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Plasma Level of Umbilical Cord Hemeoxygenase-1 (HO-1) and Neonatal Outcome in Early Onset and Late Onset Severe Preeclampsia Muhammad Ilham Aldika Akbar; Indah Mayang Sari; Ernawati Ernawati; Aditiawarman Aditiawarman
Molecular and Cellular Biomedical Sciences Vol 3, No 1 (2019)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1056.632 KB) | DOI: 10.21705/mcbs.v3i1.57

Abstract

Background: Many studies had discovered that early onset severe preeclampsia (EO-PE) has worst maternal and neonatal outcome compared to late-onset type (LO-PE), related to its placental involvement. Severe preeclampsia was defined as newly onset severe hypertension developed after 20 weeks gestation in previously normal blood pressure women, with coexistence of proteinuria, or maternal organ or uteroplacental dysfunction. Hemeoxygenase-1 (HO-1) is an enzyme with multiple effect which is protective to pregnancy.Materials and Methods: The total study subjects were 40 pregnant women consisted of 10 EO-PE, 10 normal early onset pregnancy (EO-NP), 10 LO-PE, and 10 normal late onset pregnancy (LO-NP). As much as 5 cc of plasma from umbilical cord was taken as soon as the baby was born, and the HO-1 level was examined by enzyme-linked immunosorbent assay (ELISA). The primary outcome were umbilical cord HO-1 level and neonatal composite morbidity (low Apgar score, low birthweight, length of stay >5 day, respiratory distress syndrome, jaundice and neonatal death).Results: The plasma level of HO-1 in EO-PE subjects were lower than EO-NP (0.96±0.37 ng/mL vs. 2.43±0.58 ng/mL, p<0.001). There were no significant differences in the level of HO-1 in LO-PE and LO-NP (2.18±1.07 ng/mL vs. 3.02±0.64 ng/mL, p=0.277). Plasma level of umbilical cord HO-1 of EO-PE patients was lower compared to LO-PE (0.96±0.37 ng/mL vs. 2.18±1.07 ng/mL, p=0.034). Neonatal outcome of EO-PE was worse than EO-NP (p=0.033), and LO-PE (p=0.003), while in LO-PE did not different with LO-NP (p=0.211).Conclusion: EO-PE is associated with lower plasma umbilical cord level of HO-1 and worse neonatal outcome compared to LO-PE. This indicating abnormal placental blood vessel development, placental ischemia in EO-PE, lead to reduced uteroplacental perfusion and significantly worse neonatal outcome compared to LO-PE.Keywords: severe preeclampsia, early onset preeclampsia, late onset preeclampsia, hemeoxygenase-1 
The Effect Of Progressive Muscle Relaxation and Slow Deep Breathing Combinations on Sleep Quality of Pregnant Women Mufidah Sheena Andani Prastini; Lilik Herawati; Endyka Erye Frety; Aditiawarman Aditiawarman
Halaman Olahraga Nusantara : Jurnal Ilmu Keolahragaan Vol 5, No 1 (2022): Halaman Olahraga Nusantara (Jurnal Ilmu Keolahragaan)
Publisher : Universitas PGRI Palembang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (353.275 KB) | DOI: 10.31851/hon.v5i1.6919

Abstract

Several studies suggest that poor sleep quality has an impact on both the mother and the fetus. Providing relaxation exercises in the form of progressive muscle relaxation and slow deep breathing can be a non-pharmacological effort to improve sleep quality in pregnant women. This study aims to analyze the effect of a combination of progressive muscle relaxation and slow deep breathing in pregnant women of third trimester. This research method is pre-experimental designs with a pretest-posttest control group design. The number of samples was 24 pregnant women trimester III with the sampling technique using consecutive sampling. The independent variable is the provision of progressive muscle relaxation and slow deep breathing exercises which are carried out for 3 times on a week over a period of 3 weeks. The dependent variable is sleep quality which is measured using the Pittsburgh Sleep Quality Index questionnaire. Data analysis used the Wilcoxon signed rank test. The results showed a decrease in the mean value in the direction of improved sleep quality by a difference of 4.5 in the experimental group. Whereas in the control group there was an increase in the value which led to a deteriorating sleep quality by a difference of 1.42. The test results showed a difference in the pretest and posttest of the two groups p = 0.000 (p <0.05). These data indicate that there is an effect of a combination of progressive muscle relaxation and slow deep breathing on the sleep quality pregnant women of third trimester. 
FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN PERSALINAN PREMATUR DI RSUD DR SOETOMO Noza Loviana; Ninik Darsini; Aditiawarman Aditiawarman
Indonesian Midwifery and Health Sciences Journal Vol. 3 No. 1 (2019): Indonesian Midwifery and Health Sciences Journal, January 2019
Publisher : UNIVERSITAS AIRLANGGA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/imhsj.v3i1.2019.85-97

Abstract

AbstrakLatar Belakang: Secara global, persalinan preterm menjadi penyebab utama kematian neonatus usia dini 0-7 hari pertama kehidupan dengan menimbulkan dampak morbiditas yang tinggi juga. Indonesia menempati urutan negara ke 5 estimasi persalinan preterm tertinggi di dunia. Beberapa faktor yang dapat berpengaruh terhadap persalinan preterm yaitu idiopatik, iatrogenik, sosio-demografi, maternal dan genetik. Penelitian ini bertujuan untuk melihat hubungan antara usia ibu, pendidikan ibu, pekerjaan ibu dan riwayat persalinan preterm terhadap kejadian persalinan prterm di RSUD Dr. Soetomo Surabaya. Metode: Metode penelitian ini adalah analitik observasional dengan rancang bangun case control. Jumlah populasi sebanyak 1311 orang pada periode 1 Januari - 31 Desember 2018. Sampel dibagi dalam dua kelompok yaitu kelompok kasus (ibu yang bersalin preterm) dan kelompok kontrol (ibu yang bersalin tidak preterm) sebanyak masing-masing kelompok 137 orang yang disesuaikan dengan kriteria inklusi dan eksklusi dan berdasarkan teknik pengambilan sampel yaitu simpel random sampling. Variabel independen terdiri dari usia ibu, pendidikan, pekerjaan dan riwayat persalinan preterm sedangkan variabel dependen adalah persalinan preterm. Analisis data bivariat menggunankan uji Chi-Square test dengan taraf signifikansi α = 0,05 (95% CI). Hasil: Hasil uji Chi-Square menunjukkan bahwa tidak ada hubungan bermakna antara usia ibu bersalin (nilai p = 0,259), pendidikan  (nilai p = 1), pekerjaan (nilai p = 0,225) dan riwayat persalinan preterm (nilai p = 0,191) dengan kejadian persalinan preterm. Kesimpulan: Faktor risiko seperti usa ibu bersalin, pendidikan ibu, pekerjaan ibu dan riwayat persalinan preterm tidak memiliki hubungan terhadap kejadian persalinan preterm. Abtract Background : Globally, preterm labor is the main cause of neonatal mortality in the first 0-7 days of life with a high impact of morbidity. Indonesia ranks 5th in the highest estimate of preterm labor in the world. Several factors that can influence preterm labor are idiopathic, iatrogenic, socio-demographic, maternal and genetic. This study aims to look at the relationship between maternal age, maternal education, maternal occupation and a history of preterm labor against the incidence of prenatal labor in RSUD Dr. Soetomo Surabaya. Method : The method of this study is observational analytic with a case-control design. The total population is 1311 people in the period January 1 - December 31, 2018. Samples were divided into two groups, namely the case group (preterm maternity) and the control group (mothers who were not preterm) as many as 137 groups each according to the inclusion criteria and exclusion and based on sampling techniques, namely simple random sampling. Independent variables consisted of maternal age, education, occupation and a history of preterm labor while the dependent variable was preterm labor. Bivariate data analysis used the Chi-Square test with a significance level of α = 0.05 (95% CI). Results : The Chi-Square test results showed that there was no significant relationship between maternal age (p = 0.259), education (p = 1), employment (p = 0.225) and preterm labor history (p = 0.191) with the incidence of preterm labor. Conclusion: Risk factors such as maternal age, maternal education, maternal occupation and a history of preterm labor have no relationship to the incidence of preterm labor.  
THE QUALITY OF ANTENATAL CARE BASED ON INDEX SATISFACTION OF PREGNANT WOMEN Nurmaliatul Firdaus; Aditiawarman Aditiawarman; Dwi Izzati Budiono
Indonesian Midwifery and Health Sciences Journal Vol. 5 No. 1 (2021): Indonesian Midwifery and Health Sciences Journal, January 2021
Publisher : UNIVERSITAS AIRLANGGA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/imhsj.v5i1.2021.62-72

Abstract

 AbstractBackground: Quality antenatal care in the MCH program is considered to be one of the effective efforts to reduce maternal and child morbidity and mortality. An indicator of the success of ANC services can be seen from the output produced, namely in the form of K4 coverage. According to Kotler there are 5 (five) determinants of service quality that can be used as a basis for assessing the level of customer satisfaction with the quality of service received including Tangibles, Reliability, Responsiveness, Assurance and Empathy. Method: This research method is quantitative descriptive with survey approach. The total sample of 149 pregnant women with total sampling techniques. The instrument used was a questionnaire. Data analysis uses univariate analysis. Results: The most valued statements both from each dimension namely; tangible: Midwife performance reliability: recording in the MCH handbook, responsiveness: responses to complaints, assurance: the nature of the Midwife, empathy of communication between midwives and patients. The most valued statements are enough from each dimension namely; tangible: examination room, reliability: service procedures, responsieness: midwife response to patients waiting for long queues, assurance: guarantee to service, empathy: suitability of waiting time and duration of service. Conclusion: The data shows that the majority of respondents considered the quality of antenatal services at the Tambakrejo Public Health Center to be good but still needed to be improved so that the assessment was sufficiently good. 
THE DIFFERENCES OF BEHAVIOUR TOWARDS PREGNANCY READINESS AMONG PREGNANT WOMEN BASED ON PARITY Fitri Indah Pratiwi; Wahyul Anis; Aditiawarman Aditiawarman; Reny I’tishom
Indonesian Midwifery and Health Sciences Journal Vol. 4 No. 2 (2020): Indonesian Midwifery and Health Sciences Journal, April 2020
Publisher : UNIVERSITAS AIRLANGGA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/imhsj.v4i2.2020.121-128

Abstract

Abstract Background : Low pregnancy planning can cause unwanted pregnancy, abortion, loss of reproductive health, domestic violence until death. 40% of 85 million pregnancies in the world are unplanned and 38% end with abortions, miscarriage and unplanned childbirth. Unplanned pregnancy are associated with an increased risk of birth outcomes, including preterm birth, low birth weight (LBW), high risk of congenital anomalies, and developmental delay. Most woman who have plan to get pregnant don’t prepare their pregnancy as well. Women who have children (Multiparous) having unreadiness of pregnancy as same as women who do not have children (Nulliparous). Therefore, pregnancy planning is required to avoid risks so that women become more prepared on facing the pregnancy. This study aimed to analyze the differences behaviour toward readiness of pregnancy among pregnancy women based on parity. Method : This study used observational analytical research with cross sectional approach. The sampling technique used was total sampling which was conducted for 2 months and the sample obtained 92 pregnant women (include nulliparous, primiparous and multiparous) who met the inclusion criteria. The collected data was analyzed by Fisher Exact levels with a degree of α = 0.05. Result : The study showed there were 12 respondents who ready to face pregnancy. Meanwhile, there were 80 respondents who were not ready enough to face pregnancy, it was based on the result of Fisher Exact test with the value obtained was P value = 0.223 (P > 0.223). Conclusion : This showed that there was no difference of attitudes about pregnancy readiness of nulliparous, primiparous and multiparous woman
Risks of preterm birth and low Apgar score among preeclamptic women Chiquita Febby Pragitara; Risa Etika; Lilik Herawati; Aditiawarman Aditiawarman
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 11, No 1, (2020)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol11.Iss1.art3

Abstract

Background: Preeclampsia has been a major problem for obstetric care in Indonesia due to risks of preterm birth and lower Apgar score. Objective: This study is to examine relationships of preeclampsia, preterm births, and Apgar Score.Methods: This used an analytic study with retrospective case-control design in Dr. Soetomo Academic Hospital. A case group was taken by total sampling from medical records of all patients who had preterm delivery in 2017, and a control group of term deliveries was taken by random sampling. Then the data were analysed by using Chi-square test and Fisher’s Exact Test.Results: There were 80 samples for each group. 63.75% of patients by age of 20-35 years were who delivered preterm birth, 40.00% had normal BMI, 40.00% were nulliparous, 92.50% did not have history of preterm labour, 50.00% had preeclampsia with severe features, and 46.25% had spontaneous vaginal delivery. Around 47.14% neonates from preeclamptic women were born at 32-<37 weeks gestation, 50.00% were born with low birth weight, 52.86% had the first minute Apgar score <7, and 72.86% had the fifth minutes Apgar score =7. The statistical analysis showed a significant relationship between the preeclampsia and the preterm birth (p<0.007; OR=2.54, 95% CI 1.34-4.83). The preeclampsia was also related to lower Apgar score at 1st minute (p<0.042; OR=2.03, 95% CI 1.07-3.85) and 5th minute (p<0.046; OR=2.42, 95% CI 1.08-5.41). Preterm neonates born from preeclamptic mothers were related to lower Apgar score at 1st minute (p<0.002; OR=5.82, 95% CI 1.99-17.02) and 5th minute (p<0.001; OR 17.31, 95% CI 2.15-139.54).Conclusion: Preeclampsia could make pregnant women at risks of delivering preterm birth and neonates with low Apgar score.
MIDWIVES' PERCEPTIONS OF PREECLAMPSIA SCREENING Febronia Martina Dua Lehang; Aditiawarman; Ivon Diah Wittiarika; Linda Dewanti
Indonesian Midwifery and Health Sciences Journal Vol. 8 No. 2 (2024): Indonesian Midwifery and Health Sciences Journal, April 2024
Publisher : UNIVERSITAS AIRLANGGA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/imhsj.v8i2.2024.102-116

Abstract

Background: Preeclampsia-related maternal mortality is a persistent issue globally, including in Indonesia. The International Federation of Gynecology and Obstetrics (FIGO) recommends universal preeclampsia screening in obstetric services. In Indonesia's NTT Province, pregnant women are screened based on guidelines in the MCH book. Sikka Regency mandates midwives to use the KSPR and MCH manuals for risk factor screening In 2022, 154 out of 9,685 screened pregnant women exhibited signs of preeclampsia risk factors. Despite the reduction in maternal deaths in Sikka Regency, the number of deaths directly linked to preeclampsia increased from one in 2021 to four in 2022. Notably, at Watubaing Public Health Center, two cases of maternal death were specifically attributed to preeclampsia. This underscores a significant gap in midwives' perceptions and clinical practices, elevating maternal mortality risk. This study explores midwives' perceptions of preeclampsia screening. Method: Qualitative research with a phenomenological approach at Watubaing Public Health Center involved three informants selected through purposive sampling, meeting the inclusion criteria. Data collection, conducted from April to July 2023, comprised in-depth semi-structured interviews that were subsequently analyzed thematically. Results: Midwives' expressed divergent opinions on preeclampsia screening, yet a consensus prevailed on its crucial importance. Conclusion: Midwives' perceptions of preeclampsia screening in ANC services are significantly shaped by internal and external factors, including knowledge and experience.
Low Birth Weight Infants Outcome In Single Tertiary Referral Hospital Putra, Dimas Abdi; I, Cininta N.; P, Wardhana M.; A, Aryananda R.; E, Gumilar K.; I, Aldika M.; B, Wicaksono; Ernawati, Ernawati; A, Sulistyono; Aditiawarman, Aditiawarman; J, Hermanto T.; N, Abdullah; G, Dachlan E.
Jurnal Medis Islam Internasional Vol 1 No 1 (2019): December
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v1i1.1386

Abstract

Background: Low birth weight (LBW) is defined by infants with birth weight less than 2500 gram, commonly caused by prematurity. Preterm infants are prone to problems such as organ immaturity, neurodevelopmental impairment until behavior disorder. Hypertension on pregnancy and preeclampsia is the most case referred and treated in dr. Soetomo General Hospital as a single tertiary teaching hospital in Surabaya, Indonesia which require early delivery and possess consequences to maternal and perinatal side. Objective: This study aims to determine the incidence and outcome of LBW infants born in dr. Soetomo General Hospital. Methods: Retrospective cross-sectional by using medical record data of dr. Soetomo General Hospital on January 2014 – December 2017. Results: There were 2350 infants with birth weight of 500-2499 gram, in which majority was on the range of 2001-2499 gram (38%.) Hypertension on pregnancy and the complications were the most indication for pregnancy termination that resulted in LBW infants. This study also found that the LBW outcome was linear with birth weight. In addition, the gestational age and five minutes APGAR score also had important role to the LBW outcome. Conclusion: The major cause of LBW infants in dr. Soetomo General Hospital was hypertension on pregnancy. There was a positive trend of survival in infants with birth weight range of 1501-2000 gram.
Clinical Characteristic of Congenital Fetal Anomaly In Tertiary Referral Hospital in East Java, Indonesia Amani, Fariska Zata; P, Wardhana M.; I, Cininta N.; A, Aryananda R.; E, Gumilar K.; I, Aldika M.; B, Wicaksono; Ernawati, Ernawati; A, Sulistyono; Aditiawarman, Aditiawarman; J, Hermanto T.; N, Abdullah; G, Dachlan E
Jurnal Medis Islam Internasional Vol 2 No 2 (2021): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v2i2.1624

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Background: Congenital fetal anomalies were defined as any structural defect present at birth. Congenital fetal anomalies are an important causes of neonatal morbidity and mortality in developed and developing countries that affect health care system. Reliable data on these congenital anomalies are still lacking, especially in Indonesia. Objective: This study aims to determine the characteristic profile of congenital fetal anomaly in single tertiary hospital in East Java, Indonesia. Methods: Retrospective cross-sectional by using medical record data of dr. Soetomo General Hospital on January – December 2017. Results: There were 58 cases (4,3%) with fetal congenital anomaly from 1360 deliveries in 2017. The majority of cases were referral cases (51 cases; 88%) and only seven cases were booked cases in obstetric outpatient dr. Soetomo General Hospital. Most of these congenital fetal anomaly cases ( 25 cases / 43,1%) were born from mother with ages 20 – 30 years old. Most cases (34 cases; 58,64%) were diagnosed first at third trimester (gestational age > 28 weeks). There were 36 cases (62%) had active termination of pregnancy. Thirty eight percent (22 cases) were born at 37-42 weeks and majority were born section caesaria. The three highest proportion of organ systems involved in fetal congenital anomalies were those of abdomen (22 cases; 37,9%); head (20 cases; 34,5%); thorax and muskuloskeletal (each 12 cases; 20,7%). Conclusion: The incidence of congenital fetal anomaly in dr. Soetomo Hospital at 2017 was 4,3%. Omphalocele and CTEV were two most common types of congenital fetal anomaly found. Most cases of congenital fetal anomalies have a poor prognosis, 67% cases born died. Further research about  risk factors and comprehensive database are needed on cases of congenital anomaly to establish appropriate prevention and management.
Early diagnosis and management of inseparable conjoint twins. A low-middle-income country experience Aditiawarman
Majalah Obstetri & Ginekologi Vol. 32 No. 1 (2024): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V32I12024.68-73

Abstract

HIGHLIGHTS Conjoined twins have captivated mankind for centuries due to the rarity of this birth type; nonetheless, physicians have constantly encountered difficulties in dealing with conjoined twins. Early diagnosis of conjoined twins during prenatal examination is critical for ascertaining the prognosis of the fetus, guiding parental counseling over appropriate courses of action, and potentially enabling the termination of the pregnancy. First-trimester ultrasonography and MRI are complementary modalities in determining the diagnosis and prognosis of conjoined twins in early pregnancy.   ABSTRACT Objectives: To discuss the crucial early diagnosis of conjoined twins to determine the type and prognosis. Case Report: A 27-year-old woman was referred to the type A referral hospital with suspicion of congenital abnormalities at 17 weeks of pregnancy. Ultrasound results showed intrauterine monochorionic monoamniotic twins with babies fused on their heads to the urogenital part. The MRI showed a craniopagus, suspected meningomyelocele, and severe bilateral hydronephrosis in the second baby. Due to non-separable cases and a bad prognosis for the fetus, the pregnancy was terminated using misoprostol induction and inserting a balloon catheter. The fetus was born weighing 400 g and 20 cm in length. Conjoined twins obtained the rostral type: a fused head with two faces, a fused thorax until the lower abdomen with one umbilicus, and two pairs of hands and feet. The diagnosis of conjoint twins becomes a problem in early pregnancy, mostly in developing countries. Early diagnosis of conjoined twins during prenatal examination is critical for ascertaining the prognosis of the fetus, guiding parental counseling over appropriate courses of action, and potentially enabling the termination of the pregnancy to prevent maternal stress and complications. Conclusion: Conjoined twins should be identified as soon as feasible to establish the best course of management for both mother and fetus. Ultrasonography and MRI are modalities for determining the diagnosis and prognosis of conjoined twins.