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All Journal Jurnal Kedokteran Diponegoro Majalah Obstetri dan Ginekologi Universa Medicina Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Indonesian Journal of Medicine Medica Hospitalia Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Herman Kristanto
Department Of Obstetric And Gynecology, Faculty Of Medicine, Diponegoro University, Semarang
Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Serum 8-isoprostane increased in pre-eclampsia Pramono, Besari Adi; Kristanto, Herman
Universa Medicina Vol 31, No 1 (2012)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2012.v31.43-51

Abstract

Background The main causes of maternal mortality in Indonesia are pre-eclampsia, hemorrhage, and infection. Oxidative stress has a primary role in pre-eclampsia and one of its parameters is 8-isoprostane serum level. The objective of this study is to measure 8-isoprostane and to analyze the relationship between 8-isoprostane level and birth weight in pre-eclampsia.Methods A cross-sectional study involving 23 pre-eclampsia and 29 normotensive pregnant women with normal or cesarean delivery at Dr. Kariadi Hospital Semarang from January to May 2011. Collected maternal blood samples were assessed for 8-Isoprostane levels by means of a specific ELISA kit. Neonatal birth weight was measured immediately after delivery by means of calibrated baby scales. Differences in 8-isoprostane levels between pre-eclampsia and normotensive women were assessed using independent t-test for normal distributed data, and the Mann-Whitney test for non-normally distributed data. ResultsMean 8-isoprostane level was significantly higher in women with pre-eclampsia than in normotensive women (62.52 ± 12.19 pg/mL vs 28.64 ± 8.81 pg/mL) (p<0.05). Low birth weight was twice as frequent in pre-eclampsia than in normotensives. There was no correlation between 8-isoprostane serum level and neonatal birth weight in pre-eclampsia.Conclusion The level of 8-isoprostane was higher in pre-eclampsia than in normotensives. It is recommended to conduct further studies to determine whether 8-isoprostane may be used as a predictive marker of pre-eclampsia.
Effect of L- Arginin on Placental Hipoxia Inducible Factor -1-Alpha (HIF-1-A) Expression at Preeclampsia Mice Models Anggraini, Nutria Widya Purna; Sulistyowati, Sri; Pramono, Besari Adi; Kristanto, Herman
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.436 KB)

Abstract

Background: Placental hypoxia is one of the theories that cause preeclampsia. In placental hypoxia of preeclampsia, there is an increase of Hipoxia Inducible Factor 1 Alpha (HIF-1-A) expression as a response to hypoxia. L-Arginine administration through the L-Arginine-Nitric Oxide pathway is expected to improve placental hypoxia. This study aimed to examine the effect of L- Arginin on placental HIF-1-A expression at preeclampsia mice models.Subjects and Method: Experimental study with parallel group post-test only design. The study was carried out at the Veterinary Medicine Faculty of Airlangga University. Thirty six preeclampsia mice models were made with intravenous injection 10ng anti-Qa-2 on day 1-4 of pregnancy. They were divided into 2 groups: (1)18 mice without treatment (control) and (2) 18 mice were given L-Arginin 200 mg/kgBW/day on day 7-15 of pregnancy. They were terminated on day 16 then immunohistochemistry examination of HIF-1-A expression was done on the placental samples. The dependent variable was placental Hipoxia Inducible Factor-1-Alpha (HIF-1-A) expression. The independent variables were L-Arginin administration. HIF-1-A expression was measured by H-Score method. The data were analyzed by t-test. Results: The mean of placental HIF-1-A expressions of treatment group was lower (Mean= 7.98; SD=9.35) than control group (Mean=41.95; SD= 32.20), and it was statistically significant (p <0.001).Conclusion: L-Arginin reduces the Placental Hypoxia Inducible Factor Alpha (HIF-1-A) expression on preeclampsia mice model.Keywords: L-Arginine, HIF-1-A, PreeclampsiaCorrespondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java, Indonesia. Email: nutria_dr@staff.uns.ac.id. Mobile: 08122651819.Indonesian Journal of Medicine (2020), 05(03): 191-199https://doi.org/10.26911/theijmed.2020.05.03.03 
BREAST CANCER IN PREGNANCY AT DR. KARIADI GENERAL HOSPITAL: A SERIAL CASE Ireneus Vanessa Martono; M. Besari Adi Pramono; Herman Kristanto; Albertus Ari Adrianto
JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL) Vol 10, No 2 (2021): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v10i2.29172

Abstract

Background Each year 2.1 million women were diagnosed with breast cancer, being the most common type of cancer found and cancer-related cause of death in women worldwide. In Indonesia, especially in Middle Java, more than 80% women diagnosed were already in the late stage. Physiological changes in pregnancy contributes to the delay in diagnosis in pregnant women and pregnancy also resulted in a more complicated approach of therapy. Regarding only few studies were done involving pregnancy with breast cancer, the aim of the study is to provide further knowledge associated with it.Methods Medical records of pregnant women with breast cancer in year 2014-2018 at Dr. Kariadi General Hospital were studied.Results Based on the 3 cases be studied, patients were referred from class B and C hospitals outside of Semarang city showing stage III (33.33%) and IV (66.67%) breast cancers. Two-third of the patients underwent mastectomy previously and one of them also underwent chemotherapy program prior her pregnancy. Comorbidities varied between patients and therapies were adjusted individually and multidisciplinary. Two of the cases went through transperitoneal caesarean section for delivery and one patient with twin pregnancy died by complications and intrauterine foetal death was also determined.Conclusion Overall, all patients were > 35 years old and the breast cancers were diagnosed at late stage. Complications by comorbidities such as anaemia, severe malnutrition, and infection, were found. Two pregnancies which were already in third trimester was terminated and a case of maternal mortality was found.Keywords Breast cancer, pregnancy
High-Sensitivity Cardiac Troponin I Level and Left Ventricular Diastolic Dysfunction on Severe Preeclampsia: Kadar High Sensitivity Cardiac Troponin I dan Disfungsi Diastolik Ventrikel Kiri pada Preeklamsia Berat Rahmad R. B. Wicaksono; Julian Dewantiningrum; Herman Kristanto
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 1 January 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i1.1429

Abstract

Abstract Objective: To know the relationship between high-sensitivity cardiac Troponin I (hscTnI) level with left ventricular dysfunction on severe preeclampsia.Methods: An observational analytics study with a cross-sectional approach of ten pregnant women with severe preeclampsia who underwent delivery or termination pregnancy and then performed a transthoracic echocardiography examination and serum levels of hscTnI.Results: There is a significant relationship between hscTnI levels and left ventricular diastolic dysfunction (p <0.05)Conclusion: These findings of this study have significant implications that severe preeclampsia is associated with heart remodelling and significant change in cardiac function especially left ventricular dilatation and elevation of hscTnI. Early identification and intervention may ameliorate subsequent cardiovascular disease so this requires regular and close follow-up of this target group.Keywords: high-sensitivity cardiac Troponin I, left ventricular diastolic dysfunction, severe preeclampsia. Abstrak Tujuan: Untuk mengetahui hubungan antara kadar high-sensitivity cardiac Troponin I (hscTnI) dengan disfungsi ventrikel kiri pada preeklamsia berat.Metode: Studi observasional dengan pendekatan potong lintang terhadap sepuluh ibu hamil dengan preeklamsia berat yang menjalani persalinan atau terminasi kehamilan kemudian dilakukan pemeriksaan ekokardiografi dan kadar hscTnI serum.Hasil: Ada hubungan yang bermakna antara kadar hscTnI dengan disfungsi diastolik ventrikel kiri (p <0,05).Kesimpulan: Temuan penelitian awal ini memiliki implikasi yang signifikan bahwa preeklamsia berat berhubungan dengan remodeling jantung dan perubahan signifikan pada fungsi jantung terutama dilatasi ventrikel kiri disertai peningkatan kadar hscTnI. Identifikasi dan intervensi dini dapat memperbaiki perjalanan penyakit kardiovaskular sehingga diperlukan pengawasan lanjut pada kelompok pasien ini.Kata kunci: disfungsi diastolik ventrikel, high-sensitivity cardiac troponin I jantung sensitivitas tinggi, kiri, preeklamsia berat
Fetal Growth Cut-Off Point To Predict Neonatal Outcome In Pregnancy With Normal And Deficient Vitamin D Levels: Intergrowth-21, World Health Organization Fetal Growth Curve, And Hadlock’s Estimated Fetal Weight Dewantiningrum, Julian; Kristanto, Herman; Pudjonarko, Dwi; Mexitalia, Maria; Ediati, Annastasia; Soejoenoes, Ariawan; Hadisaputro, Suharyo
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.877

Abstract

Purpose : Analyze the cut-off point of fetal growth based on the Intergrowth-21, World Health Organization (WHO), and Hadlock’s estimated fetal weight (EFW) in pregnant women with normal or deficient vitamin D levels to predict neonatal outcomes. Method: This cross sectional study to develop a diagnostic test, included 120 of pregnant women who completed follow up until children aged 2 years, divided into normal and deficient vitamin D group. Ultrasound and maternal vitamin D level examined during the second trimester of pregnancy. EFW was calculated using Hadlock’s formula and plotted on the Intergrowth-21 and WHO curves. The reference standards were the neonatal outcome, LBW, stunting, and neurocognitive impairment. Significant odds ratio (OR) value and area under the curve (AUC) of 0.6 are used to determine the cut-off point to be used. Result: Fetal growth curve was based on the WHO at the 5th percentile to predict LBW to have an AUC of 0.6 and OR of 6, 95% confidence interval (CI) of 1.36–26.45. The AUC for predicting LBW based on Intergrowth and Hadlock were 0.45 and OR not significant. As well as the AUC estimated stunting based on Hadlock, the Intergrowth-21 and the WHO fetal growth curves is <0.6 with OR not statistically significant. The AUC predicted neurocognitive impairment based on WHO’s chart was 0.6 but OR not statistically significant. Conclusion: The WHO fetal growth curve can be used to predict LBW. The cut-off point of the fetal growth curve and which percentile is determined by the neonatal outcome.
Endothelin-1 Level In Early Onset Preeclampsia Riantyoko, Yoshi; Hadijono, Raden Soerjo; Iskandar, Teuku Mirza; Trisetiyono, Yuli; Pramono, Besari Adi; Suhartono, Suhartono; Kristanto, Herman
DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN Vol 14, No 1 (2023): Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Publisher : Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33859/dksm.v14i1.917

Abstract

Introductions: Preeclampsia is a specific syndrome in pregnancy as a result of abnormal placental invasion leading to placental hypoperfusion. Persistent hypoxia of the placenta causes the release of various inflammatory mediators into the circulation and results in local endothelial dysfunction. Increased endothelin-1 (ET-1) secretion and increased inflammatory mediators occur in preeclampsia.Aims: To analyze the relationship between endothelin-1 and early onset preeclampsia.Methods: This crosssectional study included 50 pregnant women with early onset preeclampsia (n=25) and normal pregnancies (n=25). Pregnant women aged 20-35 years with single intrauterine fetus, primigravida and multigravida who experienced early onset preeclampsia 34 weeks of gestation were included in this study. Endothelin-1 levels was measured using the Enzyme Linked Immunosorbant Assay (ELISA) method. The analysis was performed using the Mann-Whitney test. Receiving Operator Characteristic (ROC) curve analysis was used to find the cut-off value and diagnostic accuracy of endothelin-1 levels.Results: The mean of ET-1 level was significantly higher in early onset preeclampsia (0.732 ± 0.56 pg/mL) compared to normal pregnancy (0.318 ± 0.09 pg/mL) with value of p = 0.000. The ROC analysis showed the AUC value of 87.8% (p = 0.000, 95% CI 78.6%-97.1%). The cut-off value for ET-1 was 0.385 pg/mL, with 80% sensitivity and 68% specificity (PR=3.14; 95% CI 1.40-7.03).Conclusion: Increased levels of endothelin-1 (ET-1) significantly associated with early onset preeclampsia. ET-1 level ≥ 0.385 pg/mL in pregnant women with 34 weeks of gestation is potential biomarkers to predict the occurrence of early onset preeclampsia with a risk up to 3.14 times.
Reinterpreting potential biomarker in umbilical cord as a marker of chorioamnionitis and funisitis in prelabor ROM Dewantiningrum, Julian; Pramono, Besari Adi; Poerwoko, Agoes Oerip; Irawan, Budi; Bachrudin, Rizky Aditya; Kristanto, Herman
Majalah Obstetri & Ginekologi Vol. 33 No. 3 (2025): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V33I32025.221-227

Abstract

HIGHLIGHTS HsCRP and IL-6 levels in umbilical cord blood serve as reliable early biomarkers of chorioamnionitis and funisitis in prelabor ROM, enabling more accurate neonatal sepsis risk assessment and targeted clinical intervention. Early identification of amnionitis and funisitis through hsCRP and IL-6 measurements guides timely clinical decisions, including prompt antibiotics or intensified monitoring, thereby reducing severe neonatal complications.   ABSTRACT Objective: Prelabor rupture of membranes (ROM) occurs in approximately 1% of all pregnancies and 30% of all preterm births, and the etiology remains unclear. Prelabor ROM is associated with a high incidence of funisitis and chorio-amnionitis leading to neonatal sepsis. This study aimed to assess whether hsCRP, procalcitonin, and IL-6 level in umbilical cord as indicators for identifying pregnancies at risk for these complications. Materials and Methods: This research used cross sectional design conducted in dr. Kariadi Hospital. Inclusion criteria were pregnant woman with 28-42 weeks of gestational age, singleton and prelabor ROM. Exclusion criteria included other comorbidities. The participants were divided into two groups: with and without funisitis-chorioamnionitis, which were detected using histopathologic examination. Statistical analysis was performed using the chi-square, t-test/Mann-Whitney between two group, wit statistically significant set at p<0.05. Results: A total of 88 pregnant women were included in the study, consisting of 23 pregnant women with chorioamnionitis-funisitis and 65 pregnant women without funisitis-chorioamnionitis. Procalcitonin levels in the group with and without chorioamnionitis-funisitis were 0.88±0.6 vs 1.06±0.46 ug/mL (p=0.07). IL-6 levels in the chorioamnionitis-funisitis were 54.41(9.34-445.9) vs 2.83(0.09-454.82) pg/mL in without chorioamnionitis-funisitis (p<0.001). HsCRP levels in the funisitis-chorioamnionitis compared to those without chorioamnionitis-funisitis group were 1.39(0.07-10.5) vs 0.17(0.03-10.5) mg/L (p<0.001). Conclusion: Elevated levels of hsCRP and IL-6 in the umbilical cord were found to be significant biomarkers for chorioamnionitis and funisitis in prelabor rupture of membranes. These biomarkers could be useful in identifying pregnant women at high risk for these complications, enabling better clinical management.
Efficacy and Tolerability of Short-Term Hormonal Therapy Following Conservative Surgery for Endometriosis: Efficay and Clinical Tolerability of Short-Term Hormonal Treatment for Endometriosis Pain Trisetiyono, Yuli; Sarastry, Razmaeda; Dewantiningrum, Julian; Anityo Mochtar, Arufiadi; Kristanto, Herman; Thaufik Hidayat, Syarief
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 4 October2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i4.2588

Abstract

AbstractObjective: To compare the efficacy and tolerability of four short-term hormonal therapies; Dienogest (DNG), Depot Medroxyprogesterone Acetate (DMPA), continuous Combined Oral Contraceptive (COC), and Leuprolide Acetate (LA); administered for 12 weeks after conservative endometriosis surgery. Methods: This randomized, prospective, open-label study enrolled reproductive-aged women with surgically confirmed endometriosis. Participants were randomly assigned to receive DNG 2 mg daily, DMPA 150 mg intramuscularly every 12 weeks, continuous COC (ethinyl estradiol 0.03 mg and levonogestrel 0.15 mg) daily, or LA 3.75 mg intramuscularly every 4 weeks. Primary outcomes were changes in pain intensity (visual analog scale, VAS), hormonal markers (estradiol, E2), inflammatory markers (TNF-?), and the Menopause Rating Scale (MRS) as an indicator of tolerability. Data were analyzed using ANOVA with a significance level of p < 0.05. Results: All four regimens resulted in significant reductions in dysmenorrhea, dyspareunia, and chronic pelvic pain after 12 weeks (p < 0.001). E2 and TNF-? levels decreased significantly in all groups, with the greatest decline observed in the LA arm. No significant differences were found among regimens in pain reduction or biomarker changes (p > 0.05). MRS scores increased transiently at week 8, particularly in the LA group, reflecting hypoestrogenic effects, but decreased by week 12 in all groups. Conclusion: Short-term postoperative hormonal therapy with DNG, DMPA, COC, or LA effectively reduces pain and inflammatory markers following endometriosis surgery. Progestin-based therapies achieve comparable clinical efficacy to GnRH agonists with superior tolerability. Individualized selection based on symptom profile, side effects, and accessibility is recommended in accordance with ESHRE guidelines. Keywords: endometriosis-associated pain, Menopause Rating Scale, short-term hormonal therapy.
Maternal and Perinatal Outcomes in Pregnancy Complicated with Pre- and Gestational Diabetes Mellitus Maheswara, Ayya; Razmaeda Sarastry; Kristanto, Herman; Julian Dewantiningrum; Putri Sekar Wiyati
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 1 January 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i1.1655

Abstract

Objective: To analyze maternal and perinatal outcomes in pregnancies complicated by pre-gestational and gestational diabetes. Methods: This is an analytical observational study with a cross-sectional design. We examined 57 women, 39 of pre-gestational diabetes mellitus (PGDM) women, and 19 had gestational diabetes mellitus (GDM). The data were analyzed using the chi-square and Fisher’s exact test. Results: There were no maternal deaths in either group. Pre-eclampsia was significantly higher in the PGDM group. Perinatal deaths and asphyxia were the same in both groups. Prematurity was higher in the PGDM group. Neonates of GDM women appeared to be heavier. Intrauterine fetal death (IUFD) rates were higher in the GDM group. Congenital anomalies were found in the GDM group. Conclusion: There were differences in maternal and perinatal outcomes in both groups, namely pre-eclampsia and congenital anomaly.
Co-Authors AA Sudharmawan, AA Agoes Oerip Poerwoko Albertus Ari Adrianto Anityo Mochtar, Arufiadi Annastasia Ediati Bachrudin, Rizky Aditya Bangun T. Purwaka, Bangun T. Besari Adi Pramono Besari Adi Pramono Budi Irawan Damar Prasmusinto Dwi Pudjonarko Hadijono, Raden Soerjo Ireneus Vanessa Martono Johanes C. Mose Julian Dewantiningrum Julian Dewantiningrum Juneke J. Kaeng Made K. Karkata, Made K. Maheswara, Ayya Maisuri T. Chalid, Maisuri T. Makmur Sitepu, Makmur Maria Mexitalia Noroyono Wibowo Nuswil Bernolian Nutria Widya Purna Anggraini Putri Sekar Wiyati Rahmad R. B. Wicaksono Razmaeda Sarastry Riantyoko, Yoshi Rima Irwinda, Rima Sarastry, Razmaeda Soejoenoes, Ariawan Sri Sulistyowati Suharyo Hadisaputro Teuku Mirza Iskandar, Teuku Mirza Thaufik Hidayat, Syarief Yuli Trisetiyono, Yuli Yusrawati Yusrawati