Chlamydia Trachomatis Infection and Spontaneous Abortion: Infeksi Chlamydia Trachomatis dan Abortus Spontan

Abstract Objective: To determine the correlation between spontaneous abortion and Chlamydia trachomatis infection. Methods: A cross-sectional study was conducted in women who experienced spontaneous abortion. Normal pregnancies with gestational age more than equal to 37 weeks as control. Detection of C. trachomatis in the product of conception or placenta from curettage using the PCR method. Results: Positive C. trachomatis was found 3 cases in the abortion group and 4 cases in control. In the abortion group, C. trachomatis found in 1 case with vaginal discharge history and 2 cases without this history. C. trachomatis also found in 3 cases without a history of abortion. This bacteria was not found in patients with an abortion history. In the control group, 2 cases of positive C. trachomatis were found in pregnant women with or without a history of vaginal discharge and abortion, respectively. There were no significant differences regarding the positive of C. trachomatis between the two study groups regarding history of vaginal discharge and abortion. Conclusions: Spontaneous abortion does not correlate with C. trachomatis infection. Keywords: chlamydia trachomatis, infection, spontaneous abortion. Abstrak Tujuan: Untuk mengetahui hubungan antara abortus spontan dan infeksi Chlamydia trachomatis. Metode: Penelitian potong lintang dilakukan pada perempuan yang mengalami abortus spontan. Kehamilan normal dengan usia kehamilan lebih dari sama dengan 37 minggu sebagai kontrol. Deteksi C. trachomatis pada produk konsepsi atau plasenta dari kuretase menggunakan metode PCR. Hasil: C. trachomatis positif ditemukan 3 kasus pada kelompok aborsi dan 4 kasus dalam kontrol. Pada kelompok abortus spontan, C. trachomatis ditemukan pada 1 kasus dengan riwayat keputihan dan 2 kasus tanpa riwayat keputihan. C. trachomatis juga ditemukan pada 3 kasus tanpa riwayat abortus. Bakteri ini tidak ditemukan pada pasien dengan riwayat abortus. Pada kelompok kontrol, 2 kasus positif C. trachomatis masing-masing ditemukan pada perempuan hamil dengan atau tanpa riwayat keputihan dan abortus. Tidak ada perbedaan signifikan C. trachomatis positif antara kedua kelompok penelitian berdasarkan riwayat keputihan dan abortus. Kesimpulan: Abortus spontan tidak berkorelasi dengan infeksi C. trachomatis. Kata kunci: abortus spontan, chlamydia trachomatis, infeksi

Conformity of Human Papillomavirus between Self-examination of Vaginal Fluid and Cervical Specimen with Fluid-Based Cytology in Precancerous Lesions: Tingkat Kesesuaian Human Papillomavirus antara Pemeriksaan Cairan Vagina secara Mandiri dan Spesimen Serviks dengan Sitologi Berbasis Cairan pada Lesi Prakanker

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

Effect of Rectal Misoprostol to Blood Loss at High Risk Pregnancy

Objective: To compare the effectiveness of rectal misoprostol administration to the amount of blood loss in 4th stage of labor at high risk pregnancy. Method: We recruited all pregnant women with high risk criteria including anemia, age 35 years old, or the number of pregnancies 4. Women would deliver appropriate to standard procedure of normal delivery. After that, we gave 400-mcg tablet of misoprostol rectally in treatment group. To count the amount of blood loss during 4th stage of labor, we put the underpad. Result: The amount of blood loss in 4th stage of labor in the treatment group was 201.1 (SD 80.3) ml less than the control group (285.9 (SD 93.2) ml). The result showed that the administration of 400-mcg misoprostol tablet rectally immediately after the birth of the placenta at high risk pregnancy impacted significantly to reduce the amount of blood loss in 4th stage of labor (