Abstract Objective: This research aim is to report the incidence of positive HPV high risk in negative cytology result. Method: We collected 83 women underwent liquid-based cytology (LBC) and HPV DNA examination at the same time. We were using DiagCor GenoFlow Human Papillomavirus Array Test (GenoFlow), a novel HPV test based on PCR and "Flow-through" hybridization that can identify 33 HPV subtypes: 18 types of High risk HPV such as 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 81 and 82 Result: We grouped the subjects based on age below or equal to 30 years old (n=6) and above 30 years old (n=77). We found a significant difference in HPV DNA result within this group (P = 0.034), with 19.3% had HPV DNA type 16 and 18 in a group of age above 30 years old. Our study showed that 27 women (32.5%) underwent screening for cervical cancer having negative LBC result but showed positive HPV DNA positive. Conclusion: We found a significant difference in HPV DNA test result among women above 30 years old. Co-testing of Pap and HPV DNA is needed, especially if HPV DNA type 16 and 18 were found among negative Pap results. Keywords: Cervical cancer, HPV DNA, incidence, LBC, screening   Abstrak Tujuan: Penelitian ini bertujuan melaporkan insidensi dari HPV risiko tinggi yang positif pada hasil sitologi negatif. Metode: Kami mengumpulkan 83 wanita yang menjalani liquid based cytology (LBV) dan pemeriksaan HPV DNA pada waktu yang bersamaan. Dengan menggunakan DiagCor GenoFlow Human Papilloma Virus Array Test (GenoFlow), yaitu sebuah uji HPV terbaru yang berbasis PCR dan “Flow-throug” hybridization dapat mengidentifikasi 33 subtipe HPV: 18 tipe HPV risiko tinggi seperti 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 81 dan 82. Hasil: Kami mengelompokkan subjek berdasarkan usia dibawah atau setara 30 tahun dan diatas 30 tahun (n=77). Kami menemukan perbedaansignifikan dari hasil HPV DNA dalam kelompok ini (P=0.034), dengan 19.3% memiliki HPV DNA tipe 16 dan 18 dalam kelompok usia diatas 30 tahun. Penelitian ini menunjukkan 27 perempuan (32.5%) menjalani skrining kanker serviks memiliki hasil LBC yang negatif namun menunjukkan HPV DNA positif. Kesimpulan: Terdapat perbedaan signifikan dari uji HPV DNA pada wanita usia diatas 30 tahun. Pemeriksaan bersamaan antara Pap dan HPV DNA dibutuhkan terutama ketika HPV DNA tipe 16 dan 18 ditemuka pada hasil Pap negatif. Kata kunci: HPV DNA, insidensi, kanker serviks, LBC, skrining

Aim: Intrauterine device (IUD) has a high effectivity of long-term contraception method. Post-placental IUD increases the number of contraception use and decreases the unmet need for contraception. The purposes of this study were to evaluate the effectivity, expulsion, acceptability, and side effects of post-placental IUD insertion using a clamp at Dr. Cipto Mangunkusumo National General Hospital. Materials and methods: This prospective longitudinal observational study was conducted at a tertiary teaching hospital (Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia) from April 2018 to March 2019. Post-placental IUD was inserted using a clamp. We interviewed the patients at 3 months and 6 months after insertion to evaluate the outcome. A total of 94 women were included in this study. Results: The effectivity was 100%. The expulsion rate was 2.13, 3.45, and 0% at 6 weeks, 3 months, and 6 months, respectively. The total acceptability rate at 6 weeks, 3 months, and 6 months was 96.81, 93.3, and 90.8%, respectively. Most of the subjects were satisfied with the IUD contraception at 3 months and 6 months. Conclusion: Post-placental IUD insertion using a clamp had good safety, effectivity, acceptance, and satisfaction. This data could be used for family planning counseling in daily practice. Post-placentaI IUD insertion should be routinely offered to all eligible postpartum women undergoing institutional deliveries.

Objectives: Reported a case demonstrate the double approach repair of niche treatment through the hysteroscopy and laparoscopy technique.Methods: Case report. We reported a case starting from the patient admission untill 3 months postoperative condition.Case: A 33 years old woman came with abnormal uterine bleeding, already got medication and combine oral contraception pill, but the bleeding never stopped. We found a cavity (niche) filled by menstrual blood with thin lower uterine segment (just serous layer) from transvaginal ultrasound. We did hysteroscopy and laparoscopy approach. We illuminated the niche by hysteroscopy, then resected it by laparoscopy. Patient had a day hospital admission and no symptoms anymore after the procedure.Conclusion: Many treatment methods have been described for repair of niche with varies effectivities. Double approach (hysteroscopy and laparoscopy) technique was a minimal access, but optimal approach of niche resection with up to 100% effectivity.Keywords: abnormal uterine bleeding, caesarean scar defect, hysteroscopy, istmochele laparoscopy, niche   Abstrak Tujuan: Melaporkan sebuah kasus yang menggambarkan pendekatan ganda dalam memperbaiki niche dengan histeroskopi dan laparoskopi.Metode: Laporan kasus. Kami melaporkan sebuah kasus dimulai dari pasien masuk sampai dengan 3 bulan pascaoperasi.Kasus: Perempuan 33 tahun datang dengan perdarahan uterus abnormal, telah diberikan terapi obat dan pil kombinasi, namun perdarahan tidak berhenti. Dari ultrasonografi ditemukan rongga berisi darah menstrusasi dengan segmen bawah uterus yang tipis (hanya lapisan serosa). Kami melakukan pendekatan histeroskopi dan laparoskopi. Dilakukan iluminasi dengan histeroskopi, kemudian reseksi dengan laparoskopi. Perawatan pasien di rumah sakit selama satu hari, dan tidak terdapat keluhan pada pasien setelah tindakan.Kesimpulan: Terdapat banyak metode dalam tata laksana niche dengan efektivitas yang beragam. Pendekatan ganda dengan histeroskopi dan laparoskopi merupakan tehnik dengan akses minimal namun hasil optimal, dengan efektivitas hingga 100%.Kata Kunci: perdarahan uterus abnormal, defek skar sesar, histeroskopi, istmpchele, laparoskopi, niche

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