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"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."

"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%."

"Preeklamsia dibagi menjadi preeklamsia awitan dini (PEAD) jika terjadi pada usia kehamilan < 34 minggu dan preeklamsia awitan lanjut (PEAL) pada kehamilan > 34 minggu. Intoleransi imun diduga menyebabkan penolakan imun terhadap fetus di plasenta. Dendritic cell 10 (DC-10) dan sel T regulator CD4+CD25+FoxP3 (Treg) di desidua berperan penting dalam menciptakan lingkungan yang tolerogenik selama kehamilan. Namun, peran spesifik dalam patomekanisme PEAD dan PEAL serta faktor-faktor nutrisi yang berperan dalam regulasi DC-10 dan Treg, yaitu seng, vitamin A, dan vitamin D belum diteliti secara jelas. Penelitian ini bertujuan untuk memahami patomekanisme penolakan imun pada preeklamsia melalui jumlah DC-10 dan sel Treg desidua serta hubungannya dengan vitamin A, vitamin D, dan seng.Desain penelitian ini adalah studi potong lintang komparatif antara kehamilan dengan PEAD, PEAL, dan NT antara Oktober 2019 dan Desember 2021. Subjek penelitian direkrut dari RSUP Fatmawati (Jakarta), RSUPN Cipto Mangunkusumo (Jakarta), dan RSUD Karawang (Jawa Barat). Kriteria penerimaan adalah semua ibu hamil 20–40 minggu yang menjalani persalinan dengan seksio sesaria dan setuju untuk dilibatkan dalam penelitian. Kriteria penolakan meliputi pasien dengan penyulit obstetrik, plasenta previa, memiliki riwayat penyakit kronik, hipertensi sebelum kehamilan 20 minggu, terdiagnosis COVID-19, demam dan leukosit >15.000 /mL pada saat pemeriksaan dan kematian janin dalam rahim. Spesimen desidua diperoleh dengan kuretase tajam setelah seksio sesaria. Jumlah DC-10 dan sel Treg dihitung dengan flow cytometry. Konsentrasi faktor nutrisi diperiksa dengan metode ICP-MS dan LC-MS. Perbandingan median dianalisis dengan uji Kruskal-Wallis, sedangkan koefisien korelasi diperoleh dengan uji korelasi Spearman. Subjek penelitian adalah 14 ibu hamil untuk setiap kelompok (total 42 kasus). Jumlah DC-10 lebih rendah secara bermakna pada PEAD dibandingkan NT (p < 0,001) dan lebih rendah secara bermakna pada PEAL dibandingkan NT (p = 0,015). Sebaliknya, sel Treg FoxP3+CD25+ lebih tinggi secara bermakna pada PEAD dibandingkan NT (p = 0,015). Tidak terdapat korelasi antara faktor nutrisi dan jumlah faktor tolerogenik pada kelompok preeklamsia (PE). Namun, terdapat korelasi sedang antara konsentrasi seng desidua dan DC-10 di kelompok NT (r = 0,656; p = 0,011) dan korelasi kuat antara konsentrasi retinol desidua dan DC-10 juga di kelompok NT (r = 0,746; p = 0,002). Korelasi sedang didapatkan antara konsentrasi vitamin D dan jumlah sel Treg FoxP3+CD25+ di kelompok NT (r = 0,590; p = 0,026). Disimpulkan bahwa jumlah DC-10 pada PEAD lebih rendah dibandingkan dengan kehamilan NT, sedangkan jumlah sel Treg pada PEAD secara bermakna lebih tinggi dibandingkan dengan kehamilan NT. Konsentrasi faktor nutrisi desidua tidak berkorelasi dengan jumlah DC-10 atau Treg desidua pada preeklamsia (PEAD dan PEAL). Namun, pada kelompok NT terdapat korelasi positif antara seng dan DC-10, retinol dan DC-10, serta vitamin D dan jumlah sel Treg desidua.

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Preeclampsia is categorized as early-onset preeclampsia (EOPE) at < 34 week of gestation and late-onset preeclampsia (LOPE) at > 34 week of gestation. Immune intolerance is thought to be the underlying cause of immune rejection to the fetus in the placenta. Decidual dendritic cell-10 (DC-10) and T regulator cell CD4+CD25+FoxP3 (Treg) play important role to create a tolerogenic environment during pregnancy. However, the specific role in the pathomechanism of EOPE or LOPE and nutritional factors that play role in the regulation of DC-10 and Treg, i.e. zinc, vitamin A, and vitamin D have not been widely studied. This study was aimed to know the pathomechanism of immune rejection in preeclampsia through the number of decidual DC-10 and Treg cell and their correlations with vitamin A, vitamin D, and zinc.

The study design was cross-sectional comparative among EOPE, LOPE, and NT pregnancies between October 2019 and December 2021. Study subjects were recruited from Fatmawati General Hospital (Jakarta), Cipto Mangukusumo National General Hospital (Jakarta), and Karawang Regional Public Hospital (West Java). Inclusion criteria were all pregnant women between 20–40 weeks of gestation who underwent cesarean delivery and gave their written consent to be included in the study. Exclusion critera were patients with obstetric complications, placenta previa, history of chronic disease, hypertension before 20 weeks of gestation, was diagnosed with COVID-19, fever and leukocyte count of >15.000 /mL at the time of examination and presence of intrauterine fetal death. Decidual specimens were obtained by curettage after the cesarian section. The number of DC-10 and Treg cells were counted using flow cytometry. Concentrations of nutritional factors were assayed using ICP-MS and LC-MS method. Median comparison among groups was analyzed using Kruskal-Wallis test, while correlation coefficient was obtained by using the Spearman correlation test. Study subjects were 14 pregnant women for each group (42 cases in total). The DC-10 was significantly lower in EOPE compared to NT (p < 0.001) and significantly lower in LOPE compared to NT (p = 0.015). On the other hand, Treg FoxP3+CD25+ cells were significantly higher in EOPE compare to NT (p = 0.015). No correlation between nutritional factors and the number of tolerogenic factors in the preeclampsia group. However, there was a moderate correlation between decidual zinc concentration and DC-10 in the NT group (r = 0.656; p = 0.011) and a strong correlation between decidual retinol concentration and DC-10 also in NT group (r = 0.746; p= 0.002). A moderate correlation was found between vitamin D concentration and Treg FoxP3+CD25+ cells in the NT group (r = 0.590; p = 0.026). To conclude, the number of DC-10 in EOPE is lower than NT pregnancy, whereas the number of Treg cells in EOPE is higher than NT pregnancy. Concentrations of dedicual nutritional factors do not correlate with the number of decidual DC-10 or Treg cells in preeclampsia (EOPE and LOPE). However, in NT group, there is positive correlation between decidual zinc and DC-10, retinol and DC-10, and vitamin D and Treg cells."

"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."

"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."

"Ketidakseimbangan trace elemen dan asam lemak berperan dalam terjadinya preeklamsia. Penelitian ini bertujuan untuk mengetahui status trace elemen serum dan eritrosit serta asam lemak pada preeklamsia berat. Desain potong lintang dilakukan pada 40 ibu hamil dalam 2 kelompok, preeklamsia berat dan normotensi. Pengukuran trace elemen dan asam lemak dalam serum dan eritrosit dilakukan dengan menggunakan Inductively Coupled Plasma and Gas Chromatography Mass Spectrometry. Receiver Operating Characteristic (ROC), analisis bivariat dan multivariat dilakukan. Trace elemen yang ditemukan berbeda nyata baik dalam serum maupun dalam eritrosit adalah selenium, besi, cadmium dan timbal (p<0,05). Hampir semua asam lemak eritrosit, ALA, EPA, DHA, omega-3, LA, GLA, DGLA, AA, omega-6 dan asam oleat ditemukan berbeda bermakna. Nilai tertinggi prediksi preeklamsia berat dengan AUC 0,77(IK95%:0,625-0,912) dan sensitifitas 90% serta spesifitas 50% terdapat pada ALA dengan cut off 0,16 amol/RBC yang mewakili asam lemak omega3 dan untuk golongan omega6 terdapat pada LA dengan cut off 54,25 amol/RBC (sensitifitas 85%; spesifitas 75%). Peningkatan risiko preeklamsia tertinggi terdapat pada EPA yang rendah(OR 14,53; IK95% 2,21-95,41) dan AA yang tinggi(OR 7,37; IK95% 1,37-39,7). Pengukuran trace elemen dan asam lemak diperlukan untuk menentukan status nutrisi dan terutama sebagai prediktor preeklamsia. Pengukuran asam lemak pada eritrosit dinilai lebih baik dibandingkan serum.

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Imbalance of trace elements and fatty acids plays a role in the occurrence of preeclampsia. The aim of the study was to determine the status of serum and erythrocyte trace elements and fatty acids in severe preeclampsia. Cross-sectional design was performed on 40 pregnant women in 2 groups, severe preeclampsia and normotensive. Measurement of trace elements and fatty acids in serum and erythrocyte was performed using Inductively Coupled Plasma and Gas Chromatography Mass Spectrometry. Receiver Operating Characteristic (ROC), bivariate and multivariate analysis were performed. Trace elements found to be significantly different both in serum and in erythrocyte were Selenium, Iron, Cadmium and Lead (p<0.05). Almost all erythrocyte fatty acids, ALA, EPA, DHA, omega-3, LA, GLA, DGLA, AA, omega-6 and oleic were found to be significantly different. The highest predictive value of severe preeclampsia with an AUC of 0.77(95% CI: 0.625-0.912); a sensitivity of 90% and specificity of 50% was found in ALA with a cut off of 0.16 amol/RBC representing omega3 fatty acids and for the omega6 group in LA with a cut off of 54.25 amol/RBC (85% sensitivity; 75% specificity). The highest increased risk of preeclampsia was found in low EPA (OR 14.53; 95% CI 2.21-95.41) and high AA (OR 7.37; 95% CI 1.37-39.7). Measurement of trace elements and fatty acids is needed to determine nutritional status especially as a predictor of preeclampsia. Erythrocyte fatty acids measurement is considered better than serum. "

"Tujuan: Mengetahui hubungan derajat proteinuri berdasarkan uji carik celup pada kasus preeklamsi berat dengan kejadian asfiksi neonatorum.Metode: Penelitian ini menggunakan metode potong lintang pada rekam medis pasien preeklamsi berat di RSCM selama tahun 2008.Hasil: Dari 171 kasus preklamsia berat yang terdapat di rumah sakit Cipto Mangunkusumo pada tahun 2008, hanya 168 kasus yang digunakan dalam penelitian ini sebab 3 kasus dieksklusi karena data tidak lengkap. Hubungan derajat proteinuria dengan terjadinya asfiksia atau tidak, diuji dengan menggunakan uji Chi-Square dengan nilai p 0,000 yang berarti berdasarkan analisa statistik terdapat hubungan bermakna antara derajat proteinuri terhadap terjadinya asfiksi. Penelitian dilanjutkan dengan mengunakan uji Chi-Square dengan nilai p 0,018 yang berarti bahwa terdapat hubungan bermakna antara derajat proteinuri dengan derajat asfiksi. Dari total 168 kasus preeklamsi berat, terdapat 41,1% bayi yang mengalami asfiksi dengan satu kasus kematian neonatal dini yang terjadi pada bayi dengan asfiksi berat.Kesimpulan: Terdapat hubungan bermakna antara derajat proteinuri berdasarkan uji carik celup pada kasus preeklamsi berat dengan derajat asfiksi pada neonatus.

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Objective : To know the relationship of proteinuri level based on dipstick test of severe preeclamsia cases with outcome of asphyxia neonatorum.

Method : The design of this research is cross-sectional study in the Cipto Mangunkusumo Hospital during 2008.

Result : From 171cases of severe preeclamsia in the Cipto Mangunkusumo Hospital on 2008, only 168 cases can be used for this research because 3 cases are have no complete data. The relationship between level of proteinuri and asphyxia occurrence is examined based on Chi-Square with the p=0,000. So there is the correlation between proteinuri level and median Apgar score. The relationship between level of proteinuri and level of asphyxia is examined based on Chi-Square with the p=0,018. So there is the relationship between proteinuri level and asphyxia level. From 168 cases of severe preeclamsia, there are 41,1% neonates with asphyxia.

Conclusion : There is relationship between proteinuri level based on dipstick test of severe preeclamsia and the level of asphyxia of neonates."

"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.

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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."

"Latar belakang: Preeklamsia dengan gejala berat adalah salah satu penyakit hipertensi ibu hamil. Penyakit ini meningkatkan kejadian komplikasi dan kematian maternal dan neonatus. Banyak karakteristik ibu hamil yang diasosiasikan sebagai faktor risiko preeklamsia berat, diantaranya adalah paritas. Tujuan penelitian ini adalah mengetahui hubungan antara paritas dan kejadian preeklamsia berat pada ibu hamil. Metode: Studi potong lintang ini dilakukan pada Rumah Sakit Cipto Mangunkusumo (RSCM) dengan menggunakan data yang diambil dari laporan jaga Departemen Obstetri dan Ginekologi tahun 2019 dengan metode consecutive sampling. Populasi yang digunakan adalah ibu hamil yang melahirkan di RSCM tahun 2019. Analisis bivariat yang digunakan adalah uji Chi-square dengan nilai kemaknaan p<0,05. Hasil: Dari 108 ibu hamil diinklusikan sebagian besar adalah warga DKI Jakarta, tidak bekerja, berusia 20-35 tahun, berstatus paritas nulipara, dan berusia kehamilan ≥37 minggu. Uji bivariat menunjukkan hubungan bermakna antara paritas dan kejadian preeklamsia dengan gejala berat (p = 0,045). Setiap paritas mempunyai efek yang berbeda-beda terhadap kejadian preeklamsia berat, odds ratio yang didapat adalah sebagai berikut: nulipara (OR 0,47; 95%CI 0,22-1,02), primipara (OR 0,91; 95%CI 0,39-2,13), dan multipara (OR 2,94; 95%CI 1,19-7,26). Kesimpulan: Terdapat hubungan antara paritas dan kejadian preeklamsia dengan gejala berat. Multiparitas merupakan satu-satunya paritas yang menjadi faktor risiko preeklamsia berat.

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Background: Preeclampsia with severe features is one of hypertension disorders of pregnancy. It can increase maternal and neonate complication as well as their mortality rate. There are many maternal characteristics that can be considered as risk factors of preeclampsia with severe features, parity being one of it. Therefore, this study aims to determine the association between parity and preeclampsia with severe features incidence in pregnant women. Methods: This cross-sectional study was conducted in Rumah Sakit Cipto Mangunkusumo (RSCM) using data collected consecutively from morning conference report of Obstetrics and Gynecology Department, 2019. The case population is pregnant women who gave birth at RSCM in 2019. The association of parity and severe preeclampsia incidence was analyzed using Chi-square test (degree of confidence 95%). Results: From 108 pregnant women included in this study, majority of the patients belong to these characteristics: located in DKI Jakarta, aged 20-35 years old, nullipara, and have gestational age ≥37 weeks. The Chi-square test showed that parity has significant association with preeclampsia with severe features (p = 0,029). Each parity category showcased different odds ratios, meaning they have different effect towards preeclampsia with severe features incidence. Said odds ratios are as followed: nullipara (OR 0,47; 95%CI 0,22-1,02), primipara (OR 0,91; 95%CI 0,39-2,13), and multipara (OR 2,94; 95%CI 1,19-7,26). Conclusion: There is a significant association between parity and preeclampsia with severe features incidence. Multiparity is the only parity that becomes the risk factor of severe preeclampsia."