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Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)

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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.

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Articles 1,731 Documents

130 131 132 133 134

Human Papilloma Virus L1 Gene Methylation as a Potential Biomarker for Precancerous Cervical Lesion: a Preliminary Report Suzanna P Mongan; Andrijono Andrijono; Hartono Tjahadi
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine whether HPV L1 gene methylation can be used in triage of precancerous cervical lesions. The main objective is to determine the genotype of HPV in cervical precancerous lesions and to determine the percentage, the sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio of DNA HPV L1 methylation in precancerous cervical lesions. Methods: A number of 57 samples of paraffin blocks (FFPE) from precancerous lesions and cervical cancer biopsies in the Department of Pathology Faculty of Medicine-Cipto Mangunkusumo General Hospital that had been re-evaluated by the pathologist, underwent extraction of HPV DNA. The genotypes of HPV DNA were examined using primers GP5 / 6 and specific HPV 16, HPV 18 and HPV 52 probes and analyzed by real time PCR. Sequencing was performed on samples with unknown HPV DNA type that were detected using the specific probes to determine the type of HPV. Bisulfite conversion procedure was then performed for the samples that met the inclusion criteria. Results: There were 30 samples (52.6%) with CIN 1, 12 samples (21.1%) CIN 2, 9 samples (15.8%) CIN 3 and 6 samples (10.5%) of cervical cancer. Most of the samples were 36-45 years (35.1%). Of the total 57 samples, 55 samples were successfully extracted and determined the DNA genotyping of HPV (96.5%). HPV 16 infections both in the form of single or multiple was found to be 76.36%. The samples were mostly dominated by co-infection of HPV16 and 18 (49.1%) followed by HPV 16 (24.6%) and HPV 18 (14.0%). Based on the sequencing results there were other types of high risk HPV infection found: HPV 33, HPV 35, HPV 58 and also undeterminate risk HPV 53 and low risk HPV 54. After several procedures of optimization for methylation examination of HPV DNA L1 there was thin band found in electrophoresis procedure in 8 of 42 samples (19%) of HPV 16 after bisulfite conversion but once it was purified there werenâ€™t any band found so we can not proceed to the stage sequencing. Until now we are still in the stage of optimizing the methylation procedure. Conclusion: HPV 16 infection were most commonly found in the form of single or multiple. Co-infection of HPV 16 and 18 were found in the majority of the samples. There were no significant correlation between HPV type and the severity of cervical lesions. Until now, the examination of DNA methylation HPV L1 already obtained eight samples of HPV 16 with a thin band on electrophoresis but the result could not be concluded because it is still in the process of optimization. [Indones J Obstet Gynecol 2017; 5-2: 120-126] Keywords: HPV DNA genotype, L1 gene methylation, precancerous cervical lesions

Tenage Pregnancy Ariawan Soejoenoes
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Sexual activity among teenagers has been increasing over the past decade, accompanied by younger age at first intercourse which is associated with inconsistent or nonuse of contraception. Problems become more complex because the onset of puberty is earlier than before and sociocultural and religious norm are less stringent, leading to greater opportunities to have pre-marital sex.1 Between 2011 and 2020, more than 140 million girls will become child brides, according to the United Nations Population Fund (UNFPA).2 If current levels of child marriages hold, 39.000 girls daily will marry too young.1 "Complication of pregnancy and childbirth are the leading cause of death in young women aged 15 - 19. Young girls who marry later and delay pregnancy beyond their adolescence have more chance to stay healthy, get higher education, and build a better life.", says Flavia Bustreo, MD, the Assistant Director-General for Family, Women and Childrenâ€™s. The prevalence of teenage pregnancy in industrialized differs in developing countries. In developed regions, teen parents tend to be unmarried, and adolescent pregnancy is seen as a social issue. By contrast, teenage parents in developing countries, such as in the WHO SEARO regions and in S.E. Asia countries, including Indonesia, are often married and their pregnancy maybe welcomed by family and society. However, in these societies, early pregnancy is usually accompanied by malnutrition and poor health care to cause medical problems.3 A report by Save the Children found that 13 million children are born to women under 20 worldwide each year, more than 90% of these births occur to women living in developing countries. The complications of pregnancy and childbirth are the leading causes of mortality among women between the age of 15 and 19.4 Resources about teenage pregnancy in Indonesia are scarce. The following data were derived from a keynote speech by the Minister of Health of the Republic of Indonesia, at the Annual Scientific Meeting of HOGSI, in Banjarmasin 2015: 38.5% and 18.4% of 22.136.584 teenage women with protein energy deficiency were pregnant and anemic, respectively. Furthermore, the pregnancy rate was 48 per 1000, the total life birth was approximately 4.809.304, and 40% of teenage mothers ended their education. Further reports have identified that premarital sex is uncommon in India, but early marriage often occurs, which means that the rate of adolescent pregnancy is high in that country. The rate of teenage pregnancy in rural regions are higher than in urbanized areas such as South Korea and Singapore. In these areas, marriage before age 20 is rare. Although the occurrence of sexual intercourse before marriage has risen, the rate of adolescent child bearing are low, approximately 4 to 8 per 1000. In Indonesia, the rate of early marriage and pregnancy has decreased sharply; however, it remains high compared to the rest of Asia. According to the World Health Organization, in several Asian countries including Bangladesh and Indonesia, maternal causes contributed a large proportion (26 - 37 %) of death among female adolescents.5 The Importance of Prevention Teenage pregnancy and childbearing bring substantial social and economic burden through immediate and long term impact on teenage parents and their children.6 Pregnancy and birth are significant contributors to high school drop outs rates among girls, only about 50% of teen mothers receive a high school diploma by 22 year of age, where as approximately 90% of woman who do not give birth, during adolescent graduate from high school. Adolescent pregnancy (i.e., in females 13 to 19 years of age) is associated with an increased risk of maternal complications during pregnancy and delivery as well as an increased risk to the fetus. Complications that are associated with adolescent pregnancy include preterm delivery, low birth weight, and infant mortality. The complications are usually are associated with behavioral, psychosocial, and economic factors. Therefore, psychosocial risk factors should be the main focus of care.7 In general, focus priorities should be given to young adolescents before the age of 15, in which relatively high proportion of young boys and girls already have sexual intercourse, and childbearing in some cases. Teenage pregnancy is one of the causes of the failure, making the goals United National Millenium Development Goals 4 and 5 failed to be accomplished. Adolescent pregnancy is a high risk, and has considerable impact in both physical and psychosocial aspects. Youth - friendly services with sensitive counseling, high quality obstetric and antenatal care, as well as a range of safe and affordable contraceptive methods should be available.

Increased Rate of Cesarean Section among Teenage Mothers Attending a Tertiary Teaching Hospital in Indonesia: Peningkatan Angka Seksio Sesarea pada Ibu Remaja yang Datang keSuatu Rumah Sakit Pendidikan di Indonesia I Putu G Kayika; Teuku K I Utama
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate adverse obstetrical outcome in teenage pregnancy, and to investigate whether the social factor, demographic factor, and antenatal care is associated with the management of delivery in teenage pregnancy. Methods: A cross-sectional study was conducted by evaluating medical records teenage mothers who went to Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia during the period of January 2010 to December 2015. Results: From 186 teenage pregnancies, 75 pregnancies was terminated by cesarean section procedures (40.3%). The amount of antenatal care visit was significantly associated with teenage pregnancy (OR 4.14, CI95% 1.86-9.21). The provider of antenatal care, maternal age classification, education, and insurance were not signifcantly associated with management of labour. Conclusion: Teenage pregnancy is associated with higher cesarean section rate. [Indones J Obstet Gynecol 2017; 5-3: 131-134] Keywords: cesarean section, profile, teenage pregnancy

Effect of Artesunate on Peripheral Parasitaemia in Pregnant Women with Plasmodium Falciparum Infection: Efek Artesunat pada Perempuan Hamil dengan Infeksi Plasmodium Falciparum terhadap Kejadian Parasitemia Perifer Susi W Saragih; St. Maisuri T. Chalid; Umar Malinta; Isra Wahid
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the effect of artesunate on peripheral parasitaemia in pregnant women with Plasmodium falciparum infection. Methods: Pregnant women in second and third trimester with Plasmodium falciparum infection and their newborns were included in cohort prospective study in Sorong West Papua from September 2015 to February 2016. All pregnant women received 200 mg orally artesunate monotherapy for 7 days. Their newborns examined for weight at delivery and parasitaemia in placenta and cord blood. Parasitaemia diagnosis by Rapid Diagnostic Test and blood smear microscopy. Results: After artesunatemonotherapy, 82.5% (33/40) malariainfected pregnant women had negative parasitaemia (p=0.000) although 17.5% (7/40) of the pregnant women had positive parasitaemia. Parasitaemia also found in 10% (4/40) of placenta and 7.5% (3/40) of umbilical cord from newborns of malaria-infected pregnant women treated with artesunate. 70% (28/40) of the newborns in this study had normal weight. Conclusion: Artesunate reduces peripheral parasitaemia in the second and third trimester of pregnancy, and is associated with normal birth weight. [Indones J Obstet Gynecol 2017; 5-3: 135-138] Keywords: artesunate, low birth weight, peripheral parasitaemia

The Side Effects of Intracesarean Intrauterine Contraception: A Descriptive Study: Efek Samping Pemasangan Alat Kontrasepsi dalam Rahim (AKDR) Intrasesarea: SuatuS tudi Deskriptif Karol A Rumopa; John Wantania; Joice Sondakh
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the side effects and acceptance of intracesarean Intrauterine Device (IUD) insertion. Methods: This was a descriptive study. Subjects were all pregnant women who had Cu T380A IUD to be placed after cesarean delivery at Prof. Dr. dr. R. D. Kandou Hospital during the period between August 2016 and September 2016. Results: A total of 52 subjects were recruited in this study.43 (82.69%) subjects were in the age group of 20-30 years. 51 of the subjects accepted the IUD. On the 7th day, 49 (94.23%) and 51 (98.07%) subjects complained of abdominal pain and vaginal bleeding, respectively, while on the 14th day, 48 (92.3%) and 50 (96.1%) subjects had abdominal pain and vaginal bleeding, respectively. There were significant decreases in both complaints on the 14th day, compared to the 7th day. (p<0.05 and p<0.05, respectively). 51 (98.07%) subjects accepted the IUD. There were no significant difference between acceptance on day 7 and 14th (p>0.05). Conclusion: The acceptance of side effects by the acceptor reaches 100%, with the incidence of early postpartum expulsion is 3.8%. The side effects of IUD are minimal. [Indones J Obstet Gynecol 2017; 5-3: 139-141] Keywords: intra-cesarean, intrauterine device, side effects

The Role of HLAC and NK Cells in Fetal Growth Restriction: Peran HLAÂC dan Sel NK pada Pertumbuhan Janin Terhambat Sri Sulistyawati; Didon M Trimulya; Supriyadi H Respati; Soetrisno Soetrisno
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the role of HLA-C and NK cell expressions in fetal growth restriction (FGR). Methods: A cross sectional study design was used. This study was conducted at the Obstetrics and Gynecology Department of Dr. Moewardi General Hospital, Surakarta, its affiliated hospitals, and at the Pathological Anatomy Laboratory of the Faculty of Medicine, University of Sebelas Maret Surakarta. A total of 40 samples were included in this study. The samples consisted of 20 normal pregnancies and 20 pregnancies with FGR. HLA-C expression in the trophoblast and NK cells in decidua of the subjects who met the inclusion and exclusion criteria were examined using immunohistochemical method and statistical analysis with T test. Results: The mean expression of HLA-C in the trophoblast in the pregnant group with FGR was 9.02ï‚±1.30, normal pregnancy was 7.96 Â± 0.97, p=0.01 (p<0.05). The mean expression of NK cells in decidua of pregnancy with FGR was 10.59 Â± 2.11, normal pregnancy was 0.91 Â± 8.18, with p=0.00 (p<0.05). Conclusion: The expressions of HLA-C in trophoblast and NK cells in decidua of pregnancy with FGR were higher compared with those of normal pregnancy. [Indones J Obstet Gynecol 2017; 5-3: 142-148] Keywords: fetal growth restriction, HLA-C, NK cells

The Role of Genital Hiatus (Gh), Perineal Body (Pb), Summation (Gh+Pb) of POP-Q Examination in Maximum Levator Hiatal Area of Women with Symptomatic Pelvic Organ Prolapse: Peran Hiatus Genitalis, Badan Perineum dan Penjumlahannya dari Pemeriksaan Pop-Q pada Luas Area Hiatus Levator Maksimal pada Perempuan dengan Prolaps Organ Panggul Simtomatik Kukuh W Kustarto; Fernandi Moegni
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: to provide data on the correlation of levator hiatus area measurements in symptomatic POP using 3D / 4D Ultrasound with clinical examination of Gh, Pb and summation (Gh+Pb). Methods: Secondary data analysis of 160 POP patients examined from January 2012 to April 2017 at the Urogynecology Clinic RSCM, Jakarta. Taken data on patient characteristics, maximum 3D / 4D Ultrasound measurement of Levator Hiatus Area, and clinical measurement results using pelvic organ prolapse quantification system (POP-Q) Results: There was a positive correlation between clinical examination and measurement of hiatal area area using ultrasound with r = 0.43 for Gh length, and the medium correlation on the sum of Gh and Pb with r = 0,51. No correlation for Pb length with r = 0.23. The optimal cut to differentiate degrees 2 by 3 is 7.5 cm / 29.7 cm2 and degree 3 by 4 is 8.3 cm / 32.1 cm2. Conclusion: Clinical examination by summing the lengths of Gh and Pb may be consider reflects the examination of the hiatal area by using transperineal ultrasound to see the strain on levator ani called â€œballooningâ€ in an area with limited resources. Keywords: genital hiatus, levator hiatus area, pelvic organ prolapse, perineal body. Abstrak Tujuan: untuk memberikan data mengenai korelasi pengukuran area hiatus levator pada POP simtomatik mengunakan Ultrasonografi 3D/4D dengan pemeriksaan klinis yaitu panjang Gh, panjang Pb dan penjumlahannya. Metode : Analisa data sekunder sebanyak 160 pasien POP yang diperiksa dari Januari 2012 hingga April 2017 di poliklinik Urogynecology RSCM, Jakarta. Diambil data karakteristik pasien, pengukuran Ultrasonografi 3D/4D maksimal Area Hiatal Levator, dan hasil pengukuran secara klinis dengan menggunakan pelvic organ prolapse quantification system (POP-Q) Hasil : Terdapat korelasi positif antara pemeriksaan klinis dengan pengukuran luas area hiatal menggunakan USG dengan r = 0,43 untuk panjang Gh, dan korelasi pada penjumlahan Gh dan Pb dengan r=0,51 termasuk kategori sedang, sedangkan untuk panjang Pb dengan r = 0,23 tidak didapatkan adanya korelasi. Didapatkan titik potong optimal untuk membedakan derajat 2 dengan derajat 3 adalah 7,5 cm / 29,7 cm2 dan derajat 3 dan derajat 4 adalah 8,3 cm / 32,1 cm2 Kesimpulan : Pemeriksaan klinis dengan menjumlahkan panjang Gh dan panjang Pb dapat dipertimbangkan untuk mencerminkan pemeriksaan area hiatal dengan mengunakan USG 3 / 4 dimensi transperineal pada daerah dengan sarana terbatas untuk melihat regangan pada levator ani atau yang disebut sebagai â€œballooning Kata kunci : badan perineum, genital hiatus, hiatal levator ani, prolaps organ panggul.

Prediction of Vaginal Delivery Using Fetal Head Descent Assessed Using Transperineal Ultrasound: Penilaian Penurunan Kepala dengan USG Transperineal untuk Penentuan Keberhasilan Persalinan Pervaginam Yudianto B Saroyo; Mahendri D Danarti
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the use of transperineal ultrasound in predicting the successfulness of vaginal delivery. Methods: This was a prospective study conducted at Karawang District Hospital during the period between March 2016 and May 2016. Inclusion criteria were term pregnancy, singleton live head presentation, and active phase of labor. Using transperineal ultrasound, fetal head perineum distance, and angle of progression within relaxation phase between contraction were being calculated. Results: There were 306 subjects who delivered vaginally. The cut off value for fetal head perineum distance as a predictor of vaginal delivery was 43.5 mm (sensitivity 91%, specificity 78%), with area under a curve of 82% (95% CI 69 - 95%, p < 0.01); while angle of progression is 107Â° (sensitivity 80 %, specificity 97%), with Area under curve is 96.4% (95% CI 87 - 99%, p < 0.01). Conclusion: Fetal head perineum distance and angle of progression can predict the successfulness of vaginal delivery. [Indones J Obstet Gynecol 2017; 5-3: 149-153] Keywords: angle of progression, fetal head-perineum distance, prediction of vaginal delivery, transperineal ultrasound

Chronic Pelvic Pain and Associated Clinical Characteristics among Women in a Tertiary Care Center in Indonesia: Nyeri Panggul Kronis dan Karakteristik Klinis yang Berhubungan pada Perempuan di Suatu Layanan Kesehatan Tersier di Indonesia Kanadi Sumapradja; Thomas Chayadi
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the prevalence and various aspects associated with female chronic pelvic pain. Methods: During the period of January to March 2016, a crosssectional study was conducted at the Womenâ€™s Health Clinic of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Subjects were female who complained of pelvic pain for more than 6 months. We performed history taking, physical examination, and laboratory investigations including hs-CRP serum examination. We calculate the prevalence and describe the clinical characteristics and diagnosis of the patient. Quality of life and levels of hs-CRP were compared between the group of mild and severe pain. Results: In this study, the prevalence of CPP was 9.78%. We found 96.9% of gynecological disorders, 1% of urological disorders, and 2.1% of musculo-skeletal disorders. The most common diagnosis is endometriosis. The Clinical characteristics of patients were found 62.9% suffer for 6 months - 1 year with the intensity of pain (VAS) 7-10 as much as 51.5%. Levels of hs-CRP serum was around 1.99 (0.00 - 404, 53). We found a decreased in the quality of life of the patient. The physical domain score was 56 (38-81); the psychology domain score was 56 (31-100); the domain of social relationships was 59 (25-75); and the environmental domain score was 56 (31-94). Conclusion: Endometriosis is the most common diagnosis in female chronic pelvic pain of reproductive age. The pain causes a decreased in quality of life who suffer from it. [Indones J Obstet Gynecol 2017; 5-3: 154-159] Keywords: chronic pelvic pain, hs- CRP, intensity of pain, quality of life

External Validation of Endometriosis Fertility Index (EFI) in an Indonesian Population: A TwoCentre Prospective Study: Validasi Eksternal Endometriosis Fertility Index (EFI) pada Populasi Indonesia: Sebuah Studi Prospektif Herbert Situmorang; Dimas Radityo
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 3, July 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To externally validate EFI in an Indonesian population. Methods: A prospective study was performed in 59 reproductive aged women diagnosed with both endometriosis and infertility who underwent laparoscopic surgery in Dr. Cipto Mangunkusumo and Carolus Hospital during the period of December 2012 to June 2016. Subjects were followed up for two years. Results: Statistical analyses suggested that younger age, infertility duration ï‚£ 3 years, higher LF score, and AFS score below 71 were significantly associated with pregnancy (p<0.001, p<0.001, p=0.035, p<0.001, respectively). Pregnant subjects had significantly higher median EFI score compared to the not pregnant group [EFI score 7 (5-9) vs 4 (1-8), p<0.001)]. Conclusion: Higher EFI score was significantly associated with higher pregnancy rate. [Indones J Obstet Gynecol 2017; 5-3: 160-163] Keywords: endometriosis, fertility, index, infertility, laparoscopy, pregnancy

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