Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Basal Temperature, Cervical Mucous, and Both Combination as Diagnostic Tools to Detect Ovulation: Akurasi Suhu Basal Tubuh, Lendir Serviks, dan Kombinasi Keduanya sebagai Alat Pendeteksi Ovulasi
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Objective: To make basal body temperature examination andcervical mucus as an alternative examination in detectingovulation, especially in health facilities that do not have ultrasound.
Methods: This cross-sectional study was conducted at the outpatientclinic of RSUPN Dr. Cipto Mangunkusumo in the year2016-2017. A total of 49 infertile female patients who had normalmenstrual cycles were asked to participate and performedbasal body temperature measurements, cervical mucussampling and transvaginal ultrasound examination, the dataare subsequently grouped into 3 Days Estimated Ovulation(DEO); DEO-2 days, DEO and DEO+ 2 days. Diagnostic testswere performed and accurate comparison between basal bodytemperature, cervical mucus and a combination of both werelater assessed.
Results: The best accuracy was found on cervical mucus andcombination of both with 65% in detecting ovulation, whilstthe lowest was basal body temperature (59%) with sensitivity46.7%, and specificity 78.9%. Cervical mucus in diagnosingovulation has a sensitivity of 70% and specificity 57.8%. Thecombination of temperature-cervical mucus in diagnosing ovulationhas sensitivity of 46.67% and specificity of 94.73%.
Conclusion: Cervical mucus examination has better accuracy comparedwith basal body temperature examination in detecting ovulation.Further research for validating these diagnostic tools to thewider community and not only in patients with infertility is needed.
Keywords: basal body temperature, cervical mucus, infertility, ovulationdetection, ultrasoun
Creatinine clearance levels are associated with the incidence of preeclampsia: Hubungan Creatinine Clearance Dengan Kejadian Preeklampsia
No full textAbstract
Objective: Determine thecorrelation between creatinine clearance relationship with preeclampsia incidence.
Method: Cross sectional research.
Result: Creatinine clearance examination conducted on 60 sample of pregnant women > 20 weeks,30 normotensive samples and 30 preeclampsia samples. The obtained data analyzed using SPSS software version 22.0 and discussed using the existing literature theory.
Creatinine clearance average level in normotensive pregnancy 124.650 ± 14.3699ml/minutes/1,73m2and preeclampsia 74.003 ± 23.169ml/minutes/1,73m2. After Mann-Whitney statistical test obtained p value = 0,000. From ROC curve analysis for creatinine clearance obtained sensitivityvalue 100% and specificity 99,53%.
Conclusion:There is a significant correlation between the creatinine clearance levels with preeclampsia.
Keywords: creatinine clearance, normotensive, preeclampsia.
Abstrak
Tujuan: Menentukan hubungan antara creatinine clearance dengan kejadian preeklamsia.
Metode: Penelitian potong lintang.
Hasil:Dilakukan pemeriksaan creatinine clearance pada 60 sampel ibuhamil > 20 minggu, 30 sampel darah normal dan 30 sampel preeklamsia. Data yang diperoleh dianalisa dengan menggunakan software SPSS versi 22.0 dan dibahas dengan menggunakan teori literatur yang ada.
Kadar rerata creatinine clearance pada kehamilan normotensi 124,650 ± 14,3699 ml / menit / 1,73m2 dan preeklampsia 74,003 ± 23,169 ml / menit / 1,73m2. Setelah uji statistik Mann-Whitney diperoleh nilai p = 0,000. Dari analisis kurva ROC untuk creatinine clearance diperoleh nilai sensitivitas 100% dan spesifisitas 99,53%.
Kesimpulan: Ada hubungan yang signifikan antara creatinine clearance dengan kejadian preeklamsia.
Kata kunci: creatinine clearance, normotensi, preeklampsia
Lidocaine Prilocaine Cream versus LidocaineHCL Injection for Pain Relief during Second Degree of Perineal Tear Suturing after Vaginal Delivery: A Comparative Study: Lidokain Prilokain Topikal versus Injeksi LidokainHCL dalam Menghilangkan Nyeri Selama Penjahitan Luka Perineum Tingkat Dua Pascapersalinan Pervaginam: Sebuah Studi Komparatif
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Objective : To compare the effectiveness of topically applied lidocaine-prilocaine cream with lidocaine-HCl injection in the reduction of pain during second degree of perineal tear suturing after vaginal delivery.
Methods : One hundred and twenty-four of women with second degree of perineal tear after vaginal delivery were enrolled in this randomized clinical trial. Women were assigned randomly to have either application of lidocaine-prilocaine cream (n=62) or local injection of lidocaine-HCl (n=62) for anesthetic during perineal suturing. Pain measured with viasual analog scale (VAS) for the first 5 minutes during the perineal suturing. Statistical analysis was performed by comparative analytic numerical unpaired with independent t test between the two groups and significance was assessed at p<0.05. Data were presented as mean ± standard deviation (SD).
Results : There was no significantly different of pain score between lidocaine-prilocaine cream and lidocaine-HCl injection group (5.66±1.07 vs 5.56±1.5; p=0.473).
Conclusion : Application of lidocaine-prolicaine cream as effective as injection of lidocaine for reducing pain during second degree of perineal tear suturing after vaginal delivery.
Keywords : Lidocaine-prilocaine cream, lidocaine-HCl injection, pain, perineal suturing, vaginal delivery
Abstrak
Tujuan: Untuk membandingkan efektivitas antara lidokain-prilokain topikal dan lidokain-HCl injeksi dalam mengurangi nyeri selama penjahitan luka perineum tingkat dua setelah persalinan normal.
Metode: Seratus dua puluh empat perempuan dengan robekan perineum tingkat dua postpartum pervaginam mengikuti uji coba klinis secara acak ini. Enam puluh dua perempuan (n=62) menggunakan lidokain-prilokain topikal dan 62 perempuan lainnya (n=62) menggunakan injeksi lokal lidokain-HCl untuk anestesi selama penjahitan perineum. Nyeri diukur dengan visual analog scale (VAS) untuk 5 menit pertama selama penjahitan perineum. Analisis statistik dilakukan dengan uji numerik komparatif tidak berpasangan dengan uji t independen antara kedua kelompok dengan tingkat kemaknaan p<0,05. Data disajikan sebagai rerata ± standar deviasi (SD).
Hasil: Tidak terdapat perbedaan signifikan skor nyeri antara kelompok lidokain-prilokain topikal dan kelompok injeksi lidokain-HCl (5,66 ± 1,07 vs 5,56 ± 1,5; p = 0,473).
Kesimpulan : Efektifitas lidokain-prolikain topikal untuk mengurangi nyeri sama dengan injeksi lidokain-HCl selama penjahitan robekan perineum tingkat dua postpartum pervaginam.
Kata kunci : Lidokain-prolikain topical, lidokain-HCl injeksi, nyeri, penjahitan perineum, persalinan norma
The Concept of Gynecologic Oncology Services in Jakarta Related to Academic Health System
No full textAn Academic Health System (AHS) is a system in partnership among universities and health care providers that focuses on education, training, service, and research. The final outcome of this partnership is to improve health status. Numerous countries have been using this system, since this system is proven to lead to better sustainable outcome.The vision of Faculty of Medicine, University of Indonesia (FMUI) is "to create infinite experience for all through Academic Health System". The third mission of FMUI is to integrate the AHS to Dr. CiptoMangunkusumo Hospital and its other affiliated hospitals.The division of Oncology Department of Obstetrics and Gynecology is a part of Academic Health System that is responsible to create the Gynecologic Oncology services in this system. We create the gynecologiconcology services in preventive approach from primary to tertiary prevention.The sister hospitals of FMUI’s including Dr. Cipto Manungunkusumo, Persahabatan, Fatmawati, Karawang, and Tangerang General Hospital. Ideally, we should have health provider partners from primary, DistrictHospital (Rumah Sakit Umum Kecamatan/RSUK and Rumah Sakit Umum Daerah/RSUD). Another partner in collaborative project of AHS is Organization of Health Care Professions, such as Indonesian Medical Association, Indonesian Obstetrics and Gynecology Society, and Indonesian Gynecologic Oncology Society, and nongovernmental organization such as Female Cancer Program, Indonesian Cancer Foundation and others are part of partnership in AHS. When talking about public health status, it is also necessary to talk about the role of government as the policy maker and The Social Warranty Institution (Badan Penyelenggara Jaminan Sosial Kesehatan, BPJS) as the public health care insurance regulator. Primary health care should be included in the AHS’s partnership members because primary prevention strategy should be conducted in primary health care.The example of this project is Cervical Cancer Surveilance as a pilot project. We would prepare the project in collaborative meeting with all partners to make proposal in gynecologic oncology services in primary,secondary, and tertiary health care, and finally Dr. Cipto Mangunkusumo Hospital as the national referral Hospital. The proposal should talk about concepts of education, training, service, and research. Primary health care can promote cervical prevention and early detection via visual inspection using acetic acid and Pap test.Cervical precancer lesion can be treated using cryotherapy in primary health care. In secondary health care setting, cervical precancer lesion until microinvasive cervical cancer (stage 1A1) can be treated. Invasive cervical cancer should be managed in tertiary health care. We are preparing concepts where all services should follow the Clinical Practice Guideline. All medical patient database should be recorded digitally as long term cohort data. By applying this system, we’ll have a large number of patients’ data from primary to tertiary health care.This is crucial, considering that the process of education, training, and research of medical students, residents, and fellows is the backbone of AHS in improving health care status
Vascular Endothelial Growth FactorC Serum and Endostatin Serum as Predictors of Lympho Vascular Invasion in Early Stage Cervical Cancer
Get PDFObjective: To determine the relationship of Vascular Endothelial Growth Factors-C (VEGF-C), endostatin and the ratio of VEGF-C/ endostatin with limfo vascular invasion in patient with early stage cervical cancer.
Methods: This study used a cross sectional method. Samples were all patients with early stage cervical cancer who came to the several teaching hospitals of Obstetrics and Gynecology Department Universitas Hasanuddin Medical Faculty that meet the criteria,
then we measured the levels of VEGF-C and endostatin.
Results: We get 30 women with cervical carcinoma. The results showed that the serum levels of VEGF-C was higher in limfo vascular invasion positive (p = 0.017); the ratio of VEGF-C/ endostatin higher in limfo vascular invasion positive (p = 0.004); whereas serum levels of endostatin did not differ significantly in limfo vascular invasion positive or negative (p = 0.522).
Conclusion: The level of VEGF-C and VEGF-C/ endostatin ratio was higher in patients with early stage cervical cancer with positive LVSI than negative LVSI.
[Indones J Obstet Gynecol 2017; 5-2: 105-109]
Keywords: cervix uteri cancer, endostatin, limfo vascular invasion, VEGF-
Chronic Pelvic Pain and Associated Clinical Characteristics among Women in a Tertiary Care Center in Indonesia: Nyeri Panggul Kronis dan Karakteristik Klinis yang Berhubungan pada Perempuan di Suatu Layanan Kesehatan Tersier di Indonesia
Get PDFObjective: To determine the prevalence and various aspects associated with female chronic pelvic pain.
Methods: During the period of January to March 2016, a crosssectional study was conducted at the Women’s Health Clinic of Dr.
Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Subjects were female who complained of pelvic pain for more than 6 months. We performed history taking, physical examination, and laboratory investigations including hs-CRP serum examination. We calculate the prevalence and describe the clinical characteristics and diagnosis of the patient. Quality of life and levels of hs-CRP were compared between the group of mild and severe pain.
Results: In this study, the prevalence of CPP was 9.78%. We found 96.9% of gynecological disorders, 1% of urological disorders, and 2.1% of musculo-skeletal disorders. The most common diagnosis is endometriosis. The Clinical characteristics of patients were found 62.9% suffer for 6 months - 1 year with the intensity of pain (VAS) 7-10 as much as 51.5%. Levels of hs-CRP serum was around 1.99 (0.00 - 404, 53). We found a decreased in the quality of life of the patient. The physical domain score was 56 (38-81); the psychology domain score was 56 (31-100); the domain of social relationships was 59 (25-75); and the environmental domain score was 56 (31-94).
Conclusion: Endometriosis is the most common diagnosis in female chronic pelvic pain of reproductive age. The pain causes a
decreased in quality of life who suffer from it.
[Indones J Obstet Gynecol 2017; 5-3: 154-159]
Keywords: chronic pelvic pain, hs- CRP, intensity of pain, quality of lif
The Role of Progesterone Induced Blocking Factor in Threatened Abortion
Get PDFObjective: To determine the role of progesterone-induced blocking factor (PIBF) in women with threatened abortion.
Methods: This was a cross-sectional study. The blood serum of two groups, the first one was women with normal gestation of ï‚£ 20 weeks, and the second one was those with imminent abortion in Prof. Dr. R.D. Kandou Hospital, and Subcenter Hospital in Manado, was collected. Samples were processed with PIBF ELISA-kit.
Results: PIBF serum value of women in normal gestation  20 weeks is (47.15323.830)ng/ml and threatened abortion is (11.540 4.892) ng/ml, with p value = 0.000. Conclusion: PIBF serum value of women with threatened abortion is significantly lower compared to women of normal gestation  20 weeks. This study showed that PIBF has an important role in maintaining pregnancy and can be used as a biologic marker of a pathologic process in pregnancy.Keywords: early pregnancy, pregnancy immunology, progesteroneinducedblocking factor, threatened abortio
The Association of Bladder Wall Thickness with Severity of Symptoms in Patients with Overactive Bladder: HubunganantaraKetebalanDindingVesikaUrinaridenganKeparahanGejalapadaPasienOveractiveBladder
Get PDFObjective: To investigate the association of bladder wall thickness (BWT) with severity of symptoms in overactive bladder patients in Obstetrics and Gynecology Department Dr. Mohammad Hoesin general hospital Palembang.
Methods: An analytical observational study was conducted at Gynecology clinic Dr. Mohammad Hoesin General Hospital Palembang from November 2015 to August 2016. Data were analyzed with SPSS 16.0 for Windows. Bivariate analysis with the Chi square and association Rank-Spearman test was used to assess the association between BWT and visual analog scale (VAS).
Results: Fourty subjects were included in the study. The mean BWT in the overactive bladder group was thicker compared to those without overactive bladder (5.8522  0.5783 vs 5.2176  0.67937). There was significant association between BWT and overactive bladder complaints. Abnormal group (5mm) had 12 times risk of overactive bladder compared to normal sample (5mm) (p = 0.029, RR = 12).
Conclusion: Thus, the thickness of the urinary bladder wall measured with ultrasound examination (USG) can be used to assess the status and degree of urinary disorders in women with complaints of painful urinate and urinary disorders.
Keywords: bladder wall thickness, detrusor overactivity, overactive bladder, visual analog scal
Human Papilloma Virus Selftesting as an Alternative Method for Cervical Cancer Screening
Get PDFObjective: To determine the level of acceptance of self Human Papilloma Virus (HPV) examination and to compare the level of sensitivity and specificity of self HPV examination with Fluid Based Cytology on precancerous cervical lesion and cervical cancer.
Methods: The analytical method used in this research was cross sectional with purposive sampling. This study is conducted at Wahidin Sudirohusodo Hospital and its affiliation from October 2014 to May 2015 with 101 subjects. The data measurement used self HPV examination tool and fluid based cytology kit. The data collected through questionnaires before and after the examination. The laboratory examination was carried out using the way of HPV Genotyping primary system (MY09/11) method Wl LTS-06, which is able to
detect 35 types of HPV viruses.
Results: A total of 101 subjects were involved in this study. The subjects were divided into two groups: the abnormal and normal group (n - 50/51). The acceptance level of self HPV examination was 62.37% (n = 63/101). Majority of subjects (88.21%) were ready to repeat the same examination in the future. The level of sensitivity and specificity for self HPV were (56% (95%CI (41.25 - 70.01%)) vs 98% (95%CI (89.55 - 99.95%)), p=<0.000001, while the level of sensitivity and specificity for fluid based cytology were (40% (95%CI (26.41 - 54.82%)) vs 98% (95%CI (89.35 - 99.95%)), p=0.000002.
Conclusion: HPV self-testing is very potential to be used as an alternative method for cervical cancer screening.
[Indones J Obstet Gynecol 2017; 5-2: 114-119]
Keywords: cervical cancer, cervical cancer screening, human papilloma virus, sensitivity, specificit