Indonesian Journal of Obstetrics and Gynecology

Screening of Preeclampsia for the Reduction of Maternal Morbidity and Mortality in Indonesia

Johanes C Mose — Fri, 31 Jan 2025 00:00:00 +0000

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Effectiveness of Long Bean Leaf Green Noodles in Enhancing Prolactin Levels in Breastfeeding Mothers

Siti Nurhidayah, Moudy E.U Djami, Erni Estiyanti, Wulan Ayunita Sabilla — Tue, 04 Feb 2025 09:49:29 +0000

Abstract

Breastfeeding plays an important role in meeting the nutritional needs of infants and is useful in preventing malnutrition in children. However, insufficient breast milk is one of the obstacles in this process. Interventions that can be done to increase breast milk can be done pharmacologically using Domperidone. On the other hand, the drug can trigger side effects, then the use of herbs is recommended. Long bean leaves (Vigna sinensis L.) are plants that are rich in nutrients and can stimulate prolactin through the phytocemichal contents(1)(2)(3).

Objectives: The aims of the research to be carried out is to formulate and analyze the effectiveness of Green Noodles based on long bean leaves (Vigna sinensis L.) to help increase prolactin of breasfeed mother.

Methods: The research method used is a quasi-experimental with a Nonrandomized Control Group Pretest-Postest Design consisting of an experimental group (given green noodles) and a control group (given plain Noodles). The intervention was carried out for 14 days by giving green noodles 2 times a day for 14 days.

Results: Green noodles contain 4 times higher levels of polyphenols than white noodles with amounts of 384.55 mg/kg and 85.39 mg/kg respectively. Based on the results of pre and post interventions in both intervention and control groups, it was found that breastfeeding mothers who consumed Green Noodles experienced an increase in prolactin levels (p value 0.004) and mothers who consumed White Noodles did not experience a significant increase in prolactin levels (p value 0.283).

Conclusion: Green noodles is rich in polyphenols which can help increasing prolactin hormone on breastfeed mother.

Keywords: Breastmilk; Long Bean Leaves; Breastfeeding; Prolactin; Vigna sinensis L.

Comparison of Pulsatility Index and Notching of Uterine Artery Doppler on Normotensive Pregnancy and Established Pre-eclampsia

Tue, 04 Feb 2025 10:04:42 +0000

Objective: The aim was to assess pulsatility index of uterine artery (Ut-A PI) of normotensive pregnancy and preeclampsia between 28-40 weeks of gestation.

Methods: This cross-sectional study was conducted at Dr. Sardjito Hospital and Harapan Kita Maternal Children Hospital as a tertiary referral hospital. The study included 220 women high risk pregnancies.

Result: There were 188 pregnant women normotensive pregnancy (85.5%) and 32 preeclampsia cases (14.5%). Weight, Body Mass Index, blood pressure, Mean Arterial Pressure, chronic hypertension, history of preeclampsia, and baby weight showed an significant association with preeclampsia. Pulsatility index of uterine artery had a sensitivity of 87.50% and a specificity of 98.94% whereas the notching had a sensitivity of 46.88% and a specificity of 87.23%.

Conclusion: The UtA PI is a complementary tool with good performance for the diagnosis of overall and severe preeclampsia with high sensitivity and specificity. UtA PI has better performance the notching.

Keywords: Pulsatility index, notching, normotensive, preeclampsia

Accuracy of Transperineal Ultrasoun Examination in Predicting Vaginal Delivery

Tue, 04 Feb 2025 10:06:23 +0000

Multimedia-Based Pelvic Anatomy And Childbirth Mechanism Learning : Phenomenological Study

Tue, 04 Feb 2025 10:10:49 +0000

Objectives: To determine students' competence in pelvic anatomy and labor mechanisms through multimedia-based learning media at University Hangtuah Pekanbaru and Helvetia Health Institute Pekanbaru

Methods: The design of this study is a qualitative study with a descriptive phenomenological approach using the framework standards for reporting qualitative research a synthesis of recommendations approach. The number of informants in this study was 10 people, consisting of 8 midwifery students, 2 lecturers. Recruitment of informants in this study used purposive sampling. Analysis of research data using the Collaizi's framework, namely first familiarization, identifying related statements, formulating meaning, grouping themes, developing in-depth descriptions, creating basic structures of statements and final validation.

Results: The results of the analysis obtained two themes, namely the parts of the pelvic bone and the process of childbirth. Informants revealed that during the learning process they got a method of the process of childbirth so that it made it easier for students to practice in the field

Conclusion: Learning methods can be accessed not only during learning but also when outside the classroom or in the field

Keywords: Pelvic Anatomy, Labor Mechanism, Midwifery Curriculum, Learning Media, Multimedia

Impact of Prenatal Yoga Classes on Maternal Mental Health in Riau, Indonesia: A Quasi-Experimental Study

Tue, 04 Feb 2025 10:11:27 +0000

INTRODUCTION Anxiety from the imagination of childbirth pain and fear of childbirth in pregnant mothers. Fear of childbirth has been associated with prolonged labor, childbirth complications that increased postpartum depression.

OBJECTIVE : This study aimed to determine the effect of prenatal classes on mental health.

METHODS The research design was a quasi-experiment of two groups with pre-test and post-test design. The sample was pregnant women who met the inclusion and exclusion criteria. A total of 106 participants were divided into two groups: intervention, and control group. The research instrument was a questionnaire. The ANOVA test was used to analyze the data.

RESULT The average mental health score of the intervention group was higher (84.04) than that of the control group (67.32), with a p-value <0.001.

CONCLUSIONS This study concludes that yoga prenatal classes improve positive mental health status

Keywords: Pregnant Women; Yoga Prenatal Class; Mental Health

OBJECTIVE : This study aimed to determine the effect of prenatal classes on mental health.

RESULT The average mental health score of the intervention group was higher (84.04) than that of the control group (67.32), with a p-value <0.001.

CONCLUSIONS This study concludes that yoga prenatal classes improve positive mental health status

Keywords: Pregnant Women; Yoga Prenatal Class; Mental Health

Current Trends in Contraceptive Use and Fertility Concerns Among Women of Reproductive Age in Indonesia

Tue, 04 Feb 2025 10:13:58 +0000

Abstract

Background

Family planning remains a key intervention in reducing maternal mortality and creating prosperous families. Assessing the unmet need for family planning allows insight into the progress of family planning programs. On the other hand, there has been much less attention given to the declining fertility rate in Indonesia. To address both the unmet need and declining fertility rate in Indonesia, this study aimed to investigate the most recent trends in contraceptive use in Indonesia as well as evaluate fertility concerns and access to reproductive healthcare service.

Methods

Women of reproductive age in Indonesia were asked to fill in an online questionnaire. They were asked about sociodemographic characteristics, marital status, pregnancy history, perception towards fertility, and access to healthcare service and information. Descriptive statistics and independent t-test were performed.

Results

Of 370 women, more than half (57.8%) had used some form of contraception. The most frequently used contraceptive method was natural family planning (30.3%), followed by condom (20%). Women with no prior sexual history, had never been pregnant before, and had not been married cared more about having a child in the future. Internet and social media represented the most popular information source for family planning.

Conclusions

Many Indonesian women still prefer traditional contraceptive methods over the more effective modern contraceptive methods. Numerous socio-cultural factors are likely to influence the behaviour of reproductive-age women regarding contraceptive use and childbearing in the future. More effort should be put into raising awareness about modern contraceptive methods and addressing fertility concerns.

Keywords: contraception; fertility; family planning; awareness; reproduction

Unraveling Of Urinary Disorders to Adenomyosis and Dysmenorrhea

Tue, 04 Feb 2025 10:16:49 +0000

Objective : This study aims to explore the relationship between micturition disorders and adenomyosis and dysmenorrhea and provide insight into the factors associated with the severity of LUTS symptoms in these conditions.

Methods : This study was a descriptive qualitative study. We retrospectively collected medical record data from the Obstetrics Gynecology Outpatient Ward of Dr. Moewardi Surakarta General Hospital in the period January 2021 to May 2023. The results of this study analyzed using Pearson correlation analysis if normally distributed and using Mann-Whitney if not normally distributed, thus, statistically analyzed.

Results: There is a significant relationship between adenomyosis and dysmenorrhea on urinary disorders (p value of 0.016) where urinary disorders are found to be more severe in adenomyosis patients with dysmenorrhea.

Conclusion : Lower urinary tract symptoms are common in symptomatic adenomyosis patients and greatly affect the patient's quality of life. Dysmenorrhea can be a potential risk factor that increases the occurrence of moderate to severe LUTS.

Keywords: adenomyosis; dysmenorrhea; urinary disturbance.

Precision of Ultrasound During Peripartum for Predicting and Diagnosing Obstetric Anal Sphincter injuries

Tue, 04 Feb 2025 09:58:38 +0000

Abstract

Objectives: To assess the accuracy of transperineal ultrasound (TPUS) in diagnosing obstetric anal sphincter injuries (OASIs) in primiparous women between 37 and 41 weeks of gestation.

Design: Cohort observational study.

Setting: Kasr Alainy Hospital, Cairo University.

Subjects: 697 nulliparous women with singleton pregnancies between 37 and 41 weeks' gestation.

Outcome Measures: Ano-vaginal distance (AVD), body mass index (BMI), fetal parameters (biparietal diameter [BPD], head circumference [HC]), and anal sphincter contraction.

Results: Significant differences were found between women with and without OASIs in BMI, fetal parameters, and AVD. The AVD's area under the ROC curve (AUC) was 0.659, showing moderate predictive value for OASIs. Multivariate analysis revealed that AVD and second-stage labor duration were the strongest predictors of OASIs.

Conclusions: TPUS is a valuable tool in identifying women at risk of OASIs and may improve detection when combined with clinical examination.

Keywords: Obstetric Anal Sphincter Injuries (OASIs), Transperineal Ultrasound (TPUS), Ano-Vaginal Distance (AVD), Vaginal Delivery, Primiparous Women, Diagnostic Accuracy.

The Age as a Risk Factor for Advanced Stage in Cervical Cancer Patients at RSUPN Cipto Mangunkusumo 2019-2022: A Retrospective Multivariate Study

Tue, 04 Feb 2025 10:19:09 +0000

Abstract

Introduction: In 2020, cervical cancer ranked as the fourth most common cancer in women globally, with an incidence of 604,000 cases. In Indonesia, cervical cancer holds the second position among the most prevalent cancers in women. This study aims to evaluate the relationship between age and the occurrence of advanced-stage cervical cancer as a step towards effective prevention, early detection, and management. Methods: This research adopts a retrospective study design based on the Cancer Registration database of RSUPN Cipto Mangunkusumo, focusing on cervical cancer patients from 2019 to 2022. Multivariate analysis was conducted with age as the primary independent variable, considering parity and employment status in the analysis. The FIGO classification of cervical cancer stages was used to categorize patients into early and advanced stages. Results: Out of 512 cervical cancer cases, 492 were included in this study. The distribution of cervical cancer stages and the age distribution of patients is depicted in Figure 1 and Figure 2. The analysis of the relationship between cervical cancer stage, age, parity, and employment status is presented in Table 2. The association between age and cervical cancer stage is statistically significant (p<0.05) with an odds ratio of 2.13, particularly in individuals aged >54 years. Conclusion: Age over 54 years is a significant risk factor for advanced-stage cervical cancer. Although there is no significant association with parity and employment history, these findings support preventive and early detection efforts in the older population. Increased screening programs and education are expected to reduce cases of advanced-stage cervical cancer in the future.

Leptin Expression in High-grade Serous Ovarian Carcinoma: The Controversy of Leptin Paradox in Ovarian Cancer

Tue, 04 Feb 2025 10:22:04 +0000

Objectives : To analyse the characteristics and expression patterns of Leptin in high-grade serous epithelial ovarian carcinoma (HGSC), and to compare them with the overall serous ovarian carcinoma population.

Methods : This was a cross-sectional study. A total of 77 paraffin-embedded tissue samples were collected from patients at the Wahidin Sudirohusodo Hospital over a period of 3 years. Immunohistochemical staining was performed using a polyclonal Leptin antibody. Data were analyzed using SPSS version 22.0.

Results: Among HGSC patients, the majority (64.3%) were over 50 years old, and a significant portion (39.3%) were obese. Leptin showed strong cytoplasmic expression in 69.6% of HGSC tumor cells and in 100% of LGSC tumor cells (p-value = 0.004). There was no correlation between lymphovascular space invasion and leptin expression. Interestingly, leptin expression in overall serous ovarian carcinoma patients exhibited a protective effect against metastasis (p-value = 0.047), suggesting a leptin paradox exists in this type of cancer. However, this association was no longer significant when the analysis excluded the LGSC group (p-value = 0.193).

Conclusion : This study suggest that leptin expression may not be a significant prognostic factor in HGSC. The appearance of the pseudo-leptin paradox phenomenon in several previous studies was confounded by sample populations with heterogeneous tumor morphology.

Keywords: high-grade serous carcinoma, leptin paradox, immunohistochemistry, leptin, obesity

Initial Management of Acute Pulmonary Edema in Pre-Eclampsia: A Case Report

Tue, 04 Feb 2025 10:28:52 +0000

Objective: Describe the initial management for severe pre-eclampsia complicated with acute pulmonary edema.

Methods: A case report.

Case: 41 years old woman, G5P4A0, unknown gestational age, admitted with headache, dyspnea, and unconsciousness. The patient denied a history of past illness. Vital signs were checked, and crisis hypertension, tachypnea, tachycardia, and low oxygen saturation were obtained. Physical examination showed audible lung crackles and leg edema. Proteinuria +3 was detected. For initial management, the patient was given oxygen with Jackson-Rees bagging, Nicardipine drip, MgSO4 injection, and Furosemide injection. After the patient was fully conscious and stable in the ICU, the patient reported contractions with pelvic examination marked 8 cm dilatation. The patient underwent vaginal delivery and gave birth to a male, BW 2900gram, BL 47cm, APGAR 3/8.

Discussion: Increased plasma volume, cardiac output, vascular permeability, peripheral vascular resistance, and decreased oncotic pressure are the causes of pulmonary edema in preeclampsia. According to Wallace et al, lowering blood pressure, giving adequate oxygen, and fluid restriction are the main management of pulmonary edema in preeclampsia. The correct initial management in the ER gives a good output on this case report.

Conclusion: Initial management of acute pulmonary edema in pre-eclampsia patients should be done correctly, consequently decreasing maternal and fetal morbidity and mortality.

Keywords: pregnancy, severe pre-eclampsia, pulmonary edema.

From Diagnosis to Management: A Rare Case of Disseminated Low-Grade Endometrial Stromal Sarcoma with Extensive Extrauterine Spread

Adrian Djatikusumo, Yulian Prastisia, Iwan Kurnia Effendi, Wina Kanya Wasystha — Tue, 04 Feb 2025 10:25:57 +0000

Objective: To report a rare case of low-grade endometrial stromal sarcoma; which was found not only in the uterus but also in several extrauterine sites, such as the ovary, omentum, and jejuno-ileum. In this article, we provided the management performed, based on appropriate literatures.

Methods: Case report.

Case: A 44-year old para 2 complained of abdominal enlargement since 3 months. Patient also complained of pelvic pain. The patient has never received treatment before and has never been diagnosed with endometriosis. Abdominal examination revealed a 20-cm mass in the lower to umbilical region and positive shifting dullness. Bimanual pelvic examination revealed immobile and smooth masses in both sides of adnexa, with pain during palpation. Computerized tomography (CT) scan of the abdomen revealed complex cystic masses suspected for right and left ovaries-origin (±11 & 15 cm respectively) Surgical resection and staging, frozen section, cytology examination, and immunohistochemistry (IHC) test were performed, revealing consistent result of endometrioid stromal sarcoma, low grade. Five-months postoperative follow-up through abdominal CT-scan in the patient revealing no abnormalities.

Conclusion: We know that LG-ESS is one of the rare types of endometrial stromal sarcoma. Moreover in this case extrauterine manifestations make it more challenging in clinical management. Risk factors and history of endometriosis are important to explore when meeting ESS cases. Further research needs to be done regarding the exact mechanism and the association between endometriosis or other risk factors and the development of ESS, especially the EESS type to allow intervention.

Keywords: uterine sarcoma, endometrial stromal sarcoma, management.