Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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The Correlation of Early Initiation of Breastfeeding with Achievement of Exclusive Breastfeeding and Corresponding Factors
No full textObjective: To study the role of early breastfeeding in time of placental expulsion, breast milk secretion and achievement of exclusive breastfeeding.
Method: A prospective cohort study was carried out at Dr. Cipto Mangukusumo General Hospital Jakarta delivery suite in January 2011. Total sample was 68 and divided into 34 sample who was conducting early initiation of breastfeeding and another 34 who did not. Time computation was conducted by the time of placental expulsion and breast milk secretion and also observation within the first 6 month to see whether exclusive breastfeeding was achieved or not.
Result: From the study the obtained patients’ characteristic data were 38.2% aged 25-29 years old, 52.9% multiparity, 72.1% having middle education degree (Junior High School to Senior High School graduates), 39.7% on low economic level, and mostly unemployed
(73.5%). From total sample, it was found 48 patients (70.6%) who succeded in managing exclusive breastfeeding and 20 patients (29.4%) who did not with 50% stated working as the reason.
Conclusion: Early initiation of breastfeeding (EIB) has correlation with duration of placental expulsion, duration of breastmilk secretion and achievement of exclusive breastfeeding. The mean time needed to achieve early initiation of breastfeeding was 46.5 minutes. The mean time of placental expulsion in patient with EIB was 7.35
minute (SD ± 2.695) there was significant correlation between EIB with the time of placental expulsion (p=0.005). The mean time of breastmilk secretion in patient with EIB was 10.65 hours (SD ± 4.947) and there was significant correlation between EIB with the time of breastmilk secretion (p=0.000). It was found significant correlation on data analysis between patients who succeeded to manage EIB with achievement of exclusive breastfeeding (p=0.033). There is also statistically significant correlation between working mothers and achievement of exclusive breastfeeding (p= 0.005) with comparison of probability to have exclusive breastfeeding success rate between unemployed mother and employed mother. Being 1.8 times (RR: 1.800, IK 95% : 1.054-3.073) with cofounding factor is employment status.
[Indones J Obstet Gynecol 2011; 35-4: 161-6]
Keywords: early initiation of breastfeeding, exclusive breastfeeding, time of placental expulsion, time of breast milk secretio
Correlation between Content of Collagen I and Tenascin-C Sacrouterine Ligament in the Uterine Prolapse
Get PDFObjective: To analyze differences in mean and correlation between content of collagen I and tenascin-C sacrouterine ligaments in patients with uterine prolapse.
Method: This type of research is analytic comparative and cross sectional correlation is cut in two research groups. Well conditioned paraffin block of patients uterine prolapse and without uterine prolapse were stained with immunohistochemical staining. The preparation is examined under a light microscope by the Pathology Specialist, assessment of content is done by looking at the distribution and intensity of the color of collagen fibers and tenascin-C.
Result: There were significant mean differences between the content of collagen I and tenascin-C sacrouterine ligament in patients with uterine prolapse and without uterine prolapse (p = 0.001). There was no correlation between the content of collagen I and tenascin-C sacrouterine ligament in patients with uterine prolapse (p
= 0.780).
Conclusion: There was a difference in the average content of collagen I and tenascin-C in the uterine prolapse group compared with no uterine prolapse group. There was no correlation betweenthe content of collagen I and tenascin-C in the uterine prolapse group.
[Indones J Obstet Gynecol 2011; 35-4:186-90]
Keywords: collagen I, tenascin-C, sacrouterine ligament, uterine prolaps
Removing the uterus and both ovaries: pros and cons of hysterectomy and bilateral oophorectomy
Get PDFRemoving the uterus and both ovaries, due to many
reasons, are still performed at perimenopausal age and
due to many reasons, uterus and ovaries removal are
still performed at reproductive age. Hysterectomy
with or without salphingooophorectomy is still the
most common procedure performed not only in developing
countries but also in developed countries.
Among of all reasons the most frequent one is to improve
the quality of life and prevent future malignancies
if the uterus and both ovaries are not removed.
Malignancies might probably occur although the incidence
rate is very low. When both of the ovaries
are removed, estrogen will decrease significantly, this
will cause short and long term medical problems and
decrease the quality of life. The incidence of coronary
heart disease and fractures increases as estrogen decreases.
A study performed by Parker et al with some
of 10.000 women who underwent total hysterectomy and
bilateral salphingooophorectomy at the age of 50 - 54
years old and did not receive HRT, shows that 838 died
due to heart disease.1 Other studies reported cognitive
disturbances among women who underwent bilateral
salphingooophorectomy.2 Further more, the incidence
of depression, anxiety and sexual disturbances is
higher in women whose ovaries were removed compared
to those who underwent natural menopausal
state.
If both ovaries were removed and then medical
problems occured, the next question would be whether
the clinician is willing to give HRT or whether
the patient is willing to have HRT? In Indonesia, clinicians
are afraid of giving HRT and patients are not
willing to have HRT. Then what will happen to the
patient? Symptomatic medication is then given. One
of the reasons of removing both ovaries is to prevent
the occurence malignancies of ovary and breast. HRT
will increase the incidence of breast cancer. If it is
so, then the patient is at the point of no return. If the
uterus is removed, will medical problems happen?
Yes, there are papillary thyroid cancer found in women
whose uterus were removed.3 It shows that uterus
also plays important role in controlling thyroid
glands. Levi et al. reported an increased risk of epithelial
thyroid cancer in women with artificial menopause
(OR 6.3%, 95% CI: 1.7 - 23.2).4 Several studies
in Europe and USA concluded that hysterectomy will
increase the risk of thyroid cancer.5,6 Estrogen indirectly
takes part in controlling the release of HRT, if
there is no estrogen then HRT release will increase
and trigger the growth of thyroid tumor.3
Myometrium and endometrium also have the ability
to produce thyroid hormone. The level of iodothyronine
deodinase enzyme is high in myometrium and
endometrium, especially during pregnancy.7,8 There
are 2 types of deodinase enzyme, type 2 and type 3.
D2 enzyme transforms T4 to active T3, while D3
transforms T4 to inactive T3.7,8 If uterus is removed,
the T3 will decrease and HRT release will be uncontrolled.
Estrogen only (+ progesterone) will increase
D2 enzyme activity while estrogen + progesterone
will increase D3 activity.9 It shows that estrogen plays
more important role in increasing D2 enzyme activity.
If there is no uterus, then there is no D2 enzyme available.
Uterus also has the ability to syntezise prostacycline.
Prostacycline has vasodilatation effect, increasing
the blood flow to the heart. Women without uterus
will have an increased risk of heart disease. Removing
the uterus has to be considered carefully. The incidence
of malignancies as a consequence of conserving
the uterus is lower compared to the adverse effect due
to hysterectomy and bilateral salphingooophorectomy.
Further study is needed in Indonesia to evaluate the
consequences of hysterectomy and bilateral salphingooophorectomy
towards thyroid cancer and quality
of life in the future
IL-10 Serum Concentration was Observed Higher in Threatened Preterm Labor
Get PDFObjective: To determine the serum concentration of Th-1 and
Th-2 cytokine in threatened preterm labor compared to that in normal
pregnancy.
Method: The design was analytical cross-sectional, comparing
the serum levels of TNF-α, IL-2, IL-10, TNF-α to IL-10 ratio and
IL-2 to IL-10 ratio between 29 subjects with threatened preterm labor
and 29 normal pregnant women. The cytokine concentration was
measured with ELISA. T test and Mann-Whitney U test was used
for statistical analysis.
Results: The mean concentration of TNF-α and IL-2 in both
groups did not reveal any difference (p = 0.188 and p = 0.493). Median of IL-10 serum concentration in the threatened preterm labor
(PTL) group was observed higher than that observed in the normal
pregnancy group (p = 0.001). Compared to normal pregnancy group,
the TNF-α to IL-10 ratio in the PTL group was observed lower (p
= 0.009). Both groups did not show any difference in the IL-2 to
IL-10 ratio (p = 0.057).
Conclusion: The IL-10 serum concentration was increased in
threatened preterm labor. There was no difference observed in the
Th-1 to Th-2 cytokines serum ratio in threatened preterm labor as
compared to normal pregnancy.
[Indones J Obstet Gynecol 2010; 34-4: 191-4]
Keywords: IL-10, preterm labor, Th-1 and Th-2 cytokine
The use of B-Lynch Technique and Lasso-Budiman Technique to Control Postpartum Hemorrhage in Uterine Atony
Get PDFObjective: To evaluate the use of B-Lynch Technique and Lasso
Budiman Technique as conservative way to control post partum
hemorrhage due to uterine atony.
Method: The cross-sectional retrospective study in Department
of Obstetrics and Gynecology, Tangerang General Hospital, Banten,
year 2005 - 2008 and Department of Obstetrics and Gynecology,
Wonosobo General Hospital, Central Java, year 2003 - 2008.
Results: Total 38 post partum hemorrhage cases managed conservatively using B-Lynch technique and Lasso-Budiman technique. Twenty-six cases were done at Wonosobo General Hospital using B-Lynch technique, with 1 failure case and hysterectomy was done with good result. No complications has been reported for the rest 25 successful cases. Twelve cases were done at Tangerang General
Hospital, using Lasso-Budiman technique, 1 failure reported, continue
to hysterectomy. Among 11 successful cases, 2 complications
were found. Ssecondary amenorrhea after performing Lasso-Budiman
technique due to uterine sinechia were reported.
Conclusion: The B-Lynch technique and Lasso-Budiman technique,
both are simple, easy, and effective to control post partum
hemorrhage due to uterine atony. If failed, hysterectomy is the last
choice. These techniques are also effective methods to conserve
uterus and fertility.
[Indones J Obstet Gynecol 2010; 34-4: 195-8]
Keywords: postpartum hemorrhage, conservative methode, BLynch
technique, Lasso-Budiman techniqu
Effect of Rectal Misoprostol to Blood Loss at High Risk Pregnancy
Get PDFObjective: To compare the effectiveness of rectal misoprostol administration
to the amount of blood loss in 4th stage of labor at high
risk pregnancy.
Method: We recruited all pregnant women with high risk criteria including
anemia, age  35 years old, or the number of pregnancies
 4. Women would deliver appropriate to standard procedure of
normal delivery. After that, we gave 400-mcg tablet of misoprostol
rectally in treatment group. To count the amount of blood loss
during 4th stage of labor, we put the underpad.
Result: The amount of blood loss in 4th stage of labor in the treatment
group was 201.1 (SD 80.3) ml less than the control group
(285.9 (SD 93.2) ml). The result showed that the administration of
400-mcg misoprostol tablet rectally immediately after the birth of
the placenta at high risk pregnancy impacted significantly to reduce
the amount of blood loss in 4th stage of labor (
Kematian Ibu di Indonesia Dapatkah kita mencapai target MDGs 2015?*
Get PDFTujuan kita masih jauh, sementara waktu tinggal 10 tahun. Dapatkah kita mencapai target yang telah disepakati AKI 125/100.000 pada 2010 dan 100/100.000 pada 2015? Padahal, saat ini masih 307/100.000?
Kalau cara kerja kita masih seperti sekarang, sudah dapat dipastikan kita akan gagal. Oleh karena itu, kita harus berubah. Teknologinya sudah tersedia, tinggal membenahi sistem dan orangnya. Kalau Cina yang sebesar itu mampu atau Srilanka yang sedemikian miskin sudah berhasil, mengapa kita harus gagal
Gynecology Cancer in Relationship with Obesity
Get PDFObjective: To know the relationship between obesity and gynecology
cancer.
Method: This study use case control study design for 250 gynecology
patients (125 controls and 125 cases) in Prof. Dr. R. D. Kandou
Manado Hospital from 1 July to 30 November 2015. The data was
collected by measuring Body Mass Index (BMI) and filing out selfadministered
questioners.
Result: From the 250 subjects, the study group (125 subjects), 72
subjects have obesity (57.6%) and 97 subjects have multiple parities
(77.6%) with 58 subjects diagnosed with cervical cancer (46.4%). In
the control group (125 subjects), 71 subjects have normal weight
(56.8%) and 67 subjects have multiple parities (53.6%) with 64 subjects
diagnosed with ovarium cysts (51.2%). Using multivariate logistic
regression, the overweight and obese subjects have 7 folds
higher risk to develop gynecology cancer compared to those with
normal or underweight subjects. Those with multiple parities and
grande multipara subjects have 3 folds higher risk to develop gynecology
cancer compared with those who are nullipara and primipara.
Conclusion: A significant correlation is found between obesity and
gynecology cancer using multivariate logistic regression analysis
(p=0.000, OR=6.9 (95% CI = 3.62-13.13).
[Indones J Obstet Gynecol 2016; 1: 23-30]
Keywords: gynecology cancer, multiple parities, obesit
Curcumin Administration on Proliferation and Apoptosis Index in Complete Hydatidiform Mole CellCulture
No full textObjective: To investigate that curcumin can decreasing proliferation
index and increasing apoptosis index.
Method: This is an experimental non-blinded study with post test
control group design, at Cell/Tissue Culture Laboratory at Medical
Faculty of Brawijaya University. This study using CHM trophoblastic
cell culture from CHM curettage patient, exposed by several doses of
curcumin, 0, 50, 100, 200, 400 and 800 μM, then examined by the
method of MTT proliferation index and apoptosis index by the
method of labeling DNA fragmentation TUNEL system. Data analyzed
by one-way ANOVA.
Result: In this study, the mean values obtained decrease in proliferation
index with increasing doses of curcumin. Giving a dose of
200 μM curcumin, 400 μM and 800 μM proved highly significant
(p = 0.001) reduced proliferation index compared with the control
and curcumin dose of 50 μM and 100 μM. From this research shows
that there are significant differences in the increase of apoptosis index
(p = 0.001) between the control group with curcumin dose
group 200 μM, 400 μM and 800 μM. But there was no significant
difference in the mean of apoptosis index among the three dose
groups.
Conclusion: Giving curcumin dose of 200 μM can decreasing the
proliferation index and increasing the apoptosis index increases in
CHM trophoblastic cell culture.
[Indones J Obstet Gynecol 2016; 1: 37-41]
Keywords: apoptosis index, curcumin, proliferation inde
Korelasi antara Hormon Reproduksi dengan Tampilan Integrin Endometrium pada Wanita dengan Infertilitas
Get PDFTujuan: Untuk mengetahui apakah terdapat hubungan antara hormon
reproduksi terhadap tampilan integrin endometrium.
Tempat: Klinik Yasmin bagian Obstetri dan Ginekologi RSCMFKUI.
Rancangan/rumusan data: Penelitian ini bersifat klinis retrospektif.
Bahan dan cara kerja: 53 orang wanita usia antara 20-40 tahun.
Pada semua pasien dilakukan biopsi endometrium pada fase sekresi dan
pemeriksaan hormon FSH, LH, Prolaktin, estradiol dan progesteron, dan
tampilan integrin dari biopsi endometrium dianalisa dengan pemeriksaan
imunohistokimia.
Hasil: Nilai rerata tampilan integrin pada penelitian ini 1,3. Dan didapatkan
angka korelasi progesteron terhadap tampilan integrin endometrium
0,285 dengan nilai probabilitas 0,04 dan koefisien determinasi
0,081. Kadar hormon FSH, LH, Prolaktin dan estradiol tidak bermakna
terhadap tampilan integrin.
Kesimpulan: Terdapat hubungan positif antara kadar hormon progesteron
terhadap tampilan integrin endometrium di fase luteal madya.
Diperlukan adanya faktor-faktor lain untuk memperkuat nilai prediktor
hormon progesteron.
[Maj Obstet Ginekol Indones 2006; 30-2: 112-5]
Kata kunci: integrin, FSH, LH, Estradiol, Progesteron, Infertilitas,
Jendela implantasi