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Bladder Function after Hysterectomy
Wijaya, Johanna;
Tendean, Hermie;
Laihad, Bismarck J
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.83
Objective: To determine the effect of hysterectomy on bladder function
pre- and post-radical hysterectomy in early stage of cervical
cancer.
Method: This study was a pre-post intervention study. Data were
collected through questionnaires from women who had radical hysterectomy
and total hysterectomy in Prof. Dr. R. D. Kandou Manado
general hospital and other networking hospitals since January 1st,
2014 to November 31st, 2014. We analyzed the data using Wilcoxon
and Mann-Whitney statistical test.
Result: There were each 18 respondents for the radical and total
hysterectomy group in Prof. Dr. R. D. Kandou general hospital and
networking hospitals. The age distribution of radical hysterectomy
was 41-45 years old for 44.4%. The parity was dominated by second
parity for 38.8%. In pre- and post-surgery, there were significant differences
for urinary incontinence disorder (p=0.003), emptying disorder
(p=0.008), urinary pain (p=0.034), and total urinary disorder
(p=0.001). While, between radical and total hysterectomy, there was
no significant difference in bladder function (p>0.05).
Conclusion: There is an association before and after surgery to urinary
function. However, there is no association between the radical
and total hysterectomy group.
[Indones J Obstet Gynecol 2016; 4-2: 97-100]
Keywords: bladder function, cervical cancer, radical hysterectomy
Factors Related to the Number of Antral Follicles on InVitro Fertilization (IVF)
Raharja, Fransiskus C;
Suwiyoga, Ketut;
Wardhiana, IPG
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.79
Objective: To determine factors which are related to the number of
antral follicles on infertile patients.
Method: This cross sectional study was conducted in In-Vitro Fertilization
(IVF) clinic of Graha Tunjung, Sanglah hospital, Bali. All fertile
patients following the IVF program were calculated the number
of antral follicles in both ovarian using transgene USG. This sample
was recruited by random sampling from April 1st, 2001 to April 30th,
2011. We analyzed the data using Chi square test through SPSS for
Windows 17.0 version.
Result: Of 102 samples, the mean of patients’ age was 32.9% (SD
4.6) years old. From 72 patients (70.6%) experienced above 3 years
of infertile period, the primary infertile was on 69 patients (67.7%).
There was a relationship between patients’ age and the number of
antral follicles significantly (prevalence ratio (PR) 1.41; 95% CI 1.11-
1.79). Meanwhile, the number of antral follicles and type of infertile
(PR 1.02; 95% CI 0.76-1.37) also infertile period (PR 0.95; 95% CI
0.72-1.27) were not associated significantly.
Conclusion: Patients’ age has an association with the number of antral
follicles on IVF.
[Indones J Obstet Gynecol 2016; 4-2: 75-77]
Keywords: age, infertile, infertile period, number of antral follicles
and type of infertile
Epidemiology Data of Ovarian Cancer in Dr. Cipto Mangunkusumo Hospital, Jakarta
Noela, Fransisca;
Nuryanto, Kartiwa H
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.84
Objective: To describe the incidence of ovarian cancer and its characteristic
in Dr. Cipto Mangunkusumo Hospital in the last 5 years.
Method: This was cross sectional study design. The data was collected
from Gynecology Oncology Division Cancer Registry and Dr.
Cipto Mangunkusumo Hospital medical record from January 2009 to
December 2013; follow up was performed to know the 4-years survival
rate.
Result: There were 98 subjects in this study. The majority incidence
of ovarian cancer was 45-54 years old (33.6%); the incidence of
ovarian cancer decreased with the increased number of parity; the
majority histotype was epithelial (76.5%); and most of them were
diagnosed on advanced stage (55.1%). The 4-year survival rate for
epithelial type was 77%; germinal type was 83.3%; and stromal type
was 100%. Based on therapy, the 4-year survival rate was 84.1% for
surgical only; 83.3% in adjuvant chemotherapy group; and 68.4% in
neoadjuvant chemotherapy. In the group of adjuvant chemotherapy,
there was 63% patients with complete response and 41.2% patients
with complete response in neoadjuvant chemotherapy.
Conclusion: The highest incidence of ovarian cancer in Dr. Cipto
Mangunkusumo Hospital belongs to the age of reproductive women
(≤ 55 years old) with the highest incidence occurs in nulliparity women.
Most of the ovarian cancer cases are diagnosed in advanced
stage (stage III-IV).
[Indones J Obstet Gynecol 2016; 4-2: 101-106]
Keywords: age, histotype, ovarian cancer, parity, response, stage,
survival, treatment
Prevalence of Postpartum Anxiety and Depression after Intrapartum Oxytocin
Valentine, Grace;
Kayika, I Putu G
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.75
Objective: To know the prevalence of postpartum anxiety and depression
in patients who received intrapartum oxytocin.
Method: Across-sectional observational study was conducted in Dr.
Cipto Mangunkusumo hospital. Observation used Edinburgh Postnatal
Depression scale and Beck Anxiety Inventory before delivery
day, on the first and fourteenth day of postpartum.
Result: Of 112 patients, we found the prevalence of mild and moderate
anxiety were 94.6% and 5.4%. There were no anxiety women
before delivery and on the first day of postpartum. The prevalence
of mild and moderate anxiety on the fourteenth day of postpartum
were 83% and 16.9%. There was no severe anxiety found at those
time. On the other hand, the prevalence of postpartum depression
on the first and fourteenth day of postpartum were 31.3% and
32.1%. There was no association between exogenous oxytocin and
postpartum anxiety also depression. In multivariate analysis, we
found that women with low self image were more prone to postpartum
anxiety (OR 0.16, 95% CI 0.06-0.46). Meanwhile, postpartum
depression was associated significantly to self image (OR 0.17, 95%
CI 0.07-0.83), low income (OR 10.35, 95% CI 1.72-62.45) and pregnancy
plan (OR 0.17, 95% CI 0.06-0.53)
Conclusion: The patients who received intrapartum oxytocin are
more prevalent to have mild anxiety. The prevalence of depression
before delivery day, on the first and fourteenth day of postpartum
are similar. In statistic, there is no relationship between intrapartum
oxytocin administration and postpartum anxiety or depression.
[Indones J Obstet Gynecol 2016; 4-2: 59-63]
Keywords: anxiety, depression, oxytocin intrapartum, postpartum
Postplacental IUD Insertion Using Ring Forceps versus Push and Push Technique
Tjahjanto, Hary;
Rizal, Rahmad
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.80
Objective: To compare IUD-endometrium (ED) distance and the incident
of malposition postplacental CuT-380A IUD insertion in vaginal
delivery between ring forceps technique and push and push
technique.
Method: This study was a double-blind randomized control trial,
performed in September 2014 until March 2015 at Dr. Kariadi Hospital.
Ring forceps and push and push insertion technique groups
consisted of 25 subjects in each group. Follow-up was performed at
1-2 weeks, 6-8 weeks and >12 weeks after insertion.
Result: The mean of IUD-ED distance in push and push group was
shorter (but not statistically significant) than ring forceps group. The
IUD-ED distance was at 1-2-week follow-up 4.1 (2.2) vs. 4.9 (3.4)
mm; p=0.208, at 6-8-week follow-up: 2.6 (1.8) vs. 3.2 (3.7) mm;
p=0.452, and at > 12-week follow-up: 0.9 (0.8) vs. 1.0 (0.9) mm;
p=0.427, respectively. Malposition was found in 1-2-week follow-up,
but the IUD was changed to the normal position (sagital position in
uterine fundus) at 6-8-week and >12-week follow-up. Up to 3
months of follow-up, there was no occurrence of perforation, expulsion
or pregnancy in both groups. Most of subjects (56% in the
ring forceps, 68% in push and push groups) did not feel painful during
IUD insertion.
Conclusion: Push and push insertion technique clinically tends to
produce IUD-ED distance shorter than ring forceps technique. Both
techniques are comfortable, safe and effective.
[Indones J Obstet Gynecol 2016; 4-2: 78-87]
Keywords: immediate postplacental IUD insertion technique, IUDendometrium
distance, IUD malposition, push and push technique,
ring forceps technique
Mesothelin versus Ca125 in Screening the Ovarian Malignancy
Jayasaputra, Meliana;
Wagey, Freddy W;
Rarung, Max R
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.85
Objective: To determine the sensitivity and specificity of mesothelin
compared with Ca-125 as a tumor marker in predicting ovarian malignancy.
Method: The cross sectional study design with diagnostic tests was
conducted in 30 samples of patients undergoing elective laparotomy
due to ovarian tumor. We compared the sensitivity and specificity
between mesothelin and Ca-125, then the data were analyzed using
SPSS software version 22.0.
Result: According to the ROC curve analysis, optimal sensitivity and
specificity value of mesothelin was 63.2% and 54.5% at a cut-off
point of 0.45 pg/ml; or 42.1% and 72.7% at a cut-off point of 0.55
pg/ml. While the value of both optimal sensitivity and specificity of
Ca-125 was 73.7% and 63.6% at a cut-off point of 46.63 U/ml.
Conclusion: Mesothelin and Ca-125 are not different significantly
for the AUC value of 50%. Due to higher sensitivity and specificity of
Ca-125 than mesothelin, Ca-125 is still used as tumor marker for
screening the ovarian malignancy.
[Indones J Obstet Gynecol 2016; 4-2: 107-110]
Keywords: Ca-125, mesothelin, ovarian malignancy
Profile of Maternal Referral Cases
Indarti, Junita;
Ocviyanti, Dwiyana;
Aditya, Reyhan
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.76
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
Ovarian Tissue Vitrification as a Method for Ovarian Preservation in Women with Cancer: an Analysis of Granulose Cell Apoptosis
Wiweko, Budi;
Andriyana, Huthia;
Aulia, Achmad
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.81
Objective: To obtain the effective method of ovarian function preservation
with granulose cell apoptosis assessment. Ovarian tissue
vitrification became a method for ovarian function preservation in
women with cancer. This technique can be done anytime without
delay on cancer therapy both in prepubertal and unmarried patient.
It can also store many primordial follicles. Ovarian tissue vitrification
study is still limited to animal test and there are no data about apoptosis
assessment after ovarian vitrification in human ovary.
Method: This quasi experimental study was held in Department of
Obstetrics and Gynecology Faculty of Medicine University of Indonesia
- Dr. Cipto Mangunkusumo General Hospital and Fatmawati
Hospital Jakarta from March 2012 to May 2015. Ovaries from thirteen
women between 31 and 37 years old who underwent oophorectomy
with gynecological indication were examined.
Result: There was no morphological difference between follicles
from fresh and warmed-vitrified ovaries. The mean protein Bax
expression on the fresh ovaries assessed in the form of H-score
was 1.66 (SD 0.14) compared with 1.68 (SD 0.13) on the warmedvitrified
group (p=0.165). The mean protein Bcl-2 expression on the
fresh ovaries examined in the form of H-score was 1.73 (SD 0.10)
compared with 1.71 (SD 0.10) on the warmed-vitrified group
(p=0.068).
Conclusion: Ovarian tissue vitrification does not affect the Bax and
Bcl-2 expression on human ovary.
[Indones J Obstet Gynecol 2016; 4-2: 88-92]
Keywords: apoptosis, bax, Bcl-2, ovarian tissue vitrification
The Outcomes of Primary Debulking Surgery and Neoadjuvant Chemotherapy in Advanced Ovarian Cancer
Rinaldy, Dino;
Andrijono, Andrijono;
Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No. 2, April 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology
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DOI: 10.32771/inajog.v4i2.86
Objective: To compare the outcomes and survival rate of primary
debulking surgery with neoadjuvant chemotherapy.
Method: We selected advanced ovarian cancer patients from medical
records. Subjects were allocated into groups of primary debulking
surgery and neoajuvant chemotherapy by considering the inclusion
and exclusion criteria. We analyzed the data using T test,
Fisher’s exact, and chi-square. The survival rate was presented in
Kaplan Meier curve, whereas the significance was tested with Logrank.
We managed the data using STRATA software version 12.
Result: We obtained 32 cases of primary debulking surgery group
and 20 cases of the neoadjuvant chemotherapy group. Most of the
subjects (44.2%) were 40-49 years old and 80.8% had delivered
more than twice. The mean value of Ca-125 at admission was
3,594.8 u/ml (range 66.6 to 73,000 u/ml). Total of 31 subjects
showed the serous histologic type (59.6%). There was no association
between primary debulking surgery and neoadjuvant chemotherapy
for the parameter of operative time, blood loss, organs injury,
ICU stay, and hospital stay (p>0.05). Primary debulking surgery
had a survival rate similar to neoadjuvant chemotherapy group
(p=0.95).
Conclusion: The perioperative outcomes of advanced ovarian cancer
patients has similar result between primary debulking surgery
and neoadjuvant chemotherapy. Primary debulking surgery has a
survival rate similar to neoadjuvant chemotherapy group.
[Indones J Obstet Gynecol 2016; 4-2: 111-115]
Keywords: advanced ovarian cancer, neoadjuvant chemotherapy,
primary debulking surgery