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Andriani Dewi Lestari
Gambaran kadar D-dimer pada hipertensi gestasional dan preeklampsia = Description of D-dimer levels in gestational hypertension and preeclampsia / Andriani Dewi Lestari
"Pendahuluan: D-dimer adalah hasil akhir degradasi cross-linked fibrin oleh plasmin yang merupakan salah satu petanda aktivasi koagulasi. Hipertensi gestasional adalah hipertensi yang terjadi setelah usia kehamilan 20 minggu tanpa adanya proteinuria dan preeklampsia adalah hipertensi yang terjadi setelah usia kehamilan 20 minggu disertai dengan proteinuria, tetapi bila tidak ada proteinuria terdapat gejala severe feature of preeclampsia. Hampir separuh kasus hipertensi gestasional berkembang menjadi preeklampsia. Pada preeklampsia terjadi hiperkoagulabel dan disfungsi endotel. Disfungsi endotel mengakibatkan permukaan nontrombogenik menjadi trombogenik, sehingga terjadi peningkatan aktivasi koagulasi. Penelitian ini bertujuan untuk mengetahui gambaran kadar Ddimer pada hipertensi gestasional dan preeklampsia.
Metode: Penelitian potong lintang dilakukan pada 30 hipertensi gestasional dan 30 preeklampsia . Penelitian dilakukan dari bulan Agustus 2015 sampai Januari 2016. Pengukuran kadar D-dimer dengan reagen Innovance memakai koagulometer Sysmex CS-2100i di Departemen Patologi Klinik.
Hasil: Kadar D-dimer pada ibu hamil dengan preeklampsia 2,37 mg/L FEU (1,78 - 5,48 mg/L FEU), kadar D-dimer ibu hamil dengan hipertensi gestasional 1,43 mg/L FEU (0,88 ? 1,95 mg/L FEU). Kadar D-dimer pada preeklampsia lebih tinggi secara bermakna dibandingkan hipertensi gestasional dengan nilai p=0,000.
Kesimpulan: Didapatkan perbedaan bermakna kadar D-dimer pada hipertensi gestasional dan preeklampsia.
Bakcground : D-dimer is degradation product of cross-linked fibrin by plasmin which is one marker of coagulation activation. Gestational hypertension is hypertension occurs after 20 weeks gestation without proteinuria, and preeclampsia is hypertension occurs after 20 weeks gestation accompanied by proteinuria, but when no symptoms proteinuria, there is severe feature of preeclampsia symptoms.Almost half of the cases of gestational hypertension developed into preeclampsia. In preeclampsia occurs hiperkoagulabel and endothelial dysfunction. Endothelial dysfunction results nonthrombogenic be thrombogenic surface, resulting in increased activation of coagulation. The aim of study is to determine the levels of D-dimer in gestational hypertension and preeclampsia.
Methods : A cross sectional study was done on 30 gestational hypertension and 30 preeclampsia from August 2015 to January 2016. D-dimer levels was measured by Innovance D-dimer using Sysmex CS-2100i coagulometer in Departement of Clinical Pathology Dr. Cipto Mangunkusumo Hospital, Jakarta.
Resuts : D-dimer levels in pregnant women with preeclampsia was preeklampsia 2,37 mg/L FEU (1,78 - 5,48 mg/L FEU, D-dimer levels of pregnant women with gestational hypertension 1,43 mg/L FEU (0,88 ? 1,95 mg/L FEU).D-dimer levels in preeclampsia were significantly higher than gestational hypertension with p=0,000.
Conclusion : There were significant differences in the levels of D-dimer in
gestational hypertension and preeclampsia"
Depok: Fakultas Kedokteran Universitas Indonesia, 2016
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Wilia Candra
Gambaran kadar fibrin monomer pada gestational hypertension dan preeklampsia = Description of fibrin monomer levels in gestational hypertension and preeclampsia
"ABSTRAK
Hipertensi merupakan kelainan yang umum dijumpai pada kehamilan.
Sekitar 70% wanita hamil mengalami gestational hypertension dan preeklampsia.
Disfungsi endotel pada preeklampsia menyebabkan permukaan endotel yang
nontrombogenik menjadi trombogenik sehingga dapat terjadi aktivasi koagulasi.
Preeklampsia meningkatkan keadaan hiperkoagulabel yang sudah ada pada
kehamilan normal. Gestational hypertension pada wanita hamil adalah hipertensi
yang tidak memenuhi kriteria preeklampsia. Hampir setengah dari pasien dengan
gestational hypertension akan berkembang menjadi preeklampsia. Fibrin
monomer merupakan petanda aktivasi koagulasi yang digunakan pada keadaan
pretrombotik oleh karena terbentuk terlebih dahulu pada keadaan hiperkoagulabel
daripada D-dimer yang terbentuk setelah fibrinolisis. Tujuan penelitian adalah
mendapatkan gambaran fibrin monomer pada gestational hypertension dan
preeklampsia. Penelitian ini adalah penelitian potong lintang pada 30 wanita
hamil gestational hypertension dan 30 wanita hamil preeklampsia yang dilakukan
pada Oktober sampai November 2015. Pemeriksaan FM menggunakan reagen
STA-Liatest memakai koagulometer STA Compact Analyzer. Kadar fibrin
monomer pada gestational hypertension didapatkan mean 4,61 µg/mL dengan
standar deviasi 0,86 µg/mL. Kadar fibrin monomer pada preeklampsia didapatkan
median 10,5 µg/mL dengan mean 11.99 µg/mL dan rentang 6,12 ? 23,26 µg/mL.
Didapatkan perbedaan bermakna kadar fibrin monomer pada gestational
hypertension dan preeklampsia dengan nilai p<0,001.
ABSTRACT
Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
"
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Riene Agustine
Perbandingan kadar D-dimer urin pada pasien hamil normotensif, preeklampsia berat dengan oligouria dan preeklampsia berat non-oligouria di RSCM = Urine D-dimer level on normotensive severe features preeclampsia with and without oliguria in Dr. Cipto Mangunkusumo National General Hospital / Riene Agustine
"ABSTRAK
Latar Belakang: Angka kematian ibu yang diakibatkan oleh kasus preeklampsia bervariasi antara 4-16 . Salah satu komplikasi yang diakibatkan oleh preeklampsia adalah Acute Kidney Injury AKI , berkaitan dengan peningkatan produksi thrombus yang berhubungan dengan peningkatan produksi D-dimer di urin. Pada studi 2013 menunjukkan bahwa D-dimer urin merupakan alat diagnostik yang baik untuk menilai adanya penumpukan fibrin pada endotel glomerulus pada pasien preklampsia dengan AKI.Tujuan: Penelitian ini bertujuan melihat perbandingan kadar D-dimer urin pada wanita hamil normotensif, preeklampsia berat disertai oligouria dan non oligouria sehingga dapat dijadikan pilihan pemeriksaan awal preventif lain terhadap komplikasi AKI. . Metode: Penelitian potong lintang dilakukan sejak September 2016 sampai Januari 2017 di Instalasi Gawat Darurat, Poliklinik, Instalasi Rawat Inap Departemen Obstetri dan Ginekologi, RSCM. Sebanyak 140 pasien hamil yang telah memenuhi syarat dan ditawarkan untuk ikut penelitian untuk diperiksa kadar D-dimer darah dan urinnya. Subyek penelitian diambil dengan metode consecutive sampling, kemudian dibagi menjadi 3 kelompok yaitu hamil dengan normotensi 45 subyek , pasien hamil dengan PEB tanpa oligouria 44 subyek , dan pasien hamil dengan oligouria 51 subjek . Kadar D-dimer diperiksa dengan menggunakan Abcam Human D-dimer ELISA. Penelitian ini telah disetuji oleh Komite Etik dan Penelitian di tahun 2016.Hasil: Terdapat perbedaan kadar D-dimer urin antara ketiga kelompok p 0,013 dan secara spesifik perbedaan terletak antara kelompok normotensi dibandingkan dengan PEB tanpa oligouria p 0,005 , tidak terdapat perbedaan bermakna antara PEB non oligouria dibandingkan PEB oligouria p 0,019 . Nilai diagnostik D-dimer urin dalam mendeteksi AKI pada PEB dengan sensitivitas 78 dan spesifisitas 55 memiliki nilai AU 0,407 40,7 dengan titik potong > 308,45 ng/dL. Hal ini menunjukkan bahwa meningkatnya kadar D-dimer urin tidak secara signifikan mendiagnosis AKI.Kesimpulan: Kadar D- dimer urin tidak berbeda bermakna pada kelompok pasien PEB dengan oligouria maupun tanpa oligouria.Kata Kunci: Preeklampsia Berat, Kadar D-dimer urin, Acute Kidney Injury.
ABSTRACT
Introduction Maternal mortality rate MMR caused by preeclampsia was ranged between 4 and 16 . One of the complication of preeclampsia is acute kidney injury AKI which is related to increase of thrombus formation that correlates with the production of D dimer level in urine. This aim of study is to determine urine D dimer level in normotensive, severe preeclampsia with oliguria and non oliguric patients.Methods This was a cross sectional study from September 2016 to January 2017 to patients in Obstetric Emergency Unit, Policlinic, ward and ICU, Obstetrics and Gynecology Department Dr. Cipto Mangunkusumo Hospital. There were 140 subjects of pregnant women fulfilled the subject rsquo s criteria included in the study. They were divided into 3 groups including pregnant normotensive 45 subjects , severe features of preeclampsia with oliguria 44 subjects , and no oliguric 51 subjects . Research was approved by Ethics Committee for Health Researches in 2016.Results Urine D dimer levels were different between each group p 0.013 and specific difference were found between normotensive group and no oliguric severe preeclampsia p 0.005 . No difference were found between group of no oliguric and oliguric severe preeclampsia p 0.119 . Urine D dimer provided 78 of sensitivity and 55 of specificity to support the diagnosis of acute kidney injury in severe preeclampsia, with cut off level 308.45 ng dL however, AUC of urine D dimer was 0.407 40.7 . High level of urine D dimer could not specifically diagnose AKI.Conclusion Urine D dimer level cannot differ between severe features of preeclampsia patient with oliguria and no oliguria.Keywords Severe features preeclampsia, Urine D dimer, Acute Kidney Injury."
2017
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UI - Tesis Membership  Universitas Indonesia Library
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Krisadelfa Sutanto
Stres oksidatif pada preeklampsia dan non preeklampsia kajian pada kadar vitamin e dan mda serum = Oxidative stress in preeclampsia and non preeclampsia study on levels of serum vitamin e and mda
"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.
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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tesis Membership  Universitas Indonesia Library
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Nissa Thoyyiba Oktavia
Analisis proses pensinyalan tgf-beta/smad2 dan hubungannya dengan ekspresi relatif mrna trombospondin-1 tsp-1 pada plasenta preeklampsia = Analysis of tgf-beta/smad2 signaling process and its relation with relative expression of trombospondin-1 tsp-1 mrna in preeclampsia placenta
"Salah satu penyebab tingginya angka kematian ibu di Indonesia adalah adanya hipertensi pada kehamilan yang disebabkan oleh preeklampsia. Hingga saat ini, penyebab preeklampsia masih belum diketahui secara pasti, namun teori yang berkembang menyebutkan adanya iskemia plasenta. Iskemia plasenta disebabkan adanya kegagalan pada proses angiogenesis. Penelitian yang menggunakan desain potong lintang ini bertujuan untuk melihat perbedaan protein yang mempengaruhi proses angiogenesis pada plasenta normal dan preeklampsia serta melihat interaksinya. Sampel yang digunakan adalah 34 plasenta kehamilan normal dan 34 plasenta kehamilan preeklampsia. Kadar protein TGF- , TGF- Reseptor dan SMAD2 diperiksa menggunakan metode ELISA dan ekspresi relatif mRNA SMAD2 dan TSP-1 diperiksa menggunakan metode RT-qPCR.Kadar protein TGF- , TGF- Reseptor 1, TGF- Reseptor 2 dan protein SMAD2 meningkat pada preeklampsia p=0,0001, p=0,004, p=0,0001, p=0,0001 . Ekspresi mRNA SMAD2 dan TSP-1 pada preeklampsia juga mengalami peningkatan p=0,033, p=0,002 . Didapatkan korelasi positif kuat antara kadar protein TGF- Reseptor 1 dan TGF- Reseptor 2 pada plasenta normal p=0,0001 R=0,799 dan preeklampsia p=0,0001 R=0,783 . Korelasi positif sedang pada korelasi TGF- dan protein SMAD2 pada plasenta normal p=0,0001 R=0,672 dan korelasi positif ringan pada plasenta preeklampsia p=0,028 R=0,331 . Ada korelasi positif kuat antara TGF- Reseptor 1 dan protein SMAD2 0,0001 R=0,704 pada plasenta normal dan korelasi positif sedang pada plasenta preeklampsia p=0,0001 R=0,675 . Pada korelasi antara TGF- Reseptor 2 dengan protein SMAD2 plasenta normal diperoleh korelasi sedang p=0,0001 R=0,650 begitu juga pada plasenta preeklampsia 0,0001 R=0,675 . Kemudian pada uji korelasi antara protein TGF- dengan mRNA SMAD2 diperoleh korelasi positif ringan pada plasenta normal p=0,022 R=0,347 dan tidak ada korelasi pada plasenta preeklampsia. Pada uji korelasi antara protein TGF- Reseptor 1 dengan mRNA SMAD2 diperoleh korelasi positif ringan pada plasenta normal p=0,016 R=0,370 dan tidak ada korelasi pada plasenta preeklampsia. Tidak ditemukan korelasi antara TGF- Reseptor 2 dengan mRNA SMAD2 pada kedua kelompok. Kemudian tidak ditemukan korelasi protein SMAD2 dengan mRNA TSP-1 pada plasenta normal namun terdapat korelasi positif kuat pada plasenta preeklampsia p=0,0001 R=0,774 . Dari penelitian ini disimpulkan bahwa ada pengaruh peningkatan kadar TGF- , TGF- Reseptor, dan protein SMAD2 dengan ekspresi relatif TSP-1 pada proses angiogenesis.
One of the causes of high maternal mortality in Indonesia is the presence of hypertension in pregnancy caused by preeclampsia. Until now, the cause of preeclampsia is still not known, but the theory suggests the presence of placental ischemia. Placental ischemia is caused by failure of angiogenesis. This cross sectional study aims to examine the differences in proteins that affect angiogenesis in normal placenta and preeclampsia and see their interactions. The sample used was 34 placentas of normal pregnancy and 34 placental preeclampsia pregnancy. TGF protein levels, TGF receptors and SMAD2 were examined using the ELISA method and the relative expression of SMAD2 and TSP 1 mRNA was examined using the RT qPCR method.Levels of TGF protein, TGF Receptor 1, TGF Receptor 2 and protein SMAD2 increased in preeclampsia p 0.0001, p 0.004, p 0.0001, p 0.0001 . SMAD2 and TSP 1 mRNA expression in preeclampsia also increased p 0.033, p 0.002 . There was a strong positive correlation between protein content of TGF receptor 1 and TGF receptor 2 in normal placenta p 0.0001 R 0,799 and preeclampsia p 0.0001 R 0,783 . Moderate positive correlations in TGF and SMAD2 protein correla tion on normal placenta p 0.0001 R 0.672 and mild positive correlation of placenta preeclampsia p 0.028 R 0.331 . There was a strong positive correlation between TGF receptor 1 and the SMAD2 protein 0.0001 R 0.704 in normal placenta and moderately positive correlation in the preeclampsia placenta p 0.0001 R 0.675 . In the correlation between TGF Receptor 2 with normal placental SMAD2 protein obtained moderate correlation p 0.0001 R 0.650 as well as on preeclampsia placenta 0.0001 R 0.675 . Then the correlation test between TGF protein and SMAD2 mRNA obtained a mild positive correlation on normal placenta p 0,022 R 0,347 and no correlation on placenta preeclampsia. In the correlation test between TGF protein Receptor 1 and SMAD2 mRNA obtained a mild positive correlation on normal placenta p 0.016 R 0.370 and no correlation in placenta preeclampsia. No correlation was found between TGF receptor 2 and SMAD2 mRNA in both groups. Then there was no correlation of SMAD2 protein with TSP 1 mRNA in normal placenta but there was a strong positive correlation in placenta preeclampsia p 0.0001 R 0.774 . From this study it was concluded that there was an effect of increased levels of TGF , TGF receptor, and SMAD2 protein with relative expression of TSP 1 in angiogenesis process."
2018
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UI - Tesis Membership  Universitas Indonesia Library
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Panjaitan, Bintang
Perbandingan kadar magnesium serum pada preeklampsia dan kehamilan normal = Comparison between serum magnesium level in preeclampsia and normal pregnancy
"Tujuan penelitian cross sectional comparative ini adalah diketahuinya perbandingan antara kadar magnesium serum pada preeklampsia dan kehamilan normal. Pengumpulan data dilakukan di Poliklinik Obstetri dan Ginekologi dan Ruang Bersalin Rumah Sakit Umum Daerah (RSUD) Tarakan pada bulan Oktober sampai November 2013. Sebanyak 46 orang ibu hamil yang terdiri dari 23 orang dengan preeklampsia dan 23 orang dengan kehamilan normal yang memenuhi kriteria inklusi menyatakan kesediaannya mengikuti penelitian ini. Data diperoleh dari wawancara, pengukuran tekanan darah dan lingkar lengan atas, evaluasi asupan magnesium dengan metode FFQ semikuantitatif dan pemeriksaan kadar magnesium serum. Analisa statistik menggunakan uji t-test dan Mann Whitney. Uji karakteristik usia, usia kehamilan, paritas, pendidikan dan status gizi kedua kelompok homogen. Tidak ditemukan perbedaan rerata kadar magnesium serum pada preeklampsia (1,98 0,26 mg/dL) dengan kehamilan normal (1,89 0,21 mg/dL). Rerata asupan magnesium pada preeklampsia lebih rendah 233,6 (190,1;319,3) mg dibandingkan dengan kehamilan normal 380,1 (229,8;444,2) mg dengan p=0,024.
Kesimpulan: tidak didapatkan perbedaan yang bermakna antara kadar magnesium serum pada preeklampsia dengan kehamilan normal sementara asupan magnesium pada preeklampsia lebih rendah bermakna dibandingkan dengan kehamilan normal.
The aim of this cross sectional comparative study was to analyze serum level of magnesium in preeclamptic pregnancies and to compare them with those in normal pregnancies. The data was collected at RSUD Tarakan on October 2013. Out of 23 women with preeclampsia and 23 women with normal pregnancies that meet our inclusion criteria given their consents to join the study. Data collated including interviews, blood pressure and mid upper arm circumference (MUAC) measurement and intake of magnesium by semiquantitative FFQ method. Statistical analysis performed by t-test and Mann Whitney. The result of the characteristic test in two groups of study shows that both groups are homogenic. There was no different between magnesium serum level in women with preeclampsia (1.98±0.26 mg/dL) and normal pregnancy (1.89±0.21 mg/dL) While the mean daily intake of magnesium is significantly lower in preeclampsia 233.6 (190.1;319.3) mg than in normal pregnancy 380.1 (229.8;444.2) mg.
Conclusion: there was no significant different between serum magnesium level in women with preeclampsia dan normal pregnancy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tesis Membership  Universitas Indonesia Library
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Achmad Feryanto
Perbandingan Kadar Delta Hemoglobin Darah Perifer Pasien Preeklampsia dengan Kehamilan Normal dan Korelasinya dengan Kadar Omega-3 Eritrosit Dan Rasio Serum Soluble Fms-Like Tyrosine Kinase 1/Placental Growth Factor = Comparison of Delta Hemoglobin Levels in Peripheral Blood of Preeclampsia Patients with Normal Pregnancies and Correlation with Erythrocyte Omega-3 Levels and Serum Soluble Fms-Like Tyrosine Kinase 1/Placental Growth Factor Ratio
"Latar Belakang: Preeklamsia, yang menyerang sekitar 5%-7% wanita hamil dengan tekanan darah tinggi, proteinuria, dan risiko kerusakan organ, merupakan bidang medis kompleks yang masih perlu banyak dipelajari. Pada preeklamsia dimana terjadi inflamasi secara sistemik, kemungkinan terjadi perubahan kadar Delta Hemoglobin.
Tujuan: Penelitian ini bertujuan untuk memahami perubahan kadar Delta Hemoglobin sebagai indikator inflamasi pada preeklampsia dan korelasinya dengan Omega-3 serta rasio sFLT-1/PlGF dalam serum pasien.
Metode: Dengan menggunakan metode pengambilan sampel konsekutif, penelitian cross-sectional ini mencakup analisis korelatif dan komparatif pada dua kelompok tidak berpasangan: pasien hamil dengan preeklampsia dan kehamilan normal.
Hasil: Hasil penelitian menunjukkan kadar Delta Hemoglobin pada preeklampsia lebih tinggi dibandingkan kelompok normal, sedangkan kadar total omega-3, EPA, DHA, dan ALA lebih rendah pada preeklamsia tanpa adanya korelasi yang signifikan antara Delta Hemoglobin dan Omega-3. Preeklampsia dikaitkan dengan tingkat sFLT-1, PlGF, dan rasio sFLT-1/PlGF yang lebih tinggi bila dibandingkan dengan kelompok normal. Terdapat juga korelasi positif lemah yang ditemukan antara rasio sFLT-1/PlGF dan delta hemoglobin. Selain itu, terdapat korelasi positif sedang dan korelasi negatif sedang antara EPA dan rasio sFLT-1/PlGF.
Kesimpulan: Terdapat variasi nilai kadar Delta Hemoglobin dan parameter lainnya antara kelompok preeklampsia dan kelompok normal.
Background: Preeclampsia, which affects approximately 5%-7% of pregnant women with high blood pressure, proteinuria, and risk of organ damage, is a complex understudied medical field. In preeclampsia where there is systemic inflammation, there may be changes in Delta Hemoglobin levels.
Objectives: This study aims to understand changes in Delta Hemoglobin levels as an indicator of inflammation in preeclampsia and its correlation with Omega-3 and the sFLT-1/PlGF ratio in patient serum.
Methods: Using the consecutive sampling method, this cross-sectional study includes correlative and comparative analysis in two unpaired groups: pregnant patients with preeclampsia and normal pregnancies.
Results: The results showed that Delta Hemoglobin levels in preeclampsia were higher compared to the normal group, while total omega-3, EPA, DHA, and ALA levels were lower in preeclampsia without a significant correlation between Delta Hemoglobin and Omega-3. Preeclampsia was associated with higher levels of sFLT-1, PlGF, and sFLT-1/PlGF ratio compared to the normal group. There was also a weak positive correlation found between the sFLT-1/PlGF ratio and delta hemoglobin. Furthermore, there was a moderate positive correlation and a moderate negative correlation between EPA and the sFLT-1/PlGF ratio, respectively.
Conclusion: there are variations in the Delta Hemoglobin level values and other parameters between the preeclampsia and normal groups."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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Novan Satya Pamungkas
Pengaruh suplementasi superoksida dismutase dari ekstrak melon dan gliadin terhadap Kadar Superoksida Dismutase di Serum dan Plasenta pada Kehamilan Normotensi dan Preeklampsia = The Effect of Superoxide Dismutase Supplementation from Honeydew Extract and Gliadin for Superoxide Dismutase Level in Serum and Placenta of Normal Pregnant Women and Preeclampsia
"Latar Belakang: Kejadian preeklamsia dilaporkan berkisar 5-15% dari seluruh
kehamilan dan terkait erat dengan morbiditas dan mortalitas maternal dan perinatal.
Preeklamsia merupakan penyakit dengan berbagai teori (disease of theory) yang
menggambarkan ketidakpastian patofisiologi dan penyebabnya. Salah satu teori
patogenesis preeklamsia adalah peningkatan stres oksidatif. Stres oksidatif
merupakan ketidakseimbangan jumlah oksidan dan antioksidan dalam tubuh.
Peningkatan radikal bebas pada preeklamsia diduga menyebabkan penurunan
antioksidan endogen seperti superoksida dismutase (SOD) karena banyak antioksidan
tersebut yang terpakai untuk menanggulangi radikal bebas. Mengingat pentingnya
peranan SOD pada patogenesis preeklamsia, maka pemberian suplementasi SOD
diduga dapat memberi manfaat pada preeklamsia maupun kehamilan normal.
Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui perbedaan kadar SOD
pada kehamilan normal dan preeklamsia. Selain itu, penelitian ini juga bertujuan
untuk mengetahui kenaikan kadar SOD pasca pemberian suplementasi SOD pada
kehamilan normal dan preeklamsia.
Metode Penelitian: Penelitian uji klinis ini dilakukan di RSCM, RSAB Harapan
Kita, RSIA Bunda, dan RSIA Brawijaya pada bulan September hingga Desember
2019. Subjek penelitian berasal dari Ibu hamil normotensi dan Ibu hamil preeklamsia
yang akan dilakukan tindakan operasi sesar berencana dalam waktu 2 minggu. Pada
subjek di kelompok uji, akan diberikan suplementasi Glisodin 2 x 250 U selama 14
hari. Dilakukan pengukuran kadar SOD serum pra- dan pasca- suplementasi Glisodin,
SOD plasenta, dan kadar Cu, Mn dan Zn serum. Data selanjutnya diolah dengan
menggunakan uji statistik dengan paket SPSS versi 15. Analisis data berupa analisis
univariat, bivariat dan multivariat.
Hasil Penelitian: Didapatkan 91 subjek penelitian yang terdiri dari 42 Ibu hamil
normotensi dan 49 Ibu hamil dengan preeklamsia. Dari 25 subjek penelitian yang
diberikan suplementasi Glisodin, 15 orang berasal dari kelompok Ibu hamil
normotensi dan 10 orang berasal dari kelompok Ibu hamil preeklamsia. Kadar Zn pada kelompok preeklamsia didapatkan lebih rendah bermakna dibandingkan pada
kelompok normotensi (45 (25,00-110,00) ug/dL vs 52,00 (36,00-88,00) ug/dL, p
0,025). Tidak didapatkan perbedaan bermakna kadar SOD pra- dan pasca
suplementasi pada kelompok normotensi dan preeklamsia. Tidak terdapat
peningkatan bermakna kadar SOD pasca suplementasi , baik pada kelompok
normotensi 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 plasenta
dimana didapatkan kadar SOD plasenta lebih rendah pada kelompok preklamsia
dibandingkan 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 lebih
rendah dibandingkan dengan normotensi. Tidak ada peningkatan bermakna kadar
SOD pasca-suplementasi dengan Glisodin pada kehamilan normotensi dan hipertensi
atau preeklamsia.
Background: Preeclampsia incidence varies between 5-15% from all pregnancy and
related to maternal and perinatal morbidity and mortality. Preeclampsia is a disease of
theory which describe uncertainty in its pathogenesis and pathophysiology. One of
the preeclampsia pathogenesis theory is the increasing oxidative stress level.
Oxidative stress is a condition caused by imbalance between oxidant and anti-oxidant
inside the body. Increased free radicals level in preeclampsia causing further
decreased in endogenous antioxidant level such as superoxide dismutase (SOD)
because antioxidant were used to neutralize free radicals. Given the important role of
SOD in the pathogenesis of preeclampsia, supplementation of SOD is thought to be
beneficial, both in the normal pregnancy and preeclampsia.
Objective: The aim of this study is to determine differences in SOD levels in normal
pregnancy and preeclampsia. This study is also aims to determine the increase in
SOD 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 research
subjects came from normotensive pregnant women and preeclampsia pregnant
women who will undergo planned cesarean operations within 2 weeks. Subjects in
the test group will be given Glisodin 2 x 250 U supplementation for 14 days. Serum
SOD pre-and post-supplementation with Glisodin, placental SOD, and serum Cu, Mn
and Zn levels were measured. Data were then processed using statistical tests with
SPSS package version 15. Data analysis was in the form of univariate, bivariate and
multivariate analyzes.
Results: There were 91 research subjects consisting of 42 normotensive pregnant
women and 49 pregnant women with preeclampsia. Of the 25 study subjects who
were given Glisodin supplementation, 15 were from the group of normotensive
pregnant women and 10 were from the group of preeclampsia. The level of Zn in the
preeclampsia 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 no
significant differences in pre- and post-supplementation SOD levels in the normotensive and preeclampsia groups. There was no significant increase in SOD
levels 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 difference
found was placental SOD levels in which placenta SOD levels were lower in the
preeclampsia 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 preeclampsia
are lower than normotensive. There was no significant increase in post-Glisodin
supplementation SOD levels in normotensive and hypertensive or preeclampsia
pregnancy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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Sri Bekti Subakir
Kadar MDA dan HSP 70 pada plasenta penderita preeklampsia
"Objektif. Preeklampsia adalah penyakit pada kehamilan ditandai dengan hipertensi dan proteinuria. Di Indonesia, preelampsia/eklampsia merupakan penyebab utama mortalitas dan morbiditas ibu dan anak. Stress oksidatif pada plasenta dan sistem sirkulasi menyebabkan disfungsi dan kerusakan sel endotel. Stres oksidatif di plasenta menyebabkan gangguan pertumbuhan janin. HSP70 adalah molekul protein yang sangat penting untuk penyembuhan sel dan menjaga homeostasis. Tujuan penelitian untuk membandingkan kadar MDA dan HSP70 yang diproduksi di plasenta pada kehamilan dengan preeklampsia berat, ringan dan kehamilan normal. Plasenta didonorkan secara sukarela dari ibu2 yang melahirkan dengan preeklampsia ringan (N=10), preeklampsia berat (N=10) dan kehamilan normal (N=10). Plasenta dikultur dengan RPMI dan FBS 20%, pada hari ke 3, supernatant diambil. Diperiksa kadar Malondealdehida (MDA), petanda untuk stres oksidatif dan kadar HSP70. Kadar MDA diukur dengan spektrofotometer pada panjang gelombang 530nm. Kadar HSP 70 diukur dengan metoda enzyme-linked immunosorbent assay. Kadar rata2 MDA pada preeklampsia berat (7,13+5,36 nmol/ml), preeklampsia ringan (4,82+2,47 nmol/ml) dan hamil normal (4,87+2,4 nmol/ml). Kadar MDA pada preeklampsia berat paling tinggi, tetapi perbedaan tersebut tidak berbeda bermakna. Kadar rata2 HSP70 pada preeklampsia ringan tertinggi (10,15+12,39 nmo/ml) dibandingkan dengan kadarnya pada preeklampsia berat (3,78 +3,07 nmol/ml) dan kehamilan normal (3,76+4,65nmol/ml), namun perbedaan ini tidak berbeda bermakna. Walaupun demikian, kadar HSP sangat tinggi pada preeklampsia ringan menunjukkan respons homeostasis relatif tinggi. Hal ini tidak ditunjukkan pada preeklampsia berat. Kadar rata2 MDA dan HSP70 pada preeklampsia berat, ringan maupun hamil normal tidak berbeda bermakna. Kadar HSP yang sangat tinggi pada preeklampsia ringan menunjukkan respons homeostasis masih tinggi.
Objective: Preeclampsia is a disease in pregnancy and characterized by hypertension and proteinuria. Preeclampsia and eclampsia are the most causes of maternal and fetal mortality and morbidity in Indonesia. Placental and systemic oxidative stress caused endothelial cell dysfunction and injury. Placental oxidative stress also linked to fetal growth restriction. HSP70 is essential for cellular recovery, survival and maintenance of homeostasis. The purpose of this study was to compare the MDA, a marker for oxidative stress and HSP70 production in placental of severe preeclampsia, mild preeclampsia and normotensive pregnant women. Placenta were collected after delivery from normotensive pregnancies (N=10), severe preeclampsia (N=10) and mild preeclampsia (N=10). Placenta was cultured in RPMI and 20% FBS, and supernatant were collected in day 3. MDA was measured using spectrophotometer and absorbance read in 530nm. HSP70 was measured using enzyme-linked immunosorbent assay. The mean MDA concentration did not differ significantly between patients with severe preeclampsia (7.13+5.36 nmol/ml) and mild preeclampsia (4.82+2.47 nmol/ml) when compared with normotensive pregnancies (4.57+2.4 nmol/ml). The mean HSP70 concentration in mild preeclampsia is highest (10.15+12.39 nmo/ml) when compared with severe preeclampsia (3.78 +3.07 nmol/ml) and normotensive pregnant women (3.76+4.65nmol/ml), but the difference was not significant. Although the difference was not significant, is indicates homeostasis response in mild preclampsia women is relative good. This response was abated in severe preeclampstic women. Although MDA and HSP70 concentration did not differ significantly between groups, however the high HSP70 concentration is indicates homeostasis response relatively good in mild preeclamptic women."
Fakultas Kedokteran Universitas Indonesia, 2008
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Danny Maesadatu Syaharutsa
Penilaian faktor maternal dan biofisik pada ibu hamil terhadap kejadian preeklampsia = Prediction of preeclampsia in pregnant women from maternal and biophysical factors.
"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.
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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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