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Fecal Incontinence Due to Occult Obstetrical Anal Sphincter Injuries in Primiparous Women: A Case Report Igsana Chyntia Murti; Muhamad Nofa Cholili; Dhian Eka Putri Harnandari; Rahajeng
Asian Journal of Health Research Vol. 3 No. 2 (2024): Volume 3 No 2 (August) 2024
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v3i2.168

Introduction: A predisposing factor for fecal incontinence in women is vaginal birth, impacting between 24 and 44% of the female population. Fecal incontinence, characterized by the inadvertent expulsion of gas or excrement, constitutes a multifactorial condition. It causes discomfort and diminishes the quality of life for women. Owing to its occurrence in 0.6–9% of vaginal deliveries, obstetric anal sphincter injury (OASI) has been identified as the most prevalent cause of AI in young women, with a 15–61% incidence rate following primary repair. Case Presentation: The case presented in this report involved a 26-year-old woman who presented with symptoms of difficult-to-control flatulence and defecation following vaginal delivery. The patient has a history of giving birth to her first child spontaneously at a midwife in June 2023; she found a tear in the birth canal, which was then stitched up. Another history of past illness has been unremarkable. Upon examination, vital signs were within normal limits. The patient was obese I, with a BMI of 27.3 kg/m2. Local examination of external genitalia within normal limits. A digital rectal examination showed that the anal sphincter was not palpable, the rectal mucosa was smooth, and other examinations were within normal limits. Lab examination showed normal results. Conclusion: After an exhaustive examination, a diagnosis of fecal incontinence was made for the patient. The patient was treated with colporrhaphy and sphincterorrhaphy, both of which produced favourable outcomes.

The role of vitamin D supplementation on levator ani muscle remodeling post-delivery Rahajeng; Zaen, Taufik Ali
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.97-105

HIGHLIGHTS 1. In pregnant women, vitamin D insufficiency may plays a role in the development of post-delivery illness.2. Vitamin D supplementation is significant in remodeling of post-delivery levator ani muscle. ABSTRACT Objectives: Vitamin D is considered a crucial vitamin for the restoration of levator ani muscle strength. Therefore, this study aimed to evaluate the association between vitamin D and levator ani muscle remodeling in the post-delivery period.Materials and Methods: The literature search was conducted across three electronic databases, namely PubMed, Google Scholar, and Springerlink. Our investigation yielded a total of 2613 studies, out of which 8 studies were found to meet the inclusion criteria and were subsequently included in our study. Among these, 4 studies specifically examined the impact of vitamin D micronutrient status on the levator ani/pelvic muscles during the post-delivery period.Results: The mean maximum contraction strength of the levator ani muscles following the administration of vitamin D supplements was 26.77 ± 7.15 cmH2O. The analysis conducted utilizing a paired t-test yielded a p-value of less than 0.05, indicating statistical significance. Additionally, a coefficient correlation of 0.831 was observed, with a p-value also less than 0.05. The findings of this study indicate a noteworthy correlation between levels of vitamin D and the magnitude of levator ani muscle contractions, as evidenced by a statistically significant p-value of less than 0.05.Conclusion: The administration of vitamin D supplements has been found to play a significant role in the remodeling of the levator ani muscle during the post-delivery period. This is evidenced by the observed increase in strength of the levator ani muscles following vitamin D supplementation.

The Effect of Flavonoids from Mahkota Dewa Fruit Extract (Phaleria macrocarpa) on Inflammation Factors (IL-1β and IL-6) and Estrogen Receptor Alpha (ERα) in The Ovaries of Endometriosis Model Mice Destikatari, Lovin; Rahajeng; Baihaqi, Irfani
Asian Journal of Health Research Vol. 4 No. 1 (2025): Volume 4 No 1 (April) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i1.220

Introduction: Endometriosis is a gynecological disorder characterized by the growth of endometrial tissue outside the uterus. The disease is marked by uncontrolled cell proliferation, increased cell aggressiveness, apoptosis defects, and an inflammatory microenvironment. Phaleria macrocarpaa, a native Indonesian plant, contains flavonoids that function as antioxidants and have anti-inflammatory and antimicrobial properties. Previous research has shown that flavonoids from Phaleria macrocarpa can inhibit endometriosis lesion growth by regulating cell apoptosis. Material and Methods: This study is an experimental study using a randomized post-test-only control group design. Six groups were included: a negative control, a positive control, and four treatment groups receiving Phaleria macrocarpa flavonoid extract at concentrations of 3.75%, 7.5%, 11.25%, and 15%. The primary data obtained were then examined using SPSS 26.0. Results: IL-1β, IL-6, and ERα levels in the treatment groups were lower than in the positive control group, with significant differences between each group. Higher extract doses were associated with a greater reduction in inflammatory mediators. Regression analysis demonstrated a strong correlation between Phaleria macrocarpa extract administration and decreased levels of IL-1β (86%), IL-6 (94%), and ERα (95%). Conclusion: In endometriosis model mice, administering Phaleria macrocarpa fruit extract can lower the concentration of IL-1β, IL-6, and ERα. There is a correlation between the reduction of concentration of IL-1β, IL-6, and ERα in endometriosis model mice and various doses of Phaleria macrocarpa fruit extract.

Advances in Urinary Tract Infection Screening Among Pregnant Women: A 5-Year Systematic Review Qonita Prasta Agustia; Rahajeng
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1331

Background: Urinary tract infections (UTIs), including asymptomatic bacteriuria (ASB), represent a significant clinical challenge during pregnancy, posing risks to both mother and fetus. Physiological changes increase susceptibility. Urine culture remains the diagnostic gold standard. This review assessed recent evidence on UTI clinical manifestations and diagnostic approaches in pregnant women. Methods: A systematic literature search of PubMed and Google Scholar was conducted for experimental studies published in the last 5 years (2019-2023) focusing on UTI diagnosis in pregnancy. Search terms included "urinary tract infection," "pregnant women," "diagnosis," and "experimental study". Studies were selected using PRISMA guidelines and PICOS criteria. Data extraction and risk of bias assessment were performed. Results: Fifteen experimental studies involving 4,377 pregnant participants were included. Common clinical manifestations included urgency, lower abdominal/pelvic pain, dysuria, fever, and hematuria. Urine culture was the primary diagnostic tool used. Escherichia coli was the most prevalent Gram-negative isolate, followed by Klebsiella spp. and Pseudomonas spp. Streptococcus aureus, Enterococcus faecalis, and Staphylococcus aureus were common Gram-positive isolates. Urine pH varied, with Gram-positive infections associated with more alkaline urine. Conclusion: Clinical presentations of UTI in pregnancy were consistent across recent studies. Gram-negative bacteria, particularly E. coli, predominated. Urine culture remains the cornerstone of diagnosis, with urine pH potentially offering adjunctive diagnostic information.

Advances in Urinary Tract Infection Screening Among Pregnant Women: A 5-Year Systematic Review Qonita Prasta Agustia; Rahajeng
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1331

Background: Urinary tract infections (UTIs), including asymptomatic bacteriuria (ASB), represent a significant clinical challenge during pregnancy, posing risks to both mother and fetus. Physiological changes increase susceptibility. Urine culture remains the diagnostic gold standard. This review assessed recent evidence on UTI clinical manifestations and diagnostic approaches in pregnant women. Methods: A systematic literature search of PubMed and Google Scholar was conducted for experimental studies published in the last 5 years (2019-2023) focusing on UTI diagnosis in pregnancy. Search terms included "urinary tract infection," "pregnant women," "diagnosis," and "experimental study". Studies were selected using PRISMA guidelines and PICOS criteria. Data extraction and risk of bias assessment were performed. Results: Fifteen experimental studies involving 4,377 pregnant participants were included. Common clinical manifestations included urgency, lower abdominal/pelvic pain, dysuria, fever, and hematuria. Urine culture was the primary diagnostic tool used. Escherichia coli was the most prevalent Gram-negative isolate, followed by Klebsiella spp. and Pseudomonas spp. Streptococcus aureus, Enterococcus faecalis, and Staphylococcus aureus were common Gram-positive isolates. Urine pH varied, with Gram-positive infections associated with more alkaline urine. Conclusion: Clinical presentations of UTI in pregnancy were consistent across recent studies. Gram-negative bacteria, particularly E. coli, predominated. Urine culture remains the cornerstone of diagnosis, with urine pH potentially offering adjunctive diagnostic information.

Cranberry extract for urinary tract infection treatment in pregnancy: A systematic review Hakim, Rahmawati Abdul; Putri, Dhian Eka; Rahajeng
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.V33I22025.121-131

HIGHLIGHTS Cranberry represents a promising and effective alternative for both the treatment and prevention of urinary tract infections during pregnancy. Cranberry acts by inhibiting bacterial adhesion to the urinary tract epithelium and exerting direct antibacterial activity. ABSTRACT Objective: Urinary tract infections (UTIs) represent the second most common infectious disease worldwide, affecting nearly 150 million people annually. Owing to anatomical and physiological alterations, UTIs are especially frequent during pregnancy, manifesting with symptoms including dysuria, cloudy urine, increased urinary frequency, and occasionally hematuria. Recurrent UTIs are defined as two or more episodes within six months or three episodes within a year. Cranberries are widely recognized for their potential in preventing UTIs during pregnancy. Their protective action involves blocking the adhesion of uropathogenic bacteria to the urinary tract epithelium, a process mediated by phenolic compounds and A-type proanthocyanidins (PACs). Materials and Methods: In this systematic review, the authors searched PubMed, ScienceDirect, ResearchGate, and Google Scholar for eligible articles published from 2013 to 2024. The search strategy employed Medical Subject Headings (MeSH) and keywords pertaining to Cranberry Extract/Juice and UTI Assessment Methods in Pregnancy. Search expressions were adapted to the specific requirements of each database to optimize retrieval precision. All identified studies were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Of the 30 studies included, a daily administration of 500 mg cranberry extract over six months exhibited notable effectiveness as an alternative therapeutic approach for UTIs in pregnancy. Conclusion: Cranberry (Vaccinium macrocarpon) extract prevents UTIs by impeding bacterial adherence and exerting antibacterial properties. This review supports cranberry as a promising and safe alternative for UTI prevention and management in pregnancy, appropriate for routine daily use.

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