Indonesian Journal of Obstetrics and Gynecology (INAJOG)
Not a member yet
904 research outputs found
Sort by
Hypertriglyceridemia - Induced Acute Pancreatitis in Pregnancy
Full text linkIntroduction: Acute pancreatitis in pregnancy (APIP) is a rare case. The mortality rate for pregnant women due to pancreatitis is reported at 37 percent and fetal mortality rate is up to 60percent. Hypertriglyceridemia (4percent-10percent) is known as the third most common cause of acute pancreatitis. There is one study reported that hypertriglyceridemia-induced acute pancreatitis (HTGP) reached up to 56percent of APIP cases.
CasePresentation: A 33-year-old woman, GIIIP2002 32/33 weeks came with shortness of breath, preceded by severe heartburn, nausea and fever. There was a decrease in consciousness, with high blood pressure, and tachycardia. The patient had no history of high blood pressure during routine ANC. From the laboratory results, leukocytes were 22,670/pL, random blood sugar level 713 mg/dL, severe metabolic acidosis on the results of blood gas analysis, amylase was 1,004.8 U/L, lipase was 899.4 U/L, and triglyceride was 789 mg/dL. From the results of an abdominal CT scan with contrast, were consistent with the description of acute pancreatitis.
Discussion: In pregnant patients with severe heartburn, with no previous history of high blood pressure, it may be suspected to be caused by an acute pancreatitis. If there are no risk factors of alcohol abuse, hypertiglyceridemia can be suspected as the cause. Triglycerides normally increase during pregnancy, but their values do not reach a concentration that can cause an acute pancreatitis.
Conclusion: Patients with risk factors for increased triglycerides, both in patients and families, require strict monitoring. Quick diagnosis and appropriate therapy are the keys to treat acute pancreatitis.
Keywords: Acute pancreatitis, hypertriglyceridemia, pregnancy, preeclampsia  
Concordance and Acceptability of HPV DNA Genotyping Test by Patient’s Self-Sampling Against Clinician Sampling
Full text linkObjectives: To determine the effectiveness of this alternative method, especially during the COVID-19 pandemic and considering Indonesia’s cultural context.
Methods: This study utilized a cross-sectional design, and involved patients at the Gynecology and Colposcopy Clinic of Dr. Cipto Mangunkusumo General Hospital. The estimated sample size was 48, determined using a diagnostic test formula. The sample population consisted of female patients with positive VIA or abnormal Pap smear results. Each patient underwent HPV DNA self-sampling and clinician sampling tests using the GenoFlow HPV Array technique and continued with colposcopy. All patients were also administered a questionnaire consisting of eight questions about their perspective on the self-sampling HPV DNA test. The data analysis employed a 2 × 2 table using SPSS version 20, and Cohen’s kappa coefficient was calculated to measure the agreement between the sampling results of patients’ and Clinicians’.
Results: Among the examinations conducted by clinicians, there were 33 patients with positive HPV results, whereas through self-sampling, there were 28 patients with positive HPV (p=0.00). High risk HPV was the most commonly observed, with HPV type 16 appearing the most (15%). Based on these data, the self-sampling sensitivity, specificity, positive predictive value, and negative predictive value were 85%, 100%, 100%, and 75%, respectively, with a concordance rate of 89.6%. The Cohen’s Kappa coefficient between samples taken by the clinician and self-sampling resulted in K=0.778, which is considered a good agreement (K=0.61-0.80). All patients concluded that the procedure was easy (100%), and the majority (60.5%) expressed a preference for the self-sampling method.
Conclusion: There is a good agreement between the results of self-sampling and clinician sampling for detecting HPV DNA, with patients positively accepting the self-sampling method, indicating its potential as an effective cervical cancer screening method.
Keywords: Cervical Cancer Screening, Clinician Sampling, Human Papillomavirus, Self-Sampling
Higher HIF-1alpha Level in Cervical Cancer Worsen the Outcome of Radiotherapy in Stage IIIB Squamous Cell Carcinoma of the Cervix
Full text linkPregnancy after Succesful Fallopian Tube Recanalization
Full text linkObjective: To report a pregnancy that ensued following the successful recanalization of a previously sterilized fallopian tube. The novel aspect of this report is its demonstration of a successful intrauterine pregnancy post-recanalization, despite a prior ectopic pregnancy resulting from tubal sterilization.
Methods: Case report
Case: A 35-year-old woman successfully conceived after the recanalization of a previously sterilized fallopian tube. It is noteworthy that she had previously experienced an ectopic pregnancy due to the tubal sterilization procedure.
Conclusion: This case study highlights the potential for successful pregnancy following fallopian tube recanalization, even after an ectopic pregnancy caused by a prior sterilization procedure. This report underscores the complexity of reproductive outcomes in these scenarios.
Keywords: fallopian tube recanalization, pregnancy, tube sterilization.
 
The Prevalence of Post-traumatic Stress Disorder (PTSD) Symptoms in Women Hospitalized Due to COVID-19 Infection during Pregnancy in Indonesia and Its Association with Employment Status and Delivery Method: A Single Center Study
Full text linkObjective: To analyze the prevalence of post-traumatic stress disorder (PTSD) symptoms in pregnant women infected with COVID-19 in one of the Indonesian tertiary referral centers for COVID-19 cases and its association with maternal employment status and delivery method.
Method: Data from medical records and an online questionnaire were collected for a cross-sectional study. The study included pregnant women treated in the COVID-19 non-intensive isolation wards throughout 2021. The occurrence of PTSD symptoms was assessed using the PTSD Checklist for DSM-5 (PCL-5). Prevalence of PTSD symptoms was decribed and its correlation with employment status and delivery method were analyzed.
Results: The analysis involved data from 75 patients, with a mean PCL-5 total score of 17 ± 13.85. Among them, 16% met the PTSD symptoms criteria (PCL-5 total score more than 32). Of the total, 72% were women who had undergone caesarean section (CS), and the same percentage were unemployed. Comparisons revealed no significant difference in PTSD symptoms occurence based on employment status (19% in employed women vs. 14.8% in unemployed women, p=0.729, 95% CI) and delivery method (14.8% in CS vs. 16.7% in spontaneous delivery, p=1, 95% CI).
Conclusion: This study revealed a significant prevalence of PTSD among pregnant women during the COVID-19 pandemic. Despite there is no association found between the prevalence of PTSD symptoms and employment status or delivery method in this study, further research is needed to understand the psychological effects, clinical implications, and relevant factors impacting pregnant women in the acute-event settings.
Keywords: COVID-19, pandemics, pregnancy, post-traumatic stress disorder
Atypical Findings of Suspect Twin to Twin Transfusion Syndrome Quintero V: a Rare Case Report
No full textIntroduction: Twin-to-twin transfusion syndrome (TTTS) is a serious complication in monochorionic multiple pregnancies.
Case Illustration: A-38 years old woman with G3P2AO felt 8 months pregnant and came for polyclinic control with the diagnosis of G3P2A0 gravida 34-35 weeks; Gemelli; Baby I Breech position; Baby I Polyhydramnios, IUFD; Suspected Twin Twin Transfusion Syndrome (TTTS Quintero V). However, atypical findings of TTTS are rarely found and should be taken as special notes such in this case. We will report a rare finding of TTTS in which the SDP level of the donor fetus was normal (not oligohydramnios). The suspected diagnosis of TTTS Quintero V in this case was made clinically based on the maternal-fetal ultrasound findings of a diamniotic monochorionic gemelli pregnancy with IUFD in the 2nd fetus II. However, there were non-standard findings in this case where the SDP level of the donor fetus was normal (not oligohydramnios). No other sequele complications were found in this case based on other examinations.
Conclusions: Several therapies are available for TTTS including amnioreduction, laser ablation of the vascular placental anastomosis, selective feticide, and septostomy. Timing of delivery after management of singleton fetal death in the late second or early third trimester is debatable. Delivery method is determined based on obstetric indications
CA-125 Examination as a Predictor the Resectability of Advanced Stage of Ovarian Cancer
Full text linkObjective: To describe the prompt and successful treatment of an extrauterine pregnancy case in a tertiary-level hospital in Indonesia.
Methods: We report a case of prompt and successful management of unruptured tubal pregnancy in the dr. Soetomo General Hospital Surabaya.
Results: A 32-years-old woman presented with lower abdominal pain and vaginal bleeding one days before admission. She was sexually active, used no contraceptives, and had a history of one miscarriage. On examination, she was hemodynamically stable. A bimanual exam revealed cervical motion tenderness and pain. A high human chorionic gonadotropin (hCG) level (1,725 IU/L) and a left-sided mass, highly suspected as an extrauterine gestational sac confirming a 6 week, 1 days age of pregnancy without sign of free fluid in the abdomen nor fetal heart rate on ultrasound, prompted diagnostic laparoscopy. We found a tubal pregnancy located on the ampullae of the left fallopian tube with minimal hemoperitoneum (50 ml). A chromopertubation test was done to ensure a patent right fallopian tube, so we did a salpingectomy. The patient recovered well and was discharged home on day 2 post-procedure.
Conclusion: Early diagnosis is vital and feasible to prevent morbidity and mortality in women with ectopic pregnancy. All sexually active women complaining painful abdomen or vaginal bleeding must be examined for an ectopic pregnancy to enable early diagnosis and prompt treatment. A laparoscopic surgery done by a trained individual provided a safe and minimally invasive intervention to this case.
Keywords: case report, ectopic pregnancy, laparoscopy, salpingectomy, tubal pregnanc
Polymorphism specific Allele Frequencies on Cervical Cancer
Full text linkObjective: To evaluate the correlation of allele frequencies of IL-6 polymorphisms between healthy women and cervical cancer patients.Methods: The study involved gynecologists diagnosing abnormal cervical tissue in 100 women aged 17-60. Each woman provided two tissue samples: one for pap smear analysis and one for genetic research, along with a blood sample for IL-6 polymorphism analysis. Traditional polymerase chain reaction (PCR) was used for genetic analysis to confirm diagnoses. Allele-specific PCR (AS-PCR) was utilized to identify allelic polymorphisms. Pap smears identified cervical intraepithelial neoplasia (CIN) II and III, characterized by dysplastic cells and mitotic figures.Results: The diagnostic PCR data demonstrated that 36% of participants were HPV-infected, with the greatest infection rates (50%). The AS-PCR reported that the IL-6 (rs1800795) gene detected at 174 G/C position was presented with GG, GC, and CC genotypes. Conclusion: The result showed a significant alteration in the IL-6 (rs1800795) gene, strongly correlating with cervical cancer based on human papillomavirus infection.Keywords: cervix cancer, human papillomavirus, interleukin-6 polymorphism, genetic analysis
The impact of Gestational Weight Gain on Preeclampsia During COVID-19 Pandemic
Full text linkObjective : To determine the Effect of Gestational Weight Gain on Preeclampsia During COVID-19 Pandemic in Public Health Centers of The West Lombok Regency
Methods : This study is an observational analytic study that uses a case control study design (case control) starting by identifying patients with effects (preeclampsia and/or eclampsia) and groups without effects (no preeclampsia and/or eclampsia) and then retrospectively tracing their risk factors at 3 public health centers, which are located in West Lombok Regency, NTB Province, Indonesia namely Narmada, Kediri and Gunung Sari Health Centers. The analysis was carried out using the SPSS application.
Results: Total of 120 samples were obtained, with 60 case samples and 60 control samples. During the COVID-19 pandemic with a time span of 2020-2021, subjects with weight gain that did not meet the recommendations had more preeclampsia, namely 56 people (93.3%) than subjects who did not had preeclampsia, which was 32 people (53.3 %). The value of Odds Ratio (OR) is 12,25 (95% Confidence Interval, 3.941-38.078).
Conclusion : Based on this study, there was a significant relationship between the increase in BMI and the incidence of preeclampsia during the COVID-19 pandemic. The increase in BMI that is not in accordance with the recommendations is a risk factor for the occurrence of preeclampsia in pregnant women. The majority of preeclampsia occurs in 3rd trimester pregnant women. In addition, the Odds Ratio value obtained in this study increased by 6 times compared to similar studies conducted in non-pandemic conditions.
Keywords : Preeclampsia, Eclampsia, Gestational Weight Gain, COVID-19