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The correlation between Leptin Levels and Onset of Preeclampsia Sriyanti, Roza; Mose, Johanes C.; Masrul, Masrul; Suharti, Netti
Andalas Obstetrics And Gynecology Journal Vol. 4 No. 2 (2020)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.4.2.139-144.2020

Abstract

The purpose of this study is to find the correlation between leptin levels and the onset of preeclampsi. This study used a cross sectional comparative study design that conducted in May 2018 - April 2019 in the SMF / Obstetrics and Gynecology department of RSUP dr. M. Djamil Padang, RSUD Achmad Mochtar, RSUD Solok, RST Reksodiwiryo. We used consecutive sampling method which consists of 69 pregnant women who fulfill the inclusion and exclusion criteria. Leptin level tests were done using ELISA method. The average level of leptin in early-onset preeclampsia is found to be the highest when compared to the late-onset preeclampsia and normal pregnancy, 64.07 ± 78.27 vs. 30.46 ± 31.99 vs. 16.61 ± 24.49. This differentiation is highly significant with the ANOVA statistical test (p <0.05). There is a significant correlation between leptin levels with the onset of preeclampsia.Keywords: preeclampsia early onset, preeclampsia late onset, leptin levels
Differences of Magnesium Level Between Normal Pregnancy and Preeclamsia Pradipta, Rengga; Sriyanti, Roza; Bachtiar, Hafni
Andalas Obstetrics And Gynecology Journal Vol. 5 No. 1 (2021)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.5.1.63-68.2021

Abstract

Background: Preeclampsia is a multi-organ disorder that occurs in pregnant women with high blood pressure which is still difficult to predict. Until now, many theories have put forward the causes of preeclampsia, one of which is much debated is the lack of nutrition in pregnant women which can lead to preeclampsia. Several studies suggest that there is a relationship with the lack of micronutrient intake, especially magnesium, which causes preeclampsia, especially in developing countries. Magnesium deficiency is one possible factor causing severe preeclampsia. Magnesium plays a role in normal neuromuscular function, regulation of calcium, potassium and transport of sodium in the membrane as a regulation of the activation of ATP. Magnesium also plays a role in blood pressure regulation. Magnesium deficiency can lead to endothelial malfunction, hypertension and failure of the cardiovascular system. The role of magnesium is in enzyme reactions that bind to anaerobic glucose metabolism, the krebs cycle, fatty acid oxidation and reactions between coenzyme and fatty acids. Magnesium deficiency will result in changes to the nerves, muscles and blood vessels.Methods: Analytical observational study with cross sectional design in 17 women with preeclampsia and 17 normal pregnant women who met the inclusion and exclusion criteria. Research subjects were collected at Dr M Djamil Padang General Hospital, November 2019 to January 2020. Magnesium levels were checked by enzymatic methods. The difference in the mean magnesium preeclampsia and normal pregnancy was analyzed using independent t test.Results: Mean magnesium in preeclampsia was lower than normal pregnancy (1.61 ± 0.59aµg / ml vs 2.20 ± 0.18, p = 0.001).Conclusion: Mean magnesium level in preeclampsia was significantly lower than normal pregnancy..Keywords: Average levels of magnesium, magnesium, preeclampsia, normal pregnancy
MODE OF DELIVERY DOES NOT CORRELATE FETAL OUTCOME IN PREGNANCY WITH COVID-19 AT DR. M. DJAMIL HOSPITAL PADANG Farnas, Heri; Sriyanti, Roza
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 1 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.1.42-49.2022

Abstract

Introduction: Corona Virus Disease 2019 (COVID-19) was first reported in Wuhan, China. Knowledge about COVID-19 infection in relation to pregnancy and the fetus is still limited. Report from China shows high rate of caesarean delivery (> 90%) due to the suspicion for vertical transmission. Globally there is an increase of caesarean delivery in women with COVID-19 infection. Clinical implications mode of delivery in pregnancies with COVID-19 infection are not fully understood.Objective: The aims of this study to assess differences in fetal outcome based on the mode of delivery in pregnancies with COVID-19 infection.Methods: This observational analytic study with cross sectional study design was conducted in single center at dr. M. Djamil General Hospital Padang from March 2020-March 2021. All study subjects qualified to inclusion and exclusion criteria included. The fetal outcome analyzed based on APGAR scores and COVID-19 status in newborn baby using Mann-Whitney test.Results: A total of 49 patients were analyzed. The results showed mean APGAR score 1 minute in the vaginal delivery was lower than caesarean delivery (6.87±1.06 vs 7.38±0.82) but not significant (p=0.09). No significant difference between vaginal delivery and caesarean delivery based on APGAR score 5 minutes (p=0.19). None newborn babies infected with COVID-19 in both groups.Conclusions: There was no difference of fetal outcome based on the APGAR score in pregnancies with COVID-19 infection by mode of delivery. There were no cases of infants with COVID-19 infection in both groups.Keywords: COVID-19, mode of delivery, APGAR score
Atypical eclampsia: A case report Sriyanti, Roza; Aldhi, Aldhi; Permatasari, Ressy
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.2.167-172.2022

Abstract

Background: Most women with eclampsia have a previous history of preeclampsia (proteinuria and hypertension). However, there has been a paradigm shift in this philosophy. There is evidence that atypical eclampsia can occur even in the absence of proteinuria and hypertension which presents a diagnostic dilemma and challenge for obstetricians and gynecologists. The purpose of this case report is to raise awareness about nonclassical and atypical signs of eclampsia so as to avoid complications Case: A multigravida woman with 39-40 weeks gestational age came to the hospital with signs of labor. On examination, blood pressure was 120/70 mmHg without a history of hypertension during antenatal examination, fetal heart rate was 146-156 beats/minute, cervical dilatation was 7-8 cm, with routine blood results within normal limits and planned for vaginal delivery . When monitoring the patient suddenly had a tonic clonic seizure, a complete blood count was performed, liver, kidney, electrolyte function was within normal limits, and proteinuria was found to be +2. The patient was treated with magnesium sulfate and the baby was delivered by vacuum extraction. This patient was managed appropriately with good outcome Discussion: Atypical eclampsia accounts for about 8% of all cases of eclampsia. Atypical forms of eclampsia have an erratic onset. This experience highlights some of the difficulties in managing atypical cases of eclampsia, namely the erratic onset and unpredictable course of the disease that can interfere with timely diagnosis and treatment and contribute to maternal and fetal morbidity and mortality. While controlling seizures by initiating magnesium sulfate therapy,
Correlation of Neutrophil Lymphocyte Ration (NLR) Values with Severe Preeclampsia, HELLP Syndrome and Eclampsia Lisfi, Indah; Sriyanti, Roza; FIrdawati, Firdawati
Andalas Obstetrics And Gynecology Journal Vol. 7 No. 2 (2023)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.7.2.379-390.2023

Abstract

Background:  Preeclampsia (PE) is the leading cause of maternal and fetal morbidity and mortality. The disease is characterized by hypertension (≥140/90 mmHg), proteinuria, thrombocytopenia, renal failure, neurological complications, liver involvement, and fetal growth retardation. HELLP syndrome is a variant of preeclampsia that causes an increase in liver enzymes and a low platelet count. Eclampsia is the heaviest complication of preeclampsia. Neutrophil lymphocyte ratio (NLR) is part of the leukocyte type count examination which is an easy, available examination parameter and can be used as an index of the severity of systemic inflammation. This study aimed to determine the relationship of neutrophil-lymphocyte ratio (NLR) values with severe Preeclampsia, HELLP syndrome, and eclampsia. Method: This research is a comparative analytical study with a case control study approach. This research was conducted from April-November 2022. This study was conducted at the emergency room (ER) and inpatient department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Andalas – RSUP Dr. M. Djamil Padang. The study sample was part of the population that met the inclusion and exclusion criteria. The study required 108 samples, namely 27 from the severe preeclampsia group, 27 from the eclampsia group, 27 from the HELLP syndrome group, and 27 from the control group. Bivariate statistical analysis using Independent T-Test. Samples were taken by the method of consecutive sampling. The data were analyzed at a 95% confidence interval, if obtained p value<0.05 then there is a significant relationship. The Data was analyzed by the SPSS computer program. Results: The results of this study obtained neutrophil-lymphocyte ratio in eclampsia has the highest average value compared with HELLP syndrome, severe preeclampsia, and control. While HELLP syndrome has a higher mean value than severe preeclampsia and control and subsequently severe preeclampsia also has a higher mean value NLR than control. This study found a significant relationship between neutrophil-lymphocyte ratio (NLR) with severe Preeclampsia, HELLP syndrome, and eclampsia (all p values=0.000). Conclusion: This study proves that neutrophil-lymphocyte ratio (NLR) has a significant relationship with severe Preeclampsia, HELLP syndrome, and eclampsia so further research can develop this study by analyzing other factors that affect preeclampsia. For clinicians can make this study as a reference in monitoring the progression of inflammation that occurs in severe preeclampsia, HELLP syndrome, and eclampsia.
Clinical Characteristics, Laboratory, Maternal and Fetal Outcomes in Pregnancy with Covid-19 at RSUP dr. M. Djamil Padang Sriyanti, Roza; Farnas, Heri; Djanas, Dovy
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.1.569-578.2024

Abstract

Introduction : The data obtained from various studies about covid-19 conducted in several hospitals in the world are currently considered not sufficient to provide a clinical picture that occurs in pregnancies with Covid-19 infection. The aims to provide an overview of the clinical, laboratory, maternal and fetal outcomes in pregnancy with Covid-19 infection at dr. M. Djamil Padang. Methods: This study used a descriptive design with data collection starting from March 01, 2020 - March 31, 2021 based on medical record data. Carried out in a single center at RSUP dr. M. Djamil Padang in pregnant patients with confirmed Covid-19 by PCR examination. Results: Total 136 pregnant patients confirmed Covid-19 by PCR examination. Most of the symptoms were asymptomatic (47.1%) and without any comorbidities (76.5%). There were 3 patients who experienced critical symptoms (2.2%). Maternal mortality was found at 2.3% and fetal death 4.7%. The values of d-dimer and NLR were found increasing significantly, 2025.35±1392.18 for d-dimer and 6.39±4.43 for NLR. Pregnancy terminations done for 77.9% patients with cesarean section is the most method (83%). There were 4 cases (3.8%) of babies infected with Covid-19 from mothers who had pregnancy terminations. Conclusions: Most cases had asymptomatic clinical symptoms (47.1%). There are 2.3% cases of maternal death and 4.7% cases of fetal death. Most of the pregnancy terminations were performed by cesarean section (88%). On laboratory examination, there was a significant increase in maternal d-dimer (2,025.35±1.392.18) and NLR (6.39±4.43) in pregnancies with Covid-19.
Early Haemorrhage Postpartum (HPP); With Complication Disseminated Intravascular Coagulation, Sepsis, Acute Kidney Injury Oktavian, Rizki; Gunawan Efri; Sriyanti, Roza; Taslim, Emilzon
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 1 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.1.632-641.2024

Abstract

Background : Hemorrhage Postpartum (HPP) is the leading cause of maternal death worldwide with an incidence of 5%-10% of all deliveries. 70% of cases of HPP are caused by atony of the uterus. If HPP is not handled properly, it will cause worsening of the patient's condition which causes various multiorgan complications. Objectives : To discuss the management of HPP cases complicated by DIC, sepsis and AKI. Method : case report. Case : A female patient, 36 years old, was referred from a private hospital to PONEK RSUP Dr. M. Djamil Padang with a diagnosis of decreased consciousness ec suspected sepsis in post SCTPP oi used SC 2x + post relaparotomy oi bleeding subfascia + moderate anemia. After surgery, the patient looked pale and the hemoglobin was 7, then relaparotomy was done and done B-lynch oi uterine hypotony. After relaparotomy, the patient experienced worsening then referred to the hospital. The patient arrives with hipovolemic shock + AKI + Sepsis + DIC , then the condition improvement is carried out in ROI and hysterectomy relaparotomy is performed. The patient has worsened, maximum treatment has been carried out from the intersivist, but the patient's condition continues to worsen and eventually dies.Conclusion : Early diagnosis and rapid treatment through a multidisciplinary team and the availability of an Intensive Care Unit (ICU) can prevent complications and reduce morbidity and mortality.
Eklamsia Atipikal: Laporan Kasus Aldhi, Aldhi; Permatasari, Ressy; Sriyanti, Roza
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (173.974 KB) | DOI: 10.36418/syntax-literate.v8i2.10584

Abstract

Kebanyakan wanita yang mengalami eklamsia memiliki riwayat preeklamsia sebelumnya (proteinuria dan hipertensi). Namun telah terjadi pergeseran paradigma dalam filosofi ini. Ada bukti bahwa eklamsia atipikal dapat terjadi bahkan tanpa protein uria dan hipertensi yang muncul sebagai dilemma diagnostik dan tantangan bagi dokter Obgin yang merawat. Tujuan dari laporan kasus ini adalah untuk meningkatkan kewaspadaan tentang tanda eklampsi anonklasikdan atipikal sehingga dapat menghindari komplikasi. Pada penelitian ini menggunakan metode literature review. Eklamsia atipikal menyumbang sekitar 8% dari semua kasus eklamsia. Bentuk eklamsia atipikal memiliki onset yang tidak menentu. Pengalaman ini menyoroti beberapa kesulitan dalam mengelola kasus eklamsia atipikal, yaitu onset yang tidak menentu dan perjalanan penyakit yang tidak dapat diprediksi sehingga dapat mengganggu diagnosis dan pengobatan yang tepat waktu dan berkontribusi pada morbiditas dan mortalitas ibu dan janin. Sementara mengendalikan kejang dengan memulai terapi magnesium sulfat, pencarian simultan untuk setiap penyebab organik/metabolic untuk kejang perlu dicari.
Activin A and Heart Function in Severe Preeclampsia: Insights From Global Longitudinal Strain Sriyanti, Roza; Permatasari, Ressy; Kino, Kino
Journal of Health and Nutrition Research Vol. 4 No. 3 (2025)
Publisher : Media Publikasi Cendekia Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56303/jhnresearch.v4i3.605

Abstract

Preeclampsia, a serious pregnancy complication affecting 2–5% of women globally, is a leading cause of maternal and fetal mortality. Its prevalence in Indonesia ranges from 0.8–7% depending on parity. Associated with long-term cardiovascular risks, recent research suggests that elevated maternal activin A levels may play a causal role in linking severe preeclampsia to subsequent cardiovascular complications, particularly through mechanisms involving cellular damage, including to the heart. The aim of this study was to assess the correlation between Activin A circulating level and cardiac ventricular function as assessed by cardiac global longitudinal strain (GLS) in severe preeclampsia. A cross-sectional study was conducted at M. Djamil Hospital, Padang, West Sumatera, Indonesia with a total of 31 patients with severe preeclampsia. The Enzyme-Linked Immunosorbent Assay (ELISA) as used to determine the level of Activin A in the blood serum. Ventricular function was assessed from the global longitudinal strain using echocardiographic evaluation. The mean level of Activin A was 2.97 ± 1.91 ng/mL. From the echocardiographic evaluation, the mean cardiac GLS value was 18.01 ± 3.27%.  The correlation between activin A levels and cardiac ventricular function was analyzed using Pearson's correlation test, which showed a strong negative correlation (r = -0.718, p < 0.001). This indicates that higher activin A levels are significantly associated with lower GLS values, demonstrating worse ventricular function.