Majalah Obstetri & Ginekologi

Cranberry extract for urinary tract infection treatment in pregnancy: A systematic review

2025-01-24T14:30:12+07:00

HIGHLIGHTS

Cranberry is a promising effective alternative treatment and prevention for UTIs in pregnancy.
Cranberry inhibits urinary tract bacteria adhesion and has antibacterial effects.

ABSTRACT

Objective: Urinary tract infections (UTIs) rank as the second most prevalent infectious condition globally, impacting approximately 150 million individuals each year. Due to anatomical and physiological changes, UTIs are particularly common during pregnancy, presenting with symptoms such as dysuria, turbid urine, increased urinary frequency, and occasionally hematuria. Recurrent UTIs are characterized by two or more episodes within six months or three within a year. Cranberries are widely acknowledged for their role in preventing UTIs during pregnancy. Their preventive mechanism involves inhibiting uropathogenic bacterial adhesion to the urinary tract epithelium, facilitated by phenolic compounds and A-type proanthocyanidins (PACs).

Materials and Methods: In this systematic review, the authors PubMed, ScienceDirect, ResearchGate, and Google Scholar for relevant articles published between 2013 and 2024. The search strategy utilized Medical Subject Headings (MeSH) and keyword terms related to Cranberry Extract/Juice and UTI Measurement Methods in Pregnancy. Search phrases were tailored to each database to enhance retrieval accuracy. All retrieved articles were evaluated in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Among the 30 studies reviewed, a daily dose of 500 mg cranberry extract over six months demonstrated promising efficacy as an alternative treatment for UTIs in pregnancy.

Conclusion: Cranberry (Vaccinium macrocarpon) extract effectively prevents UTIs by inhibiting bacterial adhesion and exerting antibacterial effects. This review confirms cranberry as a promising, safe alternative for UTI treatment and prevention in pregnancy, suitable for daily consumption.

Efficacy and role of vitamin D (25-OH-D serum) in the treatment of endometriosis: A systematic review

2025-05-23T17:22:13+07:00

HIGHLIGHTS

A frequent gynecological condition that affects 10–15% of women who are fertile is endometriosis, often leading to pelvic damage and infertility, and has been suggested to be treated with vitamin D due to its role in the immune system and reproductive health.
Vitamin D may help regulate inflammatory responses and reduce the risk of hyperplasia and cancer, with some studies suggesting it could also influence infertility associated with endometriosis.

ABSTRACT

Objective: A vital component of women's reproductive health, vitamin D has also demonstrated promise in the treatment of endometriosis by enhancing plasma levels and controlling immunological responses in chronic inflammation, including endometriosis. This study sought to shed light on the critical role that vitamin D plays in treating chronic pain and infertility related to endometriosis, as well as to offer fresh perspectives on the therapeutic application of vitamin D in reproductive medicine.

Materials and Methods: This systematic review analyzed literature from PubMed, ScienceDirect, ResearchGate, and Google Scholar, screening 1,156 articles and selecting 20 studies for qualitative synthesis. The focus was on the therapeutic role of vitamin D in treating endometriosis. Inclusion criteria included studies published in the last ten years, in English, involving non-pregnant, healthy women, particularly those with chronic pelvic pain or infertility. Accepted study designs included experimental, cohort, longitudinal, case reports, pilot, and observational studies. Exclusion criteria included non-English publications, animal or pregnant subjects, reviews, inaccessible full texts, and studies lacking relevant on vitamin D or endometriosis.

Results: Twenty eligible studies were selected, involving 5346 women and 60 girls aged 12-50 years with or without endometriosis from Iran, the USA, South Korea, Russia, Turkey, Brazil, Poland, Italy, Germany, and Japan. These studies found that many treatments were tried or done to be able to say that endometriosis can be cured in part by vitamin D.

Conclusion: This systematic review demonstrates that women with endometriosis had reduced vitamin D levels, but evidence on supplementation benefits remains inconclusive. Larger, well-designed trials are needed to confirm vitamin D’s role in endometriosis treatment.

Differences in factors associated with postpartum hemorrhage in developed and developing countries: A systematic review

2024-12-20T08:40:20+07:00

HIGHLIGHTS

Analysis of maternal and fetal risk factors associated with postpartum hemorrhage, comparing data from both developed and developing countries.
There are differences in the risk factors for postpartum hemorrhage between developed and developing countries.

ABSTRACT

Objective: This study aimed to assess maternal and fetal risk factors for post-partum hemorrhage in both developed and developing countries.

Materials and Methods: A systematic review methodology was employed, incorporating a descriptive design. The study followed Joanna Briggs Institute (JBI) techniques, the PCC framework, and the PRISMA-ScR checklist. Article searches were conducted across four databases: Research Rabbit, Science Direct, Wiley, and PubMed. Articles published in English between 2019 and 2024 that met the inclusion criteria were selected. The search terms included combinations of “Postpartum women” OR “Puerperium” AND “Risk factors” OR "Risky conditions” AND “Postpartum hemorrhag*” “Postpartum bleeding” and “Developed countr*” AND “Developing countr*”.

Results: Out of 906 articles, 20 met the inclusion criteria, representing both developed and developing countries. The findings were categorized into two themes: risk factors in developed versus developing countries. In developed countries, PPH risk factors are often linked to medical interventions and prolonged labor management, while in developing countries, the focus shifts to conditions like anemia, uterine overdistension, and trauma from delivery practices. Sociocultural disparities further exacerbate risks in both settings.

Conclusion: The study reveals significant differences in PPH risk factors between developed and developing countries. By reviewing existing research, it identifies factors that can influence PPH occurrence. The findings emphasize the need for developing policies to screen pregnant, maternity, and postpartum women to mitigate PPH risk.

Cervical cancer screening before hysterectomy in pelvic organ prolapse patients: Is it essential? A case series

2025-03-04T13:16:25+07:00

HIGHLIGHTS

Higher result of cervical pre-cancer histopathology compared with cervical smear is found in POP patients undergoing vaginal hysterectomy.
Preoperative biopsy or ultrasound among POP patients undergoing vaginal hysterectomy cannot be a routine procedure.

ABSTRACT

Objective: Pelvic organ prolapse (POP) is caused by a weakening of pelvic floor muscles. The prevalence of unanticipated premalignant and malignant pathologies after hysterectomy is varied from 0.2 to 0.8%. This report to present a case series of POP’s patients undergoing vaginal hysterectomy (VH) with preoperative evaluation of abnormal cervical smear ending with higher result of histopathology.

Case Series: Case 1: A-55-year-old woman, P3A0 was diagnosed as third grade both in uterine prolapse and cystocele. The result of Pap smear revealed atypical glandular cells of undetermined significance (AGUS). Histopathological result after VH was vaginitis and metaplastic chronic cervicitis with atypia to mild dysplasia of endocervical epithelial cell/ low grade squamous intraepithelial lesion (LSIL). Case 2: A-62-year-old woman, P5A0, was diagnosed as third grade of uterine prolapse. The result of Pap smear showed atypical squamous cells of undetermined significance (ASCH). Histopathological result after VH was high grade squamous intraepithelial lesion (HSIL) up to in situ carcinoma with involvement of microinvasive gland and focus.

Conclusion: Since cervical cancer still become the second most common cause of mortality in Indonesia, it is recommended to screen preoperatively for pre-cancerous gynecological lesion and cancer.

Back Matter Vol. 33 No. 2 August 2025

2025-08-27T13:32:45+07:00

Global research trends in partograph: A bibliometric analysis

2025-06-03T13:23:07+07:00

HIGHLIGHTS

This study highlights growing global attention on the Partograph as a part of labor monitoring.
Partograph use remains inconsistent and affects clinical decision-making and management of labor.
Future studies should focus on digital monitoring and policy effectiveness in intrapartum care as a part of enhancing maternal and neonatal outcomes.

ABSTRACT

Objective: The present study aims to clarify the emerging patterns in partograph utilization, its development, and its impact on clinical practice.

Materials and Methods: A bibliometric analysis was conducted using Scopus as the primary database. Articles were retrieved using the keywords “Partograph” or “Partogram” and analyzed using two strategies: performance analysis (Scopus “analyze” function) and network analysis (VOSviewer and NVivo).

Results: Five hundred and thirteen articles published between 1965 and 2025 were analyzed. Performance analysis revealed that the most cited studies focused on labor management, labor progression, and maternal and neonatal health outcomes. The leading publishing countries included Ethiopia, the United States, the United Kingdom, India, and South Africa. Network analysis identified strong connections between partograph research and healthcare quality, personnel delivery, and facilities. Research trends evolved from early studies on spontaneous delivery, dystocia, and maternal mortality to more recent investigations into partograph utilization as a healthcare service quality improvement tool. Pearson correlation analysis showed strong associations between partograph use and birth outcomes (0.81), mortality (0.78), and healthcare workers’ perspectives (0.76).

Conclusion: Research on partograph utilization continues to expand, focusing on labor monitoring and its impact on maternal and neonatal outcomes. Recently, studies have shifted toward labor-management quality, healthcare service improvement, and patient safety. However, certain areas remain underexplored, presenting opportunities for further research.

Pregnancy: A window of opportunity for refining and mitigating the fetal origins of adult health and disease, and maternal cardiovascular futures

2025-07-10T10:00:20+07:00

HIGHLIGHTS

Maternal nutrition, mental health, and environmental factors during pregnancy significantly influence the long-term physical and mental health of offspring, supporting the concept of Fetal Origins of Adult Disease (FOAD) and Developmental Origins of Health and Disease (DOHaD).
Adverse pregnancy outcomes like preeclampsia and gestational diabetes increase the mother's future risk of cardiovascular disease, highlighting the need for broader maternal health strategies beyond childbirth.

ABSTRACT

This review explores the profound impact of pregnancy on fetal development and long-term maternal cardiovascular health, emphasizing how early-life conditions shape lifelong health. The concept of Fetal Origins of Adult Disease (FOAD) or Developmental Origins of Health and Disease (DOHaD) is discussed, highlighting how maternal nutrition and environmental factors during pregnancy predispose offspring to chronic diseases later in life. Maternal mental health is also explored, with depression and anxiety during pregnancy linked to lasting effects on offspring, including increased risks of mental health disorders and chronic conditions in adulthood. The study "Like Mother, Like Daughter" is examined to illustrate intergenerational risks such as preeclampsia and intrauterine growth restriction (IUGR), emphasizing the role of maternal health.

Additionally, the long-term cardiovascular consequences of adverse pregnancy outcomes—such as preeclampsia, gestational diabetes, and preterm birth—are discussed, noting that they elevate the mother's risk of cardiovascular disease (CVD) in later life. The rising prevalence of obesity during pregnancy further exacerbates these risks. The paper calls for a shift in obstetrics from a narrow focus on pregnancy management to a broader approach that addresses both maternal and fetal health for long-term benefits. By recognizing pregnancy as a critical window to influence future health, comprehensive strategies could help mitigate chronic diseases in both mothers and children.

Long COVID in vaccinated women with Polycystic Ovary Syndrome: A retrospective cohort pilot study

2025-03-03T15:36:31+07:00

HIGHLIGHTS

Among women with PCOS, many still reported persistent long COVID symptoms such as hair loss and fatigue.
COVID-19 vaccination does not exacerbate symptoms of PCOS, which further emphasizes the importance of completing COVID-19 doses for women with PCOS to avoid long COVID sequelae.

ABSTRACT

Objective: Long COVID, or the persistence of symptoms after acute COVID-19 illness, can affect individuals with pre-existing health conditions such as polycystic ovary syndrome (PCOS). Long COVID and PCOS may share overlapping pathogenesis which potentially exacerbate one another. The aim of this study was to evaluate the symptoms of long COVID in women with PCOS who have been vaccinated and investigate whether COVID-19 vaccination or infection worsened PCOS symptoms.

Materials and Methods: We carried out a retrospective cohort study on 44 women with PCOS who have been vaccinated and previously diagnosed with COVID-19. Questionnaires were distributed to find out the effect of COVID infection and vaccines in these women, as well as the symptoms of long COVID-19.

Results: Of all participants, 28 women (70%) continued to report persistent long COVID symptoms, with the highest number of complaints being fatigue and hair loss. The results, using Mann-Whitney test, showed that there was no difference in PCOS symptoms before and after COVID-19 vaccination (p = 0.520) or after COVID-19 infections (p = 0.241). Although this study revealed a substantial prevalence of long COVID symptoms among women with PCOS, an encouraging finding emerged: neither the administration of COVID-19 vaccination nor prior infection with COVID-19 had a significant impact on PCOS-associated symptoms.

Conclusion: This study further underscores the importance of vaccination for all individuals, including women with a history of PCOS. Furthermore, the purpose of COVID-19 vaccination is to mitigate symptom severity, thus potentially diminishing the occurrence of long-term COVID-19 symptoms in future cases.

Maternal, socioeconomic and healthcare factors associated with postpartum maternal mortality in Papua Province, Indonesia, based on secondary data analysis of IDHS 2020

2024-12-16T11:13:32+07:00

HIGHLIGHTS

Postpartum maternal mortality is associated with factors such as number of previous parity, living place, Indonesian language ability, status/wealth index, delivery attendant, and place of delivery.
Indonesian language ability is the most influential factor, likely reflecting disparities in access to healthcare, health literacy, and geographic or social marginalization.

ABSTRACT

Objective: We conducted research based on the Indonesia Demographic Health Survey (IDHS) 2020 to investigate the association between postpartum maternal mortality and several parameters, including Maternal, socioeconomic and healthcare factor in Papua Province.

Materials and Methods: This study employed a cross-sectional design and quantitative analytical approach, using secondary data from IDHS 2020. A total of 14,802 female respondents between the ages of 15 and 49 were sampled. The data was analyzed using a simple logistic regression test for bivariate analysis with a 95% confidence level (a = 0.05). Subsequently, a multivariate multiple logistic regression analysis was performed on variables having a p-value less than 0.25.

Results: The results indicated that all factors (parity p<0.001 AOR=0.533 95% CI 0.375-0.758; living place p=0.001 AOR=2.526 95% CI 1.438-4.436; Indonesian language ability p<0.001 AOR=0.039 95% CI 0.031-0.050; delivery attendant and place of delivery p<0.001 AOR=0.118 95% CI 0.142-0.249, not associated with status/wealth index p=0.972 AOR=1.010 95% CI 0.565- 1.806). They had a significant negative association with postpartum maternal mortality (p-value <0.05) except for the status/wealth index. The highest association, with an odds ratio (OR) of 0.039, was observed in Indonesian language ability, which showed a 25.64-fold increase.

Conclusion: The research findings provide a strong foundation for future policies and interventions to reduce postpartum maternal mortality in Papua Province. Indonesian language ability was identified as the most dominant factor associated with maternal mortality, offering hope for targeted interventions and improved healthcare.

Maternal and fetal characteristics associated with successful Vaginal Birth After Cesarean (VBAC) in Dr. Soetomo and Universitas Airlangga Hospitals, Surabaya, Indonesia

2025-07-10T09:09:14+07:00

HIGHLIGHTS

VBAC at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital demonstrated a high success rate, reflecting effective patient selection and clinical management in achieving favorable outcomes for multiparous women with a prior cesarean section.
Cervical dilation, particularly greater than 4 cm at admission, is a significant predictor of VBAC success, highlighting its critical role in guiding labor management and decision-making for optimal delivery outcomes.

ABSTRACT

Objective: This study aims to evaluate the maternal and fetal characteristics associated with successful vaginal birth after cesarean (VBAC) at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital in Surabaya, Indonesia.

Materials and Methods: A retrospective analytic study was conducted using a total sampling method to review medical records from January 2021 to December 2022. Inclusion criteria encompassed singleton pregnancies with a previous one-time low-segment cesarean section, vertex presentation, and no contraindications to vaginal delivery. A total of 46 eligible cases were analyzed following exclusion criteria.

Results: Among the studied variables, cervical dilation at admission and the 5-minute Apgar score were significantly associated with successful VBAC (p < 0.05). All patients presenting with cervical dilation >4 cm delivered vaginally, indicating a strong predictive value. In contrast, those with dilation <4 cm had a markedly higher rate of cesarean delivery. A higher Apgar score also correlated positively with VBAC success, suggesting favorable neonatal outcomes in these cases. Maternal BMI did not show a statistically significant association with VBAC success (p > 0.05), likely influenced by the predominance of obesity in the cohort. Other factors, including maternal age, parity, birth interval, gestational age, and neonatal birth weight, were not significantly associated with the outcome.

Conclusion: While most maternal and fetal variables did not significantly impact the likelihood of successful VBAC, cervical dilation on admission emerged as a critical clinical predictor. These findings emphasize the importance of intrapartum evaluation, particularly cervical assessment, in guiding delivery planning for women with prior cesarean sections.

The development of "TAMENG" flipchart for eradication of anemia in pregnancy in Sumber, Kabupaten Probolinggo, Indonesia

2025-03-10T12:43:59+07:00

HIGHLIGHTS

The "TAMENG" flipchart significantly improved knowledge about anemia prevention among pregnant women.
Nutritional status (mid-upper arm circumference) and history of anemia were strongly associated with anemia prevalence.
Community-based, culturally relevant tools like the flipchart can effectively promote sustainable maternal health behaviors.

ABSTRACT

Objective: This study aimed to evaluate the effectiveness of the "TAMENG" flipchart as an educational tool to improve knowledge about anemia prevention among pregnant women in Sumber, Kabupaten Probolinggo, Indonesia, and to explore associated risk factors for anemia, including nutritional status and supplementation practices.

Materials and Methods: A community-based cross-sectional study was conducted in August 2024 as part of Universitas Airlangga’s Community Service Program. Pregnant women attending antenatal care in Sumber, Kabupaten Probolinggo were recruited based on ANC attendance and availability of hemoglobin test results. The "TAMENG" flipchart, designed with culturally relevant visuals and content on anemia prevention, was implemented during interactive education sessions. Demographic data, obstetric histories, and pre- and post-test knowledge assessments were collected. Statistical analysis was performed using chi-square tests to identify significant associations between variables.

Results: Among 65 participants, 35.38% were anemic. Significant factors associated with anemia included nutritional status (60.9% of anemic women had mid-upper arm circumference <23.5 cm; p = 0.019) and history of anemia (30.4% vs. 9.5%; p = 0.032). Knowledge scores significantly improved post-intervention for 90.5% of non-anemic women and 100% of anemic women. Employment status and supplementation practices showed notable trends but were not statistically significant.

Conclusion: The "TAMENG" flipchart effectively increased knowledge and awareness about anemia prevention. Tailored interventions addressing nutritional deficiencies, supplementation adherence, and family involvement can enhance maternal health outcomes in rural communities.

Front Matter Vol. 33 No. 2 August 2025

2025-08-27T13:30:19+07:00