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Awareness on and availment of Philhealth's maternity care benefits among selected patients of a tertiary hospital in Southern Luzon.

Bernardino Joeima D. ; Burog Honorata Lalaine P.

Philippine Journal of Obstetrics and Gynecology.2017;41(6):16-24.

BACKGROUND: In spite of policy changes and government programs aimed to improve maternal health and reduce maternal morbidity, the Philippines failed to achieve its Millennium Development Goals targets because of several identified factors.
OBJECTIVE: To determine the relationships of maternal profile and awareness on and availment of PhilHealth maternity care benefits among the selected patients of a Tertiary Hospital in Southern Luzon Department of Obstetrics and Gynecology were investigated from February 2015 to February 2016.
METHODOLOGY: Descriptive cross-sectional survey method was used in the study involving 365 respondents selected through convenience sampling. Chi-square test and Cramer's V was used to determine relationships among the variables. Maternal profile, which included the patient's age, educational attainment, employment, family income, health insurance coverage, access to mass media and the Internet and number of pregnancies were considered as an intervening variable.
RESULTS: The results of the study revealed low level of benefit awareness even for the respondents who have existing PhilHealth coverage. They also failed to avail most of the benefits. Statistical analyses revealed that age, family income, health insurance coverage and number of pregnancies were significantly related to awareness while only family income and health insurance coverage were significantly related to availment. It was established further that pregnant women who were more aware of their benefits were more likely to avail them.
CONCLUSION: To achieve optimum availment of benefits, an iterative process of awareness campaign should be instituted starting from high school education to women's employment and from initial contact with Barangay Health Workers to their consultation with health care providers.

Human ; Female ; Gynecology ; Obstetrics ; Tertiary Care Centers ; Maternal Health ; Employment ; Health Personnel ; Insurance Coverage

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Intraurethral coitus in a case of transverse vaginal septum.

Fajardo Jennifer B ; Oblepias Enrico R

Philippine Journal of Obstetrics and Gynecology.2003;27(1):26-30.

A 29 year old nulligravid, married for 11 years sought consult due to recurrent urinary tract infection and primary infertility. Physical examination revealed a dilated urethral orifice accommodating two fingers and a blind vaginal pouch 0.5 cm deep with a pinpoint opening at the apex. The septum was excised and the dilated urethra repaired. Patient became pregnant two months after the operation and subsequently delivered via low transverse cesarean section to a 3700 gram baby. Surgical resection is the treatment of choice and postoperative dilation may be necessary to prevent restenosis. Outlook for pregnancy is encouraging and the mode of delivery must be based on individual circumstances.?

Human ; Female ; Adult ; Pregnancy ; Urethra ; Dilatation ; Parturition ; Marriage ; Cesarean Section ; Gravidity ; Infertility ; Urinary Tract Infections

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Carcinoid tumor arising in a mature cystic teratoma: A case report.

Galang Katherine Abegail P. ; Aquilizan Leo Francis N.

Philippine Journal of Obstetrics and Gynecology.2017;41(6):42-47.

This report will discuss a case of carcinoid tumor arising in a mature cystic teratoma in a 27-year-old single nulligravid, who initially consulted for primary amenorrhea and right lower quadrant pain. Pelvic ultrasound was done and revealed an ovarian cyst on the right, to consider mature cystic teratoma. She underwent right oophorectomy with unremarkable post-operative course. Furthermore, this case report will tackle the diagnosis, definitive management and prognosis of the condition.

Human ; Female ; Amenorrhea ; Ovarian Cysts ; Dermoid Cyst ; Carcinoid Tumor ; Ovariectomy ; Prognosis ; Pain

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The endometrial cancer risk scoring.

Domingo Efren J ; Zamora John David V ; Manuel-Limson GENARA ; Manalo Augusto M

Philippine Journal of Obstetrics and Gynecology.2000;24(3):90-94.

Our objectives were to determine the most significant prognostic factors affecting node metastasis in endometrial cancer and to devise and validate a scoring system for endometrial cancer. The study design consisted of retrospective chart review (operative record and histopathology report) of all endometrial cancer patients who underwent total hysterectomy/radical hysterectomy, bilateral salpingooophorectomy, bilateral pelvic lymph node dissection and peritoneal fluid cytology from September 21, 1989 to February 19, 1999. The analysis included 262 women, 21.4% of whom had pelvic lymph node metastasis.The mean ages for those with metastasis and without metastasis were similar positive lymph node (LN) =53.18 years old; negative LN=51.89 years old; range: positive LN=31-84 years old, negative LN=23-76 years old. Most patients were of low gravidity, with mean=G3, median=G4, mode = GO. The most significant factors affecting pelvic lymph node metastasis were peritoneal fluid cytology, myometrial invasion, cervix involvement and histologic grade as determined by logistic regression and Odds ratio. A prognostic scoring system was devised. All subjects were scored according to a proposed scoring system to determine the latter's clinical utility. A cut-off score of 5 was shown to be significant for pelvic lymph node metastasis. The proposed scoring system may be used to determine the likelihood of pelvic lymph node metastasis for patients who did not have lymphadenectomy and may have an important role in determining the need for adjuvant treatment.

Ascitic Fluid ; Prognosis ; Gravidity ; Lymph Node Excision ; Endometrial Neoplasms ; Lymphatic Metastasis ; Lymph Nodes ; Hysterectomy

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Complete hydatidiform mole with live fetus: A report of two cases.

Dy-Meguizo Debbie GUANI

Philippine Journal of Obstetrics and Gynecology.2000;24(3):105-110.

Two cases of complete hydatidiform mole with coexistent live fetus are presented with special considerations on diagnosis and management. Incidence in the west is 1:10,000 to 1:100,000 pregnancies. These cases are only 2 of the 3 cases diagnosed in the Philippines. Diagnosis can be made by morphology, immunostaining and cytogenetics. Prognosis is unpredictable. Clinical symptoms vary from an aggressive disease requiring termination of pregnancy becuase of high risk of persistent trophoblastic disease or a more stable group that may reach viability. Clinical management should be decided on an individual basis, taking into account the risk to the mother of continuing the pregnancy and the parents wishes. (Author)

Human ; Female ; Adult ; Hydatidiform Mole ; Gestational Trophoblastic Disease ; Mothers ; Parents ; Fetus ; Prognosis

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Validity of sonographic endometrial thickness and progestin challenge test as screening method for endometrial pathology in postmenopausal women at VMMC.

Ramos-Garcia Ma. RAQUEL

Philippine Journal of Obstetrics and Gynecology.2001;25(1):9-15.

OBJECTIVE: To evaluate the usefulness of transvaginal sonographic measurement of endometrial thickness with Progestin-Induced Withdrawal as a screening method for endometrial pathology in postmenopausal women.

DESIGN: This study is an observational case control research design.

METHODOLOGY: One hundred forty three registered postmenopausal women at VMMC Out Patient Department were examined by TVS: 60 asymptomatic women (Group A) and 83 with uterine bleeding (Group B). Endometrial thickness of 5 mm was considered pathological. All women with abnormal endometrium from group A underwent PCT. All women from group A were positive for PCT and all women from group B underwent D&C. Histologic findings of hyperplasia w/ or w/o atypia, polyp and cancer were considered pathologic. Validity testing method was then used by measuring the sensitivity, specificity, positive predictive and negative predictive values of the data collected.

RESULTS: Eighteen women with a (+) PCT who underwent D&C revealed 6 benign histologic finding: Endometrial Polyp (2), Hyperplasia without atypia (4), 3 were premalignant and 1 case of Endometrial Cancer. All women with negative PCT had non-pathologic histologic findings. Validity testing showed that a Positive PCT in a asymptomatic patients with a sonographic endometrial thickness of 5mm, has a sensitivity of 100 percent, specificity of 46.66 percent,(+) predictive value of 55.55 percent and negative predictive value of 100 percent. Sixty two patients from Group B had abnormal sonographic and histologic findings: 13 benign (hyperplasia or polyp), 10 premalignant (hyperplasia w/ atypia) and 18 malignant (cancer). There was no cancer in cases w/ endometrial thickness 5 mm. The sensitivity, specificity, positive and negative predictive value of TVS for detecting endometrial pathology were 93.94 percent, 94.74 percent, 98.41 percent and 81.82 percent respectively if the cut-off limit of 5 mm was used.

CONCLUSION: TVS combined with PCT is a useful and reliable method for identifying endometrial pathology in postmenopausal women. (Author)

Human ; Female ; Progestins ; Hyperplasia ; Postmenopause ; Endometrial Hyperplasia ; Uterine Hemorrhage ; Endometrial Neoplasms ; Endometrium ; Polyps

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A retrospective analysis on treatment and survival outcome of locally advanced cervical cancer with or without brachytherapy: A single institution study

Joan Kristel B. Abrenica ; Genalin F. Amparo

Philippine Journal of Obstetrics and Gynecology.2020;44(6):1-11.

Background: Concurrent chemoradiotherapy composed of pelvic external beam radiotherapy (PEBRT) with weekly chemotherapy plus intracavitary brachytherapy (ICBT) remains to be the treatment of choice for locally advanced cervical cancer (LACC). However, some patients are not suitable to have ICBT right after pelvic radiation. Locally, active chemotherapy is being given to these patients until they can undergo the procedure. Objective: The aim of the study was to determine the impact of ICBT in the treatment and survival outcomes of cervical cancer and to compare it with active chemotherapy. Methodology: This was a retrospective study of patients with LACC treated with or without brachytherapy in a single institution from January 2002 to December 2017. Results: The 5-year over-all survival (OS) and 5-year recurrence free survival (RFS) of patients with ICBT were both significantly improved compared to those without ICBT (p=0.001 and p=0.038), respectively. Factors that were significantly correlated with adequate response for brachytherapy were non-squamous cell histology (OR 0.65, CI 0.46- 092, p=0.016), initial tumor size of > 5cm (OR 0.41, CI 0.26-0.65, p=0.001), > 50% decrease in the original tumor size at the middle part of PEBRT (OR 1.83, CI 1.2-2.8, p=0.005), > 3 cycles of chemotherapy as radiosensitizers (OR 2.66, CI 1.79- 3.9, p=0.001), > 45 days duration of PEBRT (OR 0.63, CI 0.41-0.97, p=0.04) and > 2 episodes of anemia during PEBRT (OR 0.67, CI 0.52-0.85, p=0.001). Conclusion Brachytherapy offers significant improvement on tumor control and over-all survival for patients with LACC. Active chemotherapy may offer some benefit in terms of delaying tumor recurrence or progression. However, this did not translate to survival impact if the patient was not able to have brachytherapy at all.
brachytherapy ;

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Early experience of gynecologic robotic surgery in a tertiary government hospital

Efren J. Domingo ; Patrick Jose D. Padilla

Philippine Journal of Obstetrics and Gynecology.2020;44(6):12-16.

Background: Robotic surgery is a form of minimally invasive surgery wherein the surgeon controls the camera and instruments in a console, remote from the operating room table. Currently, the system in place is the da Vinci Surgical System which was approved by the United States Food and Drug Administration in 2000 for laparoscopic surgery. Since its approval in 2005 for Gynecologic procedures, the da Vinci Surgical System has been used for hysterectomies, lymph node dissections, sacrocolpopexies, myomectomies, and cerclage. Objective: This paper presents the initial seven cases of benign gynecologic diseases operated on utilizing the da Vinci Surgical System in our institution – six hysterectomies and one myomectomy. Methodology: Seven gynecologic surgeries that utilized the da Vinci Surgical System in 2019 until the first quarter of the year 2020 were done. Medical records of the seven patients were reviewed. Results: The average docking time was 38 minutes (range: 25 – 65 minutes) and the average console time was 227 minutes (range: 175 – 345 minutes). The average blood loss was 576 cc (range: 80 – 1200 cc). No cases converted to an abdominal laparotomy and no morbidities were reported. While two cases underwent blood transfusion intraoperatively, all cases were stable post-operatively and were for discharge after two days. On follow-up, all patients were stable with an unremarkable clinical course. Conclusion Our initial experience demonstrates that robotic surgery appears as a viable alternative to traditional approaches. As more cases are to be done in the future, fine-tuning of the logistical set-up and surgical skills are expected, as well as venturing into other gynecologic diseases such as malignancies. Further research must be conducted on various aspects of robotic surgery, such as but not limited to outcome comparison with traditional and other laparoscopic approaches, long term outcomes, patient safety, and patient experience and preference, among others.
Female ; Gynecologic Surgical Procedures

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A five-year review of the clinicopathologic profile of patients with hydatidiform mole at the Philippine General Hospital

Sherry Joahne L. Cañ ; ete - Villariasa ; Agnes L. Soriano-Estrella

Philippine Journal of Obstetrics and Gynecology.2020;44(6):17-22.

Background: The clinical presentation of patients with hydatidiform mole have changed in recent years due to earlier diagnosis as a result of widespread use of ultrasonography and availability of assays for human chorionic gonadotrophin. Objective: To determine the clinicopathologic profile of patients diagnosed with hydatidiform mole at the Philippine General Hospital from January 2013 to August 2018. Methods: This retrospective cross-sectional study included all patients with histologically confirmed diagnosis of hydatidiform mole managed at the Philippine General Hospital from January 2013 to August 2018. Medical records of patients were retrieved. All abstracted variables were analyzed retrospectively. The level of significance for all sets of analysis was set at p-value < 0.05 using two-tailed comparisons. Results: From January 2013 to August 2018, a total of 435 patients diagnosed with hydatidiform mole were managed at the Philippine General Hospital with a prevalence rate of 15.7/1,000 pregnancies. Diagnosis was made in the first trimester in 52% of patients. A quarter of the patients had pre-evacuation B-hCG levels of more than 1 million mIU/mL. Vaginal bleeding was the most frequent presenting symptom but only 59% of the patients had anemia requiring blood transfusion. Majority (90.57%) had a histopathologic diagnosis of complete hydatidiform mole. Conclusion The prevalence and clinicopathologic profile of patients with hydatidiform mole in the Philippine General Hospital have remained largely unchanged.
hydatidiform mole ; Pregnancy ; Female ; gestational trophoblastic diseases

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Papillary squamous carcinoma of the cervix with metachronous clear cell renal cell carcinoma

Renee Riza C. Medalla ; Jericho Thaddeus P. Luna

Philippine Journal of Obstetrics and Gynecology.2020;44(6):23-27.

Multiple primary tumors can be classified as synchronous or metachronous. Cases have been reported, with a prevalence, in gynecologic malignancies, of 1.9 to 4.3%, and commonly occurring in endometrial and ovarian malignancies. Renal tumors coexisting with primary cervical cancer are mostly metastatic tumors, and at present, no case of cervical carcinoma metachronous with renal cell carcinoma has been reported on literature. This is a case of Papillary Squamous Cell Carcinoma of the cervix who developed a metachronous Clear Cell Renal Cell Carcinoma. Several months after the diagnosis of cervical cancer, she presented with an abdominal mass and signs of uremia secondary to obstructive uropathy. She underwent radical nephrectomy with contralateral percutaneous nephrostomy. Definitive plan for the cervical mass is concurrent chemotherapy and radiation, depending on the improvement in renal function. Currently, there are no clearly established guidelines in managing metachronous cervical and renal masses, and this presents a unique opportunity to document this case, and study its implications on management and prognosis.
Neoplasms, Multiple Primary ;

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