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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 1,778 Documents
Maternal Vitamin D and Its Role in Amniotic Membrane Thickness in Premature Rupture of Membranes Hafis Novyan; Rajuddin Rajuddin; Niken Asri Utami
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2013

Abstract

AbstractObjective: To examine the correlation between maternal serum vitamin D levels and amniotic membrane thickness in cases of premature rupture of membranes (PROM).Methods: This analytical cross-sectional study was conducted from July to November 2022 at Dr. Zainoel Abidin General Hospital, the Universitas Syiah Kuala Research Laboratory, and Prodia Banda Aceh Laboratory. A total of 30 women with term PROM who met the inclusion and exclusion criteria were enrolled. Serum vitamin D levels were measured using Electrochemiluminescence Immunoassay (ECLIA), while amniotic membrane thickness was assessed histologically using hematoxylin Eosin (HE) staining. Spearman’s correlation test was performed with a 95% confidence level.Results: Thirty mothers with PROM were included, with a mean age of 31.37 ± 6.8 years. Vaginal delivery was the predominant mode of delivery (53.3%). The mean serum vitamin D level was 20.25 ng/mL (range: 8.5–42.5 ng/mL), and the mean amniotic membrane thickness was 82.51 µm (range: 28.69–227.8 µm). No significant correlation was observed between serum vitamin D levels and amniotic membrane thickness (r = −0.029; p = 0.878).Conclusion: There was no significant correlation between maternal serum vitamin D levels and amniotic membrane thickness in cases of PROM.Keywords: amnion, pregnancy, premature rupture of membranes, thickness of the membranes, vitamin D.
Midwives’ Knowledge and Attitude about Antenatal Care in Rumbai Sub-district Muhammad Lingga Primananda; Noviardi Noviardi
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2091

Abstract

AbstractObjective: To determine the relationship between the levels of knowledge and attitudes of midwives in the Rumbai sub district and the implementation of 10T antenatal care. Methods: This was a cross-sectional study with an analytic observational design involving 43 midwives in the Rumbai sub district. Data were collected using a questionnaire that had undergone validity and reliability testing using the SPSS program. The implementation of 10T antenatal care was assessed using a Likert scale. Data were analyzed using SPSS version 23.0. Results: The majority of respondents were aged 31–35 years (39.5%), had a diploma (D3) as their highest educational level (55.8%), had 1–5 years of work experience (46.5%), and worked in clinics (44.2%). There were significant relationships between educational level (p=0.031, C=0.294), knowledge level (p=0.029, C=0.211), years of service (p=0.026, C=0.094), and attitudes(p=0.048, OR=1.391) of midwives and the implementation of 10T antenatal care in the Rumbai sub-district. Conclusion: This study demonstrated a significant relationship between midwives’ attitudes and the implementation of 10T antenatal care in the Rumbai sub-district. Additionally, there were associations between educational level, knowledge level, and the implementation of 10T antenatal care. Among the respondents, 88.3% (20 out of 24) of midwives with a diploma (D3), 77.8% (14 out of 18) with a bachelor’s degree, and 0% (0 out of 1) with a master’s degree completed the 10T implementation. These findings indicate that midwives with a diploma (D3) demonstrated the highest level of implementation compared to those with higher educational levels. Therefore, efforts to improve the implementation of 10T antenatal care should be tailored according to the educational background of midwives. Keywords: antenatal care, attitude, level of knowledge, midwives
Risk Factor Analysis in Young Adult Patients with Cervical Cancer Vrince Merlin Freshilia; Bismarck Joel Laihad; Juneke Joice Kaeng
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2191

Abstract

Objective: To identify risk factors associated with cervical cancer and determine the strongest predictors among young adults at Prof. Dr. R.D. Kandou General Hospital. Methods: This study employed an analytical case–control design. Sampling was performed using a total sampling method, including all cervical cancer patients aged <45 years treated at Prof. Dr. R.D. Kandou General Hospital from January 2022 to June 2023. The independent variables included educational level, occupation, nutritional status, age at first sexual intercourse, multiple sexual partners, type of contraception, and parity. Associations between variables were analyzed statistically. Results: A total of 210 participants were included, comprising 105 cases and 105 controls. The most common age group was 30–39 years (51%). The predominant histopathological type was squamous cell carcinoma (82%), and most cases were diagnosed at stage IIB–IIIC1r (73%). Educational level (p=0.318) and occupation (p=0.972) were not significantly associated with cervical cancer in young adults. In contrast, normal nutritional status (p<0.001), age at first sexual intercourse ≤18 years (p<0.001), multiple sexual partners (p<0.001), use of hormonal contraception (p<0.001), and multiparity (p<0.001) were significantly associated with cervical cancer in young adults. Conclusions: Early age at first sexual intercourse (≤18 years), multiple sexual partners, use of hormonal contraception, and multiparity are significant risk factors for cervical cancer in young adults. Keywords: cervical cancer, risk factor, young adult
Asymptomatic Bacteriuria in Women with Infertility Hary Tjahjanto; Gabriele Emi Badia
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2192

Abstract

BACKGROUND: This study aims to determine the proportion/incidence of asymptomatic bacteriuria in women with infertility and calculate the proportion of asymptomatic bacteriuria in infertile women. METHODS: The study was conducted at Dr. RSUP. Kariadi, Semarang, in April 2021 - July 2021 by taking data on infertile female patients at the Dr. Central General Hospital. Kariadi in 2018-2020 underwent routine urine examinations. The design of this research method uses descriptive-analytic research with a cross-sectional approach. RESULTS: There were 137 women with infertility, 88 women in the primary infertility group and 49 women in the secondary infertility group. 110 (80.3%) women with the lowest level of bacteriuria were 107/uL and the highest level was 13,768/uL. Of 88 women with primary infertility, 70 (79.55%) women had asymptomatic bacteriuria and of 49 women with secondary infertility, 40 (81.63%) women had asymptomatic bacteriuria. The proportion of asymptomatic bacteriuria between the primary and secondary infertility groups was different, but not significant (p=0.76). CONCLUSION: The incidence of bacteriuria in infertile women is high and there is no difference in the proportion of asymptomatic bacteriuria in women with primary and secondary infertility. Keywords: Infertility, asimptomatic bacteriuria
Accuracy of Tubal Patency Assessment during Office Hysteroscopy in Comparison to Hysterosalpingography Nessyah Fatahan; Herbert Situmorang; Eka Rusdianto Gunardi; Muhammad Dwi Priangga
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2428

Abstract

AbstractObjective: To evaluate the accuracy of office hysteroscopy in assessing tubal patency compared with hysterosalpingography. Methods: This cross-sectional study was conducted from January 2021 to May 2023 and involved 26 subjects who underwent office hysteroscopy as part of a subfertility work-up. Tubal patency was assessed using the bubble test (Parryscope test) and by measuring changes in the amount of fluid in the pouch of Douglas after the procedure. All subjects subsequently underwent hysterosalpingography as the standard method. Due to technical limitations, diagnostic laparoscopy the gold standardwas not performed. Agreement between office hysteroscopy and hysterosalpingography was evaluated using concordance rates and kappa values, along with sensitivity, specificity, positive predictive value, and negative predictive value. Pain scores during the procedure and post-procedural symptoms were also analyzed. Results: The concordance between the two modalities in assessing tubal patency was 67% (moderate agreement), with a kappa value of 0.28 (fair agreement). Office hysteroscopy resulted in lower pain scores and a reduced incidence of post procedural lower back pain and abdominal bloating. Conclusion: Office hysteroscopy demonstrates fair accuracy in assessing tubal patency compared with hysterosalpingography, with the advantages of minimal pain and no serious side effects. Keywords: HSG, office hysteroscopy, tubal patency.
Placenta Accreta Index (PAI) Score Association With Incidence of Placenta Accreta Spectrum, E-Cadherin Expression, Maternal and Neonates Outcome Martina Wibowo; Agoes Oerip Poerwoko; Raden Soerjo Hadijono; Julian Dewantiningrum; Besari Adi Pramono; Ratnasari Dwi Cahyanti; Dik Puspasari; Hermawan Hermawan
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2436

Abstract

Objective: To evaluated the Placenta Accreta Index (PAI) score for its association with histopathological diagnosis, E-cadherin expression, and clinical outcomes in Placenta Accreta Spectrum (PAS) disorders.Methods: A retrospective cross-sectional analysis was conducted on 81 patients with PAS at a tertiary referral center. Data on PAI scores, histopathology, and maternal/neonatal outcomes were collected. Statistical analysis compared outcomes between patients with PAI scores ≥4 and <4.Results: A PAI score ≥4 was not significantly associated with the final histopathological diagnosis of PAS (p=1.000). E-cadherin expression was lower in PAS tissue, but not significantly correlated with PAI score. However, a PAI score ≥4 was significantly associated with increased intraoperative blood loss (1275 mL vs. 968 mL, p=0.005) and a higher likelihood of requiring blood transfusion (RR 1.56, 95% CI 1.126–2.150, p=0.007). No significant associations were found between PAI score and adverse neonatal outcomes.Conclusion: The PAI score is a practical tool for predicting surgical morbidity, specifically hemorrhage and transfusion risk, in pregnancies clinically suspected of PAS, supporting its use for preoperative planning in resource-limited settings. Its utility as a primary diagnostic marker for histopathological invasion appears limited in a high-risk referral population.Keywords: E-cadherin, maternal outcome, neonatal outcome, placenta accreta spectrum, PAI Score
Multidisciplinary Management of Placenta Accreta Spectrum in a Rural Indonesian Hospital Wim Pratama Wijaya; Agustinus Gusti; Michael Reiner Wangania; Firman Nugroho; Maya Permatasari Suyata
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2445

Abstract

ABSTRACT Objective: To describe the challenges of diagnosing and managing Placenta Accreta Spectrum (PAS) in a rural setting, particularly when referral to a specialized center is not feasible. Methods: Case report. We report a case of PAS managed in a resource-limited rural hospital at Siloam Hospitals Labuan Bajo, West Manggarai, Indonesia. Results: A 34-year-old multigravida with no antenatal care was diagnosed at 34 weeks’ gestation with placenta previa accreta and a singleton pregnancy. She had a history of one previous cesarean section and was admitted with antepartum hemorrhage. A planned referral to a specialized PAS center in Surabaya was interrupted by recurrent bleeding leading to hemorrhagic shock. An emergency cesarean section followed by hysterectomy was performed by a coordinated multidisciplinary team involving obstetrics-gynecology, surgery, urology, and anesthesiology–intensive care. The estimated blood loss was approximately 2000 mL. Both maternal and neonatal outcomes were favorable, with postoperative stabilization and no immediate complications. Histopathological confirmation was not performed due to limited facilities. Conclusion: Management of PAS in rural areas remains challenging because of limited access to early diagnosis, specialized referral centers, multidisciplinary teams, and blood bank services. This case highlights the importance of early recognition and multidisciplinary readiness to achieve favorable outcomes in low-resource settings. Keywords: antepartum hemorrhage, case report, multidisciplinary management, placenta accreta spectrum, rural settings
Meconium Peritonitis Connecting the Dots between Pathophysiology, Prenatal Diagnosis and Postnatal Outcome Meilisva Audila Anggraeni; Budi Wicaksono; Agus Sulistyono
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2742

Abstract

AbstractObjective: To describe the antenatal findings, clinical course, and perinatal outcome of a case of meconium peritonitis.Methods: This is a case report.Case: A 28-year-old primigravida at 34–35 weeks’ gestation was referred for evaluation of hyperechoic fetal bowel. Serial ultrasonography revealed echogenic bowel and fetal ascites without associated major structural anomalies. Maternal serology showed reactive IgG for toxoplasma and cytomegalovirus with high avidity, suggesting past infection. Based on the Zangheri classification, the condition was categorized as grade I meconium peritonitis. The patient delivered at term (38–39 weeks). The female neonate weighed 2,640 g, with a length of 50 cm and APGAR scores of 8 and 9 at 1 and 5 minutes, respectively. Postnatal evaluation revealed no signs of acute abdomen. Babygram findings were unremarkable. The neonate was diagnosed with meconium peritonitis and early-onset sepsis and received empirical antibiotic therapy for 6 days, resulting in clinical improvement.Conclusion: Meconium peritonitis presents with a spectrum of antenatal findings, including intra-abdominal calcifications, ascites, pseudocyst formation, and bowel dilatation. The Zangheri classification is useful for predicting disease severity and the likelihood of postnatal surgical intervention. Mild cases may resolve spontaneously in utero, allowing for favorable outcomes with conservative management and term delivery.Keywords: Meconium peritonitis, prenatal diagnosis, ultrasonography.
Pre-Transfer Circulating Progesterone and Clinical Pregnancy in HRT-FET Cycles Kong Pham; Vinh Tran
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2900

Abstract

AbstractObjectives: To investigate the association between circulating progesterone concentrations measured one day prior to Frozen Embryo Transfer (FET) in Hormone Replacement Therapy (HRT) cycles and clinical pregnancy outcomes, and to determine the optimal progesterone threshold for predicting clinical pregnancy.Methods: A prospective cohort study was conducted at Da Nang Women and Children's Hospital from January 2023 to October 2024. A total of 243 women undergoing HRT-FET cycles were enrolled. Eligible participants had a body mass index (BMI) ≤25 kg/m², were aged 18–45 years, had an endometrial thickness >7 mm, and underwent transfer of one or two high-quality blastocysts. Circulating progesterone concentrations were measured on the fourth day of progesterone supplementation, one day prior to embryo transfer, and categorized into quartiles. Clinical pregnancy was defined by ultrasound confirmation of fetal cardiac activity at 7 weeks of gestation. Statistical analyses included t-tests, chi-square tests, multivariate regression, and receiver operating characteristic (ROC) curve analysis.Results: Clinical pregnancy rates across increasing progesterone quartiles were 31.7% (<9.1 ng/mL), 49.2% (9.1–<11.0 ng/mL), 50.8% (11.0–<13.5 ng/mL), and 57.4% (≥13.5 ng/mL). Women with progesterone concentrations <9.1 ng/mL had a significantly lower clinical pregnancy rate compared with those in higher quartiles (31.7% vs. 52.5%, p = 0.033). ROC analysis demonstrated moderate predictive performance (AUC 0.65; 95% CI: 0.58–0.72), with an optimal progesterone cut-off value of 10.35 ng/mL (sensitivity 80.9%, specificity 52.3%).Conclusions: Lower serum progesterone concentrations measured one day prior to embryo transfer are associated with reduced clinical pregnancy rates in HRT-FET cycles, supporting the clinical value of progesterone monitoring. However, given the single-centre design and moderate predictive performance, the proposed threshold should be interpreted with caution and validated in larger, more diverse populations.Keywords: clinical pregnancy, frozen embryo transfer, hormone replacement therapy, progesterone.
miRNA-191 and miRNA-548c-3p Expression in Embryo Culture Medium and Their Association with Chromosomal Status Riyan Hari Kurniawan; Raden Muharam Natadisastra; Indah Suci Widyahening; Pritta Ameilia Iffanolida; Budi Wiweko
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 2 April 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i2.2915

Abstract

Objective: To analyze the relationship between the expression levels of miRNA-191 and miRNA-548c-3p in embryo culture media and embryo chromosomal status. Methods: This cross-sectional study was conducted on 30 embryos from 12 patients aged 28–40 years who underwent an in vitro fertilization (IVF) program in three clinics. Embryos were cultured until the blastocyst stage. PGT-A was performed after blastocyst biopsy on day 5 or 6, and chromosomal analysis was carried out using the NGS method. The expression levels of miRNA-191 and miRNA-548c-3p were analyzed from embryo culture media samples using the qPCR method. The relationship between the expression levels of these miRNAs and embryo chromosomal status was then assessed. Results: There were no significant differences in subjects’ characteristics between the euploid and aneuploid embryo groups (p > 0.05). There was no significant difference in the expression level of miRNA-191 between euploid and aneuploid embryos (median quantification 7.260 vs 1.039, p = 0.497). Similarly, there was no significant difference in the expression level of miRNA-548c-3p between the two groups (median quantification 1.919 vs 4.311, p = 0.707). Conclusion: The expression levels of miRNA-191 and miRNA-548c-3p show no relationship with embryo chromosomal status. Their expression in embryo culture media does not appear to be a good biomarker candidate for predicting embryo chromosomal status. Keywords: Chromosomal status, IVF, miRNA-191, miRNA-548c-3p.

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