Indonesian Journal of Obstetrics and Gynecology

Addressing the Global Decline in Total Fertility Rates

Budi Wiweko — Mon, 28 Apr 2025 00:00:00 +0000

N/A

Clinical Characteristics and Management of Adolescent Ovarian Cysts in D.I. Yogyakarta

Sulistiari Retnowati, Alfaina Wahyuni, I Nyoman Tritia Widiantara, Hana Nisrina — Mon, 28 Apr 2025 00:00:00 +0000

Objective : The aim of this study to give clinical characteristic of ovarian cysts in adolescent patient and comprehend the delineation of the management protocol implemented in patients diagnosed with ovarian cysts

Methods : This study used a retrospective method conducted by reviewing patient medical records. This study was conducted by collecting medical record data retrospectively for 5 years at PKU Muhammadiyah Gamping Hospital and Panembahan Senopati Bantul Hospital. All data of outpatients, and inpatients diagnosed with ovarian cysts from January 2018 to July 2023 aged 11-21 years were taken to be included in the study.

Results: A total of 56 adolescent patients were identified with ovarian cysts. Researchers found most patients with adolescent age group 18-21 years (n=43). Patients presented with a chief complaint of abdominal pain and the cyst was unilateral.

Conclusion :. The patients exhibited a primary concern of pain, and the cyst was found to be located on one side only. Efforts to save the ovary were deemed vital owing to the relatively low probability of cyst malignancy. In this study also found that there were no correlation between clinical symtopms (abdoment pain, nausea and menstrual disorder) with size of cyst.

Keywords: adolescents, clinical characteristic, ovarian cyst, management

Physical Activity Impact on Severity of Dysmenorrhea among Junior High School Students: A Cross Sectional Study

Mon, 28 Apr 2025 00:00:00 +0000

Objective: This study aims to identify the prevalence of dysmenorrhea, the level of physical activity, the risk factors for dysmenorrhea and to determine the relationship between physical activity and the severity of dysmenorrhea among junior high school students.

Method: This is a cross-sectional, observational analytical study on the population of adolescence, junior high school students, conducted from July to December 2023 in Palembang. Primary data were obtained using Physical Activity Questionnaire for Older Children (PAQ-C) and working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) score.

Results: About 88.9% of students experienced primary dysmenorrhea, with 34.4% experiencing mild dysmenorrhea, 38.9% experiencing moderate dysmenorrhea, and 15.6% experiencing severe dysmenorrhea. The level of daily physical activity performed by the students was 43.3% low activity, 55.6% moderate activity, and 1.1% high activity. There was no significant relationship between physical activity and the degree of dysmenorrhea (p=0.459; PR=0.828; 95% CI: 0.558-1.230). Menarche age <12 years (PR=1.186), a family history of dysmenorrhea (PR=1.225), and irregular menstrual cycles (PR=1.283) are risk factors for higher degree of dysmenorrhea.

Conclusion: There is no relationship between physical activity and the degree of dysmenorrhea. Female students mostly experience moderate primary dysmenorrhea, with the dominant level of physical activity being moderate. Menarche age <12 years, a family history of dysmenorrhea, and irregular menstrual cycles are risk factors for the higher degree of dysmenorrhea.

Keywords: Adolescents, primary dysmenorrhea, physical activity

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Impact of Educational Intervention on HPV Vaccine Interest in Preclinical Medical Students

Yuliana, Rachel Chryzia Jacqueline Natividad, Lilis, Hadiyanto, Mutiara Riani — Mon, 28 Apr 2025 00:00:00 +0000

Objectives: To assess the role of education on HPV vaccination interest among preclinical medical students at School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia.

Methods: This was a descriptive analytic study with cross-sectional method. The respondents of this study were 104 of preclinical medical students, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, based on proportional sampling method. Data were obtained in November 2023 using questionnaires tool. The collected data were then statistically analyzed with univariate and bivariate analysis.

Results: There was an increase that statistically significant in knowledge and HPV vaccination interest after educational intervention. And there was an association between education and HPV vaccination interest (p=0.000).

Conclusion: There is a role of education on HPV vaccination interest among preclinical medical students at School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia.

Maternal Outcomes with Twelve Hour versus Twenty Four Hour Maintenance Doses Of Magnesium Sulfate in Severe Postpartum Preeclampsia

Mon, 28 Apr 2025 00:00:00 +0000

Introduction: Severe preeclampsia is a serious emergency that can complicate pregnancy and even lead to maternal death. It contributes to a significant increase in morbidity and mortality rates, affecting over 70,000 mothers. The cause of severe preeclampsia is still uncertain, but its management is continuously being developed to achieve the best possible outcomes for both the mother and baby. Magnesium sulfate (MgSO₄) is the preferred treatment for preventing seizures in severe preeclampsia, as it has minimal side effects and is effective. However, there is a need for further research on reducing the duration of MgSO₄ administration in Indonesia.

Method: A clinical trial was carried out with 80 participants divided into two groups (control and trial), using randomized and double-blind methods. The study was conducted at multiple hospitals including Arifin Achmad Hospital, Tengku Rafian Hospital, Dumai City Hospital, Selasih Hospital, and Bengkalis Hospital from October 2022 to February 2023. The data collected was analyzed to evaluate maternal outcomes for both groups. The study was approved by Ethical Review Board for Medicine and Health and registered with the Thai Clinical Trials Registry (TCTR 20230811008) once the data was assessed.

Results: This study examined pregnant women with severe preeclampsia, who were on average 30.98±6.04 years old, with 68.8% having had multiple pregnancies. Their gestational age was 33.37±2.88 weeks and the majority (72.5%) had a cesarean delivery. Their systolic blood pressure was 167.68±14.24mmHg and diastolic was 110.32±18.52mmHg. The study did not report on the incidence of eclampsia or maternal mortality, and there was no significant difference in serum magnesium sulfate levels between the two groups (p>0.005).

Conclusions: Administering maintenance doses of MgSO4 for both 12 and 24 hours had similar effectiveness in preventing eclampsia, but the 12-hour group saw better outcomes for the mother.

Keywords: Magnesium sulfate, Postpartum, Severe preeclampsia, 12 hours, 24 hours

Neonatal Asphyxia in Emergency and Elective Cesarean Delivery in the National Health Insurance Participants at the Referral Hospital: a cross-sectional study

Mon, 28 Apr 2025 00:00:00 +0000

Only english abstract for Indonesian Journal of Obstetrics and Gynecology (INAJOG). Abstract concise description of the background, purpose, methods, results and conclusions required. No more than 250 words. Abstract is written using Arial 8 pt. Written with the following rules:

Objectives: To analyze the correlation between the time of cesarean section and the outcome of neonatal asphyxia in the National Health Insurance participants at Referral Hospitals in Kendari.

Methods: This was an analytical observational study using a cross-sectional method. The population was cases of cesarean delivery in the National Health Insurance participants at Dr. Ismoyo Hospital in 2019. The total sample was 183 obtained using a simple random sampling technique. Data was collected from medical records. Data were analyzed using the Chi-Square test with a significance value of 0.05.

Results: There were 47.5% cases of emergency cesarean section and 52.5% of elective cesarean section. Neonatal asphyxia occurs in 9.4% of elective cesarean sections and 6.9% in emergencies. There was no correlation between the time of cesarean section and the outcome of neonatal asphyxia (p=0.542).

Conclusion: The neonatal asphyxia is not related to the time of cesarean delivery in the National Health Insurance participants. Appropriate and good treatment can reduce the risk of neonatal asphyxia.

Keywords: cesarean section, elective, emergency, neonatal asphyxia

Nature and Degree of Severity of Consultations in Gynecological Emergencies

Mon, 28 Apr 2025 00:00:00 +0000

Abstract
Introduction: Gynecological emergencies are often crowded with false emergencies. They overwhelm doctors who also have to manage the birth room. The main objective of our work was to assess the type and degree of severity of pathologies encountered in gynecological emergencies.
Methods: This is a prospective descriptive study, carried out in the gynecological emergencies of the Mongi Slim hospital, Tunisia, from July 1 to July 21, 2023. We have defined the reality of the emergency as the main endpoint and we have classified the women in three groups: "real" emergencies, "legitimate" emergencies and "false" emergencies.
Results:
We included 179 patients. The average age of the consultants was 32 years old. They had no gynecological follow-up (83.8 percent) and consulted the emergency room on their own initiative (88.8 percent). They consulted most often for abdominopelvic pain (41.9 percent) and bleeding (28 percent). Pelvic ultrasound was almost always performed (87.7 percent), as well as plasma beta-HCG assay (45.3 percent). The patients were hospitalized in 14.5 percent of cases, readmitted to central emergency departments in 20.1 percent and sent home in 65.4 percent of cases. In the end, we found that only 11.1 percent of the emergency room consultants presented a real gynecological emergency.
Conclusions:
Better organization of primary care, improved university training in gynecology for future family physicians and better information for the population must be encouraged so as not to unnecessarily encumber the gynecological emergency departments.
Key words : Emergencies, diagnosis, treatment, gynecology, ultrasound

Neonatal Outcome Associated with Birth Order and Chorionicity in Twins Pregnancy

Mon, 28 Apr 2025 00:00:00 +0000

Objectives: The objective of this study is to examine the neonatal outcomes of twin pregnancies based on the difference of chorionicity and order of delivery.

Methods: An observational cross-sectional study was done among all women with >24 completed weeks gestation having twin pregnancies in the Department of Obstetrics and Gynaecology of Dr. Soetomo General Hospital and Universitas Airlangga Hospital, Surabaya, Indonesia in 2023.

Results: 49 twin from 1638 birth (2.99%) were recruited for the study. The MC groups had a higher prevalence of preterm birth <37 weeks (83.3 vs 53.8%), preterm birth <34 weeks (52.8 vs 15.4%), VLBW (25 vs 7.7%), ELBW (25 vs 15.4%), low Apgar scores at 5^th minutes (50 vs 15.4%), admission to NICU (66.7 vs 15.4%), RDS (41.7 vs 7.7%), early neonatal death (33.3 vs 7.7%), and perinatal death (44.4 vs 15.4%) [p<0.05]. In relation to birth order, there were no significant difference in all neonatal outcomes, except the higher prevalence of lower Apgar scores in 1^st (75 vs 50%) and 5^th minutes (50 vs 19.4) in the second delivered MC twin (p=0.05). Out of the 98 twin babies, there were a total of 32 perinatal deaths (32.65%), consisting of eight stillbirths and twenty-four neonatal deaths.

Conclusions: Chorionicity and birth order were influenced by the neonatal outcomes of twin pregnancies. It is important to manage twin pregnancy in specialized or tertiary care center hospital.

Preoperative TNF-alfa Reduction in Endometriosis Lesions with Combined Oral Contraceptives.

Mon, 28 Apr 2025 00:00:00 +0000

Background: The goals of endometriosis treatment vary greatly depending on the patient's symptoms and reproductive needs. Hormonal therapy to alleviate pain has generally been shown to have positive effects. Combined Oral Contraceptives (COC) are widely available, relatively affordable, and well-known by the public.

Objective: This study aims to compare the effects of COC therapy with two newer endometriosis treatments: oral Dienogest 2 mg and injectable Leuprorelin acetate 3.75 mg on TNF alfa levels in serum and peritoneal fluid.

Methods: Forty subjects were divided into four groups: three groups receiving medical therapy—COC (0.03 mg ethinylestradiol and 0.15 mg levonorgestrel, taken one active tablet per day continuously), oral Dienogest 2 mg, and intramuscular Leuprorelin acetate 3.75 mg every four weeks—and a control group of endometriosis patients who had not received any hormonal therapy. Peripheral venous blood samples were taken before surgery, and peritoneal fluid was collected at the start of surgery in the pelvic cavity. TNF alfa levels were analyzed using the ELISA method. Data analysis was performed using the Kruskal-Wallis test with a significance level of 0.05.

Results: The Kruskal-Wallis test showed significant differences between treatment groups in TNF alfa
levels in peritoneal fluid (p:0.023), specifically between the COC group and the control group, and between the Dienogest group and the control group.

Conclusion: Preoperative hormonal therapy for estradiol suppression provides limited benefit in reducing systemic inflammatory agents but is effective locally, as evidenced by reduced TNF alfa levels in the peritoneal fluid after preoperative COC and Dienogest therapy.

Keywords: COC, Dienogest, Leuprorelin Acetate, Serum, Peritoneal Fluid, TNF alfa

Incidence of Melasma, Breast Pain, and Depression in Users of Combination Hormonal and Progesterone-Only Contraceptives

Aisyah Puspa Wardana, Uki Retno Budihastuti, Siti Munawaroh — Mon, 28 Apr 2025 00:00:00 +0000

Objective : To find out if there is a difference in the incidence of melasma, breast pain, and depression between a combination hormonal contraceptive (CHC) acceptors and a progesterone-only contraceptive.

Methods : This was a comparative analytical observational research with cross-sectional research design at Pakem Health Center, Yogyakarta. One hundred twenty subjects consisted of 60 progesterone-only contraceptive acceptors and 60 CHC acceptors aged 15-49 years, duration of use of hormonal contraceptives >6 months. Measurements on melasma were clinically determined, breast pain using a Visual Analogue Scale (VAS) score, and depression using the Montgomery Asberg Depression Rating Scale (MADRS) questionnaire.

Results: Chi-square test results and logistic regression in CHC acceptors are likely to experience melasma (b=1.55; CI 95%=0.08-0.55; p=0.002), breast pain (b=2.32; CI 95%=0.02-0.34; p=<0.001), and depression (b=-1.02; CI 95%=1.15-6.74; p=0.023).

Conclusion : There were significant differences in the incidence of melasma, breast pain, and depression in CHC acceptors and progesterone-only contraceptives. Incidence of melasma and breast pain was higher in CHC acceptors, while depression was higher in progesterone-only contraceptive acceptors.

Surgical Outcomes of Cystectomy Using Oxidized Regenerated Cellulose With and Without Drainage in Endometrioma Treatment

Fri, 18 Jul 2025 13:29:27 +0000

Objective: Our study aims to compare cystectomy and drainage using oxidized regenerated cellulose (ORC) in reducing endometrioma recurrence after surgery.

Methods: A retrospective cohort study included patients with endometrioma who undergo laparoscopic surgical management (cystectomy and drainage) with ORC from June 2020 – January 2023. All patients were followed up a year for recurrence rate. Recurrence was assessed based on symptoms and ultrasound criteria. All data were analyzed using SPSS version 26.0.

Results: Twenty-five patients were included in the cystectomy group and twenty-seven patients were included in the drainage group. The recurrence rate was higher in patients who underwent drainage (29.6%, n = 8) than in patients who underwent cystectomy (20%, n = 5). The researchers found the result was not significant (p > 0.05) in the recurrence rate between the two groups.

Conclusion: In this study, the use of oxidized regenerated cellulose showed no difference in recurrence rates in cystectomy with ORC and drainage with orc.

Keywords: endometrioma, cystectomy, drainage, oxidized regenerated cellulose

Large Epignathus Teratoma: A Rare Case with Ominous Prognosis

Cut Razianti, Muhammad Alamsyah, Dani Setiawan — Mon, 28 Apr 2025 00:00:00 +0000

Introduction:

The prevalence of epignathus teratomas is found to be less than 1% of all congenital teratomas. Incidence of female fetuses compared to male fetuses (ratio 3:1).

Method :

This case study was conducted at Dr. Hasan Sadikin General Hospital Bandung between September - December 2022.

Case Report :

We presented three cases of large epignathus teratoma with different complications each, with the same outcome, 2 cases of large epignathus teratoma were likely caused due to risk factors of poor environmental influence. The first case, large epignathus teratoma was referred with a suspicion of conjoined twin, the second case was accompanied by pulmonary tuberculosis with intracranial expansion, the third case was large epignathus teratoma with A Umbilical revered of end-diastolic flow and MCA absent end diastolic flow accompanied by scalp edema.

Conclusion:

These three cases are very rare, describing large epignathus teratomas with a poor prognosis based on size and their location associated with perinatal complications. The establishment of the diagnosis is enough to carry out an ultrasound examination. It is important to determine the time and type of labor to be chosen. Inform consent parents is important, especially to know the outcome of the baby and the recurrence in the next pregnancy