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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : 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
The Comparison of Clinical and Surgical Staging of Cervical Cancer: A Retrospective Study on Patients at Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Bram Pradipta
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 evaluate the accuracy of clinical examination in determining the stage of operable cervical cancer and the extent of the disease. Method: The study involved 58 subjects from outpatient, emergency unit, and ward of Department of Obstetrics and Gynecology Dr. Cipto Mangunkusumo Hospital, from January 2008 to December 2010 with a diagnosis of cervical cancer. Patients who were diagnosed with cervical cancer up to stage IIA were included and patients lost to follow-up, receiving preoperative neo-adjuvant chemotherapy, and died before getting treatment were excluded. The outcomes evaluation were postoperative clinical staging, including the presence of enlarged lymph nodes, parametrial involvement, and tumor size. Lymph nodes, parametrial, and the tumor size were assessed from the surgery and pathological anatomy results. Result: The age distribution of 58 subjects ranged from 25 to 70 years (mean 48.39 years, SD 8.82). Squamous cell carcinoma was the most frequent type (44.9%), followed by adenocarcinoma (24.1%). Errors in preoperative clinical staging compared with postoperative was 40% in stage IA1, 9.52% in stage IB1, 17.65% in stage IB2, and 7.14% in stage IIA. Sensitivity, specificity, positive predictive value, and negative predictive value for preoperative clinical examination of lymph nodes were 11.1%, 100%, 100%, and 85.96%. Sensitivity, specificity, positive predictive value, and negative predictive value for preoperative clinical examination of parametrial involvement were 37.5%, 100%, 100%, and 90.90%. Sensitivity, specificity, positive predictive value, and negative predictive value for preoperative clinical examination of the tumor size were 91.84%, 88.89%, 97.83% and 66.67%. Conclusion: Clinical examination has limitation, especially in determining lymph nodes and parametrial involvement. Other diagnostic modalities in determining the extent of the disease is necessary. Enforcement of the right diagnosis in patients with cervical cancer is needed to determine the appropriate treatment. [Indones J Obstet Gynecol 2011; 35-1: 25-9] Keywords: staging, cervical cancer, preoperative, postoperative
The effect of 17β Estradiol Exposure on Mutant p53 Expression in Hydatidiform Mole Trophoblast Cell Culture Tatit Nurseta
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 compare the mutant p53 expression in normal trophoblast (N) cell culture with hydatidiform mole trophoblast (HM) cell culture which was exposed to 17β estradiol. Methods: An experimental study conducted at the Laboratory of Physiology Faculty of Medicine, Brawijaya University Malang using N cell culture and HM cell culture with 17β estradiol exposure. Trophoblast cell culture of normal and hydatidiform mole was divided in 6 groups, such as: 1. Without added 17β estradiol; 2. Added 5 nm 17β estradiol; 3. Added 10 nm 17β estradiol; 4. Added 20 nm 17β estradiol; 5. Added 40 nm 17β estradiol; 6. Added 80 nm 17β estradiol. Then performed immunocytochemistry staining using p53 mutant primary antibody and observed the expression of p53 mutant. Data from observations analized with the ANOVA test and correlation test. Results: Mutant p53 expression in N cell culture showed no significant differences in each treatment dose of 17β estradiol (p = 0086 > 0.05). The dose at 80nm 17β estradiol showed an average of highest mutant p53 expression on N cell culture rather than giving the dose of 17β estradiol on 40 nm, 20 nm, 10nm and 5 nm. While the control group showed a lowest average of mutant p53 expression in N cell culture when compared to the treatment group which was exposed to 17β estradiol. Mutant p53 expression in HM cell culture showed a significant difference at each treatment dose of 17β estradiol (p = 0.000 < 0.05). The existence of the effect of 17β estradiol begins when the expression of mutant p53 in HM cell culture becomes higher after being given treatment in the form of 17β estradiol on the dose of 5 nm compared with the expression of 17β estradiol in the control group. Then the expression of mutant p53 in HM cell culture is increasing when given doses of 17β estradiol at 20 nm and 40 nm. At a dose of 40 nm it shows the highest expression of mutant p53. Expression of mutant p53 in HM cell culture decreased when given at doses 80 nm. Conclusion: Mutant p53 expression in N cell culture exposed to 17β estradiol showed no significant difference. Expression of mutant p53 in HM cell culture which was exposed to 17β estradiol showed a significant difference. Mutant p53 expression in N and HM cell culture which was exposed to 17β estradiol showed significantly different, in which mutant p53 expression in N cell culture is lower than the expression of mutant p53 in HM tissue culture. [Indones J Obstet Gynecol 2011; 35-1: 30-5] Keyword: p53 mutant, 17β-estradiol, hydatidiform mole
Correlation of Inhibin A Serum Level with Preeclampsia Dian Pratama
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: The purpose of this research is to analyze the difference of Inhibin A serum level between preeclampsia patients with normal pregnant patients and to analyze the relation between Inhibin A serum level with preeclampsia. Method: Comparison of average Inhibin A serum level of the preeclampsia group with normal pregnancy was analyzed by using Mann-Whitney test, and the correlation between Inhibin A serum level and preeclampsia was using biserial point correlation test. Samples were obtained from blood of patient suffered preeclampsia and also normal pregnancy, each containing 17 samples according inclusion and exclusion criterias. Patients came to Hasan Sadikin Hospital and two satellite hospitals in August to November 2010. Result: Characteristic test in two groups of study showed that both groups were homogeny and could compared. Mean level of Inhibin A serum was higher in preeclampsia (1268.08 pg/ml) than normal pregnancy (911.12 pg/ml) (p = 0.042) there was a strong positive correlation between Inhibin A serum level with preeclampsia (r pbi = 0.354; p = 0.027). Conclusion: From this research, we can conclude that Inhibin A serum level in preeclampsia is higher than normal. There is a positive correlation of Inhibin A serum level with preeclampsia. [Indones J Obstet Gynecol 2011; 35-1: 36-9] Keywords: inhibin A serum, normal pregnancy, preeclampsia
Effect of Spontaneous Delivery and Elective Caesarean Section on Number of Bifidobacterium Colony in Newborns Engga L. Erwanto
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To know the effect of vaginal delivery and elective caesarean section in total colony of bifidobacterium in newborn’s faeces. Method: All the research subject who has fulfilled the inclusion criteria, the newborn’s faeces taken on the 3rd to 4th day after delivery. One cc of faeces diluted into 9 cc thioglycolate in a sterile tube and sent to the Microbiology Laboratory of Hospital of Dr. M. Djamil Padang for the examination of colony of bifidobacterium. Data was processed and analized statistically. Result: The sample was taken from 41 research subject of vaginal delivery and 41 research subject of elective caesarean section. The average of total colony of bifidobacterium in newborn’s faeces with vaginal delivery is 23,588,220 CFU/gram and the average of total colony of bifidobacterium in newborn’s faeces with elective caesarean section is 4,151,829.3 CFU/gram. Conclusion: Total colony of bifidobacterium in newborn’s faeces with vaginal delivery is higher than elective caesarean section, and proved statistically significant (p < 0.05). [Indones J Obstet Gynecol 2011; 35-2: 49-52] Keywords: bifidobacterium, vaginal delivery, caesarean section
Comparison of Fibrinogen Level Changes between Pregnancy with History of Abortion and Normal Pregnancy Robbi A. Wicaksono
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To know the change of fibrinogen level in pregnancy with history of abortion and normal pregnancy on 6 - 8 weeks pregnancy and 10 - 12 weeks pregnancy. Method: This is a comparative study analytic comparative with cross sectional method on both groups, pregnancy with history of abortion and normal pregnancy. Observe the changes of fibrinogen level on 6 - 8 weeks pregnancy and then on 10 - 12 weeks pregnancy in pregnancy with history of abortion and normal pregnancy. Result: Comparison of mean fibrinogen level between 6 - 8 weeks pregnancy and 10 - 12 weeks pregnancy, on both group showed that the fibrinogen level in the group with history of abortion increased 9.6% and in the group of normal pregnancy increased 11.4%. The raise on both group was not significant stastistically (p = 0.810). The raise fibrinogen level on normal pregnancy was significant (p < 0.001), while on pregnancy with history of abortion is not significant (p = 0.255). All patterns of raise and fall on fibrinogen level on both groups were not stastistically significant (p > 0.005). Conclusion: Fibrinogen level on 10 - 12 weeks pregnancy was not lower than on 6 - 8 weeks pregnancy in pregnancy with history of abortion. There was no significant raise changes in fibrinogen level on both groups. [Indones J Obstet Gynecol 2011; 35-2: 53-6] Keywords: abortion, fibrinogen, haemostasis, history of abortion, normal pregnancy
Pregnancy Exercise Reduce Oxidative Damage in Pregnant Women Freddy W. Wagey
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To determine the effect of exercise during pregnancy in reducing oxidative damage marked by decrease of malondialdehyde (MDA) and 8-hydroxy-2-deoxy-guanosine (8-OHdG) levels. Method: A number of 66 pregnant women were recruited in this study and grouped to two groups, i.e. 30 of them as control group and the rest as treatment group. Pregnancy exercise was performed to all 36 pregnant women from 20 weeks gestation on treatment group. The exercise was performed in the morning for about 30 minutes, twice a week until fullterm. Blood sample was taken for MDA and 8 OHdG level at the beginning of research, at 20 weeks of gestation, and at intial delivery or fullterm. Student’s t-test was applied to compared the difference between treatment and control group with 5% significant value. Result: This study reveals that there were significant decrease of MDA and 8-OHdG level amongs treatment and control groups (p < 0.05). Conclusion: Light exercise started from pregnancy age 20 weeks will decrease MDA and raised 8-OHdG levels compared to control group without exercise. [Indones J Obstet Gynecol 2011; 35-2: 57-60] Keywords: oxidative stress, malondialdehyde, 8-hidroxy-2- deoxy-guanosine
Review of Preterm Labour Cases at Dr. Cipto Mangunkusumo Hospital January – December 2009 Andi Fatimah
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To describe and to evaluate preterm labour cases and management at obstetric emergency room of Dr. Cipto Mangunkusumo Hospital (RSCM) from January until December 2009. Method: This is a cross-sectional study with 202 secondary data samples from stratified random sampling performed to all preterm labour cases at obstetric emergency room of RSCM from January until December 2009. The data were processed for frequencies and bivariate analysis, and then further analyzed with multivariate analysis. Result: Most of the patient’s age were between 17 to 35 years old (82.7%). Most of them belonged to preterm group or gestational age between 32 weeks to less than 37 weeks (69.8%). Fifty three percent of the preterm labour was caused by premature rupture of the membrane. About 47% of the babies had perinatal morbidity and the most morbidity cases was respiratory distress with septic condition (47.7%). Perinatal mortality only happened to 5.9% babies. From bivariate analysis, low socioeconomic level (p = 0.032), gestational age (extreme preterm p = 0.000, very preterm p = 0.000), APGAR Score minute 1 < 7 (p = 0.000), APGAR Score minute 5 < 7 (p = 0.000) and preterm baby status (Small for Gestational Age p = 0.048) were the variable which influenced the perinatal morbidity in our hospital. Perinatal mortality was influenced by low socioeconomic level (p = 0.048), gestational age (extreme preterm p = 0.000, very preterm p = 0.063), APGAR Score minute 1 < 7 (p = 0.000), APGAR Score minute 5 < 7 (p = 0.000) and also morbidity of the preterm baby (p = 0.000). In this study, we found there was significant relation between cases of membrane rupture and perinatal sepsis (p = 0.000; RR 5.98; 95% CI 2.72 - 13.39) but there was no significant relation between cases with or without membrane rupture compared to active or expectant management to the perinatal morbidity and mortality. From multivariate analysis, APGAR score minute 5 < 7 had the greatest influence to the perinatal morbidity and preterm baby morbidity had the greatest influence to perinatal mortality. Conclusion: Perinatal morbidity and mortality caused by preterm labour in Dr. Cipto Mangunkusumo Hospital were influenced by several factors which are socioeconomic status, APGAR score, preterm baby status and also morbidity of the baby. Therefore we need to do comprehensive prevention in biologic and socioeconomic condition of the patients. Expectant management in preterm labour cases should be made on many consideration since expectant management was proven had no correlation with good perinatal morbidity and mortality outcome. [Indones J Obstet Gynecol 2011; 35-2: 61-6] Keywords: preterm labour, risk factor, perinatal morbidity, perinatal mortality
The Unique Presentation of Massive Ascites Complicating Severe Preeclampsia and HELLP syndrome Jimmy P. Wirawan
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To describe a rare case of massive ascites complicating severe preeclampsia and HELLP syndrome. Method: Reporting a case experienced and taken care in our hospital. Result: We report a case of Mrs L, 29 years old, gravid 1, admitted at 35th week gestation, with preeclampsia, HELLP syndrome (thrombocyte 49000/ul, LDH 888 U/l), and IUFD. We found ascites pre-operatively. Cesarean section was conducted. As much as 1.5 litre of ascites was evident during CS. We put intra-abdominal drain and ascites was about 4300 ml, 3800 ml and 1200 ml on 1st, 2nd and 3th day. Patient was discharged after five days of care. One week follow up, patient came with good condition and controlled blood pressure and clinically no evident ascites. Conclusion: Preeclampsia is one of the major causes of maternal mortality and morbidity in the world. Manifestation of preeclampsia can range from mild preeclampsia to full blown eclamptic condition. Herein we presented a case of massive ascites complicating severe preeclampsia and HELLP syndrome. [Indones J Obstet Gynecol 2011; 35-2: 67-9] Keywords: massive ascites, preeclampsia, HELLP syndrome
Effect of Ovarian Stimulation with Recombinant FSH for In Vitro Fertilization (IVF) on Anti Müllerian Hormone (AMH) Levels as an Early Marker of Ovarian Reserve Kartika Hapsari
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To analyze the effect of ovarian stimulation with recombinant FSH on AMH levels as a marker of ovarian reserve in patients undergoing IVF. Method: This study is an intervention study which compares AMH levels pre- and post-ovarian stimulation with recombinant FSH in IVF participants to determine the effect of ovarian stimulation on ovarian reserve. This study was conducted at Dr. Cipto Mangunkusumo Hospital, Jakarta, from January to July 2010. AMH levels measured are AMH levels pre- and post-stimulation taken on the day of hCG evaluation. Result: Of 56 patients undergoing IVF treatment, 20 subjects were eligible for study. The mean age of the patients was 35. 3 ± 4.0 years, the mean duration of infertility 9.1 ± 5.7 years, the mean BMI 21.9 ± 3.4 kg/m2, the median AMH level pre-stimulation was 4.0 ng/ml and the total dosage of FSH used was 2747.5 ± 1076.3 IU/ day, the mean duration of ovarian stimulation was 9 ± 3 days. Of the 20 subjects recruited, 11 patients (55%) had a decrease in AMH levels, and the remaining 9 patients (45%) did not. Data analysis showed that the decrease in AMH levels was not statistically significant (p = 0.295) [AMH1; median 4.0 ng/ml (range 2.2 - 5.9) and AMH2; median 3.2 ng/ml (range 1.6 - 4.8)]. Conclusion: AMH levels decrease following ovarian stimulation with recombinant FSH is not statistically significant, so it can be concluded that ovarian stimulation in IVF has no effect on ovarian reserve. [Indones J Obstet Gynecol 2011; 35-2: 70-3] Keywords: ovarian reserve, AMH, recombinant FSH, ovarian stimulation, IVF
Measurement of Glucose/Insulin Fasting Ratio (G:I Ratio) for Insulin Resistance Identification on Polycystic Ovary Syndrome Patients Fidel G. Siregar
Indonesian Journal of Obstetrics and Gynecology Volume. 35, No. 2, April 2011
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Abstract

Objective: To identify insulin resistance on PCOs patients and to know characteristics and clinical differences between PCOs patients with and without insulin resistance in Gynecologic Outpatient Clinic of H. Adam Malik Hospital, Clinic of Prof. Delfi Lutan, Clinic of Prof. Thamrin Tanjung and Clinic of Halim Fertility Center in Medan. Method: This descriptive cross sectional study conducted from July 2008 - June 2009, diagnosis of PCOs based on Rotterdam’s criteria was drawn for 5 ml blood samples, from mediana cubiti vein, after 10 - 12 hours fasting for determination of fasting glucose, fasting insulin, LH, FSH, prolactin and testosterone. Insulin resistance was determined by glucose/insulin fasting ratio < 4.5. Result: From sixty one patients were divided into PCOs without insulin resistance (50 patients; 82%) and PCOs with insulin resistance (11 patients; 18%) group. No significant differences in clinico-biochemical characteristics, fasting glucose mean level, menstrual pattern, ovary volume, follicle number and reproductive hormone profile of two groups, except in BMI value, fasting insulin level and G:I ratio (p < 0.05). Conclusion: There was significant correlation between fasting insulin level and insulin resistance with mean of fasting insulin level of 24.882 μU/ml. Insulin resistance was frequent on overweight group study according to WHO criteria (BMI 25 - 29.9 kg/m2). [Indones J Obstet Gynecol 2011; 35-2: 74-8] Keywords: insulin resistance, polycystic ovary syndrome, G:I ratio

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