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All Journal Majalah Obstetri dan Ginekologi Universa Medicina Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) eJournal Kedokteran Indonesia
Mila Maidarti
Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran Universitas Indonesia-RSUP Nasional Dr. Cipto Mangunkusumo
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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 1 
Prenatal Diagnosis and Postnatal Management of Meconium Peritonitis Maidarti, Mila
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 4, October 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.438 KB)

Abstract

Objective: To present two cases of fetal meconium peritonitis with perforated ileum and without a definite intestinal obstructive lesion. Case report: Two patients who presented prenatally with ultrasound findings of meconium peritonitis and postnatally were found to have perforation of the terminal ileum and meconium peritonitis. In both cases, the diagnosis of meconium peritonitis was suspected prenatally based on the ultrasound findings which were hyperechogenic bowel and abdominal free fluid with increased echogenicity. Both babies were delivered by c-section due to obstetrical indication. After delivery the babies were admitted to the intensive care unit because of a distended abdomen and respiratory distress. An explorative laparotomy revealed perforations of the ileum, and the pediatric surgeon performed adhesiolysis and ileostomy. The infant recovered well after the operation and was fed uneventfully. Conclusions: Echogenic intraabdominal free fluid was the most common ultrasound findings in meconium peritonitis. Early detection of meconium peritonitis was not indicative of poor neonatal outcomes, and selective termination was not necessary, unless indicated for other reasons. [Indones J Obstet Gynecol 2011; 35-4:191-8] Keywords: prenatal diagnosis, postnatal management, meconium peritonitis
Telomerase Expression Increased the Risk of Borderline Ovarian Tumors Maidarti, Mila
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 1, January 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.971 KB)

Abstract

Objective: To compare the expression of telomerase in benign ovarian tumors and borderline ovarian tumors. Methods: Thirteen samples of paraffin blocks of ovarian borderline tumors and benign ovarian tumors were taken from patients who underwent surgery from January 2006 to December 2011. In all samples, we performed immunohistochemical staining to the paraffin blocks. Semi quantitative determination of the expression of telomerase is done by an Anatomic Pathology specialist and Gynecologist, which already had the same perception about assessing the standardization sample. We used Fisher’s test to analyze the data. Results: There were significant relationship in the moderate expression of telomerase in the nucleus and cytoplasm between benign and borderline ovarian tumors, with an odds ratio of moderate telomerase expression in the cytoplasm and nucleus of 19.3 (95% CI: 1.4 - 943) and 26 (95% CI : 2.3 - 1211). This means that the risk of borderline ovarian tumors in the expression of moderate telomerase in the cytoplasm was 3.19 times compared to the negative expression, whereas in the nucleus it became 26-fold. There is no significant relationship among menopause, age, and telomerase expression in the nucleus and cytoplasm. Conclusion: There are significant differences in the expression of moderate strength telomerase in nucleus and cytoplasm between benign and borderline ovarian tumors. [Indones J Obstet Gynecol 2013; 37-1: 32-40] Keywords: benign ovarian tumor, borderline ovarian tumor, telomerase expression
Age, Low Education and Unemployment are Associated with Intimate Partner Violence among Women Maidarti, Mila
Indonesian Journal of Obstetrics and Gynecology Volume. 37, No. 2, April 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To describe the prevalence of violence in women visiting Puskesmas Kecamatan Makassar by their partners and their association with socio-demographic factors and gender role perception. Methods: A cross-sectional study using validated WHO questionnaires was conducted on 141 women visiting Puskesmas Makassar in December 2011 to identify presence of physical, sexual or emotional abuse and women’s perception of gender roles. The data was then analyzed using a combination of univariate analysis and Chisquare test. Results: Our study showed that the lifetime prevalence of female abuse in Puskesmas Makassar population was 21.3%, with physical violence constituting 5.7%, sexual violence 6.4% and emotional abuse 17.0% among the subjects. Violence was associated with the wife’s demographic factor (age >35 years, education 35 years and unemployment). Women’s perception of gender role was not significantly associated with prevalence of abuse Conclusion: A woman’s age and her partner’s age of more than 35 years, an education level of less than nine years, and unemployed partner, were all significantly associated with the lifetime prevalence of female abuse, and was not consistent with gender role beliefs. [Indones J Obstet Gynecol 2013; 37-2: 63-70] Keywords: gender role perception, intimate partner violence, Puskesmas Makassar
Anti-Müllerian Hormone Levels as Predictor of In Vitro Fertilization Outcomes Mila Maidarti; Prini Diandara Garinasih; Aprilia Asthasari Siregar; Gita Pratama; Achmad Kemal Harzif; Kanadi Sumapraja; Budi Wiweko
eJournal Kedokteran Indonesia Vol 9, No. 2 - Agustus 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (328.455 KB) | DOI: 10.23886/ejki.9.43.87

Abstract

A decrease in serum anti-müllerian hormone (AMH) concentration suggests the reduction of antral follicle number. AMH serum level was correlated with ovarian stimulation outcomes, oocyte quantity and quality, embryo quality and in vitro fertilization (IVF) outcomes. However, the use of AMH to predict pregnancy rates in IVF is still debatable. This study aimed to determine the role of AMH in predicting ovarian response and pregnancy rates in IVF programs. This was a retrospective cohort study involving patients who underwent a short protocol of ovarian stimulation for IVF at the Yasmin clinic, dr Cipto Mangunkusumo General Hospital. from March 2013 to March 2021. A total of 1,527 out of 3,880 IVF cycles were included. Poor ovarian response was determined as a collection of fewer than four oocytes following ovarian stimulation. The data was then analyzed using the Mann Whitney test if the data distribution was not normal or the unpaired t-test if the data distribution was normal. Median AMH levels were higher in the normal (2.5(0.01-32)) compared to poor responder (0.68(0.01-6.86)) group (p<0.05; Mann Whitney). Serum AMH level and age had predictive value for pregnancy rate (p<0.05; Mann Whitney). Keywords: AMH, ovarian response, pregnancy rate, IVF.   Kadar Hormon Anti-Müllerian sebagai Prediktor Luaran Fertilisasi in Vitro Abstrak Penurunan konsentrasi serum hormon anti-müllerian (HAM) menunjukkan penurunan jumlah folikel antral. HAM serum berkorelasi dengan luaran stimulasi ovarium kuantitas dan kualitas oosit serta kualitas embrio dan luaran fertilisasi in vitro (FIV). Namun, penggunaan HAM untuk memprediksi angka kehamilan dengan stimulasi ovarium pada FIV masih diperdebatkan. Tujuan penelitian ini untuk mengetahui peran serum HAM dalam memprediksi respons ovarium dan laju kehamilan pada program FIV. Penelitian ini adalah studi kohort retrospektif yang melibatkan pasien yang menjalani protokol singkat stimulasi ovarium pada program FIV di klinik Yasmin rumah sakit dr Cipto Mangunkusumo.dari bulan Maret 2013 sampai Maret 2021. Sebanyak 1.527 dari 3880 siklus IVF dimasukkan ke dalam penelitian. Dikatakan perespon buruk apabila diperoleh kurang dari empat oosit setelah stimulasi ovarium. Data kemudian dianalisis dengan menggunakan uji Mann Whitney bila sebaran data tidak normal atau uji t tidak berpasangan bila sebaran data normal. Median kadar HAM lebih tinggi pada kelompok perespons baik (2.5 (0.01-32)) dibandingkan perespons buruk (0.68 (0.01-6.86)) (p<0,05; Mann Whitney). Kadar HAM serum dan usia memiliki nilai prediktif terhadap angka kehamilan (p<0,05; Mann Whitney). Kata kunci: hormon anti-Müllerian, respons ovarium, angka kehamilan, FIV.
Evaluation of Estradiol and Pro-Inflammatory Marker Level with VAS Score After Progestin Therapy in Endometriosis Patients Muthalib, Aidrus; Sumapraja, Kanadi; Harzif, Achmad Kemal; Maidarti, Mila
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2531

Abstract

Objectives: To compare estradiol levels and proinflammatory biomarkers (IL-6, IL-1B, and COX-2) in endometriosis patients with pain and without pain after progestin therapy. Methods: This observational cross-sectional study involved 47 endometriosis patients undergoing three months of progestin therapy at RSUPN Cipto Mangunkusumo from March to June 2024. Serum levels of COX-2, IL-6, IL-1B, and estradiol will be measured using ELISA and Microplate Enzyme Immunoassay, with pain status assessed to determine associations between biomarkers and pain presence. Results: A significant difference in COX-2 levels between patients with pain and those without, with higher levels in the pain group [1.845 (1.24-10.26) vs 1.55 (0.32-3.07), p = 0.004]. A significant positive correlation was found between IL-1Beta and IL-6 (r = 0.471, p = 0.001). COX-2 levels also exhibited a weak but statistically significant positive correlation with VAS scores (r = 0.360, p = 0.013). Conclusion: There is a difference in inflammatory markers IL-6, IL-1 Beta and COX-2 in endometriosis patients with progestin therapy who experience pain and painlessness. Keywords: endometriosis, estradiol, proinflammation, progestin therapy.
Effects of autologous platelet-rich plasma in promoting endometrial thickness on patients with thin endometrium following IVF Pratama, Gita; Agustina, Elizabeth; Yanfaunnas, Atika Mahira; Maidarti, Mila; Harzif, Achmad Kemal; Muharam, R.; Wiweko, Budi
Majalah Obstetri & Ginekologi Vol. 32 No. 3 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I32024.174-180

Abstract

HIGHLIGHTS It was observed that autologous PRP substantially increased endometrial thickness in individuals experiencing infertility linked to a thin endometrium. The elevated clinical pregnancy rate emphasizes the favorable effectiveness of autologous PRP in addressing issues related to a thin endometrium in IVF programs.   ABSTRACT Objective: The objective of this research was to investigate the impact of autologous platelet-rich plasma (PRP) in enhancing endometrial thickness among individuals experiencing infertility associated with a thin endometrium. Materials and Methods: Nine individuals with a thin endometrium who participated in an in vitro fertilization (IVF) program were enrolled in the study. This study was carried out in Yasmin Clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Patients underwent a hormone replacement protocol involving the preparation of the endometrium with estradiol valerate. Treatment with PRP was initiated when the endometrial thickness was less than 7 mm. Autologous PRP was infused into the uterine cavity between the 10th and 12th days after administering estradiol valerate, and the assessment of endometrial thickness was conducted using ultrasound 48 hours later. A second administration of PRP was provided in cases where the endometrial thickness was below 7 mm. Frozen-thawed embryo transfer (FET) was performed if the endometrium reached adequate thickness (minimum 7 mm). Results: Seven of nine patients had adequate endometrial thickness followed by FET. Endometrial thickness was improved in 8 from 9 patients (88.8%). Five patients were improved at the first autologous PRP infusion (62.5%) and three patients (37.5%) at the second PRP infusion. The implantation rate was 33.3-100%, clinical pregnancy was 100%, and ongoing pregnancy rate was 83.3%. Conclusion: The use of autologous platelet-rich plasma (PRP) successfully stimulates endometrial development in individuals with a thin endometrium during frozen-thawed embryo transfer.
Comparison of natural versus artificial cycles for endometrial preparation prior to frozen embryo transfer Tyagitha, Galuh Anindya; Nuryanto, Kartiwa Hadi; Pratama, Gita; Maidarti, Mila; Harzif, Achmad Kemal; Sumapraja, Kanadi; Lestari, Silvia Werdhy; Ampri, Irfan Arieqal Hatta; Talya, Natasha; Yanfaunas, Atika Mahira
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.304-312

Abstract

BackgroundThe endometrial preparation phase preceding embryo transfer assumes pivotal significance in achieving optimal endometrial receptivity and ensuring the success of pregnancy. The natural cycle (NC) and artificial cycle (AC) are the preferred methods for many in vitro fertilization (IVF) specialists. The objective of this study was to compare the difference between NC and AC in women undergoing frozen-thawed embryo transfer (FET) after IVF. MethodsA cross-sectional study was conducted involving 150 adult women who underwent FET with a single autologous blastocyst stage embryo in a 5-year period (2014-2019). Bivariate analysis was conducted to discern implantation and pregnancy rates associated with NC and AC for endometrial preparation. Multiple logistic regression was used to assess the association between endometrial preparation and clinical outcomes while adjusting for potential confounders. ResultsOf the 150 subjects meeting study criteria, 19 underwent NC, while 131 underwent AC for endometrial preparation. Natural cycle exhibited a higher biochemical pregnancy rates compared to AC (89.5% vs. 53.4%; p=0.003). Artificial cycle is a significant determinant for biochemical pregnancy rates compared to NC (aOR: 0.132;95% CI: 0.028 – 0.623; p=0.010) ConclusionIn women undergoing FET, NC resulted in higher biochemical pregnancy rates compared to AC. However, clinical pregnancy rates and ongoing pregnancies rates did not exhibit significant disparities between NC and AC. Future studies will hopefully further illuminate which protocol is most suitable for the individual patient. Further multi-center randomized clinical trials are needed to confirm the relationship between biochemical pregnancy rates and NC.
Current Trends in Contraceptive Use and Fertility Concerns Among Women of Reproductive Age in Indonesia Muharam Natadisastra, Raden; Christopher Yo, Edward; Nurdya Irzanti, Alisha; Sumapraja, Kanadi; Kemal Harzif, Achmad; Pratama, Gita; Maidarti, Mila; Hari Kurniawan, Riyan; Wiweko, Budi; Hestiantoro, Andon
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2508

Abstract

Abstract Background Family planning remains a key intervention in reducing maternal mortality and creating prosperous families. Assessing the unmet need for family planning allows insight into the progress of family planning programs. On the other hand, there has been much less attention given to the declining fertility rate in Indonesia. To address both the unmet need and declining fertility rate in Indonesia, this study aimed to investigate the most recent trends in contraceptive use in Indonesia as well as evaluate fertility concerns and access to reproductive healthcare service. Methods Women of reproductive age in Indonesia were asked to fill in an online questionnaire. They were asked about sociodemographic characteristics, marital status, pregnancy history, perception towards fertility, and access to healthcare service and information. Descriptive statistics and independent t-test were performed. Results Of 370 women, more than half (57.8%) had used some form of contraception. The most frequently used contraceptive method was natural family planning (30.3%), followed by condom (20%). Women with no prior sexual history, had never been pregnant before, and had not been married cared more about having a child in the future. Internet and social media represented the most popular information source for family planning. Conclusions Many Indonesian women still prefer traditional contraceptive methods over the more effective modern contraceptive methods. Numerous socio-cultural factors are likely to influence the behaviour of reproductive-age women regarding contraceptive use and childbearing in the future. More effort should be put into raising awareness about modern contraceptive methods and addressing fertility concerns. Keywords: contraception; fertility; family planning; awareness; reproduction
Long COVID in vaccinated women with Polycystic Ovary Syndrome: A retrospective cohort pilot study Muharam, R; Bagastoro, Aswan; Faradina, Anindita Abigail; Yo, Edward Christopher; Irzanti, Alisha Nurdya; Sumapraja, Kanadi; Harzif, Achmad Kemal; Pratama, Gita; Maidarti, Mila; Silvana, Vita; Wiweko, Budi; Hestiantoro, Andon
Majalah Obstetri & Ginekologi Vol. 33 No. 2 (2025): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I22025.89-96

Abstract

HIGHLIGHTS Among women with PCOS, many still reported persistent long COVID symptoms such as hair loss and fatigue. COVID-19 vaccination does not exacerbate symptoms of PCOS, which further emphasizes the importance of completing COVID-19 doses for women with PCOS to avoid long COVID sequelae.   ABSTRACT Objective: Long COVID, or the persistence of symptoms after acute COVID-19 illness, can affect individuals with pre-existing health conditions such as polycystic ovary syndrome (PCOS). Long COVID and PCOS may share overlapping pathogenesis which potentially exacerbate one another. The aim of this study was to evaluate the symptoms of long COVID in women with PCOS who have been vaccinated and investigate whether COVID-19 vaccination or infection worsened PCOS symptoms. Materials and Methods: We carried out a retrospective cohort study on 44 women with PCOS who have been vaccinated and previously diagnosed with COVID-19. Questionnaires were distributed to find out the effect of COVID infection and vaccines in these women, as well as the symptoms of long COVID-19. Results: Of all participants, 28 women (70%) continued to report persistent long COVID symptoms, with the highest number of complaints being fatigue and hair loss. The results, using Mann-Whitney test, showed that there was no difference in PCOS symptoms before and after COVID-19 vaccination (p = 0.520) or after COVID-19 infections (p = 0.241). Although this study revealed a substantial prevalence of long COVID symptoms among women with PCOS, an encouraging finding emerged: neither the administration of COVID-19 vaccination nor prior infection with COVID-19 had a significant impact on PCOS-associated symptoms. Conclusion: This study further underscores the importance of vaccination for all individuals, including women with a history of PCOS. Furthermore, the purpose of COVID-19 vaccination is to mitigate symptom severity, thus potentially diminishing the occurrence of long-term COVID-19 symptoms in future cases.
Peripheral Serum AMH Level Reflects the Size of the Follicle Pool in a Mouse Model Study Suratih, Ni Made Desy; Wiweko, Budi; Maidarti, Mila; Wuyung, Puspita Eka; Jusuf, Ahmad Aulia; Louisa, Melva; Kekalih, Aria
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 3 Jully 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i3.2220

Abstract

Objective: This is to compare peripheral and central serum levels of Anti-Mullerian hormone (AMH) in experimental animals for predicting ovarian reserve. Methods: This is an experimental study involving 20 female Sprague-Dawley rats aged 8–10 weeks with normal estrus cycles as the young control group and 5 female rats aged 28–30 weeks as the old control group (n = 5/group): the young control group, the old control group, the 1x cisplatin group, the 2x cisplatin group, and the 3x cisplatin group. After treatment, tissue collection, histological staining, and blood collection through the retro-orbital bleeding (ROB) and heart were performed. Subsequently, measurements of ovarian weight, follicle counting, and levels of AMH and Follicle-stimulating hormone (FSH) were conducted.Results: The serum AMH levels from ROB in the young control, 1x cisplatin, 2x cisplatin, 3x cisplatin, and the old control groups were 1151, 1818, 2782.96, 1381.352, and 1544 ng/mL, respectively. Cisplatin 2x group was significantly (p<0.005) higher compared to the young control. The average concentrations of serum AMH in the ROB and heart were higher in the 2x cisplatin group compared to the other groups. Meanwhile, cisplatin 3x group decreased in level due to the burn out phenomenon. Conclusion: AMH is a preferred marker compared to FSH. Blood collection through the ROB is considered a less invasive alternative technique in the treatment group, requiring serial observation. Keywords: AMH, follicle pool, ovarian aging, ROB
Co-Authors Achmad K. Harzif Achmad Kemal Harzif Agustina, Elizabeth Ahmad Aulia Ampri, Irfan Arieqal Hatta Andon Hestiantoro Aprilia Asthasari Siregar Aria Kekalih Bagastoro, Aswan Budi Wiweko Christopher Yo, Edward Faradina, Anindita Abigail Gita Pratama Hari Kurniawan, Riyan Irzanti, Alisha Nurdya Kanadi Sumapradja Kartiwa Hadi Nuryanto Lestari, Silvia Werdhy Melva Louisa Muharam Natadisastra Muharam Natadisastra, Raden Muharam, R Mulyadi M. Djer Muthalib, Aidrus Nurdya Irzanti, Alisha Prini Diandara Garinasih Puspita Eka Wuyung Putri, Dyanti Prima R. Muharam Rahmadhany, Anisa Silvana, Vita Suratih, Ni Made Desy Talya, Natasha Tyagitha, Galuh Anindya Yanfaunas, Atika Mahira Yanfaunnas, Atika Mahira Yo, Edward Christopher