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"ABSTRAKPreeklampsia merupakan sindrom sistemik yang terjadi pada 3-5 % kehamilan wanita yang disebabkan oleh gangguan faktor migrasi dan faktor seluler  yang berdampak pada gangguan diferensiasi dan invasi trofoblas yang penting dalam proses perkembangan plasenta dan mempertahankan kehamilan. Protein Cullin-1 merupakan salah satu kandidat protein yang berperan dalam proses mempertahankan kehamilan, perkembangan dan invasi trofoblas di dalam  plasenta. Hingga saaat ini belum ada penelitian yang menghubungkan ekspresi Cullin-1 pada pasien preeklampsia dengan waktu terminasi kehamilan. Oleh karena itu pada penelitian ini dilakukan analisis ekspresi Cullin-1 pasien preeklampsia dan hubungannya dengan waktu terminasi kehamilan. Sampel plasenta diambil dari pasien preeklampsia yang terdiri dari tiga kelompok usia kehamilan, kemudian dilakukan perwarnaan imunohistokimia untuk dilihat dinamika ekspresi dan distribusi Cullin-1 pada berbagai kelompok usia kehamilan dan hubungannya dengan waktu terminasi kehamilan. Cullin-1 terekspresi pada sinsitiotrofoblas dan  sitotrofoblas. Kadar Cullin-1 terendah didapatkan pada kelompok usia kehamilan very preterm, dan paling tinggi didapatkan di kelompok usia kehamilan moderate preterm. Terdapat perbedaan bermakna antara ekspresi optical density (OD) Cullin-1 dengan   waktu terminasi  kehamilan, dan terdapat perbedaan bermakna  (OD) Cullin-1 pasien preeklampsia usia kehamilan very preterm dengan usia kehamilan moderate preterm. Disimpulkan bahwa Cullin-1 terekspresi pada sinsitiotrofoblas dan sitotrofoblas dan berhubungan dengan waktu terminasi kehamilan.

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ABSTRACT

Preeclampsia is a systemic syndrome that occurs in 3-5% of female pregnancies caused by disorders of migration factors and cellular factors that have an impact on the disruption of trophoblast differentiation and invasion that is important in the process of developing the placenta and maintaining pregnancy. Protein Cullin-1 is one candidate protein that plays a role in the process of maintaining pregnancy, development and trophoblast invasion in the placenta. Until now there have been no studies linking the expression of Cullin-1 in preeclamptic patients with the timing of pregnancy termination. Therefore in this study an analysis of Cullin-1 expression in preeclamptic patients and their relationship to the timing of pregnancy termination was carried out. Placental samples were taken from preeclampsia patients consisting of three gestational age groups, then immunohistochemical staining was performed to see the dynamics of expression and distribution in each age group of pregnancy and to find out their relationship with  the timing of pregnancy termination. Cullin-1 was expressed in syncytiotrophoblasts and cytotrophoblasts. The lowest Cullin-1 level was obtained in the very preterm age group, and the highest was found in the moderate preterm gestational age group. There was a significant difference between Cullin-1 optical density (OD) expression and termination time of pregnancy, and there was a significant difference (OD) in Cullin-1 preeclamptic patients with very preterm gestational age with moderate preterm gestational age. It was concluded that Cullin-1 was expressed both in syncytiotrophoblasts and cytotrophoblasts and was associated with the timing of pregnancy termination."

"Latar belakang: Preeklampsia/eklampsia merupakan penyebab utama morbiditas dan mortalitas maternal di Indonesia. Preeklampsia juga menyebabkan pertumbuhan janin terhambat dan kelahiran prematur. Etiologi preeklampsia belum jelas, diduga berhubungan dengan penurunan perfusi plasenta yang menyebabkan hipoksia plasenta. Hipoksia ini menginduksi aktivitas angiogenesis pada plasenta yang bertujuan untuk memperbaiki mikrosirkulasi plasenta.Tujuan: Menilai aktivitas angiogenesis pada plasenta preeklampsia dan dibandingkan dengan plasenta ibu hamil normal.Rancangan penelitian: Merupakan studi komparatif potong lintang. Dua belas plasenta preeklampsia dan 13 plasenta ibu hamil normal sebagai kontrol diperoleh dari ibu bersalin yang mendonorkan plasenta di satu rumah sakit. Aktivitas angiogenesis dinilai dengan pemeriksaan migrasi sel-sel endotel Untuk menganalisis perbedaan aktivitas angiogenesis antar kelompok digunakan tes Mann-Whitney.Hasil: Aktivitas angiogenesis pada plasenta preeklampsia lebih tinggi bermakna secara statistik dibanding dengan plasenta ibu hamil normal (p<0.05).Kesimpulan: Hipoksia plasenta meningkatkan aktivitas angiogenesis pada plasenta preeklampsia. Pada penelitian k d respons lokal tidak optimal dalam meningkatkan mikrosirkulasi, karena terdapat 2 kasus berat bayi lahir rendah pada kelompok preeklampsia.

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Angiogensesis Activity Of Preeclamptic PlacentaBackground: Preeclampsia/eclampsia is a major cause of maternal morbidity and mortality in Indonesia. Preeclampsia also a major cause of fetal growth retardation and premature delivery. The etiology of preeclampsia is unclear. It is suggested that reduce placental perfusion leads to placental hypoxia, and then induced placental angiogenic activity. The purpose of the activity enhances the placental vascular bed.

Objective: To study angiogenic activity in preeclamptic placentas and compare those with placenta from normal pregnant women.

Study design: Comparative cross sectional study was used. Mothers who were delivered their baby in the same hospital donated their placentas. Twelve placentas from preeclampsia and 13 from controls were examined. The angiogenic activity was assayed using an endothelial cell migration assay. Differences in placental angiogenic activity between two groups were analysed using the Mann Whitney test.

Result: The angiogenic activity in the placenta from women with preeclampsia were significantly greater than that from women with normal pregnat. (p<0.05).

Conclusion: Placental hypoxia increased angiogenic activity in the placenta from women with preeclampsia. In this study, the local respons is not optimal in enhacing vascular bed, because 2 low birth weight babies was delivered in preeclampsia group."

"TUJUAN: Tujuan dari penelitian ini adalah untuk menentukan kadar tromboksan B2 pada kultur jaringan plasenta penderita preeklampsia dengan plasenta wanita hamil normal sebagai pembanding.RANCANGAN PENELITIAN: Penelitian ini merupakan studi cross-sectional. Kultur jaringan plasenta penderita preeklampsia (n=13) dan plasenta wanita hamil normal (n=12) dengan usia dan umur kehamilan tidak berbeda bermakna secara statistic. Kultur plasenta menggunakan medium M199 dari sigma dengan 20 % serum menggunakan metode tabung menurut Rand dan dikultur selama 72 jam. Kadar tromboksan B2 diukur dengan spektrofotometri pada panjang gelombang 405 nm. Sebagai petanda bahwa plasenta yang dikultur masih memilik viabilitas set yang baik diukur melalui pemeriksaan human chorionic gonadotropin (hCG).HASIL: Kedua sel baik dari jaringan plasenta penderita preeklampsia maupun dari jaringan plasenta hamil normal memiliki viabilitas sel yang baik. Kadar tromboksan B2 yang terlarut dalam supematan kultur jaringan plasenta penderita preklampsia (887.88± 26.07 pglml) lebih tinggi secara bermakna (P<0.05) dibanding wanita hamil normal (849.82± 24.61 pglml)KESIMPULAN: Kadar Tromboksan B2 pada penderita preeklampsia lebih tinggi dibandingkan pada wanita hamil normal, peningkatan ini bertanggung jawab terhadap terjadinya vasokonstriksi pembuluh darah pada plasenta dan maternal.

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Enhanced Tromboxane B2 (TXB2) Production In Placental Culture In PreeclampsiaOBJECTIVE: To determine tromboxane B2 production in placental culture in preeclampsiaSTUDY DESIGN: The study was a crosssectional study. Placentas were obtained from having woman with normal (n=12) and woman with preeclampsia (n=13) with the same age and gestational age. Placenta tissues were incubated in M199 sigma medium with 20 % serum for 72 hour using the with tube method from Rand. Samples were analyzed spectrophotometrically and with absorbtion at 405 nm for tromboxane B2. hCG was also determined as a marker for cell viability.RESULT : The placentas of women will preeclampsia and from normal pregnanly were viable. The concentration of tromboxane B2 from placental of preeclampsia cultured for 72 hour (887.88±26.07 pg/ml) was significantly higher (p<0.05) than from placental of normal pregnanly (849.83±24.60 pg/ml).CONCLUSION : The concentration of tromboxane B2 from cultures of placental preeclampsia was significantly higher than from cultures of placental of normal pregnanly. The increased tromboxane B2 production in placental culture could be responsible for increased placental and maternal blood vessel vasoconstriction."

"Banyak faktor yang mempengaruhi aktivitas angiogenesis plasenta, misalnya VEGF dan oksigenasi dalam plasenta. Pada awal kehamilan normal b-hCG meningkatkan aktivitas VEGF untuk merangsang angiogenesis. Tujuan penelitian ini adalah untuk mengetahui hubungan antara kadar b-hCG pada kultur plasenta dengan aktivitas angiogenik plasenta preeklampsia. Sampel plasenta diambil dari 10 plasenta wanita dengan preeklampsia dan 10 kontrol (wanita dengan kehamilan normal). Semua subjek bersedia berpartisipasi dalam penelitian ini dan menandatangani informed consent. Konsentrasi b-hCG dalam supernatan kultur plasenta diukur dengan Microparticle Enzyme Immunoassay (MEIA) dan aktivitas angiogenik plasenta diukur dengan mengukur migrasi sel endotel menuju eksplan plasenta (skor 0-4). Hasil menunjukkan median skor aktivitas angiogenik plasenta pada preeklampsia lebih tinggi secara bermakna dari kontrol (p<0,05). Konsentrasi b-hCG dalam kultur plasenta preeklampsia lebih tinggi secara bermakna dari plasenta kehamilan normal (p<0,001). Konsentrasi b-hCG mempunyai korelasi positif dengan aktivitas angiogenik plasenta baik pada preeklampsia (r=0,50) maupun kehamilan normal (r=0,57). Walaupun korelasi ini lemah, bagaimanapun juga b-hCG merupakan salah satu faktor yang mempengaruhi aktivitas angiogenik plasenta. (Med J Indones 2004; 14: 67-70)

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Numerous factors, such as VEGF and intra-placental oxygenation, can influence placental angiogenic activity. Early in the normal gestation period, b-hCG enhance VEGF activity to induce angiogenesis. The aims of this study were to identify the correlation between b-hCG concentration in placental culture and placental angiogenic activity in pre-eclampsia. Ten placenta samples from women with pre-eclampsia and 10 from controls (normal pregnancy) were collected. All subjects agreed to participate in this study and signed an informed consent form. b-hCG concentration in supernatant of placental culture was measured by Microparticle Enzyme Immunoassay (MEIA) and placental angiogenic activity was measured by endothelial cell migration toward placental explant (score 0-4). The results showed that the median score of placental angiogenic activity in pre-eclampsia was significantly higher than in normal pregnancy (p<0.05). Concentration of b-hCG in pre-eclampsia was significantly higher than in normal pregnancy (p<0.001). hCG concentration in placental culture was positively correlated to placental angiogenic activity both in pre-eclampsia (r=+0.50) and in normal pregnancy (r=+0.57). Although the correlations were weak, b-hCG is considered one of the factors that influence placental angiogenic activity. (Med J Indones 2004; 14: 67-70)"

"Hypoxia-inducible factor-1a (HIF-1a) adalah faktor transkripsi yang bertanggung jawab pada kondisi hipoksia seperti preeklampsia. Studi ini membandingkan konsentrasi HIF-1a pada kehamilan preeklampsia di bawah 32 minggu gestasi dan kehamilan normal. Sebagai penelitian observasional potong lintang pendahuluan, 10 sampel digunakan untuk masing-masing grup. Konsentrasi HIF-1a diukur menggunakan kit enzyme-linked immunosorbent assay (ELISA). Analisis statistik menunjukkan adanya perbedaan yang insignifikan (p>0.05) antara konsentrasi HIF-1a pada kehamilan preeklampsia awal dan kehamilan normal walaupun terdapat kecenderungan untuk konsentrasi yang lebih tinggi pada kehamilan preeklampsia awal. HIF-1a kemungkinan tidak terlibat pada perkembangan preeklampsia awal. Sebaliknya, konsentrasi HIF-1a pada plasenta dipengaruhi oleh kerusakan syncytiotrophoblast akibat modifikasi arteri spiralis yang inadekuat dan berujung pada kurangnya jumlah HIF-1a.

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Hypoxia-inducible factor-1a (HIF-1a) is a transcription factor that is expressed by cytotrophoblast in the placenta during hypoxic condition of preeclampsia. This study compares the level of placental HIF-1a in preeclampsia pregnancies under 32 weeks old of gestation and normal pregnancies. As an observational cross-sectional preliminary study, 10 samples were used for each group. The level of placental HIF-1a was measured by using enzyme-linked immunosorbent assay (ELISA) kit. Statistical analysis revealed insiginificant difference (p>0.05) of placental HIF-1a concentration between the early preeclampsia pregnancies and the normal ones although there’s a tendency of the level being higher for the former. HIF-1a might not be involved in the development of early preeclampsia. Instead, its level in the placenta is affected by the syncytiotrophoblast damage due to inadequate spiral arteries remodeling that leads to a reduced amount of HIF-1a."

"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.

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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."

"Laporan Praktek Spesialis Keperawatan Maternitas Fokus Pada Penerapan Teori Keperawatan Need For Help 'Wiedenbach' Dan Goal Attainment 'King' Pada Asuhan Keperawatan Ibu Hamil Dengan Plasenta Previa ABSTRAK Petugas kesehatan termasuk perawat spesialis maternitas bertanggung jawab dalam upaya menurunkan angka kematian ibu Program Ners Spesialis Keperawatan Maternitas merupakan program pendidikan yang bertujuan untuk memberikan pengetahuan keterampilan serta sikap untuk dapat menjalankan peran dan fungsi dalam memberikan asuhan keperawatan Melalui program ini para calon Ners Spesialis Keperawatan Maternitas melaksanakan peran dan fungsinya sebagai care giver edukator konselor komunikator pengelola advokat kolabolator change agent dan peneliti baik ditatanan klinik maupun di komunitas Salah satu fungsi yang dilaksanakan adalah memberikan asuhan keperawatan dengan penerapan teori keperawatan need for help 'Wiedenbach' dan teori goal attainment 'King' pada ibu hamil dengan plasenta previa Integrasi kedua teori ini tepat digunakan dalam membantu mempertahankan kesehatan ibu dan janin serta mencegah terjadinya komplikasi Kata kunci Plasenta previa need for help goal attainment

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Maternity Nursing Specialist Practice Report Focused on the Application of Wiedenbach's 'Need For Help' and King's 'Goal Attainment' Nursing theory in Nursing Care of Pregnant Women with Placenta Previa ABSTRACT Health professionals including maternity nursing specialist are responsible in an attempt to reduce maternal mortality rate Maternity Nursing Specialist Program is an educational program that aims to provide the knowledge skills and attitudes to be able to perform the role and functions in providing nursing care Through this program the candidates of Maternity Nursing Specialist performed the role and function as a care giver an educator a counselor a communicator a manager an advocate a collaborator a change agent and a researcher both in the clinical area and in the community One of the functions implemented was providing nursing care with the application of Wiedenbach's 'Need For Help' and King's 'Goal Attainment' Nursing theory to pregnant women with placenta previa The integration of both theories was appropriate to maintain the health of the mother and fetus and to avoid complications Keywords Placenta previa need for help goal attainment "

"Berat plasenta umum digunakan untuk mengukur pertumbuhan dan fungsi yang baik dari plasenta. Anemia merupakan salah satu faktor risiko dari berat plasenta yang tinggi. Namun sampai saat ini belum dapat dipastikan apakah anemia karena kekurangan zat besi mempengaruhi berat plasenta. Penelitian ini meneliti hubungan antara anemia defisiensi besi dan berat plasenta pada wanita hamil anemia di Jakarta Timur. Penelitian ini menggunakan desain penelitian potong lintang yang melibatkan 90 ibu hamil anemia di 10 Puskesmas Kecamatan, Jakarta Timur. Prevalensi defisiensi besi pada ibu hamil anemia adalah 36,9%. Berat plasenta rata-rata adalah 549,3 ± 115 gr. Ada hubungan positif antara anemia defisiensi besi dan berat plasenta setelah dikontrol oleh variabel paritas, perokok pasif dan frekuensi kunjungan pemeriksaan kehamilan (B = 0,22; p = 0,038). Berat plasenta yang tinggi pada ibu hamil dengan anemia defisiensi besi menunjukkan adanya mekanisme adaptasi dari plasenta dikarenakan kurangnya oksigen dalam darah.

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Placental weight is a commonly used to measure placental growth and function including nutrient transfer to the fetus. Anemia may link to a risk factor for higher placental weight, however, it is uncertain whether iron deficiency anemia influence a placental weight, and could be used a public health measure for fetal growth and healthy pregnancy. This study investigated the relationship between iron deficiency anemia and placental weight among anemic pregnant women in East Jakarta. We conducted a cross sectional study of 90 anemic pregnant women and their singleton pregnancies in 10 Primary Health Center in East Jakarta. The prevalence of iron deficiency among anemic pregnant women was 36.9%. The mean placental weight was 549.3 ± 115 gr. There was a positive relationship between iron deficiency anemia and placental weight after adjusting for parity, passive smoker and ANC visit frequency (B=0.22; p=0.038). A higher placenta weight was observed among iron deficiency anemic pregnant women, suggesting the adaptive mechanism of placenta to chronic poor oxygenation."

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Pendahuluan: Preeklampsia diketahui sebagai sindrom spesifik kehamilan dan salah satu penyebab tersering kematian ibu. Terdapat dua jenis preeklampsia, awitan lambat dan awitan dini. Akan tetapi, penelitian menujukkan bahwa preeklampsia awitan dini jauh lebih berbahaya untuk ibu dan bayi. Meskipun patogenesis preeklampsia masih belum jelas, insufisiensi plasenta akibat meningkatnya peroksidasi lipid dan invasi trofoblas yang defektif diduga sebagai salah satu faktor pencetus preeklampsia. PPARg, yang berfungsi untuk metabolisme lipid dan diferensiasi sel di plasenta, secara teori dapat mencetuskan preeklampsia apabila aktivasinya berkurang. Dengan demikian, studi ini ditujukan untuk menganalisis secara spesifik ekspresi protein PPARg pada plasenta preeklampsia awitan dini. Selain itu, analisis terhadap ekspresi protein PPARg juga dilakukan berdasarkan kategori karakteristik subjek, yaitu usia ibu dan usia kehamilan.

Metode: Penelitian ini merupakan studi deskriptif potong lintang. Sebanyak 26 sampel jaringan plasenta dengan usia gestasi ≤ 33 minggu (preeklampsia awitan dini) digunakan dalam penelitian ini. Konsentrasi protein PPARg diukur pada homogenat jaringan plasenta dengan menggunakan metode ELISA. Selanjutnya, analisis data dilakukan secara statisik mennggunakan perangkat lunak IBM SPSS Statistics. Varian tes yang digunakan adalah t-test dan Mann-Whitney test untuk perbandingan, serta Pearson dan Spearman untuk tes korelasi.

Hasil: Ekspresi PPARg adalah 3.19±1.13 ng/mg protein; usia ibu 29.65±5.97 tahun; usia gestasi 30.50 (24-33) minggu. Berdasarkan kategori usia ibu, usia <30 tahun mengekspresikan PPARg  sebesar 2.81 (0.60 – 5.71) ng/mg protein, sedangkan usia ≥30 tahun mengekspresikan 3.17 (1.75 – 5.40) ng/mg protein. Pada kategori usia gestasi, usia <30 minggu mengekspresikan PPARg sebanyak 2.86±1.14 ng/mg protein PPARg dan usia ≥30 minggu sebanyak 3.48±1.07 ng/mg protein. Dibandingkan dengan plasenta kehamilan normal (3.52 (1.12 – 12.43) ng/mg protein), plasenta preeklampsia mengekspresikan 2.94 (0.60 – 5.71) ng/mg protein PPARg.

Kesimpulan: Konsentrasi PPARg yang lebih tinggi ditemukan pada wanita berusia ≥30 tahun daripada wanita berusia <30 tahun. Berdasarkan usia gestasi (UG), konsentrasi PPARg pada UG ≥ 30 minggu lebih tinggi dibandingkan UG < 30 minggu. Jika dibandingkan dengan plasenta kehamilan normal, plasenta preeklampsia memiliki konsentrasi PPARg yang lebih rendah.

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Introduction: Preeclampsia is regarded as a specific pregnancy disorder and one of the leading causes of maternal death. There are two types of preeclampsia, late-onset and early-onset. However, evidences have proven that early-onset preeclampsia is associated to deleterious outcomes for both mother and newborns. Though the pathogenesis is still unclear, placental insufficiency due to increased lipid peroxidation and defective trophoblast invasion is thought to be one cause of preeclampsia. PPARg, which functions for lipid metabolism and cell differentiation in placenta, is correlated to preeclampsia once the activation is lessened, theoretically. Thus, this research was intended to analyse protein expression of PPARg, specifically in placenta of early-onset preeclampsia. In addition, the analysis also conducted according to characteristics of the subjects, which are maternal age and gestational age.

Methods: The design of this research was descriptive cross-sectional study. There are 26 samples of placental tissues used with gestational age ≤ 33 weeks (early onset preeclampsia). In form of placental homogenates, protein concentration of PPARg was measured by using ELISA method. Statistical data analyses was performed in IBM SPSS Statistics software by using t-test and Mann-Whitney test for comparison, also Pearson and Spearmen for correlation test. 

Results: The expression of PPARg was 3.19±1.13 ng/mg protein; maternal age 29.65±5.97 years; gestational age 30.50 (24-33) weeks. PPARg expression according to maternal age category is 2.81 (0.60 – 5.71) ng/mg protein in <30 years and 3.17 (1.75 – 5.40) ng/mg protein in ≥30 years. Based on gestational age (GA) group, GA <30 weeks expresses 2.86±1.14 ng/mg protein PPARg, while GA ≥30 weeks shows 3.48±1.07 ng/mg protein PPARg. In comparison to normal placenta (3.52 (1.12 – 12.43) ng/mg protein), preeclamptic placenta expresses  2.94 (0.60 – 5.71) ng/mg protein PPARg.

Conclusion: Distribution of PPARg is established higher in women aged ≥30 years than women aged <30 years. In gestational age ≥30 weeks, the PPARg distribution is also higher compared to gestational age <30 weeks. However, preeclamptic placenta distributes lower amount of PPARg than normal placenta.

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"Background: Placental morphology and cellular arrangement can be altered in maternal diseases. Rheumatic heartdisease (RHD) is a chronic heart condition that can lead to death in pregnant women. The aim of this study is todetermine the histological changes of the placenta in pregnant women suffering from RHD. Methods: Placentae werecollected from 10 healthy pregnant women, and 31 pregnant women with heart conditions (26 with RHD and 5 withNRHD) who had been admitted to the Baghdad Teaching Hospital. Placental tissues were fixed in10% formal-salineand were processed for light microscopy. Measurements including the placental weight and diameter of the chorionicvilli capillaries were recorded. Results: The results indicate that there are many histological changes in pregnantwomen with RHD such as hyalinisation, fibrosis of the chorionic villi, proliferation of trophoblastic cells, andthickening of its membrane. Additionally, expectant mothers with RHD experience a reduction in capillary diameterand thickening of the capillary walls, and decreased size and weight of their placenta when compared with the control.Conclusions: Heart diseases, especially RHD, are associated with developmental damage of the placenta in pregnantwomen by injuring the endothelial cells of the placentas capillaries."