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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 1,760 Documents
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Atypical Findings of Suspect Twin to Twin Transfusion Syndrome Quintero V: a Rare Case Report Gusasih, Bahar Sangkur; Irianti, Setyorini; Aziz, Muhammad Alamsyah; Kurniadi, Andi
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2352

Abstract

Introduction: Twin-to-twin transfusion syndrome (TTTS) is a serious complication in monochorionic multiple pregnancies. Case Illustration: A-38 years old woman with G3P2AO felt 8 months pregnant and came for polyclinic control with the diagnosis of G3P2A0 gravida 34-35 weeks; Gemelli; Baby I Breech position; Baby I Polyhydramnios, IUFD; Suspected Twin Twin Transfusion Syndrome (TTTS Quintero V). However, atypical findings of TTTS are rarely found and should be taken as special notes such in this case. We will report a rare finding of TTTS in which the SDP level of the donor fetus was normal (not oligohydramnios). The suspected diagnosis of TTTS Quintero V in this case was made clinically based on the maternal-fetal ultrasound findings of a diamniotic monochorionic gemelli pregnancy with IUFD in the 2nd fetus II. However, there were non-standard findings in this case where the SDP level of the donor fetus was normal (not oligohydramnios). No other sequele complications were found in this case based on other examinations. Conclusions: Several therapies are available for TTTS including amnioreduction, laser ablation of the vascular placental anastomosis, selective feticide, and septostomy. Timing of delivery after management of singleton fetal death in the late second or early third trimester is debatable. Delivery method is determined based on obstetric indications.
The value of intrapartum ultrasound in predicting mode of delivery: A prospective cohort study Omar, Gamal; Marwa F Sharaf; Mohammad A. Taymour
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2526

Abstract

Abstract Objectives: Ultrasound contributes significantly to management of labor, delivery and prevention of adverse maternal and fetal outcomes. Among many suggested intra-partum ultrasound parameters, the use of transperineal ultrasound scan to assess the angle of progression (AoP) and levator hiatus anteroposterior diameter (APD) has been suggested to result in a more objective evaluation of labor progress. The aim of this study was to assess this claim. Methods: This was a prospective observational cohort study involving primparous term singleton vertex presentation pregnant patients >18 years old admitted in the first stage of labor between January 2021 and May 2023. All patients provided an informed written consent. This investigation utilized both transabdominal and transperineal ultrasonography for comprehensive fetal and pelvic floor assessment. Transabdominal ultrasound evaluated standard parameters including fetal occiput position, biometry number, viability, presentation, and estimated fetal weight. Intrapartum transperineal ultrasonography, specifically performed during the first stage of labor, focused on the Levator Hiatus, measuring its anteroposterior diameter (APD) at rest and during Valsalva maneuver, as well as the angle of progression (AOP). Results: The study population comprised 609 participants with a mean age of 22.8 ± 4.3 years and a high prevalence of being overweight and obesity (38.8% and 57.8%, respectively). When comparing patients who had an intrapartum CS to those who had a normal vaginal delivery (NVD). However, on logistic regression, age, BMI, gestational age, posterior occiput presentation, head circumference (HC), AOP (V) and APD (V) as significant predictors for both ICS and 2nd stage CS (p<0.05). Conclusion: This study demonstrated that maternal age, BMI, gestational age, occiput posterior position, Angle of progression at Valsalva and levator hiatus anteroposterior diameter at Valsalva were independent significant predictors for Intrapartum cesarean section in primiparous women at term When the ratio between HC/APD at rest, BPD/APD at Valsalva and HC/APD at Valsalva is high, while the APD at Valsalva, AoP Valsalva values are low, cesarean section was more likely to be the mode of delivery. Keywords: Intrapartum ultrasound, angle of progression, anteroposterior diameter of levator hiatus, mode of delivery, intrapartum cesarean section.
Evaluation of Estradiol and Pro-Inflammatory Marker Level with VAS Score After Progestin Therapy in Endometriosis Patients Muthalib, Aidrus; Sumapraja, Kanadi; Harzif, Achmad Kemal; Maidarti, Mila
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2531

Abstract

Objectives: To compare estradiol levels and proinflammatory biomarkers (IL-6, IL-1B, and COX-2) in endometriosis patients with pain and without pain after progestin therapy. Methods: This observational cross-sectional study involved 47 endometriosis patients undergoing three months of progestin therapy at RSUPN Cipto Mangunkusumo from March to June 2024. Serum levels of COX-2, IL-6, IL-1B, and estradiol will be measured using ELISA and Microplate Enzyme Immunoassay, with pain status assessed to determine associations between biomarkers and pain presence. Results: A significant difference in COX-2 levels between patients with pain and those without, with higher levels in the pain group [1.845 (1.24-10.26) vs 1.55 (0.32-3.07), p = 0.004]. A significant positive correlation was found between IL-1Beta and IL-6 (r = 0.471, p = 0.001). COX-2 levels also exhibited a weak but statistically significant positive correlation with VAS scores (r = 0.360, p = 0.013). Conclusion: There is a difference in inflammatory markers IL-6, IL-1 Beta and COX-2 in endometriosis patients with progestin therapy who experience pain and painlessness. Keywords: endometriosis, estradiol, proinflammation, progestin therapy.
Stem Cell Therapy in Urogynecology – Expanding Horizons in Regenerative Medicine santoso, Budi I
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 4 October 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i4.2587

Abstract

From Diagnosis to Management: A Rare Case of Disseminated Low-Grade Endometrial Stromal Sarcoma with Extensive Extrauterine Spread Djatikusumo, Adrian; Prastisia, Yulian; Effendi, Iwan Kurnia; Wasystha, Wina Kanya
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.1893

Abstract

Objective: To report a rare case of low-grade endometrial stromal sarcoma; which was found not only in the uterus but also in several extrauterine sites, such as the ovary, omentum, and jejuno-ileum. In this article, we provided the management performed, based on appropriate literatures. Methods: Case report. Case: A 44-year old para 2 complained of abdominal enlargement since 3 months. Patient also complained of pelvic pain. The patient has never received treatment before and has never been diagnosed with endometriosis. Abdominal examination revealed a 20-cm mass in the lower to umbilical region and positive shifting dullness. Bimanual pelvic examination revealed immobile and smooth masses in both sides of adnexa, with pain during palpation. Computerized tomography (CT) scan of the abdomen revealed complex cystic masses suspected for right and left ovaries-origin (±11 & 15 cm respectively) Surgical resection and staging, frozen section, cytology examination, and immunohistochemistry (IHC) test were performed, revealing consistent result of endometrioid stromal sarcoma, low grade. Five-months postoperative follow-up through abdominal CT-scan in the patient revealing no abnormalities. Conclusion: We know that LG-ESS is one of the rare types of endometrial stromal sarcoma. Moreover in this case extrauterine manifestations make it more challenging in clinical management. Risk factors and history of endometriosis are important to explore when meeting ESS cases. Further research needs to be done regarding the exact mechanism and the association between endometriosis or other risk factors and the development of ESS, especially the EESS type to allow intervention. Keywords: uterine sarcoma, endometrial stromal sarcoma, management.
Preeclampsia with Acute Pulmonary Edema Gunawan, Yuliana Wydia; Purwoatmojo, Sunarko; Prasetyo, Anton Tri; Pamungkas, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.1974

Abstract

Objective: Describe the initial management for severe pre-eclampsia complicated with acute pulmonary edema. Methods: A case report. Case: 41 years old woman, G5P4A0, unknown gestational age, admitted with headache, dyspnea, and unconsciousness. The patient denied a history of past illness. Vital signs were checked, and crisis hypertension, tachypnea, tachycardia, and low oxygen saturation were obtained. Physical examination showed audible lung crackles and leg edema. Proteinuria +3 was detected. For initial management, the patient was given oxygen with Jackson-Rees bagging, Nicardipine drip, MgSO4 injection, and Furosemide injection. After the patient was fully conscious and stable in the ICU, the patient reported contractions with pelvic examination marked 8 cm dilatation. The patient underwent vaginal delivery and gave birth to a male, BW 2900gram, BL 47cm, APGAR 3/8. Discussion: Increased plasma volume, cardiac output, vascular permeability, peripheral vascular resistance, and decreased oncotic pressure are the causes of pulmonary edema in preeclampsia. According to Wallace et al, lowering blood pressure, giving adequate oxygen, and fluid restriction are the main management of pulmonary edema in preeclampsia. The correct initial management in the ER gives a good output on this case report. Conclusion: Initial management of acute pulmonary edema in pre-eclampsia patients should be done correctly, consequently decreasing maternal and fetal morbidity and mortality. Keywords: pregnancy, severe pre-eclampsia, pulmonary edema.
Accuracy of Transperineal Ultrasoun Examination in Predicting Vaginal Delivery Rauf, Fauzia Tamara; Chalid, Maisuri Tadjuddin; Lukas, Efendi; Susiawaty; Farid, Monika Fitria; Hamid, Firdaus
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2184

Abstract

Unraveling Of Urinary Disorders to Adenomyosis and Dysmenorrhea darto, darto; Anggraeni, Asih; Ngudi Insan Ksyatria, Yudhistira; Alifa, Rosita; Farras Wahdan, Arib; Retno Budihastuti, Uki; Laqif, Abdurahman; Melinawati, Eriana; Prakosa, Teguh; Udiyanto, Hermawan; Priyanto, Heru; Angelia Ratnasari, Affi
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2203

Abstract

Objective : This study aims to explore the relationship between micturition disorders and adenomyosis and dysmenorrhea and provide insight into the factors associated with the severity of LUTS symptoms in these conditions. Methods : This study was a descriptive qualitative study. We retrospectively collected medical record data from the Obstetrics Gynecology Outpatient Ward of Dr. Moewardi Surakarta General Hospital in the period January 2021 to May 2023. The results of this study analyzed using Pearson correlation analysis if normally distributed and using Mann-Whitney if not normally distributed, thus, statistically analyzed. Results: There is a significant relationship between adenomyosis and dysmenorrhea on urinary disorders (p value of 0.016) where urinary disorders are found to be more severe in adenomyosis patients with dysmenorrhea. Conclusion : Lower urinary tract symptoms are common in symptomatic adenomyosis patients and greatly affect the patient's quality of life. Dysmenorrhea can be a potential risk factor that increases the occurrence of moderate to severe LUTS. Keywords: adenomyosis; dysmenorrhea; urinary disturbance.
The Age as a Risk Factor for Advanced Stage in Cervical Cancer Patients at RSUPN Cipto Mangunkusumo 2019-2022: A Retrospective Multivariate Study Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Purwoto, Gatot; Wulandari, Anisa Saphira; Soloan, Garry; Sini, Kieran Pasha Ivan; Utami, Tofan Widya; Anggaraeni, Tricia Dewi; Putra, Andi Darma; Nuryanto, Kartiwa Hadi; Winarto, Hariyono
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2366

Abstract

Abstract Introduction: In 2020, cervical cancer ranked as the fourth most common cancer in women globally, with an incidence of 604,000 cases. In Indonesia, cervical cancer holds the second position among the most prevalent cancers in women. This study aims to evaluate the relationship between age and the occurrence of advanced-stage cervical cancer as a step towards effective prevention, early detection, and management. Methods: This research adopts a retrospective study design based on the Cancer Registration database of RSUPN Cipto Mangunkusumo, focusing on cervical cancer patients from 2019 to 2022. Multivariate analysis was conducted with age as the primary independent variable, considering parity and employment status in the analysis. The FIGO classification of cervical cancer stages was used to categorize patients into early and advanced stages. Results: Out of 512 cervical cancer cases, 492 were included in this study. The distribution of cervical cancer stages and the age distribution of patients is depicted in Figure 1 and Figure 2. The analysis of the relationship between cervical cancer stage, age, parity, and employment status is presented in Table 2. The association between age and cervical cancer stage is statistically significant (p<0.05) with an odds ratio of 2.13, particularly in individuals aged >54 years. Conclusion: Age over 54 years is a significant risk factor for advanced-stage cervical cancer. Although there is no significant association with parity and employment history, these findings support preventive and early detection efforts in the older population. Increased screening programs and education are expected to reduce cases of advanced-stage cervical cancer in the future.
Leptin Expression in High-grade Serous Ovarian Carcinoma: The Controversy of Leptin Paradox in Ovarian Cancer Ham, Jonathan; Masadah, Rina; Nasser, Andi Sitti Halija Diawanti; Rauf, Syahrul; Nelwan, Berti Julian; Cangara, Muhammad Husni; Miskad, Upik Anderiani; Mardiati; Tawali, Suryani
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 1 January 2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i1.2373

Abstract

Objectives : To analyse the characteristics and expression patterns of Leptin in high-grade serous epithelial ovarian carcinoma (HGSC), and to compare them with the overall serous ovarian carcinoma population. Methods : This was a cross-sectional study. A total of 77 paraffin-embedded tissue samples were collected from patients at the Wahidin Sudirohusodo Hospital over a period of 3 years. Immunohistochemical staining was performed using a polyclonal Leptin antibody. Data were analyzed using SPSS version 22.0. Results: Among HGSC patients, the majority (64.3%) were over 50 years old, and a significant portion (39.3%) were obese. Leptin showed strong cytoplasmic expression in 69.6% of HGSC tumor cells and in 100% of LGSC tumor cells (p-value = 0.004). There was no correlation between lymphovascular space invasion and leptin expression. Interestingly, leptin expression in overall serous ovarian carcinoma patients exhibited a protective effect against metastasis (p-value = 0.047), suggesting a leptin paradox exists in this type of cancer. However, this association was no longer significant when the analysis excluded the LGSC group (p-value = 0.193). Conclusion : This study suggest that leptin expression may not be a significant prognostic factor in HGSC. The appearance of the pseudo-leptin paradox phenomenon in several previous studies was confounded by sample populations with heterogeneous tumor morphology. Keywords: high-grade serous carcinoma, leptin paradox, immunohistochemistry, leptin, obesity

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