Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Profil flora vagina dan tingkat keasaman vagina perempuan Indonesia
No full textTujuan: Mendapatkan data profil flora vagina dan tingkat keasaman vagina pada perempuan Indonesia.
Tempat: Puskesmas di Kabupaten Karawang, Balai Kesehatan Batalyon 201 Cijantung, dan Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Indonesia (FKUI).
Bahan dan cara kerja: Penelitian ini merupakan studi deskriptif. Populasi adalah semua perempuan Indonesia berusia 15-50 tahun. Populasi terjangkau adalah semua perempuan Indonesia berusia 15-50 tahun yang datang memeriksakan diri ke beberapa Puskesmas di Kabupaten Karawang, Balai Kesehatan Batalyon 201 Cijantung dan Laboratorium Mikrobiologi FKUI pada periode Mei 2008 - Februari 2009. Dilakukan wawancara dan pengisian kuesioner untuk mendapatkan data demografik dan karakteristik medik, pemeriksaan tingkat keasaman (pH) vagina dengan tes celup (Merck@), pemeriksaan Gram untuk mencari morfotipe flora vagina, serta deteksi bakterial vaginosis (BV) menggunakan tes Whiff dan kriteria Nugent.
Hasil: Jumlah subjek penelitian adalah 492 orang, rata-rata umur 30,9 tahun dengan jumlah terbanyak pada kelompok umur 26 - 40 tahun (59,1%). Kelompok menikah adalah yang terbanyak (76,4%). Sebagian besar subjek adalah ibu rumah tangga (69,1%). Sebagian besar subjek berpendidikan setingkat SMU (46,3%). Rata-rata pH vagina yang didapatkan pada penelitian ini adalah 4,8. Didapatkan subjek dengan pH ≤ 5 sebesar 65,4%, sisanya sebesar 36,6% mempunyai pH > 5. Pada tiap kelompok umur lebih banyak yang mempunyai pH ≤ 5 dibandingkan pH > 5, dan tampak jelas perbedaannya pada kelompok umur 15-19 tahun di mana 89,1% mempunyai pH ≤ 5 dan 10,9% mempunyai pH > 5 (ratarata 4,6; median 4,5). Terdapat perkecualian untuk kelompok umur 41- 45 tahun di mana subjek yang mempunyai pH ≤ 5 lebih sedikit (46,7%) dibandingkan subjek yang mempunyai pH > 5 (53,3%). Dari pemeriksaan Gram didapatkan prevalensi Lactobacillus sp sebesar 63%, Gardnerella sp. sebesar 51,4%, Coccus gram positif sebesar 48,7%, dan Candida sp. sebesar 4,6%. Terdapat perbedaan yang cukup besar pada prevalensi BV berdasarkan pemeriksaan dengan tes Whiff dan skor Nugent, masing-masing sebesar 5,7% dan 30,7%.
Kesimpulan: Rata-rata pH vagina yang didapatkan pada penelitian ini pada kelompok umur < 20 (15-19) tahun, 20-40 tahun dan 41-50 tahun berturut-turut adalah 4,6; 5,3 dan 5,6 dengan rata-rata keseluruhan 4,8. Prevalensi Lactobacillus sp, Gardnerella Sp, Coccus gram positif pada penelitian ini sebesar 63%, 51,4%, 48,7%. Prevalensi kandidiasis adalah 4,7%. Prevalensi bakterial vaginosis (BV) dengan kriteria Nugent adalah 30,7%.
[Maj Obstet Ginekol Indones 2009; 33-2: 124-31]
Kata kunci: flora vagina, tingkat keasaman (pH) vagina, bakterial vaginosis (BV
Antioxidant Milk Supplementation in Pregnancy: A Study of Retinol Binding Protein and Angiogenic Factors in Preeclampsia
Get PDFObjectives: To assess the role of retinol supplementation in the process of angiogenesis in preeclampsia.
Methods: The research was a double blind randomized clinical trial conducted Dr. Cipto Mangunkusumo Hospital outpatient clinic since January 2009 - December 2010. Samples were analyzed in Prodia Laboratory and Showa University in Tokyo, Japan. Subjects
were tested in trimester 1, 2 and 2 weeks after delivery. During
pregnancy subjects were given pregnancy milk supplements available
on the market which had and that has been retinol fortified. Bivariate
and multivariate analysis were performed of which retinol
milk feeding, retinol binding protein (RBP) level, and level of
angiogenic factors as independent variables and preeclampsia acted as the dependent one.
Results: One hundred four study subjects were divided into a control group of 55 and treatment of 49. Incidence of preeclampsia in this study was is 8.7% from which 8 persons (14.5%) came from the control group and 1 person (2%) from the treatment group. Characteristics
of the two groups were equivalent. RBP levels obtained
in the treatment group was lower than the control group, while in the subjects with preeclampsia the RBP level was higher than the group without preeclampsia. Correlation between the level of RBP with angiogenic factors showed no significant relationship except for the level of PlGF (p=0.036) which had a weak correlation (r=0.206). The level of angiogenic factors in the treatment group showed lower result than the control group whereas among the subjects with preeclampsia angiogenic factor levels were always higher than without preeclampsia. With multivariate analysis we found that significant factors associated with preeclampsia was sFlt-1 levels (p=0.004) and sFlt-1/PlGF ratio (p=0.017).
Conclusions: Providing milk supplements can reduce the levels of retinol (RBP), and antiangiogenic factors, but does not significantly increase proangiogenic factor level. Assuming there is no problem with the process of angiogenesis provision of retinol-fortified milk can reduce the incidence of preeclampsia. However, further research with a larger scale is needed.
[Indones J Obstet Gynecol 2011; 35-3:100-4]
Keywords: retinol-fortified milk, RBP level, sFlt-1 level, sEng
level, PlGF level, preeclampsi
Knowledge and attitude of pregnant woman toward umbilical-cord-blood collection
Get PDFObjective: Stem cell technology from umbilical cord blood (UCB) has developed fast as health services. UCB could be used in many kinds of disease. Private UCB bank has been operated in many places all over Indonesia. There’s a need for research to evaluate the knowledge and attitude of pregnant woman towards the act of collecting UCB.
Method: This is a cross-sectional study base on question-naire
given to 163 pregnant women in three private hospitals in the Bandung City from September - November 2009. The result was analyzed with Rank-spearman correlation and Kruskal-Wallis chisquare.
Result: Most respondent were 20 - 29 years old pregnant women
(54.6%), with educational level of strata-1 (S-1) (41.1%), with
monthly income within 5 - 10 million rupiah (35.6%). This is the
second pregnancy or more (42.9%), with gestational age less than
24 weeks (61.3%) and variative obstetric history (59.5%). The
average level of knowledge was poor and attitude scale was uncertain
(3.4). There is a significant correlation between age (p = 0.008%; CI 95%), level of education (p = 0.0001; CI 95%) and knowledge. There is a significant correlation between gestational age and attitude (p = 0.003; CI 95%). Respondent’s level of knowledge also has a significant correlation with attitude (τs = 0.421; p = 0.0001; CI 95%).
Conclusion: This study described the respondent’s poor knowledge
will influence their attitudes toward UCB collection, so it is necessary for disseminating more information on UCB as an effort to get better research result on UCB.
[Indones J Obstet Gynecol 2010; 34-2: 97-100]
Keywords: knowledge level, attitudes, collecting UCB, pregnant
woman, the Bandung cit
Etiologies of Male Infertility in Dr. Cipto Mangunkusumo Hospital, Jakarta
Get PDFObjective: To have description about the etiologies of male infertility in Dr. Cipto Mangunkusumo Hospital.
Method: This was a retrospective study of 315 male infertility patients treated at the Urology Department Dr. Cipto Mangunkusumo Hospital from January 2009 to June 2011.
Result: There were 78 patients excluded from the analysis due to incomplete or missing data. The available data consisted of 237 males, with a median age of 35 years old. The median duration of infertility was 4 years. Primary infertility was identified in 89.4% and secondary infertility in 10.6% of all cases. Semen analysis results were classified as normal 2.5%, aspermia 1.3%, azoospermia
41.4%, multiple abnormal parameters 38.0%, single abnormal parameter (oligozoospermia 7.6%, asthenozoospermia 6.8%, teratozoospermia 2.1%), and cryptozoospermia 0.4%. From 237 subjects, there were 39 men (15.9%) with multiple etiologies of male infertility. The most common etiology in this study was varicocele
(48.5%). Other etiologies were idiopathic 27.8%, acquired factors 14.3%, obstruction 8.0%, congenital anomalies 6.3%, urogenital infection 2.5%, sexual factors 2.1%, endocrine disturbance 2.1%, no demonstrable cause 1.3%, and other abnormalities 0.8%. This study also found Y-chromosome microdeletions in 2.5% of subjects or
6/98 (6.1%) of azoospermic patients. Lifestyle factors associated with male infertility were smoking 31.6%, alcohol consumption 13.4%, hot-bathing 6.7%, and sauna 2.9%.
Conclusion: There are numerous possible contributing factors of male infertility, and varicocele was the most commonly identified etiology in this study. Some of our patients were presented very late for infertility treatment, therefore prompting the necessity to increase general awareness of male infertility in the society.
[Indones J Obstet Gynecol 2011; 35-3: 130-4]
Keywords: azoospermia, varicocele, risk facto
Correlation of Total Antioxidant Capacity Measured by Ferric Reducing Ability of Plasma (FRAP) Assay with the Severity of Preeclampsia
Get PDFObjective: To analyze correlation between total antioxidant capacity measured by Ferric Reducing Ability of Plasma (FRAP) assay with severity of preeclampsia.
Method: The cross sectional method was used in this study to compare TAC of four different groups of study, consists of normal pregnancy, mild preeclampsia, severe preeclampsia and eclampsia. The study consisted of 15 women in each group. All of the subjects met the inclusion criteria and were admitted to Dr. Hasan Sadikin Hospital and it’s district hospital. The study was conducted from
August until September 2011. 3 ml blood samples were taken and were measured by FRAP assay in the laboratory PRODIA Jakarta.
Result: There was no significant difference (
The Correlation between Calcium Serum and Calcium Urine Level with the Blood Pressure in Preeclampsia
Get PDFObjective: To analyze the differences of calcium serum and calcium urine level in preeclampsia and normal pregnancy, and to analyze the correlation between calcium serum and calcium urine level with blood pressure.
Method: This study is a cross sectional study with 44 women with preeclampsia and 45 women with normal pregnancies, that meet our inclusion criteria. The samples were obtained from Dr. Hasan Sadikin Hospital and six satellite hospitals from June to September 2011. The comparison of mean calcium serum and calcium urine
level of the preeclampsia group was calculated using Mann-Whitney test, and the correlation between calcium serum and calcium urine level and preeclampsia were calculated using Rank Spearman correlation test.
Result: The result of the characteristic test in two groups of study shows that both groups are homogenic and comparable. The mean of calcium serum level in women with preeclampsia (7.97 mg/dl) is lower than in normal pregnancy (8.82 mg/dl) with
Malaria Detection using Polymerase Chain Reaction (PCR) Method in Pregnant Women’s Saliva on Several Hospitals in North Sulawesi Province
Get PDFObjective: To detect malaria by PCR examination of saliva in pregnant women and to obtain the incidence of malaria and the type of plasmodium causing malaria in pregnant women at various hospital in North Sulawesi.
Method: A descriptive cross sectional study in pregnant women during antenatal care at the Department of Obstetrics and Gynecology Faculty of Medicine University of Sam Ratulangi/Prof. Dr. R.D. Kandou General Hospital in Manado, R.W. Monginsidi Hospital in Manado, Bethesda Hospital in Tomohon, and Datoe Binangkang Hospital in Kotamobagu, from 1 April until 31 May 2008.
Result: There were 43 pregnant women clinically diagnosed with malaria, 23 (53.49%) by PCR examination of saliva and 20 (46.59%) by blood smears. From 23 cases of malaria in pregnancy detected by PCR, there were 18 diagnosed as tropical malaria, 3 tertian malaria, and 2 mixed malaria.
Conclusions: The incidence of malaria in pregnancy at various hospital in North Sulawesi using PCR methods for saliva examination from April 1 - May 31 2008 is 53.49%. In this study malaria are mostly caused by Plasmodium falciparum with the largest incidence in primigravida, in the first trimester.
[Indones J Obstet Gynecol 2012; 36-1:14-9]
Keywords: malaria, PCR, pregnancy, saliv
Level of Education as the Determinant Factor of Obstetric Outpatients’ Knowledge about Intra Uterine Device in Kramat Jati Public Health Center
Get PDFObjective: To know the main factor affecting the knowledge of obstetric outpatients about intra uterine device (IUD).
Method: This is across sectional study involving 106 subjects who were selected by a consecutive random sampling in obstetric outpatients clinic, Kramat Jati Public Health Center, Jakarta. Data were obtained from guided questionnaire. There are several dependent variables,
including the knowledge level of respondents toward IUD.
Meanwhile, there are also independent variables, including education level, job, number of children, history of contraception use, and sources of information. The knowledge score >60% is considered good. Afterwards, the data was evaluated with multivariate analysis
with binary logistic regression.
Result: The study found association between the rate of knowledge with the level of education (p=0.015) and history of contraceptive usage (p=0.022). In multivariate analysis, it appeared that education level was the determinant factor, with the rate of low knowledge 2.6 times higher in the low education group.
Conclusion: Level of education are the determinant factor of obstetric outpatients’ knowledge about intra uterine device in Kramat Jati Public Health Center.
[Indones J Obstet Gynecol 2012; 36-1:43-7]
Keywords: IUD, knowledge, level of educatio
The Influence of Low HLA-G Protein Expression on Hsp-70 and VCAM-1 Profile in Preeclampsia
Get PDFObjective: To analyze HLA-G, Hsp-70, and VCAM-1 proteins
expression on trophoblast in women with preeclampsia and women
with normal pregnancy, and to assess causality relationship between
low HLA-G expression and the increased Hsp-70 and VCAM-1 expression in preeclampsia.
Method: Observational analytic study with cross sectional design.
Results: Trophoblastic HLA-G expression in pregnant women
with preeclampsia is lower (p = 0.01) than its expression in women
with normal pregnancy. The expressions of Hsp-70 (p = 0.02) and
VCAM-1 (p = 0.00) in preeclampsia are higher, compared to normal
pregnancy. Regression analysis showed that low HLA-G is a
predictor for the increase of trophoblastic Hsp-70 and VCAM-1.
Conclusion: Low trophoblastic HLA-G in is a predictor for endothelial
dysfunction in women with preeclampsia.
[Indones J Obstet Gynecol 2010; 34-4: 185-90]
Keywords: preeclampsia, HLA-G, Hsp-70, VCAM-1, endothelial
dysfunctio
Maternal and Fetal Outcome on Pregnancy in Advanced Maternal Age
Get PDFObjective: Pregnancy in advanced maternal age (AMA) was classified as high risk. The study aims to provide a better description of pregnancy outcome in AMA.
Method: The cross sectional study was to review the demography, medical and obstetrics problems, mode of delivery, maternal and fetal outcome in Tangerang General Hospital as a referral center in Banten. The data were taken from medical records of 35-year-old and above women age who delivered on the period of January to December 2014.
Result: The total number of delivery and live birth was 6,107 and 5,926 respectively, including 1,548 (25.36%) pregnancies in AMA. The prevalence of grandmultiparities was 11.4%. The average education level was mostly elementary. The prevalence of hypertension in pregnancy was 34.6%. There was increasing trend of miscarriages from 10.8% in 35-40-year-old group to 25% in above 45- year-old group. Pregnancy complications were higher consisting of 3.2% multifetal, 16.6% malpresentation, and 7.1% placenta previa. Cesarean section rate was 33.6%. Maternal near-missed cases were 56 of 1000 and the maternal mortality rate (MMR) was 932 of 100,000 live births. The prevalence of stillbirth and perinatal mortality were 5.3% and 12.9%; respectively.
Conclusion: Adverse maternal and fetal outcome were higher in AMA as it takes special attention and multidiscipline-approached care started from preconception, antenatal, preparation of delivery, and also postpartum care.
Keywords: advanced maternal age (AMA), fetal outcome, maternal outcome, pregnanc