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CXC Motif Chemokine Receptor 2: Glimpses into the Molecular Pathogenesis of Placenta Accreta Spectrum Disorder Mirani, Putri; Lestari, Peby Maulina; Murti, Krisna; Liberty, Iche Andriyani; Kesty, Cindy; Andrina, Hana; Stevanny, Bella
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.481

Investigation into the mechanism underlying excessive trophoblast invasion yields further strategies and insights for the diagnosis and treatment of placenta accreta spectrum disorder (PASD). We conducted a comprehensive literature review to analyze the relationship between CXCR2 expression and PASD, as well as the possibility of CXCR2 being used as a therapeutic and diagnostic biomarker for PASD. Chemokines are well-known mediators in the immune system, particularly for cell recruitment, angiogenesis, and tumor infiltration. CXCR2 is an important component of the immune system, particularly in neutrophils. One of the CXCR2 ligands, IL-8, has also been found to be expressed in the decidua and trophoblasts of humans and to promote autocrine or paracrine trophoblast migration and invasion. The potential role of CXCR2 in trophoblast invasion in PASD provides researchers with a glimpse into the molecular pathogenesis of PASD.CXC Motif Chemokine Receptor 2: Sekilas tentang Patogenesis Molekuler Gangguan Spektrum Plasenta AkretaAbstrakInvestigasi mekanisme invasi berlebihan trofoblas pada gangguan Spektrum Plasenta Akreta (SPA) akan memberikan lebih banyak strategi dan ide untuk diagnosis dan pengobatan. Kami melakukan tinjauan literatur yang komprehensif untuk menganalisis hubungan antara ekspresi CXCR2 dan SPA serta potensi CXCR2 sebagai penanda terapeutik dan diagnostik untuk SPA. Kemokin berperan sebagai mediator dalam sistem imun karena perannya dalam perekrutan sel, angiogenesis, dan infiltrasi tumor. CXCR2 mempengaruhi sistem imun, terutama pada neutrofil. Salah satu ligan CXCR2, IL-8, juga telah ditemukan diekspresikan dalam desidua dan trofoblas manusia serta untuk mempromosikan migrasi dan invasi trofoblas autokrin atau parakrin. Peran CXCR2 dalam invasi trofoblas pada SPA memungkinkan para peneliti untuk melihat sekilas patogenesis molekuler SPA.Kata kunci: penanda; CXCR2; plasenta akreta

Good Perinatal Outcome of Rhesus Incompatibility in Multigravida without Anti-D Injection Therapy: A Rare Case Report Husada, Abdillah; Lestari, Peby Maulina; Maritska, Ziske; Sari, Dian Puspita; Al Farisi Sutrisno, Muhammad; Stevanny, Bella
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 2 Juli 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i2.668

Introduction: Rhesus (Rh) incompatibility problem arises exclusively when an Rh-positive male impregnates an Rh-negative female, resulting in maternal Rh sensitization to produce anti-D antibodies that can bind and destroy Rh-positive erythrocytes of the fetus. Hemolytic disease of the neonate due to Rh incompatibility ranges from self-limited hemolytic anemia to severe hydrops fetalis. Rh incompatibility can be prevented by administering anti-D injection therapy containing Rh Intravenous Immunoglobulin (RhIVIG). We report a rare case of good perinatal outcome of rhesus incompatibility in multigravida without anti-D therapy injection due to weak D phenotype.Case Illustration: A gravida 3, para 2 woman at 27 weeks gestation with Rh-negative blood type, who has not experienced any previous compatibility problems, came to our facility for routine antenatal care. The husband has an Rh-positive blood type with a Dd genotype (heterozygous), suggesting a 50% probability that the offspring will have an Rh-positive blood type. Laboratory results showed a negative Coombs test and weak D phenotype. The patient had never received an anti-D therapy injection in this pregnancy and her previous two pregnancies. None of her children developed hemolytic disease in the neonate. Ultrasonography showed a well-developed 27-week gestational age fetus with no major congenital disorders. The good perinatal outcomes of her children might be due to weak D phenotype. Pregnant women with weak D phenotype have fewer D antigens that can still result in Rh sensitization but not enough to cause serious complications to the fetus. Conclusion: Rhesus incompatibility with weak D phenotype can have good perinatal outcomes without anti-D injection therapy. Administration of Anti-D injection remains a viable option to prevent subsequent Rh alloimmunization.Inkompatibilitas Rhesus pada Multigravida dengan Luaran Perinatal Baik tanpa Terapi Injeksi Anti-D: Laporan KasusAbstrakPendahuluan: Masalah inkompatibilitas Rhesus (Rh) muncul secara eksklusif pada ayah Rh-positif dan ibu Rh-negatif, sehingga terjadi sensitisasi Rh ibu untuk menghasilkan antibodi anti-D yang dapat mengikat dan menghancurkan eritrosit janin yang Rh-positif. Penyakit hemolitik pada neonatus akibat ketidakcocokan Rh dapat berupa anemia hemolitik yang bisa sembuh sendiri hingga hidrops fetalis berat. Inkompatibilitas Rh dapat dicegah dengan pemberian terapi injeksi anti-D yang mengandung Rh Intravenous Immunoglobulin (RhIVIG). Kami melaporkan kasus langka dengan hasil perinatal yang baik inkompatibilitas rhesus pada multigravida tanpa injeksi terapi anti-D akibat fenotip D yang lemah.Ilustrasi Kasus: Seorang wanita gravida 3, para 2 pada usia kehamilan 27 minggu dengan golongan darah Rh-negatif, yang sebelumnya tidak mengalami masalah kompatibilitas, datang ke fasilitas kami untuk pemeriksaan antenatal rutin. Suami mempunyai golongan darah Rh-positif dengan genotipe Dd (heterozigot), sehingga kemungkinan keturunannya mempunyai golongan darah Rh-positif sebesar 50%. Hasil laboratorium menunjukkan tes Coombs negatif dan fenotipe D lemah. Pasien belum pernah menerima suntikan terapi anti-D pada kehamilan ini dan dua kehamilan sebelumnya. Semua anaknya tidak menderita penyakit hemolitik pada neonatus. Hasil USG menunjukkan janin usia kehamilan 27 minggu berkembang baik tanpa cacat bawaan mayor. Hasil perinatal yang baik mungkin disebabkan oleh lemahnya fenotip D. Ibu hamil dengan fenotip D yang lemah memiliki antigen D yang lebih sedikit sehingga masih dapat menyebabkan sensitisasi Rh, namun tidak cukup menyebabkan komplikasi serius pada janin.Kesimpulan: Inkompatibilitas rhesus dengan fenotip D lemah dapat memberikan outcome perinatal yang baik tanpa terapi injeksi anti-D. Injeksi Anti-D tetap dapat diberikan untuk mencegah aloimunisasi Rh di kemudian hari.Kata kunci: Fenotip D lemah, Imunoglobulin Rh, Inkompatibilitas rhesus, Multigravida, Terapi injeksi anti-D

Factors Affecting Breastfeeding Practice among Mothers with Hospitalized Neonates Lestari, Peby Maulina; Ramadanti, Afifa; Latifah, Murwani Emasrissa; Sutrisno, Muhammad Al Farisi; Andrina, Hana; Stevanny, Bella
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 1 Maret 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i1.707

Introduction: Breastfeeding is essential for premature infants, as it reduces morbidity while enhancing cognitive development, ultimately supporting a more productive adulthood. However, in the United States, where 10–12% of infants are born prematurely, hospitalization in the Neonatal Intensive Care Unit (NICU) presents significant challenges to breastfeeding practices as it introduces barriers such as maternal stress, mother-infant separation, limited visitation, and inadequate support, which hinder successful breastfeeding. Method: This review used several databases, namely Google Scholar, Science Direct, Elsevier, Medline, PubMed, Proquest, dan Wiley Online Library to search original and review articles in English about breasfeeding, internsive care unit, and risk factors in the last 10 years. Other reference sources used were guidelines and textbooks.Result: The findings reveal that breast milk’s bioactive components play a critical role in protecting against morbidity during NICU hospitalization, while also fostering cognitive development. Factors influencing breastfeeding practices include demographic (maternal age, education), biological (maternal and infant health), attitudinal (breastfeeding confidence), social (family support), and hospital regulations (NICU policies).Conclusion: Factors affecting breastfeeding practice among mothers with hospitalized neonates include planned pregnancy, medical interventions, and family support. NICU hospitalization can be a significant barrier to breastfeeding due to inadequate support, visitation time, mother-infant separation, maternal stress and anxiety, and clinical conditions.Faktor-Faktor yang Memengaruhi Praktik Menyusui pada Ibu dengan Neonatus Rawat InapAbstrakPendahuluan: Pemberian Air Susu Ibu (ASI) sangat penting bagi bayi prematur karena dapat mengurangi morbiditas sekaligus meningkatkan perkembangan kognitif, yang pada akhirnya mendukung kehidupan dewasa yang lebih produktif. Namun, di Amerika Serikat, di mana 10–12% bayi lahir prematur, rawat inap di Neonatal Intensive Care Unit (NICU) menghadirkan tantangan signifikan terhadap praktik menyusui akibat berbagai hambatan seperti stres maternal, pemisahan ibu dan bayi, waktu kunjungan yang terbatas, serta dukungan yang tidak memadai, yang menghalangi keberhasilan menyusui.Metode: Tinjauan pustaka ini menggunakan beberapa basis data, yaitu Google Scholar, Science Direct, Elsevier, Medline, PubMed, Proquest, dan Wiley Online Library, untuk mencari artikel asli dan ulasan dalam bahasa Inggris tentang menyusui, unit perawatan intensif, dan faktor risiko dalam 10 tahun terakhir. Sumber referensi lainnya yang digunakan adalah pedoman dan buku teks.Hasil: Kumpulan bukti yang ada di literatur saat ini menunjukkan bahwa komponen bioaktif dalam ASI memiliki peran penting dalam melindungi bayi dari morbiditas selama hospitalisasi di NICU, sekaligus mendukung perkembangan kognitif. Faktor-faktor yang memengaruhi praktik menyusui meliputi faktor demografis (usia ibu, pendidikan), biologis (kesehatan ibu dan bayi), sikap (kepercayaan diri dalam menyusui), sosial (dukungan keluarga), dan kebijakan rumah sakit (aturan di NICU).Kesimpulan: Faktor-faktor yang memengaruhi praktik menyusui pada ibu dengan bayi yang dirawat di NICU meliputi kehamilan yang direncanakan, intervensi medis, dan dukungan keluarga. Rawat inap di NICU dapat menjadi penghalang signifikan terhadap keberhasilan menyusui akibat kurangnya dukungan, waktu kunjungan yang terbatas, pemisahan ibu dan bayi, stres dan kecemasan maternal, serta kondisi klinis bayi.Kata Kunci: Air susu ibu, Faktor risiko, Ibu, Menyusui, NICU

COVID-19 in pregnancy: Maternal and perinatal outcomes at Dr. Mohammad Hoesin Hospital, Palembang, Indonesia Martadiansyah, Abarham; Mirani, Putri; Ridwan, Metta Rania; Hartati; Andriyani Liberty, Iche; Stevanny, Bella
Majalah Obstetri & Ginekologi Vol. 33 No. 1 (2025): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I12025.11-20

HIGHLIGHTS COVID-19 increases the likelihood of adverse maternal outcomes throughout pregnancy, including pneumonia, cesarean section, and ICU admission. Prompt diagnosis and treatment of COVID-19 may improve maternal outcomes. COVID-19 does not increase the likelihood of adverse perinatal outcomes. Reassurance can be provided to expectant mothers. ABSTRACT Objective: The objective of this study was to analyze the maternal and perinatal outcomes of COVID-19 in pregnancy at Dr. Mohammad Hoesin Hospital, Palembang, Indonesia. Materials and Methods: This retrospective cohort study was carried using medical records of pregnant mothers who delivered at Dr. Mohammad Hoesin Hospital Palembang from March 2020 to August 2021. The subjects were into two groups: pregnant women with and without COVID-19. Pearson Chi-Square test was used for bivariate analysis to determine the associations between COVID-19 and maternal as well as neonatal outcomes. The data were analysed using the Stata 15 statistical software. Multivariate analysis was done using the cox regression test to determine whether maternal characteristics affected those associations. P-value of < 0.05 were considered statistically significant. Results: The study analyzed 220 subjects, including 62 COVID-19-positive (28.18%) and 158 COVID-19-negative (71.82%) patients. Among expectant mothers with COVID-19, caesarean sections were the most common maternal outcome (82.26%), while fetal distress was the most frequent perinatal outcome (12.13%). Significant associations were found between COVID-19 and maternal outcomes, including pneumonia (RR = 12.76), caesarean section (RR = 2.74), and ICU hospitalization (RR = 6.90). These associations remained significant after adjusting for maternal characteristics. However, no significant association was found between COVID-19 and perinatal outcomes. Conclusion: COVID-19 increases the likelihood of adverse maternal outcomes throughout pregnancy.

Female Sexual Function and Quality of Life After Pelvic Floor Surgery Krisna, Ratih; Fauzi, Amir; Latifah, Murwani Emasrissa; Andrina, Hana; Arini, Putri; Astawa, I Gede Agus; Stevanny, Bella
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.735

Introduction: Pelvic floor surgery can significantly affect female sexual function and quality of life, impacting clinical outcomes and patient satisfaction. Understanding these effects is crucial for optimizing patient care.Objective: To review the literature about the impact of pelvic floor surgery on female sexual function and quality of life.Methods: A comprehensive literature search was conducted through PubMed and Scopus databases, covering publications from the last ten years. Articles were selected based on relevance, quality, and focus on sexual function and quality of life after pelvic floor surgery.Results: Pelvic floor surgery may affect female sexual function through physical, emotional, and anatomical changes. Postoperative dysfunction may involve pain, vaginal scarring, altered anatomy, or psychological distress. Decreased function is reported in 13% of women undergoing stress incontinence surgery and 37.5% of those undergoing complex urgency-type incontinence surgery. However, many studies report improvements in quality of life and sexual function following successful repair of pelvic organ prolapse or incontinencConclusion: Pelvic floor surgery can affect sexual function and the quality of life. A multidisciplinary approach is essential to help women regain sexual satisfaction and achieve optimal quality of life after pelvic floor surgery.Fungsi Seksual dan Kualitas Hidup Wanita Pasca Operasi Dasar PanggulAbstrakPendahuluan: Bedah dasar panggul dapat secara signifikan memengaruhi fungsi seksual dan kualitas hidup wanita, yang berdampak pada hasil klinis dan kepuasan pasien. Oleh karena itu, pengetahuan mengenai fungsi seksual dan kualitas hidup wanita pasca operasi dasar panggul sangat penting untuk mengoptimalkan perawatan pasien.Tujuan: Meninjau literatur mengenai dampak operasi dasar panggul terhadap fungsi seksual dan kualitas hidup wanita.Metode: Tinjauan pustaka dilakukan melalui basis data PubMed dan Scopus untuk publikasi 10 tahun terakhir. Artikel dipilih berdasarkan relevansi, kualitas, serta fokus pada fungsi seksual dan kualitas hidup pasca operasi dasar panggul.Hasil: Operasi dasar panggul dapat memengaruhi fungsi seksual melalui perubahan fisik, emosional, dan anatomi. Disfungsi seksual pascaoperasi dapat berupa nyeri, jaringan parut, perubahan anatomi, atau stres psikologis. Penurunan fungsi dilaporkan pada 13% pasien pascaoperasi inkontinensia urin tipe stres dan 37,5% pada kasus kompleks urgensi. Namun, banyak studi menunjukkan perbaikan fungsi seksual dan kualitas hidup setelah perbaikan prolaps atau inkontinensia yang berhasil..Kesimpulan: Pembedahan dasar panggul dapat mempengaruhi fungsi seksual dan kualitas hidup pasien. Pendekatan multidisiplin sangat penting untuk membantu wanita mencapai kembali kepuasan seksual serta kualitas hidup yang optimal setelah operasi dasar panggul.Kata Kunci: Fungsi Seksual Wanita; Inkontinensia Urin; Operasi Dasar Panggul; Prolaps Organ Panggul

Correlation between Elevated Nerve Growth Factor mRNA Expression with Pain Intensity or Disease Severity in Endometriosis Octarina, Bertha; Abadi, Adnan; Hidayat, Syarief Taufik; Usman, Fatimah; Saleh, Masagus Irsan; Theodorus, Theodorus; Stevanny, Bella
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.908

Objective: analyzed the relationship between NGF mRNA expression and pain levels and severity of endometriosis.Methods: This research involved 30 endometriosis patients undergoing surgery from November 2024 to April 2025. NGF mRNA expression was measured in blood plasma and ectopic tissue. Pain history was assessed retrospectively, and disease stage determined intraoperatively.Results: No significant relationship was found between NGF mRNA expression and pain levels or severity of endometriosis in either plasma or lesion tissue. Based on the Livak method analysis, the average value of relative expression of NGF gene mRNA increased 6.943-fold in blood plasma and 17.319-fold in endometriosis lesions of women with endometriosis. In the Mann Whitney test, there was a significant difference in the level of NGF gene mRNA expression between blood plasma and with p < 0.0001. NGF expression may not always correlate with disease severity because it is influenced by many factors.Conclusion: No significant correlation was found between NGF mRNA expression and endometriosis severity or pain intensity, but expression levels differed significantly between plasma and lesion tissue.

Correlation of Vitamin D and Antimullerian Hormone Level in Infertile Women with Polycystic Ovary Syndrome and Obesity Usman, Fatimah; Saleh, Irsan; Effendi, Kms. Yusuf; Putra, Hadrians Kesuma; Abadi, Adnan; Siahaan, Salmon Charles Pardomuan Tua; Kesty, Cindy; Rizda, Dian Permata; Stevanny, Bella; Lestari, Peby Maulina
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.723

Introduction: Increasing amount of research indicates that women with PCOS are more likely to have a shortage in vitamin D with abnormally high anti-Müllerian hormone (AMH) levels. This study aims to assess the correlation between vitamin D and Anti-Mullerian Hormone (AMH) levels in infertile women with polycystic ovarian syndrome (PCOS) and obesity. Method: This observational cross-sectional study examined all obese women with PCOS who sought infertility treatment at Dr. Mohammad Hoesin Hospital Palembang from August 2021 to November 2021. PCOS diagnosis was determined using the Rotterdam criteria. All research subjects underwent a physical examination and transvaginal ultrasound to evaluate body mass index (BMI) and polycystic ovary morphology. Blood samples were collected to evaluate their testosterone, AMH, and vitamin D levels. Statistical analysis was performed using the Spearman correlation test with IBM® SPSS Statistics version 24. Results: Thirty infertile women with PCOS and obesity were included in the study, with average age of 31.17±4.48 years and average BMI of 33.45±2.67 kg/m2. The majority of the subjects had polycystic ovary morphology (86.7%) and oligomenorrhea (76.7%). No correlation between BMI and vitamin D as well as AMH levels was found in infertile women with PCOS and obesity. The Spearman test showed moderate negative correlation (p = 0.011. r = -0.458) between vitamin D and AMH levels in infertile women with PCOS and obesity. Conclusion: There is a moderate negative correlation between vitamin D and AMH levels among infertile women with PCOS and obesity. Further research is required to comprehend the role of vitamin D in female fertility.Korelasi Vitamin D dan Kadar Hormon Anti-Müllerian pada Wanita Infertil dengan Sindrom Ovarium Polikistik dan ObesitasAbstrakPendahuluan: Semakin banyak penelitian melaporkan bahwa wanita dengan PCOS cenderung mengalami defisiensi vitamin D dengan penignkatan kadar hormon anti-Müllerian (AMH). Penelitian ini bertujuan untuk mengkaji hubungan vitamin D dan kadar AMH pada wanita infertil dengan sindrom ovarium polikistik (SOPK) dan obesitas.Metode: Penelitian ini merupakan studi observasional potong lintang terhadap seluruh wanita infertil dengan SPOK dan obesitas yang di RSUP Dr. Mohammad Hoesin Palembang pada bulan Agustus 2021 hingga November 2021. Diagnosis SOPK ditegakkan berdasarkan kriteria Rotterdam. Seluruh subjek penelitian menjalani pemeriksaan fisik dan ultrasonografi transvaginal untuk menilai indeks massa tubuh (IMT) dan morfologi ovarium polikistik. Sampel darah dikumpulkan dari semua wanita untuk mengukur kadar testosteron, AMH, dan vitamin D. Analisis statistik dilakukan dengan menggunakan uji korelasi Spearman menggunakan IBM® SPSS Statistics versi 24.Hasil: Tiga puluh wanita infertil dengan SOPK dan obesitas dilibatkan dalam penelitian ini dengan usia rata-rata 31,17±4,48 tahun dan rata-rata IMT 33,45±2,67 kg/m2. Mayoritas subjek memiliki morfologi ovarium polikistik (86,7%) dan oligomenore (76,7%). Tidak ada korelasi antara IMT dan vitamin D maupun kadar AMH pada wanita infertil dengan SOPK dan obesitas. Uji Spearman menunjukkan korelasi negatif sedang (p=0.011.r=-0.458) antara kadar vitamin D dan AMH pada wanita infertil dengan SOPK dan obesitas. Kesimpulan: Kadar vitamin D berkorelasi negatif dengan kadar AMH pada wanita infertil dengan SOPK dan obesitas. Penelitian lebih lanjut diperlukan untuk memahami peran vitamin D pada kesuburan wanita.Kata kunci: Anti-Müllerian Hormone, Indeks Massa Tubuh, Obesitas, Sindrom Ovarium Polikistik, Vitamin D

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