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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Published by Perkumpulan Obstetri dan Ginekologi Indonesia
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published quarterly.
Arjuna Subject : -
Articles 1,731 Documents
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Two Designated Pathways of Ovarian Cancer and the Crucial Implications to the Treatment Henny M.A. Rachmasari Putri
Indonesian Journal of Obstetrics and Gynecology Volume. 33. No. 4, October 2009
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To review the two designated pathways of ovarian cancer and their implications to the management of ovarian cancer. Method: Literature review Result: A proposed carcinogenesis of ovarian cancer has been developed based on a long history of pathological and molecular genetic findings. It divides ovarian cancer as having designated type I or type II pathway. Type I pathway involves ovarian carcinomas with low-grade serous subtype, mucinous, clear cell and endometrioid subtypes. They grow in a stepwise manner, shows low response toward platinum-based chemotherapy and mostly relate to MAPK pathway mutations. High-grade serous ovarian carcinomas which are often found in rapid-aggressive progression with poorer prognosis are suggested as type II pathway. Their major mutations are mainly in TP53. Optimal surgery and adjuvant chemotherapy are the treatment for both confined and advanced cancers. However, the optimal cytoreduction in type II pathway is becoming more important to increase overall survival or disease-free interval. The strategy of screening type II pathway is proposed to be shifted from detection of stage I tumors to detection of minimal ovarian carcinomas probably by biomarkers since the rapid inception is hardly found. Meanwhile the BRCA1/2 screening and classification should be improved for the hereditary breast/ovarian cancer screening. Mutations of KRAS, BRAF, PTEN and CTNNB1 occur majorly in the type I tumors. Therefore, targeted chemotherapy and inhibitor treatments which are investigated foremost in type II recurrence of ovarian malignancies may also be directed to the low response of type I pathway to platinum-based chemotherapy. Conclusion: A different strategy based on the tumorigenesis of ovarian cancer should be considered in term of screening, primary approach and following chemotherapy since there are some distinctive patterns in both pathways. [Indones J Obstet Gynecol 2009;33-4:239-46] Keywords: ovarian cancer, carcinogenesis, screening, cytoreduction, chemotherapy
Relation between CYP17 Polymorphism and Hyperandrogenemia in Polycystic Ovarian Syndrome Budi Wiweko
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objectives: To find 5-untranslated region polymorphism of CYP17 gene and its connection with hyperandrogenemia in polycystic ovarian syndrome. Methods: A cross sectional descriptive study with consecutive random sampling method. Body mass index, ovarian morphology by ultrasonography, fasting insulin level, fasting blood glucose level, 17-hydroxyprogesterone level, total testosterone level, serum hormone binding globulin level, and CYP17 gene polymorphism in 45 subject with PCOs and 45 control subject who attend Yasmin clinic of Cipto Mangunkusumo General Hospital with menstruation problems were measured. CYP17 gene polymorphism was evaluated using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method with MspA1 restriction enzyme. Results: In PCOs group, the genotype distribution were; 11.1% subject with genotype CC, 71.1% subject with genotype TC and 17.8% subject was wild type TT. In non PCOs group, the genotype distribution for CC, TC and TT respectively were 13.3%, 46.7% and 40%. There was significant difference between both group in distribution of TC and TT genotype, with p value 0.013. Frequencies of allele c and allele t in PCOs group were 47% and 53%. In non PCOs group, frequency of allele c and t were 37% and 63%. There were tendency for higher frequency of allele c in the PCOs group but the difference was not statistically significant. Median FAI value for genotype CC homozygote, TC heterozygote and TT homozygote in PCOs group respectively were; 6.82 (6.07 - 8.23); 5.59 (0.25 -21.45) and 4.74 (3.48 - 8.88). There was tendency for increase FAI value in PCOs group corresponds to variant allele, but the result was not statistically different. Conclusion: There were higher proportion of CC homozygote and TC heterozygote genotype in PCOs patient with tendency of increasing FAI value. [Indones J Obstet Gynecol 2011; 35-1: 3-7] Keyword: polycystic ovarian syndrome, free androgen index, CYP17 polymorphism
Increment of placental Caspase 3 expression in preeclampsia and its effect on birth weight and blood pressure Mintareja Teguh
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 1, January 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To determine the placental apoptosis process in preeclampsia. Methods: This study was an observational analytical study using cross sectional design. This study was performed at Dr. Hasan Sadikin Hospital, during April to June 2008. Immunohistochemical analysis was used to examine the placental expression of kaspase 3. Results: Placental expression kaspase 3 was significantly higher in preeclampsia group (21,9%) than in the normal pregnancies (0) with p=0,006. There was significantly correlation between placental kaspase 3 with birth weight in preeclampsia on the otherhand, there was no significant difference of placental expression kaspase 3 with birth weight in normal pregnancies. There was no significant difference of placental expression kaspase 3 with mother’s blood pressure in the two group. Conclusion: there is a significant increase of placental expression of kaspase 3 in preeclampsias. [Indones J Obstet Gynecol 2010; 34-1:3-6] Keywords: caspase 3, preeclampsia, apoptosis.
The use of elastic stocking to reduce the risk of varicose vein Ucke Sugeng Sastrawinata
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 1, January 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To reduce the risk of varicoses in primigravida by wearing elastic stockings with mechanical compression. Method: A prospective study was performed in a randomized single blinded trial with analysis of variance and repeated measures. The study was done at The Obstetrics and Gynecology Department Immanuel Hospital Bandung, with subjects obtained from the Obstetrics outpatient clinic during the period of May 2008 to March 2009. This study consisted of a population of 66 primigravidas randomly allocated in to 2 groups, 34 women in control group and 32 women in study group. Women in the study group were instructed to wear elastic stockings, while the control group was not. Measurements of veins dilatation were carried out using a Color Duplex Ultrasound. Results: The 12 week examination didn’t show any significant change on left femoral veins diameters in both groups. Examination at 34 weeks gestational age showed significant changes on left femoral veins in study group and control group (subsequently 0,83 ± 0,07 cm and 1,02 ± 0,35 cm). It also happened on examination at 2 weeks post-partum. The incidence of reflux was found only in the study group at sapheno-femoral junction in 6 of 34 women. Conclusion: Mechanical compression provide protective effect from the development of varicoses shown by the reduced incidence in developing reflux in blood flow in saphenous-femoral junction, in addition to minimal dilatation of the lower limbs and pelvic veins. [Indones J Obstet Gynecol 2010;34-1:7-11] Keywords: varicoses; pregnancy; endothelial injury; saphenousfemoral junction; reflux; mechanical compression
The correlation between serum protein Bcl-2 and caspase 3 levels as a risk factor in abortion Herlambang Noerjasin
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 1, January 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To determine the correlation between serum protein Bcl-2 with caspase-3 levels on normal pregnancy and abortion, and the strength of serum protein Bcl-2 with caspase-3 levels as means for diagnostic test. Methods: A case control study was carried out. Samples were obtained from the serum of incomplete abortion patients and normal pregnancy as control. Serum protein Bcl-2 and caspase-3 levels were examined with ELISA method. Result: Mean Bcl-2 level in subjects with abortions is 7.263 (SD 1.71) ng/ml, lower than normal pregnancies, which is 7.490 (SD 3.938) ng/ml, with significant different (p=0.050). Mean caspase-3 in subjects with abortions is 112.74 (SD 152.73) mg/ml, higher than normal pregnancies, which is 14.94 (SD 23.18) mg/ml, with significant different (p
Monoplant® the Indonesian Implant: The Overview of Implant and Its Development Eka R. Gunardi
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Norplant®, as a first-generation levonorgestrel implant and containing six capsules, has been shown to be effective as long-term contraception since more than 25 years ago. In the process, then the number of implants was reduced to two rods called Norplant-2®, which is then updated into Jadena® (in Indonesia) or Jadelle® (in America). As a country with the largest implant acceptors in the world, Indonesia has developed its own implant method consisting of two rods called Indoplant®. Currently being developed implant that consists of single rod called Monoplant®. Monoplant® is expected to be the best option because it only consists of a single rod implant that is easy to insertion and remove, effective and safe for at least three years. [Indones J Obstet Gynecol 2011; 35-1: 40-6]
Profile of Policystic Ovarian Syndrome Patients in Dr. Cipto Mangunkusumo General Hospital Jakarta March 2009 - March 2010 Niken P. Pangastuti
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To study phenotype profile and correlation between fasting blood glucose-fasting insulin ratio and luteinizing hormonefollicle stimulating hormone ratio with free androgen index in polycycstic ovarian syndrome in Dr. Cipto Mangunkusumo Hospital Jakarta. Method: A descriptive cross-sectional study was carried out at Dr. Cipto Mangunkusumo General Hospital Jakarta in March 2009 - March 2010, using secondary data, were involved 105 reproductive age women who has been diagnosed as PCOs with Rotterdam criteria. History of the subjects was taken from medical record that consist of interview result about menstrual history and clinical manifestations of hyperandrogenemia and clinical, biochemical, and ovarian ultrasound assessment. Result: From 105 women were identified, 100 women with oligo/amenorrhea (94.2%) and 34 women with hirsutism (32.4%). Further evaluation of the 105 cases, it was identified 80% subjects with polycystic ovaries morphology, 34.3% with hyperandrogenemia, 71.4% with insulin resistant, and 66.7% with increasing LH and FSH ratio. While, the most symptom and sign combination is oligo/amenorrhea and polycystic ovaries morphology, that is 44.8%. With Spearman non parametric correlation test, there were a significant correlation between fasting blood glucose-fasting insulin ratio and free androgen index (FAI) with coefficient of correlation -0.342 and and between LH/FSH and FAI with coefficient of correlation 0.386. Conclusion: The most common symptom and sign of PCOs patients in this study were oligo/amenorrhea and polycystic ovaries and insulin resistant. There were significant correlations between fasting blood glucose-fasting insulin ratio and LH/FSH with FAI. [Indones J Obstet Gynecol 2011; 35-1: 8-13] Keywords: polycystic ovarian syndrome, insulin resistance, luteinizing hormone hypersecretion, hyperandrogenemia
The Effect of Analog GnRH before Laparoscopic Cystectomy to Ovarian Reserve which was Measured with anti Müllerian Hormone at Bilateral Endometriosis Cyst Kanadi Sumapraja
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To know the effect of preoperative GnRH-a treatment to preserve the ovary after laparoscopic excision of endometriomas by measuring antimüllerian hormonal before and after operation and analize the correlation with age and size of the endometrioma. Methods: Double blind randomized control trial, which is done to patients with bilateral endometriomas in Raden Saleh Clinic. Subject devided into groups GnRH-a and placebo. Patient was undergoing laparoscopic excision after four weeks of medication (GnRHa or placebo). AMH Serum levels was measured before preoperative medication and four weeks after operation. Result: There were eight bilateral endometriomas (25% patients requirement), 4 patient GnRH-a and four patients placebo, all with primary infertility. The average changes of AMH serum level before and after laparoscopy ovarian cystectomy in GnRH-a groups was 0.011 ng/ml and placebo groups was 1.502. The average changes of AMH serum level, in age strativication on both groups show the same result, GnRH-a 0.035 and placebo 1.681. In diameter cyst strativication, GnRH-a 0.011 and placebo 1.090. Conclusions: With the restrictiveness of the patient, this study find GnRH-a therapy initiated before laparoscopic cystectomy has better outcomes in ovarian reserve compared with placebo, and also the same result in age and size of cyst strativication analize. [Indones J Obstet Gynecol 2011; 35-1: 14-7] Keywords: laparoscopic cystectomy, GnRH-a, ovarian reserve
Effects of Peritoneal Fluid on Sperm Motility and Viability in Endometriosis Marissa Tasya
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To know the effects of peritoneal fluid on sperm motility and viability in patients with endometriosis. Design/data identification: This was a laboratory experimental study to peritoneal fluid from endometriosis and non-endometriosis patients who underwent surgery in Dr. Hasan Sadikin Hospital and around with endoscopy facility which fulfill inclusion and exclusion criterias. Experiments was performed in ASTER Fertility Clinic, Dr. Hasan Sadikin Hospital. Method: Semen samples were normozoospermic of which has been prepared using swim up method with sperm count 3 x 106/ml. The sperm were exposed to peritoneal fluid from endometriosis and non-endometriosis patients and analyzed at h 0, 1, 3, 6, and 24 to see the difference of sperm motility and viability postincubation with endometriosis peritoneal fluid. The sperm viability was detected using trypan blue 0.4%. Result: Exposure of sperm to peritoneal fluid reduced sperm motility significantly from the h 6 observation (Zw = 2.17; p = 0.03) and the h 24 (Zw = 2.35; p = 0.01). The sperm viability which incubated with endometriosis peritoneal fluid reduced significantly from h 6 observation (Zw = 1.99; p = 0.04) and the h 24 (Zw = 2.55; p = 0.01). Conclusion: The endometriosis peritoneal fluid reduced the motility and viability of the sperm began from the h 6 postincubation. This indicate the possibility of involvement of endometriosis peritoneal fluid to infertility. [Indones J Obstet Gynecol 2011; 35-1: 18-20] Keywords: sperm motility, sperm viability, endometriosis
Distribution of Age, Stage, and Histopathology of Cervical Cancer: A Retrospective Study on Patients at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia, 2006-2010 Tricia D. Anggraeni
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 1, January 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To review the distribution of age, stage at presentation, and histology of cervical cancer at Dr. Cipto Mangunkusumo Hospital. Materials and methods: This cross sectional study involved 2297 subjects with cervical cancer at Dr. Cipto Mangunkusumo Hospital and registered at the Cancer Registration Information System during 5 years period from January 2006 to December 2010. Histotype was confirmed by histopathology examination. The International Federation of Gynecology and Obstetrics (FIGO) classification was used to stage the disease. Result: The mean age of cervical cancer patients was 51.42 years old (SD 9.694, range 21 - 85). The highest incidence was in 35 - 64 years (87.3%), with the peak incidence in 40 - 59 years (71.3%). There were 0.4 % patients identified at stage IA1, 0.1% at stage IA2, 7.3% at stage IB1, 4.9% at stage IB2, 10.5% at stage IIA, 17.3% at IIB, 1.7% at stage IIIA, 50.2% at stage IIIB, 4.3% at stage IVA, 3.2% at stage IVB. Of the 2297 patients, 70.2% had epidermoid carcinoma, 15.1% had adenocarcinoma, 10.2% had adenosquamous, 0.6% had clear cell, 3.9% had other types. Conclusion: A large proportion of cervical cancer (76.7%) presented in advanced stage (≥ stage IIB). The highest incidence (57.8%) was in the age range 45 - 59 years. Squamous cell carcinoma is the most frequent histopathology type (70.2%), followed by adenocarcinoma (15.1%) and adenosquamosa (10.2%). A lack of effective screening programs aimed at detecting and treating precancerous conditions is a key reason for the high incidence of cervical cancer at advanced stage. [Indones J Obstet Gynecol 2011; 35-1: 21-4] Keywords: cervical cancer, age, stage, histopathology

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