Majalah Obstetri & Ginekologi

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

Rahmawati Abdul Hakim, Dhian Eka Putri, Rahajeng — Wed, 27 Aug 2025 00:00:00 +0700

HIGHLIGHTS

Cranberry represents a promising and effective alternative for both the treatment and prevention of urinary tract infections during pregnancy.
Cranberry acts by inhibiting bacterial adhesion to the urinary tract epithelium and exerting direct antibacterial activity.

ABSTRACT

Objective: Urinary tract infections (UTIs) represent the second most common infectious disease worldwide, affecting nearly 150 million people annually. Owing to anatomical and physiological alterations, UTIs are especially frequent during pregnancy, manifesting with symptoms including dysuria, cloudy urine, increased urinary frequency, and occasionally hematuria. Recurrent UTIs are defined as two or more episodes within six months or three episodes within a year. Cranberries are widely recognized for their potential in preventing UTIs during pregnancy. Their protective action involves blocking the adhesion of uropathogenic bacteria to the urinary tract epithelium, a process mediated by phenolic compounds and A-type proanthocyanidins (PACs).

Materials and Methods: In this systematic review, the authors searched PubMed, ScienceDirect, ResearchGate, and Google Scholar for eligible articles published from 2013 to 2024. The search strategy employed Medical Subject Headings (MeSH) and keywords pertaining to Cranberry Extract/Juice and UTI Assessment Methods in Pregnancy. Search expressions were adapted to the specific requirements of each database to optimize retrieval precision. All identified studies were assessed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Of the 30 studies included, a daily administration of 500 mg cranberry extract over six months exhibited notable effectiveness as an alternative therapeutic approach for UTIs in pregnancy.

Conclusion: Cranberry (Vaccinium macrocarpon) extract prevents UTIs by impeding bacterial adherence and exerting antibacterial properties. This review supports cranberry as a promising and safe alternative for UTI prevention and management in pregnancy, appropriate for routine daily use.

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

Yuli Ayu Diani, I Wayan Arsana Wiyasa — Wed, 27 Aug 2025 00:00:00 +0700

HIGHLIGHTS

Endometriosis frequently causes pelvic damage and infertility, and vitamin D has been proposed as a therapeutic option owing to its involvement in immune regulation and reproductive health.
Vitamin D may contribute to the modulation of inflammatory pathways and decrease the risk of hyperplasia and malignancy, with several studies indicating that it might also impact infertility related to endometriosis.

ABSTRACT

Objective: Vitamin D, an essential element in women’s reproductive health, has shown potential benefits in endometriosis management by improving plasma concentrations and modulating immune responses in chronic inflammatory conditions, including endometriosis. This study aimed to elucidate the pivotal role of vitamin D in alleviating chronic pain and infertility associated with endometriosis and to provide new insights into its therapeutic application in reproductive medicine.

Materials and Methods: This systematic review examined literature retrieved from PubMed, ScienceDirect, ResearchGate, and Google Scholar, screening 1,156 records and including 20 studies for qualitative assessment. The review focused on the therapeutic contribution of vitamin D in endometriosis management. Eligible studies were those published in the last decade, in English, involving non-pregnant, healthy women, particularly patients with chronic pelvic pain or infertility. Accepted study designs comprised experimental, cohort, longitudinal, case reports, pilot, and observational studies. Excluded were non-English articles, animal or pregnant populations, reviews, inaccessible full texts, and studies lacking relevance to vitamin D or endometriosis.

Results: Twenty selected studies were analyzed, encompassing 5,346 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 indicated that multiple therapeutic approaches were attempted, suggesting that endometriosis may be partially ameliorated by vitamin D administration.

Conclusion: This systematic review highlights that women with endometriosis presented with lower vitamin D levels; however, the evidence regarding supplementation efficacy remains uncertain. Further large-scale, rigorously designed trials are necessary to establish vitamin D’s therapeutic role in the management of endometriosis.

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

Sri Astuti Handayani, Farida Kartini — Wed, 27 Aug 2025 00:00:00 +0700

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

Wed, 27 Aug 2025 00:00:00 +0700

HIGHLIGHTS

More advanced cervical precancerous histopathological findings compared with cervical cytology are observed in POP patients undergoing vaginal hysterectomy.
Routine use of preoperative biopsy or ultrasound in POP patients undergoing vaginal hysterectomy cannot be recommended.

ABSTRACT

Objective: Pelvic organ prolapse (POP) results from weakening of the pelvic floor musculature. The reported prevalence of unexpected premalignant and malignant pathologies following hysterectomy ranges from 0.2 to 0.8%. This study aims to present a case series of patients with POP who underwent vaginal hysterectomy (VH) after preoperative evaluation for abnormal cervical cytology, which subsequently demonstrated more advanced histopathological findings.

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

Conclusion: Given that cervical cancer remains the second leading cause of mortality among women in Indonesia, preoperative screening for precancerous gynecological lesions and malignancy is strongly recommended.

Back Matter Vol. 33 No. 2 August 2025

Majalah Obstetri & Ginekologi — Wed, 27 Aug 2025 00:00:00 +0700

Global research trends in partograph: A bibliometric analysis

Alfun Dhiya An, Asri Nur Maulidya, Maria Ulfa — Wed, 27 Aug 2025 00:00:00 +0700

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 aimed 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

Hermanto T Joewono — Wed, 27 Aug 2025 00:00:00 +0700

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

Wed, 27 Aug 2025 00:00:00 +0700

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

Dian Laily Safitri, Samsriyaningsih Handayani, Budi Prasetyo, Ratna Dwi Jayanti — Wed, 27 Aug 2025 00:00:00 +0700

HIGHLIGHTS

Postpartum maternal mortality demonstrates associations with determinants including parity, place of residence, proficiency in the Indonesian language, socioeconomic status or wealth index, type of delivery attendant, and place of childbirth.
Proficiency in the Indonesian language constitutes the most dominant factor, plausibly indicating inequalities in healthcare access, levels of health literacy, and conditions of geographic or social marginalization.

ABSTRACT

Objective: This study utilized data from the Indonesia Demographic Health Survey (IDHS) 2020 to examine the relationship between postpartum maternal mortality and several determinants, including maternal, socioeconomic, and healthcare-related factors in Papua Province.

Materials and Methods: A cross-sectional design with a quantitative analytical framework was applied, drawing on secondary data from IDHS 2020. The sample comprised 14,802 women aged 15–49 years. Data were analyzed through a simple logistic regression test for bivariate analysis with a 95% confidence level (a = 0.05). Subsequently, multivariate multiple logistic regression analysis was conducted on variables with a p-value of less than 0.25.

Results: Findings demonstrated that all variables (parity p<0.001 AOR=0.533 95% CI 0.375–0.758; place of residence p=0.001 AOR=2.526 95% CI 1.438–4.436; proficiency in Indonesian language p<0.001 AOR=0.039 95% CI 0.031–0.050; delivery attendant and place of birth p<0.001 AOR=0.118 95% CI 0.142–0.249, whereas wealth index status p=0.972 AOR=1.010 95% CI 0.565–1.806) showed a significant negative association with postpartum maternal mortality (p<0.05), except for the wealth index. The strongest association, with an odds ratio (OR) of 0.039, was identified in Indonesian language proficiency, indicating a 25.64-fold increase.

Conclusion: The findings provide a crucial evidence base for the development of policies and interventions aimed at lowering postpartum maternal mortality in Papua Province. Proficiency in the Indonesian language emerged as the most influential factor, underscoring the potential for targeted interventions and improved healthcare outcomes.

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

Syihab Armawa, Agus Sulistyono, Muhammad Ilham Aldika Akbar, Risa Etika — Wed, 27 Aug 2025 00:00:00 +0700

HIGHLIGHTS

High VBAC success rate demonstrated with effective patient selection and intrapartum management.
Cervical dilation >4 cm at admission identified as a critical predictor of VBAC success.

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

Wed, 27 Aug 2025 00:00:00 +0700

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

Majalah Obstetri & Ginekologi — Wed, 27 Aug 2025 00:00:00 +0700