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INDONESIA
Indonesian Journal of Perinatology
Published by The Indonesian Society of Perinatology
ISSN : 27750744     EISSN : 27750736     DOI : https://doi.org/10.51559/inajperinatol.
Core Subject : Health,
Health Professions Medicine & Pharmacology Nursing
peer-reviewed journal aiming to communicate high-quality research articles, reviews, and general articles in the field. InaJPerinatol publishes articles that encompass basic research/clinical studies related to the cardiovascular and thorax field. The Journal aims to bridge and integrate the intellectual, methodological, and substantive diversity of medical scholarship and encourage a vigorous dialogue between medical scholars and practitioners.
Arjuna Subject : Kedokteran - Obstetrics and Gynaecology
Articles 59 Documents
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Lavender aromatherapy reduces menstrual pain intensity in adolescents: a double-blind randomized clinical trial Made Tangkas; Mahadinata, Made; Artana, Adi; Rasti, Wida Maha
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.76

Abstract

Introduction: Before, during, or after a period, dysmenorrhea may occur.  Menstrual discomfort may persist for one to several days throughout the menstrual cycle.  The uterine muscles contracting to release endometrial tissue is believed to be the cause of colic or chronic discomfort. Some predisposing factors that play a role in the pathophysiology of primary dysmenorrhea have not been explained to date, it is suspected that prostaglandin factors are the main cause of perceived pain. There are two methods for treating menstruation pain: pharmaceutical and non-pharmacological. A non-pharmacological treatment that can give good results is the use of lavender aromatherapy because the content of essential substances in it is suspected to reduce anxiety and pain sensations to reduce the intensity of dysmenorrhea. Method: This study employs a double-blind, randomized pre- and post-test control design, thereby constituting a true experiment. This research was conducted in Susut Village, Bangli from January 2024 to March 2024. This study used a consecutive sampling technique followed by randomizing the grouping of treatment subjects who received the aroma of lavender therapy and the control subjects received a placebo for 15 minutes for 2 consecutive days. Pain intensity was measured using the NRS scale before and after the intervention. Results: This study involved 60 subjects consisting of 30 cases and 30 controls. The administration of lavender aroma therapy significantly reduced the intensity of dysmenorrhea pain compared to placebo. Conclusion: The administration of lavender aromatherapy lowers the intensity of dysmenorrhea pain.
Ethnopharmacological insights and clinical prospects of ten Indonesian medicinal plants for pregnancy, postpartum, and lactation: a systematic review Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Rahardjo, Theresia Monica; Suryawan, Aloysius; Rahardjo, Bambang; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.77

Abstract

Background: The perinatal period involves significant physiological and metabolic transitions, particularly concerning hypertensive disorders, preeclampsia, hemorrhage, lactation challenges, and oxidative stress. Although pharmacological therapies are available, their safety and accessibility remain inconsistent, especially in resource-limited settings. Indonesia’s extensive biodiversity and deep-rooted ethnomedicinal traditions offer promising yet underutilized botanical alternatives. This study aimed to review the efficacy of Indonesian medicinal plants used in pregnancy, postpartum, and lactation. Methods: This systematic review investigates ten Indonesian medicinal plants traditionally used during pregnancy, postpartum recovery, and lactation: Sauropus androgynus, Curcuma longa, Moringa oleifera, Nigella sativa, Centella asiatica, Orthosiphon aristatus, Syzygium polyanthum, Andrographis paniculata, Solanum nigrum, and Zingiber officinale. Literature from 2000 to 2025 was reviewed using PRISMA guidelines across global and regional databases. Phytochemical composition, mechanisms of action, therapeutic effects (e.g., antihypertensive, antidiabetic, galactagogue, hemostatic, antioxidant), and clinical relevance were critically evaluated. Results: All ten plants demonstrated pharmacological potential relevant to perinatal health challenges. Notably, Zingiber officinale offers antiemetic and anti-inflammatory benefits during early pregnancy, complementing the lactogenic, antihypertensive, and wound-healing properties of other species. However, gaps persist in human trials, dosage standardization, and regulatory oversight. Conclusion: The review highlights the importance of integrating validated traditional botanicals into perinatal care through interdisciplinary research, targeted clinical trials, and culturally responsive health policies. Bridging ethnopharmacology with maternal health systems offers a scalable, sustainable pathway toward maternal wellness and equity in Indonesia and comparable global settings.
Retrograde Hysterectomy Approaches in Difficult Gynaecology Surgery I Gde Sastra Winata; Ongko, Eric Gradiyanto; I Nyoman Gede Budiana; I Nyoman Bayu Mahendra; Kade Yudi Saspriyana; Pande Kadek Aditya Prayudi; Arlando Martino Anapaku; Florencia
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.70

Abstract

Hysterectomy remains one of the most frequently performed gynecological surgeries worldwide. While extra-fascial hysterectomy is the standard abdominal approach, complex cases involving large fibroids, severe endometriosis, adhesions, or malignancy often require alternative techniques such as the Aldridge method or retrograde hysterectomy. These challenging situations are associated with distorted pelvic anatomy, fibrosis, and adhesions, increasing the risk of complications, including injury to adjacent organs. This article reviews strategies and operative steps in managing complex abdominal hysterectomies, with emphasis on retrograde hysterectomy as a valuable approach when the cervicovaginal junction cannot be clearly identified or when extensive adhesions are present. The surgical technique is described step by step, supported by imaging and intraoperative findings, and highlights methods such as hydrodissection and careful dissection around critical structures to minimize morbidity. Preoperative imaging, intraoperative decision-making, and technical modifications are emphasized as key factors for optimizing patient outcomes. Although this study provides a detailed description of techniques under challenging hysterectomies, its limitation lies in the reliance on schematic illustrations rather than comprehensive intraoperative photographic documentation.
Metastatic breast cancer during pregnancy: a case report Widi, Made Yudha Ganesa Wikantyas; Putra, Wayan Artana; Kusuma, Anak Agung Ngurah Jaya; Wiradnyana, Anak Agung Putra; Sanjaya, I Nyoman Hariyasa; Budiana, I Nyoman Gede; Mahayasa, Putu Doster; Marta, Kadek Fajar
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.73

Abstract

Introduction: Breast cancer is the most prevalent malignancy among women and a notable comorbidity during pregnancy. Pregnancy-associated breast cancer (PABC) presents unique challenges due to physiological breast changes that complicate early diagnosis. This case report aimed to present a 31-year-old female with a diagnosis of bilateral breast tumors, pleural effusion, and multiple thoracic soft tissue tumors during her second pregnancy, highlighting the complexities and treatment considerations involved. Case presentation: A 31-year-old female patient, referred to Prof. Dr. I. G.N.G Ngoerah General Hospital, Denpasar, was in her second pregnancy at 20-21 weeks of gestation. She presented with bilateral breast lumps, worsening pain, and shortness of breath. Her obstetric history included a previous cesarean delivery and two abortions. Clinical examination revealed pleural effusion and multiple nodules suggestive of metastases. Biopsies confirmed tubular adenoma in the right breast and invasive breast carcinoma in the left breast. Ultrasound and chest x-ray findings indicated metastases to the liver and lungs. The patient was diagnosed with G4P1021 at 20 weeks of gestation with pregnancy-associated bilateral breast cancer and metastases. Conclusion: PABC diagnosis and treatment are fraught with challenges due to the need to balance maternal and fetal health. Delays in diagnosis, limited antenatal care, and the aggressive nature of PABC contribute to poor outcomes. This case underscores the necessity of early detection, prompt multidisciplinary intervention, and tailored treatment strategies to improve PABC patients' prognoses.
Characteristics of cervical cancer screening using visual inspection with acetic acid and pap smear in the outpatient clinic at Prof. Dr I.G.N.G. Ngoerah Hospital Denpasar from January to December 2023 Aryana, Made Bagus Dwi; Surya, I Gede Ngurah Harry Wijaya; Winata, I Gde Sastra; Ongko, Eric Gradiyanto; Budiana, Nyoman Gede; Mahendra, I Nyoman Bayu; Saspriyana, Kade Yudi; Darmayasa, I Made; Prayudi, Pande Kadek Aditya
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.67

Abstract

Introduction: According to GLOBOCAN 2022, cervical cancer is the fourth leading cause of cancer-related morbidity and mortality among women worldwide, with 662,044 new cases and 348,709 deaths. In Southeast Asia, it ranks third in incidence and fourth in mortality. Indonesia contributes more than 50% of new cases (36,964) and deaths (20,708) in the region. Cervical cancer is largely preventable through early detection methods such as visual inspection with acetic acid (VIA) and Pap smear. However, differences in diagnostic accuracy between these screening methods highlight the need to identify patient characteristics appropriate for each modality. This study aimed to compare the characteristics of patients undergoing VIA and Pap smear screening at the outpatient clinic of Prof. Dr I.G.N.G. Ngoerah Hospital, Denpasar, from January to December 2023. Methods: This observational analytical study used secondary data obtained from outpatient clinic registers and medical records of female patients who underwent VIA or Pap smear screening during the study period. Data were analysed using univariate analysis. Results: Among 122 participants undergoing VIA, 24 (19.6%) had positive results. Pap smear examinations in 125 participants showed CIN I in 10 (8.0%), CIN II in 4 (3.2%), and CIN III in 5 (4.0%) participants. Vaginal discharge was reported in 7 VIA participants (5.7%) and 15 Pap smear participants (12.0%), while postcoital bleeding was reported in 2 participants (1.6%) in each group. Among VIA-positive cases, lesions were most commonly found in all four quadrants (45%). Conclusion: Patient characteristics in VIA and Pap smear screening at Prof. Dr I.G.N.G. Ngoerah Hospital varied considerably, with a higher proportion of positive results observed in VIA compared to Pap smear screening.
Water Birth as Neuroendocrine Medicine: A Critical and Integrative Review of Hormonal and Psychophysiological Impacts on Maternal and Neonatal Outcomes Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Darmawan, Ernawati; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.79

Abstract

Background: Water birth, defined as labor and/or delivery conducted in warm water, has gained increasing recognition as a patient-centered and physiologically supportive birth practice. Beyond analgesia, growing evidence indicates that water immersion during labor modulates maternal neuroendocrine regulation, psychological well-being, and neonatal physiological adaptation. Nevertheless, these hormonal and psychophysiological mechanisms remain insufficiently integrated into conventional perinatal research and clinical frameworks. This review aims to synthesize current evidence on the neuroendocrine, psychophysiological, obstetric, and neonatal effects of water birth and to evaluate its clinical effectiveness and safety in low-risk pregnancies. Methods: An integrative review was conducted using a PRISMA-guided approach to identify peer-reviewed studies published between 2000 and 2025. Literature searches retrieved 3,287 records from major biomedical databases, of which 44 studies (12 randomized controlled trials, 19 cohort studies, 6 case–control studies, and 7 systematic reviews) met inclusion criteria. Data were synthesized thematically, focusing on maternal hormonal responses (oxytocin, β-endorphins, cortisol, prolactin), labor outcomes, breastfeeding, postpartum mood, neonatal adaptation, and safety considerations. Results: Across study designs, water immersion during labor was associated with increased endogenous oxytocin and β-endorphin activity and reduced stress-related hormonal responses. Clinically, first-stage labor was shortened by approximately 42–78 minutes, and epidural analgesia use was reduced by 30–50% compared with conventional land birth. Episiotomy rates were generally below 5%, and maternal satisfaction scores were consistently higher. Early breastfeeding initiation occurred in 86–92% of water birth cases, with exclusive breastfeeding rates at six weeks ranging from 66–77%. Neonatal outcomes, including 5-minute Apgar scores and NICU admission rates, were comparable to or slightly better than conventional birth in low-risk populations, with no consistent increase in infection or respiratory complications when standardized protocols were applied. Conclusion: Water birth supports a hormonally optimized and psychologically protective labor environment, with measurable benefits for labor efficiency, maternal experience, breastfeeding success, and neonatal physiological transition. When implemented under evidence-based guidelines, it represents a credible non-pharmacological option within contemporary, physiology-informed maternity care.
Challenges and strategies in implementing kangaroo mother care across Indonesia: a literature review Gunawan, Rendi Prawira; Edhy, Anky Tri Rini Kusumaning; Tehuteru, Edi Setiawan; Widnyana, Anak Agung Ngurah Ketut Putra; Rustina, Yeny; Tobing, Hesti Kristina P
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.82

Abstract

Kangaroo Mother Care (KMC) is a simple and low-cost intervention proven effective in reducing morbidity and mortality among low birth weight (LBW) infants through skin-to-skin contact, exclusive breastfeeding, and post-discharge monitoring. KMC plays an essential role in maintaining the infant’s body temperature, enhancing physiological stability, improving the sucking reflex, accelerating weight gain, and strengthening the emotional bond between mother and baby. In Indonesia, KMC has been integrated into national health policy since 2009 through the “Mother and Baby Friendly Hospital Program,” yet its implementation still faces several challenges, including limited facilities, inadequate health worker training, and insufficient family support. Studies conducted at the hospital and primary care levels have demonstrated positive outcomes in terms of growth, physiological stability, and breastfeeding success among LBW infants who received KMC. The main barriers of KMC implementation in Indonesia are found at the maternal and family level, the healthcare provider and facility level, and also the social-cultural and economic level. Multistage efforts, such as developing legal frameworks, training, teamwork, utilizing the available resources, communication, supervision, documentation, and evaluation, may overcome the barriers and increase the KMC implementation in Indonesia.
Characteristics of preeclampsia cases based on early-onset and late-onset preeclampsia at Batuyang Primary Health Center in 2022–2024 Wirananda, I Made Surya Vedo; Putra, Dewa Made Sucipta
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.83

Abstract

Introduction: Preeclampsia remains one of the leading causes of maternal and neonatal morbidity and mortality in Indonesia, with a significant incidence during pregnancy. It is classified into early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE) based on the gestational age at the time of diagnosis, each characterized by distinct clinical presentations and etiological mechanisms. This study aims to compare demographic and clinical characteristics between early-onset pre-eclampsia (EOPE) and late-onset pre-eclampsia (LOPE) at PKM Batuyang during the period 2022–2024. Methods: This study employed a retrospective cross-sectional design with non-probability sampling. Data were obtained from the medical records of preeclamptic patients treated at Batuyang Primary Health Center between 2022 and 2024. The analyzed variables included maternal age, gestational age, parity, body mass index (BMI), history of abortion, hypertension, diabetes mellitus, and multiple pregnancies. Results: Among the 162 preeclampsia cases reviewed, LOPE was more prevalent (84.6%) compared to EOPE (15.4%). Most cases occurred in women aged ≥35 years and those with multiparity. The majority of patients had a BMI below 30 kg/m². A small proportion of patients had a history of chronic hypertension, diabetes mellitus, or multiple gestation. Conclusion: Late-onset preeclampsia was more frequently observed than early-onset cases at Batuyang Primary Health Center. Classification based on onset time is essential to guide optimal clinical management strategies. Further research is needed to identify risk factors to improve early detection and management of pre-eclampsia, thereby potentially reducing maternal and infant morbidity and mortality rates.
A predictive model for in vitro fertilization success: a retrospective cohort study from a tertiary clinic in Indonesia Tangkas, Made; Putra, I Made Mahadinata; Endarwati, Juwita
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.84

Abstract

Background: In vitro fertilization (IVF) remains one of the most effective assisted reproductive technologies for the management of infertility; however, its success rate varies widely across populations and clinical settings. In Indonesia, data-driven evaluations of IVF success predictors remain limited, and locally validated prognostic tools to support individualized counseling and treatment planning are scarce. This study aimed to identify factors associated with successful pregnancy outcomes among couples undergoing IVF at the WIN Infertility Clinic, Puri Bunda Hospital, Denpasar. Methods: A retrospective cohort study with a case–control approach was conducted using secondary data from medical records of 243 infertile couples who underwent IVF cycles between January 2023 and December 2024. Clinical pregnancy confirmed by laboratory and ultrasound findings was classified as the success group (n = 100), while unsuccessful cycles constituted the control group (n = 143). Variables evaluated included female age, basal hormonal profile, ovulation induction protocol, number of embryos transferred, body mass index (BMI), infertility duration, and infertility status. Univariate and multivariate logistic regression analyses were performed to identify independent predictors, followed by the development of a predictive scoring model. Results: The overall clinical pregnancy rate was 41.2%. Multivariate analysis demonstrated that four variables were independently associated with IVF success: female age (adjusted OR [aOR] 0.91; 95% CI 0.85–0.98; p = 0.012), number of embryos transferred (aOR 1.68; 95% CI 1.22–2.33; p = 0.001), normal BMI (aOR 2.00; 95% CI 1.12–3.59; p = 0.019), and duration of infertility (aOR 0.92; 95% CI 0.86–0.99; p = 0.041). A predictive scoring system derived from these factors demonstrated moderate discriminatory performance (AUC = 0.724). Conclusion: Female age, number of embryos transferred, BMI, and infertility duration are significant independent predictors of IVF success at this center. The proposed scoring model may serve as a practical tool to support individualized patient counseling and optimize treatment planning in IVF programs.

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