoskopi umumnya ringan dan dapat ditangani dengan baik. Walaupun jarang terjadi, komplikasi berat umumnya sangat merugikan pasien dan menjadi beban operator. Langkah-langkah pencegahan ini harus dilaksanakan oleh operator, tim anestesi serta seluruh tim kamar operasi. Simulasi harus dilaksanakan, guna mempertahankan kecakapan tim
Kata kunci : komplikasi, laparoskopi ginekologi, laparoskopi operati
A Comparative Study of Nomegestrol Acetate and a Combination of Ethinylestradiol and Levonorgestrel for Delaying Menstruation among Umrah Pilgrims
Get PDFObjective: To compare the effectiveness efficacy of nomegestrolacetate with and combination of ethinylestradiol and levonorgestrelas a regimen for delaying menstruation in Umrah pilgrims in Palembangcity.Methods: This single-blind randomized controlled trial was conductedin Hajj and Umrah Guidance Group in Palembang city duringDecember 2016 to January 2017. Population of this study was 30women who meet the inclusion and exclusion criteria. Frequencyand distribution of data was described in a table. Effectiveness andthe side effects treatment between the two groups were analyzedwith Chi Square test. Data was were analyzed using SPSS version18.0.Results: There were no differences in age, education, occupation,parity, body weight, height and contraceptive history betweentwo both groups (all p values > 0.05). Statistical analysis showedthere was no difference in spotting between nomegestrol acetate5 mg or a combination of levonorgestrel 150 mcg and 30 mcgethinylestradiol in Umrah pilgrims (p = 1.000). Other side effectssuch as (dizziness, depression, breast tenderness, heavy limbs,nauseam and vomiting) between the two groups could not beanalyzed because all subjects did not experience any other sideeffects.Conclusion: There is no difference in effectiveness betweennomegestrol acetate 5 mg or combination of levonorgestrel 150mcg and 30 mcg ethinylestradiol as a regimen for delayingmenses in Umrah pilgrims in Palembang city.[Indones J Obstet Gynecol 2018; 6-1: 45-49]Keywords: delay menstruation, ethinylestradiol, levonorgestrel,nomegestrol, side effects, spotting, umra
The Role of Matrix Metalloproteinase2 (MMP2) in Serum and Peritoneal Fluid of Endometriotic Patients
Get PDFObjective: To determine the role of matrix metalloproteinase-2(MMP-2) in serum and peritoneal fluid of endometrioticpatients.Methods: Research’s design using cross-sectional method in Dr.Wahidin Sudirohusodo hospital and several other hospitals inMakassar within May 2015 until May 2016. Subjects were chosenusing consecutive sampling technique. The examination usingthe ELISA method. The data were analysed using Fisher exact,t-independent, Mann-Whitney, and Spearman association.Results: A total of 50 subjects were recruited in this study. Mostlythe value of MMP-2 serum and peritoneal fluid in endometriosisgroup was higher compare to study control. There was significantdifferent between the total of MMP-2 serum and peritoneal fluid.There was also a significant association between the value ofMMP-2 serum and peritoneal fluid with endometriosis.Conclusion: The value of MMP-2 serum and peritoneal fluid werehigher in endometriotic patients compared to those withoutendometriosis. The higher the value of MMP-2 serum andperitoneal fluid, the higher the stage of endometriosis.[Indones J Obstet Gynecol 2018; 6-2: 104-109]Keywords: endometriosis, matrix metalloproteinase-2, MMP-