Association of age at menarche, parity, and hormonal contraceptive use with the histologic type of ovarian cancer

HIGHLIGHT1. Relationship between age at menarche, parity, and contraceptive use with histologic type of ovarian cancer was analyzed. 2. A number of patients with ovarian cancer were analytically observed with retrospective cross-sectional approach and the histologic types of the cancer were determined.3. Age of menarche, parity, and hormonal contraceptive use was found not to have significant correlation with histologic type of ovarian cancer. ABSTRACTObjectives: This study analyze the relationship between age at menarche, parity, and contraceptive use with histologic type of ovarian cancer.Materials and Methods: This study used an observational analytic with a retrospective cross-sectional approach. The research samples were 128 patients with ovarian cancer at RSUD Dr. Saiful Anwar Malang in 2017-2019, all patients underwent primary staging laparotomy. The histologic type of ovarian cancer consist of: serous 45, mucinous 45, endometrioid 10, clear cell 20, and others 4. Data analysis using chi square.Results: The p value for the relationship between the age of menarche and histologic type of ovarian cancer was p = 0.500 (p> 0.05), parity p = 0.313, and contraceptive use p = 0.824. The distribution of clear cell was more common in multiparous, 40% of endometrioid found in nulliparous, serous were more common in women with hormonal contraceptive use >5 years, whereas mucinous were more common in history of use <5 years.Conclusion: There was no significant relationship between the age of menarche, parity, and hormonal contraceptive use on histologic type of ovarian cancer.

Relationship of pregnant mother’s anxiety level with preparation for childbirth during Covid-19 pandemic in Surabaya, Indonesia

HIGHLIGHT1. Due to Covid-19 pandemics, anxiety among pregnant mothers is increasing and good preparation for childbirth is needed.2. A survey was carried out to find pregnant mothers level of anxiety and preparation for childbirth during the pandemics.3. Most of the pregnant mothers were severely anxious, but most of them also felt prepared for childbirth. No relationship was found between anxiety and preparedness for childbirth. ABSTRACTObjective: Corona Virus (COVID-19) currently occurring in Indonesia greatly affects the health of the entire community, both physically and psychologically. During the pandemic period, social restrictions are required in an effort to reduce the spread of the virus, especially for pregnant women who are vulnerable to infection because of their weak immune system. This causes increased maternal anxiety during pregnancy. Therefore, good preparation for childbirth is needed so that mothers receive sufficient information and receive safe services from exposure to viruses.Materials and Methods: This research used an analytic survey method with a cross sectional approach. Done by distributing closed questions on online questionnaires to pregnant women in Surabaya through social media networks. The sampling technique used simple random sampling and managed to collect a sample of 90 people.Results: This research showed that pregnant women during the COVID-19 pandemic in Surabaya experienced 13% mild anxiety, 24% moderate anxiety, 63% severe anxiety. Preparation for childbirth during the COVID-19 pandemic in Surabaya was 20% unprepared and 80% ready.Conclusion: There is no relationship between the anxiety experienced by pregnant women during the COVID-19 pandemic and their preparation for delivery. Pregnant women were worried that they can be exposed to the virus. Therefore, they can prepare for childbirth properly so that they can go through delivery safely and comfortably.

Comparison of pain intensity, smooth muscle cells density, and alpha-smooth muscle actin expression in ovarial and peritoneal endometriosis

HIGHLIGHT1. Pain intensity, smooth muscle cells density, and alpha-SMA expression can be used to analyze the role of smooth muscle in endometriosis.2. Compared to healthy individuals, those with endometriosis have higher pain intensity, smooth muscle cells density, and alpha-SMA expression. 3. Among endometriotic patients, those with peritoneal endometriosis have higher pain intensity, smooth muscle cells density, and alpha-SMA expression than those with ovarial endometriosis.3. The expression of alpha-SMA, smooth muscle density, and pain intensity were found to correlate significantly in endometriosis. ABSTRACTObjectives: to identify the role of smooth muscle through the analysis of smooth muscle cells density, expression of a-SMA, and the pain intensity.Materials and Methods: Study design is a cross sectional analytic observational. Study sample consists of women with ovarial endometrios and women with peritoneal endometriosis that undergo laparoscopy and laparotomy in RSUD Saiful Anwar Malang and RSIA Melati Malang from January until December 2019. There are 16 samples: 8 samples of ovarial endometriosis and 8 samples of peritoneal endometriosis. Smooth muscle cell density was analyzed by comparing the number of smooth muscle cells with the total area of endometriosis tissue in one microscopical field. a-SMA expression obtained by immunohistochemistry. Degree of pain obatined by filling the part 1 point 1-11 of EHP-30 queistionnaire the day after the procedure. Data was analyzed by Independent T-test and Pearson correlation.Results: Pain intensity, smooth muscle cells density, and a-SMA expression is higher in the endometriosis patient compared to healthy individual. Pain intensity, smooth muscle cells density, and a-SMA expression is lower in the ovarial endometriosis compared to peritoneal endometriosis.Conclusion: There are a significant correlation between the expression of a-SMA, smooth muscle density, and pain intensity in endometriosis.

Trends in delivery mode occurring during the Covid-19 pandemic and risks in long-term urogynecology cases: A narrative review

HIGHLIGHT 1. Trend of delivery types during Covid-19 pandemic and the risk of urogynecology cases, particularly sexual dysfunction, pelvic floor dysfunction and stress urinary incontinence, was reviewed.2. Cesarean section was found higher than normal deliveries due to the consideration of possiblee exposure to the virus.3. Sexual dysfunction was found not to have relations to mode of delivery, but those with mode of delivery other than normal likely had dyspareunia at 18 months postpartum.4. The choice of method of delivery needs to be determined wisely by considering medical indications and the risk factors. ABSTRACTWomen's quality of life in the long term is also influenced by their reproductive health. Various diseases appear related to urogynecology cases such as sexual dysfunction, pelvic floor dysfunction and stress urinary incontinence. The study reviews the trend of types of delivery during the pandemic and the risk of urogynecology cases, especially in the three cases. The narrative review study was conducted using the PubMed, Science Direct, and Google Scholar databases. The results showed that the percentage of cesarean section was higher than normal deliveries because of the view on the safety of exposure to the virus. Several studies have found that sexual dysfunction was not related to mode of delivery but women who delivered by emergency caesarean section, vacuum extraction, or caesarean section were more likely to report dyspareunia at 18 months postpartum but adjusted for maternal age and other confounders. Meanwhile, compared with spontaneous vaginal delivery, cesarean delivery with a protective effect or reduction of stress urinary incontinence, overactive bladder, and pelvic organ prolapse. There is a tendency to choose a certain pattern of delivery so that the choice of method needs to be chosen wisely and through medical indications and consider risk factors for long-term reproductive health problems.

Corellation between mother's knowledge and husband's support for the success of the Lactational Amenorrhea Method (LAM)

HIGHLIGHTS 1. Lactational Amenorrhea Method (LAM) is one of the natural contraception methods of postpartum women.2. Mothers' knowledge and husband's support for LAM contraceptive method was suggested to contribute to its success.3. Research and statistical instruments used found that the success of LAM contraceptive was related to mothers' knowledge, but not related to husband's support. ABSTRACTObjectives: This study aims to analyze the relationship between mother's knowledge and husband's support for the success of LAM contraception in Brengkok Village, Brondong District, Lamongan Regency, East Java.Materials and Methods: This study is an analytic observational study with a sample of 46 mothers who gave exclusive breastfeeding to their babies who met the inclusion criteria. The research instrument used a questionnaire to determine the level of mother's knowledge and husband's support about exclusive breastfeeding. Spearman Rank Correlation Test was used for data analysis with a significance level of 0.05.Results: More than 50% of respondents (25 respondents) successfully used the LAM method to prevent pregnancy. Statistical test showed that there was a relationship between mother's knowledge and success of LAM contraception with p value (0.000), with a correlation coefficient of 0.523. Meanwhile, husband's support is not related to the success of LAM contraception with p value (0.461) with a correlation coefficient of 0.111.Conclusion: Mother's knowledge is related to the success of LAM contraception, and there is no relationship between husband's support and the success of LAM contraception.

Postpartum contraceptive use among pregnant women who delivered at Cipto Mangunkusumo General Hospital: A descriptive study

HIGHLIGHT1. As maternal mortality rate (MMR) is still high, there should be ways to reduce the rate, one of which is the prevention of conception through contraceptive methods. 2. A descriptive study was conducted to all patients giving birth in a national hospital between 2016 to 2019 covering data on the patients, including age, parity, the origin of referral, and type of contraception.3. Most patients who gave birth in the hospital had postpartum contraception, especially permanent contraception and long-term contraception. ABSTRACTObjectives: The maternal mortality rate in Indonesia is one of the highest in the world at 305 out of 100.000 live birth. One of the best ways to reduce MMR is conception prevention through contraceptive methods. According to 2018 Demographic and Health Survey, Indonesia’s Contraceptive Prevalence Rate is as low as 57%, not even reaching the 2015 Millenium Development Goals target of 65%. We conducted a study on postpartum contraceptive use in Dr. Cipto Mangunkusumo National Central General Hospital (RSCM) to see the use of contraception in RSCM so that it can be an example of how contraception is used in RSCM for patients who give birth here.Materials and Methods: A descriptive study was conducted from all patients giving birth in RSCM from 2016 until 2019, data including patient data, consisting of patient age, parity, the origin of referral, and type of contraception, are input from the medical recordResults: There were 5,596 deliveries, consisting of 3,785 C-sections and 1,811 vaginal deliveries. As much as 5332 (95.3%) of subjects had postpartum contraception, 725 (13.67%) of which received tubectomy, and most of which received long-term contraceptive methods (IUD 4414 (82.78%) and implant 44 (0.82%)). As many as 1.065 subjects were more than 35 years of age, 6,2% of which did not use any postpartum contraception. As many as 984 subjects were RSCM bookcases, 6,9% of which did not use any postpartum contraception.Conclusion: Most patients giving birth in RSCM had postpartum contraception, especially permanent contraception and long-term contraception. The contraception profile in RSCM alone can neither describe nor represent the condition and distribution of contraceptive methods in Indonesia because RSCM is a national referral and medical education center whose cases are relatively more complex.

Maternal outcome in accreta cases. Conservative surgery and hysterectomy in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from January 2017 to January 2018

HIGHLIGHT1. As the incidence of placenta accreta is increasing which seems to parallel the increasing cesarean delivery rate, advance planning should be made for the management of delivery. 2. Maternal outcome of placenta accreta cases in a national hospital was reported based on the surgical technique performed.3. No significant results of maternal outcome undergoing conservative surgery and conventional hysterectomy in managing accreta cases in the national hospital.ABSTRACTObjectives: To report maternal outcome based on surgical technique on the management of accreta. The study was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from January 2017 to January 2018.Case Report: There were 1609 cases of pregnant women delivered during the study period. From these, the prevalence of previous caesarean section was 73 cases, including 20 cases of accreta. Total maternal mortality for 1 year in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, was 11, and accreta contributed 3 cases. We reported 20 cases of accreta in pregnancy The maternal outcomes, including bladder injury, duration of operation, intraoperative bleeding, length of hospitalization, and mortality, were evaluated. From 20 cases, 8 patients had one previous caesarean history, 11 had second previous caesarean section, while 2 patient had third previous caesarean section history. Of women with placenta accreta, about 7 patients (35%) had delivery in fullterm pregnancies, while 13 (65%) had delivery in preterm pregnancy. Surgical technique in accreta management mostly was hysterectomy to override bleeding complication along the delivery. From 20 cases, 16 caesarean sections were followed-up with hysterectomy. Four cases were with conservative management. From all the hysterectomy performed, four were complicated with bladder injury. The mean intraoperative bleeding was 600 - 5500 cc of blood, while the mean of post-operative transfusion was 1000 -3000 cc. There were 2 maternal deaths in this study. Thirteen patients were admitted to the ICU after the procedure.Conclusion: Accreta increases morbidity due to massive bleeding. It is important to have algorithm for managing abnormal implantation of the placenta. Our cases revealed no significant results of maternal outcome between conservative surgery and conventional hysterectomy in managing accreta cases in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Development of auditory and palpatory educational media on pregnancy danger signs for visually impaired mothers

HIGHLIGHTS1. Pregnancy dangers should be known by any pregnant mothers, including those with visual impairment. 2. Educational media for visually impaired pregnant mothers can be in the form of auditory and palpatory media. 3. Auditory and palpatory media has been researched and developed in this study.4. The auditory and palpatory media increase the knowledge in health education of visually impaired pregnant mothers as they overcoming difficulties the often found. ABSTRACTObjectives: This study was a preliminary study (pilot project) on auditory and palpatory educational media of pregnancy danger signs for blind mothers. With the development of auditory and palpatory educational media, it was hoped that it helps blind mothers to understand pregnancy danger signs.Materials and Methods: The design of the study was a research and development study adapted into two stages, namely the needs analysis and the product design stages.Results: The results of the development of auditory and palpatory educational media included braille-lettered health education media and audio mp4 media which contained material on the danger signs of pregnancy in blind mothers.Conclusion: Auditory and palpatory media can increase the knowledge in health education because of their function to help overcoming many problems of difficulties in understanding and facilitating the reception of information by blind mothers.

Diagnostic value of abdominal CT scan in ovarian tumors in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January 2017 to December 2018

HIGHLIGHTS1. Ovarian tumors diagnostic value has been determined using the tools on contrast-enhanced abdominal CT Scan2. The tools including primary finding like mass size, septation, solid component, and additional finding such as ascites, peritoneal implants, lymph node enlargement3. Most tumors were ovarian malignant tumors according to their histopathological results 4. Contrast-enhanced abdominal CT Scan of ovarian tumors evaluated by the tools gave better and more reliable diagnostic value than without using the toolsABSTRACTObjectives: The purpose of this study was to determine the diagnostic value of contrast-enhanced abdominal CT scan in ovarian tumors in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, to provide scientific and clinical benefits.Materials and Methods: Samples were taken retrospectively by contrast-enhanced abdominal CT scan raw data in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January 2017 to December 2018. Using inclusion and exclusion criteria, a total of 88 samples were obtained and reviewed blindly by Female Organ Division of Radiology Department, Faculty of Medicine Universitas Airlangga, and by using "tools" (primary and additional findings of modified ovarian tumors malignancy). The data were correlated with histopathological findings and analyzed by statistical tests and the results with and without "tools" were compared.Results: Samples were grouped by age, distributed with a range of 20 years and the group of 41-60 years had the highest age of ovarian tumor samples (46.6%) with 84.1% being ovarian malignant tumors according to their histopathological results. It was dominated by serous, mucinous and endometroid types with sensitivity of 93.3%, specificity of 64.3%, positive predictive value of 93.3% negative predictive value of 69.2%, and accuracy value of 89.8%. More reliable results were obtained by using “tools”.Conclusion: Contrast-enhanced abdominal CT scan of ovarian tumors in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, evaluated by “tools” still had a better and more reliable diagnostic value than without tools in determining policy steps in handling ovarian tumors with a note that more in-depth research on pitfalls is needed so it may enrich the characteristic findings in imaging.

Retroperitoneum parasitic leiomyoma: Dilemmatic diagnostic

HIGHLIGHTS1. Parasitic leimyoma was found in a 38 year-old woman with complaint of mass in lower abdomen and already done biopsy by laparotomy 4 months before.2. During operation, the tumor was detached from the uterus, located retroperitoneally as high as L4 – S1 vertebrae.3. The tumor had been confirmed intraoperatively and proven histopathologically as parasitic leimyoma.4. Retroperitoneal parasitic leiomyoma is of a rare type and it needs multidisciplinary examination and approaches to increase the quality of its management.ABSTRACTObjectives: To describe a retroperitoneum parasitic leiomyoma case: a dilemma in diagnosis and operation finding.Case Report: A 38 year-old woman with 3 children visited Ulin Hospital, Banjarmasin, Indonesia, with complaint of mass in lower abdomen and about 4 months before, she underwent biopsy by laparotomy which revealed leiomyoma. Parasitic leiomyoma is a rare type of leiomyoma with predilection area in broad ligament, pelvic peritoneum, pouch of douglas, and omentum. During operation, the tumor was detached from the uterus and located retroperitoneally as high as L4–S1. It had been confirmed intraoperatively and proven histopathologically as a leiomyoma.Conclusion: Retroperitoneal parasitic leiomyoma may cause a dilemma in the diagnosis. Multidiscipline examination and approaches may increase the quality of management.