Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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The use of elastic stocking to reduce the risk of varicose vein
Get PDFObjective: To reduce the risk of varicoses in primigravida by
wearing elastic stockings with mechanical compression.
Method: A prospective study was performed in a randomized
single blinded trial with analysis of variance and repeated measures.
The study was done at The Obstetrics and Gynecology Department
Immanuel Hospital Bandung, with subjects obtained from the Obstetrics
outpatient clinic during the period of May 2008 to March
2009. This study consisted of a population of 66 primigravidas randomly
allocated in to 2 groups, 34 women in control group and 32
women in study group. Women in the study group were instructed
to wear elastic stockings, while the control group was not. Measurements
of veins dilatation were carried out using a Color Duplex Ultrasound.
Results: The 12 week examination didn’t show any significant
change on left femoral veins diameters in both groups. Examination
at 34 weeks gestational age showed significant changes on left
femoral veins in study group and control group (subsequently 0,83
± 0,07 cm and 1,02 ± 0,35 cm). It also happened on examination at
2 weeks post-partum. The incidence of reflux was found only in the
study group at sapheno-femoral junction in 6 of 34 women.
Conclusion: Mechanical compression provide protective effect
from the development of varicoses shown by the reduced incidence
in developing reflux in blood flow in saphenous-femoral junction,
in addition to minimal dilatation of the lower limbs and pelvic veins.
[Indones J Obstet Gynecol 2010;34-1:7-11]
Keywords: varicoses; pregnancy; endothelial injury; saphenousfemoral
junction; reflux; mechanical compressio
Elastin Expression and Elastic Fiber Thickness in The Uterosacral Ligament of Women With Uterine Prolapse
Get PDFObjective: To measure and correlate bet-ween elastin expression and elastic fibre thickness in the uterosacral ligaments of women with uterine prolapse.
Method: This analytic with cross sectional study was done in January - March 2011. Specimens were obtained from the parafin block of uterosacral ligaments of women having uterine prolapse (prolapse group, n = 16) and the same location in patients with no prolapse having simple hysterectomy, radical hysterectomy or staging laparotomy (control group, n = 16) who came to Dr. Hasan Sadikin hospital and its network. The percentage of elastin positive tissue and elastic fibre thickness were measured by immunohistochemistry from random field readings per sample. The examiner was unaware of sample identity and the patients’ clinical history.
Result: The risk factors (age, parity and vaginal delivery) were compared between the control and prolapse groups, and there were no difference of body mass index between the groups. Immunohistochemical staining and morphometric analysis indicated there were significant different beween elastin expression in the prolapse group
compare with the control group (p < 0.001). The mean thickness of elastic fibres was 0.938 μm in the group with uterine prolapse and 2.244 μm in the control groups (p = 0.02). Elastin expression was associated with elastic fiber thickness (r = 0.589 and p = 0.016).
Conclusion: In this cross-sectional study investigating elastin changes in women with prolapse, there was correlation between elastin expression and elastic fiber thickness in uterosacral ligament of women with uterine prolapse.
[Indones J Obstet Gynecol 2011; 35-2: 79-83]
Keywords: elastin, uterosacral ligament, uterine prolaps
The Changes of H2O2 Level and Glutathione/Glutathione dioxide Ratio with the Administration of N-Acetylcystein, Vitamin C, and Vitamin E towards in Vitro Eclampsia Human Umbilical Vein Endothelial Cell Model
Get PDFObjective: To identify the optimum dosage to lower H2O2 and
to increase the highest ratio of Glutathione/Glutathione dioxide in
the media of eclampsia HUVEC’s model with the administration of
NAC, Vitamin C, and Vitamin E.
Method: We compare the concentration of H2O2 and ratio of
glutathione (GSH) glutathione dioxide (GSSG) in eclampsia HUVEC’s
model (as control group), and administration of three different
dose of N-Acetyl Cystein (NAC), vitamin C, vitamin E and
combination of them.
Result: The addition of NAC, vitamin C and vitamin E to
eclampsia HUVEC’s model can reduce the H2O2 level and increase
GSH/GSSG ratio (p < 0.05). The optimal dose for NAC administration
is 2 μM, while greater dose hamper the result. Combination
of three antioxidants showed the best result compare to single antioxidant.
Conclusion: The lowest level of H2O2 and the highest ratio of
GSH/GSSG is achieved with the administration of the combination
of NAC 2 μM, Vitamin C 100 μM and Vitamin E 100 μM.
[Indones J Obstet Gynecol 2010; 34-2: 64-8]
Keywords: HUVECs, eclampsia plasma, antioxidan
The Correlation of Decreased E-Cadherin and β1-Integrin Expression with the Depth of Myometrial Invasion and Pelvic Lymph Node Metastasis in Resectable Endometrial Cancer
Get PDFObjective: The purpose of this study was to determine the correlation
between decreased E-Cadherin and β1-integrin expression
in resectable endometrial cancer with the depth of myometrial invasion and pelvic lymph node metastasis.
Method: This was a cross sectional study, we used immunohistochemistry examination on E-Cadherin and β1-integrin expression in resectable endometrial cancer patients who had surgery in 1997 to 2006 in Dr. Cipto Mangunkusumo Hospital and searched the correlation with the depth of myometrial invasion and pelvic lymph node metastasis.
Result: The prevalence of endometrial cancer from 1997 to 2006
in Dr. Cipto Mangunkusumo Hospital was 7.0 in a year. Out of 64
patients with endometrial cancer only 36 paraffin block could be
found and immunostaining on E-Cadherin and β1-integrin was done
in 30 samples. Decreased E-Cadherin and β1-integrin expression
was associated with the depth of myometrial invasion, pelvic lymph
node metastasis, lymph ovascular space involvement and degree of
differentiation in resectable endometrial cancer patients.
Conclusion: Decreased E-Cadherin and β1-integrin expression
was associated with the depth of myometrial invasion and pelvic
lymph nodes metastasis.
[Indones J Obstet Gynecol 2010; 34-3: 136-42]
Keywords: E-Cadherin, β1-integrin, the depth of myometrial invasion,
pelvic lymph node metastasi
Neonatal Haemoglobin and Haematocrit Level on Delayed Cord Clamping
Get PDFObjectives: To assess neonatal haemoglobin and haematocrit level during delayed cord clamping on normal delivery.
Methods: This was a randomised control trial with simple random sampling method. During March until June 2011, we collected blood sample from venous umbilical cord on newborn baby. Twenty babies were assigned to the first group, of which the clamping of the umbilical was delayed until 2 minutes (DCC). The other 20 babies were assigned to the second group, of which the clamping of the umbilical
was performed as early as 10 second (ECC) after delivery of the whole body of the baby. The haemoglobin and haematocrit level was noted and compared between two groups using Mann-Whitney U test in SPSS 16 for Windows.
Result: There were no difference on maternal characteristic between two groups, except for the maternal education and maternal economic status. The median neonatal haemoglobin level on DCC group was 15.77 g/dl and on ECC group was 14.36 g/dl. There was
statically significant higher neonatal haemoglobin level on DCC group (p=0.005). The median neonatal haematocrit level was 44.1% on DCC group and was 43.35% on ECC group. There was no difference on neonatal haematocrit level between two groups (p=0.652).
Conclusion: Delaying cord clamping until at least two minutes after delivery could increase haemoglobin level on newborn babies. Therefore, this method was suggested for every delivery in area where there is a risk of anemia in neonates such as Indonesia.
[Indones J Obstet Gynecol 2012; 36-1:24-7]
Keywords: delayed cord clamping, haemoglobin, haematocri
Acute Toxicity and Outcomes of Radiation Alone Versus Concurrent Chemoradiation for Locoregional Advanced Stage Cervical Cancer
Get PDFObjective: To evaluate and determine the toxicity and outcomes in patient receiving radiation (RT) alone versus concurrent chemoradiation (CRT) using cisplatin for locoregional advanced cervical cancer in Dr. Cipto Mangunkusumo Hospital (RSCM).
Methods: Simple randomized single-blind clinical study, done during the period of November 2010-April 2011, in 32 patients with locoregional advanced cervical cancer (16 were treated RT alone and the rest is treated with CRT). Teletherapy was administrated using 60Co Gamma Rays 1.3 MV and photon beam linear accelerator 4-10 MV. The radiation was administered as much as 2.0 Gy per fraction
daily for 5 days/week, for the total of 25 fractions. Brachytherapy was performed using HDR after-loading method, with Microselectron plane radiation source 129I, as much as 3x7 Gy doses to point A. CRT using cisplatin 30 mg/m2 were given for 5 series during the radiotherapy
course. The toxicity assessments were carried out each
week, up until 3 months after the therapy was deemed completed based on the RTOG and ECOG criteria.
Results: We acquired 100% complete response in both the CRT and RT groups. In the CRT group, we found acute gastrointestinal toxicity grade 3 (18.75%) and grade 2 (43.75%); acute genitourinary toxicity grade 3 (25%), grade 2 (31.25%); and acute hematological toxicity
grade 3 (12.50%) and grade 2 (25%). It is contrasted with the RT group, in which we did not found any cases of acute gastrointestinal toxicity, genitourinary or acute hematologic toxicity. The overall time treatment (OTT) of 56-58 days in CRT and RT group were 25% vs. 81.25% respectively, and the OTT of 59-70 days in CRT and RT
group were 75% vs. 18.75%, respectively.
Conclusion:The response to CRT and RT for locoregional advanced cervical cancer was not different in 3 month evaluation. Acute gastrointestinal, genitourinary, and hematologic toxicities found in CRT were higher than in RT (p=0.000; p=0.000; p=0.002).
[Indones J Obstet Gynecol 2012; 36-1:37-42]
Keywords: acute toxicity, concurrent chemoradiation, locoregional advanced stage cervical cancer, response therap
The Prevalence and Risk Factors of Stress Urinary Incontinence in Postpartum
Get PDFObjective: To know the incidence of stress urinary incontinence in
postpartum and determine the relationship among age, parity, infant
birth weight, mode of delivery, episiotomy and perineum rupture.
Method: This study used cross sectional analytic design. Qualified
subjects from inclusion criteria were interviewed by researchers
using pre-defined MESA questioner. Subjects with stress urinary
incontinence were found from the questionnaire result. The acquired
data was measured and analyzed using SPSS v. 22.0 software and
discussed using available literature.
Result: From 162 subjects, 36 cases (22.22%) had stress urinary
incontinence, 47.22% aging ? 35 years old, 72.22% had multiple
pregnancies, 88.89% had per vaginal delivery. Using multivariate
logistic regression test, we found there was a relationship between
stress urinary incontinence with age and parity (p 35 years old and multiple parities.
Keywords: multiple parities, post-partum, stress urinary incontinenc
AntiMüllerian Hormone Level in Laparoscopic Cystectomy
Get PDFObjective: To evaluate the impact of laparoscopic cystectomy using
cautery and suturing technique on the ovarian reserve represented
by the level of Anti-Müllerian Hormone (AMH) serum.
Method: This used prospective cohort study design conducted in
Dr. Wahidin Sudirohusodo Hospital, Department of Obstetrics and
Gynecology, Faculty of Medicine Universitas Hasanuddin, Makassar,
from November 2014 to October 2015. We got total samples of 60
subjects divided into cautery and suturing group. Anti-Mullerian
hormone serum test was examined on all subjects pre and post
laparoscopic cystectomy.
Result: The result indicated a significant decrease of AMH level
undergoing laparoscopic cystectomy both cautery and suturing
technique; whereas, more dominant results were showed in the
cautery group (p0.05).
Conclusion: The decline in the number of ovarian reserve as
described by the reduction of AMH level occurs significantly in both
cauterization and suturing technique, which are more dominant
reduction in the cauterization group.
[Indones J Obstet Gynecol 2016; 4-4: 203-207]
Keywords: Anti-Müllerian Hormone, laparoscopic cystectomy, ovarian
reserv
Perbandingan Kadar Laktat Dehidrogenase pada Asites yang disebabkan Kanker Ovarium dengan Asites Nonmaligna (Laporan Pendahuluan)
Get PDFTujuan: Membuktikan manfaat pemeriksaan kadar LDH untuk
membedakan asites maligna dengan asites nonmaligna.
Tempat: Kamar operasi ginekologi bedah pusat RSUPN Dr. Cipto
Mangunkusumo, poliklinik Penyakit Dalam dan ruang pera-watan Penyakit
Dalam IRNA B RSUPNCM, Jakarta.
Bahan dan cara kerja: Analisis potong lintang dengan membandingkan
kadar LDH dalam asites kanker ovarium dengan kadar
LDH dalam asites nonmaligna. Diambil sampel cairan asites pasien
kanker ovarium dan asites pasien bukan kanker dengan cara paresintesis/
aspirasi saat operasi sebanyak 10 cc. Pada asites yang terkumpul,
dilakukan pemeriksaan kadar LDH dengan cara enzimatik.
Hasil: Data kadar LDH diperoleh dari 17 pasien kanker ovarium
(delapan kasus stadium IA, 3 kasus stadium IB, 1 kasus stadium IC, dan
5 kasus stadium IIIC; delapan puluh dua persen dari kasus merupakan
adenokarsinoma, sisanya 12% kasus jenis sel granulosa dan 6% kasus
dengan germ cell) dan 9 pasien bukan kanker (empat kasus sirosis hepatis,
2 kasus gagal jantung, 1 kasus peritonitis tuberkulosis dan 2 kasus
kista jinak ovarium) dengan karakteristik kelompok usia terbanyak 30 -
50 tahun. Didapatkan kadar LDH asites pada pasien kanker ovarium lebih
tinggi secara bermakna dibandingkan dengan kadar LDH asites
pasien bukan kanker (
Prognostic value of p53 gene in ovarian cancer
Get PDFTujuan: Mengetahui peranan gen p53 dan mengidentifikasi nilai
prognostik ekspresi protein p53 mutan terhadap kanker ovarium.
Rancangan/rumusan data: Penelitian survei analitik dengan desain
cross sectional pada rumah sakit pendidikan di Makassar.
Bahan dan cara kerja: Pasien dinyatakan kanker ovarium berdasarkan
hasil pemeriksaan histopatologi, dianalisis ekspresi protein p53-
nya dengan teknik imunohistokimia.
Hasil: Derajat ekspresi protein p53 ditemukan lebih tinggi pada
kanker ovarium stadium lanjut. Follow-up penderita antara 6 bulan sampai
2 tahun setelah operasi menunjukkan bahwa penderita yang mempunyai
ekspresi protein p53 mutan yang tinggi mempunyai angka kematian
yang tinggi.
Kesimpulan: Analisis p53 dapat dipakai sebagai indikator prognostik
terhadap kanker ovarium.
[Maj Obstet Ginekol Indones 2008; 32-3: 172-6]
Kata kunci: p53, kanker ovarium, prognosis