Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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The Impacts of Pelvic Floor Dysfunction Counseling to Knowledge Level and Attitude of Pregnant Women with Gestational Age above Thirty Six Weeks in the Selection of Delivery Method
Get PDFObjective: To determine the level of knowledge about pelvic floor dysfunction before and after counseling in term pregnant women and knowing whether a difference a change of attitude in the selection method of delivery before and after counseling.
Methods: This study design using pre - post test. At the beginning of our study provide some sort of written test to determine the initial knowledge of participants prior to the extension and the selection of the desired method of delivery. Having obtained the results of the test, followed by education about pelvic floor dysfunction. Then do the post-test to determine the level of knowledge of the subject and mode of delivery that would be pursued. The study took place between February and May 2016 in 5 Public Health Center (PHC) in Jakarta that PHC Warakas (North Jakarta), PHC Tanah Abang (Central Jakarta), PHC Cengkareng (West Jakarta), PHC Jatinegara (East Jakarta) and PHC Jagakarsa (South Jakarta).
Results: A total of 102 study subjects who began the study gave the results of the pretest mean 71  10.49 (p<0.0001) and post test results of 80.725  7.7 (p<0.0001). Of the 102 subjects who began the study, there were two people who had previously chose method of delivery by caesarean section turned into vaginal.
Conclusion: There is a change scores better in knowledge about pelvic floor dysfunction after counseling. There was no significant
difference between selecting the desired method of delivery before the after counseling.
[Indones J Obstet Gynecol 2017; 5-2: 99-104]
Keywords: fecal incontinence, pelvic floor dysfunction, sexual dysfunction, stress urinary incontinence, uterine prolaps
Human Papilloma Virus L1 Gene Methylation as a Potential Biomarker for Precancerous Cervical Lesion: a Preliminary Report
Get PDFObjective: To determine whether HPV L1 gene methylation can be used in triage of precancerous cervical lesions. The main objective is to determine the genotype of HPV in cervical precancerous lesions and to determine the percentage, the sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio of DNA HPV L1 methylation in precancerous cervical lesions.
Methods: A number of 57 samples of paraffin blocks (FFPE) from precancerous lesions and cervical cancer biopsies in the Department of Pathology Faculty of Medicine-Cipto Mangunkusumo General Hospital that had been re-evaluated by the pathologist, underwent extraction of HPV DNA. The genotypes of HPV DNA were examined using primers GP5 / 6 and specific HPV 16, HPV 18 and HPV 52 probes and analyzed by real time PCR. Sequencing was performed on samples with unknown HPV DNA type that were detected using the specific probes to determine the type of HPV. Bisulfite conversion procedure was then performed for the samples that met the inclusion criteria.
Results: There were 30 samples (52.6%) with CIN 1, 12 samples (21.1%) CIN 2, 9 samples (15.8%) CIN 3 and 6 samples (10.5%) of cervical cancer. Most of the samples were 36-45 years (35.1%). Of the total 57 samples, 55 samples were successfully extracted and determined the DNA genotyping of HPV (96.5%). HPV 16 infections both in the form of single or multiple was found to be 76.36%. The samples were mostly dominated by co-infection of HPV16 and 18 (49.1%) followed by HPV 16 (24.6%) and HPV 18 (14.0%). Based on the sequencing results there were other types of high risk HPV infection found: HPV 33, HPV 35, HPV 58 and also undeterminate risk HPV 53 and low risk HPV 54. After several procedures of optimization for methylation examination of HPV DNA L1 there was thin band found in electrophoresis procedure in 8 of 42 samples (19%) of HPV 16 after bisulfite conversion but once it was purified there weren’t any band found so we can not proceed to the stage sequencing. Until now we are still in the stage of optimizing the methylation procedure.
Conclusion: HPV 16 infection were most commonly found in the form of single or multiple. Co-infection of HPV 16 and 18 were found in the majority of the samples. There were no significant correlation between HPV type and the severity of cervical lesions. Until now, the examination of DNA methylation HPV L1 already obtained eight samples of HPV 16 with a thin band on electrophoresis but the result could not be concluded because it is still in
the process of optimization.
[Indones J Obstet Gynecol 2017; 5-2: 120-126]
Keywords: HPV DNA genotype, L1 gene methylation, precancerous cervical lesion
Prediction of Vaginal Delivery Using Fetal Head Descent Assessed Using Transperineal Ultrasound: Penilaian Penurunan Kepala dengan USG Transperineal untuk Penentuan Keberhasilan Persalinan Pervaginam
Get PDFObjective: To evaluate the use of transperineal ultrasound in predicting the successfulness of vaginal delivery.
Methods: This was a prospective study conducted at Karawang District Hospital during the period between March 2016 and May 2016. Inclusion criteria were term pregnancy, singleton live head presentation, and active phase of labor. Using transperineal ultrasound, fetal head perineum distance, and angle of progression within relaxation phase between contraction were being calculated.
Results: There were 306 subjects who delivered vaginally. The cut off value for fetal head perineum distance as a predictor of vaginal delivery was 43.5 mm (sensitivity 91%, specificity 78%), with area under a curve of 82% (95% CI 69 - 95%, p < 0.01); while angle of progression is 107° (sensitivity 80 %, specificity 97%), with Area under curve is 96.4% (95% CI 87 - 99%, p < 0.01).
Conclusion: Fetal head perineum distance and angle of progression can predict the successfulness of vaginal delivery.
[Indones J Obstet Gynecol 2017; 5-3: 149-153]
Keywords: angle of progression, fetal head-perineum distance, prediction of vaginal delivery, transperineal ultrasoun
Sensitivity and Specificity of the SelfAdministered HPV Testing in Detecting Precancerous Conditions of the Cervix and Cervical Cancer: sensitivitas dan Spesifisitas Pemeriksaan Mandiri dalam Mendeteksi Lesi Prakanker dan Kanker Serviks
Get PDFObjective: To determine the sensitivity and specificity of selfadministered Human Papilloma virus (HPV) test in detecting pre-cancerous lesions and high degree cervical cancer.
Methods: A case control study design was used in this study. This study was conducted at Dr. Wahidin Sudirohusodo Hospital and its affiliate hospitals during the period of October 2014 to May 2015. Measurement data using HPV self test grant from the Dutch School Netherlands, Evalyn Brush. Collecting data used questionnaires before and after doing HPV self test. Laboratory tests are carried out in Kalbe Genomic using HPV Genotyping capable detect 35 types of the HPV virus.
Results: A total of 101 subjects were involved in this study. The subjects were divided into two groups, the case and the controls (n = 50/51). Level of sensitivity and specificity were obtained for HPV self test (56% vs 98%). The level of acceptance of new tests by 62.37% (63 out of 101 respondents) of them admitted that the new test is simple / easy enough to do. The acuracy rate of diagnostic test of this examination is 79%.
Conclusion: Self-administered HPV test could be used as an alternative or primary screening for cervical cancer.
[Indones J Obstet Gynecol 2017; 5-3: 173-179]
Keywords: HPV, self, specificity, the sensitivit
Clinical and Laboratory Predictors of Deep Vein Thrombosis in Ovarian Malignant Tumor: Prediktor Klinis dan Laboratorium dari Trombosis Vena Dalam pada Tumor Ganas Ovarium
Get PDFObjective: To investigate the clinical and laboratory predictors of symptomatic deep vein thrombosis (DVT) in ovarian malignant tumor.
Methods: One hundred sixteen patients with suspected ovarian malignant tumor were recruited. Age, body mass index (BMI); D-dimer, fibrinogen, thrombocyte level, comorbid, tumor diameter, staging, distant metastasis, ascites, histopathology, length of surgery, blood loss and transfusion were recorded.
Results: Incidence of symptomatic DVT was 16.5% and 88.2% cases occurred before surgery. No case of symptomatic DVT during postoperative care was found. Predictors of DVT were distant metastasis (OR 28.99; 95% CI 3.83-219.52, BMI ≥ 22.7 kg/m2 (OR 15.52, 95% CI 2.24-107.37), D-Dimer ≥ 1700 mg/ml (OR 13.30, 95% CI 2.40- 73.84), advanced stage (OR 6.66; 95% CI 1.05-42.27), epithelial tumor (OR 6.5; 95% CI 0.34-125.75), tumor’s diameter ≥ 18.25 cm (OR 2.36, 95% CI 0.48-11.54), and comorbidity (OR 2.49, 95% CI 0.53-11.66). Prediction score of DVT were score 3 for distant metastasis, BMI ≥ 22.7 kg/m2, D-Dimer ≥ 1700 mg/ml, score 2 for advanced stage, score 1 for tumor diameter ≥ 18.25 cm, comorbid, epithelial tumor and score 0 for the absence of variables or its value less than the cut off. Total score ≥ 8 of 14 is the least score which has a good predictive value for DVT with AUC 0.92, 95% CI 0.86-0.92, probability 86.46%.
Conclusion: Distant metastasis and D-dimer are independently associated with the development of DVT in ovarian malignant tumor.
[Indones J Obstet Gynecol 2017; 5-3: 180-184]
Keywords: deep vein thrombosis, D-dimer, ovarian malignant, tumor predicto
Incidence and Audit of Treatment on Third and Fourth Grade Perineal Tear
Get PDFObjective: To describe the incidence of 3rd and 4th grade perineal
tear in Dr. Cipto Mangunkusumo hospital on the period of 2011 -
2014 and its compatibility of treatment based on RCOG guidelines.
Methods: Data were collected through medical records on women
who had vaginal delivery in Dr. Cipto Mangunkusumo hospital from
January 2011 to December 2014. This was a descriptive study with
cross sectional design.
Results: The incidence of 3rd and 4th grade perineal tear each year
were 3.55%, 4.35%, 3.95%, and 1.77% consecutively. About 100%
treatment were accompanied by consultant; 3.5% performed in
operating theatre; 90.7% were given postoperative antibiotic;
42.2% were given urinal catheter in 1x24 hour postoperative;
100% were given analgesic. About 61.4% of procedures were not
compatible with RCOG guidelines.
Conclusion: The study showed that the incidence of 3rd and 4th
grade of perineal tear was 3.66% for 4 years and the compliance to
RCOG standard was 38.6%.
[Indones J Obstet Gynecol 2017; 5-1: 35-41]
Keywords: incidence, RCOG, third and fourth grade of perineal tear,
treatmen
Single vs Multiple Dose of Cefazolin Prophylaxis in Elective Cesarean Section
Get PDFIntroduction: Caesarean section (CS) is one of port d’ entrée from
infection in women and it is related to maternal morbidity during
puerpureal period. Until now, there is still lack of consensus
regarding prophylactic antibiotic protocol before CS procedure. This
study aims to determine the comparative efficacy between single
dose and multiple doses of cefazolin prior incision toward the
incidence of maternal infection.
Methods: This was a single-blind, randomized, clinical trial study
with two methods of intervention including 2-gram single dose
cefazolin at 30 minutes’ prior incision and 2-gram single dose
cefazolin at 30 minutes’ prior incision continued 1-gram cefazolin
after 8 hours of procedure. We recruited women undergone elective
CS at Fatmawati and Anna Hospital, Jakarta from January to March
2016. The primary outcomes were surgical site infection, urinary
tract infection, and endometritis based on clinical findings during 30
days of follow-up period.
Results: A total of 46 subjects were recruited which 23 of them were
in single dose cefazolin group and the other 23 subjects were in
multiple dose of cefazolin group. There were 9 subjects having
infection (19.6%). There was no statistical difference in the
incidence of infection between two groups (p=1.00; relative risk
0.80, 95% CI 0.25-2.61).
Conclusion: Single dose of cefazolin shows similar rates of infection
incidence to multiple dose. Therefore, single dose of cefazolin can be
a protocol in CS based on its efficacy and efficiency.
[Indones J Obstet Gynecol 2017; 5-1: 60-65]
Keywords: cefazolin, maternal infection, multipe dose, single dos
Anti Müllerian Hormone as a Predictor of Metabolic Syndrome in Polycystic Ovary Syndrome
Get PDFObjective: To evaluate whether Anti Müllerian Hormone (AMH) can be used as a predictor of metabolic syndrome in Polycystic Ovarian Syndrome (PCOS).Methods: This cross-sectional study was conducted in Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital Jakarta between June and December 2012. Forty-one patients diagnosed with PCOSbased on Rotterdam Criteria were enrolled. Secondary were was taken from medical record..Results: A total of 22 subjects were involved in this study. Mean AMH level in the metabolic syndrome group is compared to the non-metabolic syndrome group (10.72 ± 6.23 ng/ml vs 7.97 ± 4.50ng/ml, p=0.12). AMH was strongly associated with HDL, triglyceride and insulin resistance (r-value of -0.29, 0.23, and 0.21 respectively, p < 0.05).Conclusion: AMH can be used as a predictor of metabolic syndrome in PCOS.[Indones J Obstet Gynecol 2017; 5-2: 83-86]Keywords: anti müllerian hormone, metabolic syndrome, polycystic ovarian syndrom
Evaluation of the Accuracy of Human Kallikrein6, Cancer Antigen125, and Human Epididymis 4 in Predicting Ovarian Cancer
Get PDFObjective: To evaluate the accuracy of hK6, HE4, and CA125 in predicting the malignancy of ovarian mass.
Methods: The design of this study was cross-sectional. This study was conducted in the Obstetrics and Gynecology Clinic, Sanglah Hospital, Denpasar, between the period of September 2014 and August 2016. Samples were all patients with ovarian tumors who underwent surgery at Sanglah Hospital, Denpasar. Data analysis was performed using McNemar and chi square test in SPSS for windows version 17.0.
Results: 22 samples were obtained. P > 0.05 value of age and parity variables indicated no differences between the two groups. There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of hK6 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of HE4 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy difference (sensitivity, specificity, positive predictive value, negative predictive value) of CA125 compared to histopathology examination in diagnosing ovarian cancer (p = 0.687).
Conclusion: There was no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) found between hK6, CA125, HE4 compared to histopathology examination in predicting ovarian cancer.
[Indones J Obstet Gynecol 2017; 5-2: 110-113]
Keywords: cancer antigen 125, human epididymis-4, human kallikrein 6, ovarian cance
Increased Rate of Cesarean Section among Teenage Mothers Attending a Tertiary Teaching Hospital in Indonesia: Peningkatan Angka Seksio Sesarea pada Ibu Remaja yang Datang keSuatu Rumah Sakit Pendidikan di Indonesia
Get PDFObjective: To evaluate adverse obstetrical outcome in teenage pregnancy, and to investigate whether the social factor, demographic factor, and antenatal care is associated with the management of delivery in teenage pregnancy.
Methods: A cross-sectional study was conducted by evaluating medical records teenage mothers who went to Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia during the period of January 2010 to December 2015.
Results: From 186 teenage pregnancies, 75 pregnancies was terminated by cesarean section procedures (40.3%). The amount of antenatal care visit was significantly associated with teenage pregnancy (OR 4.14, CI95% 1.86-9.21). The provider of antenatal care, maternal age classification, education, and insurance were not signifcantly associated with management of labour.
Conclusion: Teenage pregnancy is associated with higher cesarean section rate.
[Indones J Obstet Gynecol 2017; 5-3: 131-134]
Keywords: cesarean section, profile, teenage pregnanc