Ovarian Reserve Tests: The Use in Daily Clinical Practice

Objective: To evaluate the significance of conducting ovarian reserve testing and decide when to order this testing in the clinical setting. And also to give individualized counseling to patients regarding the prognosis of infertility treatment based on their ovarian reserve tests, such as: basal antral follicle count, basal ovarian volume, ovarian stromal blood flow, ovarian biopsy, basal serum Follicle Stimulating Hormone (FSH), basal serum estradiol, basal serum inhibin B, basal anti-Mullerian hormone serum. Clomphine Citrate Challenge Test (CCCT), GnRH Agonist Stimulation Test (GA ST), and Exogenous FSH Ovarian Reserve Test (EFORT). Method: Literature study on published studies about the methods of ovarian reserve testing. Conclusion: Ovarian reserve is an important key in initial assessment of the infertile patients and as a predictor of the success of infertility treatment. Currently, there is no single test which is highly reliable for assessing ovarian reserve. AMH serum may be a future hope and suggested as the best biomarker. [Indones J Obstet Gynecol 2011; 35-4:235-40] Keywords: ovarian reserve tes

Kegel’s Exercise could Reduce the Incidence of Postpartum Urinary Stress Incontinence

Objective: To investigate the cause of postpartum urin ary incontinence in primi gravida women and to determin e the relationship between stress urinary incontinence and kegel's exercise. Method: This was an observational study with cross sectional method , perform ed in instituti onal hospitals in Makassar. Thirty primigravida women who performed kegel's exercise were compared with 30 primi gravida women who did not perform kegel's exercise. Data were analyzed with independent-t sta tistical analysis. Result: Urinary incontinence were significantly lower in primigravida women who performed kegel's exercise (P=O.OOO). Conclusion: Kegel's exercise may reduce the incidence of postpartum stress urinary incontinence. Keywords: kegel's exercise, primigravida, urinary Incontinence

Chlamydia Trachomatis Infection and Ectopic Pregnancy: Infeksi Chlamydia Trachomatis dan Kehamilan Ektopik

  Objective: To determine the relationship of Chlamydia trachomatis infection in patient with ruptured ectopic pregnancy through examination of endocervical swabs, tubal tissue using Polymerase chain reaction (PCR) and Enzyme linked immunoabsorb and assay (ELISA) serum IgG antibodies Specific to Chlamydia trachomatis.Method: This study was an observational analytic study with a cross sectional study design. In this study, there were 50 participants consisting of 25 ruptured ectopic pregnancy patients and 25 non-ruptured ectopic pregnancy patients who underwent treatment at Dr.Wahidin Sudirohusodo Hospital as well as networking hospitals at the Universitas Hasanuddin in Makassar City.Results: The results showed that Chlamydia trachomatis infection in patients with ruptured ectopic pregnancies was found to be 84% positive in tubal tissue, 72% with endocervical swabs and 64% with serum examination. There was a significant relationship between chlamydial tracheal infection obtained through examination of tubal tissue, endocervical swab and specific serum IgG in patients with ruptured ectopic pregnancy (p <0.001).Conclusion: Based on the results of the study, it can be concluded that Chlamydia trachomatis infection can significantly affect the occurrence of ruptured ectopic pregnancy.Keywords: Chlamydia trachomatis, endocervical swab, ruptured ectopic pregnancy, serum IgG, tubal tissue.   Abstrak Tujuan : Untuk mengetahui hubungan infeksi Chlamydia trachomatis pada pasien penderita Kehamilan Ektopik Terganggu (KET) melalui swab endoserviks dan jaringan tuba menggunakan pemeriksaan Polymerase Chain Reaction (PCR) dan Enzyme linked immunoabsorb and assay (ELISA).Metode : Penelitian ini merupakan studi analitik observasional dengan desain studi potong lintang. Pada penelitian ini terdapat 50 orang partisipan yang terdiri atas 25 orang pasien kehamilan ektopik terganggu dan 25 orang pasien non-kehamilan ektopik terganggu yang menjalani pengobatan di RSUP Dr.Wahidin Sudirohusodo serta RS jejaring Universitas Hasanuddin di Kota Makassar.Hasil : Hasil penelitian menunjukkan bahwa infeksi Chlamydia trachomatis pada pasien dengan kehamilan ektopik tergangu didapatkan sebesar 84% positif di jaringan tuba, 72% dengan swab endoserviks dan 64% dengan pemeriksaan serum. Terdapat hubungan yang signifikan antara infeksi klamidia trakomatis yang didapatkan melalui pemeriksaan jaringan tuba, swab endoserviks maupun serum IgG spesifik pasien kehamilan ektopik terganggu (p<0,001).Kesimpulan : Berdasarkan hasil penelitian, dapat disimpulkan bahwa infeksi Chlamydia trachomatis secara signifikan dapat mempengaruhi terjadinya kehamilan ektopik terganggu.Kata kunci : chlamydia trachomatis, jaringan tuba, kehamilan ektopik terganggu, swab endoserviks, serum Ig

The Role of Matrix Metalloproteinase9 (MMP9) in Endometriosis

Objective: To investigate the role of MMP-9 expression in endometriosis. Methods: The study was conducted from October 2015 to March 2016, an observational study with cross-sectional design. Samples are all endometriosis patients who underwent laparoscopic surgery in Dr. Wahidin Sudirohusodo Hospital and several other hospitals in Makassar. Samples were stored and fixed in the Grand Medika Histopathology Laboratory Makassar for examination the expression of MMP-9 using immunohistochemical methods. Conducted an analysis of 50 samples, of which 11 samples of stage II, 21 stage III samples, and 18 samples of stage IV. The data obtained and analyzed statistically using Mann Whitney and Chi Square test with a significance level of p <0.05. Results: The results reported rankings mean the expression of MMP-9 in stage I-II = 16.68, stage III-IV 27.99 (p = 0.013). There were differences in the expression of MMP-9 based on the stage. Stage I-II endometriosis had a more positive 2 expression of MMP-9 (45.5%), stage III-IV endometriosis have more positive 3 expression of MMP-9 (59.0%). The results of chi square test (p = 0.043). Conclusion: Higher expression of MMP-9 is significantly associated with higher degree of endometriosis. Keywords: matrix metalloproteinase-9, stages of endometriosi

Primipara Undergoing Episiotomy had Lower Postpartum Sexual Function

Objective: To compare postpartum sexual functions between primipara with episiotomy and without episiotomy. Method: The research was conducted in public service section of Dr. Wahidin Sudiro Husodo hospital and a number of educational hospitals obstetrics and gynecology of Faculty of Medicine of Hasanuddin University, started from February to May 2012. The research evaluated the sexual function of postpartum with episiotomy in 171 primipara, and 150 primipara postpartum without episiotomy. Sexual function was measured by Female Sexual Function Index (FSFI) questionnaire which had been validated in various countries. The research was conducted with cross sectional approach. Samples were withdrawn with consecutive sampling method. The data was processed with SPSS version 17, with chi-square test, and significant level of 0.05. Result: Indicated that either the episiotomy or non-episiotomy group has undisturbed sexual function score (>28.5), however, higher score was indicated in non-episiotomy group (65.477) compared to the episiotomy group (59.70), (p<0.05). Conclusion: Primipara with episiotomy and breastfeeding has lower sexual functions compared to the non-breastfeeding group, however, it was statistically insignificant (p>0.05). Keywords: episiotomy, FSFI, primipara, sexual function

Risk factors for stress urinary incontinence following vaginal and caesarean delivery

Abstract   Background: Most of the stress urinary incontinence (SUI) occurs after first delivery and related to the mode of delivery. Objective: To determine the factors that affects the incidence of stress urinary incontinence post partum Methods: Women experienced with stress urinary incontinence 3 months after birth vaginally or section caesarean were enrolled in the present cross sectional study. The strength of the pelvic floor muscle measured with perineometer. All of women were assessed for SUI using Sandvix Severity Index (SSI) dan The three incontinence question (3IQ) questionnaire. A person chi-square test was used to analysis with p value <0.05 was considered significant. Results: Eighty-four women with stress urinary incontinence  (SUI) after vaginal delivery or caesarean section enrolled in the study. There was a significant difference between mode of delivery and SUI following delivery (p<0.05). Perineal tear (grade 1-2), BMI, newborn weight and circumference significantly affect the SUI after vaginal or caesarean section. Perineal tear increase SUI after delivery 7-fold compared to other factors (OR=7.367; 95% CI=1.815-29.904). Conclusion : SUI after delivery affected by Mode of delivery, pelvic muscle floor weakness, perineal tear, BMI, newborn weight and head circumference.   Keywords: stress urinary incontinence, mode of delivery     Abstrak   Latar belakang: Sebagian besar kasus stress inkontinensia urin terjadi setelah partus pertama kali dan berhubungan dengan metode persalinan. Tujuan: Untuk mengetahui faktor-faktor yang mempengaruhi terjadinya stress inkontinensia urin post partum Metode: Wanita yang mengalami stres inkontinensia urin 3 bulan postpartum normal atau seksio dilibatkan dalam penelitian cross sectional ini. Kekuatan otot dasar panggul diukur dengan perineometer. Penilaian SUI dilakuakn dengan menggunakan kuesioner Sandvix Severity Index (SSI) dan The three incontinence question (3IQ). Data dianalisis dengan uji Chi-square dengan tingkat kemaknaan p<0,05. Hasil: Delapan puluh empat wanita dengan SIU postpartum per vaginam atau operasi caesar dilibatkan dalam penelitian ini. Terdapat perbedaan signifikan antara cara persalinan dan SIU setelah postpartum (p<0,05). Ruptur perineum (grade 1-2), IMT, berat bayi lahir dan lingkar kepala secara signifikan mempengaruhi SIU postpartum. Ruptur perineum meningkatkan SUI postpartum 7 kali lipat dibandingkan dengan faktor-faktor lainnya (OR = 7,367; 95% CI = 1,815-29,904). Kesimpulan: SIU postpartum dipengaruhi oleh cara persalinan, kelemahan dasar otot panggul, robekan perineum, IMT, berat bayi lahir dan lingkar kepala.   Kata kunci : stress inkontinensia urin, metode persalina

Anti Müllerian Hormone (AMH) Level as Ovarian Reserve Marker before and after Cystectomy Laparotomy

Objective: To investigate the comparison of the Anti-Mullerian Hormone (AMH) as the ovarian reserve marker before and after cystectomy. Methods: This study used prospective cohort design which included all women with the ovarian cyst who underwent cystectomy laparotomy. The subjects were examined AMH level before and after the procedure. Data were analyzed using one- way Anova, T- paired test, and T-independent test with p valu

The Level of Ca125 in Preand Postoperative of Endometriosis

Objective: To determine the Ca-125 level in pre- and post-operative of endometriosis and its correlation to endometriosis stage and severity of dysmenorrhea. Method: This was a cross-sectional study design conducted at Dr. Wahidin Sudirohusodo dan some affiliated hospitals. We took the patients undergoing laparoscopy or laparotomy consecutively. Result: The mean value of preoperative Ca-125 level in stage I-II was 21.53 (SD 12.64) IU/ml vs 72.52 (SD 8.52) IU/ml in stage III-IV. The mean value of postoperative Ca-125 level was 14.82 (SD 10.00) IU/ml (stage I-II) vs 61.03 (SD 8.43) IU/ml (stage III-IV); they were significantly different (

Estradiol Level and Psychosocial Stress in Perimenopausal Women

Objective : To determine the relationship between estradiol levels and psychosocial stress in the perimenopausal women. Methods : Sixty perimenopausal included in a cross-sectional study from July to December 2016. Blood samples obtained from the women to measure the estradiol and the cortisol levels. Stress level measured with visual. Data presented as the mean and standard deviation (mean±SD) with p-value <.05 was considered statistically significant.  Results : There was no significant difference between the estradiol levels and the stress level (p=0.27) during perimenopause period. The estradiol levels were higher compared with the cortisol levels. The non parametrik correlations analysis show the estradiol levels were not correlated with the cortisol levels (p=0.352). However, the cortisol levels were correlated with the stress levels (p<0.05). Conclusion : Estradiol does not cause psychosocial stress during perimenopause period in our study population Keywords : Estradiol, psychosocial stress, perimenopaus

The Effect of Cyclophosphamide Chemotherapy on Ovarian AntiMüllerian Hormone Levels in Breast Cancer Patients

Objective: To evaluate cyclophosphamide effects on Anti- Müllerian hormone (AMH) levels in breast cancer patients treated with cyclophosphamide chemotherapy. Methods: This cohort prospective study was conducted in Dr. Wahidin Sudirohusodo Hospital in the Department of Obstetrics and Gynecology in collaboration with Department of Surgery, Faculty of Medicice, Universitas Hasanuddin between September 2015 and June 2016. Serum levels of AMH from forty breast cancer patients received three series of cyclophosphamide chemotherapy determined by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Serum AMH levels decreased significant in the first series (from 2.092.04 ï­g/ml to o.651.06 ï­g/ml; p<0.05) through the third series (from 1.531.34 ï­g/ml to 0.50.65 ï­g/ml; p<0.05) of cyclophosphamide chemotherapy. Conclusion: AMH levels decreased significant after cyclophosphamide indicated that cyclosphosphamide decrease ovarian reserve. [Indones J Obstet Gynecol 2018; 6-1: 64-67] Keywords: anti-müllerian hormone, breast cancer, cyclophosphamide, ovarian reserveObjective: To evaluate cyclophosphamide effects on Anti- Müllerian hormone (AMH) levels in breast cancer patients treated with cyclophosphamide chemotherapy. Methods: This cohort prospective study was conducted in Dr. Wahidin Sudirohusodo Hospital in the Department of Obstetrics and Gynecology in collaboration with Department of Surgery, Faculty of Medicice, Universitas Hasanuddin between September 2015 and June 2016. Serum levels of AMH from forty breast cancer patients received three series of cyclophosphamide chemotherapy determined by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Serum AMH levels decreased significant in the first series (from 2.092.04 ï­g/ml to o.651.06 ï­g/ml; p<0.05) through the third series (from 1.531.34 ï­g/ml to 0.50.65 ï­g/ml; p<0.05) of cyclophosphamide chemotherapy. Conclusion: AMH levels decreased significant after cyclophosphamide indicated that cyclosphosphamide decrease ovarian reserve. Keywords: anti-müllerian hormone, breast cancer, cyclophosphamide, ovarian reserv