Sriwijaya Journal of Obstetrics and Gynecology

The Effect of Infusing Soursop Leaves (Annona muricata L.) on Vaginal Discharge in Women of Childbearing Age: A Randomized Clinical Trial at the Lolo Community Health Center, Kerinci Regency, Jambi, Indonesia

Yohana Suganda, Gusmadewi, Rahmatul Ulya, Mekar Zenni Radhia — Wed, 17 Jul 2024 00:00:00 +0000

Introduction: Vaginal discharge (leukorrhea) is a common gynecological complaint among women of childbearing age. While physiological discharge is normal, pathological discharge can be indicative of underlying infections or conditions. This study aimed to investigate the efficacy of soursop leaf infusion (Annona muricata L.) as a complementary treatment for vaginal discharge in women of childbearing age.

Methods: A randomized controlled trial was conducted at the Lolo Community Health Center, Kerinci Regency, Jambi, Indonesia. Women aged 15-49 years presenting with vaginal discharge were randomly assigned to either the intervention group (soursop leaf infusion) or the control group (standard care). The intervention group received soursop leaf infusion twice daily for seven days, while the control group received standard care as per the health center's protocol. The primary outcome was the reduction in vaginal discharge symptoms (amount, color, odor, and associated discomfort) after seven days. Secondary outcomes included changes in vaginal pH and microbiological assessment.

Results: A total of 130 women participated in the study (65 in each group). After seven days, the intervention group showed a significantly greater reduction in vaginal discharge symptoms compared to the control group (p < 0.05). The amount, color, and odor of discharge improved significantly in the intervention group, along with a reduction in associated discomfort such as itching and irritation. Vaginal pH was also normalized in the intervention group, and microbiological assessment revealed a decrease in pathogenic microorganisms.

Conclusion: Soursop leaf infusion (Annona muricata L) appears to be a safe and effective complementary treatment for vaginal discharge in women of childbearing age. Its antimicrobial and anti-inflammatory properties may contribute to its beneficial effects. Further research is warranted to explore its long-term efficacy and potential use in combination with conventional therapies.

The Effect of Red Spinach Juice on Hemoglobin Levels in Pregnant Women: A Randomized Controlled Trial

Endang Sari, Mekar Zenni Radhia, Hanifa Zaini S — Tue, 23 Jul 2024 00:00:00 +0000

Introduction: Iron deficiency anemia is a prevalent health concern among pregnant women globally, including Indonesia. Red spinach (Amaranthus tricolor), rich in iron and other nutrients, holds promise as a natural intervention. This randomized controlled trial aimed to investigate the efficacy of red spinach juice in improving hemoglobin levels in pregnant women in West Sumatra.

Methods: This study enrolled 180 pregnant women (18-35 years) with mild anemia (hemoglobin 10.0-10.9 g/dL) in their second trimester. Participants were randomly assigned to either the intervention group (daily red spinach juice, 200 mL) or the control group (standard iron supplementation) for eight weeks. Hemoglobin levels were measured at baseline, week four, and week eight.

Results: A significant increase in hemoglobin levels was observed in both groups (p < 0.001). However, the intervention group exhibited a greater mean increase in hemoglobin (1.8 g/dL) compared to the control group (1.2 g/dL) at week eight. There were no significant differences in adverse events between the groups.

Conclusion: Red spinach juice demonstrates potential as an effective adjunct or alternative to standard iron supplementation in improving hemoglobin levels in pregnant women with mild anemia. Further research is warranted to confirm these findings and investigate long-term effects.

Barriers and Facilitators to Optimal Midwife Competence in Normal Delivery Care: Perspectives from Community Health Centers in Padang Pariaman, Indonesia

Elwitri Silvia, Dewi Asmawati, Wiwi Syaptiani — Mon, 25 Nov 2024 00:00:00 +0000

Introduction: Midwives are essential healthcare providers for maternal and neonatal health, particularly in normal deliveries. Their competence directly affects the health outcomes of both mothers and newborns. This study aimed to identify the barriers and facilitators influencing midwife competence in providing normal delivery care in Community Health Centers (CHCs) in Gasan Gadang, Padang Pariaman, Indonesia.

Methods: A cross-sectional study was conducted among 31 midwives in CHCs in Gasan Gadang, Padang Pariaman, Indonesia. Data were collected using questionnaires assessing midwife competence, workload, work environment, and disciplinary adherence. Descriptive statistics, inferential analysis (Chi-square), and multivariate analysis were performed using SPSS v.16.

Results: 61.3% of midwives demonstrated good competence in normal delivery care. A significant association was found between workload and competence (p=0.001). No significant association was observed between the work environment and competence (p=0.149) or between disciplinary adherence and competence (p=0.567). Multivariate analysis revealed that workload had the most significant impact on midwife competence.

Conclusion: Workload is a significant factor influencing midwife competence in normal delivery care. Interventions aimed at optimizing workload, such as adequate staffing and resource allocation, are crucial for ensuring competent care and positive health outcomes.

Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP) in Jakarta, Indonesia: A Comprehensive Assessment of Clinical Features, Risk Factors, and Management Outcomes

Rini Kuswohadi Pramono, Felicia Sari, Muhammad Yusuf, Nadia Khoirina — Thu, 06 Mar 2025 02:35:13 +0000

Introduction: Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy (PEP), is a common, self-limiting dermatosis of pregnancy. However, its specific characteristics and management outcomes in Indonesia, a diverse and populous nation, remain understudied. This study aimed to comprehensively assess the clinical features, risk factors, and management outcomes of PUPPP in an Indonesian population.

Methods: A retrospective cohort study was conducted at Private Hospital in Jakarta, Indonesia, between January 2019 and December 2023. Medical records of pregnant women diagnosed with PUPPP were reviewed. Data collected included demographics, gestational age at onset, clinical presentation (lesion morphology, distribution, pruritus severity), associated symptoms, parity, pre-pregnancy BMI, weight gain during pregnancy, smoking history, presence of comorbidities, treatment modalities, and treatment outcomes (symptom resolution time, recurrence). Statistical analysis was performed using SPSS version 28.

Results: A total of 285 pregnant women were included in the study. The mean age was 29.5 years (SD ± 4.8). The majority (72.3%) were primigravida. Onset was most common in the third trimester (88.4%). The most frequent presenting symptom was severe pruritus (94.7%), followed by erythematous papules (98.2%) and urticarial plaques (91.6%). Lesions predominantly affected the abdomen (96.5%), particularly the striae distensae (89.1%), with frequent involvement of the thighs (75.4%) and buttocks (62.1%). Higher pre-pregnancy BMI (p=0.012) and excessive gestational weight gain (p=0.003) were significantly associated with PUPPP development. Topical corticosteroids (85.6%) were the most commonly used treatment, followed by oral antihistamines (68.4%). Symptom resolution occurred within a mean of 10.2 days (SD ± 3.5) after treatment initiation. Recurrence was observed in 8.4% of cases.

Conclusion: PUPPP in Indonesian women predominantly affects primigravida in the third trimester, presenting with severe pruritus and characteristic lesions on the abdomen, thighs, and buttocks. Higher pre-pregnancy BMI and excessive gestational weight gain appear to be significant risk factors. Topical corticosteroids and oral antihistamines are effective in achieving symptom resolution. These findings highlight the need for increased awareness and appropriate management of PUPPP in Indonesia.

First Trimester Ultrasound Biomarkers for Predicting Preeclampsia: A Prospective Cohort Study in Surabaya, Indonesia

Reisha Notonegoro, Aline Hafidzah, Reza Andrianto, Tanvir Ahmed — Mon, 10 Mar 2025 04:05:00 +0000

Introduction: Preeclampsia (PE) remains a leading cause of maternal and perinatal morbidity and mortality worldwide, particularly in developing countries like Indonesia. Early identification of high-risk women is crucial for timely intervention. This study aimed to evaluate the predictive performance of first-trimester ultrasound biomarkers, specifically uterine artery pulsatility index (UtA-PI) and mean arterial pressure (MAP), combined with maternal characteristics, for predicting PE in a cohort of pregnant women in Surabaya, Indonesia.

Methods: This prospective cohort study enrolled pregnant women attending their first-trimester antenatal care visit at Private Hospital, Surabaya, between January 2022 and December 2023. Inclusion criteria were singleton pregnancies, gestational age between 11 and 13 weeks 6 days, and availability of complete follow-up data until delivery. Maternal characteristics (age, body mass index, parity, smoking history, family history of PE) were recorded. UtA-PI was measured using transabdominal Doppler ultrasound, and MAP was calculated from blood pressure measurements. The primary outcome was the development of PE, defined according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Logistic regression analysis was used to develop a prediction model, and its performance was assessed using receiver operating characteristic (ROC) curves and area under the curve (AUC).

Results: A total of 850 pregnant women were included in the final analysis. The incidence of PE was 8.2% (n=70). The prediction model incorporating maternal age, BMI, prior history of PE, UtA-PI, and MAP demonstrated good predictive performance for overall PE (AUC = 0.85; 95% CI, 0.81-0.89). For early-onset PE (delivery <34 weeks), the AUC was 0.92 (95% CI, 0.87-0.97), and for late-onset PE (delivery ≥34 weeks), the AUC was 0.78 (95% CI, 0.73-0.83). UtA-PI and MAP were significant independent predictors of PE (p<0.001). A risk score was developed, with a cut-off value showing a sensitivity of 80% and specificity of 75% for overall PE.

Conclusion: The combination of maternal characteristics, UtA-PI, and MAP in the first trimester provides a valuable tool for predicting PE in an Indonesian population. This model demonstrates particularly strong performance for predicting early-onset PE, which is associated with greater maternal and fetal morbidity. Early identification of high-risk women allows for targeted surveillance and potential preventative strategies.