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All Journal Indonesian Journal of Obstetrics & Gynecology Science Media Gizi Kesmas Indonesian Journal of Perinatology
Darmawan, Ernawati
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Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health Social Sciences

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Faktor Risiko Hasil Janin/Bayi pada Wanita Hamil dengan Kanker di Jawa Timur Indonesia: Studi Epidemiologi Naoum, Nardeen Adel Mekhail; Darmawan, Ernawati
Media Gizi Kesmas Vol 12 No 1 (2023): MEDIA GIZI KESMAS (JUNI 2023)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mgk.v12i1.2023.277-284

Abstract

Background: Cancer during pregnancy is a rare event, despite its rarity, its incidence nowadays keeps on increasing worldwide. Objective: This study aims to describe the available data on pregnant women with cancer in East Java- Indonesia, maternal outcomes and fetal outcomes, and knowing the risk factors of bad fetal outcomes in pregnant women with cancer from an epidemiological point of view. Method: This is a quantitative observational study of pregnant women with cancer in East Java Indonesia. Its design is a Cross-sectional study. Data collection was obtained from secondary data (the medical report in the Obgyn department at Dr. Seotomo Hospital from 2016 – 2020). Data were analyzed statistically by using SPSS program version 25. Result: The results showed that from 2016 to 2020, 54 cases of pregnant women with cancer had been extracted with an incident rate 0.8%. The incident rate of Non-Obgyn Cancer (55.6%) is higher than Obgyn Cancer (44.4%). The highest incident rates in non-Obgyn Cancer are Breast cancer (7.5%) and Leukemia (3.7%), while the highest incident rates in Obgyn Cancer are Cervical and Ovarian (8.4%). There was no relationship between cancer type and fetal outcomes, while there is a relationship between cancer stage and fetal outcomes. Conclusion: Cancer stage could be risk factor for fetal outcomes in Indonesian pregnant women with cancer.
Water Birth as Neuroendocrine Medicine: A Critical and Integrative Review of Hormonal and Psychophysiological Impacts on Maternal and Neonatal Outcomes Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Darmawan, Ernawati; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.79

Abstract

Background: Water birth, defined as labor and/or delivery conducted in warm water, has gained increasing recognition as a patient-centered and physiologically supportive birth practice. Beyond analgesia, growing evidence indicates that water immersion during labor modulates maternal neuroendocrine regulation, psychological well-being, and neonatal physiological adaptation. Nevertheless, these hormonal and psychophysiological mechanisms remain insufficiently integrated into conventional perinatal research and clinical frameworks. This review aims to synthesize current evidence on the neuroendocrine, psychophysiological, obstetric, and neonatal effects of water birth and to evaluate its clinical effectiveness and safety in low-risk pregnancies. Methods: An integrative review was conducted using a PRISMA-guided approach to identify peer-reviewed studies published between 2000 and 2025. Literature searches retrieved 3,287 records from major biomedical databases, of which 44 studies (12 randomized controlled trials, 19 cohort studies, 6 case–control studies, and 7 systematic reviews) met inclusion criteria. Data were synthesized thematically, focusing on maternal hormonal responses (oxytocin, β-endorphins, cortisol, prolactin), labor outcomes, breastfeeding, postpartum mood, neonatal adaptation, and safety considerations. Results: Across study designs, water immersion during labor was associated with increased endogenous oxytocin and β-endorphin activity and reduced stress-related hormonal responses. Clinically, first-stage labor was shortened by approximately 42–78 minutes, and epidural analgesia use was reduced by 30–50% compared with conventional land birth. Episiotomy rates were generally below 5%, and maternal satisfaction scores were consistently higher. Early breastfeeding initiation occurred in 86–92% of water birth cases, with exclusive breastfeeding rates at six weeks ranging from 66–77%. Neonatal outcomes, including 5-minute Apgar scores and NICU admission rates, were comparable to or slightly better than conventional birth in low-risk populations, with no consistent increase in infection or respiratory complications when standardized protocols were applied. Conclusion: Water birth supports a hormonally optimized and psychologically protective labor environment, with measurable benefits for labor efficiency, maternal experience, breastfeeding success, and neonatal physiological transition. When implemented under evidence-based guidelines, it represents a credible non-pharmacological option within contemporary, physiology-informed maternity care.
Precision Chromosomal Surgery before Birth: Allele-Specific CRISPR-Cas9 Editing for Trisomy 21 in Perinatal Medicine Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Prabowo, Wisnu; Yuliantara, Eric Edwin; Lukas, Efendi; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Wiradnyana, Anak Agung Gede Putra; Mulyana, Ryan Saktika; Kusuma, Anak Agung Ngurah Jaya; Pangkahila, Evert Solomon; Gumilar, Khanisyah Erza; Darmawan, Ernawati; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Pribadi, Adhi; Anwar, Anita Deborah; Suryawan, Aloysius; Putra, Ridwan Abdullah; Gondo, Harry Kurniawan; Nugraha, Laksmana Adi Krista; Andanaputra, Waskita Ekamaheswara Kasumba; Dharma, Wibisana Andika Krista; Djanas, Dovy; Stanojevic, Milan
Indonesian Journal of Obstetrics & Gynecology Science Volume 9 Number 1 March 2026
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v9i1.965

Abstract

Objective: Trisomy 21 remains the most common live-born aneuploidy and a major contributor to perinatal morbidity. Although prenatal screening, particularly non-invasive prenatal testing (NIPT), has advanced substantially, clinical management offers no corrective options. Emerging allele-specific genome-editing approaches propose targeted removal or silencing of the extra chromosome 21. This review summarizes current evidence and evaluates the translational relevance of these technologies in perinatal medicine.Methods: A narrative review was conducted following PRISMA-aligned procedures. A structured search of PubMed, Scopus, and Web of Science (January 2000–July 2025) identified 1,242 records. After duplicate removal, title/abstract screening, and full-text assessment based on predefined inclusion criteria, 54 studies met eligibility requirements. Data were synthesized across four domains: mechanistic strategies, developmental applicability, translational feasibility, and ethical–regulatory considerations.Results: Allele-specific CRISPR-Cas9 studies demonstrated selective cleavage of the supernumerary chromosome 21 in cellular models, with partial restoration of near-euploid transcriptional patterns. Additional approaches—XIST-mediated silencing and centromere destabilization—provided alternative mechanisms with varying stability and specificity. Evidence remains limited to in vitro systems, with no validated embryo or fetal applications. Key challenges include mosaicism, delivery barriers, individualized SNP targeting, and ethical governance.Conclusions: Allele-specific chromosome editing represents a promising but still experimental direction for future perinatal therapeutics. Current findings justify continued multidisciplinary investigation while emphasizing cautious interpretation and rigorous ethical oversight prior to any clinical translation. Abstrak Tujuan: Trisomi 21 tetap menjadi aneuploidi yang paling sering ditemukan pada kelahiran hidup dan merupakan kontributor utama terhadap morbiditas perinatal. Meskipun skrining prenatal—khususnya non-invasive prenatal testing (NIPT)—telah mengalami kemajuan yang signifikan, penatalaksanaan klinis hingga kini belum menawarkan opsi korektif. Pendekatan pengeditan genom spesifik alel yang mulai berkembang mengusulkan penghilangan atau penghambatan terarah terhadap salinan ekstra kromosom 21. Tinjauan ini merangkum bukti terkini serta mengevaluasi relevansi translasional teknologi tersebut dalam kedokteran perinatal.Metode: Tinjauan naratif dilakukan dengan mengikuti prosedur yang selaras dengan PRISMA. Pencarian terstruktur terhadap PubMed, Scopus, dan Web of Science (Januari 2000–Juli 2025) mengidentifikasi 1.242 rekaman. Setelah penghapusan duplikasi, penyaringan judul/abstrak, dan penilaian teks lengkap berdasarkan kriteria inklusi yang telah ditentukan, sebanyak 54 studi memenuhi persyaratan kelayakan. Data disintesis ke dalam empat domain: strategi mekanistik, aplikabilitas perkembangan, kelayakan translasional, serta pertimbangan etika dan regulasi.Hasil: Studi CRISPR-Cas9 spesifik alel menunjukkan pemotongan selektif terhadap kromosom 21 supernumerari pada model seluler, dengan pemulihan parsial pola transkripsi menuju profil ekspresi gen yang menyerupai kondisi euploid. Pendekatan lain—seperti penghambatan berbasis XIST dan destabilisasi sentromer—menyediakan mekanisme alternatif dengan tingkat kestabilan dan spesifisitas yang bervariasi. Bukti saat ini terbatas pada sistem in vitro, tanpa aplikasi yang tervalidasi pada embrio maupun janin. Tantangan utama meliputi mosaikisme, hambatan pengantaran, kebutuhan penargetan SNP individual, serta tata kelola etis.Kesimpulan: Pengeditan kromosom spesifik alel merupakan arah yang menjanjikan, namun masih bersifat eksperimental bagi terapi perinatal di masa mendatang. Temuan saat ini mendukung keberlanjutan penelitian multidisipliner, sekaligus menekankan perlunya interpretasi yang hati-hati dan pengawasan etika yang ketat sebelum penerapannya dalam praktik klinis.Kata Kunci: Bedah genom janin; CRISPR-Cas9; Penyuntingan gen perinatal; Terapi kromosom; Trisomi 21
Co-Authors Adhi Pribadi Aldiansyah, Dudy Aldika Akbar, Muhammad Ilham Aloysius Suryawan Andanaputra, Waskita Ekamaheswara Kasumba Andonotopo, Wiku Anita Deborah Anwar Bachnas, Muhammad Adrianes Cut Meurah Yeni Dharma, Wibisana Andika Krista Djanas, Dovy Efendi Lukas Eric Edwin Yuliantara Evert Solomon Pangkahila Harry Kurniawan Gondo I Nyoman Hariyasa Sanjaya Julian Dewantiningrum Khanisyah Erza Gumilar Kurjak, Asim Kusuma, Anak Agung Ngurah Jaya Naoum, Nardeen Adel Mekhail Nugraha, Laksmana Adi Krista Nuswil Bernolian Pramono, Mochammad Besari Adi Putra, Ridwan Abdullah Ryan Saktika Mulyana Stanojevic, Milan Wiradnyana, Anak Agung Gede Putra WISNU PRABOWO