Indonesian Journal of Obstetrics & Gynecology Science
OBGYNIA (Indonesian Journal of Obstetrics & Gynecology Science) is a journal in the field of Obstetrics and Gynecology, and is officially issued by the Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Padjadjaran. OBGYNIA published research articles about the new scientific, clinical management of the patient, surgical techniques, new treatments and service evaluation, management and treatment services in obstetrics and gynecology covers areas: Fertility and Reproductive Endocrine Maternalfetal Medicine Oncology Reconstruction Urogynecology Obstetrics and Social Gynecology This journal is expected to be a reliable source of information, quality and complete knowledge about medicine and health. Indonesian Journal of Obstetrics & Gynecology Science (Obgynia) is accredited (2022-2026) by National Journal Accreditation (ARJUNA) Managed by Ministry of Research, Technology, and Higher Education, Republic of Indonesia with Third Grade (Peringkat 3, Sinta 3), Nomor 79/E/KPT/2023.
Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran
Rising Adolescents Pregnancy Cases: An Additional Problem in Efforts to Reduce Maternal Mortality Rates
In the past three months, our institution have cared for 17 cases of pregnancies involving mothers under 20 years old. The youngest case involved a 14-year-old adolescent. These adolescent pregnancies are accompanied by various pregnancy pathologies, such as preterm birth, cephalopelvic disproportion, preeclampsia and eclampsia, mental disorders, and the potential for death for both the mother and the baby. In past decades, the majority of adolescent pregnancies were due to early marriage, while currently, unmarried pregnancies are on the rise. This is noteworthy, as it may be not only in Bandung and its surrounding areas but also throughout Indonesia and even globally. The increase in adolescent pregnancies results in the potential for maternal deaths, which are expected to increase in the future if this is not prevented and controlled properly.
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Reframing Female Genital Cosmetic and Aesthetic Surgery: Ethics, Function, and Sexual Health Beyond Appearance
In recent years, the convergence of aesthetic medicine and urogynecology has reshaped the dialogue on women’s health. Procedures once confined to reconstructive domains—repairing pelvic floor disorders, perineal trauma, or postpartum laxity—now coexist with aesthetic motivations emphasizing appearance and self-confidence. This editorial reflects on how female genital cosmetic surgery (FGCS) and female genital aesthetic surgery (FGAS) overlap yet differ ethically, functionally, and philosophically. Defining FGCS and FGAS According to the American College of Obstetricians and Gynecologists (ACOG) and the Royal College of Obstetricians and Gynaecologists (RCOG), FGCS comprises elective surgical procedures that modify the appearance of genitalia without clear medical indication. These interventions originate in the cosmetic surgery paradigm, focusing on visual symmetry and patient satisfaction. In contrast, FGAS has evolved within gynecology and minimally invasive aesthetic medicine, aiming not only at external appearance but also at comfort, tissue quality, and functional harmony. The distinction matters: while FGCS is largely appearance-driven, FGAS aspires toward holistic well-being and sexual confidence. Recognizing these nuances helps physicians maintain ethical boundaries and ensure that patient motivation is grounded in informed understanding rather than social pressure.
Urinary Complications after Radical Hysterectomy in Cervical Cancer: A Retrospective Cohort Study
Objective: Radical hysterectomy and pelvic lymphadenectomy are standard treatments for cervical cancer. A common long-term complication is lower urinary tract dysfunction (LUTD), which can lead to urinary tract infections (UTIs) due to urinary stasis. Incontinence may also increase UTI risk by allowing bacteria to enter through the urethra. This study aims to determine the incidence of LUTD and UTI in cervical cancer patients after radical hysterectomy and to analyze their relationship. Methods: A retrospective cohort study was conducted on patients with stage IA2–IIA2 cervical cancer who underwent radical hysterectomy at Margono Soekarjo General Hospital. Urinary catheters were placed postoperatively, and bladder training was initiated on postoperative day three. Urine samples were collected on day fourteen or upon the return of bladder sensation to assess for urinary tract infection (UTI). The relationship between lower urinary tract dysfunction (LUTD) and UTI was analyzed using. Result: LUTD incidence was 13.8%. UTI incidence was significantly higher in patients with LUTD than in those without (7.7% vs. 1.5%, p < 0.001). The relative risk of UTI in patients with LUTD was 31.1 (95% CI: 6.396–739.029), likely due to the limited sample size. Conclusion: There is a significant association between LUTD and UTI in cervical cancer patients after radical hysterectomy. Early detection and monitoring of bladder function are essential in postoperative care. Keywords: Lower urinary tract dysfunction; radical hysterectomy; urinary tract infection. Komplikasi Urinaria Setelah Histerektomi Radikal pada Kanker Serviks: Studi Kohort Retrospektif Abstrak Tujuan: Histerektomi radikal dan limfadenektomi pelvik merupakan terapi standar untuk kanker serviks. Salah satu komplikasi jangka panjang yang umum adalah disfungsi saluran kemih bagian bawah (Lower Urinary Tract Dysfunction/LUTD), yang dapat menyebabkan infeksi saluran kemih (ISK) akibat stasis urin. Inkontinensia urin juga dapat meningkatkan risiko ISK melalui masuknya bakteri melalui uretra. Penelitian ini bertujuan untuk mengevaluasi insidensi LUTD dan ISK pada pasien kanker serviks pasca-histerektomi radikal tipe II serta hubungan antara keduanya. Metode: Sebuah studi kohort retrospektif dilakukan pada pasien kanker serviks stadium IA2–IIA2 yang menjalani histerektomi radikal di RSUD Margono Soekarjo. Setelah operasi kateter urin dipasang dan melatih kandung kemih dimulai pada hari ketiga pascaoperasi. Sampel urin dikumpulkan pada hari keempat belas atau saat sensasi kandung kemih kembali untuk menilai adanya infeksi saluran kemih (ISK). Hubungan antara disfungsi traktus urinarius bawah (LUTD) dan ISK dianalisis menggunakan uji Fisher’s exact. Hasil: Penelitian ini menunjukan insidensi LUTD adalah 13,8%. Insidensi ISK secara signifikan lebih tinggi pada pasien dengan LUTD dibandingkan yang tidak mengalami LUTD (7.7% vs. 1.5%, p < 0.001). Risiko relatif ISK pada pasien dengan LUTD adalah 31.1 (CI 95%: 6.396–739.029) karena jumlah subjek penelitian sedikit. Kesimpulan: Terdapat hubungan yang signifikan antara LUTD dan kejadian ISK pada pasien kanker serviks pasca-histerektomi radikal. Deteksi dini dan pemantauan fungsi kandung kemih sangat penting dalam perawatan pascaoperasi. Kata kunci: Disfungsi urin; histerektomi radikal; infeksi saluran kemih
Non-Severe Preeclampsia and Subclinical Inflammation: A Study of Cyclophilin A, NF-κB, PARP- 1, and Apoptosis in Human Placentas
Objective: To compare the expression of CyP-A, NF-κB, PARP-1, and apoptotic index in Non-Severe Preeclampsia (NS-PE) and Normal Pregnancy (NP) and explore their roles in inflammation during preeclampsia. Methods: Conducted in Depok, Indonesia, the cross-sectional study involved 28 participants divided into NS-PE and NP groups based on ISSHP criteria. NP was defined as uncomplicated pregnancies at 38–40 weeks gestation. Placental weight was measured, and ELISA was used to assess biomolecule levels. Data were analyzed using T-tests or Mann-Whitney tests. Result: Maternal gestational age, body mass index, and leukocyte levels were significantly higher in NS-PE. The apoptotic index, measured by TUNEL assay, was also significantly elevated in NS-PE (41.56 ±24.87) compared to NP (23.96 ±18.79; p = 0.044). While CyP-A, PARP-1, and NF-κB levels were higher in NS-PE eventhough they were not statistically significant. Immunohistochemistry confirmed an overall increase in these molecules, supporting their clinical relevance. Conclusion: Despite the lack of statistical significance, increased inflammation and apoptosis in NS-PE may contribute to placental dysfunction and adverse pregnancy outcomes. Non-Severe Preeclampsia dan Inflamasi Subklinis: Studi CyP-A, NF-κB, PARP-1, dan Apoptosis pada Plasenta Manusia Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi CyP-A, NF-κB, PARP-1, dan indeks apoptosis antara preeklamsia non-severe (NS-PE) dan kehamilan normal (NP), serta perannya dalam proses inflamasi pada preeklamsia. Metode: Metode penelitian yang digunakan dalam penelitian ini adalah cross-sectional. Penelitian ini dilakukan di Depok, Indonesia, dengan 28 partisipan yang dikelompokkan menjadi NS-PE dan NP berdasarkan kriteria ISSHP. Berat plasenta diukur dan kadar biomolekul dianalisis menggunakan ELISA. Uji T dan alternatif Mann-Whitney digunakan untuk analisis statistik. Hasil: Hasil penelitian menunjukkan bahwa usia kehamilan, indeks massa tubuh (IMT), dan kadar leukosit secara signifikan lebih tinggi pada NS-PE. Indeks apoptosis (TUNEL) juga lebih tinggi secara signifikan pada NS-PE (41,56 ±24,87) dibandingkan NP (23,96 ±18,79; p = 0,044). Kadar CyP-A, PARP-1, dan NF-κB lebih tinggi pada NS-PE meskipun tidak signifikan secara statistik, pemeriksaan IHK mengonfirmasi relevansi klinis peningkatan pada keseluruhan biomolekul tersebut. Kesimpulan: Meskipun signifikansi statistik rendah, peningkatan peradangan dan apoptosis pada NS-PE dapat menyebabkan disfungsi plasenta dan dampak buruk pada kehamilan. Kata kunci: Apoptosis; inflamasi; preeklamsia.
A Comparative Analysis of Internal Radiation vs Box System in Treatment Efficacy and Patient Survival of Advanced Stage Cervical Cancer
Objectives: To evaluate the comparative effectiveness of brachytherapy and the box system in therapeutic success and patient survival in cervical cancer, along with associated prognostic factors. Methods: This retrospective analytical study used medical records from the Obstetrics & Gynecology Oncology Clinic and Radiotherapy Unit at Dr. Kariadi General Hospital in Semarang. The study included cervical cancer patients with stage IIB-IIIB disease who were treated between January 2017 and December 2022. Data analysis involved both statistical methods and survival analysis using the Kaplan-Meier approach. Results: During the 2017-2022 study period, a total of 939 patients with stage IIB-IIIB cervical cancer who completed full radiation therapy were evaluated for their 2-year survival rate. The cohort included 89 patients in the box system group and 850 in the brachytherapy/internal radiation group. Complete response was achieved in 46.1% of box system patients compared to 75.5% in the brachytherapy group (p<0.0001); partial response rates were 53.9% and 24.5%, respectively. Kaplan-Meier analysis showed a 2-year survival rate (2 YSR) of 41.6% for the box system and 64.0% for brachytherapy. The mean survival time was 15.37 months for the box system and 19.09 months for brachytherapy. Conclusion: Internal radiation therapy (brachytherapy) showed significantly better clinical outcomes compared to the box system approach. It resulted in a longer mean survival time (19.09 vs 15.37 months; p<0.001) and higher 2-year survival rates (64.0% vs 41.6%; log-rank p<0.001). Keywords: Cervical cancer, box system, brachytherapy, therapy response, survival Perbandingan antara Radiasi Interna vs Box System dalam Keberhasilan Terapi dan Kelangsungan Hidup Pasien Kanker Servik Stadium Lanjut Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui perbandingan radiasi interna dan box system dalam keberhasilan terapi dan kelangsungan hidup pasien kanker serviks serta faktor-faktor yang memengaruhi. Metode: Penelitian ini menggunakan metode analitik retrospektif dengan menggunakan rekam medis Poli Kandungan dan Onkologi dan Instalasi Radioterapi RSUP Dr. Kariadi Semarang. Subyek penelitian adalah pasien kanker servik stadium IIB-IIIB mulai periode januari 2017-Desember 2022. Analisis statistika menggunakan analisis analitik dan analisis survival menggunakan metode Kaplan Meier. Hasil: Hasil penelitian menunjukkan bahwa selama tahun 2017– 2022 didapatkan total 939 pasien dengan diagnosis kanker servik stadium IIB-IIIB yang menjalankan terapi radiasi lengkap dan dapat dilakukan evaluasi survival rate 2 tahun. Total subjek pada kelompok box system sebanyak 89, sedangkan kelompok brakiterapi/radiasi interna sebanyak 850 subjek. Respon terapi komplet sebesar 46,1% pada kelompok box system, dan 75,5% pada kelompok radiasi interna, respon terapi parsial 53,9% pada kelompok box system dan 24,5% pada kelompok radiasi interna, dengan nilai p <0.0001. Analisis survival dengan metode Kaplan -Meier didapatkan 2-YSR 41,6% pada kelompok Box system, sedangkan 64% pada kelompok radiasi interna sedangkan mean survival time pada kelompok box system 15,37 bulan dan kelompok radiasi interna 19,09 bulan dengan nilai p <0.001 Kesimpulan: Pemberian radiasi interna memberikan keberhasilan terapi klinis yang lebih tinggi dengan nilai mean survival time lebih tinggi. Pemberian radiasi interna memberikan kelangsungan hidup 2 tahun sebanyak 64%, sedangkan box system sebanyak 41,6% Kata kunci: Kanker servik, box system, brakiterapi, respon terapi, survival
Reevaluating Predictors of Extremely Low Birth Weight: The Dominance of Hemoglobin over Maternal Age and the Discovery of 9.25 g/dL as a New Risk Threshold
Abstract Objectives: Extremely Low Birth Weight (ELBW) is a critical factor influencing neonatal morbidity and mortality. Maternal anemia has been linked to negative pregnancy outcomes; the precise hemoglobin threshold for predicting ELBW risk remains poorly defined, especially in low-resource environments. Methods: A cross-sectional observational study was carried out at Ciawi District Hospital between 2019 and 2020. Data from medical records on maternal hemoglobin levels (g/dL) and neonatal birth weights (grams) were extracted for analysis. Statistical methods employed included the Kruskal-Wallis and Mann-Whitney tests, as well as ROC curve analysis. Results: The study comprised 320 cases. The optimal cutoff value for maternal hemoglobin to accurately predict ELBW was identified as 9.25 g/dL (AUC 0.615; p = 0.045). Mothers with hemoglobin levels below this threshold exhibited a 2.1-fold increase in the risk of delivering ELBW infants (p = 0.039). Additionally, the negative predictive value was determined to be 94.05%, indicating that this threshold may serve as a viable screening tool for assessing the risk of ELBW. Conclusion: Maternal hemoglobin levels below 9.25 g/dL are significantly correlated with an elevated risk of ELBW. This threshold may function as an effective early screening parameter for identifying high-risk pregnancies, thereby improving maternal and neonatal health outcomes. Keywords: Birth Weight, ELBW, Hemoglobin, Maternal Anemia, Risk Screening Evaluasi Ulang Prediktor Berat Badan Lahir Sangat Rendah: Dominasi Hemoglobin pada Usia Ibu dan Penemuan 9,25 g/dL sebagai Ambang Risiko Baru Abstrak Tujuan: Berat Badan Lahir Sangat Rendah (BBLR) merupakan faktor penting yang memengaruhi morbiditas dan mortalitas neonatal. Anemia ibu telah dikaitkan dengan hasil kehamilan yang negatif. Ambang hemoglobin yang tepat untuk memprediksi risiko BBLR masih belum didefinisikan dengan baik, terutama di lingkungan dengan sumber daya rendah. Metode: Metode yang digunakan dalam penelitian ini adalah studi observasional potong lintang dilakukan di Rumah Sakit Daerah Ciawi antara tahun 2019 dan 2020. Dilakukan analisis data dari catatan medis tentang kadar hemoglobin ibu (g/dL) dan berat badan lahir neonatal (gram). Metode statistik yang digunakan meliputi uji Kruskal-Wallis dan Mann-Whitney, dan analisis kurva ROC. Hasil: Studi ini terdiri atas 320 kasus. Nilai batas optimal hemoglobin ibu untuk memprediksi BBLR secara akurat diidentifikasi sebesar 9,25 g/dL (AUC 0,615; p = 0,045). Ibu dengan kadar hemoglobin di bawah ambang batas ini menunjukkan peningkatan risiko melahirkan bayi ELBW sebanyak 2,1 kali lipat (p = 0,039). Selain itu, nilai prediktif negatif ditetapkan sebesar 94,05%, yang menunjukkan bahwa ambang batas ini dapat berfungsi sebagai alat skrining yang layak untuk menilai risiko ELBW. Kesimpulan: Kadar hemoglobin ibu di bawah 9,25 g/dL berkorelasi signifikan dengan peningkatan risiko ELBW. Ambang batas ini dapat berfungsi sebagai parameter skrining dini yang efektif untuk mengidentifikasi kehamilan berisiko tinggi sehingga meningkatkan hasil kesehatan ibu dan bayi baru lahir.
Association between Serum Cotinine Levels, Fetal Biometry, and Umbilical Artery Flow in Pregnant Women Exposed to Secondhand Smoke
Objective: This study aimed to investigate the impact of SHS exposure on fetal biometry and umbilical artery flow at 24 – 28 weeks of gestation. Methods: This cross-sectional study included 110 pregnant women, divided into a study group (55 passive) smokers and a control group (55 non-passive smokers). Serum cotinine levels were measured using ELISA. Fetal biometry (biparietal diameter, head circumference, abdominal circumference, and femur length) and umbilical artery flow (pulsatility and resistance indices) were assessed via ultrasound and Doppler ultrasonography. Group comparisons were conducted using Chi-square and independent t-tests. Results: The passive smoker group had significantly higher mean serum cotinine levels compared with the control group (10.97 ng/mL vs. 4.53 ng/mL; p = 0.01). However, no statistically significant differences (p > 0.05) were found in any of the fetal biometric parameters or umbilical artery flow indices between the groups. Correlation analyses also showed no significant association between cotinine levels and the measured fetal outcomes. Conclusion: In this second-trimester study, SHS exposure, confirmed by elevated cotinine levels, was not associated with measurable adverse effects on fetal biometry or umbilical artery flow. These non-significant findings underscore the need for longitudinal research to evaluate the cumulative impact of SHS, particularly in the third trimester and on final birth outcomes. Hubungan antara Kadar Kotinin Serum, Biometri Janin, dan Aliran Arteri Umbilikalis pada Ibu Hamil yang Terpapar Asap Rokok Pasif Abstrak Tujuan: Penelitian ini bertujuan untuk menelaah dampak paparan asap rokok pasif terhadap biometri janin dan aliran arteri umbilikalis pada usia kehamilan 24 – 28 minggu. Metode: Penelitian potong lintang ini melibatkan 110 ibu hamil yang dibagi menjadi kelompok studi (55 perokok pasif) dan kelompok kontrol (55 bukan perokok pasif). Kadar kotinin serum diukur menggunakan metode ELISA. Biometri janin (meliputi diameter biparietal, lingkar kepala, lingkar perut, dan panjang femur) serta aliran arteri umbilikalis (indeks pulsasi dan indeks resistensi) dinilai melalui ultrasonografi (USG) dan USG Doppler. Perbandingan antarkelompok dianalisis menggunakan uji Chi-square dan uji t independen. Hasil: Kelompok perokok pasif memiliki rerata kadar kotinin serum yang secara signifikan lebih tinggi dibandingkan kelompok kontrol (10,97 ng/mL vs. 4,53 ng/mL; p = 0,01). Namun, tidak ditemukan perbedaan bermakna secara statistik (p > 0,05) pada parameter biometri janin maupun indeks aliran arteri umbilikalis antara kedua kelompok. Analisis korelasi juga tidak menunjukkan adanya hubungan bermakna antara kadar kotinin dengan luaran janin yang diukur. Kesimpulan: Pada penelitian trimester kedua ini, paparan asap rokok pasif yang dikonfirmasi dengan peningkatan kadar kotinin tidak berhubungan dengan efek merugikan yang terdeteksi pada biometri janin maupun aliran arteri umbilikalis. Temuan yang tidak signifikan ini menekankan pentingnya penelitian longitudinal untuk menilai dampak kumulatif paparan asap rokok pasif, terutama pada trimester ketiga dan luaran kelahiran akhir. Kata kunci: Aliran arteri umbilikalis; biometri janin; kotinin; paparan asap rokok pasif
Hypomethylation of the Promoter Region of the Vascular Endothelial Growth Factor (VEGF) Gene and It’s Low Expression in Placenta as a Risk Factor for Preeclampsia
Objective: This study aimed to determine the association between hypomethylation of VEGF gene promoter region and low VEGF expression in the placenta as a potential risk factor for preeclampsia. Methods: An observational case-control study was conducted involving pregnant women with preeclampsia and normotensive controls. Placental tissue samples were collected and analysed for DNA methylation status of the VEGF gene promoter using quantitative real-time PCR. VEGF expression levels in placental tissue were measured using ELISA. Results: Significant hypomethylation of the VEGF promoter region was observed in placenta samples from preeclamptic women compared to controls. This finding correlated with decreased VEGF expression. These results indicate that reduced VEGF expression due to promoter hypomethylation may impair placental vascularization, contributing to preeclampsia. Conclusions: Hypomethylation of the VEGF promoter and subsequent reduction in placental VEGF expression may serve as early biomarkers to predict preeclampsia. These results highlight the importance of epigenetic regulation in preeclampsia pathogenesis and suggest potential targets for early diagnosis and intervention. Hipometilasi Regio Promoter Gen Vascular Endothelial Growth Factor (VEGF) dan Ekspresi Vascular Endothelial Growth Factor (VEGF) yang Rendah pada Plasenta sebagai Faktor Risiko Preeklampsia Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara hipometilasi pada daerah promoter gen VEGF dan rendahnya ekspresi VEGF di plasenta sebagai faktor risiko potensial terjadinya preeklampsia. Metode: Penelitian observasional dengan desain kasus-kontrol ini melibatkan ibu hamil dengan preeklampsia dan kontrol normotensif. Sampel jaringan plasenta dikumpulkan dan dianalisis untuk menentukan status metilasi DNA pada daerah promoter gen VEGF menggunakan quantitative real-time PCR. Tingkat ekspresi VEGF dalam jaringan plasenta diukur menggunakan metode ELISA. Hasil: Didapatkan hipometilasi yang signifikan pada daerah promoter gen VEGF pada jaringan plasenta ibu dengan preeklampsia dibandingkan kelompok kontrol. Temuan ini berkorelasi dengan penurunan ekspresi VEGF. Hasil tersebut menunjukkan bahwa penurunan ekspresi VEGF akibat hipometilasi promoter dapat mengganggu vaskularisasi plasenta, sehingga berperan dalam patogenesis preeklampsia. Kesimpulan: Hipometilasi pada daerah promoter gen VEGF dan penurunan ekspresi VEGF di plasenta dapat berfungsi sebagai biomarker awal untuk memprediksi terjadinya preeklampsia. Hasil ini menyoroti pentingnya regulasi epigenetik dalam patogenesis preeklampsia serta membuka peluang untuk diagnosis dini dan intervensi yang lebih tepat. Kata kunci: Preeklampsia, VEGF, Hipometilasi, Plasenta, Epigenetik
Comparing Optimal Debulking Surgery Outcomes between Anemic and Non-Anemic Ovarian Cancer Patients at Dr. Hasan Sadikin General Hospital Bandung in 2022 – 2023
Objective: Ovarian cancer remains one of the most lethal gynecological malignancies. Optimal debulking surgery is one of the treatment options of ovarian cancer. Anemia was commonly observed in ovarian cancer patients, yet its association with the outcome of optimal debulking surgery remains unclear. This study aims to evaluate the association between preoperative anemia and the outcome of optimal debulking surgery. Methods: A case-control analytical observational study was conducted on 87 ovarian cancer patients who had undergone optimal debulking surgery at Dr. Hasan Sadikin General Hospital in 2022-2023. Data were collected from medical records and was analyzed using Chi-square test. Results: The majority of ovarian cancer patients at Dr. Hasan Sadikin General Hospital in 2022–2023 presented with mild to moderate anemia, accounting for 37,78% and 33,33% of cases, respectively. Only 24,44% had normal hemoglobin levels, while 4,44% had severe anemia. Optimal debulking was achieved in 76,7% of cases. No significant association was found between preoperative anemia and optimal debulking outcomes (p = 0,601; OR 1,21, 95% CI: 0,68–2,16). Conclusion: Preoperative anemia was not associated with optimal debulking surgery outcomes. Perbandingan Keberhasilan Optimal Debulking Surgery antara Pasien Kanker Ovarium dengan Anemia dan Non-Anemia di RSUP Dr. Hasan Sadikin Bandung Tahun 2022 – 2023 Abstrak Tujuan: Kanker ovarium merupakan salah satu keganasan ginekologi dengan angka kematian tertinggi. Optimal debulking surgery merupakan salah satu terapi utama pada pasien kanker ovarium. Anemia sering ditemukan pada pasien kanker ovarium. Namun, hubungan anemia dan keberhasilan optimal debulking surgery belum jelas. Penelitian ini bertujuan untuk mengevaluasi hubungan anemia preoperatif dan keberhasilan optimal debulking surgery pada pasien kanker ovarium. Metode: Metode penelitian yang digunakan adalah studi observasional analitik dengan desain case control yang melibatkan pasien kanker ovarium yang menjalani optimal debulking surgery di RSUP Dr. Hasan Sadikin Bandung periode 2022 – 2023. Data diperoleh dari rekam medis dengan total 87 pasien yang memenuhi kriteria inklusi. Analisis hubungan anemia preoperatif dengan keberhasilan optimal debulking surgery dilakukan dengan uji Chi square. Hasil: Mayoritas pasien kanker ovarium di RSUP Dr. Hasan Sadikin tahun 2022 – 2023 mengalami anemia ringan (37,78%) dan sedang (33,3%). Hanya 24,4% pasien memiliki kadar hemoglobin normal dengan 4,44% pasien mengalami anemia berat. Optimal debulking surgery berhasil dicapai pada 76,6%. Tidak ditemukan hubungan bermakna antara anemia preoperatif dan keberhasilan optimal debulking surgery (p = 0,601; OR 1,21; 95% CI : 0,68-2,16) Kesimpulan: Hasil penelitian menunjukkan anemia preoperatif tidak berhubungan dengan keberhasilan optimal debulking surgery pada pasien kanker ovarium. Kata kunci: Anemia; kanker ovarium; optimal debulking surgery
The Relationship Between Pre-Pregnancy Body Mass Index and the Incidence of Preeclampsia in Primigravida at Cibabat Regional Hospital
Objective: This study investigates the association between pre-pregnancy body mass index (BMI) and the incidence of preeclampsia in primigravida women. Methods: This cross-sectional study includes women who delivered at Cibabat General Hospital between 2023 and 2024. Pre-pregnancy BMI (kg/m²) was classified according to WHO categories: underweight (less than 18.5), normal (18.5–22.9), overweight (23.0–24.9), obese class I (25.0–29.9), and obese class II (≥30.0). The Spearman-Rho correlation coefficient was employed to analyze the relationship between pre-pregnancy BMI and the incidence of preeclampsia. Result: Our study demonstrated that, among 217 participants, 159 (73.3%) experienced preeclampsia. The proportion of women with an overweight/obese BMI who have preeclampsia is higher (36%-38%) compared to those with normal BMI (19%) and underweight BMI (15%). The Spearman-Rho correlation coefficient suggested a positive correlation between pre-pregnancy BMI and the incidence of preeclampsia (r = 0.367; p < 0.001), indicating that an increased BMI is statistically associated with an increased risk of preeclampsia. Conclusion: A BMI is associated with an increased risk of preeclampsia in primigravida women. Hubungan antara Indeks Massa Tubuh Sebelum Kehamilan terhadap Kejadian Preeklamsia pada Ibu Primigravida di RSUD Cibabat Abstrak Tujuan: Penelitian ini bertujuan untuk menilai hubungan antara IMT pra-kehamilan dan insiden preeklamsia pada ibu primigravida. Metode: Penelitian ini menggunakan desain penelitian potong lintang dan melibatkan ibu primigravida yang menjalani persalinan di RSUD Cibabat pada periode 2023 hingga 2024. IMT partisipan sebelum kehamilan dikategorikan berdasarkan standar WHO: berat badan kurang (< 18.5), normal (18.5-22.9), berat badan berlebih (23.0 – 24.9), obesitas tipe 1 (25.0 – 29.9), dan obesitas tipe 2 (≥30.0). Data kemudian dianalisis lebih lanjut menggunakan metode spearman-rho correlation coefficient untuk menetukan korelasi antara IMT pra kehamilan dan kejadian preeklampsia. Hasil: Hasil penelitian menunjukkan, dari 217 partisipan pada penelitian ini, 73,3% diantaranya mengalami kejadian preeklamsia. Proporsi preeklampsia tampak lebih tinggi pada partisipan dengan berat badan berlebih/obesitas (36–38%) dibandingkan dengan partisipan dengan IMT normal (19%) dan IMT kurang berat badan (15%). Hasil uji spearman-Rho correlation coefficient menunjukkan korelasi positif antara IMT pra-kehamilan dan kejadian preeklamsia (r = 0,367; p < 0,001), mengindikasikan peningkatan IMT sebelum kehamilan berhubungan dengan risiko preeklamsia. Kesimpulan: Peningkatan IMT pra-kehamilan berhubungan dengan peningkatan risiko preeklamsia pada wanita primigravida. Kata kunci: Edukasi prakonsepsi; Indeks massa tubuh; Primigravida
Survival Outcomes at Three Years After Primary vs Interval Debulking in Advanced Ovarian Cancer: A Retrospective Study from Hasan Sadikin Hospital (2021)
Objective: Ovarian cancer is the third most prevalent malignancy among women in Indonesia. The 5-year survival rate is approximately 49%, with 68% of patients diagnosed at an advanced stage. Standard treatment involves debulking surgery, which is categorized into primary debulking surgery (PDS) and interval debulking surgery (IDS). This study aims to compare the survival outcomes of ovarian cancer patients treated with PDS versus IDS at Dr. Hasan Sadikin General Hospital (RSHS) during 2021. Methods: A retrospective review of medical records was performed for ovarian cancer patients who underwent surgery at RSHS in 2021. Patients were classified according to the type of surgical management (PDS or IDS), and survival data were analyzed accordingly. Result: A total of 46 patients were included, with 38 undergoing PDS and 8 undergoing IDS. The mean overall survival was 34.1 months for the PDS group and 27.5 months for the IDS group. Bivariate analysis showed no significant difference in survival between the two groups (HR: 1.810, p = 0.341; 95% CI: 0.53–6.13). However, age (HR: 0.950, p = 0.014; 95% CI: 0.91–0.99) and progression-free survival duration (HR: 0.788, p = 0.0001; 95% CI: 0.71–0.86) were identified as significant prognostic factors for overall survival. Conclusion: The mean overall survival for patients undergoing primary debulking surgery (PDS) was higher than for those undergoing interval debulking surgery (IDS), although this difference was not statistically significant. Angka Kelangsungan Hidup Tiga Tahun Setelah Debulking Primer vs Interval pada Kanker Ovarium Stadium Lanjut: Sebuah Studi Retrospektif di RSUP Hasan Sadikin (2021) Abstrak Tujuan: Kanker ovarium merupakan keganasan ketiga terbanyak pada wanita di Indonesia. Angka kelangsungan hidup 5 tahun sekira 49%, dengan 68% pasien datang pada stadium lanjut. Tatalaksana standar melibatkan operasi debulking yang diklasifikasikan menjadi operasi debulking primer (PDS) dan operasi debulking interval (IDS). Penelitian ini bertujuan untuk membandingkan hasil kelangsungan hidup pasien kanker ovarium yang diobati dengan PDS versus IDS di RSUP Dr. Hasan Sadikin (RSHS) selama tahun 2021. Metode: Sebuah studi retrospektif dilakukan melalui tinjauan rekam medis pasien kanker ovarium yang menjalani tatalaksana bedah di RSHS pada tahun 2021. Pasien dikategorikan berdasarkan jenis tatalaksana bedah (PDS atau IDS), dan data kelangsungan hidup dianalisis. Hasil: Sebanyak 46 subjek diikutsertakan, dengan 38 pasien menjalani PDS dan 8 pasien menjalani IDS. Rerata kelangsungan hidup keseluruhan adalah 34,1 bulan pada kelompok PDS dan 27,5 bulan pada kelompok IDS. Analisis bivariat tidak menunjukkan perbedaan signifikan dalam kelangsungan hidup antara kedua kelompok (HR: 1,810, p = 0,341; 95% CI: 0,53–6,13). Namun, usia (HR: 0,950, p = 0,014; 95% CI: 0,91–0,99) dan durasi kelangsungan hidup bebas progresi (HR: 0,788, p = 0,0001; 95% CI: 0,71–0,86) diidentifikasi sebagai faktor prognostik yang signifikan terhadap kelangsungan hidup keseluruhan. Kesimpulan: Rata-rata kelangsungan hidup keseluruhan pasien yang menjalani operasi debulking primer (PDS) lebih tinggi daripada rata-rata kelangsungan hidup keseluruhan pasien yang menjalani operasi debulking interval (IDS), meskipun tidak signifikan secara statistik. Kata kunci: Angka kelangsungan hidup; kanker ovarium; pembedahan debulking interval; pembedahan debulking primer
Correlation of Cesarean Section and Curettage History with Placenta Previa at Limboto Regional Hospital
Objective: To investigate the correlation of cesarean section and curettage history with placenta previa at Dr. M.M. Dunda Limboto Hospital. Methods: A cross-sectional analytical study was conducted from January to February 2025, involving 180 pregnant women with gestational age ≥28 weeks from records from 2022-2024. Data were collected through consecutive sampling from medical records. Chi-square analysis was performed using SPSS version 24. Result: Among women with a history of cesarean section, 8.3% (12/145) had placenta previa compared to 54.3% (19/35) without such a history (p<0.001; PR=0.152, 95% CI: 0.082-0.284). Similarly, only 2.9% (1/35) with a history of curettage had placenta previa compared to 20.7% (30/145) without a curettage history (p=0.012; PR=0.138, 95% CI: 0.019-0.978). These findings suggest apparent protective effects that contradict established literature. Conclusion: Although statistically significant associations were observed between surgical histories and placenta previa in unexpected directions, these probably reflect study artifacts rather than actual protective effects. Multivariate analysis will be crucial in future research to account for confounding variables. Hubungan Riwayat Sectio Caesarea dan Kuretase dengan Plasenta Previa di RSUD Limboto Abstrak Tujuan: Penelitian ini bertujuan menganalisis hubungan antara riwayat kuretase dan sectio caesarea dengan kejadian plasenta previa di RSUD Dr. M.M. Dunda Limboto. Metode: Penelitian analitik potong lintang dilakukan pada Januari – Februari 2025, melibatkan 180 ibu hamil dengan usia kehamilan ≥28 minggu dari rekam medis 2022 – 2024. Data dikumpulkan melalui consecutive sampling. Analisis Chi-square dilakukan menggunakan SPSS ver 24. : Pada kelompok dengan riwayat sectio caesarea, 8,3% (12/145) mengalami plasenta previa dibandingkan 54,3% (19/35) tanpa riwayat tersebut (p<0,001; PR=0,152, 95% CI: 0,082-0,284). Demikian pula, hanya 2,9% (1/35) dengan riwayat kuretase mengalami plasenta previa dibandingkan 20,7% (30/145) tanpa riwayat kuretase (p=0,012; PR=0,138, 95% CI: 0,019-0,978). Temuan ini menunjukkan efek protektif yang bertentangan dengan literatur medis. Kesimpulan: Meskipun ditemukan asosiasi signifikan antara riwayat bedah dan plasenta previa dalam arah yang tidak terduga, temuan ini kemungkinan merupakan artefak penelitian daripada efek protektif sejati. Analisis multivariat sangat penting untuk penelitian masa depan guna mengontrol faktor perancu. Kata kunci: kuretase; plasenta previa; sectio caesarea.
Correlation of Histological Type, Stage, Age, and Prognosis in Uterine Cervical Cancer at Margono Soekardjo Hospital Purwokerto from January – December 2024
Objective: To evaluate the correlation of histological subtype, stage, age, and prognosis in cervical cancer patients treated at Prof. Dr. Margono Soekarjo Hospital, Purwokerto. Methods: This is a retrospective descriptive cohort study conducted using medical records. Data on cervical cancer staging, age, and histopathological subtype were collected from all patients meeting the inclusion criteria. Statistical analysis was performed, and associations were examined using chi-square tests. The data used in the study were obtained from the medical records of patients at the research site from January to December 2024. Result: Of 582 patients identified, 245 met the inclusion criteria. Squamous cell carcinoma (SCC) accounted for 147 cases, and adenocarcinoma (AC) for 98. Most patients were aged >50 years old and diagnosed at stage II. SCC was most common at stage II, while AC was most frequently found at stage III. Statistical analysis revealed a significant but weak association between age, stage, prognosis, and histological subtype. Conclusion: There was a significant weak correlation of histological subtype and age, stage, and prognosis in cervical cancer. Korelasi Tipe Histologis, Stadium, Usia, dan Prognosis pada Kanker Uterin Serviks di Rumah Sakit Margono Soekardjo pada Januari – Desember 2024 Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui korelasi antara subtipe histologis, stadium, usia, dan prognosis kanker serviks uteri pada pasien yang diobati di RSUD Prof. Dr. Soekarjo Margono, Purwokerto, dalam rentang waktu Januari – Desember 2024 Metode: Studi ini merupakan studi retrospektif deskriptif kohort dengan data dari rekam medis. Data yang diambil adalah stadium kanker, usia, dan subtipe histopatologis dan didapatkan dari semua pasien yang memenuhi kriteria inklusi. Analisis statistik dilakukan serta asosiasi diuji dengan uji Chi-Square. Data yang digunakan dalam penelitian diperoleh dari rekam medis pasien di RSUD Margono Soekardjo, Purwokerto pada bulan Januari hingga Desember 2024 Hasil: Dari 582 pasien, sebanyak 245 pasien memenuhi kriteria inklusi. Karsinoma sel skuamosa (SCC) ditemukan pada 147 kasus, sedangkan adenokarsinoma (AC) pada 98 kasus. Sebagian besar pasien berusia >50 tahun dan didiagnosis pada stadium II. SCC paling banyak ditemukan pada stadium II, sementara AC didapatkan paling banyak pada stadium III. Analisis statistik menunjukkan adanya hubungan bermakna dengan korelasi lemah antara usia, stadium, dan prognosis dengan tipe histologis. Kesimpulan: Terdapat korelasi signifikan antara subtipe histologis dan usia, stadium, serta prognosis kanker serviks. Kata kunci: Kanker serviks; prognosis; subtipe histologis; stadium; usia
Relationship between Antenatal Care in Severe Preeclampsia and Maternal and Neonatal Outcomes
Objective: This study aims to evaluate the relationship between the frequency of antenatal care (ANC) visits and maternal and infant outcomes in cases of severe preeclampsia. Methods: The collected data were processed using computerized methods to convert them into analyzable information. Data analysis was conducted to describe the proportion of each variable descriptively. Furthermore, the results were elaborated through descriptive analysis and hypothesis testing. Result: Based on medical record data, 91.7% of patients had undergone antenatal care (ANC) visits; however, only about 80% received pre-eclampsia screening services according to the 10T standard. Conclusion: The study concluded that inadequate antenatal care (ANC) visits were significantly associated with an increased risk of eclampsia and acute renal failure. On the other hand, there was no statistically significant association between ANC compliance and the occurrence of complications such as placental abruption, HELLP syndrome, DIC, and maternal death. Hubungan Antenatal Care Pada Preeklampsia Berat terhadap Luaran Maternal dan Neonatal Abstrak Tujuan: Penelitian ini bertujuan untuk mengevaluasi hubungan antara frekuensi kunjungan antenatal care (ANC) dan luaran maternal dan infant pada kasus preeklamsia berat. Metode: Data yang telah terkumpul diolah secara komputerisasi untuk mengubah data menjadi informasi. Analisis data dilakukan untuk melihat gambaran proporsi masing-masing variabel yang disajikan secara deskriptif. Selanjutnya, hasil analisis tersebut diuraikan ke dalam analisis deskriptif dan pengujian hipotesis. Hasil: Berdasarkan data rekam medis, ditemukan bahwa 91,7% pasien telah menjalani kunjungan antenatal care (ANC), namun hanya 80% yang mendapatkan pelayanan skrining preeklamsia sesuai standar 10T. Kesimpulan: Kesimpulan menunjukkan bahwa kunjungan Antenatal Care (ANC) yang tidak memadai memiliki hubungan yang signifikan dengan peningkatan risiko eklamsia dan gagal ginjal akut. Sementara di sisi lain, tidak terdapat hubungan yang signifikan secara statistik antara tingkat kepatuhan ANC dengan kejadian komplikasi seperti solusio plasenta, edema paru, Sindrom HELLP, DIC, dan kematian ibu. Kata kunci: Antenatal Care; Preeklamsia; Neonatal
Characteristics of Patients with Diminished Ovarian Reserve Undergoing in Vitro Fertilization (IVF) at Hasan Sadikin Hospital from 2019-2023
Objective: This study aimed to describe the characteristics of patients with diminished ovarian reserve undergoing in vitro fertilization (IVF) to improve understanding of its implications for infertility. Methods: Cross-sectional descriptive study using medical records of patients who underwent IVF at Dr. Hasan Sadikin General Hospital (RSHS) from 2019 to 2023. Analyzed variables included age, education level, occupation, duration of marriage, body mass index, Anti-Müllerian hormone (AMH) level, and ovarian stimulation protocol. Results: A total of 57.14% of the 55 patients were aged 35 – 40 years, 87.5% nulliparous, and 55.36% had a body mass index greater than 24.9 kg/m2. The percentage that held a bachelor’s degree was 64.29%, and 55.36% had AMH levels below 1.1 ng/ml. A total of 78.57% received a short stimulation protocol, and 21.43% received a long stimulation protocol. Conclusion: Most patients with diminished ovarian reserve undergoing IVF at RSHS (2019 – 2023) were aged 35 – 40, nulliparous, obese class I–II, AMH value <1.1 ng/ml, and were subjected to a short IVF protocol. Karakteristik Pasien dengan Diminished Ovarian Reserve yang Melakukan In Vitro Fertilization (IVF) di Rumah Sakit Hasan Sadikin pada Tahun 2019 – 2023 Abstrak Tujuan: Penelitian ini bertujuan menggambarkan karakteristik pasien dengan cadangan ovarium menurun yang menjalani fertilisasi in vitro untuk meningkatkan pemahaman tentang implikasi cadangan ovarium menurun pada infertilitas. Metode: Metode yang digunakan dalam penelitian ini adalah deskriptif observasional potong lintang yang menggunakan data rekam medis pasien yang menjalani fertilisasi in vitro di Rumah Sakit Hasan Sadikin (RSHS) periode 2019 – 2023. Variabel yang dianalisis meliputi usia, tingkat pendidikan, pekerjaan, lama menikah, indeks massa tubuh, kadar hormon anti-Müllerian, dan protokol stimulasi ovarium. Hasil: Hasil penelitian menunjukkan bahwa dari 55 pasien, 57,14% berusia 35 – 40 tahun, 87,5% belum pernah melahirkan, 55,36% memiliki indeks massa tubuh lebih dari 24,9 kg/m2, 64,29% berpendidikan sarjana, dan 55,36% memiliki kadar hormon anti-Müllerian kurang dari 1,1 ng/ml. Sebanyak 78,57% menjalani protokol stimulasi pendek dan 21,43% menjalani protokol stimulasi panjang. Kesimpulan: Sebagian besar pasien dengan cadangan ovarium menurun yang menjalani fertilitasi in vitro di RS Dr. Hasan Sadikin (201 – 2023) berusia 35 – 40 tahun, nullipara, obesitas kelas I–II, nilai AMH <1.1 ng/ml dan menjalani protokol IVF pendek. Kata kunci: Anti-mullerian hormone; diminished ovarian reserve; FSH; infertilitas; in vitro fertilization (IVF), teknologi reproduksi berbantu
Comparison of Endometriosis Characteristics in Adolescents and Women of Advanced Reproductive Age
ABSTRACT Objective: To compare clinical and pathological characteristics of endometriosis between adolescents (10–19 years) and women of advanced reproductive age (35–45 years) to guide early diagnosis and tailored management. Methods: A retrospective, cross-sectional study of 68 patients (31 adolescents; 37 advanced-age women) with laparoscopically and histopathologically confirmed endometriosis at Dr. Margono Soekarjo Regional General Hospital between January 2022 and December 2024. Statistical analyses included independent t-tests, chi-square tests, and multivariate logistic regression. Results: Adolescents exhibited higher dysmenorrhea prevalence (80.6% vs. 43.2%; p=0.003), more early-stage disease (Stage I–II: 71% vs. 22%; p<0.001), and increased peritoneal lesions (29% vs. 8%; p=0.030). They also had lower BMI (21.4 vs. 24.3 kg/m²; p=0.007) and earlier menarche (12.9 vs. 13.8 years; p=0.016). Advanced-age women predominantly presented with late-stage disease (Stage III–IV: 78%) and showed significant associations with age (OR 1.15; 95% CI 1.02–1.30), primiparity (OR 5.67; 95% CI 1.23–26.12), multiparity (OR 6.23; 95% CI 1.34–28.98), and Stage III–IV disease (OR 4.89; 95% CI 1.25–19.16). Conclusion: Endometriosis in adolescents manifests as severe dysmenorrhea, milder stages, and peritoneal involvement, whereas older women present with advanced disease linked to age and parity. Age-specific diagnostic vigilance and management are essential
Analysis of Outpatient and Postpartum Family Planning Services in Makassar Teaching Hospitals for Two Years
Objective: To evaluate the distribution and characteristics of the family planning (FP) service acceptors in the outpatient clinics and postpartum wards in the main teaching hospital and its affiliated hospitals in Makassar in a two-year period. Method: The retrospective descriptive study was conducted using FP service registers and patients’ medical records from January 2023 to January 2024. Data included sociodemographic characteristics (age, parity, education, occupation), type of procedure (postpartum vaginal delivery, caesarean section, curettage), and contraceptive method chosen (implant, intrauterine device [IUD], sterilization). All eligible acceptors during the study period were included. The Data were analyzed descriptively and presented as the frequencies and percentages. Result: The total of 5,684 FP acceptors is recorded. The most commonly used methods are IUD (2,882; 50.7%), implants (2,239; 39.4%), and sterilization (563; 9.9%). The majority of the acceptors are 20-35 years old (4,835; 85.1%) and have the parity two (1,978; 34.8%). The most contraceptive initiation occurs after the vaginal delivery (3,420; 60.2%). The high school graduates represent the largest education group (3,125; 54.9%), and housewives are the most frequent occupational group (3,974; 69.9%). Conclusion: The postpartum FP services remain the main entry point for the contraceptive use in the teaching and affiliated hospitals. The counseling strengthening, especially during the antenatal and postpartum care, may further improve the uptake of the appropriate contraception in line with the socio-demographic needs. Analisis Pelayanan Keluarga Berencana Rawat Jalan dan Pascasalin di Rumah Sakit Pendidikan di Makassar Selama Dua Tahun” Abstrak Tujuan: Penelitian ini bertujuan mengevaluasi distribusi dan karakteristik akseptor pelayanan keluarga berencana (KB) pada poliklinik rawat jalan dan ruang nifas di rumah sakit pendidikan utama dan rumah sakit jejaring di Makassar selama periode dua tahun. Metode: Metode yang digunakan dalam penelitian ini adalah deskriptif retrospektif dilakukan dengan menggunakan register pelayanan KB dan rekam medis pasien dari Januari 2023 hingga Januari 2024. Data yang dikaji meliputi karakteristik sosiodemografi (usia, paritas, pendidikan, pekerjaan), jenis tindakan (persalinan pervaginam pascapersalinan, seksio sesarea, kuretase), serta metode kontrasepsi yang dipilih (implan, alat kontrasepsi dalam rahim, sterilisasi). Semua akseptor yang memenuhi kriteria selama periode penelitian diikutsertakan. Data dianalisis secara deskriptif dan disajikan dalam bentuk frekuensi serta persentase. Hasil: Sebanyak 5.684 akseptor KB tercatat. Metode yang paling banyak digunakan adalah alat kontrasepsi dalam rahim (2.882; 50,7%), implan (2.239; 39,4%), dan sterilisasi (563; 9,9%). Mayoritas akseptor berusia 20-35 tahun (4.835; 85,1%) dan memiliki paritas dua (1.978; 34,8%). Sebagian besar inisiasi kontrasepsi dilakukan setelah persalinan pervaginam (3.420; 60,2%). Lulusan Sekolah Menengah Atas merupakan kelompok pendidikan terbesar (3.125; 54,9%), sedangkan ibu rumah tangga merupakan kelompok pekerjaan terbanyak (3.974; 69,9%). Kesimpulan: Pelayanan KB pascasalin tetap menjadi pintu masuk utama penggunaan kontrasepsi di rumah sakit pendidikan dan jejaring. Penguatan konseling, terutama pada masa antenatal dan pascasalin, dapat lebih meningkatkan pemilihan kontrasepsi yang tepat sesuai kebutuhan sosiodemografi. Kata kunci: Keluarga berencana, kontrasepsi pasca persalinan, Makassar, metode kontrasepsi, pelayanan rawat jalan
Insulin Treatment for Gestational Diabetes Mellitus
Abstract Introduction: Gestational diabetes is one of the most common pathologies in pregnancy that can potentially cause other complications, both to the mother and the fetus. This condition is considered a global health problem, with Asia having the highest prevalence. Methods: This article is a literature review of publications from the past five years (2019–2024) obtained from the NCBI, PubMed, and Science Direct databases. The keywords used include “gestational diabetes,” “insulin therapy,” “types of insulin,” dan “management”. Results: Insulin remains the gold standard therapy for managing GDM when lifestyle interventions over 1–2 weeks fail to achieve glycemic targets. Various types of insulin, such as human insulin, rapid-acting analogs (lispro, aspart), intermediate-acting insulin (NPH), and basal analogs (detemir, glargine), are considered safe and effective for use during pregnancy Discussion: The main advantage of insulin is that it does not cross the placenta, thereby avoiding teratogenic risks. Some insulin analogs, such as lispro and detemir, have the advantage of reducing the risk of maternal hypoglycemia and providing more stable glycemic control. Conclusion: Insulin is the only therapy that does not cross the placenta, and most types do not affect pregnancy and fetuses or neonates. Keywords: diabetes gestational; insulin; treatment Pengobatan Insulin untuk Diabetes Mellitus Gestasional Abstrak Pendahuluan: Diabetes gestasional merupakan salah satu patologi yang paling umum terjadi pada kehamilan. Penyakit ini berpotensi menimbulkan komplikasi lain, baik pada ibu maupun janin. Kondisi ini dianggap sebagai masalah kesehatan global dan di Asia memiliki prevalensi tertinggi. Metode: Artikel ini merupakan tinjauan literatur dari publikasi dalam lima tahun terakhir (2019–2024) yang diperoleh dari basis data NCBI, PubMed, dan Science Direct. Kata kunci yang digunakan meliputi “gestational diabetes,” “insulin therapy,” “types of insulin,” dan “management”. Hasil: Hasil penelitian menunjukkan bahwa insulin tetap menjadi terapi standar emas dalam penatalaksanaan GDM apabila intervensi gaya hidup selama 1 – 2 minggu tidak mampu mencapai target glikemik. Berbagai jenis insulin seperti insulin manusia, analog kerja cepat (lispro, aspart), insulin intermediet (NPH), dan analog basal (detemir, glargine) dinilai aman dan efektif digunakan selama kehamilan. Diskusi: Keuntungan utama insulin adalah tidak melewati plasenta sehingga menghindari risiko teratogenik. Beberapa jenis insulin analog seperti lispro dan detemir memiliki keunggulan berupa penurunan risiko hipoglikemia maternal dan kontrol glikemik yang lebih stabil. Kesimpulan: Insulin merupakan satu-satunya terapi yang tidak melewati plasenta dan sebagian besar jenis insulin tidak memiliki efek pada kehamilan dan janin atau neonatus. Kata kunci: diabetes gestasional; insulin; tatalaksana
The Role of Neuron Growth Factor and Interleukin-10 in The Development of Pain in Adenomyosis: A Narrative Review
Introduction: Adenomyosis, a benign uterine condition characterized by endometrial tissue within the myometrium, leads to uterine enlargement, infertility, dysmenorrhea, and heavy menstrual bleeding. While its precise etiology remains elusive, delayed pregnancy may contribute to its increasing incidence among infertile women. This condition, predominantly affecting parous women, is also associated with higher rates of early miscarriage. Although immune dysregulation in endometriosis is well-documented, comparable research in adenomyosis is limited. Objective: This review aims to explore the roles of Interleukin-10 (IL-10), an anti-inflammatory cytokine, and Neuronal Growth Factor (NGF), a neuroimmune factor, in adenomyosis. Discussion: Elevated IL-10 levels in ectopic endometrial tissue suggest a potential immunosuppressive mechanism that may exacerbate symptoms. NGF is also implicated in the pain and inflammation associated with adenomyosis. A deeper understanding of the interplay between IL-10 and NGF could offer critical insights into the inflammatory nature and pain mechanisms of this condition. Conclusion: This review proposes IL-10 as a potential inflammatory biomarker and NGF as a pain marker in adenomyosis, paving the way for future research into novel therapeutic targets. Elucidating these pathways could lead to treatments focused on mitigating inflammation and alleviating associated symptoms of adenomyosis. Keywords: adenomyosis; neuronal growth factor; interleukin-10; pelvic pain Peran Neuron Growth Factor (NGF) dan Interleukin-10 (IL-10) dalam pembentukan Nyeri pada Adenomyosis : Sebuah Review Naratif Abstrak Pendahuluan: Adenomyosis, suatu kondisi rahim jinak yang ditandai dengan adanya jaringan endometrium di dalam miometrium, menyebabkan pembesaran rahim, infertilitas, dismenore, dan perdarahan menstruasi yang berat. Meskipun etiologi pastinya masih belum jelas, kehamilan yang tertunda kemungkinan berkontribusi pada peningkatan insidennya di kalangan wanita infertil. Kondisi ini, yang sebagian besar memengaruhi wanita multipara, juga dikaitkan dengan tingkat keguguran dini yang lebih tinggi. Meskipun disregulasi imun pada endometriosis telah didokumentasikan dengan baik, penelitian serupa pada adenomyosis masih terbatas. Tujuan: Tinjauan ini bertujuan untuk mengeksplorasi peran Interleukin-10 (IL-10), sitokin anti-inflamasi, Faktor Pertumbuhan Saraf (NGF) dan faktor neuroimun dalam adenomyosis. Diskusi: Peningkatan kadar IL-10 dalam jaringan endometrium ektopik menunjukkan mekanisme imunosupresif potensial yang dapat memperburuk gejala. NGF juga berperan dalam nyeri dan peradangan yang terkait dengan adenomyosis. Pemahaman yang lebih dalam tentang interaksi antara IL-10 dan NGF dapat memberikan wawasan penting mengenai sifat inflamasi dan mekanisme nyeri dari kondisi ini. Kesimpulan: Tinjauan ini mengusulkan IL-10 sebagai biomarker inflamasi potensial dan NGF sebagai penanda nyeri pada adenomyosis. Hal tersebut membuka jalan bagi penelitian lebih lanjut untuk target terapeutik baru. Menguraikan jalur-jalur ini dapat mengarah pada perawatan yang berfokus pada mitigasi peradangan dan mengurangi gejala adenomyosis. Kata kunci: adenomiosis; interleukin-10; neuronal growth factor; nyeri pelvis.
Risk of Urinary Tracy Infection Among Pregnant Women with Anemia: A Systematic Review and Meta-Analysis
Objective: This study aims to provide an evidence-based answer to whether anemia during pregnancy is a risk factor for the development of UTI Methods: A literature search for the systematic review and meta-analysis was carried out by PubMed, ScienceDirect, and Scopus databases for observational studies that reported the incidence of anemia during pregnancy and urinary tract infections (UTI). Quantitative analysis of pooled odd ratio with a 95% confidence interval was performed using Review Manager 5.4 software and visualized by forest plot graph Result: Based on 9 articles included in the analysis, anemia revealed a statistically significant for UTI [Pooled OR 2.38, 95% CI: 1.24—4.56; p<0.00001] but not for asymptomatic bacteriuria (ASB) [Pooled OR 2.08, 95% CI: 0.89—4.90; p=0.09]. We accumulated both outcomes for the total bacteriuria and demonstrated statistically significant [Pooled OR 2.27, 95% CI: 1.38—3.75; p<0.0001]. Discussion: Statistical significance was observed for the development of UTI 2.38 times in pregnant women with anemia compared to pregnant women without anemia. Conclusion: This research showed evidence that anemia during pregnancy was a significant risk factor for the development of UTI and bacteriuria, but not a significant risk factor for ASB. Risiko Infeksi Saluran Kemih pada Ibu Hamil dengan Anemia: Tinjauan Sistematis dan Meta-Analisis Abstrak Tujuan: Penelitian ini bertujuan untuk memberikan jawaban berbasis bukti mengenai apakah anemia selama kehamilan merupakan faktor risiko untuk perkembangan ISK atau bukan Metode: Metode yang digunakan dalam penelitian ini adalah tinjauan sistematis dan meta-analisis yang disusun berdasarkan PRISMA guideline. Pencarian literatur dilakukan melalui basis data PubMed, ScienceDirect, dan Scopus pada penelitian observasional yang melaporkan kejadian anemia selama kehamilan dan infeksi saluran kemih (ISK). Analisis kuantitatif untuk gabungan odd ratio dengan interval kepercayaan 95% dilakukan menggunakan perangkat lunak Review Manager 5.4 dan divisualisasikan dengan grafik forest plot Hasil: Berdasarkan 9 artikel yang disertakan dalam analisis menunjukkan bahwa anemia selama kehamilan memiliki hubungan yang signifikan terhadap kejadian ISK [Pooled OR 2.38, 95% CI: 1.24—4.56; p<0.00001], tetapi tidak untuk bakteriuria asimtomatik (ASB) [Pooled OR 2,08, 95% CI: 0,89—4,90; p=0,09]. Kami menggabungkan kedua hasil untuk total bakteriuria dan menunjukkan signifikansi statistik [Pooled OR 2,27, 95% CI: 1,38—3,75; p<0,0001]. Pembahasan: Anemia selama kehamilan dapat meningkatkan risiko ISK sebesar 2,38 kali lebih tinggi daripada tanpa anemia yang terjadi melalui mekanisme disregulasi sistem imun. Pemantauan kadar hemoglobin pada periode antenatal dapat menjadi upaya skrining faktor risiko terjadinya ISK. Kesimpulan: Anemia selama kehamilan merupakan faktor risiko untuk perkembangan ISK dan bakteriuria, tetapi bukan faktor risiko untuk ASB. Evaluasi faktor risiko dan penatalaksanaan anemia lebih dini menjadi upaya penting bagi klinisi dalam mencegah perkembangan terjadinya ISK selama kehamilan Kata kunci: Anemia; faktor risiko; infeksi saluran kemih; kehamilan; meta-analisis
Cadmium Exposure and Preeclampsia: A Systematic Review of Environmental Risk in Pregnancy
Objective: To systematically evaluate current scientific evidence on the association between cadmium (Cd) exposure and the risk of preeclampsia in pregnant women, and to explore underlying mechanisms and population-specific patterns. Methods: This systematic review was conducted according to PRISMA guidelines. Comprehensive literature searches were performed across PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar without time restriction, focusing on the past 15 years. Inclusion criteria encompassed original human studies measuring cadmium exposure—biological, dietary, or environmental—and reporting preeclampsia as an outcome. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results: Twenty-five eligible studies were included, spanning case-control, cohort, and cross-sectional designs across diverse geographic regions. Most studies found a positive association between cadmium exposure and increased preeclampsia risk, though methodological heterogeneity exists. Proposed mechanisms include cadmium-induced oxidative stress, endothelial dysfunction, placental insufficiency, and hormonal dysregulation. Evidence also highlights differences in risk based on diet, region, and environmental regulation. However, inconsistencies in exposure metrics and population stratification remain. Conclusion: The cumulative evidence suggests cadmium is a plausible environmental risk factor for preeclampsia. Future research must standardize exposure assessments and address population-specific modifiers. This review provides critical groundwork for hypothesis-driven studies and policy frameworks addressing toxic metal exposure in maternal health. Paparan Kadmium dan Preeklampsia: Tinjauan Sistematis terhadap Risiko Lingkungan pada Kehamilan Abstrak Tujuan: Penelitian ini bertujuan untuk melakukan tinjauan sistematis terhadap bukti ilmiah terkini mengenai hubungan antara paparan kadmium (Cd) dan risiko preeklampsia pada ibu hamil, serta mengeksplorasi mekanisme biologis yang mendasari dan pola risiko spesifik populasi. Metode: Tinjauan sistematis ini disusun berdasarkan pedoman PRISMA. Pencarian literatur dilakukan secara menyeluruh melalui basis data PubMed, Scopus, Web of Science, ScienceDirect, dan Google Scholar tanpa batasan waktu, dengan fokus pada publikasi 15 tahun terakhir. Kriteria inklusi meliputi penelitian asli pada manusia yang mengukur paparan kadmium—baik secara biologis, dietetik, maupun lingkungan—dan melaporkan preeklampsia sebagai luaran. Risiko bias dinilai menggunakan Newcastle-Ottawa Scale. Hasil: Sebanyak 25 studi memenuhi kriteria dan dianalisis, mencakup desain studi kasus-kontrol, kohort, dan potong lintang dari berbagai wilayah geografis. Mayoritas studi menunjukkan adanya hubungan positif antara paparan kadmium dan peningkatan risiko preeklampsia, meskipun terdapat heterogenitas metodologis. Mekanisme yang diusulkan meliputi stres oksidatif akibat kadmium, disfungsi endotel, insufisiensi plasenta, dan disregulasi hormonal. Bukti juga menunjukkan perbedaan risiko berdasarkan pola diet, lokasi geografis, dan tingkat pengawasan lingkungan. Namun, masih terdapat ketidakkonsistenan dalam metrik paparan dan stratifikasi populasi. Kesimpulan: Bukti kumulatif mendukung bahwa kadmium merupakan faktor risiko lingkungan yang potensial terhadap preeklampsia. Penelitian selanjutnya perlu menstandarkan metode pengukuran paparan dan mempertimbangkan faktor-faktor spesifik populasi. Tinjauan ini memberikan landasan penting bagi studi berbasis hipotesis dan penyusunan kebijakan terkait paparan logam toksik dalam kesehatan maternal. Kata kunci: Komplikasi kehamilan; paparan kadmium; preeklampsia; stres oksidatif; toksikologi lingkungan
Pregnancy With Multidrug-Resistant Pulmonary Tuberculosis and Autoimmune Hemolytic Anemia Complicated by Intrauterine Growth Restriction - A Case Report
Abstract Introduction Intrauterine growth restriction (IUGR) is a major obstetric complication often caused by maternal infections and anemia. We present a case of IUGR in a pregnant woman caused by multidrug-resistant tuberculosis (MDR-TB) and autoimmune hemolytic anemia (AIHA). Case presentation A 37-year-old G5P2A2 woman with confirmed MDR-TB and AIHA was treated with levofloxacin, clofazimine, cycloserine, ethambutol, bedaquiline, and methylprednisolone. Fetal biometry showed estimated fetal weight below the 10th percentile, with a significantly declining growth curve thereafter. After administration of fetal lung maturation at 33 – 34 weeks, she underwent an elective cesarean section at 35 – 36 weeks. A female infant weighing 1,840g was delivered. The treatment for MDR-TB and AIHA in the mother was continued afterward. Conclusion Pregnancies complicated by MDR-TB and AIHA require strict monitoring and individualized multidisciplinary treatment. Further research is needed to establish treatment strategies that improve maternal and fetal outcomes in similar cases. Keywords : Autoimmune hemolytic anemia; intrauterine growth restriction; multidrug resistance; pregnancy; tuberculosis. Kehamilan dengan Tuberkulosis Paru Resisten Obat Ganda dan Anemia Hemolitik Autoimun yang Diperberat oleh Pertumbuhan Janin Terhambat – Laporan Kasus Abstrak Pendahuluan IUGR adalah komplikasi obstetrik yang dapat disebabkan infeksi dan anemia pada maternal. Pada kasus ini dipresentasikan kasus wanita hamil dengan IUGR yang disebabkan multidrug resistant TB (MDR-TB) dan autoimmune hemolytic anemia (AIHA). Ilustrasi kasus Ibu hamil 37 tahun G5P2A2 datang dengan TB-MDR dan AIHA. Pasien menjalani terapi TB-MDR dengan levofloksasin, klofazimin, sikloserin, etambutol, dan bedaquiline, serta metilprednisolon untuk AIHA. Pada fetal biometri ditemukan estimated fetal weight (EFW) di bawah 10 persentil dengan kurva pertumbuhan janin menurun signifikan setelahnya. Setelah dilakukan induksi pematangan paru janin pada usia kehamilan 33 - 34 minggu, operasi sesar elektif dilakukan pada usia kehamilan 35 – 36 minggu melahirkan bayi perempuan dengan berat janin 1840gram. Pengobatan TB-MDR dan AIHA pada ibu dilanjutkan setelahnya. Kesimpulan Kehamilan dengan TB dan AIHA memerlukan pemantauan ketat dan terapi multidisiplin yang terindividualisasi. Penelitian lebih lanjut diperlukan. Kata kunci : Hemolitik anemia autoimun; kehamilan; pertumbuhan janin terhambat; resisten obat; tuberkulosis.
The Critical Role of CT Imaging in Detecting Acute Neurological Complications of Eclampsia: A Case Series
Abstract Introduction: An intracranial hemorrhage (ICH) is a rare condition but potentially life-threatening event, especially in pregnancy, and could happen in patients with eclampsia. At Hasan Sadikin General Hospital (RSHS), several eclampsia cases are admitted annually, some with worsening neurological conditions. Neuroimaging using CT-Scan is indicated in patients with seizures, decreased consciousness, or visual disturbances to detect intracranial pathology. Case: We reported three cases of maternal eclampsia, two patients' chief complaint was seizures, but all of our patients were unconscious. All of our patients had a previous history of pre-eclampsia in the last pregnancy. All of our patients performed a CT scan performed in postpartum patients as a neurologic examination. All of our patients have worse outcomes. The Medical and Health Research Ethics Committee of the Faculty of Medicine, Padjajaran University with Ref no: DP.04.03/D/XIV.6.5/71/2025. Conclusion: Neuroimaging in patients with seizure-induced worsening of the condition has an important role in identifying other abnormalities, specifically intracranial hemorrhage. In this study, we conclude that patients with seizures in pregnancy should be screened with neuroimaging (computed tomography scan) to rule out central nervous system pathology, thereby improving the patient's condition and reducing maternal mortality. Keywords: CT scan, Convulsion, Eclampsia, Pregnancy Peran Kritis Pencitraan CT dalam Mendeteksi Komplikasi Neurologis Akut pada Eklampsia: Seri Kasus Abstrak Pendahuluan: Perdarahan intrakranial (PIK) merupakan kondisi langka namun berpotensi mengancam jiwa, terutama pada kehamilan, dan dapat terjadi pada pasien eklampsia. Neuroimaging menggunakan CT-Scan berperan dalam deteksi dini perburukan kondisi pasien dengan penurunan kesadaran. Kasus: Penelitian ini melaporkan tiga kasus eklampsia maternal, keluhan utama dua pasien adalah kejang, namun semua pasien pada penelitian ini tidak sadar. Semua pasien memiliki riwayat preeklampsia sebelumnya pada kehamilan terakhir. Semua pasien melakukan CT scan sebagai pemeriksaan neurologis. Semua pasien memiliki hasil yang lebih buruk. Komite Etik Penelitian Kedokteran dan Kesehatan Fakultas Kedokteran Universitas Padjadjaran dengan Ref no: DP.04.03/D/XIV.6.5/71/2025. Kesimpulan: Neuroimaging pada pasien dengan kondisi yang memburuk akibat kejang memiliki peran penting dalam mengidentifikasi kelainan lain, khususnya perdarahan intrakranial. Dalam penelitian ini, peneliti menyimpulkan bahwa pasien dengan kejang selama kehamilan harus diskrining dengan neuroimaging (pemindaian tomografi terkomputasi) untuk menyingkirkan patologi sistem saraf pusat sehingga memperbaiki kondisi pasien dan mengurangi angka kematian ibu. Kata kunci: CT scan, Eklampsia, Kehamilan, Kejang
Diagnosis and Management of Complex Genital Warts: Case Report
Introduction: This case reports a pregnancy complicated by condyloma acuminata with co-infection of HIV and tuberculosis (TB). Such a combination is rarely documented and presents significant clinical and therapeutic challenges. This case aims to demonstrate the effectiveness of a simple surgical approach in managing extensive condyloma acuminata during high-risk pregnancy. Case Presentation: A 24-year-old pregnant woman was diagnosed with condyloma acuminata along with confirmed HIV and TB co-infection. Electrocauterization was performed successfully, leading to complete lesion removal and significant improvement in wound healing, with no early recurrence observed. The pregnancy was planned to be delivered by cesarean section. Conclusion: This case demonstrates that, even with multiple comorbidities and a high-risk pregnancy, simple surgical treatments like electrocauterization can be both safe and effective. Early multidisciplinary intervention is crucial for achieving the best maternal outcomes. Diagnosis dan Penatalaksanaan Kondiloma Genital dengan Komplikasi: Laporan Kasus Abstrak Pendahuluan: Laporan kasus ini membahas kehamilan yang disertai komplikasi berupa kondiloma akuminata dengan ko-infeksi HIV dan tuberkulosis (TB). Kombinasi tersebut jarang didokumentasikan dan menimbulkan tantangan klinis serta terapeutik yang signifikan. Kasus ini bertujuan untuk menunjukkan efektivitas pendekatan bedah sederhana dalam menangani kondiloma akuminata ekstensif pada kehamilan risiko tinggi. Presentasi Kasus: Seorang wanita hamil berusia 24 tahun didiagnosis menderita kondiloma akuminata dengan ko-infeksi HIV dan TB terkonfirmasi. Tindakan elektrokauter berhasil dilakukan dengan hasil berupa pengangkatan lesi secara menyeluruh dan perbaikan yang nyata pada penyembuhan luka, tanpa adanya kekambuhan dini yang teramati. Kehamilan direncanakan untuk dilahirkan dengan operasi sesar. Kesimpulan: Kasus ini menegaskan bahwa dalam konteks komorbiditas multipel dan kehamilan risiko tinggi, penatalaksanaan bedah sederhana seperti elektrokauter dapat aman dan efektif. Intervensi multidisiplin sejak dini sangat penting untuk mencapai luaran maternal yang optimal. Kata kunci: HIV: Kehamilan; kondiloma akuminata; tuberkulosis
Case Report: Family’s Role in Mentoring Adolescent Pregnancy
Introduction: Adolescent pregnancy negatively affects maternal and infant health, leading to preterm birth, low birth weight (LBW), and intrapartum hemorrhage, all of which contribute to increased maternal and neonatal mortality. It is also associated with unintended pregnancies and unsafe abortions. Deliveries by mothers under 20 years old are associated with higher neonatal, infant, and under-five mortality rates and a greater risk of stunting. Infant health outcomes are heavily influenced by maternal nutritional status. Case Report: A 15-year-old adolescent (Mrs. S) was brought by her aunt to Ahmad Ripin District Hospital, Muaro Jambi, on November 10, 2022, for antenatal assessment. Initial examination showed a body mass index (BMI) of 16 (underweight; <18.5), for which a total gestational weight gain target of 12.5–18 kg was recommended. Her MUAC was 21 cm and hemoglobin (Hb) 9 g/dL. The case underscores the crucial role of a strong family support system in achieving adequate weight gain in pregnant adolescents, given its significant association with maternal health during pregnancy and infant birth weight. Conclusion: this case highlights the importance of healthcare education and monitoring in adolescent pregnancy. It shows that when combined with the family’s role as a supporter, these factors can effectively protect maternal and infant health, resulting in positive outcomes. Laporan Kasus: Peranan Keluarga dalam Pendampingan Kehamilan Remaja Abstrak Pendahuluan: Kehamilan remaja berdampak negatif pada kesehatan ibu dan bayi. Beberapa dampak negatif tersebut adalah bayi prematur, berat badan lahir rendah (BBLR), dan perdarahan persalinan yang berujung pada kenaikan kematian maternal–neonatal. Kehamilan pada remaja juga berkaitan dengan kehamilan tidak diinginkan dan aborsi tidak aman. Persalinan pada ibu <20 tahun berkontribusi pada tingginya kematian neonatal, bayi, dan balita, serta meningkatkan risiko stunting. Luaran bayi sangat dipengaruhi status gizi ibu. Laporan Kasus: Seorang ibu Ny.S berusia15 tahun, pertama kali dibawa oleh bibinya ke Rumah Sakit Daerah Ahmad Ripin, Kabupaten Muaro Jambi, pada tanggal 10 November 2022 untuk memeriksakan kehamilannya. Setelah dilakukan pemeriksaan, Ny.S memiliki Indeks Massa Tubuh (IMT) 16 yang berarti kurang dari 18,5 (gizi kurang) harus meningkatkan berat badannya sebesar 12,5 sampai 18 kg. Ny.S memiliki nilai LILA 21 cm, dan kadar Hemoglobin 9 gr/dl. Dalam menyukseskan pertambahan berat badan remaja yang hamil diperlukan peranan keluarga yang berkualitas untuk menjadi support system terbaik karena berhubungan dengan kesehatan ibu selama kehamilan serta berat badan bayi saat lahir. Kesimpulan: Berdasarkan laporan kasus ini, peran keluarga sebagai pendamping kehamilan remaja terbukti efektif menjaga kesehatan ibu dan bayi. Di samping itu, pengetahuan tentang kesehatan ibu dan bayi pada tingkat individu (faktor pengetahuan ibu) serta dukungan tenaga kesehatan juga berkontribusi signifikan terhadap luaran yang baik. Kata kunci: kehamilan remaja; kesehatan ibu dan bayi: peran keluarga