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Majalah Obstetri dan Ginekologi
Published by Universitas Airlangga
ISSN : 08540381     EISSN : 25981013     DOI : 10.20473/mog.V27I32019.90-93
Core Subject : Health,
Health Professions Medicine & Pharmacology
Majalah Obstetri & Ginekologi (MOG) or the Journal of Obstetrics & Gynecology Science is a scientific journal published by the Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia, in collaboration with the Indonesian Obstetrics and Gynecology Association (POGI) of Surabaya branch.
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Articles 12 Documents
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Search results for , issue "Vol. 32 No. 2 (2024): August" : 12 Documents clear
The prognostic role of mitosis index, stage and grade of endometrial cancer in Dr. Soetomo General Academic Hospital Surabaya, Indonesia, in 2018-2020 Umi Choviva, Farida; Sandhika, Willy; Mulawardhana, Pungky
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.74-79

Abstract

HIGHLIGHTS 1. Mitotic index and grade are prognostic factors for endometrial cancer, but both are independent.2. Stage and mitotic index associated with cell proliferation affect the prognosis of endometrial cancer.   ABSTRACT Objective: This study aimed to analyze the correlation between the mitotic index and the stage and grade of endometrial cancer. Materials and Methods: We collected pathology reports of endometrial cancer from the Pathology Laboratory at Dr. Soetomo General Hospital in Surabaya, Indonesia, covering cases diagnosed between 2018 and 2020. A total of 106 cases of endometrial cancer were included in this study. For each case, detailed records of the cancer stage, grade, and mitotic index were recorded. The mitotic index, an indicator of cell proliferation, was quantified, and its correlation with cancer stage and grade was assessed. To determine the strength and direction of these relationships, we performed a Spearman rank correlation statistical analysis for non-parametric data. Results: Our findings indicated a significant positive correlation between the mitotic index and the stage of endometrial cancer. An increase in the mitotic index, reflecting a higher proliferation rate of cancer cells, was associated with a more advanced cancer stage, suggesting that the mitotic index could potentially serve as a prognostic marker for assessing tumor progression in endometrial cancer. However, our analysis revealed no significant correlation between the mitotic index and the histological grade of endometrial cancer, implying that the grade, which typically reflects the differentiation status and morphological characteristics of the tumor cells, is independent of the proliferation rate as measured by the mitotic index. Conclusion: The mitotic index is positively correlated with the stage of endometrial cancer but does not show a correlation with the histological grade. These findings highlight the potential use of the mitotic index in staging endometrial cancer.
The role of vitamin D supplementation on levator ani muscle remodeling post-delivery Rahajeng; Zaen, Taufik Ali
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.97-105

Abstract

HIGHLIGHTS 1. In pregnant women, vitamin D insufficiency may plays a role in the development of post-delivery illness.2. Vitamin D supplementation is significant in remodeling of post-delivery levator ani muscle.   ABSTRACT Objectives: Vitamin D is considered a crucial vitamin for the restoration of levator ani muscle strength. Therefore, this study aimed to evaluate the association between vitamin D and levator ani muscle remodeling in the post-delivery period.Materials and Methods: The literature search was conducted across three electronic databases, namely PubMed, Google Scholar, and Springerlink. Our investigation yielded a total of 2613 studies, out of which 8 studies were found to meet the inclusion criteria and were subsequently included in our study. Among these, 4 studies specifically examined the impact of vitamin D micronutrient status on the levator ani/pelvic muscles during the post-delivery period.Results: The mean maximum contraction strength of the levator ani muscles following the administration of vitamin D supplements was 26.77 ± 7.15 cmH2O. The analysis conducted utilizing a paired t-test yielded a p-value of less than 0.05, indicating statistical significance. Additionally, a coefficient correlation of 0.831 was observed, with a p-value also less than 0.05. The findings of this study indicate a noteworthy correlation between levels of vitamin D and the magnitude of levator ani muscle contractions, as evidenced by a statistically significant p-value of less than 0.05.Conclusion: The administration of vitamin D supplements has been found to play a significant role in the remodeling of the levator ani muscle during the post-delivery period. This is evidenced by the observed increase in strength of the levator ani muscles following vitamin D supplementation.
Body fat percentage and Body Mass Index in association with menstrual irregularities in young adults: A cross-sectional study de Liyis, Bryan Gervais; David, George; Gunawan, Made Favian Budi
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.80-88

Abstract

HIGHLIGHTS 1. Body fat percentage and BMI were found to be associated with menstrual cycle and menstrual bleeding period.2. The odds of having a prolonged menstrual cycle were increased by a factor of 1.109 with an increase of one unit of body fat percentage, while the odds of having a prolonged menstrual bleeding period was decreased by a factor 0.887 with an increase of one unit of body fat percentage.   ABSTRACT Objectives: Body fat percentage measures overall amount of fat as a proportion of total body weight. Basal metabolic index (BMI) is an unreliable predictor of body fat percentage as excess fat, lean, muscle, or bone density are indifferentiable. However, the relation between body fat percentage and BMI on menstrual characteristics are still unclear. The aim was to compare the correlations between body fat percentage and BMI towards menstrual characteristics.Materials and Methods: A cross-sectional sample of 211 young adults was taken by means of cluster random sampling. Cross tabulations were performed between variables and Pearson's chi square value were observed. Multiple logistic regressions were performed to observe the odds ratio and 95% confidence interval.Results: Body fat percentage was found to be associated with menstrual cycle (p=0.000) and menstrual bleeding period (p=0.000) but not daily pads usage, intermenstrual bleeding, and menstrual pains. Age was found not to correlate with any of the collected menstrual characteristic data. BMI was also found to be associated with menstrual cycle (p=0.008) and menstrual bleeding period (p=0.003). Further analysis showed that a one unit increase of body fat percentage was linearly correlated with increased of menstrual cycle by a factor of 1.109 days (p<0.01) and a decreased of menstrual bleeding period by a factor of 0.887 days (p<0.01).Conclusion: Although both body fat percentage and BMI showed associations with menstrual cycle and menstrual bleeding period, only body fat percentage was linearly correlated with menstrual cycle and menstrual bleeding period.
The use of N-acetylcysteine to prevent further progression of preeclampsia Indrawan, I Wayan Agung; Farida, Leny
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.106-111

Abstract

HIGHLIGHTS 1. The generation of free radicals in the placenta leads to endothelial dysfunction, which contributes greatly in preeclampsia.2. N-acetylcysteine have a role in the oxidative stress pathway, helping in glutathione synthesis and as a free radical scavenger.3. N-Acetylcysteine supplementation in women with preexisting preeclampsia had positive effects on oxidative stress biomarkers, laboratory values, and blood pressure.   ABSTRACT Objectives: Preeclampsia is a prevalent disorder among pregnant women, characterized by hypertension and proteinuria, leading to serious complications. However, the precise pathophysiology of preeclampsia remains debated. Oxidative stress is believed to play a significant role in its development, and N-acetylcysteine (NAC) is known to influence this pathway. NAC aids in glutathione synthesis, a critical antioxidant, and acts as a free radical scavenger. This study aimed to examine the role of NAC in women with preeclampsia, focusing on its potential therapeutic benefits. Materials and Methods: A comprehensive literature search was conducted using PubMed and ScienceDirect databases, yielding 17 articles from PubMed and 395 articles from ScienceDirect. Reviews were excluded, resulting in 12 articles from PubMed and 89 articles from ScienceDirect. After further screening, 5 articles were selected for review, including 2 human studies and 3 animal studies, to understand the impact of NAC on preeclampsia. Results: Human studies indicated that NAC supplementation reduced the rate of preeclampsia among women at increased risk. Animal studies supported these findings, showing improvements in oxidative stress biomarkers, laboratory values, and blood pressure in models treated with NAC. NAC supplementation was associated with positive outcomes in managing oxidative stress, a key factor in the pathogenesis of preeclampsia. Conclusion: NAC supplementation in women with preexisting preeclampsia has beneficial effects on oxidative stress biomarkers, laboratory values, and blood pressure. These highlight the potential of NAC as a therapeutic intervention for preeclampsia, particularly in women at high risk. However, no significant differences were observed in maternal complication rate between the NAC-treated group and the control group. Further research is needed to fully understand the clinical implications of NAC supplementation and its long-term safety and efficacy in managing preeclampsia.
Evaluation and diagnostic approach in patient with Perrault Syndrome Nathania, Rachael Christin; Usman, Steven Yulius; Aryasatiani, Ekarini
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.143-147

Abstract

HIGHLIGHTS 1. The rare hereditary condition Perrault Syndrome is characterized by sensorineural hearing loss (SNHL) and ovarian dysfunction2. Cyclic estrogens and progesterone may be given to adolescents with amenorrhea to induce withdrawal bleeding and mimic the menstrual cycle.   ABSTRACT Objectives: A multidisciplinary team, which included a reproductive endocrinologist and an otolaryngologist, identified Perrault Syndrome in a patient with secondary amenorrhea and bilateral sensorineural hearing loss. Case Report: A 16-year-old female presented to the obstetrics and gynecology clinic at a type B hospital with primary amenorrhea for one year. Menarche occurred at age 13, followed by regular menstrual cycles for two years, after which menstruation gradually ceased. She denied dysmenorrhea, constipation, leukorrhea, genital pruritus, growth retardation, and weight loss. The patient expressed concern about potential future infertility. At age 9, she was diagnosed with a viral infection by an ENT specialist due to bilateral hearing loss, leading to emotional disturbances. There was no history of prior medication, family illness, or chronic infections. Born at term via spontaneous vaginal delivery, the patient weighed 3,000 grams. Laboratory tests revealed normal T3 (1.51 ng/dl), FT4 (1.16 ng/dl), prolactin (18.25 ng/ml), estrogen (11 pg/ml), and progesterone (0.1 pg/ml) levels, but elevated FSH (66.46 mIU/ml) and LH (29.97 mIU/ml) levels. Symptomatic treatment included bone conduction hearing aids and estrogen replacement therapy. Conclusion: Perrault Syndrome, a rare hereditary condition, manifests as sensorineural hearing loss (SNHL) and ovarian dysfunction, including primary ovarian insufficiency (POI) and gonadal dysgenesis, in individuals with a 46, XX karyotype. Molecular diagnosis remains challenging. Consultation with a pediatric endocrinologist can guide cyclic estrogen and progesterone therapy to induce withdrawal bleeding in adolescents with amenorrhea. Women at risk of ovarian failure should consider donor eggs or oocyte cryopreservation. Avoiding aminoglycosides and excessive noise is crucial for managing hearing loss.
The influence of patriarchal cultural factors on pregnancy complications (antepartum hemorrhage) at Mitra Medika General Hospital, Bandar Klippa, Indonesia Simamora, Liyana; Ismah, Zata; Susilawati
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.89-96

Abstract

HIGHLIGHTS 1. Antepartum hemorrhage stands as one of the major contributors to maternal mortality globally. 2. Patriarchal culture is among the societal factors impacting maternal mortality rates.3. Patriarchal cultural factors associated with antepartum hemorrhage are examined to establish effective preventive measures.   ABSTRACT Objectives: The objective of this study was to determine the influence of patriarchal culture on the occurrence of antepartum hemorrhage at Mitra Medika General Hospital. Materials and Methods: This study employed an analytical observational design with a case-control approach. The sample for this study included pregnant women in their third trimester and mothers who had given birth within a maximum of 4 months from the time of the study at Mitra Medika General Hospital, Bandar Klippa, Indonesia. There were 90 respondents, comprising 30 case groups and 60 control groups. The sampling method for the case group used quota sampling, while the control group utilized accidental sampling. The research instrument utilized questionnaires and secondary data (antepartum hemorrhage diagnoses). Data analysis employed the chi-square test for bivariate analysis and multiple logistic regression for multivariate analysis, with a significance level of 0.05. Results: There was a significant relationship between decision-making (p=0.030), family support (p=0.003), psychological domestic violence (p=0.024), and sexual domestic violence (p=0.039), no relationship with physical domestic violence (p=0.257) with the occurrence of antepartum hemorrhage. Multivariate analysis revealed that the family support variable was the most dominant risk factor with an Exp (B) value of 8.230 in causing antepartum hemorrhage. Conclusion: The patriarchal cultural factors that significantly affect antepartum hemorrhage at Mitra Medika General Hospital, Bandar Klippa, Indonesia, are decision-making, family support, psychological domestic violence, and sexual domestic violence.
Left hemiparesis due to space-occupying lesion in pregnancy Luminto; Aryasatiani, Ekarini; Panuntun, Mahendro Aji; Hassan, Bobby Wirawan; Sananta, Tania; Neil, Arya Elbert
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.136-142

Abstract

HIGHLIGHTS 1. Present a case report detailing the diagnosis and management of a space-occupying lesion identified late in pregnancy.2. Current studies consistently indicate that the optimal period for tumor removal during pregnancy is the second trimester, balancing maternal and fetal outcomes. This case report contributes to the existing literature by providing a practical reference for managing space-occupying lesions in accordance with the latest evidence.   ABSTRACT Objectives: The objective of this study was to present the findings from cases of space-occupying lesions (SOL) that were diagnosed late in pregnancy. This case report aimed to highlight the importance of considering space-occupying lesions as a differential diagnosis in instances of hemiparesis during pregnancy, thereby raising clinical awareness and improving diagnostic accuracy. Case Report: A female patient aged 30 years 34 weeks pregnant came with complaints of slurred speech since 3 months before entering the hospital accompanied by weakness in the left limbs since 3 months before admission. The patient felt weak and fell in the bathroom 2 times, at the office and at home. The patient had a history of taking aspilet for 1.5 months due to a misdiagnosis as a stroke in a Type B hospital and stopped when she came to the obstetric emergency room at a Type A Hospital for the first time. Cardiothoracograph examination shows a picture of a silent baby. Computed Tomography (CT) Scan examination showed a picture of hydrocephalus. Conclusion: To date, it has not been proven that pregnancy triggers brain tumors. However, increased blood supply to the brain during pregnancy may lead to tumor growth. This is also evident in this case where there is an increase in maternal blood volume and subsequent cerebral blood flow, causing an increase in the size of the SOL. On the other hand, there is no evident that brain tumors directly harm the fetus, though fetal hypoxia may occur indirectly due to maternal respiratory failure.
The promise and challenges of Artificial Intelligence-Large Language Models (AI-LLMs) in obstetric and gynecology Gumilar, Khanisyah Erza; Tan, Ming
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.128-135

Abstract

HIGHLIGHTS 1. The article highlights how Artificial Intelligence with Large Language Models (AI-LLMs) greatly improves diagnosis and treatment personalization in obstetrics & gynecology, and also enhances medical education through interactive simulations and up-to-date learning materials.2. The article also discusses the ethical issues linked to AI, emphasizing the need for cooperation among different stakeholders to use AI responsibly in medicine, focusing on protecting data privacy and minimizing reliance on technology.   ABSTRACT The introduction of Artificial Intelligence through Large Language Models (AI-LLM) into medicine holds great promise for improving patient care and medical education, especially in obstetrics and gynecology. AI-LLM can significantly improve diagnostic accuracy and treatment efficiency by utilizing large medical databases, which is especially useful for dealing with rare diseases that are difficult to document or understand by human practitioners alone. In addition, AI-LLM can provide informed patient care recommendations by analyzing large amounts of data and providing insights based on unique patient profiles, with the added benefit of being accessible 24/7 via the internet. This constant availability ensures that patients receive prompt information and assistance as needed. In the field of education, AI-LLMs enhance the learning experience by incorporating interactive simulations into the curriculum, improving medical students' and professionals' practical knowledge. They also ensure that educational materials are always up-to-date reflecting the most recent research and worldwide medical standards. This access latest information from global resources helps to bridge the educational gap, making advanced knowledge more accessible to learners regardless of their geographic location. However, the introduction of AI-LLMs is not without challenges. Ethical issues, such as data privacy and the risk of overreliance on technology, must be addressed. Effective management of these concerns necessitates collaboration among medical professionals, technological experts, academics, hospital committees, and representatives of patients. This multidisciplinary teamwork is vital for upholding ethical norms and preserving patient dignity and respect. AI-LLMs can considerably improve both patient care and medical education in obstetrics and gynecology provided they are appropriately balanced with innovation and ethics.
Maternal-related factors associated with development and improvement of peripartum cardiomyopathy and therapeutic outcomes of bromocriptine Pradnyaandara, I Gusti Bagus Mulia Agung; Mulyana, Ryan Saktika; Sutedja, Jane Carissa; Jagannatha, Gusti Ngurah Prana; Wibawa, I Bagus Satriya; Deantri, Fanny; Pradnyana, I Wayan Agus Surya; de Liyis, Bryan Gervais
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.112-127

Abstract

HIGHLIGHTS Younger age, black race, normotension, and multiparity indicate a poorer prognosis for peripartum cardiomyopathy recovery, while bromocriptine therapy reduces adverse events.   ABSTRACT Objectives: This study aimed to fill the significant knowledge gap regarding peripartum cardiomyopathy (PPCM), a heart failure phenotype linked to pregnancy. The main objectives were to explore the factors influencing the development and progression of PPCM and to assess the outcomes of bromocriptine.Materials and Methods: Systematic search across PubMed, ScienceDirect, and Cochrane Library identified studies until December 2022. This study includes non-randomized prospective and retrospective studies, as well as relevant randomized controlled trials. Risk factors were compared between the recovered and non-recovered PPCM groups, and bromocriptine therapy outcomes were evaluated against standard heart failure treatment as the primary endpoint.Results: The analysis included 24 observational studies and 1 randomized controlled trial involving 1,651 PPCM patients; 9 studies evaluating the outcomes of bromocriptine therapy. The most prevalent factors were caesarean delivery (proportion=53%, 95%CI=41%-66%) and anemia (proportion=51%, 95%CI=38%-65%). Non-recovered patients were younger (MD=-1.04 years old, 95%CI=-1.82-(-0.27), p=0.008) and predominantly black (RR=1.82, 95%CI=1.43-2.31, p <0.001). Hypertensive disorders and primiparity were found less among non-recovered patients (RR=0.73, 95%CI=0.60-0.88, p=0.001; RR=0.81, 95%CI=0.66-0.99, p=0.04, respectively). Non-recovered patients also exhibited higher baseline serum creatinine levels, lower LVEF, larger left ventricular end-systolic diameter (LVESD), larger left ventricular end-diastolic diameter (LVEDD), and lower fractional shortening (all P-values<0.05). Furthermore, bromocriptine significantly reduced major adverse cardiac events (MACE), mortality, and increased LVEF (all P-values<0.05).Conclusion: Younger maternal age, black race, absence of hypertension, and multiparity are associated with poorer prognosis for PPCM recovery. Bromocriptine therapy demonstrates superior benefits in reducing adverse events in PPCM.
Acquired uterine arteriovenous malformation after cesarean section Usman, Fatimah; Sutrisno, Muhammad Al Farisi; Effendi, Kemas Yusuf; Abadi, Adnan; Manan, Heriyadi; Amran, Rizani; Zulqarnain, Iskandar
Majalah Obstetri & Ginekologi Vol. 32 No. 2 (2024): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I22024.148-155

Abstract

HIGHLIGHTS 1. Acquired uterine arteriovenous malformation (AVM) is an uncommon sequela of cesarean section, warranting consideration in instances of persistent uterine bleeding in the puerperium.2. Embolization represents a viable and well-established treatment modality for AVM, providing a safe and efficacious intervention that serves as an alternative, less invasive modality for patients desiring fertility preservation.   ABSTRACT Objectives: To demonstrate that embolization is a viable and well-established treatment for acquired arteriovenous malformations (AVMs), offering a safe and effective, less invasive option for patients seeking to preserve fertility.Case Report: A 20-year-old female experiencing recurrent massive bleeding with a history of previous caesarean section and wound infection resuturing. The transvaginal color Doppler ultrasound showed a hypervascularity in the uterus around the surgical lesion, suggesting a uterine AVM and its confirmed by angiography. The patient underwent a series of uterine artery embolization interventions, which proved to be a successful therapeutic approach. As a result of this treatment modality, not only was the patient's condition effectively resolved, but her fertility was also preserved.Conclusion: Acquired uterine arteriovenous malformation (AVM) is an uncommon sequela of cesarean section, warranting consideration in instances of persistent uterine bleeding in the puerperium. Embolization represents a viable and well-established treatment modality for AVM, providing a safe and efficacious intervention that serves as an alternative, less invasive modality for patients desiring fertility preservation.

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