Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Level of Retinol Deposit and Cervical Cancer
Get PDFObjective: To analyze level of retinol deposit sufficiency in the
natural history of cervical cancer.
Methods: Serum retinol level was measured by ELISA from
peripheral blood of subjects with normal cervix, cleared and
persistent high risk human papilloma virus (HR-HPV) subclinical
infection, and cervical cancer who fulfilled the inclusion and
exclusion criteria. The study was held in Dr. Cipto Mangunkusumo
and Fatmawati Hospital, Jakarta, within 2 years (August 2013-
2015). Blood was taken twice, consisting of post-8-hour fasting
blood and 2 hours after 6000 IU retinyl palmitate oral
administration.
Results: Of 47 total samples, sufficient level of retinol deposit in
normal cervix, cleared and persistent HR-HPV subclinical infection,
and cervical cancer group was 85.0% (reference), 75.0% (OR 1.89),
33.3% (OR 11.33), and 75% (OR 1.89); respectively. Statistically,
there was no significant difference from sufficiency level of retinol
deposit between normal cervix and clearance HR-HPV subclinical
infection (p=0.628), normal cervix and persistent HR-HPV
subclinical infection (p=0.078), normal cervix and cervical cancer
(p=0.433), cervical cancer and clearance HR-HPV subclinical
infection (p=1.000), cervical cancer and persistent HR-HPV
subclinical infection (p=0.430), persistent and clearance HR-HPV
subclinical infection group (p=0.740).
Conclusion: This study proves that normal cervix group has the
highest level of retinol deposit sufficiency; however, it cannot
be stated that cervical cancer group has less sufficiency level.
Persistent HR-HPV subclinical infection group has the lowest
level of retinol deposit (OR 11.33). There is no association
between sufficient level of retinol deposit and clearance of
HR-HPV.
[Indones J Obstet Gynecol 2017; 5-1: 46-54]
Keywords: cervical cancer, HR-HPV clearance, retinol deposi
Endothelin1 Levels in Pregnant Women with Severe Preeclampsia and Normal Pregnant Women
Get PDFObjective: To determine the ratio of serum endothelin-1 levels between severe preeclampsia and normotensive pregnancy.
Methods: Observational analytic study using cross-sectional. Sixteen woman with normal pregnancy and sixteen others with severe preeclampsia who met the inclusion and exclusion criteria, were tested for ET-1. The serum was analyzed at Prodia Laboratory, Manado. The ET-1 level was examined using ELISA (R&D Systems, Inc., Minneapolis, MN 55413, USA). The data obtained was analyzed using SPSS software version 20.0.and discussions were held using the existing literature theory.
Results: The mean and median levels of endothelin-1 plasma in patients with severe preeclampsia is 2:46 ± 1:44 pg/ml, 1:09 ± 0:26 pg/ml, whereas in normotensive pregnancy is 1:03 ± 0:26 pg/ml,
1.95 ± 1:44 pg/ml with p < 0:05 (0000).
Conclusion: There was a significant difference between endothelin- 1 level in severe preeclampsia and normotensive pregnancies.
[Indones J Obstet Gynecol 2017; 5-2: 77-82]
Keywords: endothelin-1, normotensive, preeclampsi
Preterm Labor and the Associated Factors
Get PDFObjective: To determine the risk factors that affect preterm labor in
Dr. Cipto Mangunkusumo Hospital.
Methods: This was an analytic descriptive study done in Emergency
Unit of Dr. Cipto Mangunkusumo Hospital from July to December
2014. We recruited all women who gave birth in Emergency Unit of
Dr. Cipto Mangunkusumo Hospital from July to December 2014 with
gestational age less than 37 weeks. Of the total sampling method, we
got 365 patients. We analyzed the data using chi square.
Results: The characteristic age of subjects were 14.0% of less than
20 years old, 69.0% of 21-35 years old, and the rest were more than
35 years old. Most subjects (93.1%) were employed, 94.5% were
married once, 62.3% of subjects had cesarean section history, 73.7%
were primiparous, only 4.4% had history more than 1 abortion, and
most of them were at 33-36 weeks of gestation. Socio-demographic
factor associated with preterm labor and Preterm Premature
Rupture of Membrane (PPROM) was age (p=0.011; OR 1.74; 95% CI
1.136-2.679). Obstetric history associated with preterm labor and
PPROM was parity (p=0.017; OR 1.78; 95% CI 1.132-2.878).
Conclusion: In this study, age and parity are associated with
preterm labor and PPROM.
[Indones J Obstet Gynecol 2017; 5-1: 3-7]
Keywords: obstetric history, parity, PPROM, preterm labor,
socio-demographic factor
Role of Glycated Albumin during Pregnancy
Get PDFObjective: To determine the glycated albumin profile during
pregnancy with normal glycemic status.
Methods: We recruited 60 pregnant women between 21 and 36
weeks of gestation. We conducted several laboratory tests, such as
glycated albumin, blood glucose, and albumin. These parameters
were compared among four groups of gestational age (21-24 weeks,
25-28 weeks, 29-32 weeks, and 33-36 weeks) using ANOVA or
Kruskal-Wallis test continued by Post-hoc test.
Results: Glycated albumin was not statistically different among the
groups. Albumin level of 33-36 weeks of gestation women (3.6 (SD
0.2) g/dl) was lower than 21-24 weeks of gestation women (3.8 (SD
0.2) g/dl).
Conclusion: Glycated albumin level is not affected by gestational
age. Therefore, glycated albumin may be used as glycemic status
indicator during pregnancy from 21 to 36 weeks.
[Indones J Obstet Gynecol 2017; 5-1: 16-18]
Keywords: HbA1c, glycated albumin, glycemic status, pregnanc
Acceptor Comment of PostPlacental Copper T380A Intrauterine Device
Get PDFObjective: To describe the characteristics of subjective complaints
reported by post-placental inserted intrauterine device (IUD)
acceptor, especially those who used Copper T380A (CU T380A) type
of IUD.
Methods: Seventy-two-married women whose age ranged from 19
to 44 years old and received post-placental IUD in Dr. Cipto
Mangunkusumo Hospital, Jakarta, were included in this study.
Subjective complaints regarding the use of CU T380A IUD were
evaluated twice including during the puerperium and six months
afterwards by a direct interview.
Results: Most respondents were 20-35 years old, 50% of whom
were primiparous (n=36). There were 42% respondents reporting
pain during insertion, 32% respondents reporting abdominal pain
during the use, 22% respondents reporting menstrual disorder,
18% respondents reporting vaginal discharge, and 3% respondents
complaining of having IUD repulsion.
Conclusion: There are variety of subjective complaints reported
after post-placental IUD use. However, most of the respondents does
not complain anything.
[Indones J Obstet Gynecol 2017; 5-1: 19-22]
Keywords: complication, contraception, intrauterine device (IUD)
post-placental, postpartu
Feasibility Profile of Endometrial Nodule Resection in the Uterosacral and Rectovaginal Ligament
Get PDFObjective: To know the feasibility of uterosacral and rectovaginal
nodule resection in endometriosis patients who
underwent laparoscopy surgery in Fatmawati Hospital.
Methods: Observational study was done by involving trained and
experienced laparoscopist who performed deep infiltrating
endometriosis (DIE) nodule resection laparoscopy on uterosacral
and rectovaginal ligament. We observed on 35 patients which were
histologically proven of DIE. We recorded the total procedure time,
surgical complications occurred intra-operative, postoperative, and
length-of-stay. The data were described descriptively.
Results: Mean (SD) of total laparoscopic procedure time including
nodule resection was 200 (SD 52) minutes. There were two
procedures (5.7%) with intra-operative complications, one (2.9%)
with bowel injury which was converted to laparotomy, and the other
one (29%) with intra-operative bleeding so that the operator
cancelled nodules resection. Mean (SD) on length of stay after the
procedures was 2.5 (2.1) days. On follow up observation, there was
not any postoperative complication.
Conclusion: Laparoscopic uterosacral and rectovaginal nodules
resection in endometriosis patient is feasible to be done by
trained and experienced laparoscopic surgeon.
[Indones J Obstet Gynecol 2017; 5-1: 42-45]
Keywords: endometriosis, laparoscopy, nodule resectio
Neutrophil and Platelet to Lmphocyte Ratio in Ovarian Malignancy
Get PDFObjective: To determine the sensitivity and specificity of neutrophil
- lymphocyte ratio compared with platelet - lymphocyte ratio in
predicting ovarian malignancies.
Methods: This was an observational analytic study with diagnostic
test design on 37 ovarian tumor patients who were planned to
perform laparotomy in Prof. Dr. R.D. Kandou Hospital Manado and
network hospitals in Manado from March to May 2016. We took
blood samples to assess the complete blood count.
Results: During the period, we obtained the mean age of 28.1 years
old (range 18-71 years old). A total of 13 samples showed
malignancy which the cystadenocarcinoma mucinosum (27.0%) as
the most common histopathological types. Sensitivity and specificity
value of neutrophil - lymphocyte ratio were 92.3% and 95.8% with
2.47 as the cut-off point. Meanwhile, the sensitivity and specificity
of platelet - lymphocyte ratio were 61.5% and 75.0% with 152.86
as cut-off point.
Conclusion: Both neutrophil - lymphocyte ratio and platelet -
lymphocyte ratio are associated with ovarian malignancy. The
sensitivity and specificity of neutrophil - platelet ratio show better
prediction for ovarian malignancies.
[Indones J Obstet Gynecol 2017; 5-1: 55-59]
Keywords: neutrophil - lymphocyte ratio, ovarian cancer, platelet -
lymphocyte rati
The Impact of Educational Intervention of HighRisk Pregnancy and HighRisk Childbirth on Knowledge, Attitude, and Behavior in Recognizing Danger Signs in Pregnancy: A Single Blind Clinical Trial
Get PDFObjective: To assess the impact of additional educational interventions given to pregnant women in identifying high-risk pregnancy and high-risk childbirth by measuring changes in knowledge, attitudes and behaviors in the pregnancy and after childbirth.
Methods: This study was a single blind clinical trial conducted at obstetrics out-patient clinic of Dr. Cipto Mangunkusumo Hospital, Jakarta. Total sample were 52 responders, for the 26 responders to the control group and 26 responders to the intervention group. The research instrument was a questionnaire form, which include knowledge, attitude and behaviour of a number of 48 questions. Analysis was performed using SPSS 20 with bivariate analysis.
Results: We did not found significant differences in a range of age (30.65  29.38 with 1.20  0.75), education (both groups showed a high level of education) and employment for both groups. We found significant differences on knowledge, behaviour (p = 0.001 and = 0.042, respectively) on the first antenatal care compared with after childbirth.
Conclusion: The educational intervention gives significant impact in attitude and behaviour.
[Indones J Obstet Gynecol 2017; 5-2: 69-72]
Keywords: attitude, behaviour, educational intervention, knowledg
The Degree of Cystocele and Rectocele with Hiatal Area Levator Ani: Derajat Cystocele dan Rectocele dengan Hiatal Area Levator Ani
Get PDFObjective: To investigate the degree of cystocele and rectocele with a maximum of levator hiatal area (AHL) during Valsava.
Methods: Secondary data analysis of 90 patients with uterine prolapse January 2012 to November 2013 in the clinic Uroginekologi RSCM, Jakarta. 3D/4D ultrasound measurement and pelvic organ prolapse system Quantification (POP-Q) stage I-IV cystocele and rectocelestage I-IV. All statistical analyses were analyzed using Stata 20 for Windows.
Results: Significant difference cystocele stage I-II (n = 25) with stage III-IV (n = 65), the maximum AHL with a difference of 4.33 cm2 (p = 0.040). In rectocele stage I-II (n = 64) and stage III-IV (n = 26) of 3.85 cm2 (p = 0.130). AUC values for stage I-II and III-IV cystocele was 0.607 (IK95% from 0.467 to 0.738), and the ROC for rectocele was 0.603 (IK95% from 0.472 to 0.734). The ROC optimal cut point for cystocele stage I-II with III-IV with the highestsensitivity and specificity is 29 cm2 (0.523 sensitivity, specificity 0.520), the rectocele is 30 cm2 (0.538 sensitivity, specificity 0.584).
Conclusion: There is a significant relationship between the degree of cystocele and area of the levator ani muscles when Valsava, but there is no relationship at rectocele. The value of maximum area under the curve (AUC) hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystocele are relatively similar to rectocele stage I-II and III-IV. Optimal cut point hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystoceleis 29 cm2, while for rectocele is 30 cm2 with sensitivity and specificity values were quite good.
Keywords: cystocele, levatorani hiatal area, pelvic organ prolapse, rectocel
The Efficacy of Monoplant® and Indoplant® as Contraceptive Methods: A Comparative Study
Get PDFObjective: To determine the effectiveness, safety, and time of insertion between Monoplant® with Indoplant® to prevent pregnancy.
Methods: Data were collected from November 2015 until May 2016 in Raden Saleh Clinic. A total of 153 patients met the inclusion and exclusion criteria for the study and were divided into 77 patients who received Monoplant® and 76 patients received Indoplant®. The study period was 6 months.
Results: The data obtained showed no significant difference in the effectiveness of both contraceptive methods. In addition, side effects such as menstrual disorders and weight gain did not differ significantly in those study groups. However, the time of insertion between Monoplant® and Indoplant® was siginificantly different (162.91 + 197.04 + 49.81 seconds versus 44.96 seconds, p<0.001). For complications such as skin irritation, inflammation, there are no differences
between Monoplant® (0.0%) and Indoplant® users (0.0%).
Conclusion: There are no significant differences in efficacy and side effects using Monoplant® and Indoplant® during the 6-month follow-up. However, the insertion time of Monoplant® is shorter compared to Indoplant®’s. Monoplant® can be considered for use as contraception with the effectiveness and side effects are almost the same, but with shorter time of insertion compared to Indoplant ®.
[Indones J Obstet Gynecol 2017; 5-2: 94-98]
Keywords: contraception, implant, indoplant®, monoplantÂ