Indonesian Journal of Obstetrics and Gynecology (INAJOG)
Not a member yet
904 research outputs found
Sort by
Emotional Impact of In Vitro Fertilization (IVF): Anxiety, Depression, and Their Relationship with Pregnancy Outcomes
Full text linkObjectives: Infertility can significantly impact women's physical and psychological health. Numerous treatment options are commonly pursued, with IVF often considered the last resort for infertile couples. However, IVF is associated with increased stress at every stage, potentially influencing women's perceptions and experiences throughout the procedure. This research examines anxiety and depression faced by women at different stages of IVF and analyzes their association with pregnancy outcomes.
Methods: This cohort study was conducted at Dr. Cipto Mangunkusumo General Hospital and Dr. Sander B. Daya Medika Clinic from May 2018 to March 2023. Data were collected using questionnaires and assessments during IVF, focusing on the evaluation of anxiety, depression, and pregnancy outcomes. Chi-square and Fisher’s exact test was used to assess associations between variables, while Friedman ANOVA was used for longitudinal analysis of anxiety and depression scores during IVF.
Results: The final analysis comprised 61 participants. The study revealed significant changes in anxiety and depression throughout IVF. Both anxiety (p < 0.001, Kendall’s w = 0.19) and depression levels (p = 0.001, Kendall’s w = 0.121) showed a significant rise across the IVF timeline. There is no statistically significant association between anxiety and depression scores and pregnancy outcomes across three measurement points during IVF (p > 0.05).
Conclusion: Anxiety and depression significantly increase during IVF but do not affect clinical pregnancy rates. These findings highlight the importance of mental health screening and psychiatric support during IVF to ensure women’s comfort and enable them to navigate IVF more effectively.
Keywords: Anxiety, Depression, Pregnancy Outcomes, Women, In Vitro Fertilization (IVF
Maternal Outcomes with Twelve Hour versus Twenty Four Hour Maintenance Doses Of Magnesium Sulfate in Severe Postpartum Preeclampsia
Full text linkIntroduction: Severe preeclampsia is a serious emergency that can complicate pregnancy and even lead to maternal death. It contributes to a significant increase in morbidity and mortality rates, affecting over 70,000 mothers. The cause of severe preeclampsia is still uncertain, but its management is continuously being developed to achieve the best possible outcomes for both the mother and baby. Magnesium sulfate (MgSO4) is the preferred treatment for preventing seizures in severe preeclampsia, as it has minimal side effects and is effective. However, there is a need for further research on reducing the duration of MgSO4 administration in Indonesia.
Method: A clinical trial was carried out with 80 participants divided into two groups (control and trial), using randomized and double-blind methods. The study was conducted at multiple hospitals including Arifin Achmad Hospital, Tengku Rafian Hospital, Dumai City Hospital, Selasih Hospital, and Bengkalis Hospital from October 2022 to February 2023. The data collected was analyzed to evaluate maternal outcomes for both groups. The study was approved by Ethical Review Board for Medicine and Health and registered with the Thai Clinical Trials Registry (TCTR 20230811008) once the data was assessed.
Results: This study examined pregnant women with severe preeclampsia, who were on average 30.98±6.04 years old, with 68.8% having had multiple pregnancies. Their gestational age was 33.37±2.88 weeks and the majority (72.5%) had a cesarean delivery. Their systolic blood pressure was 167.68±14.24mmHg and diastolic was 110.32±18.52mmHg. The study did not report on the incidence of eclampsia or maternal mortality, and there was no significant difference in serum magnesium sulfate levels between the two groups (p>0.005).
Conclusions: Administering maintenance doses of MgSO4 for both 12 and 24 hours had similar effectiveness in preventing eclampsia, but the 12-hour group saw better outcomes for the mother.
Keywords: Magnesium sulfate, Postpartum, Severe preeclampsia, 12 hours, 24 hour
Preoperative TNF-a Reduction in Endometriosis Lesions with Combined Oral Contraceptives
Full text linkBackground: The goals of endometriosis treatment vary greatly depending on the patient's symptoms and reproductive needs. Hormonal therapy to alleviate pain has generally been shown to have positive effects. Combined Oral Contraceptives (COC) are widely available, relatively affordable, and well-known by the public.
Objective: This study aims to compare the effects of COC therapy with two newer endometriosis treatments: oral Dienogest 2 mg and injectable Leuprorelin acetate 3.75 mg on TNF alfa levels in serum and peritoneal fluid.
Methods: Forty subjects were divided into four groups: three groups receiving medical therapy—COC (0.03 mg ethinylestradiol and 0.15 mg levonorgestrel, taken one active tablet per day continuously), oral Dienogest 2 mg, and intramuscular Leuprorelin acetate 3.75 mg every four weeks—and a control group of endometriosis patients who had not received any hormonal therapy. Peripheral venous blood samples were taken before surgery, and peritoneal fluid was collected at the start of surgery in the pelvic cavity. TNF alfa levels were analyzed using the ELISA method. Data analysis was performed using the Kruskal-Wallis test with a significance level of 0.05.
Results: The Kruskal-Wallis test showed significant differences between treatment groups in TNF alfalevels in peritoneal fluid (p:0.023), specifically between the COC group and the control group, and between the Dienogest group and the control group.
Conclusion: Preoperative hormonal therapy for estradiol suppression provides limited benefit in reducing systemic inflammatory agents but is effective locally, as evidenced by reduced TNF alfa levels in the peritoneal fluid after preoperative COC and Dienogest therapy.
Keywords: COC, Dienogest, Leuprorelin Acetate, Serum, Peritoneal Fluid, TNF alf
Surgical Outcomes of Cystectomy Using Oxidized Regenerated Cellulose With and Without Drainage in Endometrioma Treatment
Full text linkObjective: Our study aims to compare cystectomy and drainage using oxidized regenerated cellulose (ORC) in reducing endometrioma recurrence after surgery.
Methods: A retrospective cohort study included patients with endometrioma who undergo laparoscopic surgical management (cystectomy and drainage) with ORC from June 2020 – January 2023. All patients were followed up a year for recurrence rate. Recurrence was assessed based on symptoms and ultrasound criteria. All data were analyzed using SPSS version 26.0.
Results: Twenty-five patients were included in the cystectomy group and twenty-seven patients were included in the drainage group. The recurrence rate was higher in patients who underwent drainage (29.6%, n = 8) than in patients who underwent cystectomy (20%, n = 5). The researchers found the result was not significant (p > 0.05) in the recurrence rate between the two groups.
Conclusion: In this study, the use of oxidized regenerated cellulose showed no difference in recurrence rates in cystectomy with ORC and drainage with orc.
Keywords: endometrioma, cystectomy, drainage, oxidized regenerated cellulos
A Case Series on Pregnant Patients with Ovarian Cysts and Management of Potential Complications
Full text linkAbstract (English)
Objective: To report a series of ovarian cyst cases in pregnancy that we diagnosed in our obstetrics and gynecology department; and to provide literary perspective in management of potential complications.
Methods: A case series
Case: We present three cases of pregnant patients with ovarian cysts diagnosed at different trimesters of gestational age. Patients included in this case series were shown to have cysts at the time of sonographic examination. Each patient displayed different complications and underwent specific management for each complication which includes laparotomy and emergency cesarean section. All patients were discharged in clinically stable conditions and the mass was evaluated for further histopathologic examination. This case series will also discuss possible complications of pregnancy with ovarian cysts, and the prevalence of each complication based on the gestational age. Due to its potential complications, ovarian cysts in pregnancy must be accurately evaluated and given appropriate management.
Conclusion: Ovarian cysts in pregnancy must be evaluated accurately so that appropriate management is carried out. Clinicians should be aware of cyst complications during pregnancy.
Keywords: Ovarian Cysts, Pregnancy, Potential Complication
Effect of Bengkoang (Pachyrhizus erosus) Extract on Estrogen Receptor-?, Progesterone Receptor Expression, and Follicle-Stimulating Hormone Levels
Full text linkAbstract
Objective: Progesterone functions by inhibiting the release of Gonadotropin-Releasing Hormone (GnRH), which decreases Follicle-Stimulating Hormone (FSH) levels and converts them into hypoestrogens. This condition affects the expression of steroid, estrogen, and progesterone receptors, contributing to endometrial proliferation and secretion during the menstrual cycle.
Methods: This study aims to demonstrate that Bengkoang extract administration increases the expression of Estrogen Receptor (ER), Progesterone Receptor (PR), and Follicle-Stimulating Hormone (FSH) in Wistar model rats. This study divided 25 female Wistar rats into five groups: one control group without progesterone and Bengkoang extract and four treatment groups injected with progesterone. After exposure, Bengkoang extract was administered to three treatment groups at doses of 70 mg/200 g BW/day (treatment 1), 140 mg/200 g BW/day (treatment 2), and 280 mg/200 g BW/day (treatment 3).
Results: The results showed an increase in the expression of Estrogen Receptor- ? (Er?), Progesterone Receptor (PR), and Follicle-Stimulating Hormone (FSH) levels in treatment 1, treatment 2, and treatment 3 groups compared to the KP with p <0.05
Conclusion: The study investigating the effect of Bengkoang (Pachyrhizus erosus) extract on estrogen receptor-? (ER?), progesterone receptor (PR) expression, and follicle-stimulating hormone (FSH) levels has demonstrated significant findings.
Keywords: Estrogen, Estrogen receptor-?, Follicle-stimulating hormone, Pachyrhizus erosus, Progesterone, Progesterone recepto
Efficacy and Tolerability of Short-Term Hormonal Therapy Following Conservative Surgery for Endometriosis: Efficay and Clinical Tolerability of Short-Term Hormonal Treatment for Endometriosis Pain
No full textAbstractObjective: To compare the efficacy and tolerability of four short-term hormonal therapies; Dienogest (DNG), Depot Medroxyprogesterone Acetate (DMPA), continuous Combined Oral Contraceptive (COC), and Leuprolide Acetate (LA); administered for 12 weeks after conservative endometriosis surgery.
Methods: This randomized, prospective, open-label study enrolled reproductive-aged women with surgically confirmed endometriosis. Participants were randomly assigned to receive DNG 2 mg daily, DMPA 150 mg intramuscularly every 12 weeks, continuous COC (ethinyl estradiol 0.03 mg and levonogestrel 0.15 mg) daily, or LA 3.75 mg intramuscularly every 4 weeks. Primary outcomes were changes in pain intensity (visual analog scale, VAS), hormonal markers (estradiol, E2), inflammatory markers (TNF-?), and the Menopause Rating Scale (MRS) as an indicator of tolerability. Data were analyzed using ANOVA with a significance level of p < 0.05.
Results: All four regimens resulted in significant reductions in dysmenorrhea, dyspareunia, and chronic pelvic pain after 12 weeks (p < 0.001). E2 and TNF-? levels decreased significantly in all groups, with the greatest decline observed in the LA arm. No significant differences were found among regimens in pain reduction or biomarker changes (p > 0.05). MRS scores increased transiently at week 8, particularly in the LA group, reflecting hypoestrogenic effects, but decreased by week 12 in all groups.
Conclusion: Short-term postoperative hormonal therapy with DNG, DMPA, COC, or LA effectively reduces pain and inflammatory markers following endometriosis surgery. Progestin-based therapies achieve comparable clinical efficacy to GnRH agonists with superior tolerability. Individualized selection based on symptom profile, side effects, and accessibility is recommended in accordance with ESHRE guidelines.
Keywords: endometriosis-associated pain, Menopause Rating Scale, short-term hormonal therapy
Incidence of Melasma, Breast Pain, and Depression in Users of Combination Hormonal and Progesterone-Only Contraceptives
Full text linkObjective : To find out if there is a difference in the incidence of melasma, breast pain, and depression between a combination hormonal contraceptive (CHC) acceptors and a progesterone-only contraceptive.
Methods : This was a comparative analytical observational research with cross-sectional research design at Pakem Health Center, Yogyakarta. One hundred twenty subjects consisted of 60 progesterone-only contraceptive acceptors and 60 CHC acceptors aged 15-49 years, duration of use of hormonal contraceptives >6 months. Measurements on melasma were clinically determined, breast pain using a Visual Analogue Scale (VAS) score, and depression using the Montgomery Asberg Depression Rating Scale (MADRS) questionnaire.
Results: Chi-square test results and logistic regression in CHC acceptors are likely to experience melasma (b=1.55; CI 95%=0.08-0.55; p=0.002), breast pain (b=2.32; CI 95%=0.02-0.34; p=<0.001), and depression (b=-1.02; CI 95%=1.15-6.74; p=0.023).
Conclusion : There were significant differences in the incidence of melasma, breast pain, and depression in CHC acceptors and progesterone-only contraceptives. Incidence of melasma and breast pain was higher in CHC acceptors, while depression was higher in progesterone-only contraceptive acceptors