Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Clinical Characteristics and Management of Adolescent Ovarian Cysts
Full text linkObjective : The aim of this study to give clinical characteristic of ovarian cysts in adolescent patient and comprehend the delineation of the management protocol implemented in patients diagnosed with ovarian cysts
Methods : This study used a retrospective method conducted by reviewing patient medical records. This study was conducted by collecting medical record data retrospectively for 5 years at PKU Muhammadiyah Gamping Hospital and Panembahan Senopati Bantul Hospital. All data of outpatients, and inpatients diagnosed with ovarian cysts from January 2018 to July 2023 aged 11-21 years were taken to be included in the study.
Results: A total of 56 adolescent patients were identified with ovarian cysts. Researchers found most patients with adolescent age group 18-21 years (n=43). Patients presented with a chief complaint of abdominal pain and the cyst was unilateral.
Conclusion :. The patients exhibited a primary concern of pain, and the cyst was found to be located on one side only. Efforts to save the ovary were deemed vital owing to the relatively low probability of cyst malignancy. In this study also found that there were no correlation between clinical symtopms (abdoment pain, nausea and menstrual disorder) with size of cyst.
Keywords: adolescents, clinical characteristic, ovarian cyst, managemen
Nature and Degree of Severity of Consultations in Gynecological Emergencies: A Tunisian prospective study
No full textAbstractIntroduction: Gynecological emergencies are often crowded with false emergencies. They overwhelm doctors who also have to manage the birth room. The main objective of our work was to assess the type and degree of severity of pathologies encountered in gynecological emergencies.Methods: This is a prospective descriptive study, carried out in the gynecological emergencies of the Mongi Slim hospital, Tunisia, from July 1 to July 21, 2023. We have defined the reality of the emergency as the main endpoint and we have classified the women in three groups: "real" emergencies, "legitimate" emergencies and "false" emergencies.Results:We included 179 patients. The average age of the consultants was 32 years old. They had no gynecological follow-up (83.8 percent) and consulted the emergency room on their own initiative (88.8 percent). They consulted most often for abdominopelvic pain (41.9 percent) and bleeding (28 percent). Pelvic ultrasound was almost always performed (87.7 percent), as well as plasma beta-HCG assay (45.3 percent). The patients were hospitalized in 14.5 percent of cases, readmitted to central emergency departments in 20.1 percent and sent home in 65.4 percent of cases. In the end, we found that only 11.1 percent of the emergency room consultants presented a real gynecological emergency.Conclusions:Better organization of primary care, improved university training in gynecology for future family physicians and better information for the population must be encouraged so as not to unnecessarily encumber the gynecological emergency departments.Key words : Emergencies, diagnosis, treatment, gynecology, ultrasoun
Social Determinants of Maternal Mortality Trends in Banyumas Regency: A Qualitative Study
Full text linkBackground: Indonesia reduced maternal mortality from 390 per 100,000 live births in 1994 to 228 in 2007, but this rose again to 305 in 2015. In Banyumas Regency, maternal mortality declined from 2014 to 2020 but increased again from 2021 to 2023.
Purpose: This study aims to identify social determinants affecting maternal mortality trends in Banyumas from 2014 to 2023.
Methods: A qualitative study was conducted following the Standards for Reporting Qualitative Research (SRQR). Data collection involved in-depth interviews with 45 respondents—including health office staff, hospital informants, midwives, and health cadres—and a Focus Group Discussion. Interviews and discussions were guided by semi-structured protocols to explore participants’ views on maternal health issues.
Results: Most respondents had over three years of experience and were aged 40–50. Key themes emerged: challenges in maternal and neonatal health services, referral refusal influenced by sociocultural factors, emergency training for health workers, collaboration and tiered referral systems, and hospital standardization.
Discussion: The five key determinants influencing maternal mortality rate in Banyumas Regency were identified: human resource adequacy in maternal care, continuity of emergency training, accessibility of referral systems and collaborations, and hospital standardization. Healthcare personnel shortages, especially post-Covid-19, also combined with inadequate emergency training, may affect the healthcare quality. Sociocultural beliefs and poor referral coordination lead to treatment delays, particularly in rural areas. Inconsistencies in hospital standardization further exacerbate access inequities. While maternal mortality showed a declining trend from 2014 to 2023 (excluding pandemic years), systemic challenges remain. Strengthening referral systems, improving hospital standards, continuous training, and culturally sensitive public education are crucial.
Conclusion: Social determinants influencing maternal mortality trends include the adequacy of human resources, ongoing emergency maternal and neonatal training, accessible and integrated referral systems, consistent hospital accreditation standards (PONEK), and sociocultural factors. Addressing these areas is essential to improving maternal health outcomes in Banyuma
Impact of Nutritional Intervention Using Mung Bean Juice and Soy Milk on Hemoglobin Levels in Adolescent Girls
Full text linkObjectives: Anemia, which the general population is more familiar with as anemia, is below normal or is known as hemoglobin (HB), with women's typical levels being 11 gr/dl and 13 gr/dl in teenage boys. Anemia data in the Jambi Province area, the number of anemia sufferers aged 10-14 years (19.5%), 15-24 years (84.6%), 25-24 years (33.7%), 35-44 years (33 .6%), and 45-54 years (24%). Data on the number of anemia in Muaro Jambi is 97 people
Methods: his study employed a quasi-experimental design methodology (quasi-experimental) pretest and posttest intervention to compare green bean juice and soy milk for 14 days.
Results: One-way ANOVA was used to evaluate the data. The variables iron, folic acid, vitamin C in the green bean juice intervention obtained a p value of 0.000. The variables iron, folic acid, vitamin C in the soy milk intervention obtained a p value of 0.000. Showing that the hemoglobin levels between the intervention group, the control group of green bean juice and soy milk had quite large significant differences. As a result, hemoglobin levels in the soy milk intervention group in adolescents increased significantly compared to the green bean juice control group with a ratio of 0.68 g/dl per 500 ml to the average hemoglobin level before to the test administration of green bean juice.
Conclusion: The conclusion obtained According to this study, young women's hemoglobin levels can rise when they are given green bean juice and soy milk
Multiple Congenital Anomalies with Breech Presentation: Dilemma in Diagnostic Procedures, Delivery Management, and Counseling in Developing Country
Full text linkObjective: Multiple congenital anomalies present significant diagnostic and management dilemmas, particularly in resource-limited settings. Globally, these conditions affect approximately 1 in 33 infants and are a major contributor to perinatal mortality. We report a rare case of a term pregnancy with severe, undiagnosed multiple congenital anomalies, highlighting the challenges in diagnosis, delivery management, and counseling in a developing country.Case Illustration: A 22-year-old primigravida presented at 35-36 weeks of gestation in active labor with a fetus in breech presentation. Antenatal ultrasonography at 27 weeks had revealed a single live fetus with severe fetal growth restriction, polyhydramnios, and multiple structural anomalies suspicious for an underlying trisomy. Amniocentesis was offered for a definitive diagnosis but was declined by the family. A female neonate was delivered via spontaneous vaginal breech delivery, with low APGAR scores. The infant was admitted to the High Care Unit for respiratory support but passed away the following day due to respiratory failure. The family had opted for a Do Not Resuscitate (DNR) status.Conclusions: In cases of severe fetal anomalies detected by ultrasound, advanced genetic testing like NIPT followed by diagnostic testing should be offered to facilitate definitive diagnosis and counseling. Delivery decisions in such cases should be individualized, prioritizing maternal safety while considering the fetal prognosis. This case underscores the urgent need for improved access to and awareness of genetic counseling and diagnostic services in developing countries to optimize perinatal outcomes.Keywords: breech presentatoin, developing countries, genetic counceling, multiple congenital anomalies, prenatal diagnosis
Quality of Life Among High-Risk Antenatal Women in a Tertiary Care Hospital Kerala, South India
Full text linkObjectives: The study aims to assess the quality of life (QoL) among high-risk antenatal women and to determine its association with selected baseline and obstetric variables.
Methods: A cross-sectional design was utilized, and 82 high-risk antenatal women meeting the inclusion criteria were purposively sampled from the antenatal outpatient department of a tertiary care hospital in Kerala, South India. Data collection involved a structured questionnaire to evaluate baseline, obstetric factors, and the QOL/GRAV Questionnaire to measure QoL. Data were analysed using SPSS version 23. Categorical variables were summarized as frequencies and percentages. The association between selected variables and quality of life (QoL) was assessed using Fisher’s Exact test, and regression analysis was performed to identify predictors of low QoL.
Results: The mean QoL scores of the respondents in the current study were 30.43 ± 4.461, which suggests a good QoL despite potential pregnancy-related challenges. The presence of leg cramps, anaemia, and multiple pregnancies among high-risk antenatal women was significantly associated with reduced QoL.
Conclusion: The findings provide insights into the QoL in high-risk antenatal populations, emphasizing the need for tailored interventions to improve maternal health outcomes.
Key words:antenatal women,high risk, quality of lif
Association Between High-risk HPV Infection and Cervical Precancerous Lesions
Full text linkAbstractIntroduction: More than 70% of cervical cancer cases are associated with high-risk HPV infections, especially those of type 16/18. Persistent high-risk HPV infection can cause cervical lesions and develop into cancer; therefore, early detection of HPV infection is important. Screening using HPV DNA tests, either as a single test or combined with a cervical cytological test, is recommended. This study aimed to determine the association between high-risk HPV infection and the development of cervical precancerous lesions.Methods: This cross-sectional study was conducted on 104 patients at RSUPN Dr. Cipto Mangunkusumo in 2020-2022 using secondary data from HPV DNA test results with the DiagCor GenoFlow Human Papilloma Virus Array Test and cervical cytology results from liquid-based cytology. The data were presented in tables and analyzed using SPSS version 26.Results: The prevalence of high-risk HPV infection was 30.8%, with the most common genotypes being HPV 18 & 52 (15.6%), HPV 51 (12.5%), and HPV 58 (9.4%). Cytological results from the high-risk HPV types showed that 16 out of 32 (50%) were abnormal. High-risk HPV caused 11 (78.6%) low-grade squamous intraepithelial lesions and 5 (83.3%) high-grade squamous intraepithelial lesions. It is known by the statistical analysis test that there was a significant relationship between high-risk HPV infection and cervical precancerous lesions (p=0.000).Conclusion: A significant association was observed between the occurrence of high-risk HPV infection and the development of cervical precancerous lesions. Appropriate management and supervision can be carried out in accordance with risk stratification based on screening results.Keywords: cervical precancerous lesions, high-risk HPV infection, screenin
Incidental Finding of Wandering Spleen
Full text linkIntroduction: Wandering spleen (WS) is a rare case due to inadequate spleen binding ligaments, causing increased spleen hypermobility and displacement of the spleen from the left upper quadrant abdominal location. Case findings can be incidental or symptomatic with acute abdomen due to complications of WS cases.
Case Report: A 36-year-old, gravida 3, para 1, abortus 0, at 41-42 gestational age woman presented at our hospital for planned cesarean section indicated for premature rupture of membranes and preeclampsia. Intraoperative findings revealed that the spleen was incidentally in the pelvic cavity, lateral to the uterus. There were no abnormalities of the spleen intraoperatively, and the patient did not show any complaints related to the abnormal location of the spleen. The patient was planned for Splenopexy to maintain the spleen function.
Conclusion: WS cases are rare, with varied manifestations from asymptomatic to acute abdomen due to acute complications. This patient was asymptomatic, and the findings of the WS were incidental. The most common complications in WS cases are torsion and splenic infarction, with splenectomy as the main treatment. Asymptomatic patients are advised to undergo Splenopexy to maintain spleen function and reduce the risk of WS complications.
Keywords: spleen, ectopic spleen, rare diseases, pregnancy
Clinical Characteristics of Pelvic Organ Prolapse at a Nationally Referred General Hospital: A Retrospective Study (2023-2024)
Full text link AbstractObjective: To evaluate the clinical characteristics of patients with Pelvic Organ Prolapse (POP) in national referral hospitals and analyze the relationship between age, parity, and prolapse severity.
Methods: This medical record–based retrospective study included 353 POP patients from 2023–2024. Variables assessed were age, parity, prolapse severity (POP-Q), sexual activity status, and type of therapy received. Correlation analysis was performed using Spearman’s rank correlation with SPSS version 26.
Results: Most patients (81.3%) were postmenopausal, and 64.6% were multiparous. The majority presented with stage IV prolapse (34.8%), and operative therapy was the primary treatment choice (89.5%). Significant associations were observed between age and prolapse severity (? = 0.208, p < 0.001) and between parity and prolapse severity (? = 0.215, p < 0.001). These findings indicate that increasing age and higher parity are significantly associated with more severe POP, although the correlation strength was weak.
Conclusions: POP was most commonly found in postmenopausal women, with higher severity among older and multiparous patients. These findings highlight the importance of early screening and preventive strategies to reduce POP progression. Further prospective multicenter studies are needed to evaluate the long-term impact of POP on quality of life and to compare the effectiveness of conservative versus operative therapies.
Keywords: conservative therapy, degree of prolapse, parity, Pelvic Organ Prolapse, reproductive age, surgical intervention
Large Epignathus Teratoma: A Rare Case with Ominous Prognosis
Full text linkIntroduction:
The prevalence of epignathus teratomas is found to be less than 1% of all congenital teratomas. Incidence of female fetuses compared to male fetuses (ratio 3:1).
Method :
This case study was conducted at Dr. Hasan Sadikin General Hospital Bandung between September - December 2022.
Case Report :
We presented three cases of large epignathus teratoma with different complications each, with the same outcome, 2 cases of large epignathus teratoma were likely caused due to risk factors of poor environmental influence. The first case, large epignathus teratoma was referred with a suspicion of conjoined twin, the second case was accompanied by pulmonary tuberculosis with intracranial expansion, the third case was large epignathus teratoma with A Umbilical revered of end-diastolic flow and MCA absent end diastolic flow accompanied by scalp edema.
Conclusion:
These three cases are very rare, describing large epignathus teratomas with a poor prognosis based on size and their location associated with perinatal complications. The establishment of the diagnosis is enough to carry out an ultrasound examination. It is important to determine the time and type of labor to be chosen. Inform consent parents is important, especially to know the outcome of the baby and the recurrence in the next pregnanc