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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana E-Journal Obstetric & Gynecology Udayana Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico
I Wayan Megadhana
Department Of Obstetrics And Gynaecology, Udayana University, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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DIAGNOSIS AND MANAGEMENT OF HYPEREMESIS GRAVIDARUM Ary Widayana; I Wayan Megadhana; Ketut Putera Kemara
E-Jurnal Medika Udayana vol 2 no4 (2013):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (85.218 KB)

Abstract

Hyperemesis gravidarum is excessive nausea and vomiting in pregnant women to interfere with everyday activities because of poor patient's general condition due to dehydration. Studies estimate that nausea and vomiting occurred in 50-90% of pregnancies. Nausea and vomiting occurred in 60-80% of primi gravida and 40-60% of multi gravida. The cause of hyperemesis gravidarum is not known. Hyperemesis gravidarum, according to the severity of symptoms can be divided into three levels. The diagnosis of hyperemesis gravidarum is made through history, physical examination, and laboratory and USG finding. In patients with hyperemesis gravidarum levels II and III must be hospitalization with the provision of medical treatment, nutrition, parenteral fluids, and alternatives medicine. With a good treatment, the prognosis of hyperemesis gravidarum will be satisfying.
Wider pelvic transverse and intertuberum diameter are risk factors for pelvic organ prolapse Kadek Fajar Marta; Ketut Suwiyoga; I Wayan Megadhana
Neurologico Spinale Medico Chirurgico Vol 3 No 2 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i2.110

Abstract

Background: Pelvic floor’s shape and size are suspected of having associations with the occurrence of pelvic organ prolapse (POP). However, these relationships are not definitive and have never been evaluated. This study aims to identify the relationship between POP and pelvic floor size. Methods: This is a cross-sectional study involving women with or without POP who underwent gynecologic visits at the outpatient clinic. POP was diagnosed using the POP-Q questionnaire, whereas pelvic floor diameter was measured from the x-ray, comprising anteroposterior (AP), transverse (TS), interspinous (IS), and intertuberous (IT) diameters. Results: The TS and IT diameter of subjects with POP are significantly wider (p<0.001 and p=0.016), on the other hand, the AP and IS diameter were similar among two groups (p=0.36 and p=0.58). The subjects who have TS and IT diameter each above 12.185 and 10.140 cm have a higher risk of POP when compared to those who have TS and IT diameter lesser than the corresponding values (PRTS 3.85, 95% CI1.47-20.11; p<0.001; PRIT 2.49, 95% CI 1.12-5.53; p=0.013), with both, have partial correlation but TS more significant (Lambda 0.7; p-value 0.001 and Lambda 0.4; p-value 0.075). There was a relationship between a pelvic floor with POP. Subjects with POP have wider TS and IT diameters when compared to non-POP subjects. Conclusion: TS and IT diameters above 12.185 cm and 10.140 cm increase the risk of POP.
Ekspresi Enzim 1 Alfa-Hidroksilase Plasenta yang Rendah sebagai Faktor Risiko Terjadinya Preeklamsia Berat Florencia Desiree; I Wayan Artana Putra; I Wayan Megadhana; Anak Agung Ngurah Anantasika; Made Darmayasa; I Gde Sastra Winata
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 2 September 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n2.399

Abstract

Abstrak Tujuan: Untuk mengetahui ekspresi enzim 1-alfa-hidroksilase (CYP27B1) pada plasenta yang rendah sebagai faktor risiko terjadinya preeklamsia (PE) berat.Metode: Penelitian ini merupakan studi kasus-kontrol yang tak berpasangan, dengan total sampel 44 kasus dan kontrol. Sampel berupa plasenta yang diproses secara imunohistokimia, untuk melihat ekspresi enzim berdasarkan histoscore kumulatif (H-score) sebagai ekspresi rendah (H-score <200) atau ekspresi tinggi (H-score >200). Regresi logistik ganda digunakan untuk memperkirakan rasio odds yang disesuaikan (OR) dengan interval kepercayaan 95% (95% CI).Hasil: Ekspresi enzim 1alfa-hidroksilase plasenta yang rendah merupakan faktor risiko terjadinya PE berat sebesar sembilan kali lebih tinggi dibandingkan dengan ekspresi enzim 1-alfa-hidroksilase yang tinggi pada plasenta (OR 9,148; IK05% 2,072-40,386, p=0,002).Kesimpulan: Ekspresi rendah 1alfa-hidroksilase plasenta meningkatkan risiko terjadinya PE berat.Low Expression of 1 Alpha-Hydroxylase Enzyme in The Placenta as Arisk Factor for Preeclampsia with Severe FeaturesAbstractObjective: This study aims to determine the low expression of the 1-alpha-hydroxylase (CYP27B1) enzyme in the placenta as a risk factor for severe preeclampsia (PE).Methods: This study is an unpaired case-control study, with a total sample of 44 cases and controls. Samples were placentas that were immunohistochemically processed, to see enzyme expression based on the cumulative histoscore (H-score) as low expression (H-score <200) or high expression (H-score >200). Multiple logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI).Results: Low placental 1-alpha-hydroxylase expression was a risk factor for severe PE which was nine times higher than placental 1-alpha-hydroxylase expression (OR 9,148; 05% CI 2.072-40,386, p=0.002).Conclusions: Low placental 1alpha-hydroxylase expression increases the risk of severe PE.Key words: 1aplha-hydroxylase, expression, placenta, risk factor, severe preeclampsia
Purandare Hysteropexy in A 32 Years Old Woman with Stage III Pelvic Organ Prolapse and Cesarean History: Case Report Kadek Fajar Marta; I Wayan Megadhana; I Gede Mega Putra; Andy Susanto
Indonesian Journal of Obstetrics & Gynecology Science Volume 5 Nomor 2 September 2022
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v5n2.347

Abstract

Background: In reproductive age and low-parity women, pelvic organ prolapse is an uncommon case. Although this condition isn’t harmful, giving an appropriate treatment is important while considering women needs. This case report covers about the management of Purandare hysteropexy in a 32 years old woman with stage III pelvic organ prolapse and cesarean section history.Case: Conservative surgical therapy, Purandare hysteropexy, was performed on a reproductive age woman with stage III pelvic organ prolapse who wish to conserve her uterus.Result: Purandare hysteropexy was successfully performed on the patient, and she has better quality of life and minimal complaint after surgery.Conclusion: Purandare hysteropexy is an appropriate conservative surgical therapy, comparable to mesh using surgery, for women of reproductive age with pelvic organ prolapse.Histeropexi Purandare pada Wanita Usia 32 Tahun dengan Prolaps Organ Panggul Derajat III dan Riwayat Seksio Cesarea: Laporan KasusAbstrakLatar Belakang: Prolaps organ panggul adalah kasus yang jarang terjadi pada wanita usia reproduktif atau riwayat paritas rendah. Walaupun kondisi ini tidak berbahaya, terapi yang diberikan harus sesuai dengan keperluan dari wanita. Laporan kasus ini menggambarkan proses manajemen histeropexi purandare pada wanita usia 32 tahun dengan prolaps organ panggul wanita derajat III dan riwayat seksio cesarea.  Kasus: Terapi bedah konservatif, histeropexi purandare, dilakukan pada wanita usia reproduktif dengan prolaps organ panggul derajat III yang masih ingin mempertahankan uterusnya. Hasil: Purandare histeropeksi berhasil dilakukan pada pasien. Pasien mempunyai kualitas hidup dan keluhan yang minimal setelah prolaps organ panggul Kesimpulan: Histeropexi Purandare adalah terapi bedah konservatif, yang sesuai, setara dengan pembedahan yang menggunakan mesh, untuk dilakukan pada wanita usia reproduktif dengan prolaps organ panggul. Kata kunci: prolaps organ panggul, wanita usia reproduktif, purandare, histeropexi.
Infeksi Saluran Kemih Sebagai Faktor Risiko Terjadinya Persalinan Preterm Sugianto Sugianto; I Wayan Megadhana; Ketut Suwiyoga; Tjokorda Gde Agung Suwardewa; I Gusti Putu Mayun Mayura; Anom Suardika; I Wayan Artana Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (336.351 KB) | DOI: 10.15562/ism.v11i2.774

Abstract

Introduction: Preterm labor is one of the major problem and challenge in the obstetric field, since it is associated with high mortality and morbidity in newborn. Preterm delivery around 39.6% was thought to be caused by infection. One of the most common causes of preterm labor is Urinary Tract Infection (UTI). This study aims to determine the role of UTI in pregnancy as a risk factor for preterm labor.Method: This study is a case control study conducted from February 2019 to November 2019. This study involved 52 women (26 case group and 26 control group) with gestational ages over 20 weeks and under 37 weeks, where in case group with signs and symptoms of threatened of preterm delivery and in control group with no signs and symptoms of threatened of preterm delivery. The research sample is maternal peripheral blood for evaluation of Haemoglobin and mid stream urine for evaluation of Bacteriuria and Urine Culture - Resistance Test. Result: In this study, there were no differences in the value of characteristics of maternal age, gestasional age, and gravidity between the two groups (p> 0.05). Pregnancy with UTI (asymptomatic bacteriuria) increased the risk of preterm labor by 13 times compared to pregnancies without UTI (OR = 13.24; 95% CI = 1.53-114.30; p = 0.005 ).Conclusion: Based on the results of this study it can be concluded that a pregnancy with a UTI has a 13 times higher risk of experiencing preterm labor when compared to a pregnancy without a UTI.  Pendahuluan: Persalinan preterm adalah salah satu masalah dan tantangan dalam bidang obstetrik, terkait dengan tingginya mortalitas dan morbiditas pada bayi yang dilahirkan. Persalinan preterm sekitar 39,6% disebabkan oleh infeksi. Salah satu penyebab yang paling umum adalah Infeksi Saluran Kemih (ISK). Penelitian ini bertujuan untuk mengetahui peranan ISK dalam kehamilan sebagai faktor risiko terjadinya persalinan preterm.Metode: Penelitian ini adalah studi kasus kontrol yang dilakukan dari Februari 2019 hingga November 2019. Penelitian ini melibatkan 52 wanita (26 kelompok kasus dan 26 kelompok kontrol) dengan usia kehamilan lebih dari 20 minggu dan di bawah 37 minggu, di mana dalam kelompok kasus dengan adanya tanda dan gejala ancaman persalinan preterm dan dalam kelompok kontrol tanpa adanya tanda dan gejala ancaman persalinan preterm. Sampel penelitian adalah darah tepi ibu untuk keperluan menilai kadar Hemoglobin dan urin aliran tengah untuk keperluan evaluasi adanya Bakteriuria dan selanjutnya untuk Kultur Urin – Uji Resistensi.Hasil: Dalam penelitian ini, diketahui bahwa tidak ada perbedaan bermakna dalam karakteristik usia ibu, usia kehamilan, dan graviditas antara kedua kelompok (p>0,05). Diketahui bahwa kehamilan dengan ISK (bakteriuria asimptomatik) meningkatkan risiko persalinan preterm sebesar 13 kali dibandingkan dengan kehamilan tanpa ISK (OR = 13,24; IK 95%= 1,53-114,30; p = 0,005).Simpulan: Berdasarkan hasil penelitian ini disimpulkan bahwa kehamilan dengan ISK memiliki risiko 13 kali lebih tinggi mengalami persalinan preterm bila dibandingkan dengan kehamilan tanpa ISK.
Ekspresi tenascin-C yang tinggi pada ligamentum sakrouterina sebagai faktor risiko terjadinya prolaps uterus derajat III-IV di RSUP Sanglah Denpasar, Bali-Indonesia I Wayan Megadhana; Riza Firman Satria; Ketut Suwiyoga; I Gusti Putu Mayun Mayura; Putu Doster Mahayasa; I Nyoman Bayu Mahendra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (442.813 KB) | DOI: 10.15562/ism.v11i2.791

Abstract

Introduction: Uterine prolapse is the descent of the uterus into the vagina or out of the vagina as a result of the failure of the ligament as a pelvic support. Uterine prolapse has multifactorial risk factors, but in every case of uterine prolapse, weakness is found in the pelvic floor supporting tissues, including the sacrouterine ligament. Childbirth is direct trauma that cause damage and weakness of levaor ani muscle, which leads to stretch of sacrouterine ligament that plays important role in maintaining uterus in its normal position. The main structure of the sacrouterine ligament consists of cells and extracellular matrix such as collagen, elastin, glycoproteins (fibronectin, tenascin, link protein, fibromodulin and dan osteopontin) and proteoglycans (agrecan, versican, biglican, dan perlecan). Tenascin is a major oligomeric glycoprotein found in the extracellular matrix. Tenascin has an important role not only during development but also when there are pathological conditions in adulthood such as tissue injury and tumorigenesis. Based on the current research, there are four tenascin groups, that are: tenascin-C, tenascin-R, tenascin-X, tenascin-Y and tenascin-W. If there is an expression of tenascin-C disturbance  in the sacrouterine ligament, it will cause uterine prolapse. The purpose of this study was to prove the high expression of tenascin-C in the sacrouterine ligament as a risk factor for stage III-IV uterine prolapse.Method: This research is an observational study with case control design. Forty four cases was included in this study. Twenty-two cases of III-IV degree uterine prolapse as study group and another 22 non-prolapse cases as a control group. This research was carried out in Sanglah General Hospital and Patobiology Laboratory of the Faculty of Veterinary Medicine UNUD. Samples were taken from the sacrouterine ligament of grade III-IV uterine prolapse patients and uterine non-prolapse patients, that had been performed total hysterectomy.Result: The results showed that high tenascin-C expression was a risk factor for stage III - IV uterine prolapse by 5.9 times (OR = 5.9; IK 95% = 1.59-22.32; p = 0.006).Conclusion: It can be concluded  that high expression of tenascin-C in the sacrouterine ligament is a risk factor of III-IV degree uterine prolapse.  Latar Belakang: Prolaps uterus adalah turunnya uterus ke dalam liang vagina atau keluar liang vagina sebagai akibat gagalnya ligmentum penyokong dasar panggul. Prolaps uterus memiliki faktor risiko yang bersifat multifaktorial, namun pada setiap  kasus prolaps uterus, selalu ditemukan kelemahan pada jaringan penyangga dasar panggul, termasuk ligamentum sakrouterina. Trauma langsung pada jalan lahir yang mengakibatkan kerusakan dan kelemahan otot levaor ani sehingga mengakibatkan ligamentum sakrouterina meregang untuk mempertahankan uterus dalam posisi normal. Struktur utama ligamen sakrouterina terdiri dari sel dan matriks ekstraseluler seperti kolagen, elastin, glikoprotein (fibronectin, tenascin, link protein, fibromodulin ) dan proteoglikan (agrecan, versican, biglican, dan perlecan). Tenascin merupakan suatu glikoprotein oligomerik utama yang terdapat pada matriks ekstraseluler. Tenascin memiliki peranan penting tidak hanya pada masa perkembangan tetapi juga saat terjadi kondisi patologis pada usia dewasa  seperti cedera jaringan dan tumorigenesis. Berdasarkan penelitian saat ini,  dikenal empat kelompok tenascin yaitu : tenascin-C, tenascin-R, tenascin-X, tenascin-Y dan tenascin-W. Apabila terjadi gangguan dalam ekspresi tenascin-C pada ligamentum sakrouterina akan menyebabkan terjadinya prolaps uterus. Tujuan penelitian ini adalah untuk membuktikan ekspresi tenascin-C yang tinggi pada ligamentum sakrouterina sebagai faktor risiko terjadinya prolaps uterus derajat III-IV.Metode: Penelitian ini merupakan rancangan observasional dengan kasus kontrol. Terdapat  22 kasus prolaps uterus derajat III-IV sebagai kelompok kasus dan 22 kasus non prolaps sebagai kelompok kontrol. Penelitian ini dikerjakan di RSUP Sanglah dan Laboratorium Patobiologi FKH UNUD. Sampel diambil dari ligamentum sakrouterina pasien prolaps uterus derajat III-IV dan  non-prolaps uterus yang telah dilakukan histerektomi total.Hasil: Hasil penelitian didapatkan bahwa ekspresi tenacin-C yang tinggi merupakan faktor risiko terjadinya prolaps uterus derajat III - IV sebesar 5,9 kali (OR =5,9; IK 95% =1,59-22,32; p =0,006).Simpulan: Sehingga dapat disimpulkan bahwa ekspresi tenascin-C yang tinggi pada ligamentum sakrouterina sebagai faktor risiko terjadinya prolaps uterus derajat III-IV.
Ekspresi sel fibroblas yang rendah pada ligamentum sakrouterina sebagai faktor risiko terjadinya prolaps uterus derajat III-IV di RSUP Sanglah Denpasar, Bali-Indonesia Yosevangelika Hutabarat; I Wayan Megadhana; Ketut Suwiyoga; Nyoman Mantik Astawa; Arthawan Arthawan
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.008 KB) | DOI: 10.15562/ism.v11i2.793

Abstract

Introduction: Uterine prolapse is the fall of the uterus into the vaginal due to the failure of the pelvic floor supporting ligaments. Uterine prolapse has multifactorial risk factors, but in every case of uterine prolapse, weakness in the pelvic floor, including the sacrouterine ligament, is always found. The strength of the sacrouterine ligament is determined by fibroblasts and extracellular matrix. Fibroblasts are the most cells making up the ligament, where the ligament is a connective tissue consisting of most collagen fibers that provide a structure with high tensile strength. Women with POP have a picture of changes that occur in the supporting tissues, where the extracellular matrix plays an important role because of accelerated remodeling in POP patients caused by biochemical changes in extracellular matrix such as collagen, elastin and stromal cells. Myofibroblasts play an important role in extracellular matrix remodeling and its regulation by matrix cell regulators such as metalloprotease (MMP) matrix, transformation growth factor (TGF) -β, and thrombospondin (TSP)-1. The purpose of this study was to prove the low expression of fibroblast cells in the sacrouterine ligament as a risk factor for stage III-IV uterine prolapse.Method: This study was an observational design with case control. There were 22 cases of grade III-IV uterine prolapse as a group of cases and 22 cases of non-prolapse as a control group. This research was carried out at Sanglah General Hospital and the Integrated Biomedical Laboratory of Faculty of Medicine, Universitas Udayana. Samples were taken from sacrouterine ligament of uterine prolapsed patients with stage III-IV and uterine non-prolapse who had performed total hysterectomy at Sanglah Hospital.Results: The results showed that low expression of fibroblasts became a risk 9 times higher of uterine prolapse grade III-IV compared to high level of fibroblast expressin (OR = 9.1; IK95% = 2.3-35.7; p = 0.001).Conclusion: From the results of this study it can be concluded that the low expression of fibroblasts in the sacrouterine ligament is a risk factor for stage III-IV uterine prolapse. Pendahuluan: Prolaps uterus adalah turunnya uterus ke dalam liang vagina atau keluar liang vagina sebagai akibat gagalnya ligamentum penyokong dasar panggul. Prolaps uterus memiliki faktor risiko yang bersifat multifaktorial, namun pada setiap kasus prolaps uterus, selalu ditemukan kelemahan pada jaringan penyangga dasar panggul, termasuk ligamentum sakrouterina. Kekuatan ligamentum sakrouterina ditentukan oleh fibroblas dan matriks ekstraselular. Fibroblas adalah sel terbanyak penyusun ligamentum, dimana ligamentum merupakan jaringan ikat yang terdiri dari sebagian besar serat kolagen yang menyediakan struktur dengan daya tarik yang tinggi. Wanita dengan POP memiliki gambaran perubahan yang terjadi pada jaringan penyokong, dimana matriks ekstraseluler memegang peranan penting karena akselerasi remodeling pada pasien POP yang disebabkan oleh perubahan biokimia pada matriks ekstraseluler seperti kolagen, elastin dan sel stromal. Miofibroblas berperan penting dalam remodeling matriks ekstraseluler dan pengaturannya oleh regulator sel matriks seperti matriks metalloprotease (MMP), transformation growth factor (TGF)-β, dan thrombospondin (TSP)-1. Tujuan penelitian ini adalah untuk membuktikan ekspresi sel fibroblas yang rendah pada ligamentum sakrouterina sebagai faktor risiko terjadinya prolaps uterus derajat III-IV.Metode: Penelitian ini merupakan rancangan observasional dengan kasus kontrol. Terdapat 22 kasus prolaps uterus derajat III-IV sebagai kelompok kasus dan 22 kasus non prolaps sebagai kelompok kontrol. Penelitian ini dikerjakan di RSUP Sanglah dan Laboratorium Biomedik Terpadu FK Universitas Udayana. Sampel diambil dari ligamentum sakrouterina pasien prolaps uterus derajat III-IV dan non-prolaps uterus yang telah dilakukan histerektomi total di RSUP Sanglah.Hasil: Hasil penelitian didapatkan bahwa ekspresi fibroblas yang rendah menjadi risiko terjadinya prolaps uterus derajat III-IV sebesar 9 kali (OR=9,1; IK95%=2,3-35,7; p=0,001).Simpulan: Dari hasil penelitian ini dapat disimpulkan bahwa ekspresi fibroblas yang rendah pada ligamentum sakrouterina menjadi faktor risiko terjadinya prolaps uterus derajat III-IV.
Ekspresi reseptor vitamin D plasenta yang rendah sebagai faktor risiko terjadinya preeklampsia dengan gambaran berat I Gede Mahendra Adiguna Dira; Ketut Suwiyoga; I Wayan Artana Putra; I Gede Mega Putra; Ida Bagus Gede Fajar Manuaba; I Gde Sastra Winata; I Wayan Megadhana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1208

Abstract

Introduction: Preeclampsia is the cause of 10-15% of maternal deaths in Indonesia and occurs in about 2-10% of all pregnancies worldwide. The pathogenesis that underlies the occurrence of preeclampsia is not yet clearly known so that preeclampsia is referred to as a disease of theory. Nutritional factors such as vitamin D also play a role in the development of preeclampsia. This study aims to determine the relationship between vitamin D receptor expression as a risk factor for preeclampsia with severe features.Method: This study used a case-control design conducted in the maternity ward of Sanglah General Hospital, Denpasar from February to August 2020. A sample of 44 subjects was obtained and divided into case groups and control groups. Examination of vitamin D receptors using a central area placenta measuring 2x2 cm which was then examined semi-quantitatively at the Histology Laboratory, Faculty of Medicine, Udayana University.Result: The results were analyzed using the chi square test. There was no significant difference in the characteristics of the two groups. There was a significant relationship between low VDR expression in the placenta and the incidence of preeclampsia with severe features (p-value 0.002; 95% CI 1.96-31.57; OR 7.88).Conclusion: Low VDR placenta expression in pregnant women increases the risk of preeclampsia with a severe picture of 7.88 times greater than high VDR expression. Pendahuluan: Preeklampsia menjadi penyebab 10-15% kematian maternal di Indonesia, dan terjadi pada sekitar 2-10% dari seluruh kehamilan di seluruh dunia. Patogenesis yang mendasari terjadinya preeklampsia sampai saat ini belum jelas diketahui sehingga preeklampsia disebut sebagai disease of theory. Faktor nutrisi seperti vitamin D juga memainkan peran dalam terjadinya preeklampsia. Penelitian ini bertujuan mencari hubungan ekspresi reseptor vitamin D sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.Metode: Penelitian ini menggunakan desain kasus-kontrol yang dilakukan di Ruang Bersalin RSUP Sanglah Denpasar pada Februari sampai Agustus 2020. Didapatkan sampel sebanyak 44 subyek dan dibagi kedalam kelompok kasus dan kelompok kontrol. Pemeriksaan reseptor vitamin D menggunakan plasenta area sentral ukuran 2x2 cm yang kemudian diperiksa secara semikuantitatif di Laboratorium Histologi Fakultas Kedokteran Universitas Udayana. Hasil dianalisa menggunakan uji chi square.Hasil: Tidak terdapat perbedaan karakteristik yang bermakna pada kedua kelompok. Terdapat hubungan yang bermakna antara ekspresi VDR pada plasenta yang rendah terhadap kejadian preeklamsia dengan gambaran berat (p-value 0.002; IK 95% 1.96-31.57; OR 7.88).SimpulanEkspresi VDR plasenta yang rendah pada ibu hamil meningkatkan risiko terjadinya preeklamsia dengan gambaran berat sebesar 7,88 kali lebih besar dibandingkan ekspresi VDR tinggi.
Polimorfisme gen COL1A1 sebagai faktor risiko terjadinya prolaps organ panggul pada perempuan Bali, Indonesia Putra Agung Eka Aricandana; I Gede Mega Putra; I Wayan Megadhana; Anak Agung Ngurah Anantasika; Ida Bagus Gde Fajar Manuaba; I Gede Ngurah Harry Wijaya Surya
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1209

Abstract

Introduction: Pelvic organ prolapse (POP) is still a common health problem in women, especially in the elderly female population. Pelvic organ prolapse is associated with a reduced quality of life for millions of women worldwide. The purpose of this study was to determine the role of the COL1A1 rs 1800012 gene polymorphism as a risk factor for pelvic organ prolapse in Balinese women, Indonesia.Methods: This case-control observational study involved 60 Balinese women aged 30-70 years divided into 30 subjects with pelvic organ prolapse as a case group and 30 subjects with non-pelvic organ prolapse as a control group. Subject selection and clinical examination were carried out at the Reconstructive Urogynecology Polyclinic and Obstetrics and Gynecology Polyclinic, Sanglah Central General Hospital Denpasar and Prima Medika General Hospital Denpasar. Three ml of blood sample was drawn and then put into a bottle containing EDTA for Polymerase Chain Reaction COL1A1 rs 180012 gene polymorphisms at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The data obtained were then analyzed using the Statistical Product and Service Solutions software version 21.0.Results: COL1A1 gene polymorphism was found in eight subjects in the case group and one subject in the control group. The results of bivariate analysis showed a significant relationship between the COL1A1 gene polymorphism and the incidence of pelvic organ prolapse (p = 0.011). The results of multivariate analysis revealed a significant relationship between COL1A1 gene polymorphisms and pelvic organ prolapse after controlling for controlled variables (parity status, occupation, BMI, age, menopause, and history of hysterectomy). Multivariate analysis showed adjusted odd ratio of 16.157 for the COL1A1 gene polymorphism (p = 0.021).Conclusion: COL1A1 gene polymorphism significantly increases the risk of pelvic organ prolapse in Balinese women.  Pendahuluan: Prolaps organ panggul (POP) masih menjadi masalah kesehatan umum pada perempuan, terutama pada populasi wanita lanjut usia. Prolaps organ panggul berkaitan dengan penurunan kualitas hidup dari jutaan wanita di seluruh dunia. Tujuan dari penelitian ini adalah untuk mengetahui peran polimorfisme gen COL1A1 rs 1800012 sebagai faktor risiko kejadian prolaps organ panggul pada perempuan Bali, Indonesia.Metode: Studi observasional kasus kontrol ini melibatkan 60 orang perempuan Bali berusia 30-70 tahun yang terdiri dari 30 orang dengan diagnosis prolaps organ panggul sebagai kelompok kasus dan 30 orang dengan diagnosis non prolaps organ panggul sebagai kelompok kontrol. Pemilihan subjek dan pemeriksaan klinis dilakukan di Poliklinik Uroginekologi Rekonstruksi dan Poliklinik Obstetri dan Ginekologi Rumah Sakit Umum Pusat Sanglah Denpasar dan Rumah Sakit Umum Prima Medika Denpasar. Sampel darah diambil sebanyak 3 ml kemudian dimasukkan ke dalam botol yang berisi EDTA dan dilakukan pemeriksaan Polymerase Chain Reaction untuk polimorfisme gen COL1A1 rs 180012 di Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Data yang diperoleh kemudian dianalisis menggunakan perangkat lunak Statistical Product and Service Solutions versi 21.0.Hasil: Polimorfisme gen COL1A1 ditemukan pada 8 subjek pada kelompok kasus dan 1 subjek pada kelompok kontrol. Hasil analisis bivariat menunjukkan adanya hubungan signifikan antara polimorfisme gen COL1A1 dan kejadian prolaps organ panggul (p = 0,011). Hasil analisis multivariat memperjelas hubungan signifikan antara polimorfisme gen COL1A1 dan prolaps organ panggul setelah dikontrol dengan variabel terkendali (status paritas, pekerjaan, imt, umur, menopause, dan riwayat histerektomi). Hasil analisis multivariat menunjukkan adjusted odd ratio sebesar 16,157 untuk polimorfisme gen COL1A1 (p = 0,021).Simpulan: Polimorfisme gen COL1A1 secara signifikan meningkatkan risiko terjadinya prolaps organ panggul pada perempuan Bali.
The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM) Danny Aguswahyudi; Ketut Suwiyoga; I Ketut Surya Negara; I Wayan Megadhana; I Nyoman Bayu Mahendra; I Gusti Putu Mayun Mayura; Made Bagus Dwi Aryana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.252 KB) | DOI: 10.15562/ism.v13i1.1216

Abstract

Background: Several biomarkers have been investigated as predictors of Premature rupture of membrane (PROM), but these biomarkers have not been applied in clinical practice due to their high cost and complexity. Beta-HCG is thought to be an easy, cost-effective and promising predictor of PROM in clinical practice. This study aims to determine the relationship between beta-hCG level in vaginal washing fluid with the PROM and the cut-off value of beta-hCG level in vaginal washing fluid in predicting the incidence of PROM.Methods: This diagnostic study was conducted in the Sanglah General Hospital, Denpasar, from May to July 2020. The subjects involved in this study are all pregnant women with gestational age ?24 weeks who came with complaints of vaginal discharge and were treated in the delivery room of the Emergency Ward, Sanglah General Hospital. The beta-HCG level was evaluated using the immunoassay method and the ROC curve analysis was performed to determine the beta-hCG level in vaginal washing cut-off point that can predict the incidence of PROM. Data were analyzed using SPSS version 22 for Windows.Results: Thirty-five subjects who met the inclusion and exclusion criteria were involved in this study. The cut-off value of beta-hCG vaginal washing fluid to predict PROM obtained in this study was 118.1 mIU/ml with sensitivity of 95.83%, specificity of 81.81%, PPV of 92.00%, NPV of 90.00%, and accuracy of 91.43% (AUC: 0.947; 95%CI: 0.870-1.000; p<0.001).Conclusion: Beta-hCG level in the vagina washing fluid can be used as a fast and non-invasive predictor of PROM in pregnant women.
Co-Authors Agustinus Darmawan Hariyanto Anak Agung Gede Putra Wiradnyana Anak Agung Ngurah Anantasika Anak Agung Ngurah Anantasika Anak Agung Ngurah Jaya Kusuma Andy Susanto Anom Suardika Arthawan Arthawan Ary Widayana Clara Marcaelia Valerian Daniel Hadinata Susanto Danny Aguswahyudi Florencia Desiree Gede Angga Permana AW I Gde Sastra Winata I Gede Egy Saputra Jaya I Gede Mahendra Adiguna Dira I Gede Mega Putra I Gede Ngurah Harry Wijaya Surya I Gusti Agung Ayu Sri Wulandari Pramana I Gusti Putu Mayun Mayura I Ketut Surya Negara I Ketut Suwiyoga I Made Darmayasa I Nyoman Gede Budiana I NYOMAN MANTIK ASTAWA I Wayan Artana Putra Ida Bagus Gde Fajar Manuaba Ida Bagus Putra Adnyana Ida Bagus Rendra Kurniawan Artha Ines Kurniaty Hartono Kadek Fajar Marta Ketut Putera Kemara Leony Lim Made Bagus Dwi Aryana Nyoman Bayu Mahendra Putera Kemara Putra Agung Eka Aricandana Putra, I Wayan Artana Putu Adi Sujana Putra Putu Doster Mahayasa Riza Firman Satria Ryan Saktika Mulyana Sugianto Sugianto Tjokorda Gde Agung Suwardewa Widyasari, Putu Kartika Yosevangelika Hutabarat