Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Korelasi antara insulin-like growth factor - 1, anemia defisiensi besi, dan biometri janin pada kehamilan trimester III
Get PDFTujuan: Untuk menganalisis korelasi antara kadar IGF-1 serum ibu,
anemia defisiensi besi, dan biometri janin pada kehamilan trimester
ketiga.
Tempat: Poliklinik Obstetri dan Ginekologi RS Dr. Wahidin Sudirohusodo
dan RSIA Siti Fatimah di Makassar.
Rancangan/rumusan data: Penelitian potong lintang.
Bahan dan cara kerja: Dilakukan pemeriksaan kadar Hb, ferritin,
dan insulin-like growth factor-1 (IGF-1) dari serum 70 perempuan hamil
(34 penderita anemia defisiensi besi dan 36 normal). Kemudian dilakukan
pemeriksaan biometri janin dengan ultrasonografi.
Hasil: Ditemukan korelasi bermakna antara kadar IGF-1 serum ibu
dengan ukuran AC dan FL janin (p = 0,0010 dan p = 0,013, berturutturut).
Juga ditemukan hubungan linier positif antara kadar IGF-1 serum
ibu dengan ukuran AC (r = 0,350; p = 0,001) dan ukuran FL janin
(r = 0,320; p = 0,003). Anemia defisiensi besi ibu hamil trimester III
berhubungan dengan janin yang mempunyai AC kecil berdasar usia kehamilan
(p = 0,0450).
Kesimpulan: Pada kehamilan trimester III: kadar IGF-1 serum ibu
tidak berbeda bermakna antara ibu dengan anemia defisiensi besi dan
normal tetapi terdapat korelasi positif antara kadar IGF-1 serum ibu dengan ukuran AC dan FL janin dan antara anemia defisiensi besi ibu dengan ukuran AC janin.
[Maj Obstet Ginekol Indones 2009; 33-3:160-6]
Kata kunci: kadar IGF-1, anemia defisiensi besi, biometri jani
Serum Anti Mullerian Hormone level as ovarium response predictor at women received ovarium stimulation invitro
Get PDFObjective: To evaluate clinical value of basal anti-Mullerian
Hormone level as predictor of ovarian response to stimulation in
women following in vitro fertilization program; compared with Follicle
Stimulating Hormone (FSH), estradiol and basal antral follicle.
Method: Research was conducted in Yasmin Clinic Cipto Mangunkusumo
Hospital as tertiary referral center for reproductive
health and in vitro fertilization. Infertile patients which going to undergo
controlled ovarian hyper stimulation cycle for in vitro fertilization
were checked for basal FSH level, estradiol level, AMH level
and amount of basal antral follicle. We were divided the sample into
two categories; poor responders and good responders. Statistical
analysis using ANOVA was done to evaluate demographic data and
Receiver Operator Characteristic area under curve (ROCAUC), and to
analyze whether AMH was more superior than the other 3 predictors
and to get the cut off point for AMH level.
Result: We have collected 22 patients data; 14 were categorized
as good responders and 8 were bad responders. Mean AMH value
in the good responders group was 4.46±1,01 and in the poor responders
group was 1,35±0,96, with p 0,000. According to ROCAUC,
AMH is a good predictor for good ovarian response in patient who
are a good responders (AUC 0,821), compared to the other three
predictors (FSH, E2 and basal antral follicle). Anti Mullerian Hormone
cut-off point level is 3, which means valu
Low Class Ib (HLA-G/Qa-2) MHC Protein Expression against Hsp-70 and VCAM-1 Profile on Preeclampsia. An observation on experimental animal Mus Musculus with Endothelial Dysfunction model
Get PDFObjective: To analyze the expression of MHC class Ib Qa-2 protein
(homologue to HLA-G in human), Hsp-70, and VCAM-1 in trophoblast
cells of preeclampsia and control using endothelial dysfunction
model on Mus Musculus.
Method: Design of study is experimental study. Pregnant mice
was treated with anti-Qa-2. Hsp-70 and VCAM-1 expressions of
trophoblast cells was assessed on week I, II, and III.
Result: Negative Qa-2 expression was achieved after administration
of 40ng anti Qa-2 on the fifth day of pregnancy. The Hsp-70
and VCAM-1 expressions in negative Qa-2 mice (preeclampsia)
was higher compared with those of positive Qa-2 mice (normal
pregnancy) on week I, II and III.
Conclusion: Low Qa-2 and high of HSP-70 and VCAM-1 expression
might be useful for prediction of preeclampsia or endothelial
dysfunction.
[Indones J Obstet Gynecol 2010; 34-3: 103-7]
Keywords: preeclampsia, HLA-G/Qa-2, Hsp-70, VCAM-1, endothelial
dysfunctio
Prenatal Diagnosis and Postnatal Management of Meconium Peritonitis
Get PDFObjective: To present two cases of fetal meconium peritonitis with perforated ileum and without a definite intestinal obstructive lesion.
Case report: Two patients who presented prenatally with ultrasound findings of meconium peritonitis and postnatally were found to have perforation of the terminal ileum and meconium peritonitis. In both cases, the diagnosis of meconium peritonitis was suspected
prenatally based on the ultrasound findings which were hyperechogenic bowel and abdominal free fluid with increased echogenicity. Both babies were delivered by c-section due to obstetrical indication. After delivery the babies were admitted to the intensive care unit because of a distended abdomen and respiratory distress. An explorative laparotomy revealed perforations of the ileum, and the pediatric surgeon performed adhesiolysis and ileostomy. The infant recovered well after the operation and was fed uneventfully.
Conclusions: Echogenic intraabdominal free fluid was the most common ultrasound findings in meconium peritonitis. Early detection of meconium peritonitis was not indicative of poor neonatal outcomes, and selective termination was not necessary, unless indicated for other reasons.
[Indones J Obstet Gynecol 2011; 35-4:191-8]
Keywords: prenatal diagnosis, postnatal management, meconium peritoniti
Perineal Massage during Second Stage of Labor to the Perineal Laceration Degree in Primigravida
Get PDFObjective: To determine the effect of perineal massage during
second stage of labor on the perineal laceration degree in primigravida.
Methods: The design of this study was non randomized controlled
trial by conducting massage training of the perineum to 20 obstetrics
and gynecology residents. All residents had passed the normal
delivery care training. Primigravida who met the inclusion criteria
were included in this study. We assessed the degree of perineal laceration
in this study. Data were analyzed using Chi square test in
SPSS.
Results: We obtained 103 subjects for massage group and 79 subjects
for control group. There was a significant association between
massage group and the incidence of intact perineum. In the massage
group, most of perineal lacerations were first degree of laceration
(52.4%); whereas, in the control group, most of them were second
degree of laceration (77.2%). Statistical analysis showed a significant
association between perineal massage and decreased of perineal
laceration degree (
Phosphatase Regenerating Liver3 and ECadherin Expression in Epithelial Ovarian Cancer
Get PDFObjective: To determine the expression of Phosphatase Regenerating
Liver-3 (PRL-3) and E-Cadherin in the epithelial ovarian cancer
on various stages and differentiation grades.
Method: This was a cross-sectional study design conducted at
Obstetrics and Gynecology Department of several teaching hospitals,
Faculty of Medicine Universitas Hasanuddin from January
to June 2015. The expression of PRL-3 and E-cadherin was
assessed immunohistochemically in 40 patients with epithelial
ovarian cancer including 15 patients in early stage and 25 patients
in advanced stage. We used the Fisher’s exact test with the
significance of p0.05). The significant difference was
found in the expression of E-cadherin whereas the high expression
was shown at early stage than advanced stage (p0.05). This study also pointed out no
correlation between the expression of PRL-3 and E-cadherin in
epithelial ovarian cancer (p>0.05).
Conclusion: PRL-3 overexpression does not decrease E-cadherin
expression in epithelial ovarian cancer.
Keywords: E-cadherin, epithelial ovarian cancer, PRL-
The Outcomes of Primary Debulking Surgery and Neoadjuvant Chemotherapy in Advanced Ovarian Cancer
Get PDFObjective: To compare the outcomes and survival rate of primary
debulking surgery with neoadjuvant chemotherapy.
Method: We selected advanced ovarian cancer patients from medical
records. Subjects were allocated into groups of primary debulking
surgery and neoajuvant chemotherapy by considering the inclusion
and exclusion criteria. We analyzed the data using T test,
Fisher’s exact, and chi-square. The survival rate was presented in
Kaplan Meier curve, whereas the significance was tested with Logrank.
We managed the data using STRATA software version 12.
Result: We obtained 32 cases of primary debulking surgery group
and 20 cases of the neoadjuvant chemotherapy group. Most of the
subjects (44.2%) were 40-49 years old and 80.8% had delivered
more than twice. The mean value of Ca-125 at admission was
3,594.8 u/ml (range 66.6 to 73,000 u/ml). Total of 31 subjects
showed the serous histologic type (59.6%). There was no association
between primary debulking surgery and neoadjuvant chemotherapy
for the parameter of operative time, blood loss, organs injury,
ICU stay, and hospital stay (p>0.05). Primary debulking surgery
had a survival rate similar to neoadjuvant chemotherapy group
(p=0.95).
Conclusion: The perioperative outcomes of advanced ovarian cancer
patients has similar result between primary debulking surgery
and neoadjuvant chemotherapy. Primary debulking surgery has a
survival rate similar to neoadjuvant chemotherapy group.
[Indones J Obstet Gynecol 2016; 4-2: 111-115]
Keywords: advanced ovarian cancer, neoadjuvant chemotherapy,
primary debulking surger
Measurement of Vitamin A Level in Patients with Malignant and Benign Ovarian Tumors
Get PDFPendahuluan: Tumor ovarium ganas adalah salah satu tumor ganas
ginekologi yang mempunyai angka kematian tertinggi. Beberapa penelitian
telah dilakukan untuk mengetahui etiologi atau faktor risiko tumor
ovarium ganas. Beberapa penelitian dilakukan seperti faktor genetik,
kontaminasi kimiawi, penggunaan kontrasepsi. Penelitian faktor predisposisi
sangat penting dalam upaya untuk mencegah terjadinya tumor
ganas ovarium. Vitamin A adalah vitamin yang bekerja mengatur proliferasi
sel dan diferensiasi sel. Defisiensi vitamin A diduga menyebabkan
gangguan metabolisme p53 sehingga proliferasi tidak dapat dikendalikan
atau dikontrol.
Tujuan: Membandingkan kadar vitamin A pada pasien tumor ganas
ovarium dengan tumor ovarium jinak.
Tempat: Departemen Obstetri dan Ginekologi Fakultas Kedokteran
Universitas Indonesia. Rumah Sakit Umum Pusat Nasional Dr. Cipto
Mangunkusumo, Jakarta.
Bahan dan cara kerja: Penelitian potong lintang pada kasus tumor
ganas ovarium dan tumor ovarium jinak yang memenuhi kriteria penerimaan.
Contoh darah diambil dari kedua kelompok dan dilakukan pemeriksaan
kadar vitamin A. Kadar vitamin A diperiksa dengan HPLC
(high performanced liquid chromatography). Dengan proporsi pengaruh
tumor ovarium jinak 0,1 dan risiko relatif 3, dibutuhkan sampel 39 kasus
setiap grup. Dilakukan analisis statistik secara Anova untuk menilai
adakah perbedaan kadar vitamin A pada kedua kelompok.
Hasil: Sejumlah 71 kasus yang masuk dalam penelitian untuk dianalisis.
Faktor paritas tampak adanya peningkatan risiko sebesar 2,1
kali pada paritas yang meningkat setelah paritas tiga. Faktor keluarga
yang menderita tumor ganas ovarium terdapat hanya pada kelompok tumor
ovarium ganas. Kadar vitamin A pada tumor ganas ovarium sebesar
28,2 μg/100 ml dengan standar deviasi 7,3 μg/100 ml, sedangkan kadar
vitamin A rata-rata pada kelompok tumor ovarium jinak 33,5 μg dengan
standar deviasi 8 μg/100 ml. Perbedaan ini secara statistik bermakna.
Kesimpulan Terdapat perbedaan bermakna, kadar vitamin A ratarata
dari penderita tumor ovarium ganas pada penelitian ini, yaitu 28,3
μg/100 ml dibandingkan dengan 33,5 μg/100 ml kadar rata-rata tumor
ovarium jinak.
[Maj Obstet Ginekol Indones 2006; 30-2: 124-7]
Kata kunci: tumor ovarium, vitamin A
Manajemen Risiko Klinik
Get PDFTujuan: Memberi pemahaman tentang manajemen risiko klinik.
Bahan dan cara kerja: Kajian literatur.
Hasil: Manajemen risiko klinik merupakan proses yang terencana
dan sistematik untuk menurunkan dan atau mengendalikan kemungkinan
kerugian akibat segala risiko yang ada dalam manajemen pasien.
Manajemen risiko melibatkan kultural, proses, dan struktur yang
ditujukan ke arah manajemen efektif dan pengendalian efek samping.
Prinsipnya adalah identifikasi akar permasalahan, mengarah pada
penilaian risiko medik dalam situasi klinik untuk dapat mengambil
langkah yang rasional dalam rangka mengontrol risiko. Tahap-tahap
manajemen risiko terdiri dari identifikasi, analisa, pengendalian, evaluasi
risiko, yang ditujukan untuk menurunkan risiko serta morbiditas
dan mortalitas. Pada dasarnya, tahapan tersebut berlaku dalam setiap
kasus medik, namun pada situasi gawat darurat diperlukan kecepatan
dan kecermatan yang tinggi untuk memecahkan masalah klinik serta
menentukan tindakan dan terapi yang tepat dalam situasi yang terbatas.
Kesimpulan: Manajemen risiko klinik merupakan suatu metode untuk
mengidentifikasi, mengontrol, memonitor, serta meminimalisasi semua
aspek risiko melalui proses yang terencana dan sistematik untuk
menurunkan dan atau mengendalikan kemungkinan kerugian akibat
risiko yang ada dalam manajemen pasien sehingga terwujud sistem
pelayanan medik yang aman, efektif, dan berkualitas. Dalam menjalankan
praktik kedokteran harus senantiasa berdasarkan pedoman
pelayanan yang berlaku serta pokok-pokok etika kedokteran sesuai dengan
Kode Etik Kedokteran Indonesia.
[Maj Obstet Ginekol Indones 2006; 30-3: 141-4]
Kata kunci: manajemen risiko klinik