Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Soluble Endoglin Serum Level is Higher in Preeclampsia Compared to Molar and Normal Pregnancy
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Objective: To analyze th e differences of maternal serum soluble endoglin level in pr eeclampsia, molar pregnan cy, and normal pregnancy, and to analyze th e correlation between maternal serum soluble endoglin level with gestational age.
Method: This is a cros s-sectional compara tive analytic study involving 18 preeclamps ia cases, 18 molar pr egnan cies, and 18 normal pregnancies. The sample were obtained from Dr. Hasan Sad ikin hospital and six satellite hospitals from January until Mar ch 2013. The comparison of mean seng se rum level of th e preeclampsia,molar pregnancy, and normal pregnancy gro up was calculated using Kruskal Wallis, and the corr elation we re calculated using Rank Spearman.
Result: The mean level of seng se rum in pr eeclamp sia gro up was higher (168.79 ngjml) than in molar pr egnan cy (43.47 ngjml) and normal pregnancy (32.38 ngjml). Ther e is no significant difference of se rum seng level be tween molar and norm al pregnan cy, with p value of 0.393 (p>0.05). There is significant differ ences of seng serum level between pr eeclampsia gro up and molar pr egnancy (p=O.OOO), but no significant differ ences between molar and normal pregnancy, p value=0.393 (p >0.05). Ther e is positive correlati on between seng se rum level of norm al pregnancy with gestational age (rs=0 .647 ; p<0.001).
Conclusion: Mat ern al se rum seng level in preeclampsia is higher than th e level of which in molar pre gnan cy and norm al pregnancy.
Keywords: molar pregnancy, norm al pr egnancy, pr eeclamp sia, soluble endoglin leve
Expression Collagen I and III in Anterior Vaginal Women with and without Pelvic Organ Prolapse
Get PDFObjective: To find out the expression of collagen [ and III in the anterior vaginal wall of women with and without pelvic organ prolapse (POP).
Method: The research was a cross sect ional study, conducted in Dr. Wahidin Sudiro Husodo hospital and its networks from January 1, 2011 to April 1, 2012. The case group consisted of 35 women with POPlevel III and IV.The contro l group consisted of35 women without POP. The expression of collagen I and III were examined by immunohistochemical test with the stain ing of antibody of collagen I (mouse monoclonal collagen lab 90395 ) and the antibody collagen III (Mu167 4i).The data was then analyzed by using a computer statistic program with a significance level of 0.05.
Result: It was found that in the group of women with POP, there were 28 cases of expression collagen III (84%), which is significantly higher than in women without POP, found in only 20 cases (58.8%), with p=0.02. Meanwhile, in the group of POP, 9.1% of subjects showed moderate expre ssion of collagen I, significantly less compared to the expressio n in the contro l group (35.3%), with p=0.007. For the ratio of collagen I and III, the result was weak in women with POP(58.5% ) while in the control group, the result was high (85.7%).
Conclu sion: In terms of collagen I and III expression, there was no significant difference between the two groups.
Keywords: collagen I, collagen III, pelvic organ prolapse, vaginal wal
Ovarian Reserve In Infertile Women with and without Endometriosis Measured with Anti Müllerian Hormone: Cadangan Ovarium pada Perempuan Infertil dengan dan tanpa Endometriosis Diukur dengan Anti Müllerian Hormone
Get PDFObjective: To compare serum Anti Müllerian Hormone (AMH) levels in infertile women with and without endometriosis, and to determine the mean levels of serum AMH in every stage of endometriosis.
Method: We performed a cross-sectional study. Sixty-eight subjects who have undergone laparoscopy and fulfilled both inclusion and exclusion criteria are recruited consecutively. They are divided into two groups, namely group with endometriosis and without endometriosis. Blood samples are taken from each subject before laparoscopy, where serum AMH levels are then measured. The difference in mean levels of each group are tested with Mann-Whitney test. Result: The mean levels of serum AMH were significantly lower in the endometriosis group than those in the group without endometriosis (2.30 1.8 ng/ml vs 3.75 2.13 ng/ml; p=0.005). Using Kruskal-Wallis test, it was found that there was a statistically significant difference among endometriosis groups based on the severity of endometriosis. There was no significant difference in the mean serum AMH levels between the minimal-mild endometriosis group and without endometriosis group (p=0.34), but the mean levels of serum AMH were significantly lower in the moderate-severe endometriosis compare to the group without endometriosis (p<0.005).
Conclusion: The mean levels of serum AMH in infertile women with endometriosis were significantly lower than those in women without endometriosis. There was no significant difference in the mean serum AMH levels in minimal-mild endometriosis group and those without endometriosis; while in moderate-severe endometriosis group, it was significantly lower than in the group without endometriosis.
Keywords: endometriosis, infertility, serum AM
Contraception for Women with Diabetes Mellitus: Kontrasepsi untuk Perempuan dengan Diabetes Mellitus
Get PDFObjective: To compare the different types of contraception and itsuse in women with diabetes mellitus.
Method: Literature review.
Result: Women in the reproductive age who are affected by a wide range of chronic medical conditions, one of which is diabetes mellitus (DM), may experience adverse health effects pre-conception and in pregnancy. This condition will influence outcome of pregnancy and contraceptive choice after delivery. Planning the use of contraception for women with DM who would experience high-risk pregnancy is a necessity, and counseling must consider the safety of different types of contraception that in comparison to the risk of pregnancy. WHO has provided a guideline on choosing contraception, which is available from the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC), as the basis for contraception selection for women with DM. For DM patients without complication any type of contraception can be used in consideration for the advantages and disadvantages of each type of contraception. For diabetics with complications or multiple risk factors, in the selection of contraceptive, hormonal contraception (especially for combined hormonal contraception (CHC) pill and injection method) requires proper consideration and consultation with health care providers.
Keywords: complications, contraception, diabetes mellitus, hormonal, pregnanc
Extending Coverage and Developing a Network for Achieving Cervical Cancer Screening with Documentation on Visual Inspection of Acetic Acid (Do-VIA) in Indonesia Laila Nuranna
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Recurrence-Free Survival Stage IB1-IIA2 Intermediate Risk Group (Based on Kartu Delgado) Cervical Carcinoma after Radical Surgery and Adjuvant Radiotherapy: Kesintasan Bebas Kekambuhan Kelompok Risiko Menengah Berdasarkan Kartu Delgado pada Kanker Serviks Stadium IB1-IIA2 Pascaoperasi Radikal dan Radioterapi Ajuvan
Get PDFObjective: To evaluate the benefits of adjuvant radiotherapy (ART) based on Kartu Delgado (simple form of Gynecologic Oncology Group (GOG) scoring system) aimed at women with early stage cervical cancer after radical surgery.
Method: Fifty patients were enrolled for this study. Twenty one patients from 2011-2012 were given ART following surgery based on their Kartu Delgado score from as follows: score <120 were designated for observation; score >120 were given ART. Their score and recurrence were compared with 29 patients who were treated in 2009-2010 (based on single prognostic factor).
Result: We observed eighteen recurrences for the duration this study. Thirteen patients from the period of 2009-2010 and five patients from the period of 2011-2012. Most recurrences occurred in patients from 2009-2010 with score > 120 but were not designated ART. Two-years recurrence-free survival (RFS) for subjects with score <120 who were designated observation was 76.23% while for score >120 with ART was 64.29%.
Conclusion: Adjuvant radiotherapy given based on Kartu Delgado reduced the number of recurrences in women with stage IB-IIA cervical cancer after treated by surgery.
Keywords: cervical carcinoma, intermediate risk, prognostic factor, radical hysterectom
Ovarian Malignancy Prediction by Gatot Purwoto (GP) Score, Risk Malignancy Index (RMI), and Frozen Section in Young Age: Prediksi Keganasan Ovarium dari Skor Gatot Purwoto (GP), Risk Malignancy Index (RMI), dan Potong Beku pada Usia Muda
Get PDFObjective: To know the diagnostic value of a scoring system taken before surgery and frozen section in young-aged patients with suspected malignancy. Using that result, we can also investigate whether frozen section gives additional value to clinical scoring system.
Method: This study is a diagnostic test. This study was carried out by accessing RSCM’s medical record from 2006-2011. From 437 patients suspected of ovarian malignancy, we included 157 patients due to age.
Result: Diagnostic value of GP score are 77%, 49%, 61%, 68%, 63%, while RMI are 69%, 49%, 58%, 45%, 59%, (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy respectively). Diagnostic value of frozen section in patients with suspected malignancy using GP score >4 are 81.7%, 87.2%, 90.7%, 75.6%, 83%, while in patients with RMI 200 are 81%, 87%, 89%, 77%, 83% (sensitivity, spesificity, positive predictive value, negative predictive value, and accuracy respectively).
Conclusion: Gatot Purwoto score and RMI have good diagnostic value in proving malignancy in young age. Its predictive value will be increased by frozen section.
Keywords: frozen section, gatot purwoto score, ovarian malignancy, RMI, young ag
Urinary Incontinence in Women Living in Nursing Homes: Prevalence and Risk Factors: Inkontinensia Urin pada Perempuan yang Tinggal di Panti Werdha: Prevalensi dan Faktor Risiko
Get PDFObjective: To identify the prevalence of urinary incontinence, the distribution of the type of urinary incontinence and related risk factors in women older than 50 years.
Method: This is a descriptive study with cross sectional design. Two hundred and seventy eight women older than 50 years old living in nursing home were interviewed using the Questionnaire for Urinary Incontinence Diagnosis (QUID) that has been translated and validated. The prevalence will be presented in the form of percentage; while the relationship between risk factors and the incidence or urinary incontinence will be analyzed using Chi square test or Fisher’s exact test, as appropriate, and multivariate analysis. Result: Of 278 research subjects, we obtained 95 subjects (34.2%) suffering from urinary incontinence. Moreover, the distribution of the type is 67 subjects (70.5%) with mixed urinary incontinence, 17 (17.9%) with stress incontinence and 11 subjects (11.6%) with urge incontinence. Body mass index (BMI) showing overweight and obesity are not related with the prevalence of urinary incontinence (p>0.05), which may be caused by the low number of subjects with overweight and obesity. Meanwhile, factors related to urinary incontinence are age older than 60 years (OR=7.79, p=0.021), menopause 10 years (OR=5.08, p=0.004) and multiparity (OR=1.82, p=0.019). Based on multivariate analysis, the risk factor of age older than 60 years is no longer related to urinary incontinence (p>0.05). Thus it can be inferred that age older than 60 years is not a singular factor causing urinary incontinence but rather a part of a multifactorial model.
Conclusion: This study shows that the prevalence of urinary incontinence in women living in nursing home is 34.2%; while the distribution of the urinary incontinence is 67 subjects (70.5%) with mixed urinary incontinence, 17 subjects with stress incontinence (17.9%) and 11 subjects (11.6%) with urge incontinence. Risk factors for urinary incontinence are menopause 10 years and multiparity.
Keywords: mixed urinary incontinence, menopause, multiparity, prevalence, stress incontinence, urge incontinence, urinary incontinence, Questionnaire for Urinary Incontinence Diagnosis (QUID
Length of Menopause has a Positive Correlation with C-Telopeptide Plasma Level in Pascamenopause Women
Get PDFObjective: To determine the correlation between length of menopause
with C-telopeptide in pascamenopause women.
Method: An analytic cross-sectional study of 29 pascamenopause
women in Malalayang hospital Manado. Sampling method with consecutive random sampling. Data were analyzed with Spearman test with significance level of
The Role of Hospitals in Cervical Cancer Prevention
Get PDFObjective: To evaluate the role of hospitals in DKI Jakarta on primary and secondary cervical cancer prevention. Method: This was a survey conducted to 25 hospitals, chosen with simple random sampling from 109 hospitals in DKI Jakarta. Questionnaire used for interview contained statements regarding knowledge, attitude and behavior of 117 health care professionals along with identification of facility preparedness for cervical cancer prevention within those 25 hospitals.
Result: The assessment of knowledge shows that all health care professionals (100%) knew that HPV vaccination is used as a primary prevention for cervical cancer. About 98.3% respondent knew HPV vaccine injected intramuscularly. As much as 91.5% of the respondent knew HPV vaccine is given three times either at month 0, 1, 6 or at month 0, 2, 6. About 71.8% respondent knew deltoid as site for vaccine injection. Most of health care professionals (99.1%) knew VIA (visual inspection with acetic acid) can be used for early detection of cervical cancer. About 76.9% respondent knew how to interpret positive VIA results and 60.7% respondent knew how to do VIA test. As much as 93.2% health care professional knew the purpose of Pap test and about 82.1% knew how to do it. From attitude aspect, most of health care professionals (96.6%) agreed in giving HPV vaccination. About 94% of them agreed to do VIA test and about 98.3% agreed in conducting Pap test. From behavioral aspect, most of the respondent (76.9%) offered HPV vaccination to their clients/patients and 62.4% respondent did HPV vaccination. VIA test was offered and conducted by 52.1% and 30.8% of them, respectively. About 86.3% respondent offered Pap test and 71.8% did the Pap test. As many as 75% of female health care professionals who meet the qualification already had a Pap test for themselves, but only 32.5% ever been vaccinated for HPV. From facility aspect, twenty hospitals (80%) in DKI Jakarta offered HPV vaccination with Pap test can be done in all of them. VIA test and colposcopy were only available in eleven (44%) and ten (40%) hospitals respectively.
Conclusion: Most hospitals in DKI Jakarta have health care professionals with good knowledge and attitude in cervical cancer prevention. However, not many have shown expected behavior in the primary prevention. Most hospitals in DKI Jakarta provide facilities for HPV vaccination and Pap test, but only few have VIA facilities and colposcopy.
Keywords: cervical cancer prevention, health care professional, hospita