Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Anti Müllerian Hormone (AMH) Level as Ovarian Reserve Marker before and after Cystectomy Laparotomy
Get PDFObjective: To investigate the comparison of the Anti-Mullerian
Hormone (AMH) as the ovarian reserve marker before and
after cystectomy.
Methods: This study used prospective cohort design which included
all women with the ovarian cyst who underwent cystectomy
laparotomy. The subjects were examined AMH level before and after
the procedure. Data were analyzed using one- way Anova, T- paired
test, and T-independent test with p valu
Postlaparoscopic GnRHagonist Therapy does not Improve Spontaneous Conception Rates of Women with Endometriosis
Get PDFObjective: To investigate the reproductive benefits of combining laparoscopic surgery with GnRH-agonist hormonal therapy in treating women with endometriosis.
Methods: This is a non-randomized prospective analytic study of patients with endometriosis conducted in a private hospital in Bandung during the period of January 2014 to December 2015, whom were later followed up after 12-24 months for assessment of post-surgical reproductive performance. A total of 121 patients were enrolled, 60 of which received post-surgical GnRH-agonist hormonal therapy.
Results: We discovered that 56 women (46.3%) eventually achieved spontaneous conception after surgery but upon further analysis, it was discovered that GnRH-agonist played no significantly meaningful role in improving the spontaneous pregnancy rates of these patients (OR 1.539; 95% CI 0.750-3.159; p-value 0.239). Furthermore, even though there was a wide range as to when they achieved conception, those untreated with hormonal therapy tended to conceive far more quickly than those who were (5.91 ± 6.28; 8.56 ± 4.24; p-value: 0.011).
Conclusion: Post-laparoscopic GnRH-agonist administration to women with endometriosis does not significantly improve their chances of spontaneous conception. In fact, such administration seems to delay it.
[Indones J Obstet Gynecol 2017; 5-2: 87-93]
Keywords: endometriosis, GnRH-agonist, laparoscop
The Role of HLAC and NK Cells in Fetal Growth Restriction: Peran HLAÂC dan Sel NK pada Pertumbuhan Janin Terhambat
Get PDFObjective: To determine the role of HLA-C and NK cell expressions in fetal growth restriction (FGR).
Methods: A cross sectional study design was used. This study was conducted at the Obstetrics and Gynecology Department of Dr. Moewardi General Hospital, Surakarta, its affiliated hospitals, and at the Pathological Anatomy Laboratory of the Faculty of Medicine, University of Sebelas Maret Surakarta. A total of 40 samples were included in this study. The samples consisted of 20 normal pregnancies and 20 pregnancies with FGR. HLA-C expression in the trophoblast and NK cells in decidua of the subjects who met the inclusion and exclusion criteria were examined using immunohistochemical method and statistical analysis with T test.
Results: The mean expression of HLA-C in the trophoblast in the pregnant group with FGR was 9.021.30, normal pregnancy was 7.96 ± 0.97, p=0.01 (p<0.05). The mean expression of NK cells in decidua of pregnancy with FGR was 10.59 ± 2.11, normal pregnancy was 0.91 ± 8.18, with p=0.00 (p<0.05).
Conclusion: The expressions of HLA-C in trophoblast and NK cells in decidua of pregnancy with FGR were higher compared with
those of normal pregnancy.
[Indones J Obstet Gynecol 2017; 5-3: 142-148]
Keywords: fetal growth restriction, HLA-C, NK cell
A Case of BeckwithWiedemann Syndrome with Polyhydramnios: Suatu Kasus Sindrom Beckwith ÂWiedemann dengan Poli hidramnion
Get PDFObjective: To report a rare case of Beckwith-Wiedemann Syndrome with polyhydramnios.
Methods: Reporting a case of Beckwith-Wiedemann syndrome with polyhydramnios.
Results: Case of Mrs. Y, 27 years old woman, G2P1A0L1 preterm pregnancy (30-31 weeks) with polyhidramnios. From ultrasound found renomegaly, bilateral hyperechogenic polycystic kidney, and the karyotype result was 46,XX. Caesarean section was performed due to fetal distress. A female baby was born by caesarean section with birth weight of 1300 grams, 37 centimeters of body length, and APGAR score of 6/8. The congenital anomalies found were hepatomegaly, renomegaly, bilateral hyperechogenic renal polycystic, low set ears. The baby was died in NICU on day care 5th, with suspected of sepsis.
Conclusion: Prenatal diagnosis of Beckwith-Wiedemann syndrome on fetus with polyhydramnios.
[Indones J Obstet Gynecol 2017; 5-3: 185-188]
Keywords: amniocentesis, beckwith-wiedemann syndrome, polyhydramnios, prenatal diagnostic, US
Effect of Artesunate on Peripheral Parasitaemia in Pregnant Women with Plasmodium Falciparum Infection: Efek Artesunat pada Perempuan Hamil dengan Infeksi Plasmodium Falciparum terhadap Kejadian Parasitemia Perifer
Get PDFObjective: To determine the effect of artesunate on peripheral parasitaemia in pregnant women with Plasmodium falciparum infection.
Methods: Pregnant women in second and third trimester with Plasmodium falciparum infection and their newborns were included in cohort prospective study in Sorong West Papua from September 2015 to February 2016. All pregnant women received 200 mg orally artesunate monotherapy for 7 days. Their newborns examined for weight at delivery and parasitaemia in placenta and cord blood. Parasitaemia diagnosis by Rapid Diagnostic Test and blood smear microscopy.
Results: After artesunatemonotherapy, 82.5% (33/40) malariainfected pregnant women had negative parasitaemia (p=0.000) although 17.5% (7/40) of the pregnant women had positive parasitaemia. Parasitaemia also found in 10% (4/40) of placenta and 7.5% (3/40) of umbilical cord from newborns of malaria-infected pregnant women treated with artesunate. 70% (28/40) of the newborns in this study had normal weight.
Conclusion: Artesunate reduces peripheral parasitaemia in the second and third trimester of pregnancy, and is associated with normal birth weight.
[Indones J Obstet Gynecol 2017; 5-3: 135-138]
Keywords: artesunate, low birth weight, peripheral parasitaemi
External Validation of Endometriosis Fertility Index (EFI) in an Indonesian Population: A TwoCentre Prospective Study: Validasi Eksternal Endometriosis Fertility Index (EFI) pada Populasi Indonesia: Sebuah Studi Prospektif
Get PDFObjective: To externally validate EFI in an Indonesian population.
Methods: A prospective study was performed in 59 reproductive aged women diagnosed with both endometriosis and infertility who underwent laparoscopic surgery in Dr. Cipto Mangunkusumo and Carolus Hospital during the period of December 2012 to June 2016. Subjects were followed up for two years.
Results: Statistical analyses suggested that younger age, infertility duration ï‚£ 3 years, higher LF score, and AFS score below 71 were significantly associated with pregnancy (p<0.001, p<0.001, p=0.035, p<0.001, respectively). Pregnant subjects had significantly higher median EFI score compared to the not pregnant group [EFI score 7 (5-9) vs 4 (1-8), p<0.001)].
Conclusion: Higher EFI score was significantly associated with higher pregnancy rate.
[Indones J Obstet Gynecol 2017; 5-3: 160-163]
Keywords: endometriosis, fertility, index, infertility, laparoscopy, pregnanc
Prevalence and Characteristics of Pelvic Floor Dysfunction in a Tertiary Care Center in Indonesia: Prevalensi dan Karakteristik Disfungsi Organ Panggul di Pusat Pelayanan Kesehatan ersier diI ndonesia
Get PDFObjective: To determine the prevalence and characteristics of pelvic floor dysfunction (PFD) in Jakarta, Indonesia.
Methods: A cross sectional study was conducted at gynecology, endocrinology, and urogynecology clinic of Dr. Cipto Mangunkusumo Hospital during the period from January 2016 to April 2016. Subjects were selected using consecutive sampling. Data were taken using research and POP-Q form.
Results: A total of 197 subjects were recruited. The prevalence of patients with PFD was 33%. The prevalence of POP, UI, and FI were 26.4%, 15.3% and 2.5%; respectively. Association between individual characteristics and PFD was found on women aged ≥ 60 and aged 40-59 years old with 69 and 14 times probability to be PFD. The probability of developing PFD was 76 and 14.2 times in multiparity and primiparity. Woman with vaginal delivery had a change to develop PFD 1.9 times and postmenopausal woman had a probability 18 times. The infuencing risk factor in PFD were age parity, race, mode of delivery, and menopausal status.
Conclusion: Pelvic floor dysfunction affects a substantial of women and increases with age, parity and aging.
[Indones J Obstet Gynecol 2017; 5-3: 168-172]
Keywords: fecal incontinence, pelvic floor dysfunction, pelvic organ prolapse, urinary incontinenc
Postplacental IUCD CuT380A: Acceptability, Effectivity and Side Effects: AKDR Cu T380A Pasca plasenta: Penerimaan, Efektivitas dan Efek Samping
Get PDFObjective: To evaluate the acceptability, effectivity and side effects of Postplacental IUCD after vaginal delivery at Dr. Cipto Mangunkusumo Hospital (RSCM) after 6 month of insertion.
Methods: A prospective study was conducted at RSCM Jakarta during the period of August to October 2012. Postplacental IUCD was inserted into the subjects’ uterus until it reached the fundus. Follow up was done at 40-42 days and 6 months after delivery.
Results: A total of 234 women were recruited in this study, with 19.2% loss of follow up. No significant difference on subjects characteristics who came and loss of follow up in this study. Expulsion was experienced by 5.1% subjects (total expulsion 4.1% and partial 1%) at the first visit on 40-42 days and 7.5% subjects (total expulsion 0.6% and partial 6.9%) at the second visit, after 6 months. 9.3% subjects had the IUCD removed at the first and second visit. Among all of the subjects who had the IUCD removed by request or had the expulsion, 61% were willing to do reinsertion. The effectivity of IUCD was 100%, with 68.9% subjects was still breastfeeding. The side effects were vaginal discharge (23%), dysmenorrhea (4-21%), and spotting (2-10%).
Conclusion: The acceptability and effectivity of postplacental IUCD after 6 months were 86.8% and 100%. Cummulative expulsion rate were 12.6%, and the most common side effects were vaginal discharge, dysmenorea, and spotting.
Keywords: acceptability, effectivity, expulsion rate, IUD, postplacent
The Accuration of Liquid Based Cytology and HPV DNA Test Combination as Precervical Cancer Lesion Screening: Akurasi Pemeriksaan Kombinasi Liquid ÂBased Cytology dan Tes DNA HPV sebagai Penapis Lesi Prakanker Serviks
Get PDFObjective: To investigate the accuracy of liquid-based cytology, HPV DNA test, and the combination of liquid-based cytologyband HPV DNA test, compared to histopathology as the gold standard of precervical cancer lesion screening.
Methods: This was a cross-sectional study. The medical records of patients who came to the Women’s Health Clinic of Dr. Cipto Mangunkusumo Hospital during the period of July 2013 to December 2015 were evaluated.
Results: The high risk type HPV DNA is detected in 76% CIN 1, 88.46% CIN 2, and 84.21 CIN 3 in histopathology results. The accuracy of liquid-based cytology; sensitivity 88.54%, specificity35.71%, PPV 75.89%, and NPV 57.69%. The accuracy of HPV DNA; sensitivity 81.25%, specificity 78.57%, PPV 89.66%, and NPV 64.71%. The accuracy of combination: sensitivity 94.79%, specificity 35.71%, PPV 77.12%, and NPV 75%.
Conclusion: The addition of HPV DNA test increased the sensitivity from 88.54% to 94.79% because of decreasing of false negative of liquid-based cytology. This thing has showed that the combination of liquid-based cytology and HPV DNA test could the one of the option of precervical cancer lesion screening method, especially in secondary or tertier health center in Indonesia.
Keywords: accuracy test, HPV DNA, liquid-based cytology, precervical cancer lesion, precervical cancer lesion screenin