Indonesian Journal of Obstetrics and Gynecology

Integrating Herbal Remedies in Indonesian Obstetric and Gynecologic Care: Bridging Tradition with Modern Medicines

2025-11-13T11:16:36+07:00

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Characteristics and treatment in patient with Vaginismus in East Java Indonesia

2025-10-23T10:51:24+07:00

Background - Vaginismus is still an under-researched case of women's health despite its universal prevalence.

Aim -This study aims to explore the characteristics of vaginismus in East Java Indonesia.

Methods- The subjects in this study were all new female patients with Vaginismus was found in a single hospital - East Java Indonesia in 2022. The data used in this study are secondary data obtained from the medical records. Descriptive data are presented as numbers and percentages for categorical data.

Results – Vaginismus was found in a single hospital - East Java Indonesia. Based on medical record data, throughout 2022 there will be 60 patients with a diagnosis of Genito Pelvic Pain Penetration Disorder (GPPPD). The results of the assessment of patient characteristics showed that almost all patients were of reproductive age. Most of the respondents have been married for more than 1 year. Management is carried out independently and collaboratively. A total of 60 patients underwent anamnesis and physical examination. Complaints experienced by patients are failure to penetrate. Treatment was done using Botox injections, dilatation, hymenectomy, and consultation to psychiatrist and andrologist.

Conclusion - Management in cases of Vaginismus requires cross-professional collaboration such as psychiatrists and andrology. The treatment given also tends to be complex.

A Mixed-Methods Evaluation of an Iron Supplementation Program for Adolescent Girls in Magelang City

2025-11-13T11:16:19+07:00

Abstract
Objective: To evaluate the implementation of the iron supplementation program for adolescent girls in Magelang City and
identify supporting and inhibiting factors.
Methods: This study used a mixed-methods triangulation design with purposive sampling. Quantitative data from the Magelang
City Health Office were analyzed descriptively, while qualitative data from interviews and FGDs explored implementation
barriers.
Results: The program achieved 72.2% coverage, meeting the national target. Supporting factors included regulatory planning,
digital reporting via e-PPGBM, cross-sectoral collaboration, and the Aksi Bergizi initiative. However, barriers such as lack of
budget, SOPs, human resources, and low adherence were identified.
Discussion: Quantitative findings provided an overview of program success, while qualitative insights revealed operational
challenges. Low adherence was influenced by limited awareness, unclear benefits, and perceived barriers like nausea and lack
of parental support. Reporting delays and system closures also hindered performance.
Conclusion: Despite meeting coverage targets, the program faces significant implementation challenges. Strengthening
budgeting, SOPs, and human resources, along with improving adolescent awareness, is essential for future success.
Keywords: Adolescent girls, iron supplementation, mixed-methods study, program evaluation.

Feasibility Study For Birth Defect’s and Congenital Abnormalities’s Integrated Service In A Low-Middle Income Country

2025-11-13T11:16:56+07:00

Background: Congenital abnormalities are anatomical and physiological abnormalities that are present in babies from birth. One of the main causes of high infant mortality and neonatal mortality in Indonesia is congenital abnormalities in babies. This study describes the prevalence of congenital abnormalities in Dr. Cipto Mangunkusumo Hospital, as a tertiary referral hospital in Indonesia, which requires integrated healthcare service to be treated well.

Methods: Data obtained from 323 patients at Dr. Cipto Mangunkusumo General Hospital are collected in a year, to be further analyzed in retrospective cohort study. Collected data includes the patients’ age, birth date, reproductive history, gestational age, and congenital abnormalities of the baby.

Results: The data shows that patients with the age group of 30-39 years old dominated the cases of pregnancy with congenital abnormalities. Cases are also more dominant in the gestational age of 13 – 28 weeks (second-trimester). Most cases of abnormalities are from the central nervous system with 159 cases and followed by cardiovascular system with 130 cases. Overall prevalence of congenital abnormalities are detected within patients during prenatal screening in Dr. Cipto Mangunkusumo General Hospital.

Conclusion: This study highlights the importance in managing congenital abnormalities and birth defects by developing an integrated service in the healthcare system to lower infant and neonatal mortality.

Keywords: birth defect, congenital abnormalities, prenatal screening

Emotional Impact of In Vitro Fertilization (IVF): Anxiety, Depression, and Their Relationship with Pregnancy Outcomes

2025-10-27T12:17:18+07:00

Objectives: Infertility can significantly impact women's physical and psychological health. Numerous treatment options are commonly pursued, with IVF often considered the last resort for infertile couples. However, IVF is associated with increased stress at every stage, potentially influencing women's perceptions and experiences throughout the procedure. This research examines anxiety and depression faced by women at different stages of IVF and analyzes their association with pregnancy outcomes.

Methods: This cohort study was conducted at Dr. Cipto Mangunkusumo General Hospital and Dr. Sander B. Daya Medika Clinic from May 2018 to March 2023. Data were collected using questionnaires and assessments during IVF, focusing on the evaluation of anxiety, depression, and pregnancy outcomes. Chi-square and Fisher’s exact test was used to assess associations between variables, while Friedman ANOVA was used for longitudinal analysis of anxiety and depression scores during IVF.

Results: The final analysis comprised 61 participants. The study revealed significant changes in anxiety and depression throughout IVF. Both anxiety (p < 0.001, Kendall’s w = 0.19) and depression levels (p = 0.001, Kendall’s w = 0.121) showed a significant rise across the IVF timeline. There is no statistically significant association between anxiety and depression scores and pregnancy outcomes across three measurement points during IVF (p > 0.05).

Conclusion: Anxiety and depression significantly increase during IVF but do not affect clinical pregnancy rates. These findings highlight the importance of mental health screening and psychiatric support during IVF to ensure women’s comfort and enable them to navigate IVF more effectively.

Keywords: Anxiety, Depression, Pregnancy Outcomes, Women, In Vitro Fertilization (IVF)

Vaginal Microbial Patterns and Matrix Metalloproteinase-9 Levels in relation to Premature Rupture of Membranes

2025-11-13T11:17:15+07:00

Introduction: The premature rupture of membranes (PROM) before the onset of labor, characterized by the painless leakage of fluid from the vagina, can lead to fetal distress and increase the risk of cesarean section. This study analyzed the microbial patterns and matrix metalloproteinase 9 (MMP-9) levels in cases of PROM.

Methods: This was an observational study with cross-sectional design. Samples were collected from 60 pregnant women diagnosed with PROM who underwent examination and treatment at St. Khadijah I Hospital in Makassar in November 2023. Statistical analysis was performed using the Independent Samples T-Test for microbial patterns and MMP-9 levels.

Results: The MMP-9 level in PROM group was significantly higher (1706,78 ± 386,36) compared to non-PROM group (1328,20 ± 1556,22) with p = 0.006. For microbial pattern, E. coli was the predominant bacteria in PROM group (72,0%) compared to non-PROM group (28,0%) with p = 0.004.

Conclusion: The results of this study indicate that high MMP-9 level and predominant E. coli presence in the vaginal swab may increase the risk of PROM.

Relationship of History of Hypertension with Severity and Onset of Preeclampsia: A Cross-Sectional Study

2025-10-23T10:51:24+07:00

Abstract
Objective: This study aimed to find correlation between a history of hypertension with severity and onset of preeclampsia.
Methods: A retrospective cohort study with retrospective analysis of medical record data in patients with preeclampsia and
severe preeclampsia from November 2021 – February 2022 was conducted at dr. Soediran Mangun Sumarso Regional General
Public Hospital, Wonogiri, Central Java. Analysis was performed between the history of hypertension with severity and onset
(<34 weeks and age ? 34 weeks gestational age). Data analysis was performed using SPSS software with univariate Chi-Square
analysis.
Results: A total of 44 medical record data were obtained in this study. A total of 20 patients (45.5%) had a history of
hypertension and 24 (55.5%) patients had no history of hypertension. A total of 23 patients (52.3%) were diagnosed with
severe preeclampsia and 21 patients (47.7%) were diagnosed with preeclampsia. Based on statistical analysis, it was found
that there was no significant correlation between the history of hypertension and the severity of preeclampsia (p=0.741; OR
(CI 95%): 0,818 (0,249 – 2,690)) and onset (p=0.88; OR (CI 95%): 1,133 (0,222 – 5,788)).
Conclusion: There is no relationship between history of hypertension with the severity and onset of preeclampsia. Further
studies with larger populations are needed to analyze the relationship between history of hypertension and preeclampsia.
Keywords: blood pressure, cardiovascular disease, hypertension, onset, preeclampsia

Effect of Bengkoang (Pachyrhizus erosus) Extract on Estrogen Receptor-?, Progesterone Receptor Expression, and Follicle-Stimulating Hormone Levels

2025-10-23T10:51:24+07:00

Abstract

Objective: Progesterone functions by inhibiting the release of Gonadotropin-Releasing Hormone (GnRH), which decreases Follicle-Stimulating Hormone (FSH) levels and converts them into hypoestrogens. This condition affects the expression of steroid, estrogen, and progesterone receptors, contributing to endometrial proliferation and secretion during the menstrual cycle.

Methods: This study aims to demonstrate that Bengkoang extract administration increases the expression of Estrogen Receptor (ER), Progesterone Receptor (PR), and Follicle-Stimulating Hormone (FSH) in Wistar model rats. This study divided 25 female Wistar rats into five groups: one control group without progesterone and Bengkoang extract and four treatment groups injected with progesterone. After exposure, Bengkoang extract was administered to three treatment groups at doses of 70 mg/200 g BW/day (treatment 1), 140 mg/200 g BW/day (treatment 2), and 280 mg/200 g BW/day (treatment 3).

Results: The results showed an increase in the expression of Estrogen Receptor- ? (Er?), Progesterone Receptor (PR), and Follicle-Stimulating Hormone (FSH) levels in treatment 1, treatment 2, and treatment 3 groups compared to the KP with p <0.05

Conclusion: The study investigating the effect of Bengkoang (Pachyrhizus erosus) extract on estrogen receptor-? (ER?), progesterone receptor (PR) expression, and follicle-stimulating hormone (FSH) levels has demonstrated significant findings.

Keywords: Estrogen, Estrogen receptor-?, Follicle-stimulating hormone, Pachyrhizus erosus, Progesterone, Progesterone receptor

A Case Series on Pregnant Patients with Ovarian Cysts and Management of Potential Complications

2025-10-23T10:51:24+07:00

Abstract (English)

Objective: To report a series of ovarian cyst cases in pregnancy that we diagnosed in our obstetrics and gynecology department; and to provide literary perspective in management of potential complications.

Methods: A case series

Case: We present three cases of pregnant patients with ovarian cysts diagnosed at different trimesters of gestational age. Patients included in this case series were shown to have cysts at the time of sonographic examination. Each patient displayed different complications and underwent specific management for each complication which includes laparotomy and emergency cesarean section. All patients were discharged in clinically stable conditions and the mass was evaluated for further histopathologic examination. This case series will also discuss possible complications of pregnancy with ovarian cysts, and the prevalence of each complication based on the gestational age. Due to its potential complications, ovarian cysts in pregnancy must be accurately evaluated and given appropriate management.

Conclusion: Ovarian cysts in pregnancy must be evaluated accurately so that appropriate management is carried out. Clinicians should be aware of cyst complications during pregnancy.

Keywords: Ovarian Cysts, Pregnancy, Potential Complications

Management of Severe Preeclampsia with Anemia in Pregnant Women with Covid-19 Infection : A Multidisciplinary Approach

2025-10-23T10:51:24+07:00

Coronavirus disease 2019 (COVID-19) is a disease that is currently pandemic almost worldwide, with the first case in Indonesia on March 2, 2020, spreading rapidly across the entire country. Pregnant women are a vulnerable group to experience health disorders, especially infectious diseases, due to changes in physiological body and immune response mechanisms within their bodies. In this study, we report a case of COVID-19 in a 31-year-old pregnant woman at 30-31 weeks of gestation, who is pregnant with her second child and complained of leaking amniotic fluid and shortness of breath. Physical examination results showed: positive SARS-CoV-2 antigen swab test, BP 156/112 mmHg, T (36.0°C), heart rate 107 beats per minute, respiratory rate 30 breaths per minute, fetal heart rate 144 beats per minute, SpO2 97%, urine protein +4, Hb 4.4 g%. Vaginal toucher examination revealed cervical dilation of 1 cm, negative for amniotic fluid leakage, and cephalic presentation. Spontaneous delivery process. The baby was born normally, female, APGAR score 1-2, weight 900 grams, length 27 cm, positive anus. Complications accompanying pneumonia, metabolic acidosis, anemia, melena, coagulopathy. This case report contains clinical descriptions, diagnosis, and management of care for pregnant women with Covid-19.

Multiple Congenital Anomalies with Breech Presentation: Dilemma in Diagnostic Procedures, Delivery Management, and Counseling in Developing Country

2025-10-23T10:51:24+07:00

polyhydramnios with multiple congenital anomalies (micrognathia, hypotelorism, low set ear, club hand bilateral with clenched hand, club foot bilateral); arthrogryposis suspect of trisomy along with dilemmatic for diagnostic, management, and counseling aspect in developing country.

Case Illustration: A-22 years old G1P0A0 felt 8 months pregnant came to obstetrics and gynecology ward withcomplaints of labor pain since one day before admission. Physical examination revealed a normal result and external obstetric examination showed a breech fetal position. Maternal-Fetal ultrasonography at 27-28 weeks of pregnancy demonstrated a single intrauterine alive fetus, in breech position; according 27-28 (at 8 weeks before admission or 35-36 weeks at current admission) gestational weeks (27⁺³ weeks), estimated fetal weight of 1041 grams. fetal heart rate (+); polyhydramnios with multiple congenital anomalies (micrognathia, hypotelorism, low set ear, club hand bilateral with clenched hand, club foot bilateral); arthrogryposis suspect of trisomy. For diagnostic purpose, the patient was suggested for amniocentesis but the patient's family refused. Vaginal delivery was planned and the baby was born through spontaneous bracht vaginal delivery method. The patient discharged the following day but her baby was admitted to high care unit installed with continuous positive airway pressure and passed away the following day due to respiratory failure.

Conclusions: Non-Invasive Prenatal Testing (NIPT) could be performed, followed by CVS or Amniocentesis in severe congenital anomalies cases to confirm trisomy, especially when combined with sonography findings. The method of delivering a preterm breech patient through spontaneous bracht delivery is preferred than caesarean section due to survival rate of the baby. A genetic counseling is necessary in this patient given the recurrence rate in subsequent pregnancies, but the importance in developing country is still debated.

Keywords: breech, prenatal counseling, multiple congenital anomalies, genetic