This work provides consensus guidance regarding clinical diagnosis and early medical management of endometriosis within Asia. Clinicians with expertise in endometriosis critically evaluated available evidence on clinical diagnosis and early medical management and their applicability to current clinical practices. Clinical diagnosis should focus on symptom recognition, which can be presumed to be endometriosis without laparoscopic confirmation. Transvaginal sonography can be appropriate for diagnosing pelvic endometriosis in select patients. For early empiric treatment, management of women with clinical presentation suggestive of endometriosis should be individualized and consider presentation and therapeutic need. Medical treatment is recommended to reduce endometriosis-associated pelvic pain for patients with no immediate pregnancy desires. Hormonal treatment can be considered for pelvic pain with a clinical endometriosis diagnosis; progestins are a first-line management option for early medical treatment, with oral progestin-based therapies generally a better option compared with combined oral contraceptives because of their safety profile. Dienogest can be used long-term if needed and a larger evidence base supports dienogest use compared with gonadotropin-releasing hormone agonists (GnRHa) as first-line medical therapy. GnRHa may be considered for first-line therapy in some specific situations or as short-term therapy before dienogest and non-steroidal anti-inflammatory drugs as add-on therapy for endometriosis-associated pelvic pain.

Tujuan: Untuk mengetahui gambaran infeksi C. trachomatis pada kerusakan tuba fallopi wanita infertil. Bahan dan Metode: Penelitian ini melibatkan 42 wanita yang menjalani laparoskopi dalam tata laksana infertilitasnya. Infeksi C. trachomatis diperiksa menggunakan metode PCR dari usapan endoserviks dan IgG C. trachomatis diperiksa menggunakan metode ELISA dari darah vena. Kondisi tuba fallopi dilakukan evaluasi saat laparoskopi. Hasil: Didapatkan C. trachomatis sebesar 14,29% dari PCR usapan endoserviks dan 38,10% dari IgG C. trachomatisdi darah. Sebagian besar tuba fallopi pada subyek dengan infeksi C. trachomatis menunjukkan kerusakan, ditandai adanya adhesi perituba, oklusi tuba, fimosis fimbria atau hidrosalping saat laparoskopi. IgG C. trachomatis berbeda signifikan pada kerusakan tuba fallopi (p = 0. 01), sedangkan endometriosis dan riwayat operasi sebagai faktor risiko tidak didapatkan perbedaan yang signifikan (p = 0. 26 dan p = 0. 27). Subyek dengan IgG C. trachomatis memiliki OR: 5. 5 (95% CI 1. 42-21. 7)untuk terjadi kerusakan tuba fallopi. IgG C. trachomatis memiliki sensitifitas 62,5%, spesifisitas 81,25%, PPV 62,5% dan NPV 81,25% dalam mendeteksi kerusakan tuba fallopi bila dikonfirmasi dengan hasil laparoskopi. Simpulan: Angka kejadian infeksi C. trachomatis pada wanita infertil cukup tinggi. Pemeriksaan IgG C. trachomatis dapat menjadi penanda adanya kerusakan tuba fallopi.Kata Kunci: C. trachomatis, infertilitas, kerusakan tuba fallopi, IgG, PCR Objectives: To know the description of C. trachomatis infection in tubal dysfunction of infertile women Materials and Methods: This study involves 42 women who underwent laparoscopy procedure in their infertility work up. Chlamydia trachomatis was detected using PCR from endocervical swabs and IgG was detected using ELISA from blood. Evaluation of the fallopian tube was done during laparoscopy procedure. Results: C. trachomatis was detected in 14,29% by PCR of endocervical swab and IgGin serum was detected in 38,10%. Most of the infected women in this study have fallopian tube dysfunction, confirmed by laparoscopic visualization of peritubal adhesion, tubal occlusion, fimbriae phimosis, or hydrosalphing. IgG C. trachomatis is significantly different between normal and dysfunctional fallopian tube (p = 0. 01). The occurrence of endometriosis and previous surgery was not statistically different (p = 0. 26 and p = 0. 27). Women with IgG C. trachomatis had OR: 5. 5 to get fallopian tube dysfunction(95% CI, 1. 42-21. 7). IgG C. trachomatis has sensitivity of 62. 5% and specificity of 81. 25%, PPV of 62,5% and NPV of 81,25% in detecting dysfunctional tube compared to laparoscopy. Conclusion:The incidence of C. trachomatis infection is quite high in infertile women. IgG Chlamydia trachomatis can be used as a marker of fallopian tube dysfunction. Keywords: Chlamydia trachomatis, infertility, fallopian tube dysfunction, IgG, PCRCorrespondence: Wafi Sariroh, Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Airlangga, RSUD Dr. Soetomo, Sur...

Introduction: Antibiotics are well known and recommended as the main therapy for preterm premature rupture of membranes (PPROM.) But the research on antibiotics other than the recommended macrolides regimens is still lacking. This research aims to evaluate whether there are effects differences of cefotaxime and ceftriaxone given on pregnancy with PPROM by comparing the duration of the latency period and the infants outcomes. Material and Methods: Data was taken retrospectively through medical records at Dr. Soetomo Surabaya General Hospital, Indonesia during the period of January-December 2017. The inclusion criteria were a history of PPROM in pregnancy <37 weeks, given cefotaxime or ceftriaxone therapy, and have labor data. The analysis was performed by the Mann-Whitney comparison test for the latency period and Fisher's exact test for infant outcomes. Results: There were 52 samples obtained. The antibiotics used were cefotaxime 3x1gr (A) and ceftriaxone 2x1gr (B). The results of the analysis showed that there were no significant differences between the types of antibiotics with the length of the latency period, with a value of p = 0,601 (p>0,05), where group A had a median of 52,67 hours and group B was 34,17 hours. Group A was found to be more able to extend the latency period for >48 hours with a percentage of 57,8%, whereas in group B only 42,9%. There are no significant differences in infant outcomes; infant birth weight and Apgar score among the two therapies used. Conclusion: Cefotaxime was more preferably to be used in the Dr. Soetomo Surabaya General Hospital. Nevertheless, ceftriaxone can still be a good choice for PPROM therapy since both cephalosporins have succeeded in preventing infections in women with PPROM.

Background: Endometriosis is a common disease among women of reproductive age and often associated with infertility. Endometrioma is one of the most common manifestations in endometriosis patient. In Vitro Fertilization is one of the methods used as infertility management in endometriosis women. There are some basal parameters that could affect the IVF result, such as basal E2, FSH and AFC. This study aim is to analyze the basal E2, FSH and AFC of women with endometrioma patients compared to non-endometriosis patients.