Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Correlation of Anti-Müllerian Hormone Level with Ki-67 Expression in Patients with Ovarian Cancer
Get PDFObjective: This research was carried out to discover the correlation between the AMH serum in patients with malignant ovarian tumor of epithelial type with the Ki-67 expression as a marker of proliferation, therefore it was expected through the research to know the role of AMH in the inhibition of proliferation and growth of malignant
ovarian tumor of epithelial type.
Method: The study design was cross-sectional, with data obtained retrospectively from 24 medical records of patients with malignant ovarian of epithelial type, who had been examined for AMH levels in 2009, along with the sample in the form of preparation of paraffin embedded tissue of malignant ovarian tumor patients, who fulfilled the inclusion criteria. Furthermore examination of Ki-67
expression was performed with the statistical analysis using the rank Spearman analysis.
Result: There was a negative correlation between AMH levels and Ki-67 expression in patients with malignant ovarian tumors of epithelial (r = -0.652, p < 0.05).
Conclusion: These data indicate a significant negative
correlation between serum AMH levels and Ki-67 expression in epithelial ovarian cancer patients.
[Indones J Obstet Gynecol 2011; 35-2: 87-90]
Keywords: anti-müllerian hormone, epithelial ovarian cancer, Ki-67, Müllerian inhibiting substanc
Behavior study about teenage pregnancy and related factors in female junior and senior high school students in Jakarta
Get PDFObjective: To get data about female teenage behavior in their
sexual changes, unwanted teenage pregnancy and their negative
consequences, contraception, and the relation between factors which
are related to female teenage behavior.
Method: Cross-sectional study at five Government Junior High
Schools and five Government Senior High Schools in five regions
in Jakarta. Two hundred female teenage respondents, aged between
11-17 years old, came from five Government Junior High Schools
and five Government Senior High Schools in Jakarta who were
picked by cluster random sampling, 20 students from each grade of
school. The respondents were given questionnaires which have been
validated before, and then we did scoring and statistical measurement
with SPSS 13th version.
Result: The respondents’ knowledge about their sexual organ
changes and sexual behavior is moderate (46%), unwanted teenage
pregnancy and their consequences is poor (79.5%), contraception is
poor (62%) and scoring result of knowledge is poor (71%). Knowledge
scoring among respondents aged between 11-14 years old is
poor (85.9%), and also in age group 15-17 years old (60%). Respondents’
attitude about their sexual organ changes and sexual behavior
is good (40.5%), unwanted teenage pregnancy and their consequences
is good (42.5%), while contraception is poor (73.5%), and
scoring result of attitude is poor (56.5%). Attitude scoring in age
group 11-14 years old is poor (68.2%), and in group 15-17 years old
is also poor (47.8%). Respondents’ behavior about their sexual organ
changes and sexual behavior is poor (51%), unwanted teenage
pregnancy and their consequences is good (66%), contraception is
moderate (49%), and scoring result of behavior is moderate (49%).
Attitude scoring age between 11-14 years old is moderate (55.3%),
between 15-17 years old is moderate and poor (each 44.3%). The
relation between behavior and the greatest impression of information
source which is significant is from teacher/school (p=0.001).
The relation between behavior and knowledge is only significant in
age group 15-17 years old (p=0.014). There is significant relationship
between behavior and attitude in age group 11-14 years old
(p=0.013) and 15-17 years old (p=0.000). Determinant factor contributing
to this behavior level is the information taken from their
teacher/school (p=0.010).
Conclusion: Respondents’ behavior about their sexual organ
changes and sexual behavior is poor (51%), about unwanted teenage
pregnancy and their consequences is good (66%), about contraception
is moderate (49%) and scoring result of behavior is moderate
(49%). Attitude scoring in age group 11- 14 years old is slightly better
than in group 15-17 years old.
[Indones J Obstet Gynecol 2010; 34-2: 51-8]
Keywords: teenage pregnancy, unwanted pregnancy, sexual behavior,
contraceptio
Objective: There were only few studies about the characteristic of vaginal pH among contraception user in Indonesia. This study aimed to determine the effect of contraception on vaginal pH among Indonesian women. Method: This study is a cross-sectional study. The target population was Indonesian women aged 15 - 50 years. The samples consisted of 492 people. Based on the method of contraception, subjects were grouped into 4 groups, subjects with combination hormonal contraceptives, progestin only, condoms/IUDs, and subjects with no contraception or sterile. Vaginal acidity (pH) was examined by Dip- Stick (Merck®). Result: The average age was 30.9 ± 8.27. The methods of contraception the subjects used were combination hormonal contraception (18.0%), progestin-only (29.5%), condom/IUDs (5.1%) and no contraception/sterile (47.4%). Most subjects had vaginal pH
Get PDFObjective: There were only few studies about the characteristic
of vaginal pH among contraception user in Indonesia. This study
aimed to determine the effect of contraception on vaginal pH among
Indonesian women.
Method: This study is a cross-sectional study. The target population
was Indonesian women aged 15 - 50 years. The samples consisted
of 492 people. Based on the method of contraception, subjects
were grouped into 4 groups, subjects with combination hormonal
contraceptives, progestin only, condoms/IUDs, and subjects with no
contraception or sterile. Vaginal acidity (pH) was examined by Dip-
Stick (Merck®).
Result: The average age was 30.9 ± 8.27. The methods of contraception
the subjects used were combination hormonal contraception
(18.0%), progestin-only (29.5%), condom/IUDs (5.1%) and no
contraception/sterile (47.4%). Most subjects had vaginal p
Clinical appearance and vaginal cytology of atrophic vaginitis in postmenopausal women
Get PDFObjective: To find out atrophic vaginitis pattern in postmenopausal
women based on clinical appearance and vaginal cytology.
Method: Descriptive retrospective study with hypothesis cohort
to find out clinical appearance and vaginal cytology of atrophic
vaginitis based on distribution of estrogen effect (maturation value/
total maturation index) in post menopausal women in outpatient
clinic of tertiary hospital in Manado, North Sulawesi.
Result: There were 50 subjects met the inclusion criteria. Most
of them are 55 to 59 years old, with length of menopausal period 6
to 20 years, and onset of menopause in 45 to 49 years old. Cytology
study showed that atrophic vaginitis present in 66% patients. Clinical
symptoms are ranging from vaginal dryness (10%), vaginal discharge
(6%), and dyspareunia (20%). From clinical appearance we
found 44% women had atrophic vaginitis based on vaginal secretion,
42% based on macroscopic surface/integrity of vaginal epithelium,
54% based on vaginal rugae and elasticity, and 42% based on
vaginal color. However, 80% of all participants showed vaginal pH
more than 7 and most of them categorized as having atrophic vaginitis.
Conclusion: By using clinical appearance, we found 42% to
54% of menopausal women had atrophic vaginitis, while cytology
study confirmed 66% having it.
[Indones J Obstet Gynecol 2010; 34-2: 92-6]
Keywords: clinical appearance, cytology, menopause, atrophic
vaginiti
Comparison of Macrophage Migration-Inhibitory-Factor (MIF) Serum Level between 28 - 36 Weeks of Pregnancy and Delivery
Get PDFObjective: To analyze the differences in Macrophage Migration Inhibitory Factor (MIF) serum level between 28 - 36 weeks of pregnancy and delivery, and determine the serum level of Macrophage MIF as a risk factor for preterm labor.
Methods: The design of our study was cross sectional of 72 subjects who met the inclusion- and exclusion-criteria that came to Dr. Hasan Sadikin Hospital, Bandung and six satelite hospitals (in July - August 2011). Macrophage Migration Inhibitory Factor (MIF) level was measured with ELISA. Comparison of mean serum levels of MIF between 28 - 36 weeks of pregnancy and delivery was analyzed
using the Mann Whitney test. MIF level, which is a risk factor for preterm delivery, was calculate with a prevalence ratio (PR) based on ROC curve.
Results: Characteristics test in both groups showed homogeneous and comparable data. The mean levels of Macrophage Migration Inhibitory Factor (MIF) in 28 - 36 weeks of delivery was higher (54.433 ng/ml) compared with 28 - 36 weeks of gestation (31.765 ng/ml) with p ≤ 0.001. MIF levels > 37.684 ng/ml had a risk for preterm labor incidence 3.35 times greater than that of ≤ 37.684
ng/ml.
Conclusion: Serum levels of Macrophage Migration Inhibitory Factor (MIF) at delivery was higher than that of at 28 - 36 weeks pregnancy. MIF levels > 37.684 is a risk factor for preterm labor.
[Indones J Obstet Gynecol 2011; 35-3: 115-8]
Keywords: Macrophage Migration-Inhibitory-Factor (MIF), preterm labo
Effect of the Feeding of Formula Milk Enriched with Pro-Antioxidants for the Prevention of Preeclampsia; Study of High Sensitivity C-Reactive Protein (hs-CRP) and Cell-Free mRNA of Plasminogen Activator Inhibitor-1 (PAI-1) in Plasma
Get PDFObjective: To evaluate the effect of the feeding of formula milk enriched with pro-antioxidants to high sensitivity C-reactive protein (hs-CRP) and cell-free mRNA of Plasminogen Activator Inhibitor-1 (PAI-1) in the first trimester, second trimester, and post labor for the
prevention of preeclampsia.
Method: This is double-blinded randomized clinical trial in 8-12 weeks pregnant woman with low (below 900 μmol/l) Ferric Reducing Ability of Plasma (FRAP), as a marker of low systemic antioxidant. A total of 104 samples were collected from patients who had antenatal care in Bunda Hospital Jakarta, Budi Kemuliaan Hospital, and Dr.Cipto Mangunkusumo General Hospital from January 2007
until December 2009. From block randomization, 49 samples were allocated in the case group, and 55 samples to the control group. A formula milk enriched with pro-antioxidants was fed to the case group throughout their pregnancy, and a regular pregnancy formula
milk was fed to the control group. Hs-CRP and cell-free mRNA PAI-1 test in the two groups at first trimester, second, and post labour was conducted. The incidence of preeclampsia was then compared in the two groups.
Result: Significant difference (
Maternal Mortality and Contributing Risk Factors
Get PDFObjectives: Maternal mortality is one indicator to assess a nation’s health care quality. This research was conducted to determine the determinant risk factors for maternal mortality.
Methods: A retrospective case control study at Dr. Mohammad Hoesin General Hospital for 5 years, with 200 samples consists of 50 cases of maternal mortality and 150 physiological labor cases as control group.
Results: For 5 years, there was 109 cases of maternal mortaliy. Of the 50 samples of maternal mortality cases, the most common cause were preeclampsia/eclampsia (50%), followed by hemorrhage (28%). The risk factors were categorized as distant, intermediate, and outcome factors, as stated by McCarthy et al. On bivariate analysis,
we found the significance on maternal education and husband’s occupation (distant factors), residence, referral status, numbers of ANC visits, first attendant, labor facility and history of prior medical history (intermediate factors), and also modes of delivery and complications (outcome factors). On the multivariate analysis to determine
the most contributing risks factors for maternal mortality, it was found that maternal education and residence were the most influencing factors for maternal mortality (OR 5.74 and 4.65 respectively; p=0.001).
Conclusions: The most contributing risks factors for maternal mortality were maternal education and residence.
[Indones J Obstet Gynecol 2012; 36-1:8-13]
Keywords: case control study, maternal mortality, risk factors
Effect of Administering Enteral Nutrition pre Caesarean Section Towards High Sensitivity C-Reactive Protein Levels
Get PDFObjective: To determine the effect of enteral nutrition pre caesarean
section (CS) on high sensitivity C-Reactive Protein (hsCRP)
serum levels post CS.
Method: This clinical trial study on elective CS patients with
lumbal anesthesia, was done to compare hsCRP levels two hours pre
and 48 hours post CS between the treatment group (P) who was
given 200 ml enteral nutrition per oral and control group (K) received
200 ml sweet tea two hours pre CS. The study was already
approved by the Ethical Clearance Research Committee of Faculty
of Medicine University of Indonesia.
Results: Twenty seven elective CS patients in Rumah Sakit
Umum Daerah (RSUD) Bekasi were selected using certain criteria
and divided into two groups using block randomization. Data collected
included age, gestational age, nutritional status, indication, of
CS total blood volume, and duration of CS, as well as energy intake
of energy and protein. Laboratory hsCRP serum levels were examined
two hours pre and 48 hours post CS. Statistical analysis were
performed using t-test and Mann-Whitney, with 5% level of significancy. Twelve subjects in each P and K group, completed the study respectively. The mean of age was 30.08 ± 4.01 years. The nutritional status based on upper mid arm circumference in both groups was normal, while using kartu menuju sehat (KMS) in all of subjects were classified as overweight. The characteristic of the two
groups closely matched at base line (p > 0.05). There was increased
hsCRP serum at post CS which was higher in the K group and statistically significant (p = 0.00).
Conclusion: Administration of 200 ml enteral nutrition two
hours pre CS is associated with a reduction of 48 hours post CS
hsCRP serum level compared with sweet tea.
[Indones J Obstet Gynecol 2010; 34-4: 159-63]
Keywords: elective CS, enteral nutrition pre CS, hsCRP serum
concentratio
Embryo Quality: The Most Critical Factor for Pregnancy Rates after day-2, day-3, and day-5 of Embryo Transfer
Get PDFObjective: To determine the most critical factor on day-2, day-3,
and day-5 of embryo transfer in correlation with pregnancy rates.
Method: This research is a retrospective study in Aster Fertility
Clinic, IVF program- Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
One hundred ninety five women enrolled in an IVF program
conducted from March 2006 through November 2009 at the Aster
Fertility Clinic. Effect of embryo-transfer day and any other factors
(including quality of embryo, oocyte quantity, difficulty of embryo
transfer technique, and blood or mucus contamination on the catheter)
on pregnancy rate in IVF.
Results: The mean age of the pregnant group was 34.65 (SD =
3.91), and the mean of the infertility period was 7.25 years (SD =
3.54). There were no siginificant differences in pregnancy rates in
the day-2, day-3, and day-5 groups. The most critical factor influencing pregnancy was the total score for the quality of embryos [p = 0.001; OR (CI 95%) = 1.94 (0.91 - 4.08)]. Otherwise, the day of embryo transfer, oocyte quantity, and difficulties in embryo transfer
did not affect the pregnancy rate (p > 0.05).
Conclusion: Our study suggests that the total score for the quality
of the embryos was the most critical factor for the success rate
of pregnancy rather than the day of embryo transfer, oocyte quantity,
difficulty of embryo transfer technique, or contamination of
blood and mucus on the catheter.
[Indones J Obstet Gynecol 2010; 34-4: 175-9]
Keywords: day of embryo transfer, in vitro fertilization, quality
of embryo total score, oocytes quantity, catheter contaminatio
Management Therapy in Chronic Ectopic Pregnancy
Get PDFObjective: Improving skill in making a diagnosis and management
therapy in chronic ectopic pregnancy.
Method: Case Report.
Conclusion: Diagnosis of chronic EP is difficult to establish before
surgery. Conservative treatment using medication (methotrexate)
can not be applied to chronic EP because the β-hCG level is
difficult to be detected.
[Indones J Obstet Gynecol 2010; 34-4: 199-203]
Keywords: ectopic pregnancy, chronic ectopic pregnanc