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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 1,760 Documents

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Prediction of Vaginal Delivery Using Fetal Head Descent Assessed Using Transperineal Ultrasound Saroyo, Yudianto B; Danarti, Mahendri D
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 107° (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

IIIB-IV Degree Perineal Rupture Repair Using Overlapping and End-to-End Techniques with Pudendal Block Anesthesia Pangastuti, Nuring; Junizaf, Junizaf; Pranoto, Ibnu; Santoso, Budi I; Priyatini, Tyas
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the incidence of persistent sonographic anal sphincter defect, fecal urgency, anal and fecal incontinence after IIIb- IV degree perineal rupture repair using overlapping and end-to-end technique. Method: An open clinical trial with randomization was carried out in July 2010-April 2012. The population consisted of the patients who underwent vaginal delivery in Dr. Sardjito Central General Hospital, Sleman District General Hospital, as well as Tegalrejo, Jetis and Mergangsan Community Health Centers who did no have complaints of fecal urgency, anal incontinence, and/or fecal incontinence, and suffered IIIb-IV degree perineal rupture repaired within less than 24 hours of rupture. The exclusion criteria included conditions in which patients could not undergo repair at the moment (shock, uncooperative patient). Fourty-eight research samples were divided into 2 groups, 24 samples for each of the treatment group (overlapping repair) and the control group (end-to-end repair). Local anesthesia was performed in a pudendal-block manner. Result: Success of the repair was assessed based on the presence of persistent sonographic anal sphincter defects in the 6-week evaluation after repair. Successful repair was higher in the overlapping group than that of the end-to-end group (94.74% vs 81.25%, p=0.31). Clinically and based on the Fecal Continence Scoring Scale (FCSS), evaluation at weeks II and VI indicated successful repair in both groups. Conclusion: There was no difference in the incidence of persistent sonographic anal sphincter defects, fecal urgency, anal incontinence, and fecal incontinence, after IIIb-IV degree perineal rupture repair using overlapping technique in comparison with end-to-end technique. Keywords: end-to-end technique, III-IV degree perineal rupture, obstetric perineal rupture, overlapping technique

Survival and Side Effects of Cisplatin/Cyclophosphamide and Carboplatin/Paclitaxel Adjuvant Chemotherapy in Stage IC-IV Ovarian Cancer Markus, Unedo H; Winarto, Hariyono; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the survival and side effects in epithelial ovarian cancer patients receiving adjuvant chemotherapy of cisplatin/ cyclophosphamide and carboplatin/paclitaxel. Method: We recruited epithelial ovarian cancer patients receiving cisplatin/cyclophosphamide (group A) or carboplatin/paclitaxel (group B) adjuvant chemotherapy after surgery. Chemotherapy was given for six cycles. Overall survival and side effects were assessed. Result: A total of 49 patients were recruited, consisting of 25 patients for group A and 24 patients for group B. In this study, the overall survival of stage IC-IV ovarian cancer patients was 37.3 months in group A (95%CI=31.86-43.46) and 35.5 months (95%CI= 13.93- 43.46) in group B (p

Accuracy of Intraoperative Frozen Section in Diagnosing Malignancy of Ovarian Neoplasm Utami, Tofan W; Iskandar, Jasmine; Tanamas, Gregorius; Jamtani, Mona; Nuranna, Laila; Nuryanto, Kartiwa H
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the accuracy of frozen section for ovarian neoplasm in our hospital. Method: A retrospective evaluation was conducted on medical records of patients with ovarian neoplasms who underwent a frozen section laparotomy between the years 2008 and 2013 at Dr. Cipto Mangunkusumo Hospital. Records with incomplete data on frozen section or paraffin block report were excluded. Criteria for frozen section laparotomy in our facility was based on a malignancy score of equal to or more than 6. Frozen section reports were compared to paraffin block report based on benign, borderline, or malignant cases. Result: From 139 patients with ovarian neoplasm, only 91 patients fulfilled the inclusion and exclusion criteria. Frozen section examination revealed benign cases was 15.4%, borderline cases was 15.4%, and malignant cases was 69.2%. Based on histopathological type, clear cell cystoadenocarcinoma was the most commonly observed histotype (19.8%). The sensitivity of frozen section for benign, borderline, and malignancy cases respectively was 81.8%, 76.9%, 91.0%. The specificity of frozen section for benign, borderline, and malignancy case respectively was 93.8%, 94.8%, 91.6%. Conclusion: We found that the accuracy of intraoperative frozen section in our facility is adequate to diagnose ovarian neoplasm and can be used to assist in determining the extent of surgical management. [Indones J Obstet Gynecol 2015; 3: 161-164] Keywords: frozen section, ovarian neoplasm, paraffin block, sensitivity, specitificity

Treatment Response of PlatinumBased Chemoradiation on Locally Advanced Cervical Cancer Khonsa, Oni; Purbadi, Sigit; Supriana, Nana; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 4, October 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the efficacy (treatment response), toxicity, and overall survival of concomitant chemoradiation (CRT) with three-weekly cisplatin-ifosfamide compared to CRT with weekly cisplatin in advanced stage cervical cancers (stage IIB-IIIB). Method: This is a historical cohort between 32 patients receiving CRT with three-weekly cisplatin and ifosfamide and 29 patients receiving weekly cisplatin in Gynecologic Oncology division outpatient clinic and ward, Dr. Cipto Mangunkusumo Hospital. Results: There was no significant difference in treatment response, overall and disease-free survival. There was more gastrointestinal toxicity in the cisplatin-ifosfamide arm compared to the other arm (p=0.014), but other toxicity effects were not different. Conclusion: Platinum based-chemoradiation has the same efficacy in terms of treatment response for locally advanced cervical cancer. [Indones J Obstet Gynecol 2015; 3-4: 212-221] Keywords: cisplatin, concomitant chemoradiation, ifosfamide, locally advance stage cervical cancer

Prevalence of Lower Urinary Tract Symptoms in Women Based on Bahasa Indonesia Validated ICIQ-FLUTS Long Form Moegni, Fernandi; Retnoningrum, Endah
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To obtain the prevalence of women with lower urinary tract symptoms (LUTS) in Dr. Cipto Mangunkusumo National Hospital, Indonesia. Method: We conducted a descriptive and analytic study with questionnaire- based data collection. All subjects were interviewed using the conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS long form validated in Indonesian language in the gynecology outpatient clinic in Dr. Cipto Mangunkusumo Hospital. Result: Using the conventional method, proposing only one question of urinary disturbance without asking the detailed symptoms, a low prevalence of LUTS was obtained (17.3%). On the other hand, with a well-structured questionnaire using ICIQ-FLUTS long form, the prevalence of LUTS was 95.3%. This result revealed that LUTS was a common condition among Indonesian women in the study population with vaginal delivery as the common risk factor. Conclusion: Screening for LUTS using a structured questionnaire identified a significantly higher prevalence of LUTS than the conventional method. The ICIQ-FLUTS long form validated in Indonesian language is a robust questionnaire that can be recommended for use in epidemiological research as well as routine clinical practice. Keywords: ICIQ FLUTS long form, Indonesia, LUTS, prevalence, women

Effectiveness of Oral Probiotics as Adjuvant Therapy in Reproductive Aged Women with Vaginal Discharge Indarti, Junita; Budidarmo, Utomo
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 1. January 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

  Objective: To investigate the efficacy of oral proboiotics and prove the high proportion of cure and satisfaction levels of post-treatment patients with a combination of antimicrobial-probiotic oral Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 compared to a combination of antimicrobial-placebo in the treatment of reproductive aged patients with vaginal discharge in the outpatient obstetrics and gynecologic clinic in Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia and Arifin Achmad Regional Hospital Pekanbaru, Riau, Indonesia. Methods:This was a randomized, double-blind, placebo-controlled trial involving50 subjects consisting of reproductive aged women. Data were collected using syndromic approach, probiotics were given as an adjuvant for standard antimicrobial therapy versus placebo as control, response was recorded 4 weeks later, for cure proportion and satisfaction level. Statistical analysis was performed to assess the variables. Interim analysis with conditional power assesment and futility testing were performed at midway due to insufficient sample size. Research was approved by Ethics Commitee for Health Researches Faculty of Medicine University of Indonesia-Dr. Cipto Mangunkusumo Hospital in March 2016. Results: A total of 50 subjects participated in this study. and analyzed (25 subjects in each group), cure proportion 56%(14) of the treatment and 60%(15)on the control group, with relative risk of 1.1, Chi-square test p value (0.77, 95% CI; 0.57 to 2 , 11). High satisfaction level (score ≥67) was higher in the placebo (52,6%, 10 subjects) compared to probiotic group (47,4%, 9 subjects), p value 0,65 (≥0,05). Conditional power and futility testing curve, revealed Z = -0.2865, conditional power 0.11 to 0.13, and futility index of 0.87 to 0.88, equals to low possibility of statistical significance with full sample size (84). Conclusion: There was no clinical and statistical difference in the proportion of cure rate and the level of satisfaction in patients of probiotics vs placebo groups after treatment for 4 weeks. The initial hypothesis of higher proportion of the cure ratein the treatment group still cannot be excluded, due to insufficient samples. Keywords: bacterial vaginosis, , lactobacillus reuteri RC-14, lactobacillus rhamnosus GR-1, randomized double blind controlled trial, trichomoniasis , vaginal discharge,  vulvovaginal candidiasis.

Laparoscopic Transperitoneal Approach for Vesicovaginal Fistula Repair: the First Experience Santoso, Jumadi
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To report our first experience in transperitoneal laparoscopic repair of vesicovaginal fistula in Dr. Hasan Sadikin Hospital. Method: A 31-year-old female presented with vesicovaginal fistula after cesarean section. Patient complained of urinary incontinence since 5 years ago. After a failed trial of conservative treatment with catheter drainage, a transperitoneal laparoscopic repair was performed. Initially, cystoscopy was performed to confirm the fistula location and for bilateral ureteric catheterization. A 4-port technique was performed with the patient in lithotomy position and slightly Trendelenburg. Without opening the bladder, the fistula tract was excised and the bladder was separated from the anterior vaginal wall. Both the bladder and vaginal walls were then closed separately using intracorporeal suturing, interposed with the omentum. Result: Total operative time was 270 minutes. Normal diet was resumed on day 1, drain was removed on the first day after surgery, and the patient was discharged on the second day with an indwelling catheter. Surgical wound showed good cosmetic result and no leakage was identified from cystogram after 2 weeks. The catheter was removed after 2 weeks. Conclusion: Laparoscopic transperitoneal repair of vesicovaginal fistula with omentum inteposition is feasible in Dr. Hasan Sadikin Hospital with good outcome, short hospital stay, and good cosmetic result. [Indones J Obstet Gynecol 2014; 4: 223-225] Keywords: laparoscopy, vesicovaginal fistula

Serum F2-Isoprostane Levels in Preterm Deliveries Compared to Normal Preterm Pregnancies Hartono, Johannes
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To determine the difference between serum F2-isoprostane levels in women with preterm deliveries compared to women in normal preterm pregnancies. Method: Our study is a cross sectional study. During the period of January to August 2012, we collected 72 samples in the Emergency Department and Obstetrics and Gynecology outpatient clinic of Sanglah hospital, Denpasar. Our sample was divided into two groups, 36 cases of preterm deliveries at 28-37 weeks gestational age and 36 preterm normal pregnancies at 28-37 weeks gestational age. We collected 3 ml of blood sample from the cubital vein and quantified the F2-isoprostane levels at the Biology Molecular Laboratory, Faculty of Medicine University of Udayana, Denpasar. Data was analyzed using the Shapiro Wilk test and independent t-test with significance of =0.05. Result: The mean F2-isoprostane level for preterm deliveries and preterm normal pregnancies were 0.315 0.292 pg/ml and 0.017 0.018 pg/ml. Conclusion: We can conclude from this study that there is a difference in F2-isoprostane serum level in preterm labor and normal preterm pregnancies. [Indones J Obstet Gynecol 2014; 4: 182-184] Keywords: F2-Isoprostane, normal preterm pregnancy, preterm delivery

Effect of Delay in Postpartum Hemorrhage Management on the Rate of Near-Miss and Maternal Death Cases Siswosudarmo, Risanto
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To recognize the effect of delay in the management of postpartum bleeding to the occurrence of near-miss and maternal death cases. Method: Prospective cohort. The study population was patients with postpartum hemorrhage. All PPH cases from thirteen hospitals (Sardjito and 12 affiliated hospitals) were recorded. The study was carried out from January 1st to June 30th 2009. The study group was those who experienced delay and the control group was those withoutdelay. The outcome was measured as the number of near-miss and death cases. Near-miss was defined as those who experienced severe shock, demonstrated by systolic blood pressure 90 mmHg or less. Chi square test, t-test and logistic regressions were used to analyze our data.Result: From January 1st to June 30th 2009 we identified 139 cases of PPH from 8,924 deliveries (1.6%). From the 80 referred cases, as much as 22 cases (27.5%) were delayed, and 12 from 139 (8.6%) experienced delay in the hospital. A total of 30 cases among 139 (21.6%) experienced delay both outside and in the hospital. There were 74 near-miss cases, 9 of which ended in death of the patient. This means the real occurrence of near-miss cases is 65 from 139 cases or 46.8% while the occurrence of maternal death was 9 out of 139, or 6.47%. Case fatality rate was 9 from 139 or 6.47%; maternal near-miss ratio was 6.22; mortality index was 13.84% and maternal mortality ratio is estimated as 103/100.000 live births. Multivariate analysis showed delay in referral increased the risk of near-miss cases as much as 8.37 folds, while bleeding >1500 ml increased risk of near-miss by 12.12 folds. Delay in both referral and management in the hospital increased the risk of maternal death rate as much as 25.34 folds, hemoglobin <6 g/dl and unavailability of blood increase maternal death by 31.58 folds and 13.39 folds, respectively.Conclusion: Delay in referral and delay of in-hospital management ncreased the occurrence of near-miss and maternal mortality cases significantly. Multivariate analysis showed that the amount of bleeding, hemoglobin level and lack of blood availability influenced the occurrence of near-miss and maternal death more than the delay itself.Keywords: delay, maternal death, maternal near-miss, PPH

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eko subaktiansyah

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