Junita Indarti
Department Of Obstetrics And Gynecology, Faculty Of Medicine, University Of Indonesia

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A Real-time Optoelectronic Device in Screening of Precancerous Cervical Lesion Rizky Rahmadhany; Junita Indarti
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (108.381 KB) | DOI: 10.32771/inajog.v3i2.38

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Objective: To obtain the diagnostic values of optoelectronic device for screening of precancerous cervical lesions. Method: We performed a diagnostic study with cross sectional design. Subjects were recruited from Dr. Cipto Mangunkusumo Hospital, from February until December 2013. Subjects were enrolled based on consecutive sampling until the minimum sample was achieved (60 samples). Result: During the study period, 60 patients were enrolled. Sensitivity, specificity, positive predictive value, and negative predictive value of the optoelectronic device were 76%, 95%, 96%, and 64%, respectively. We also investigated diagnostic values of other screening methods, namely citology and colposcopy. Sensitivity and specificity of liquid based cytology were 83% and 63% respectively. The combination of optoelectronic device and liquid based cytology increased the sensitivity to 92.8%. Meanwhile, sensitivity and specificity of colposcopy were 88% and 58%, respectively. Based on Altman criteria, kappa value for optoelectronic device with cytology was 0.35 (fair) and optoelectronic device with colposcopy was 0.45 (moderate). Conclusion: A real-time optoelectronic device might be used as an alternative method in early detection of precancerous cervical lesions, either as a single method or combined with liquid based cytology. Keywords: diagnostic values, optoelectronic device, precancerous cervical lesions
Daily Application of EvidenceBased Medicine Junita Indarti
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (60.511 KB) | DOI: 10.32771/inajog.v3i3.39

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Profile of Maternal Referral Cases Junita Indarti; Dwiyana Ocviyanti; Reyhan Aditya
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (78.153 KB) | DOI: 10.32771/inajog.v4i2.76

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Objective: To explore the demography of maternal referral cases in Dr. Cipto Mangunkusumo Hospital (RSCM) along with the accuracy of referral. We also aim to evaluate the types of referral, origin of referral, referring healthcare facility and quality of referring healthcare facility. Method: The design of this study was a cross sectional design which described the accuracy of obstetrics referred cases in Emergency Unit Dr. Cipto Mangunkusumo Hospital from 2013 to 2014. Result: The total referred obstetric cases in 2013 was 1,645 patients. It was consisted of 1,307 appropriate (79.5%) and 338 inappropriate (20.5%) referred cases. Primary healthcare and general hospital were the most often referring cases to RSCM during two consecutive years. The top three cases referred to RSCM in both 2013 and 2014 were preterm premature rupture of membrane (PPROM), continued by severe preeclampsia and preterm labor. Conclusion: The number of referral cases in Indonesia is considered high, particularly in RSCM as the tertiary healthcare facility. There are still a high number of inappropriate referrals originating from primary healthcare facilities, pointing to the fact that the referral system is not running according to design or plan. To improve the quality of referral system, proper monitoring and evaluation of referral should be performed by local health department. [Indones J Obstet Gynecol 2016; 4-2: 64-66] Keywords: maternal case, referral system
Expression of p16INK4a Biomarker has a Diagnostic Value in Predicting the Progressivity of Precancerous Cervical Lesion Junita Indarti
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 3, July 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (46.744 KB)

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Objective: To evaluate clinical value of p16INK4a biomarker level, by doing p16INK4a immunocytochemistry staining, as a predictor of progressivity of precancerous cervical lesion. Method: Design of this research is case-control study which will be stratified. Research was conducted in Cytology Laboratorium, Gynecology Specialistic Division, Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital from August 2007 to September 2008. Immunocytochemistry examination was conducted in Anatomic Pathology Department, Dr. Hasan Sadikin Hospital. We divided the sample into two categories; patients with and without cervical intraepithelial neoplasia (CIN). This research will evaluate HPV infection and p16INK4a biomarker by doing p16INK4a immunocytochemistry (ICC) staining. Results: We have done immunocytochemistry examination in 130 patients, 26 without CIN and 104 with CIN. Immunocytochemistry cut-off point level is 50, which means value < 50 means low (L) p16INK4a expression and in reverse, value ≥ 50 means high (H) p16INK4a expression. The bivariate analysis of our study were p16INK4a (H) expression has the risk of CIN 1 with OR 8.4, for CIN 2 with OR 13 and for CIN 3 with OR 21, greater than p16INK4a (L) with all p values are significant. ICC p16INK4a (H) expression, age, number of sexual partners, and education are contributory to the risk of progressivity in CIN. The multivariate analysis demonstrates, ICC expression of p16INK4a (H) has a risk (OR) of CIN 1 17.19 times greater than p16INK4a (L); p16INK4a (H) expression’s OR for CIN 2 is 25.56; and for OR CIN 3 is 37.32. The expression of p16INK4a has a significant p value and high OR, thus ICC expression of p16INK4a is suggested to be included in the algorithm of precancerous cervical lesion guidelines and scoring of probability of CIN as an alternative to HPV DNA considering less cost of the test. In this research, we found a scoring model to determine probability of progressivity in precancerous cervical lesion. Conclusion: The expression of p16INK4a has a diagnostic value in predicting the progressivity of precancerous cervical lesion. [Indones J Obstet Gynecol 2010; 34-3: 125-30] Keywords: p16INK4a expression, immunocytochemistry, predictor of progressivity, precancerous cervical lesion
Characteristics of Maternal Mortality Cases in a Tertiary Hospital Junita Indarti; Ferry Y Irawan
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1251.405 KB) | DOI: 10.32771/inajog.v4i3.431

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Objective: To identify the characteristics of maternal mortality cases in a tertiary hospital in Jakarta, including socio-demographic characteristics, previous medical and obstetric history, and patient’s clinical condition on arrival at the hospital. Method: This was a survey to identify the descriptive data of maternal mortality cases through medical records during study period. Manual review of 51 medical records was conducted for 2 years from January 2013 to December 2014 in Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo Hospital (RSCM). Result: Of 51 cases of maternal deaths, 46 subjects (90.19%) had nine years of minimum education background. There were two subjects less than 21 years old and another was 42 years old. None of these subjects were using intrauterine device (IUD) or implant as the contraceptive methods where 66.6% subjects with underlying disease never used contraception. Ninety-two percent of subjects did antenatal care (ANC) regularly and 80.4% (41 subjects) of them was done in midwives. There were 14 subjects (29.78%) who had ANC in the first trimester of pregnancy. Severe preeclampsia is the most prevalent complication in pregnancy (26 subjects, 65%), which all (100%) patients arrived at RSCM with HELLP Syndrome. Therefore, preeclampsia was the leading cause of death in RSCM. Conclusion: The characteristics of maternal death in RSCM are prevalent in the group of 25-34 years old with the high school as the educational background. Most of them are multiparity and do not use the long-term contraceptive methods. Preeclampsia is the major cause of maternal death in RSCM. Keywords: maternal mortality, risk factors, tertiary hospital
The Accuration of Liquid Based Cytology and HPV DNA Test Combination as Precervical Cancer Lesion Screening: Akurasi Pemeriksaan Kombinasi Liquid ­Based Cytology dan Tes DNA HPV sebagai Penapis Lesi Prakanker Serviks Junita Indarti; Yuven S Pratama
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (91.721 KB) | DOI: 10.32771/inajog.v5i4.570

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Objective: To investigate the accuracy of liquid-based cytology, HPV DNA test, and the combination of liquid-based cytologyband HPV DNA test, compared to histopathology as the gold standard of precervical cancer lesion screening. Methods: This was a cross-sectional study. The medical records of patients who came to the Women’s Health Clinic of Dr. Cipto Mangunkusumo Hospital during the period of July 2013 to December 2015 were evaluated. Results: The high risk type HPV DNA is detected in 76% CIN 1, 88.46% CIN 2, and 84.21 CIN 3 in histopathology results. The accuracy of liquid-based cytology; sensitivity 88.54%, specificity35.71%, PPV 75.89%, and NPV 57.69%. The accuracy of HPV DNA; sensitivity 81.25%, specificity 78.57%, PPV 89.66%, and NPV 64.71%. The accuracy of combination: sensitivity 94.79%, specificity 35.71%, PPV 77.12%, and NPV 75%. Conclusion: The addition of HPV DNA test increased the sensitivity from 88.54% to 94.79% because of decreasing of false negative of liquid-based cytology. This thing has showed that the combination of liquid-based cytology and HPV DNA test could the one of the option of precervical cancer lesion screening method, especially in secondary or tertier health center in Indonesia. Keywords: accuracy test, HPV DNA, liquid-based cytology, precervical cancer lesion, precervical cancer lesion screening
Knowledge of Midwives as a Healthcare Provider About Hypertensive Disorders During Pregnancy: Tingkat Pengetahuan Bidan sebagai Petugas Layanan Kesehatan terhadap Tekanan Darah Tinggi dalam Kehamilan Junita Indarti; Sandy Prasetyo
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (67.569 KB) | DOI: 10.32771/inajog.v7i1.638

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Objective: To investigate the knowledge of midwives about hypertensive disorders during pregnancy. Methods: The study design is cross-sectional by evaluating the knowledge of midwives regarding hypertensive disorders during pregnancy by using questionnaire. This study was conducted in Jakarta during the period between September and October 2017. The subject is a midwife member of Indonesian Midwives Association (IBI) practicing in DKI Jakarta, Indonesia. Results: Total respondents were 639 practicing midwives in Central, South, West and North Jakarta. A total of 323 (50.5%) of the respondents had a sufficient level of knowledge about the basic science of high blood pressure in pregnancy, 372 (58.2%) of respondents had a good level of knowledge related to clinical examination and early diagnosis of high blood pressure in pregnancy, and 385 (60.3%) of respondents had a good level of knowledge about the management of high blood pressure in pregnancy. The location of the clinic, physician attendance, the number of patients treated by the midwives, and the number of midwives attending the clinic had significant association with the knowledge level of the subjects (all P values < 0,05) Conclusion: The lowest knowledge level was about the basic science of hypertensive disorders during pregnancy. Factors affecting the knowledge levels of the midwives were location of the clinic, physician attendance, the number of patients treated by the midwives, and the number of midwives attending the clinic Keywords: knowledge, midwive, hypertensive disorders, pregnancy, preeclampsia
Effectiveness of Oral Probiotics as Adjuvant Therapy in Reproductive Aged Women with Vaginal Discharge Junita Indarti; Utomo Budidarmo
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 1. January 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (473.481 KB) | DOI: 10.32771/inajog.v6i1.663

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Objective: To investigate the efficacy of oral proboiotics and prove the high proportion of cure and satisfaction levels of post-treatment patients with a combination of antimicrobial-probiotic oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 compared to a combination of antimicrobial-placebo in the treatment of reproductive aged patients with vaginal discharge in the outpatient obstetrics and gynecologic clinic in Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia and Arifin Achmad Regional Hospital Pekanbaru, Riau, Indonesia. Methods:This was a randomized, double-blind, placebo-controlled trial involving50 subjects consisting of reproductive aged women. Data were collected using syndromic approach, probiotics were given as an adjuvant for standard antimicrobial therapy versus placebo as control, response was recorded 4 weeks later, for cure proportion and satisfaction level. Statistical analysis was performed to assess the variables. Interim analysis with conditional power assesment and futility testing were performed at midway due to insufficient sample size. Research was approved by Ethics Commitee for Health Researches Faculty of Medicine University of Indonesia-Dr. Cipto Mangunkusumo Hospital in March 2016. Results: A total of 50 subjects participated in this study. and analyzed (25 subjects in each group), cure proportion 56%(14) of the treatment and 60%(15)on the control group, with relative risk of 1.1, Chi-square test p value (0.77, 95% CI; 0.57 to 2 , 11). High satisfaction level (score ≥67) was higher in the placebo (52,6%, 10 subjects) compared to probiotic group (47,4%, 9 subjects), p value 0,65 (≥0,05). Conditional power and futility testing curve, revealed Z = -0.2865, conditional power 0.11 to 0.13, and futility index of 0.87 to 0.88, equals to low possibility of statistical significance with full sample size (84). Conclusion: There was no clinical and statistical difference in the proportion of cure rate and the level of satisfaction in patients of probiotics vs placebo groups after treatment for 4 weeks. The initial hypothesis of higher proportion of the cure ratein the treatment group still cannot be excluded, due to insufficient samples. Keywords: bacterial vaginosis, , lactobacillus reuteri RC-14, lactobacillus rhamnosus GR-1, randomized double blind controlled trial, trichomoniasis , vaginal discharge, vulvovaginal candidiasis.
Incidence of Positive Human Papillomavirus High Risk in Negative Cytology Result: Insidensi Kejadian Human Papillomavirus RisikoTinggi Positif pada Hasil Sitologi Negatif Junita Indarti; Darrell Fernando; Finish Fernando; Ribkhi A. Putri; Anggara Mahardika; Muhammad Ikhsan
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (66.731 KB) | DOI: 10.32771/inajog.v7i4.1158

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Abstract Objective: This research aim is to report the incidence of positive HPV high risk in negative cytology result. Method: We collected 83 women underwent liquid-based cytology (LBC) and HPV DNA examination at the same time. We were using DiagCor GenoFlow Human Papillomavirus Array Test (GenoFlow), a novel HPV test based on PCR and "Flow-through" hybridization that can identify 33 HPV subtypes: 18 types of High risk HPV such as 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 81 and 82 Result: We grouped the subjects based on age below or equal to 30 years old (n=6) and above 30 years old (n=77). We found a significant difference in HPV DNA result within this group (P = 0.034), with 19.3% had HPV DNA type 16 and 18 in a group of age above 30 years old. Our study showed that 27 women (32.5%) underwent screening for cervical cancer having negative LBC result but showed positive HPV DNA positive. Conclusion: We found a significant difference in HPV DNA test result among women above 30 years old. Co-testing of Pap and HPV DNA is needed, especially if HPV DNA type 16 and 18 were found among negative Pap results. Keywords: Cervical cancer, HPV DNA, incidence, LBC, screening Abstrak Tujuan: Penelitian ini bertujuan melaporkan insidensi dari HPV risiko tinggi yang positif pada hasil sitologi negatif. Metode: Kami mengumpulkan 83 wanita yang menjalani liquid based cytology (LBV) dan pemeriksaan HPV DNA pada waktu yang bersamaan. Dengan menggunakan DiagCor GenoFlow Human Papilloma Virus Array Test (GenoFlow), yaitu sebuah uji HPV terbaru yang berbasis PCR dan “Flow-throug” hybridization dapat mengidentifikasi 33 subtipe HPV: 18 tipe HPV risiko tinggi seperti 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 81 dan 82. Hasil: Kami mengelompokkan subjek berdasarkan usia dibawah atau setara 30 tahun dan diatas 30 tahun (n=77). Kami menemukan perbedaansignifikan dari hasil HPV DNA dalam kelompok ini (P=0.034), dengan 19.3% memiliki HPV DNA tipe 16 dan 18 dalam kelompok usia diatas 30 tahun. Penelitian ini menunjukkan 27 perempuan (32.5%) menjalani skrining kanker serviks memiliki hasil LBC yang negatif namun menunjukkan HPV DNA positif. Kesimpulan: Terdapat perbedaan signifikan dari uji HPV DNA pada wanita usia diatas 30 tahun. Pemeriksaan bersamaan antara Pap dan HPV DNA dibutuhkan terutama ketika HPV DNA tipe 16 dan 18 ditemuka pada hasil Pap negatif. Kata kunci: HPV DNA, insidensi, kanker serviks, LBC, skrining
The Role of HPV-DNA Test Combined with Cervical Cytology to Improve the Accuracy of Cervical Precancerous Lesion Screening Junita Indarti
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 2, April 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v37i2.1473

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Co-Authors Abror Irsan Adithya Weladatika Aditya, Reyhan Adri Dwi Anggayana Affan Solihin Agassi Antoniman, Mohammad Ajeng Larasati Alda, Kristian Aldri Frinaldi Alida Harahap Andi Yasmon Andrijono Andrijono Anggara Mahardika Aria Kekalih Arietta Pusponegoro Arini Setiawati Ario B. Hanggono Arisda Oktalia Arresta V. Suastika Bambang Sutrisna Bethy Suryawati Boeyoeng E.A.P Dalimunte Bonifasius, Bonifasius Budidarmo, Utomo Caesar Nurfiansyah Caroline Caroline Chakti A. Swastika Cherysa Rifiranda Dalri Suhartomo Darrell Fernando David Eka Prasetya Diana Natalia Diana Natalia Ditha Loho Dwiana Ocviyanti Dwiyana Ocviyanti Dyah P. Wardhani Effiana Effiana Effiana, Effiana Elizabeth Novita Erda Ayu Umami Erda Ayu Umami Ferry Y Irawan Finish Fernando Fitriyadi Kusuma Gatot Purwoto Gumilang Gumilang Handika Zulimartin Hanny Nilasari Hari Sandi Henny S. Wonodihardjo Heru Prasetyo Hesti N. Rizqi I Putu G Kayika Imam Rahmadi Iwan Darmansjah Jan Susilo JM Seno Adjie Kristian Alda Kristian Alda Kristian Alda Kristian Alda Kristian Alda Laila Nuranna Leonita T. A. Sutrisna Leonita Triwachyuni Agustina Sutrisna Lisnawati Rachmadi Lucas Christiawan Maemonah, Maemonah Mardhatillah, Syifa Mardhia, Mardhia Mardhia, Mardhia Mohammad A.F Dilmy Mohammad F. Aziz Muhammad Azmi Muhammad Ikhsan Muhammad Ikhsan Muhammad T. Ramadhani Najmarani Devi Firdaus Natasya Prameswari Nova V. Wijaya Nuni Sulastri Nuryati C. Siregar Ocviyanti, Dwiyana Omo Abdul Madjid Prasetyo, Sandy Pratama, Yuven S Quamila F. Afdi Rahmadhany, Rizky Raymond Surya Rendy Pratama Reyhan Aditya Ribkhi A. Putri Riyan H Kurniawan Riyan H Kurniawan, Riyan H Rizky Rahmadhany RR. Ella Evrita Hestiandari Sandy Prasetyo Sari Rahmayanti Shinta Pangestu Sigit Purbadi Simon Fongana Siti R. F. Harun Siti R.F Harun Solihin, Affan Sumulyo, Ganot Surya, Ilham Utama Syaharutsa, Danny Maesadatu Syifa M. Syafitri Tofan W Utami Utomo Budidarmo Vitasatria, Arresta Wiguna, Sandra Yuven S Pratama