Indonesian Journal of Obstetrics and Gynecology

Fetoscopic Surgery: The Frontier of Maternal–Fetal Medicine in Indonesia

Muhammad Alamsyah Aziz — Wed, 29 Oct 2025 00:00:00 +0700

N/A

Usability, Acceptability, and Satisfaction of Indonesian Birth Attendant Practitioners Using the 2020 World Health Organization Labor Care Guide

Josef Maria Seno adjie, Sisca Indrianie — Wed, 29 Oct 2025 00:00:00 +0700

Objectives: This study was conducted to determine whether the World Health Organization Labor Care Guide 2020 (WHO LCG 2020) can be accepted and implemented by Indonesian birth attendant practitioners.
Methods: This study is mixed-method research, with a quantitative study using a cross-sectional design and a qualitative study using an in-depth interview design. The study was conducted from July to November 2023 in Dr. Cipto Mangunkusumo General Hospital and associated teaching hospital. The subjects in this study were birth attendant practitioners who had received training in the use of partographs or normal delivery care (APN). Data analysis was performed descriptively to determine the distribution and characteristics of practitioners and patients, which will be presented in a tabular form. Data from the interviews were reported narratively.
Results: Fifty-nine participants (45 midwives and 14 doctors) received training in the use and filling of the LCG sheet. The participants used the LCG for 120 patients, with the majority of patients having spontaneous vaginal births (78.3%). From the results of the questionnaire, 40 participants (67.8%) felt that the LCG sheet was useful and 42 participants (71.2%) felt satisfied. Overall, most participants felt that the LCG sheet was useful and satisfied with its use in helping health workers assist in childbirth.
Conclusion: It was found that regular training is needed on how to complete the WHO LCG 2020 sheet, and a lot of experience is required to become accustomed to using the LCG new birth monitoring format.
Keywords: birth attendant, childbirth, doctors, labor care guide, midwives

Impact of Nutritional Intervention Using Mung Bean Juice and Soy Milk on Hemoglobin Levels in Adolescent Girls

Wed, 29 Oct 2025 00:00:00 +0700

Objectives: Anemia, which the general population is more familiar with as anemia, is below normal or is known as hemoglobin (HB), with women's typical levels being 11 gr/dl and 13 gr/dl in teenage boys. Anemia data in the Jambi Province area, the number of anemia sufferers aged 10-14 years (19.5%), 15-24 years (84.6%), 25-24 years (33.7%), 35-44 years (33 .6%), and 45-54 years (24%). Data on the number of anemia in Muaro Jambi is 97 people

Methods: his study employed a quasi-experimental design methodology (quasi-experimental) pretest and posttest intervention to compare green bean juice and soy milk for 14 days.

Results: One-way ANOVA was used to evaluate the data. The variables iron, folic acid, vitamin C in the green bean juice intervention obtained a p value of 0.000. The variables iron, folic acid, vitamin C in the soy milk intervention obtained a p value of 0.000. Showing that the hemoglobin levels between the intervention group, the control group of green bean juice and soy milk had quite large significant differences. As a result, hemoglobin levels in the soy milk intervention group in adolescents increased significantly compared to the green bean juice control group with a ratio of 0.68 g/dl per 500 ml to the average hemoglobin level before to the test administration of green bean juice.

Conclusion: The conclusion obtained According to this study, young women's hemoglobin levels can rise when they are given green bean juice and soy milk.

Social Determinants of Maternal Mortality Trends in Banyumas Regency: A Qualitative Study

Wed, 29 Oct 2025 00:00:00 +0700

Background: Indonesia reduced maternal mortality from 390 per 100,000 live births in 1994 to 228 in 2007, but this rose again to 305 in 2015. In Banyumas Regency, maternal mortality declined from 2014 to 2020 but increased again from 2021 to 2023.

Purpose: This study aims to identify social determinants affecting maternal mortality trends in Banyumas from 2014 to 2023.

Methods: A qualitative study was conducted following the Standards for Reporting Qualitative Research (SRQR). Data collection involved in-depth interviews with 45 respondents—including health office staff, hospital informants, midwives, and health cadres—and a Focus Group Discussion. Interviews and discussions were guided by semi-structured protocols to explore participants’ views on maternal health issues.

Results: Most respondents had over three years of experience and were aged 40–50. Key themes emerged: challenges in maternal and neonatal health services, referral refusal influenced by sociocultural factors, emergency training for health workers, collaboration and tiered referral systems, and hospital standardization.

Discussion: The five key determinants influencing maternal mortality rate in Banyumas Regency were identified: human resource adequacy in maternal care, continuity of emergency training, accessibility of referral systems and collaborations, and hospital standardization. Healthcare personnel shortages, especially post-Covid-19, also combined with inadequate emergency training, may affect the healthcare quality. Sociocultural beliefs and poor referral coordination lead to treatment delays, particularly in rural areas. Inconsistencies in hospital standardization further exacerbate access inequities. While maternal mortality showed a declining trend from 2014 to 2023 (excluding pandemic years), systemic challenges remain. Strengthening referral systems, improving hospital standards, continuous training, and culturally sensitive public education are crucial.

Conclusion: Social determinants influencing maternal mortality trends include the adequacy of human resources, ongoing emergency maternal and neonatal training, accessible and integrated referral systems, consistent hospital accreditation standards (PONEK), and sociocultural factors. Addressing these areas is essential to improving maternal health outcomes in Banyumas

Quality of Life Among High-Risk Antenatal Women in a Tertiary Care Hospital Kerala, South India

Wed, 29 Oct 2025 00:00:00 +0700

Objectives: The study aims to assess the quality of life (QoL) among high-risk antenatal women and to determine its association with selected baseline and obstetric variables.

Methods: A cross-sectional design was utilized, and 82 high-risk antenatal women meeting the inclusion criteria were purposively sampled from the antenatal outpatient department of a tertiary care hospital in Kerala, South India. Data collection involved a structured questionnaire to evaluate baseline, obstetric factors, and the QOL/GRAV Questionnaire to measure QoL. Data were analysed using SPSS version 23. Categorical variables were summarized as frequencies and percentages. The association between selected variables and quality of life (QoL) was assessed using Fisher’s Exact test, and regression analysis was performed to identify predictors of low QoL.

Results: The mean QoL scores of the respondents in the current study were 30.43 ± 4.461, which suggests a good QoL despite potential pregnancy-related challenges. The presence of leg cramps, anaemia, and multiple pregnancies among high-risk antenatal women was significantly associated with reduced QoL.

Conclusion: The findings provide insights into the QoL in high-risk antenatal populations, emphasizing the need for tailored interventions to improve maternal health outcomes.

Key words:antenatal women,high risk, quality of life

Socioeconomic and Parental Determinants of Adolescent Pregnancy: A Cross-Sectional Study at Pekauman Community Health Center, Banjarmasin

Renny Aditya — Wed, 29 Oct 2025 00:00:00 +0700

Objective:This study examined the relationship between parental economic status, parental role, and the incidence of teenage pregnancy among adolescents at the Pekauman Community Health Center in Banjarmasin.

Methods:An observational, cross-sectional analytic study was conducted with 50 randomly selected respondents. Data collection utilized validated questionnaires and in-depth interviews. Independent variables included education level, economic status, parental role, and reproductive health knowledge. Data analysis was performed using chi-square tests at a significance level of ? = 0.05 (SPSS, IBM).

Results:Adolescent pregnancy was found to be significantly associated with low reproductive health knowledge (p = 0.0219; OR = 0.16), low economic status (p = 0.0008; OR = 10.40), low education level (p < 0.0001; OR = 19.43), and inadequate parental role (p = 0.034; OR = 4.0). The majority of adolescent mothers were under 18 years of age and had not completed high school. Health complications were prevalent, with 32% of adolescent mothers experiencing anemia.

Conclusion:Adolescent pregnancy is primarily influenced by inadequate reproductive health knowledge, low educational attainment, economic hardship, and insufficient parental support. Comprehensive strategies are required, including reproductive health education, socioeconomic empowerment, and active parental engagement. These interventions are essential for reducing adolescent pregnancy rates and improving maternal and child health outcomes. Local health authorities should prioritize community-based reproductive health education programs that involve both adolescents and their parents to facilitate accurate knowledge dissemination and open communication.

Keywords:Adolescent pregnancy, parental role, reproductive health knowledge, socioeconomic status.

Vitamin D Levels and Its Influence on Maternal Blood Glucose, Blood Pressure, and Fetal Weight: A Cross-Sectional Study

Hanif Reza, Yulice Soraya, Fadhli Rizal Makarim, Rizki Alfarizi — Wed, 29 Oct 2025 00:00:00 +0700

Objectives: Vitamin D is needed for many physiological functions. Vitamin D deficiency is a global problem, including vitamin D deficiency in pregnancy. Maternal vitamin D deficiency has been associated with an increased risk of adverse gestational outcomes. This cross-sectional study was conducted to assess the influence of vitamin D levels on the maternal blood glucose, blood pressure, and fetal weight.

Methods: Twenty-six women with gestational age 12-16 weeks as participants of this study were recruited from two Primary health care in Semarang, Indonesia between September - October 2023. were analyzed for serum 25 hydroxy vitamin D (25 (OH) D ). The samples then were assessed for blood glucose, blood pressure and fetal weight using ultrasonography.

Results: The results of the Pearson's correlation rank test for Vitamin D with estimated fetal weight, blood glucose, systolic blood pressure, and gestational ages as covariate showed a value of P>0.05. Statistically, it means that there is no correlation between vitamin D and other variables.

Conclusion: Our study showed level of vitamin D has no influence on of blood glucose level, incidence of hypertension, and low fetal weight

Keywords: blood pressure, fetal weight, maternal blood glucose, vitamin D

Antifertility Effects of Ethanol-Extracted Turmeric on Male Rats: ELISA-Based Evaluation

Wed, 29 Oct 2025 00:00:00 +0700

Abstract
Objective: To determine the effect of administering 96% ethanol extract of turmeric (Curcuma longa Linn, syn. Curcuma domestica Val.) on the antifertility effect on male rats.

Methods: 18 Male and 18 Female Sprague-Dawley Rats were grouped into 6 Groups, namely the Control Group, Positive Control Group (Birth Control Pills), Treatment Group 1 with a dose of 25 mg/KgBW, Treatment Group 2 with a dose of 50 mg/KgBW, Treatment Group 3 with a dose of 25 mg/KgBW, Treatment Group Mating of Male and Female Rats given turmeric with a dose of 50 mg/KgBW, Treatment Group Mating of Male and Female Rats given turmeric is Male with a dose of 50 mg/KgBW. Turmeric extract was given orally every day for 30 days.
Results: The data obtained were statistically analyzed using a one-way ANOVA test. Testosterone levels increased compared to the control group, indicating no significant difference, with a P value of 0.317 (p>0.05), and in vivo male sperm motility at doses of 25 mg/kgBW, 50 mg/kgBW, and 100 mg/kgBW was significantly different from the control group (p 0.00 < 0.05).
Conclusion: Giving 96% turmeric ethanol extract (Curcuma longa Linn, syn. Curcuma domestica Val.) did not affect testosterone levels in male rats in vivo at doses of 25 mg/kgBW, 50 mg/kgBW, and 100 mg/kgBW, with a significance value of p 0.317 > 0.05, indicating no significant difference. Meanwhile, sperm motility testing showed a significant difference with a result of p = 0.00 < 0.05. For further research, it is hoped that further observations will be made regarding the potential of turmeric ethanol extract by conducting histological tests, and a mating test will be carried out as evidence of whether or not the treated rats are fertile.

Keywords: antifertility, concentration testosterone, effectiveness, Sprague-Dawley Rats, turmeric extract.

Efficacy and Tolerability of Short-Term Hormonal Therapy Following Conservative Surgery for Endometriosis

Wed, 29 Oct 2025 00:00:00 +0700

Abstract
Objective: To compare the efficacy and tolerability of four short-term hormonal therapies; Dienogest (DNG), Depot Medroxyprogesterone Acetate (DMPA), continuous Combined Oral Contraceptive (COC), and Leuprolide Acetate (LA); administered for 12 weeks after conservative endometriosis surgery.

Methods: This randomized, prospective, open-label study enrolled reproductive-aged women with surgically confirmed endometriosis. Participants were randomly assigned to receive DNG 2 mg daily, DMPA 150 mg intramuscularly every 12 weeks, continuous COC (ethinyl estradiol 0.03 mg and levonogestrel 0.15 mg) daily, or LA 3.75 mg intramuscularly every 4 weeks. Primary outcomes were changes in pain intensity (visual analog scale, VAS), hormonal markers (estradiol, E2), inflammatory markers (TNF-?), and the Menopause Rating Scale (MRS) as an indicator of tolerability. Data were analyzed using ANOVA with a significance level of p < 0.05.

Results: All four regimens resulted in significant reductions in dysmenorrhea, dyspareunia, and chronic pelvic pain after 12 weeks (p < 0.001). E2 and TNF-? levels decreased significantly in all groups, with the greatest decline observed in the LA arm. No significant differences were found among regimens in pain reduction or biomarker changes (p > 0.05). MRS scores increased transiently at week 8, particularly in the LA group, reflecting hypoestrogenic effects, but decreased by week 12 in all groups.

Conclusion: Short-term postoperative hormonal therapy with DNG, DMPA, COC, or LA effectively reduces pain and inflammatory markers following endometriosis surgery. Progestin-based therapies achieve comparable clinical efficacy to GnRH agonists with superior tolerability. Individualized selection based on symptom profile, side effects, and accessibility is recommended in accordance with ESHRE guidelines.

Keywords: endometriosis-associated pain, Menopause Rating Scale, short-term hormonal therapy.

Clinical Characteristics of Pelvic Organ Prolapse at a Nationally Referred General Hospital: A Retrospective Study (2023-2024)

Wed, 29 Oct 2025 00:00:00 +0700

Abstract
Objective: To evaluate the clinical characteristics of patients with Pelvic Organ Prolapse (POP) in national referral hospitals and analyze the relationship between age, parity, and prolapse severity.

Methods: This medical record–based retrospective study included 353 POP patients from 2023–2024. Variables assessed were age, parity, prolapse severity (POP-Q), sexual activity status, and type of therapy received. Correlation analysis was performed using Spearman’s rank correlation with SPSS version 26.

Results: Most patients (81.3%) were postmenopausal, and 64.6% were multiparous. The majority presented with stage IV prolapse (34.8%), and operative therapy was the primary treatment choice (89.5%). Significant associations were observed between age and prolapse severity (? = 0.208, p < 0.001) and between parity and prolapse severity (? = 0.215, p < 0.001). These findings indicate that increasing age and higher parity are significantly associated with more severe POP, although the correlation strength was weak.

Conclusions: POP was most commonly found in postmenopausal women, with higher severity among older and multiparous patients. These findings highlight the importance of early screening and preventive strategies to reduce POP progression. Further prospective multicenter studies are needed to evaluate the long-term impact of POP on quality of life and to compare the effectiveness of conservative versus operative therapies.

Keywords: conservative therapy, degree of prolapse, parity, Pelvic Organ Prolapse, reproductive age, surgical intervention.

Therapy of Dequalinium Chloride Vaginal Tablets in Pregnant Women with Vulvovaginal Candidiasis

Lita Setyowatie, Nanda Shaskia Larasaty — Wed, 29 Oct 2025 00:00:00 +0700

Background: Vulvovaginal candidiasis (VVC) is a Candida infection on vulva and vagina region. The most common etiology is C. albicans. Besides being the risk factor for developing VVC, pregnancy also limits the possible medication. This report presents the efficacy of Dequalinium Chloride (DQC) on VVC during pregnancy due to C. albicans.

Case: A third-trimester primigravidae, 27-year-old, complained first odorless thick curd-like consistency vaginal discharge accompanied with pruritus (VAS 9/10) and pain since 3 months prior to admission. Venerology examination showed erythema on the labia majora and a great amount of thick vaginal discharge on the labia minora, vaginal, and cervix area. Vaginal discharge examination using KOH 10% showed pseudohyphae. Gram examination found pseudohyphae and polymorphonuclear (PMN) cells >30 in the vagina, and pseudohyphae on the cervix’s discharge. VITEK-2 culture showed fluconazole-sensitive C. albicans. The patient was given DQC intravaginal tablets for 10 days and showed remarkable clinical and microscopic examination improvement.

Conclusion: Intravaginal DQC is effective in treating pregnant patients with VVC. VVC in pregnancy should be treated appropriately to prevent perinatal adverse effects.

Keywords: Vulvovaginal Candidiasis, dequalinium chloride, pregnancy, C. albicans

Incidental Finding of Wandering Spleen

Wed, 29 Oct 2025 00:00:00 +0700

Introduction: Wandering spleen (WS) is a rare case due to inadequate spleen binding ligaments, causing increased spleen hypermobility and displacement of the spleen from the left upper quadrant abdominal location. Case findings can be incidental or symptomatic with acute abdomen due to complications of WS cases.

Case Report: A 36-year-old, gravida 3, para 1, abortus 0, at 41-42 gestational age woman presented at our hospital for planned cesarean section indicated for premature rupture of membranes and preeclampsia. Intraoperative findings revealed that the spleen was incidentally in the pelvic cavity, lateral to the uterus. There were no abnormalities of the spleen intraoperatively, and the patient did not show any complaints related to the abnormal location of the spleen. The patient was planned for Splenopexy to maintain the spleen function.

Conclusion: WS cases are rare, with varied manifestations from asymptomatic to acute abdomen due to acute complications. This patient was asymptomatic, and the findings of the WS were incidental. The most common complications in WS cases are torsion and splenic infarction, with splenectomy as the main treatment. Asymptomatic patients are advised to undergo Splenopexy to maintain spleen function and reduce the risk of WS complications.

Keywords: spleen, ectopic spleen, rare diseases, pregnancy.