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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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Conformity of Human Papillomavirus between Self-examination of Vaginal Fluid and Cervical Specimen with Fluid-Based Cytology in Precancerous Lesions Anwar, Rahmawaty; Rauf, Syahrul; Moeljono, Eddy R.
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To determine the conformity of human papillomavirus between self-examination of vaginal specimen and cervical specimen with fluid-based cytology in precancerous lesions. Methods: A cross-sectional study performed on cervical and vaginal fluid from 90 pre-cancerous lesions patients from April to September 2016. Cytological examination performed with self-examination and liquid-based cytology technique. HPV genotyping performed with PCR technique. Data were analyzed with SPSS. Results: Most of the women aged >35 years (89%), 78% (71/90) multiparity and 74.4% (67/90) do not know about HPV screening. High risk type found in both vaginal and cervical fluid was type 16, 18, 33 and 45 whereas type 35 found only in vaginal fluid. The most prevalent high-risk HPV for both specimens were type 16 and 18. HPV type 42 and 53 were the low risk HPV found in the vaginal and cervical specimens (table 2). Cohen’s kappa for inter-test agreement shows a strong correlation (r=0.864). Conclusion: The HPV self-examination method can be used as a primary examination of cervical cancer lesions detection in addition to fluid-based cytology with the similar results. Keywords: Human papillomavirus, self-examination, fluid-based cytology, cervical cancer   Abstrak Tujuan: Untuk mengetahui tingkat kesesuaian antara pemeriksaan HPV mandiri dari spesimen vagina dan hasil pemeriksaan sitologi berbasis cairan dari spesimen serviks. Metode: Penelitian cross-sectional dilakukan pada cairan serviks dan vagina dari 90 pasien lesi pra-kanker pada April sampai September 2016. Pemeriksaan sitologi dilakukan dengan pemeriksaan diri dan teknik sitologi berbasis cairan. Pemeriksaan genotip HPV dilakukan dengan teknik PCR. Data dianalisis dengan SPSS. Hasil: Sebagian besar wanita dalam penelitian iniaberusia >35 tahun (89%), 78% (71/90) multiparitas dan 74,4% (67/90) tidak mengetahui tentang skrining HPV. Tipe HPV risiko tinggi yang ditemukan pada cairan vagina dan serviks adalah tipe 16, 18, 33 dan 45 sedangkan tipe 35 hanya ditemukan pada cairan vagina. Tipe HPV risiko tinggi yang dominan untuk kedua spesimen adalah tipe 16 dan 18. HPV tipe 42 dan 53 adalah HPV risiko rendah yang ditemukan pada baik spesimen vagina maupun serviks. Kappa Cohen untuk tingkat kesesuaian antara pemeriksaan mandiri dan sitologi berbasis cairan menunjukkan korelasi kuat (r = 0,864). Kesimpulan: Metode pemeriksaan HPV secara mandiri sendiri dapat digunakan sebagai pemeriksaan primer deteksi lesi kanker serviks selain sitologi berbasis cairan dengan hasil yang sama.

Post-operative Recovery Assessment of Urinary Tract Dysfunction Following Radical Hysterectomy for Cervical Cancer Patients Nuranna, Laila; Kusuma, Sang A F Adi
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objectives: To assess the length of recovery phase in urinary tract dysfunction following radical hysterectomy for cervical cancer patients in Ciptomangunkusumo Hospital. Methods: This survey study was conducted in Cipto Mangunkusumo Hospital from September 2016 to May 2017. Subjects were cervical cancer patients from stage IA2 to IIA2 underwent radical hysterectomy. Suprapubic catheter (SPC) was inserted to observe the urine production after procedure. Patients were then directed for bladder training protocol involving clamping and opening SPC. Sensation of bladder fullness followed by spontaneous micturition were recorded. Measurement of post voiding residual (PVR) urine volume after spontaneous micturition until less than 100 mL was considered as resolution of urinary tract dysfunction. The average days of every achieved phase were then calculated. Results: Twenty-nine subjects underwent radical hysterectomy during observation period. But only 21 subjects continued the bladder training protocol and recorded for the recovery phases. The average time needed to obtain sensation of bladder fullness and spontaneous micturition were 7.57 ± 4.78 days (median 5 days, minimum 3 days,  maximum 22 days)and  8 ± 5.21 days (median 6 days, minimum 3 days, maximum 23 days). The objective PVR urine became less than 100mL was obtained after 21.42 ± 18 days (median 18 days, minimum 7 days, maximum 74 days). Conslusion: Following radical hysterectomy, recording the recovery phase of urinary tract dysfuction is essential to ensure complete resolution. Complete resolution of the urinary dysfunction is achieved after 21.42±18 days in average (median 18 days, minimum 7 days, maximum 74 days). Keywords: cervical cancer, radical hysterectomy, urinary tract dysfunction, post voiding residual volume.   Abstrak Tujuan: Menilai masa pemulihan disfungsi saluran kemih setelah histerektomi radikal pada pasien kanker serviks di RSUPN Ciptomangunkusumo. Metode: Studi survei dilakukan di RSUPN Cipto Mangunkusumo dari September 2016 hingga Mei 2017. Subjek penelitian terdiri dari pasien kanker serviks stadium IA2 hingga IIA2 yang menjalani histerektomi radikal. Kateter suprapubik (SPC) digunakan sebagai alat untuk memantau produksi urin pasca operasi. Pasien diinstruksikan untuk mengikuti protokol bladder training yaitu melalui prosedur menutup dan membuka kateter. Rasa sensasi ingin berkemih dan berkemih spontan. Pengukuran residu volume urin pasca berkemih dibawah 100mL dianggap merupakan indikator pemulihan disfungsi saluran kemih. Rata-rata hari dari setiap fase kemudian dihitung. Hasil: Dua puluh sembilan subjek didapatkan selama penelitian. Namun, hanya 21 subjek yang dapat mengikuti protocol bladder traning dan dicatat perkembangan pemulihannya. Rata-rata hari yang diperlukan untuk merasakan sensasi berkemih dan berkemih spontan adalah 7,57 ± 4.78 hari (median 5 hari, minimum 3 hari, dan maksimum 22 hari) dan 8 ± 5.21 hari. (median 6 hari, minimum 3 hari dan maksimum 23 hari) Rata-rata hari untuk mencapai residu urin di bawah 100 mL adalah 21.42 ± 18 (median 18 hari, minimum 7 hari, dan maksimum 74 hari). Kesimpulan: Setelah prosedur histerektomi radikal, pencatatan masa pemulihan penting untuk dipantau untuk memastikan pemulihan lengkap. Rata-rata hari yang diperlukan untuk pemulihan adalah 21.42 ± 18 hari (median 18 hari, minimum 7 hari, dan maksimum 74 hari). Kata kunci: kanker serviks, histerektomi radikal, disfungsi saluran kemih, volume residu paska berkemih.

The Proportion of Lymph Node Metastasis in Patients with Stage IIA1 and IIA2 Cervical Cancer who were Treated for Radical Hysterectomy and Pelvic Lymphadenectomy andrijono, Andrijono; Ginealdy, Wahyu
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: This study was designed to determine a difference in prognosis of stage IIA1 cervical cancer compared to stage IIA2 based on the incidence of metastasis to pelvic lymph nodes by radical hysterectomy. Methods:A cross sectional study was conducted among 108 stage II cervical cancer patient post radical hysterectomy in obstetric gynecologic department of Dr. CiptoMangunkusumo hospital since 2006-2016. Results: From 108 patients with cervical cancer stage IIA, 80 (74%) patients are stage IIA1 and the remaining the remaining 28 (26%) patients are stage IIA2. The average age of patients at stage IIA2 (47.79 years) younger than IIA1 (55.85 years) and also patient at stage IIA1 having a higher parity number which is 4 compare to stage IIA2 with the number of parity 2. The Involvement of lymph node metastasis in patients with stage IIA1 and IIA2 cervical cancer were 51 (63.75%) and 16 (57.14%) respectively. Conclusion: Metastatic factor to lymphnode in both stage have the same result. There was no difference in the proportion of lymph node metastasis occurring in both stage IIA cervical cancer stage which was corrected with radical hysterectomy and pelvic lymphadenectomy with p = 0,535. Changing staging does not seem to improve the prognosis. Keywords: cervical cancer, stage IIA, lymphnode metastatic   Tujuan:Membuktikan adanya perbedaan prognosis kanker servik stadium IIa1 dibanding stadium IIa2 berdasarkan kejadian metastasis ke kelenjar getah bening pelvik yang dilakukan histerektomi radikal. Metode: Dengan menggunakan metode potong lintang dilakukan pengambilan data  108 sampel pasien kanker serviks stadium IIA yang dilakukanpembedahanhisterektomiradikal di Departemen OnkologiGinekologi RSUP. Dr. Cipto Mangunkusumo Jakarta sejak tahun 2006 hingga tahun 2016. Hasil: Pasien kanker serviks stadium IIA1 sebanyak 80 (74%) pasien dan stadium IIA2 sebanyak 28 (26 %) pasien. Pada stadium IIA2 (47.79 tahun) didapatkan rata ratausiapasienlebihmudadibandingkan IIA1 (55.85 tahun). Pada stadium IIA1 jugadidapatkanjumlahparitas yang lebihtinggiyaitu 4 sedangkanpada stadium IIA2 denganjumlahparitas 2. Keterlibatan metastasis kelenjar getah bening pada pasien kanker serviks stadium IIA1 dan IIA2 berjumlah 51 (63.75%) dan 16 (57.14%) secara berurutan. Tidak terdapat perbedaan proporsi kejadian metastasis kelenjar getah bening pada kedua kelompok stadium kanker serviks pada stadium IIA dengan nilai p = 0,535. Kesimpulan: Faktor metastasis kelenjar getah bening pada kedua stadium memiliki hasil yang serupa.Tidak terdapat perbedaan proporsi kejadian metastasis kelenjar getah bening pada kedua kelompok stadium kanker serviks stadium IIA1 dan IIA2 yang ditatalaksna dengan histerektomi radikal dan limfadenektomi pelvis. Perubahan penetapan stadium sepertinya tidak memperbaiki prognosis. Kata kunci : Kanker serviks, stage IIA, kelenjar getah bening, faktor prognostik

How to Recognize, Prevent and Address Complications of Laparoscopic Gynecologic Surgery Pramayadi, cepi T; Fani, Erliana
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

AbstractObjective: to highlight the needs of awareness on recognizing, prevent and address complications in laparoscopic gynecologic surgery.Method: Literature reviewDiscussion: The complications of laparoscopic gynecologic surgery mainly can be classified as complications related to anesthesia, entry technique, electrosurgical, postoperative and visceral due to surgical procedure itself. Lam proposed a 6 phase-based classification of laparoscopic surgery complications; patient identification, anesthesia and positioning, abdominal entry and port placement, surgery, postoperative recovery and counselling. The aim of this classification is to promote a culture risk management to improve patient safety and outcome. Each and every phase above should be able to assessed, analyzed and executed properly to prevent complications. Conclusion: Complication in operative laparoscopy is generally minor and can be handled successfully. However, although very rare, major complications are detrimental to the patient. It also becomes heavy burden for the surgeons. Preventive measures should be implemented not only by the operator but also the anesthesiologist, and theatre practitioners. Systematic drills, which regularly re rehearsed is important in order to maintain team proficiencies. Keywords: complications, gynecologic laparoscopy, operative Laparoscopy   Abstrak Tujuan: Untuk menekankan pentingnya mengenali, mencegah dan mengatasi secara dini komplikasi operasi laparoskopi ginekologi. Metode: Kajian pustaka Diskusi : Komplikasi operasi ginekologi laparoskopi dapat diklasifikasikan menjadi komplikasi yang berhubungan dengan anestesi, teknik masuknya trokar utama, terkait elektro surgikal, komplikasi pascaoperasi dan komplikasi visera (pembuluh darah, usus, cedera traktus urinarius) terkait tindakan operasi itu sendiri. Lam mengusulkan suatu klasifikasi berbasis fase, antara lain, identifikasi pasien, anestesi dan posisi pasien, akses masuk abdomen dan penempatan trokar, terkait operasi, pemulihan pascaoperasi dan konseling. Tujuan dari klasifikasi ini adalah untuk meningkatkan budaya sadar risiko,guna meningkatkan keselamatan pasien. Setiap tahap harus dapat dilaksanakan, dinilai dan dianalisis dengan baik untuk mencegah terjadinya komplikasi. Kesimpulan: Komplikasi pada operasi ginekologi laparoskopi umumnya ringan dan dapat ditangani dengan baik. Walaupun jarang terjadi, komplikasi berat umumnya sangat merugikan pasien dan menjadi beban operator. Langkah-langkah pencegahan ini harus dilaksanakan oleh operator, tim anestesi serta seluruh tim kamar operasi. Simulasi  harus dilaksanakan, guna mempertahankan kecakapan tim Kata kunci : komplikasi, laparoskopi ginekologi, laparoskopi operatif

INDEX Hestiantoro, Andon
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

n/a

Born too Early, Where are We Now? Joewono, Hermanto T
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

n/a

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

Preeclampsia after the Seven Quantum Leap Prediction Mose, Johanes C
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Evidence Based Patient-Centered Care: Are We Ready? Baziad, Ali
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 3, July 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

N/A

Clinical Evaluation of Neoadjuvant Chemotherapy Followed by Radical Hysterectomy in the Management of Cervical Cancer Stage IIB Sanif, Rizal
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To evaluate the clinical efficacy, operability, radicality, toxicity, and incidence of recurrences of neoadjuvant chemotherapy (NAC) followed by radical hysterectomy (RH) among patients with stage IIB cervical cancer. Method: This is an observational clinical study at Dr. Moh. Hoesin Hospital, Palembang. Data were analyzed from 27 patients who matched the inclusion criteria and underwent 3 cycles of neoadjuvant chemotherapy (NAC) with Paclitaxel (75 mg/m2) in combination with Cisplatin (50 mg/m2) and Docetaxel (75 mg/m2) combined with Carboplatin (300 mg/m2) according to AUC 6, followed by radical hysterectomy from January 2012 until December 2013. Result: The operability rate after NAC was 96.4%. Lymph node metastases were negative in 75% of patients, and we found bilateral lymph node metastases in 14.3% of patients. Parametric infiltrations were negative in 85.7% of the patients, and positive in 14.3% of patients. No vaginal infiltrations were found. As much as 89.3% of the patients did not experience any side effect, while anemia and thrombocytopenia were found in 10.8% of the patients. We found that 7.1% of patients had recurrences within 6 months interval. Conclusion: NAC followed by radical hysterectomy showed significant advantages for patients with stage IIB cervical cancer, with fewer side effects. However, long-term evaluation and a larger number of patients are required to confirm this result. Keywords: cervical cancer, neoadjuvant chemotherapy, radical hysterectomy

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