Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Fertility Outcomes after Laparoscopic Reversal of Tubal Sterilization
Full text linkObjective: To know pregnancy outcome in the tubal reversal of sterilized women. Method: Literature review. Results: Sterilization is considered the most common contraception methods in United States of America, approximately 39% women in reproductive age (15 - 44 years) used this method. However, approximately 15% of these patients deplored this decision due to the influence of their own environment and some factors, such as: young age, the death of a child, the disability of child, and change of partner/ remarried. Tubal reanastomosis or tubal reversal is a surgical procedure that attempts to restore the fallopian tube patency following sterilization. To date, the modern procedure is performed by doing an excision of the tubal segment and reanastomosis by transabdominal laparoscopy. Recently, the laparoscopic technology has developed and evolved rapidly as the robotic assisted laparoscopy was invented. There is alternative method for restoring the fertility in sterilized women who regretted the decision of being sterilized. Unlike the tubal reversal which is conducted in order to restore the tubal function, the IVF is performed to bypass the function of tubes in fertility. The major advantage for laparoscopic surgery is short postoperative stay duration with minimal tissue handling, less postoperative adhesions, and diminish morbidity rate. Despite of its major drawback, high-cost of robotic machine and machine maintenance; there are advantages of robotic laparoscopy compared to the conventional laparoscopy, such as improved dexterity, more precise and accurate articulation, reduced tremor, and better visualization of the operating field. In vitro fertilization (IVF) is the hallmark in the era of assisted reproductive technology and became an alternative option to regain the fertility in sterilized women. Conclusion: The pregnancy rate and live birth rate in laparoscopy, robotic and open surgery were relatively similar. Surgical reversal to women younger than 40 is recommended and laparoscopic reversal should be performed if the expertise is available. It is reasonable to counsel IVF to over 40 women. [Indones J Obstet Gynecol 2012; 36-3: 154-60] Keywords: gynecology, IVF, pregnancy outcomes, reanastomosis, robotic laparoscopy, tubal reversa
Elastin Expression in Sacrouterina Ligament is Weaker in the Women with Pelvic Organ Prolapse
Full text linkObjective: The research aims at comparing the elastin immunolabeling in the uterosacral ligaments in women with pelvic organ prolapse and without pelvic organ prolapse (POP). Methods: The research is done at Dr. Wahidin Sudirohusodo Hospital and education networking some hospitals the Obstetrics and Gynecological School of Medicine Hasanuddin University that began in January 2011 until April 2012. This research assessing expression of elastin on 35 women with a pop level III and IV and as control is 35 women without POP. Immunolabeling of elastin valued in staining checkings immunohistokimia uses antibodies elastin ( clone no. Ba-4 1:1600; Novacastra Laboratories Ltd, UK). The research was carried out by the cross sectional study. Mixed with chi-square. Level significance used is 0.05. Results: The results showed that the elastin immunolabeling in women with POP is decline on most sample expression with the intensity of elastin is weak (74.3%). The most control with the intensity of elastin immunolabeling is moderate (48.6%). Elastin immunolabeling seem significant in women with menopause and with BMI that overweight (all with p<0.05). Other factors that contributed to the occurrence of pelvic organ prolapse are age, parity, history of childbirth, and the history of newborn’s weight. Conclusion: Elastin expression is weaker in the sacrouterina ligament of women with pelvic organ prolapse, thus it could contribute to the occurence of pelvic organ prolapse. [Indones J OIbstet Gynecol 2012; 36-4: 188-93] Keywords: elastin, pelvic organ prolapse, risk facto
Evaluation of Combination Chemotherapy Effect of Platinum, Vincristin, Bleomycin, and Mitomycin C on Cervical Cancer Based upon Apoptosis Description
Full text linkObjective: To observe the success of platinum, vincristin, bleomycin and mitomycin C (PVB-MMc) combination chemotherapy on cervical carcinoma by evaluating apoptosis feature. Methods: This study was performed at Dr. Wahidin Sudirohusodo Hospital and several other hospitals. The method of this study was prospective longitudinal. Cervical biopsy was performed on 15 cervical carcinoma patients before and after PVB-MMc chemotherapy. Six patients were at early stage and 9 patients were at advanced stage. Biopsy result were sent to pathologic anatomic laboratory to be made into paraffin block and further examined for apoptosis with Tunel method. Data were analyzed by using Wilcoxon Signed Rank test. Results: Study results indicating no significant difference for apoptosis index before and after PVB-MMc chemotherapy for early stage (p=0.463), advance stage (p=0.594), but quantitatively there were increasing apoptosis index before and after chemotherapy. Conclusion: Chemotherapy combination PVB-MMc for cervix carcinoma can increase apoptosis index and give a good response in term of reducing the tumor size although statistically not significant. [Indones J Obstet Gynecol 2012; 36-4: 200-5] Keywords: apoptosis, cervical carcinoma, PVB-MMc combination chemotherapy
One Point Technique of Intracutaneous Sterile Water Injection is as Effective as Four Points Technique in the Management of Labor Pain
Full text linkObjective: To compare the score of VAS (visual analog scale), length of labor, and APGAR score in intracutaneous sterile water injection between one point technique and four points technique at Michaelis Rhomboid area in management of labor pain. Method: This is an experimental study, subjects were included by blinded controlled randomized study on 50 women with term pregnancy stage I active phase and were planned for spontaneous delivery. Subjects were divided into 2 groups randomly, 25 women with 0.5 ml sterile water intracutaneous injection on 4 points and 25 women with that on 1 point injection at one site at the painful area. Result: Reduction of labor pain on 1-point technique could decrease VAS score the most, 85.4 (4.3) into 48.4 (8.5) on minute 10. Length of labor was 11.2 (1.15) on 1 point injection group compared to 11.4 (1.2) on those with 4 point injection. On the other hand, APGAR score of the baby on group having 1-point injection was 7.86 (0.5) on min 1 and 9.68 (0.5) on min 5, compared to that on 4-points injection group, 7.52 (0.7) and 9.56 (0.5), respectively. In addition, 60% felt uncomfortable with 1-point injection whereas 80% of patients felt uncomfortable in 4-points injection. Conclusion: There is no significant difference on reduction of VAS score, duration of labor, and APGAR score of the baby between the group having 1 point injection and 4-point injection. However, injection on 1 point is more comfortable. [Indones J Obstet Gynecol 2012; 36-4: 167-70] Keywords: APGAR , intracutaneous sterile water injection, length of labor, VA