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Indonesian Journal of Obstetrics and Gynecology
The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published quarterly.
Articles
524
Articles
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

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Abstract

  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.

Effectiveness of Oral Misoprostol to Prevent Postcesarean Section Urinary Retention

Mahadika, Febrinata, Fauzi, Amir, Mirani, Putri, Theodorus, Theodorus

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

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Abstract

Objective: to determine the effect of misoprostol on the incidence of urinary retention in post cesarean section patients by measuring maternal residual urine volume 6 hours after catheter removal. Methods: This was a single-blind randomized controlled trial, at Department of Obstetrics and Gynecology Mohammad Hoesin Palembang Hospital from October 2016 to February 2017. Samples were patients who underwent cesarean section, either elective or emergencies treated at Department of Obstetrics and Gynecology Hospital, Mohammad Hoesin Palembang. Subjects were allocated into two groups: treatment group (receiving misoprostol) and placebo group. Urinary retention is diagnosed if post-voiding residual urine volume after Foley catheter removal was > 200 ml. Statistical analysis was performed using SPSS 17.0 Results: There were no differences in mean time between of urination between control group (placebo) and 600μg oral misoprostol group. The average of urine volume, and residual urine volume between control group (placebo) and 600μg oral misoprostol group was significantly different. 600μg misoprostol orally can increase the amount of urine and reduce the volume of urinary residue after cesarean section. Conclusion: 600μg oral misoprostol can increase urine volume and reduce volume of residual urine post cesarean section Keywords: Misoprostol, urinary retention, cesarean section   Tujuan: untuk mengetahui pengaruh misoprostol terhadap kejadian retensi urin pada pasien operasi seksio sesaria dengan mengukur volume residu urin maternal 6 jam setelah kateter dilepaskan. Metode: Penelitian uji klinik acak berpembanding (Randomized Controlled Trial) secara single blind (tersamar tunggal) ini dilakukan di Departemen Obstetri dan Ginekologi RSUP Mohammad Hoesin Palembang mulai bulan Oktober 2016 sampai dengan Februari 2017. Sampel penelitian adalah semua pasien seksio sesaria, baik elektif maupun emergensi yang dirawat di Departemen Obstetri dan Ginekologi RSUP Mohammad Hoesin Palembang. Subjek dialokasikan menjadi 2 kelompok yaitu kelompok penanganan yang menerima misoprostol dan kelompok placebo. Retensio urin didiagnosis jika volume residu urin pasca berkemih setelah kateter Foley dilepaskan >200 ml. Analisis statistik dilakukan dengan menggunakan SPSS 17.0 Hasil:Tidak terdapat perbedaan rerata waktu urinasi antara kelompok kontrol (plasebo) dengan misoprostol peroral 600µg.Terdapat perbedaan rerata jumlah urine, dan volume residu urine antara kelompok kontrol (plasebo) dengan misoprostol peroral 600µg. Misoprostol per oral 600µg dapat meningkatkan jumlah urin dan mengurangi volume residu urin pasca persalian seksio sesaria. Kesimpulan:. Misoprostol per oral 600µg dapat meningkatkan jumlah urin dan mengurangi volume residu urin pasca persalian seksio sesaria Kata kunci: Misoprostol, retensio urin, seksio sesaria

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

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Abstract

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

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Abstract

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.

Relationship of Retinol Binding Protein Four Serum Level on Endometrial Hyperplasia and Endometrial Carcinoma

Limy, Ivan, Suparman, Eddy, Tendean, Hermie M. M.

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

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Abstract

Abstract Objective : To determine the relationship of elevated serum retinol binding protein 4 with abnormal uterine bleeding Methods : This study was an observational quantitative with cross sectional methods, with all women who had abnormal uterine bleeding caused either by endometrial carcinoma or endometrial hyperplasia at RSUP Prof.DR.RD Kandou, and affiliation hospitals from November 2016 until April 2017. Data were analyzed With SPSS version 2.0 to see the significancy level. Results: Of 26 research subjects, 23 subjects with endomtrial hyperplasia and 3 subjects with endometrial carcinoma. From the total of 26 malignancy and hyperplasia diagnoses, 21 had IMT> 25 and 23 were diagnosed with Endometrial Hyperplasia and 3 Carcinoma Endometrium. 18 subjects had elevated serum RBP4 levels, with 15 people with endometrial hyperplasia and 3 with endometrial carcinoma. With the Fischer Exact test statistic, serum retinol binding protein 4 levels were found in both endometrial hyperplasia and endometrial carcinoma p = 1.00, meaning no significant difference for the occurrence of abnormal uterine bleeding. Conclusion: There was no significant association between serum retinol binding protein 4 between endomterium carcinoma and endometrial hyperplasia. Keywords: abnormal uterine bleeding, endometrial carcinoma, endometrial hyperplasia, serum retinol binding protein 4   Abstrak Tujuan : Mengetahui adanya hubungan peningkatan kadar serum retinol binding protein 4 pada hyperplasia endomterium dengan carcinoma endometrium Metode : Penelitian ini adalah jenis kuantitatif observasional secara potong lintang, dengan semua perempuan yang mengalami perdarahan uterus abnormal yang disebabkan oleh hiperplasia endometrium atau carcinoma endometrium di Bagian Kebidanan dan Kandungan Rumah Sakit Umum Pusat (RSUP) Prof.DR.R.D Kandou, dan RS jejaring mulai November 2016 sampai April 2017.Data dianalisa dengan SPSS versi 2.0 untuk melihat tingkat kemaknaannya. Hasil : Dari 26 subjek penelitian, 23 subjek dengan hyperplasia endomtrium dan 3 subjek dengan carcinoma endometrium. Didapatkan data penelitian dari total keganasan diagnosa  dan hiperplasia sejumlah 26 orang, sebanyak 21 orang memiliki IM T>25 dan sebanyak 23 orang didiagnosa dengan Hiperplasia Endometrium dan 3 orang karsinoma Endometrium. Didapatkan sebanyak 18 subyek penelitian mengalami peningkatan kadar serum RBP 4, dengan 15 orang yang mengalami hiperplasia endometrium dan 3 orang dengan karsinoma endometrium. Dengan uji statistik Fischer Exact test, didapatkan kadar serum retinol binding protein 4 baik pada hiperplasia endometrium dengan karsinoma endometrium p=1.00, mengartikan tidak mempunyai perbedaan bermakna untuk terjadinya perdarahan uterus abnormal. Kesimpulan : Tidak terdapat hubungan bermakna kadar serum retinol binding protein 4 antara karsinoma endomterium dengan hiperplasia endometrium. Kata kunci : hiperplasia endometrium , kadar serum retinol binding protein 4, karsinoma endometrium, perdarahan uterus abnormal

Effect of Pyridoxine on Prostaglandin Plasma Level for Primary Dysmenorrheal Treatment

Randabunga, Ervan J, Lukas, Efendi, Tumedia, Josephine L, T. Chalid, St. Maisuri

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

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Abstract

Objective : To determine the effect of vitamin B6 (pyridoxine) the levels of prostaglandins and intensity of pain in primary dysmenorrheal. Methods : The levels of prostaglandin (PGF2α) in plasma measured by ELISA and pain intensity by verbal rating scales conducted on 35 women with primary dysmenorrheal (n=35) supplemented with vitamin B6 100mg for 4 days and controls with placebo (n=35). Results : Prostaglandin levels decreased significantly after vitamin B6 supplementation (2212.9+1374.2 vs 1490.3+1119.0; p<0.05) followed by a significant reduction in pain intensity (4.29+0.7 vs 1.71+0.5; p<0.05) in the test group compared to control. Conclusion : Due to vitamin B6 effects on decreasing prostaglandin levels and pain of primary dysmenorrheal, so that B6 vitamin can become the treatment for the primary dysmenorrheal. Keywords : Primary dysmenorrheal, pyridoxine, prostaglandin   Tujuan: Untuk mengetahui pengaruh pemberian vitamin B6 (piridoksin) terhadap kadar prostaglandin dan intensitas nyeri pada dismenore primer. Metode: Pemeriksaan kadar prostaglandin (PGF2α) dengan ELISA dan pengukuran intensitas nyeri dengan verbal rating scales dilakukan pada 35 orang (n=35) wanita dengan dismenore primer yang mendapatkan vitamin B6 100mg selama 4 hari dan kontrol yang mendapatkan plasebo (n=35). Hasil: Kadar prostaglandin menurun bermakna setelah pemberian vitamin B6 (2212,9+1374,2 vs 1490,3+1119,0; p<0,05) disertai dengan penurunan intensitas nyeri yang bermakna (4,29+0,7 vs 1,71+0,5; p<0,05) pada kelompok uji dibandingkan kontrol. Kesimpulan: Vitamin B6 menurunkan kadar prostaglandin dan nyeri sehingga vitamin B6 dapat dipertimbangkan menjadi salah satu pengobatan dismenore primer. Kata kunci : Dismenore primer, piridoksin, prostaglandin

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

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Abstract

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

Lidocaine Prilocaine Cream versus LidocaineHCL Injection for Pain Relief during Second Degree of Perineal Tear Suturing after Vaginal Delivery: A Comparative Study

Rahmawati, Rahmawati, Lotisna, David, Abdullah, Nusratuddin, Chalid, Maisuri T, Tessy, Telly

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

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Abstract

Abstract Objective : To compare the effectiveness of topically applied lidocaine-prilocaine cream with lidocaine-HCl injection in the reduction of pain during second degree of perineal tear suturing after vaginal delivery. Methods : One hundred and twenty-four of women with second degree of perineal tear after vaginal delivery were enrolled in this randomized clinical trial. Women were assigned randomly to have either application of lidocaine-prilocaine cream (n=62) or local injection of lidocaine-HCl (n=62) for anesthetic during perineal suturing. Pain measured with viasual analog scale (VAS) for the first 5 minutes during the perineal suturing. Statistical analysis was performed by comparative analytic numerical unpaired with independent t test between the two groups and significance was assessed at p<0.05. Data were presented as mean ± standard deviation (SD). Results : There was no significantly different of pain score between lidocaine-prilocaine cream and lidocaine-HCl injection group (5.66±1.07 vs 5.56±1.5; p=0.473). Conclusion : Application of lidocaine-prolicaine cream as effective as injection of lidocaine for reducing pain during second degree of perineal tear suturing after vaginal delivery. Keywords : Lidocaine-prilocaine cream, lidocaine-HCl injection, pain, perineal suturing, vaginal delivery     Abstrak Tujuan: Untuk membandingkan efektivitas antara lidokain-prilokain topikal dan lidokain-HCl injeksi dalam mengurangi nyeri selama penjahitan luka perineum tingkat dua setelah persalinan normal. Metode: Seratus dua puluh empat perempuan dengan robekan perineum tingkat dua postpartum pervaginam mengikuti uji coba klinis secara acak ini. Enam puluh dua perempuan (n=62) menggunakan lidokain-prilokain topikal dan 62 perempuan lainnya (n=62) menggunakan injeksi lokal lidokain-HCl untuk anestesi selama penjahitan perineum. Nyeri diukur dengan visual analog scale (VAS) untuk 5 menit pertama selama penjahitan perineum. Analisis statistik dilakukan dengan uji numerik komparatif tidak berpasangan dengan uji t independen antara kedua kelompok dengan tingkat kemaknaan p<0,05. Data disajikan sebagai rerata ± standar deviasi (SD). Hasil: Tidak terdapat perbedaan signifikan skor nyeri antara kelompok  lidokain-prilokain topikal dan kelompok injeksi lidokain-HCl (5,66 ± 1,07 vs 5,56 ± 1,5; p = 0,473). Kesimpulan : Efektifitas lidokain-prolikain topikal untuk mengurangi nyeri sama dengan injeksi lidokain-HCl selama penjahitan robekan perineum tingkat dua postpartum pervaginam. Kata kunci : Lidokain-prolikain topical, lidokain-HCl injeksi, nyeri, penjahitan perineum, persalinan normal

The Prevalence and Outcome of Teenage Pregnancies in a Tertiary Care Teaching Hospital

Kayika, I Putu G, Lidyasna, Farrah

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

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Abstract

Abstract Objectives: To examine the prevalence as well as maternal and perinatal outcome of teenage pregnancies. Methods: For analyzing the prevalence of the teenage mothers, we used cross-sectional study design by evaluating the medical records of all pregnant mothers who went to the obstetric clinic of Cipto Mangunkusumo Hospital, Jakarta, Indonesia, during January 2014 until December 2016. For the outcome of the teenage mothers, we used retrospective study design by analyzing medical records of teenage mothers who had delivery at the delivery ward of Cipto Mangunkusumo Hospital during January 2014 until December 2016. We compared their outcomes to outcomes of pregnant women aged 20 to 30 years old delivered at the same hospital in the same period. Maternal outcomes that were measured include preeclampsia, methods of delivery, anemia, and postpartum hemorrhage, as well as perinatal outcomes including preterm delivery, and low birthweight. Results: Among 3.578 outpatients at Obstetric Clinic, RSUPN Cipto Mangunkusumo, we got 503 pregnant subjects, 16 (3.2%) were teenagers. Among 520 subjects who had delivery, 78 (15%) subjects were ≤ 19 years old. Teenage pregnancy was significantly associated with anemia (p < 0.05, adjusted OR = 2,08) and low birthweight (p < 0.05, adjusted OR = 1.83). Teenage pregnancy was not significantly associated with preeclampsia, methods of delivery, postpartum hemorrhage, and preterm delivery. Conclusion: The prevalence of teenage pregnancy at Cipto Mangunkusumo Hospital is 3.2% and teenage mothers who had delivery is 15%. Teenage mothers are at increased risk of anemia and delivering low birth weight babies. Keywords: maternal outcome, perinatal outcome, prevalence,teenage pregnancies   Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui prevalensi kehamilan remaja serta luarannya. Metode: Untuk menganalisis prevalensi ibu remaja, kami menggunakan desain studi potong lintang dengan mengeavaluasi rekam medis dari seluruh ibu hamil yang berobat ke klinik obstetri RSUPN Cipto Mangunkusumo pada periode Januari 2014 sampai Desember 2016. Pada luaran ibu hamil, kami menggunakan desain studi retrospektif dengan menganalisis rekam medis ibu remaja yang bersalin di RSUPN Cipto Mangunkusumo pada periode yang sama. Luaran ibu remaja dibandingkan dengan ibu yang bersalin yang berusia 20-30 tahun. Luaran ibu yang kami ukur meliputi preeklampsia, metode persalinan, anemia, perdarahan pasca persalinan, sedangkan luaran perinatal yang kami ukur meliputi kelahiran prematur dan BBLR. Hasil: Dari seluruh 3.578 pasien di Poliklinik Obstetri RSUPN Dr. Cipto Mangunkusumo, diperoleh 503 subjek yang hamil,sebanyak 16 (3.2%) subjek adalah remaja. Dari seluruh 520 subjek yang bersalin, 78 (15%) subjek adalah remaja. Kehamilan remaja berhubungan signifikan dengan anemia (p < 0.05, adjusted OR = 2.08) dam BBLR (p < 0.05, adjusted OR = 1.83).  Kehamilan remaja tidak berhubungan signifikan dengan preeklamsia, metode persalinan, perdarahan pascapersalinan, dan kelahiran prematur. Kesimpulan: Prevalensi kehamilan remaja di RSUPN Dr. Cipto Mangunkusumo adalah 3.2% dan persalinan remaja di RSUPN Dr. Cipto Mangunkusumo adalah 15%. Ibu remaja berada pada peningkatan risiko anemia dan melahirkan bayi BBLR. Kata kunci: kehamilan remaja, luaran ibu, luaran perinatal, prevalensi,

Identification of microorganisms in vaginal swab and peritoneal fluid of women with endometriosis

Hadisaputra, Wachyu, Judio, Johny, Gunardi, Eka R

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

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Abstract

Abstract Objective: to discover correlation between microorganisms found in vaginal swab culture and in peritoneal fluid culture from laparoscopy in reproductive age women diagnosed with endometriosis. Methods: This cross sectional study was conducted in Bunda Hospital and YPK Hospital, Central Jakarta. Thirty one subjects was includedby consecutive sampling. Data were analyzed using SPSS 20.0 for Windows. Bivariate analysis was used to identify the correlation between independent and dependent variable. Results: From 31 subjects with mean age 34.42+5.056 years old, 87.1% were infertile. Vaginal swab culture was found positive in 83.9% subjects while peritoneal fluid culture was found positive only in 9.6% subjects. There was moderate correlation between chronic pelvic pain and positive vaginal swab culture (r=0.601; p=0.001), but weak correlation between Ca125 and vaginal swab culture (r=0.440; p=0.010). Peritoneal fluid culture had significant inverse correlation with left tubal patency (r=-0.346; p=0.047). There was weak correlation between vaginal swab culture and peritoneum fluid culture with correlation coefficient of 0.13. Conclusion: Most of bacteria found in vaginal swab culture and peritoneal fluid culture were the ones found in gastrointestinal tract. However, vaginal swab and peritoneal fluid culture were not sufficient to prove the hypothesis that infection has a role in pathogenesis of endometriosis. Therefore, advance and more complete examination such as LPS and PCR might be needed to be done in the future research with cohort study, to overcome the limitation of this study. Keywords: endometriosis, ascending bacterial contamination, vaginal swab, peritoneal fluid, culture   Abstrak Tujuan : Membuktikan adanya korelasi antara mikroorganisme yang ditemukan pada hasil kultur bilasan vagina dengan mikroorganisme yang ditemukan pada cairan peritoneum hasil laparoskopi perempuan usia reproduksi yang terdiagnosis endometriosis Metode :Penelitian ini menggunakan desain penelitian analitik poltong lintang yang bertujuan untuk melihat adanya hubungan korelasi serta mengetahui tingkat korelasi antara mikroorganisme kultur bilasan vagina dengan mikroorganisme pada cairan peritoneum pasien endometriosis. Hasil: Hasil kultur bilasan vagina dari 31 subjek penelitian yang diteliti, mikroorganisme terbanyak adalah Enterococcus faecalis (32.3%), Eschericia coli (29.1%), dengan 16.1 % dengan hasil kultur negatif. Sedangkan dari hasil kultur bilasan peritoneum terdapat 3 subjek (9.6%) dengan hasil positif yaitu dengan jenis bakteri Eschericia coli, Enterococcus faecalis, dan Pseudomonas. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum (r 0.13). Terdapat korelasi sedang antara kultur positif bilasan vagina dengan nyeri pelvik kronis, korelasi lemah antara kultur positif bilasan vagina dengan nilai Ca 125, dan korelasi lemah antara kultur positif cairan peritoneum dengan tuba kiri yang non paten. Kesimpulan:          Sebagian besar bakteri dari bilasan vagina dan bilasan peritoneum pada pasien endometriosis memiliki hasil bakteri dari organ pencernaan. Terdapat korelasi lemah antara hasil kultur bilasan vagina dengan kultur bilasan peritoneum pada pasien endometriosis. Kata kunci: endometriosis, kontaminasi bakteri asenden, kultur, bilasan vagina, cairan peritoneum

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