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All Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) The Indonesian Journal of Infectious Diseases
Levina, Jessica
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Management of Vulvovaginal Candidiasis in Pregnancy Levina, Jessica; Ocviyanti, Dwiana; Adawiyah, Robiatul
Indonesian Journal of Obstetrics and Gynecology Volume 12 No. 2 April 2024
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v12i2.1990

Abstract

Pregnancy is a risk factor for vulvovaginal candidiasis (VVC). The most common cause of VVC in pregnancy is Candida albicans. During pregnancy, physiological changes occur, such as increased levels of estrogen, lower vaginal pH, increased production of vaginal mucosal glycogen and immunological changes so that Candida colonization in the vagina increases. Increased colonization can be symptomatic or asymptomatic. When symptoms and signs of vulvar pruritus, pain, swelling, redness, burning, dyspareunia, dysuria, vulvar edema, fissures, excoriation and vaginal discharge are found, it is necessary to perform microscopic examination and/or fungal culture to establish the diagnosis of VVC. Topical intravaginal antifungal therapy such as clotrimazole and nystatin, are the recommended treatment for VVC in pregnancy that has been shown its safety. Treatment with oral antifungal is not recommended because of the risk of causing congenital abnormalities in the fetus. Prophylactic administration in the last trimester of pregnancy in asymptomatic VVC cases provides good pregnancy and neonatal outcomes but is still being debated. In severe, prolonged or recurrent cases of VVC, other co-infections may be sought which may also need to be managed. Administration of probiotics for VVC therapy still requires further research.
Peranan Fibrinogen terhadap Kejadian Abortus pada Wanita Hamil Penderita Toksoplasmosis Levina, Jessica; Wahdini, Sri
The Indonesian Journal of Infectious Diseases Vol. 9 No. 1 (2023): The Indonesian Journal of Infectious Disease
Publisher : Rumah Sakit Penyakit Infeksi Prof Dr. Sulianti Saroso

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32667/ijid.v9i1.159

Abstract

Toxoplasma gondii merupakan penyebab penyakit toksoplasmosis. Lebih dari 60%  populasi di dunia sudah terinfeksi T. gondii. Prevalensi toksoplasmosis akut pada perempuan hamil adalah 4,8 per 1000 perempuan. Risiko infeksi janin hingga 13 minggu kehamilan sekitar 15% dan setelah itu risiko infeksi meningkat serta mencapai 72% pada minggu ke 36 kehamilan. Fibrinogen merupakan salah satu protein fase akut terpenting wanita hamil. Secara fisiologis terjadi peningkatan kadar prokoagulan darah (termasuk fibrinogen), namun kadar antikoagulan dalam darah berkurang selama kehamilan serta kinerja sistem fibrinolitik melemah. Di kondisi ini, jika wanita terinfeksi toksoplasmosis selama kehamilan, peningkatan faktor koagulatif berlebihan dapat meningkatkan risiko tromboemboli. Infeksi T.gondii diketahui meningkatkan sekresi IFN- γ pada hewan coba domba dan tikus kemudian mensekresi fibrinogen-like protein 2 (fgl2) yang berperan dalam deposisi fibrin dan trombosis. Fgl2 sebuah protrombinase transmembran yang secara langsung membelah protrombin menjadi trombin. Aktivitas protrombinase dari Fgl2 diobservasi pada kejadian abortus. Secara keseluruhan, sistem koagulasi makin kuat pada wanita hamil. Namun proses inflamasi akibat toksoplasmosis mengakibatkan terjadinya situasi prothrombic state yang berhubungan dengan peningkatan kadar fibrinogen. Peningkatan fibrinogen meningkatkan lagi inflamasi.  Peningkatan fibrinogen yang berlebihan meningkatakan risiko tromboemboli yang menyebabkan infark pada plasenta dan menyebabkan abortus.
Co-Authors Dwiana Ocviyanti Robiatul Adawiyah Sri Wahdini