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High Expression F2-Isoprostan (F2-IsoP), High Sterol Regulatory Element Binding Protein-2 (SREBP-2) and Low 2-Methoxyestradiol (2-ME) On Placenta Tissue as a Risk Factor of Pre-Eclampsia Jaya Kusuma AAN; Suwiyoga K; Mantik AN; Sukrama DM
Journal of Global Pharma Technology Volume 09 Issue 09
Publisher : Journal of Global Pharma Technology

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To date, pre-eclampsia (PE) still a problem of Maternal Fetal Medicine related to high incidence, maternal and neonatal morbidity and mortality. Pre-eclampsia is caused by pregnancy; however, the mechanism has not been established so it is still a disease of theories. This relates to differences in treatment, resulting in different ways of prevention and output of PE itself. Recently, the role of F2-IsoP ,SREBP-2 and 2-ME was suspected to be very important in the mechanism of the PE. Meanwhile, the placenta acts as a source regulatory protein production, so that the material of this study was taken from placental tissue. The study objective was to prove the high F2I-soP, high SREBP-2 and low 2-ME expression in the placenta as risk factors for PE Case control study has been conducted in the department of obstetrics and gynecology Sanglah Hospital with 62 samples in 2015. The case group consisted of 31 mothers with PE and control groups consisted of 31 non-PE mother. The study material is a placental tissue. F2-IsoP and SREBP-2 expression study was performed using immunohistochemistry and 2-ME with ELISA techniques in Pathobiology Laboratory Faculty of Veterinary Medicine Udayana University. Data were analyzed with chi square test and discriminant using SPSS. The statistical test results are presented in tabular form and narrative. In this study, it was found that high expression of F2-IsoP increased the risk of PE 4 times higher (OR = 4.44; 95% CI = 1.53 to 12.94; p = 0.005) ; high expression of SREBP-2 increased the risk of PE 8 times higher (OR = 8.19, CI95% = 2,311 to 29.073; p = 0.001) and low expression of 2-ME increased the risk of PE 5 times higher (OR = 5.23; CI95% = 1.75 to 15.55; p = 0.002). On the discriminant test, we obtained contributing risk factor for the occurrence of PE were SREBP-2, F2Isop and 2-ME (p = 0.002) respectively. Conclusion, high F2-IsoP expression, high SREBP-2 expression and low 2-ME expression in placenta were risk factors for PE. The most dominant risk factor of PE mechanism was SREBP-2.Keywords: Pre-eclampsia, F2-Isoprostane, Sterol Regulatory Element Binding Protein-2, 2-Methoxyestradiol.

Impact of COVID-19 on the histopathological aspect of the placenta during pregnancy Anak Agung Ngurah Jaya Kusuma
Majalah Obstetri & Ginekologi Vol. 31 No. 2 (2023): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V31I22023.97-102

The coronavirus disease 2019 (COVID-19) is still classified as a world pandemic. This disease can affect numerous systems of the human body. Pregnant women are classified as a vulnerable group since COVID-19 can cause high morbidity and mortality. Angiotensin-converting enzyme-2 (ACE-2) acts as a COVID-19 receptor, and this receptor is also present in the placenta. The placenta plays a significant part in the fetus, especially protecting it from harmful conditions. Since only a few studies are available, COVID-19’s influence on the placenta in pregnancy needs to be discussed further. The SARS-CoV-2-infected pregnant woman’s placenta showed histopathological alterations. Viral particles were detected on syncytiotrophoblast and chorionic villi vascular endothelial cells. Some studies show inflammatory conditions are not prominent in SARS-CoV-2 positive infection. This, perhaps due to the placenta’s immunological reaction, plays a significant role. The SARS-CoV-2 disorder tends to cause abnormalities within the placental tissue. Fetal vascular malperfusion (FVM) and maternal vascular malperfusion (MVM) are the most frequent findings from the studies included.

Beyond the Scar: A Case Report on the Clinical Presentation, Diagnostic Nuances, and Surgical Management of Type I Cesarean Scar Pregnancy Pradnyana, I Wayan Agus Surya; Anak Agung Ngurah Jaya Kusuma; Gde Bagus Rizky Kornia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1341

Background: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy where the gestational sac implants within the fibrous tissue of a previous cesarean section scar. Its incidence is rising in parallel with increasing cesarean delivery rates, posing significant risks of maternal morbidity, including uterine rupture and severe hemorrhage. Type I CSP, or endogenic CSP, involves implantation on a healed scar with growth primarily towards the uterine cavity. Early and accurate diagnosis, relying heavily on ultrasonographic nuances, is crucial for appropriate management and fertility preservation. Case presentation: We present the case of a 36-year-old woman, G7P3033, with a history of two prior cesarean sections, who presented at 6-7 weeks of gestation with vaginal discharge. Transabdominal ultrasonography revealed a gestational sac implanted on the anterior uterine wall within the cesarean scar area, with a thin myometrium between the sac and the bladder, consistent with a Type I (endogenic, COS-1, Grade II) Cesarean Scar Pregnancy. The patient also had Stage II hypertension. After thorough evaluation and counseling, the patient underwent a laparotomy with wedge resection of the CSP and scar revision, along with bilateral fimbriectomy as per her request for sterilization. Conclusion: This case highlights the importance of high clinical suspicion for CSP in pregnant women with previous cesarean sections presenting with early pregnancy symptoms. Detailed ultrasonography is paramount for accurate diagnosis, classification, and guiding management. Surgical management, specifically laparotomy with wedge resection and scar repair, proved to be an effective treatment for this Type I CSP, allowing for removal of the ectopic pregnancy and reinforcement of the uterine wall, while addressing the patient's desire for permanent contraception. Timely intervention is key to preventing life-threatening complications and preserving future reproductive options if desired.

Beyond the Scar: A Case Report on the Clinical Presentation, Diagnostic Nuances, and Surgical Management of Type I Cesarean Scar Pregnancy Pradnyana, I Wayan Agus Surya; Anak Agung Ngurah Jaya Kusuma; Gde Bagus Rizky Kornia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1341

Background: Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy where the gestational sac implants within the fibrous tissue of a previous cesarean section scar. Its incidence is rising in parallel with increasing cesarean delivery rates, posing significant risks of maternal morbidity, including uterine rupture and severe hemorrhage. Type I CSP, or endogenic CSP, involves implantation on a healed scar with growth primarily towards the uterine cavity. Early and accurate diagnosis, relying heavily on ultrasonographic nuances, is crucial for appropriate management and fertility preservation. Case presentation: We present the case of a 36-year-old woman, G7P3033, with a history of two prior cesarean sections, who presented at 6-7 weeks of gestation with vaginal discharge. Transabdominal ultrasonography revealed a gestational sac implanted on the anterior uterine wall within the cesarean scar area, with a thin myometrium between the sac and the bladder, consistent with a Type I (endogenic, COS-1, Grade II) Cesarean Scar Pregnancy. The patient also had Stage II hypertension. After thorough evaluation and counseling, the patient underwent a laparotomy with wedge resection of the CSP and scar revision, along with bilateral fimbriectomy as per her request for sterilization. Conclusion: This case highlights the importance of high clinical suspicion for CSP in pregnant women with previous cesarean sections presenting with early pregnancy symptoms. Detailed ultrasonography is paramount for accurate diagnosis, classification, and guiding management. Surgical management, specifically laparotomy with wedge resection and scar repair, proved to be an effective treatment for this Type I CSP, allowing for removal of the ectopic pregnancy and reinforcement of the uterine wall, while addressing the patient's desire for permanent contraception. Timely intervention is key to preventing life-threatening complications and preserving future reproductive options if desired.

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