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"Latar belakang: Penelitian ini bertujuan untuk menganalisis kadar F2α-isoprostan, aktivitas enzim Na+-K+ ATPase dan fluiditas membran sel sinsitiotrofoblas plasenta penderita pre-eklampsia yang diberi vitamin E.Metode: Penelitian dilakukan pada bulan September 2003 ? Februari 2005 di Rumah Sakit Bersalin Budi Kemuliaan, Jakarta Pusat. Sampel penelitian adalah 6 wanita pre-eklampsia yang mendapatkan vitamin E, 6 wanita pre-eklampsia yang tidak mendapat vitamin E dan 6 wanita hamil normal. F2α-isoprostan diukur dengan ELISA Reader pada λ = 450 nm. Fluiditas diukur dengan membandingkan rasio molar kolesterol total dan kadar fosfolipid membran sel. Kolesterol diukur menggunakan Modular C800 dengan reagen Roch. Fosfolipid diukur menggunakan spektrofluorometer Shimadzu RF5301PC dengan filter eksitasi 267 nm dan emisi 307 nm. Aktivitas Na+-K+ ATPase dihambat dengan ouabain. Produksi Pi diukur dengan metode Fiske dan Subbarow menggunakan spektrofotometer pada λ = 660 nm. Data dianalisis menggunakan uji F melalui ANOVA 1 arah.Hasil: Pemberian vitamin E pada penderita pre-eklampsia menurunkan stres oksidatif dengan indikasi turunnya F2α-isoprostan secara bermakna (26,72 ± 11,21 vs 41,85 ± 7,09 ng/mL, p = 0.017). Vitamin E mampu menangkal radikal bebas sehingga peroksidasi fosfolipid dapat dihambat dan fluiditas membran sel dapat dipertahankan pada 0,39 ± 0,08 dibandingkan tanpa pemberian vitamin E yaitu 0,53 ± 0,14 (p = 0,024). Aktivitas enzim Na+-K+ ATPase membran sel sinsitiotrofoblas tidak dipengaruhi oleh vitamin E (p = 0,915).Kesimpulan: Suplementasi vitamin E pada wanita pre-eklampsia menurunkan kadar F2α-isoprostan, mempertahankan fluiditas membran sel, namun tidak meningkatkan aktivitas enzim Na+-K+ ATPase sel sinsitiotrofoblas.

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AbstractBackground: The aim of our study was to analyze F2α-isoprostane level, Na+-K+ ATPase activity and placental syncytiotrophoblast cell membrane fluidity in preeclamptic women who received vitamin E supplementation.Methods: The study was conducted between September 2003 and February 2005 at Budi Kemuliaan Maternity Hospital, Central Jakarta. Samples were 6 preeclamptic women with vitamin E supplementation, 6 preeclamptic women without vitamin E supplementation and 6 normal pregnant women. The dose of vitamin E was 200 mg daily. F2α-isoprostane was measured with ELISA reader at λ of 450 nm. Cell membrane fluidity was measured by comparing the molar ratio of total cholesterol and cell membrane phospholipid concentration. The cholesterol was measured by Modular C800 using Roche reagent. Phospholipid was measured by Shimadzu RF5301PC spectrofluorometer (excitation 267 nm, emission 307 nm). Na+-K+ ATPase activity was inhibited by ouabain. Pi production was measured with Fiske and Subbarow method using spectrophotometer at λ of 660 nm. Data was analyzed using F test with one-way ANOVA.Results: Vitamin E supplementation in preeclamptic women decreased the oxidative stress, indicated by significantly lower level of F2α-isoprostane compared to those without vitamin E (26.72 ± 11.21 vs 41.85 ± 7.09 ng/mL, respectively, p = 0.017). Membrane fluidity in syncytiotrophoblast cell of preeclampsia with vitamin E group was maintained at 0.39 ± 0.08 while in those without vitamin E was 0.53 ± 0.14 (p = 0.04). Na+-K+ ATPase activity in syncytiotrophoblast cell membrane was not affected by vitamin E (p = 0.915).Conclusion: Vitamin E supplementation in preeclamptic women decreases F2α-isoprostane level and maintains cell membrane fluidity of syncytiotrophoblast cells; however, it does not increase Na+-K+ ATPase enzyme activity."

"Preeklampsia merupakan gangguan kehamilan yang mengancam kesehatan ibu dan bayi Penelitian ini merupakan studi potong melintang yang bertujuan untuk mengetahui perbedaan kadar vitamin E dan MDA pada 48 subyek preeklampsia dan non preeklampsia di RS Tarakan Jakarta Penilaian mencakup wawancara sosio demografi riwayat obstetri asupan vitamin E dengan FFQ semikuantitatif LILA kadar vitamin E dan MDA serum Kategori usia usia kehamilan dan kadar MDA lebih tinggi pada preeklampsia Edukasi untuk perempuan usia reproduktif tentang pentingnya asupan makanan vitamin E yang cukup diperlukan untuk mencapai keberhasilan kehamilan.

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Preeclampsia is a disorder of pregnancy that deteriorate mother and baby rsquo s health This study was a cross sectional study aiming to investigate differences in the levels of vitamin E and MDA of 48 subjects with preeclampsia and non preeclampsia in Tarakan Hospital Jakarta Assessment included interviews of socio demographic obstetric history vitamin E intake with semiquantitative FFQ MUAC serum vitamin E and MDA concentrations Categories of age gestational age and MDA levels were higher among preeclamptics Education for reproductive age women about the importance of sufficient intake of vitamin E foods is necessary to achieve successful pregnancy."

"Preeklamsia merupakan kondisi spesifik pada kehamilan yang menjadi penyebab utama morbiditas dan mortalitas maternal-perinatal. Plasentasi abnormal menyebabkan hipoksia plasenta dan gangguan regulasi responss imun sehingga mengakibatkan perubahan mikroskopik struktur plasenta berupa penurunan syncytial bridge. Penelitian ini bertujuan mengetahui toleransi imun dan nekrosis pada preeklamsia berdasarkan gambaran syncytial bridge, jumlah sel Treg, konsentrasi LDH serta profil vitamin 1,25(OH)2D3, dan seng. Penelitian potong lintang ini dilakukan pada bulan Februari–Agustus 2019 di RS Budi Kemuliaan dan RSUD Koja, Jakarta. Subjek penelitian adalah ibu hamil normotensi dan preeklamsia yang memenuhi kriteria penerimaan dan tidak memenuhi kriteria penolakan. Subjek dibagi tiga kelompok yaitu: normotensi/NT (n = 20), preeklamsia tanpa komplikasi/PE (n = 21), dan preeklamsia dengan komplikasi/PEK (n = 20). Semua subjek dilakukan pengukuran. jumlah syncytial bridge plasenta (HE), jumlah sel Treg (flowcytometric dan IHK), konsentrasi LDH (enzymatic colorimetric dan ELISA), vitamin 1,25(OH)2D3 (LC-MS/MS) dan seng (ICP-MS) darah maternal dan plasenta. Data diolah menggunakan SPSS versi 2 dan dianalisis dengan uji test-tidak berpasangan dan Mann-Whitney. Jumlah syncytial bridge pada kelompok PE (10,52/LPB) dan PEK (6,33/LPB) lebih rendah bermakna dibanding NT (14,71/LPB). Syncytial bridge PEK lebih rendah bermakna dibanding PE. Jumlah Treg plasenta kelompok PE (2,89/LPB) dan PEK (2,94/LPB) lebih rendah bermakna dibanding NT (4,11/LPB). Konsentrasi LDH maternal pada PEK (418U/L) lebih tinggi dibanding NT (167,5 U/L), dan PEK lebih tinggi dibanding PE (204 U/L) secara bermakna. Kkonsentrasi 1,25(OH)2D3 maternal kelompok PE (55 pg/mL) dan PEK (41,3 pg/mL) lebih rendah dibanding NT (63,5 pg/mL). Konsentrasi 1,25(OH)2D3 maternal PEK lebih rendah bermakna dibanding PE. Tidak ada perbedaan bermakna konsentrasi seng maternal dan plasenta pada ketiga kelompok. Sel Treg plasenta kelompok syncytial bridge sangat rendah (SSR) 2,86/LPB dan syncytial bridge rendah (SR) 3,09/LPB lebih rendah secara bermakna dibanding syncytial bridge normal (SN) 3,87/LPB. Konsentrasi LDH maternal SSR (318 U/L) lebih tinggi bermakna dibanding SR (213 U/L) dan SN (168 U/L). Konsentrasi vitamin 1,25(OH)2D3 maternal pada SSR (39 pg/mL) lebih rendah dibandingkan SR (53,85 pg/mL) dan SN (58,10 pg/mL). Peningkatan konsentrasi LDH maternal, penurunan konsentrasi 1,25(OH)2D3 maternal dan sel Treg plasenta merupakan faktor risiko berkurangnya jumlah syncytial bridge. Disimpulkan berkurangnya jumlah syncytial bridge menggambarkan beratnya proses nekrosis yang berhubungan dengan penurunan toleransi imun dan konsentrasi 1,25(OH)2D3 maternal.

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Preeclampsia is a specific condition in pregnancy as the main cause of maternal-perinatal morbidity and mortality. Abnormal placentation causes placental hypoxia and disturbances in the regulation of the immune response, thereby resulting in the microscopic structure of the placenta in the form of syncytial bridges. The present study aimed to determine the immune tolerance and necrosis in preeclampsia, on the basis of the syncytial bridge characteristic, Treg cell count, LDH concentration and vitamin 1,25(OH)2D3, and zinc profiles.

This cross-sectional study was carried out from February to August 2019 at RS Budi Kemuliaan and RSUD Koja, Jakarta. The subjects were pregnant women who met the inclusion criteria and did not meet the exclusion criteria. The subjects were divided into three groups, namely the normotensive (NT) group (n = 20), the uncomplicated preeclampsia (PE) group (n = 21), and the complicated preeclampsia (PEC) group (n = 20). All subjects underwent the following examinations: placental syncytial bridge count (HE), Treg cell count (flowcytometric and IHC), LDH (enzymatic colorimetric and ELISA), 1,25(OH)2D3 (LC-MS/MS) and zinc (ICP-MS) concentration in maternal blood and placenta. The data were processed using SPSS version 20 and analyzed by means of the unpaired t and Mann-Whitney tests.

The syncytial bridge count in groups PE (10.52/HPF) and PEC (6.33/HPF) was significantly lower compared with NT (14.71/HPF). PEC syncytial bridge count was significantly lower than PE. Placental Treg count in groups PE (2.89/HPF) and PEC (2.94/HPF) were significantly lower than that of the NT (4.11/HPF). Maternal LDH concentration in PEC (418U/L) was significantly higher than in NT (167.5 U/L), and PE (204 U/L). Maternal 1,25(OH)2D3 concentration in groups PE (55 pg/mL) and PEC (41.3 pg/mL) was lower compared with NT (63.5 pg/mL). Maternal 1,25(OH)2D3 concentration in group PEC was significantly lower than in PE. There were no significant differences in maternal blood and placental zinc concentration in the three groups. Placental Treg cell counts in the very low syncytial bridge count (VLSB) group (2.86/HPF) and the low syncytial bridge count (LSB) (3.09/HPF) were significantly lower than in the normal syncytial bridge count (NSB) (3.87/HPF). Maternal blood LDH in group VLSB (318 U/L) was higher than those in LSB (213 U/L) and NSB (168 U/L). Maternal 1,25(OH)2D3 concentration in group VLSB (39 pg/mL) was lower compared with LSB (53.85 pg/mL) and NSB (58.10 pg/mL). Increased maternal LDH concentration, decreased maternal 1,25(OH)2D3 concentration and placental Treg cell count were risk factors for decreased syncytial bridge count. It was concluded that the decrease in syncytial bridge count depicts the severity of the necrotic process that is associated with decreased immune tolerance and maternal 1,25(OH)2D3 concentration."

"Latar Belakang: Kejadian preeklamsia dilaporkan berkisar 5-15% dari seluruhkehamilan dan terkait erat dengan morbiditas dan mortalitas maternal dan perinatal.Preeklamsia merupakan penyakit dengan berbagai teori (disease of theory) yangmenggambarkan ketidakpastian patofisiologi dan penyebabnya. Salah satu teoripatogenesis preeklamsia adalah peningkatan stres oksidatif. Stres oksidatifmerupakan ketidakseimbangan jumlah oksidan dan antioksidan dalam tubuh.Peningkatan radikal bebas pada preeklamsia diduga menyebabkan penurunanantioksidan endogen seperti superoksida dismutase (SOD) karena banyak antioksidantersebut yang terpakai untuk menanggulangi radikal bebas. Mengingat pentingnyaperanan SOD pada patogenesis preeklamsia, maka pemberian suplementasi SODdiduga dapat memberi manfaat pada preeklamsia maupun kehamilan normal.Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui perbedaan kadar SODpada kehamilan normal dan preeklamsia. Selain itu, penelitian ini juga bertujuanuntuk mengetahui kenaikan kadar SOD pasca pemberian suplementasi SOD padakehamilan normal dan preeklamsia.Metode Penelitian: Penelitian uji klinis ini dilakukan di RSCM, RSAB HarapanKita, RSIA Bunda, dan RSIA Brawijaya pada bulan September hingga Desember2019. Subjek penelitian berasal dari Ibu hamil normotensi dan Ibu hamil preeklamsiayang akan dilakukan tindakan operasi sesar berencana dalam waktu 2 minggu. Padasubjek di kelompok uji, akan diberikan suplementasi Glisodin 2 x 250 U selama 14hari. Dilakukan pengukuran kadar SOD serum pra- dan pasca- suplementasi Glisodin,SOD plasenta, dan kadar Cu, Mn dan Zn serum. Data selanjutnya diolah denganmenggunakan uji statistik dengan paket SPSS versi 15. Analisis data berupa analisisunivariat, bivariat dan multivariat.Hasil Penelitian: Didapatkan 91 subjek penelitian yang terdiri dari 42 Ibu hamilnormotensi dan 49 Ibu hamil dengan preeklamsia. Dari 25 subjek penelitian yangdiberikan suplementasi Glisodin, 15 orang berasal dari kelompok Ibu hamilnormotensi dan 10 orang berasal dari kelompok Ibu hamil preeklamsia. Kadar Zn pada kelompok preeklamsia didapatkan lebih rendah bermakna dibandingkan padakelompok normotensi (45 (25,00-110,00) ug/dL vs 52,00 (36,00-88,00) ug/dL, p0,025). Tidak didapatkan perbedaan bermakna kadar SOD pra- dan pascasuplementasi pada kelompok normotensi dan preeklamsia. Tidak terdapatpeningkatan bermakna kadar SOD pasca suplementasi , baik pada kelompoknormotensi maupun preeklamsia (+1,08 ± 2,45, p 0,069 dan +0,12 ± 2,04, p 0,721).Satu-satunya perbedaan bermakna yang ditemukan adalah kadar SOD plasentadimana didapatkan kadar SOD plasenta lebih rendah pada kelompok preklamsiadibandingkan normotensi (26,04 (10,49-91,16) U/mL vs 37,62 (13,58-105,40) U/mL,p<0,001).Kesimpulan: Kadar SOD plasenta pada kehamilan hipertensi atau preeklamsia lebihrendah dibandingkan dengan normotensi. Tidak ada peningkatan bermakna kadarSOD pasca-suplementasi dengan Glisodin pada kehamilan normotensi dan hipertensiatau preeklamsia.

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Background: Preeclampsia incidence varies between 5-15% from all pregnancy andrelated to maternal and perinatal morbidity and mortality. Preeclampsia is a disease oftheory which describe uncertainty in its pathogenesis and pathophysiology. One ofthe preeclampsia pathogenesis theory is the increasing oxidative stress level.Oxidative stress is a condition caused by imbalance between oxidant and anti-oxidantinside the body. Increased free radicals level in preeclampsia causing furtherdecreased in endogenous antioxidant level such as superoxide dismutase (SOD)because antioxidant were used to neutralize free radicals. Given the important role ofSOD in the pathogenesis of preeclampsia, supplementation of SOD is thought to bebeneficial, both in the normal pregnancy and preeclampsia.Objective: The aim of this study is to determine differences in SOD levels in normalpregnancy and preeclampsia. This study is also aims to determine the increase inSOD levels after SOD supplementation in normal pregnancy and preeclampsia.Methods: This clinical trial study was conducted at RSCM, RSAB Harapan Kita,RSIA Bunda, and RSIA Brawijaya in September to December 2019. The researchsubjects came from normotensive pregnant women and preeclampsia pregnantwomen who will undergo planned cesarean operations within 2 weeks. Subjects inthe test group will be given Glisodin 2 x 250 U supplementation for 14 days. SerumSOD pre-and post-supplementation with Glisodin, placental SOD, and serum Cu, Mnand Zn levels were measured. Data were then processed using statistical tests withSPSS package version 15. Data analysis was in the form of univariate, bivariate andmultivariate analyzes.Results: There were 91 research subjects consisting of 42 normotensive pregnantwomen and 49 pregnant women with preeclampsia. Of the 25 study subjects whowere given Glisodin supplementation, 15 were from the group of normotensivepregnant women and 10 were from the group of preeclampsia. The level of Zn in thepreeclampsia group was significantly lower than in the normotensive group (45(25.00-110.00) ug/dL vs 52.00 (36.00-88.00) ug/dL, p 0.025). There were nosignificant differences in pre- and post-supplementation SOD levels in the normotensive and preeclampsia groups. There was no significant increase in SODlevels after supplementation, both in the normotensive and preeclampsia groups(+1.08 ± 2.45, p 0.069 and + 0.12 ± 2.04, p 0.721). The only significant differencefound was placental SOD levels in which placenta SOD levels were lower in thepreeclampsia group than normotensive (26.04 (10.49-91.16) U / mL vs 37.62 (13.58-105.40 ) U / mL, p <0.001).Conclusions: Placental SOD levels in pregnancy with hypertension or preeclampsiaare lower than normotensive. There was no significant increase in post-Glisodinsupplementation SOD levels in normotensive and hypertensive or preeclampsiapregnancy."

"Preeklampsia adalah penyebab paling sering ketiga kematian ibu di dunia. Etiologi preeklamsia belum diketahui, hipoperfusi plasenta yang mengarah ke iskemia dan cedera sel endotel dianggap peristiwa patologis utama. Hal ini menyebabkan pertumbuhan janin terhambat dan bahkan kematian ibu dan janin. Preeclampsia juga mengarah ke penurunan berat badan plasenta. Untuk mengamati pengaruh tekanan arteri rata-rata (MAP) pada berat plasenta, sebuah penelitian Cross sectional dengan total 24 perempuan dilaksanakan (12 preeclampsia VS 12 normal). Data sekunder dari Rumah Sakit Bersalin Budi Kemuliaan digunakan dan pengukuran MAP dan berat plasenta dilakukan oleh para dokter di rumah sakit. Dari hasil penelitian ini, rata-rata berat plasenta non-preeklamsia VS preeklamsia adalah 555±74.7 VS 429.2±78.2(p<0.05), sedangkan rata-rata MAP non-preeklamsia VS preeclampsia adalah 91.7±11.3 VS 131±13.4(p<0,05). Korelasi tanpa mempertimbangkan faktor-faktor lain r = 0.640 (p<0.05). Korelasi wanita tanpa preeklampsia dengan MAP mereka menghasilkan r=0,539(p>0,05) dan wanita dengan preeklamsia dengan MAP, mereka menghasilkan r=-0,352(p>0,05), semua korelasi tidak signifikan ketika status penyakit dimasukkan kedalam analisis. Kesimpulan akhirnya ditemukan analisis korelasi statistik tidak signifikan, tetapi dari studi klinis yang didukung oleh hasil tinjauan literatur sebelumnya menunjukkan bahwa ada kecenderungan penurunan pada berat plasenta dengan peningkatan MAP pada ibu preeklamsi. Oleh karena itu, kita tidak bisa hanya mengandalkan hanya pada analisis statistik saja dan analisis statistic yang tidak signifikan mungkin disebabkan karena kurangnya ukuran sampel.

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Preeclampsia is the third most frequent cause of maternal death worldwide. The cause of preeclampsia is still unclear, hypoperfusion which leads to placental ischemia and endothelial cell damage are thought to be the main pathologic events. It causes retarded fetal growth and even maternal and fetal death. Preeclampsia also leads to decreased placental weight. To observe the effect of mean arterial pressure (MAP) on placental weight, a cross sectional study with a total of 24 women in the study (12 preeclamptic VS 12 normal) was done. Secondary data from Budi Kemuliaan Maternity Hospital was used and the measurements of the MAP and placental weight were done by the doctors in the hospital. In the obtained result, mean placental weight of non-preeclampsia VS preeclampsia is 555±74.7 VS 429.2±78.2 (p<0.05), while for mean MAP of non-preeclampsia VS preeclampsia is 91.7±11.3 VS 131±13.4 (p<0.05). Correlation without considering other factors r = -0.640 (p<0.05). The correlation of women without preeclampsia with their MAP yielded r = 0.539 (p>0.05) and women with preeclampsia with their MAP yielded r = -0.352 (p>0.05), all the correlations are insignificant when disease status is considered. In conclusion, the correlation statistical analysis is insignificant but clinical studies and results supported by earlier literature reviews suggest that there is a decreasing trend on placental weight with increasing MAP in preeclamptic mothers. Therefore, we cannot just rely on just statistical analysis alone and the insignificant statistical analysis might be due to the lack of sample size."

"Latar Belakang: Pre-eklampsia adalah suatu sindrom yang berhubungan dengan kehamilan yang disebabkan oleh kecacatan dalam pembaharuan arteri spiral dalam pembentukan jaringan plasenta. Sebagai hipotesis utama, telah diusulkan bahwa pre-eklampsia terjadi akibat iskemia seluler di placenta. Dimana, hal itu mengarah ke produksi spesies oksigen reaktif (ROS) yang dapat menganggu fungsi jaringan plasenta. Superoksida dismutase (SOD) merupakan salah satu mekanisme pertahanan yang melindung sistem vaskular placenta terhadap ROS. Metode: Sebanyak 28 sampel jaringan plasenta (terdiri dari kehamilan normal, pre-eklampsia awal dan pre- eklampsia lambat) telah dihomogenisasi dan dipelajari untuk menguji aktivitas enzim SOD. Aktivitas spesifik SOD diukur dengan xanthine, xanthine oksidase (XOD) dan INT dimana aktivitas SOD dihitung melalui tingkat penghambatan atas reaksi superoksida (dihasilkan oleh substrat xanthine) dengan INT untuk membentuk warna formazan merah. Lalu, jumlah zat warna yang dihasilkan tersebut dihitung dengan spektrofotometri UV (505 nm). Hasil: Rata-rata log aktivitas spesifik SOD untuk kehamilan normal, pre-eklampsia lambat dan pre-eklampsia awal masing-masing adalah 6.43 U/mg, 3.46 U/mg dan -0.18 U/mg. Analisis statistik juga menunjukkan bahwa terdapat perbedaan signifikan antara aktivitas SOD dalam onset pre-eklampsia (dini dan akhir) dan juga antara kedua onset pre-eklampsia dengan kehamilan normal. Kesimpulan: Aktivitas SOD pada pre-eklampsia awal mempunyai nilai terendah diikuti oleh nilai aktivitas SOD pada pre-eklampsia lambat. Dengan demikian, jaringan plasenta dalam pre-eklampsia awal memiliki stres oksidatif tertinggi dibanding dengan dalam kehamilan normal dan pre-eklampsia lambat.

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Background: Pre-eclampsia is a pregnant-related syndrome caused by a defect in spiral arterial remodeling in placenta formation. It has been proposed as central hypothesis that pre-eclampsia is a product of cellular ischemia in the placenta. Therefore, leading to production of Reactive Oxygen Species (ROS) which began the disruption of the placental function. Superoxide dismutase (SOD) is one of the defense mechanism that protect the placental vascular system against ROS.

Method: A total of 28 placenta tissue samples (consist of normal pregnancy, early pre-eclampsia and late pre- eclampsia) were homogenized and studied for SOD enzyme activity assay. The specific activity of SOD was measured by xanthine, xanthine oxidase (XOD) and INT as the SOD activity is calculated by degree of inhibition of reaction of generated superoxide (produced by xanthine substrate) with INT to form red formazan dye. In which, the amount of dye is calculated by spectrophotometry UV (505 nm).

Result: The average log of specific activity of SOD is 6.43 U/mg, 3.46 U/mg and -0.18 U/mg for normotensive pregnancy, late pre-eclampsia and early pre-eclampsia respectively. The statistical analysis also revealed that there is significant difference between SOD activities of onset of pre-eclampsia (early and late) and also between both onset of pre-eclampsia with normal pregnancy (p<0,05).

Conclusion: SOD activity in early pre-eclampsia has the lowest value, seconded by late pre-eclampsia. Thus, placenta of early pre-eclampsia has the highest oxidative stress compare to in normal pregnancy and in late pre- eclampsia."

"Untuk mencapai kehamilan sehat dibutuhkan interaksi dalam kandungan yang baik antara ibu hamil dengan janin. Apabila terjadi gangguan, maka masalah pada kehamilan yang bersifat fatal seperti preeklamsia dapat terjadi. Banyak studi telah menunjukkan adanya korelasi yang tinggi antara rusaknya proses aktivasi invasi trofoblas dan masalah pada maternal vascular endothelium. Peranan penting sebuah faktor transkripsi bernama Hif-1⍺ penting untuk regulasi oksigen khususnya dalam kondisi hipoksia, dan dipercaya juga berperan penting pada terjadinya preeklamsia di kehamilan. Pada studi ini, 20 sampel jaringan plasenta terdiri dari 10 sampel dari kehamilan preeklamsi dan 10 sampel dari kehamilan normal dianalisis menggunakan ELISA untuk melihat peranan protein HIF-1⍺ dan diinterpretasikan untuk menunjukkan hipoksia pada kehamilan preeklamsi. Hasil dalam studi ini menemukan bahwa tidak ada hasil yang signifikan ketika dianalisa secara statistic (p>0,05), namun ada kecenderungan bahwa kadar HIF-1⍺ lebih tinggi dibanding kadar HIF-1⍺ yang ditemukan dalam plasenta kehamilan normal.

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Healthy pregnancy requires successful appropriate interaction established between mother and the fetus. When this fails to occur, problems in pregnancy such as a life- threatening disorder called preeclampsia may occur. Many studies have shown high correlation between the development of preeclampsia with faulty trophoblast invasion and spiral artery remodelling at early weeks of gestation, that consequently led to placental ischemia. Hypoxia-inducible factor-1a (HIF-1⍺), an essential transcription factor for oxygen regulation induced in hypoxic environment, is believed to be important in the course of this disease. However, the exact mechanism of the pathogenesis of preeclampsia is still elusive. In this study, 20 tissue samples composed of 10 preeclamptic placenta and 10 normal pregnancy placenta were examined using ELISA Kit, with the aim to assess the HIF-1⍺ protein level and determine whether it could be used to demonstrate presence of persistent hypoxia in preeclampsia. The results demonstrated that there is no statistically significant difference between the HIF-1⍺ level in preeclamptic and normal placenta (p>0.05), but there is an evident tendency of the level in preeclampsia placenta to be elevated."

"Tesis ini bertujuan mengetahui kadar vitamin D dan zinc serum pasien preeklamsia berat dan hamil normal, mengetahui hubungan antara kadar vitamin D dan zinc dengan kejadian preklamsia berat, dan prevalensi preeklamsia berat di RSCM. Penelitian ini merupakan observasional potong lintang. Subyek penelitian adalah perempuan hamil yang menjalani persalinan di Kamar Bersalin RSCM pada Januari sampai dengan April 2014. Terdapat 22 subyek kelompok preeklamsia berat dan 22 subyek kelompok hamil dengan tekanan darah normal. Hasil penelitian didapatkan rerata kadar vitamin D dan median kadar zinc lebih rendah pada kelompok preeklamsia berat dibandingkan hamil normal, namun tidak berbeda bermakna. Kadar vitamin D dan zinc tidak berhubungan bermakna dengan kejadian preklamsia berat, dengan p=0,689 dan 0=0,517. Prevalensi hipertensi dalam kehamilan di RSCM adalah 31,07%, dengan rincian sebagai berikut: hipertensi kronik, hipertensi gestasional, preeklamsia ringan, preeklamsia berat, preeklamsia berat superimposed, sindrom HELLP, dan eklamsia gravidarum adalah 0,54%, 2,14%, 1,96%, 17,14%, 3,21%, 4,64%, dan 1,44%.

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The purpose of this investigation was to examine the maternal plasma level of vitamin D and zinc in cases of severe preeclampsia compare to normal pregnancy, to know association between level of vitamin D and zinc and severe preeclampsia, and to know prevalence of severe preeclampsia in Cipto Mangunkusumo. This is a cross sectional observational study. Subjects were pregnant women who gave birth in delivery room Cipto Mangunkusumo Hospital in between January and April 2014. There are 22 subjects in severe preeclampsia group and 22 subjects in normotensive pregnancy. Subject with severe preeclampsia were noted to have lower maternal vitamin D and zinc level to normotensive pregnancy with not significant statistically (p 0,689 and p 0,517). Prevalence of hypertension in Cipto Mangunkusumo hospital is 31,07% which is contain of: chronic hypertension 0,54%, gestational hypertension 2,14%, mild preeclampsia 1,96%, severe preeclampsia 17,14%, superimposed severe preeclampsia 3,21%, HELLP syndrome 4,64%, and eclampsia 1,44%."

"Pada preeklampsia terjadi peningkatan kadar VEGF (vascular endothelial growth factor). Selain mempunyai aktivitas mitotik dan meningkatkan permeabilitas membran sel endotel, VEGF dilaporkan dapat menginduksi produksi molekul sel adhesi oleh sel endotel. Molekul sel adhesi mempunyai fungsi merangsang perlekatan sel makrofag ke dinding pembuluh darah dalam proses inflamasi. Tujuan penelitian ini ialah untuk mengetahui pengaruh VEGF dalam serum preeklampsia pada produksi sVCAM-1 (soluble vascular cell adhesion molecule) oleh sel endotel dalam kultur. Duabelas sampel serum preeklampsia dan 11 serum kehamilan normal (kontrol) dengan konsentrasi 20% dipajankan pada kultur sel endotel normal (HUVEC) selama 24 jam Semua subjek setuju berpartisipasi dalam penelitian ini dan menanda-tangani informed consent. Pengukuran kadar sVCAM-1 pada supernatan dilakukan dengan ELISA. Hasil menunjukkan kadar VEGF dalam serum preeklampsia cenderung lebih tinggi dari serum ibu dengan kehamilan normal. Kadar produksi VCAM-1 oleh sel endotel yang dipajankan pada serum preeklampsia lebih tinggi secara bermakna dari yang dipajankan oleh serum kontrol (p<0,05). Tidak ada korelasi antara kadar VEGF dalam serum preeklampsia dan kontrol terhadap produksi sVCAM-1 oleh kultur sel endotel. (Med J Indones 2004; 14: 3-6)

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Serum concentrations of VEGF (Vascular Endothelial Growth Factor) are elevated in preeclampsia. In addition to inducing mitosis and increase permeability of endothelial cells, VEGF was reported to activate endothelial cells to produce cell adhesion molecules. Cell adhesion molecules play an important role in the inflammation process by inducing adherence of leukocytes in blood stream to the endothelial cells. The aim of this study is to investigate the effect of VEGF in serum from preeclamptic patients on sVCAM-1 (soluble vascular adhesion molecules-1) production in endothelial cell culture. Twelve sera from women with preeclampsia and 11 from women with normal pregnancy (controls) in 20% concentration were added to human umbilical vein endothelial cell culture (HUVEC) and incubated for 24 hours. All subjects have agreed to participate in this study and signed the informed consent form. sVCAM-1 concentration in the supernatant was measured by ELISA. VEGF concentration tends to be higher in preeclamptic serum than control, but the difference is not stastitically significant. The production of sVCAM-1 by endothelial cells exposed to preeclamptic serum was significantly higher than the production by endothelial cells exposed to serum from control (p<0.05). No correlation was found between the difference in VEGF concentrations in preeclamptic and control sera, and sVCAM-1 production by endothelial cell culture. (Med J Indones 2004; 14: 3-6)"

"Latar belakang: Preeklampsia masih menjadi penyumbang angka kesakitan dan kematian maternal dengan insidens sekitar 8,6 di Indonesia. Pola asuhan antenatal dengan melakukan penapisan awal menggunakan faktor maternal dan biofisik terhadap kejadian preeklampsia diharapkan dapat menurunkan angka kesakitan dan kematian maternal dan janin.Tujuan: Memperolah kalkulasi risiko dari faktor maternal dan biofisik terhadap kejadian preeklampsia. Metode: Studi ini merupakan kohort prospektif dengan melakukan consecutive sampling pada setiap ibu hamil dengan janin tunggal hidup dan tak terdapat kelainan kongenital anomali. Telah dilakukan penapisan pada 878 sampel dengan 8,7% mengalami preeklampsia. Setiap faktor maternal dan biofisik dilakukan analisis bivariat dan yang bermakna dilanjutkan dengan analisis multivariat. Variabel yang bermakna hingga analisis multivariat akan menghasilkan persamaan regresi logistik yang nantinya dapat menghitung a priori risk seorang perempuan mengalami preeklampsia. Hasil: Faktor maternal berupa riwayat hipertensi kronik dan riwayat preeklampsia di keluarga meningkatkan risiko preeklampsia. Faktor biofisik berupa indeks massa tubuh > 26 kg/m2, tekanan arteri rerata > 95 mmHg, dan indeks pulsatilitas arteri uterina yang tinggi juga meningkatkan risiko preeklampsia. AU-ROC dengan menggunakan faktor maternal dan kombinasi faktor maternal dan biofisik sebesar 63% dan 75%. Kesimpulan: Kombinasi faktor maternal dan biofisik dapat digunakan untuk menapis seorang ibu hamil untuk mengalami kejadian preeklampsia.

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Background: Preeclampsia still contributes for maternal morbidity and mortality with incidence around 8,6% in Indonesia. Antenatal care with screening by using maternal and biophysical factors in predict the preeclampsia event is expected can reduce the number of maternal and fetal morbidity and mortality. Aim: Obtain the calculation risk from maternal and biophysical factors in predicting preeclampsia. Methods: We conducted a prospective cohort by performing consecutive sampling in every pregnant woman with singleton live intrauterine with no congenital anomaly. We screened 878 subjects with 8,7% became preeclampsia. Every maternal and biophysical factors were performed bivariate analysis and if statistically significant it continued to multivariate analysis of logistic regression. The equation of the logistic regression model will be performed to calculate the a priori risk of a pregnant woman becoming preeclampsia. Results: Maternal factors such as chronic hypertension and family history with preeclampsia will increase the risk of preeclampsia. Biophysical factors such as body mass index > 26 kg/m2, mean arterial pressure > 95 mmHg, and high value of pulsatility index of uterine artery will increase the risk or preeclampsia. The AU-ROC value by using maternal factor and combining maternal and biophysical factors were 63% and 75%, respectively. Conclusion: By combining the maternal and biophysical factors, it can be performed to screen a pregnant woman in preeclampsia event."