Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Clinical Evaluation of Neoadjuvant Chemotherapy Followed by Radical Hysterectomy in the Management of Cervical Cancer Stage IIB
Get PDFObjective: To evaluate the clinical efficacy, operability, radicality,
toxicity, and incidence of recurrences of neoadjuvant chemotherapy
(NAC) followed by radical hysterectomy (RH) among patients with
stage IIB cervical cancer.
Method: This is an observational clinical study at Dr. Moh. Hoesin
Hospital, Palembang. Data were analyzed from 27 patients who
matched the inclusion criteria and underwent 3 cycles of neoadjuvant
chemotherapy (NAC) with Paclitaxel (75 mg/m2) in combination
with Cisplatin (50 mg/m2) and Docetaxel (75 mg/m2) combined
with Carboplatin (300 mg/m2) according to AUC 6, followed by radical
hysterectomy from January 2012 until December 2013.
Result: The operability rate after NAC was 96.4%. Lymph node metastases
were negative in 75% of patients, and we found bilateral
lymph node metastases in 14.3% of patients. Parametric infiltrations
were negative in 85.7% of the patients, and positive in 14.3% of patients.
No vaginal infiltrations were found. As much as 89.3% of the
patients did not experience any side effect, while anemia and thrombocytopenia
were found in 10.8% of the patients. We found that
7.1% of patients had recurrences within 6 months interval.
Conclusion: NAC followed by radical hysterectomy showed significant
advantages for patients with stage IIB cervical cancer, with
fewer side effects. However, long-term evaluation and a larger number
of patients are required to confirm this result.
Keywords: cervical cancer, neoadjuvant chemotherapy, radical hysterectom
A Real-time Optoelectronic Device in Screening of Precancerous Cervical Lesion
Get PDFObjective: To obtain the diagnostic values of optoelectronic device
for screening of precancerous cervical lesions.
Method: We performed a diagnostic study with cross sectional design.
Subjects were recruited from Dr. Cipto Mangunkusumo Hospital,
from February until December 2013. Subjects were enrolled
based on consecutive sampling until the minimum sample was
achieved (60 samples).
Result: During the study period, 60 patients were enrolled. Sensitivity,
specificity, positive predictive value, and negative predictive
value of the optoelectronic device were 76%, 95%, 96%, and 64%,
respectively. We also investigated diagnostic values of other screening
methods, namely citology and colposcopy. Sensitivity and specificity
of liquid based cytology were 83% and 63% respectively. The
combination of optoelectronic device and liquid based cytology increased
the sensitivity to 92.8%. Meanwhile, sensitivity and specificity
of colposcopy were 88% and 58%, respectively. Based on Altman
criteria, kappa value for optoelectronic device with cytology was
0.35 (fair) and optoelectronic device with colposcopy was 0.45
(moderate).
Conclusion: A real-time optoelectronic device might be used as an
alternative method in early detection of precancerous cervical lesions,
either as a single method or combined with liquid based cytology.
Keywords: diagnostic values, optoelectronic device, precancerous
cervical lesion
Serum Zinc Level at Term Pregnancy and Newborn Anthropometry
Get PDFObjective: To determine the relationship between serum zinc level
at term pregnancy and newborn anthropometry.
Methods: This study is an observational study with cross-sectional
design. Serum zinc level at term pregnancy was measured and then
anthropometric measurement was done to the newborn, including
birth weight, birth length and head circumference at birth. The data
were statistically analyzed using regression correlation test.
Results: Mean serum zinc level at term pregnancy is 36.01 μg/dl
(SD=18.34 μg/dl), the average birth weight is 3158 gr (SD=480.4 gr),
the average birth length is 48.42 cm (SD=1.75 cm) and the average
head circumference at birth is 33.13 cm (SD=1.14 cm). There was no
statistically significant relationship between serum zinc levels at
term pregnancy and birth weight (p-value=0.152). Meanwhile, there
are statistically significant relationships between serum zinc level at
term pregnancy with birth length and head circumference with pvalue
0.026 and 0.012, respectively.
Conclusion: Serum zinc level at term pregnancy is correlated with
birth length and head circumference, but is not correlated with birth
weight.
[Indones J Obstet Gynecol 2015; 3-4: 190-195]
Keywords: birth length, birth weight, head circumference at birth,
serum zinc level, term pregnanc
Accuracy of Intraoperative Frozen Section in Diagnosing Malignancy of Ovarian Neoplasm
Get PDFObjective: To evaluate the accuracy of frozen section for ovarian neoplasm
in our hospital.
Method: A retrospective evaluation was conducted on medical records
of patients with ovarian neoplasms who underwent a frozen
section laparotomy between the years 2008 and 2013 at Dr. Cipto
Mangunkusumo Hospital. Records with incomplete data on frozen
section or paraffin block report were excluded. Criteria for frozen
section laparotomy in our facility was based on a malignancy score of
equal to or more than 6. Frozen section reports were compared to
paraffin block report based on benign, borderline, or malignant cases.
Result: From 139 patients with ovarian neoplasm, only 91 patients
fulfilled the inclusion and exclusion criteria. Frozen section examination
revealed benign cases was 15.4%, borderline cases was 15.4%,
and malignant cases was 69.2%. Based on histopathological type, clear
cell cystoadenocarcinoma was the most commonly observed histotype
(19.8%). The sensitivity of frozen section for benign, borderline,
and malignancy cases respectively was 81.8%, 76.9%, 91.0%. The
specificity of frozen section for benign, borderline, and malignancy
case respectively was 93.8%, 94.8%, 91.6%.
Conclusion: We found that the accuracy of intraoperative frozen section
in our facility is adequate to diagnose ovarian neoplasm and can
be used to assist in determining the extent of surgical management.
[Indones J Obstet Gynecol 2015; 3: 161-164]
Keywords: frozen section, ovarian neoplasm, paraffin block, sensitivity,
specitificit
Difference of Serum MMP9 and TNF ô€ƒ Level in Preterm and Term Premature Rupture of Membranes
Get PDFObjective: To examine the difference between matrix metalloproteinase†9 (MMPâ€9) and Tumor Necrosis Factor ô€ƒ (TNFâ€ô€ƒ) serum levels in preterm and term premature rupture of membranes (PROM).
Method: Our study employed an observational cross sectional approach. Seventy samples were divided into two groups, 35 samples with preterm PROM (28â€36 weeks gestational age) and 35 samples with PROM at term pregnancy (37â€42 weeks gestational age). Both groups underwent examination for serum MMPâ€9 and TNFâ€ô€ƒ concentration using ELISA method. Statistical analysis was done using ttest.
Result: Serum levels of MMPâ€9 in the preterm PROM group was 2860.68K627.32 ng/ml, which was significantly higher than in the PROM at term pregnancy group 2549.74K657.15 ng/ml (p=0.04). Likewise, the average serum level of TNFâ€ô€ƒ in subjects with preterm PROM was 12,086.60K5384.51 ng/ml, significantly higher in comparison to PROM at term pregnancy, which was 6422.51K2645.32 ng/ml (p=0.00).
Conclusion: Serum levels of MMPâ€9 and TNFâ€ô€ƒ in preterm PROM is significantly higher than that in PROM at term pregnancy.
Keywords: MMPâ€9, premature rupture of membranes, preterm, term, TNFâ€ô€
Sexually Transmitted Infection in Correlation with Cervical Precancerous Lesion
Get PDFObjective: To identify the correlation between sexually transmitted
infection and cervical precancerous lesion.
Method: The study design is crossâ€sectional. Samples were collected
by consecutive sampling method until the minimal amount was fulfilled.
This study was conducted in the Colposcopy Outpatient Clinic
and Cytology Laboratory, Division of Specialistic Gynecology, Department
of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo
Hospital (RSCM), Jakarta, from September 2008 to March 2009.
Laboratory examination for sexually transmitted infection (STI) was
performed in Department of Dermatovenereology, RSCM, Jakarta.
Patients were grouped into cases and control group. The case group
consisted of patients diagnosed with cervical intraepithelial neoplasia
(CIN) and the control group consisted of patients without CIN.
Sexually transmitted infection was identified and its relationship to
CIN was analyzed.
Result: We included 130 patients into this study, 25.38% without
CIN and 74.62% with CIN. We found that one patient can be infected
by up to five types of infection at a time. We also discovered a statistically
significant relation between CIN 1 and STI (p=0.028), CIN 2
and STI (p=0.007), and CIN 3 and STI (p=0.013).
Conclusion: Based on our study, we discovered a significant relationship
between the incidence of STI and CIN.
Keywords: cervical intraepithelial neoplasia, cervical precancerous
lesion, sexually transmitted infectio
Laceration Extension in Median and Mediolateral Episiotomy
Get PDFObjective: To compare the laceration extension between median
and mediolateral episiotomy in women with perineal body sized
more than 2.5 cm.
Method: A singleâ€blind RCT study was conducted on 104 women receiving
median episiotomy and 104 women receiving mediolateral
episiotomy at Dr. M. Djamil Hospital Padang and Reksodiwiryo Military
Hospital Padang.
Result: There was no difference in laceration extension in both
groups, but pain in the first 24 hours and pain after day 14 was
higher on mediolateral group than the median group (p=0.005 and
p=0.008, respectively).
Conclusion: There is no difference in terms of laceration extension
between median and mediolateral episiotomy, but the pain is higher
in the mediolateral group.
[Indones J Obstet Gynecol 2015; 1: 38â€43]
Keywords: laceration extension, median episiotomy, mediolateral
episiotom
The Level of Heat Shock Protein 70 is Lower in Postterm Pregnancy
Get PDFObjective: To analyze whether there are differences between the levels of HSP70 of Postterm pregnancy and aterm pregnancy in Dr. Moewardi Hospital, Surakarta, Central Java.
Method: This was a cross-sectional study. The independent variable was the level of Heat Shock Protein 70 (HSP70), and the dependent variable was the incidence of postterm pregnancy. The data was then analyzed by t test.
Result: The subjects were 45 women, who were divided into 2 groups of women with postterm pregnancies (15 women) and aterm pregnancies (30 women). The mean levels of HSP70 in the serum of women with postterm pregnancy is lower (0.40 ng/ml) compared to the level of the normal pregnant group (3.94 ng/ml) and this difference was statistically significant (p<0.001).
Conclusion: The mean level of HSP70 in postterm pregnancy is lower than in normal full-term pregnancy.
Keywords: Heat Shock Protein 70, Maternal Stress, postterm pregnanc