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All Journal International Journal of Public Health Science (IJPHS) Majalah Obstetri dan Ginekologi Universa Medicina Jurnal Kesehatan Reproduksi Indonesian Journal of Medicine Medica Hospitalia Diponegoro International Medical Journal (DIMJ) Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Besari Adi Pramono
Divisi fetomaternal Departemen Obstetri Ginekologi FK Undip RSUP Dr.Kariadi Semarang
Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience 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 
Pregnancy Associated Plasma Protein-A (PAPP-A) as a Marker to Distinguish Normotensive with Early 2nd Trimester and Late 3rd Trimester Onset of Preeclampsia Simangunsong, Ragam Pesona; Kristanto, Herman; Iskandar, Mirza; Thaufik, Syarief; Pramono, Besari Adi; Mochtar, Arufiadi Anityo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.979

Abstract

Introduction: Preeclampsia is a hypertensive condition that occurs after 20 weeks of gestation accompanied by target organ damage. Complications of preeclampsia can cause intrauterine fetal growth retardation, and placental hypoperfusion, even in the most serious situations, namely termination of pregnancy and death of the fetus and/or mother. Pregnancy-associated plasma protein-A (PAPP-A) is a high molecular weight glycoprotein that is produced in the placenta and secreted into the maternal bloodstream. However, based on several studies that have been conducted, there is uncertainty in the results of assessing PAPP-A levels obtained in pregnant women in the second and third trimesters. Aim: Proving differences in PAPP-A levels in the second and third trimesters in the incidence of early-onset preeclampsia and normotensive pregnancy. Methods: An analytic observational study with a cross-sectional approach was carried out in the delivery room of RSUP Dr. Kariadi Semarang, Halmahera Health Center, Ngesrep Health Center, Bulu Health Center, and private midwife practice in Semarang City. The subjects of the study were six 2nd-trimester preeclampsia patients, fourteen 3rd-trimester preeclampsia patients, and twenty normotensive pregnancy patients who met the inclusion and exclusion criteria. Data were analyzed using Mann Whitney with a significance of p<0.05 Results: There was a significant difference in PAPP-A levels (p<0.001) between the preeclampsia and normotensive pregnancy groups, whereas PAPP-A levels were higher in the preeclampsia group. There were significant differences in PAPP-A levels (p<0.001) between the 2nd-trimester preeclampsia, 3rd-trimester preeclampsia, and normotensive pregnancies, where the highest PAPP-A levels were found in the 2nd-trimester preeclampsia group. Conclusion: There was a significant difference in PAPP-A levels between the second and third trimesters of early-onset preeclampsia compared to normotensive pregnancies, where PAPP-A levels were higher in the second and third trimesters of early-onset preeclampsia. Elevated PAPP-A levels in the second and third trimesters are associated with an increased risk of early-onset preeclampsia.
Effectiveness of Kelly Plication Method on Clinical Improvement in Stress Urinary Incontinence Patients Notohatmodjo, Puspitasari; Pramono, Besari Adi; Mulyantoro, Inu; Kristanto, Herman; Purnaningtyas, Dewi Astri; Mochtar, Arufiadi Anityo; Mulyantoro, Erwinanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1032

Abstract

BACKGROUND: Patients with pelvic organ prolapse (POP) usually present with POP, but stress urinary incontinence (SUI) is also found during history taking and physical examination. As a result, the complaint of SUI is persistent despite POP surgery. Therefore, SUI found along with POP and undergoing surgery can be performed Kelly plication method. OBJECTIVES: To examine the effectiveness of Kelly's plication method on clinical changes and quality of life of patients suffering from SUI. METHODS: A single cohort prospective one-group pretest-posttest design conducted at RSUP Dr. Kariadi Teaching Hospital Semarang involving 31 research subjects. All subjects were measured preoperative IIQ-7 questionnaire and pad test. Then, all subjects will undergo Kelly method surgery. Postoperative evaluation will be conducted 3 months later, including measurement of the IIQ-7 questionnaire and pad test. All data will be analyzed with univariate and bivariate analysis using paired t-test and Wilcoxon test. RESULTS:  The effectiveness rate of Kelly's plication method was 58.06% in this study. Most of the subjects were aged 50-59 (38.7%) years and had experienced menopause (87.1%). Correlation analysis of baseline data on the degree of preoperative SUI showed that the degree of POP correlated SUI. The Pad test and IIQ-7 questionnaire test showed a significant decrease in postoperative measurements in the treatment group (p: <0.001 & p: <0.001). CONCLUSIONS: Kelly's plication method is effective in treating SUI.
Maternal hair lead and cytokine pro-inflammatory effects in preterm birth Qolby, Qonita Nur; Dewantiningrum, Julian; Pramono, Besari Adi; Maharani, Nani; Nugraha, Eka Djatnika; Muniroh, Muflihatul
International Journal of Public Health Science (IJPHS) Vol 13, No 4: December 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i4.24146

Abstract

This case-control study analyzed the lead (Pb), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) levels in pregnant women with preterm birth (PTB) in Central Java, Indonesia. Hair samples from 72 pregnant women were collected non-invasively. The prenatal exposure to Pb was determined with the total reflection X-ray fluorescence (TXRF) method. Serum IL-6 and TNF-α were examined using enzyme-linked immunosorbent assays (ELISA). The Pb concentration in hair was slightly higher in women with PTB than those without PTB; however, this difference was not statistically significant. An elevated hair Pb level was not associated with increased PTB risk (OR 24.69, 95% CI 0.93–653.82, p>0.05). A serum TNF-α level ≥27 pg/ml, a serum IL-6 level ≥9 pg/ml, and the spouse’s smoking frequency were significantly associated with increased PTB risk (TNF-α OR 42.25, 95% CI 5.26–339.61; IL-6 OR 22.33, 95% CI 3.12–158.54; spouse’s smoking frequency OR 1.28, 95% CI 1.09–1.5), while the maternal hemoglobin concentration significantly decreased PTB risk (OR 0.43, 95% CI 0.2–0.927). This study demonstrates that maternal hair Pb concentration has no significant relationship with PTB. Serum TNF-α, IL-6, and the spouse’s smoking frequency potentially increased PTB risk, while the maternal hemoglobin level is a protective factor.
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.
Electrocardiographic Pattern of Pregnant Women with Advanced Maternal Age Mangkoesoebroto, Arjatya Pramadita; Pramono, Besari Adi; Mochtar, Aruman Yudanto Ariwibowo Binarso
Diponegoro International Medical Journal Vol 4, No 1 (2023): July 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v4i1.15837

Abstract

Background: Advanced maternal age (AMA) is becoming increasingly common and is associated with increased maternal and fetal morbidity and mortality. Around 22,2% of maternal deaths were found to be from cardiovascular disease, and women with higher cardiovascular mortality were likely older. Electrocardiography (ECG) is a simple tool for detecting cardiovascular problems. Though there are many studies of the ECG in normal pregnant women, there is still limited data on the ECG pattern in pregnant women with AMA.Objective: Describe the characteristics of the ECG pattern in woman with AMA.Methods: This study used data retrospectively from medical records of patient in Kariadi General Hospital Semarang from 1st to 30th October 2018. The inclusion criteria were advanced age ³ 35 years,  in the last trimester. Demography, clinical, laboratory , and 12-lead ECG data were collected and reported.Results: Thirteen patients were obtained, with mean age of 38,3 years. Majority of patients had preeclampsia (61,5%) and superimposed preeclampsia (15,4%). Mean systolic blood pressure was 168 mmHg. All of the patients was sinus rhythm, with a mean heart rate 92,5 bpm. Mean QTc was 430,7ms, with 3 patients (23,1%) having borderline prolongation grade. Another abnormality was a left atrial abnormality in 3 patients (23,1%), poor R wave progression in 2 patients (15,4%), and a pathological Q wave in 1 patients (7,7%).Conclusion: ECG abnormalities are seen in 38,4% of pregnant women over 35 years old. The performance of an ECG in AMA may be a first step toward improved pregnancy outcomes since it is widely available and easily interpreted by general practitioners.
Perbandingan Karakteristik dan Luaran Maternal pada Unexpected Spektrum Placenta Akreta saat Pandemi Covid -19 Cahyanti, Ratnasari Dwi; Dewantiningrum, Julian; Pramono, Besari Adi; Larasati, Irene Astrid; Wiyati, Putri Sekar
JURNAL KESEHATAN REPRODUKSI Vol 10, No 2 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.87601

Abstract

Latar belakang: Pandemi COVID-19 mempengaruhi sistem pelayanan kesehatan di dunia. Kegawatan maternal yang diakibatkan oleh Spektrum Placenta Akreta (SPA) menjadi tantangan di bidang obstetri, khususnya dalam kinerja multidisplin tim dan dukungan sumber daya fasilitas kesehatan.Tujuan: Membandingkan karakteristik dan luaran dari pasien dengan unexpected dan expected SPA saat pandemi COVID-19.Metode: Desain penelitian secara cross-sectional. Pengambilan sampel kasus SPA secara consecutive sampling dari data rekam medis RSUP Dr. Kariadi, Semarang, pada periode 2020 – 2021.Hasil dan Pembahasan: Limapuluh tiga dari 154 kasus (34,42%) merupakan unexpected SPA. Tidak terdapat perbedaan karakteristik yang meliputi umur, indeks massa tubuh, jumlah riwayat sectio cesarea, jumlah riwayat placenta previa, cara persalinan dan kerjasama tim. Jumlah perdarahan dan kebutuhan transfusi darah yang diberikan tidak terdapat perbedaan pada kedua kelompok. Terdapat risiko untuk Cesarean histerektomi pada unexpected SPA (adjusted OR 4,13 (1,31-55,02)). Case Fatality Rate (CFR) pada unexpeted 5,67%, sedangkan pada expected 0,9%. Pada kasus unexpexted SPA didapatkan 3 kasus dengan terkonfirmasi COVID-19 dan meninggal.Kesimpulan: Tata kelola spektrum placenta akreta di RSUP Dr. Kariadi selama pandemi COVID-19 tidak terdapat perbedaan luaran maternal pada kasus unxpected dan expected dan didapatkan kualitas pelayanan optimal dengan CFR yang rendah.Kata kunci: Spektrum Placenta Akreta (SPA), unxpected dan expected, pandemi COVID-19, luaran maternal
Bacteria Patterns and Antibiotic Sensitivities in Patients with Preterm Premature Rupture of Membrane: Study of Patients with PPROM ≤ 6 Hours And > 6 Hours at General Hospital Kariadi Semarang Munthe, Rio Bornfry Haro; Pramono, Besari Adi; Kristiawan, Endy Cahyono; Poerwoko, Agoes Oerip; Cahyanti, Ratnasari Dwi
Diponegoro International Medical Journal Vol 6, No 1 (2025): July 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i1.24649

Abstract

Background: Preterm premature rupture of membranes (PPROM) has multifactorial causes. Ascending bacterial invasion can cause intrauterine infection in up to 60% of cases with PPROM. Giving antibiotics at inadequate concentrations causes bacteria to grow exponentially, which is characterized by very fast growth.Objective: This study aims to determine bacteria patterns and antibiotic sensitivity in patients with PPROM at Dr. RSUP. Kariadi, Semarang.Methods: Observational analytical research with a cross-sectional design. The research subjects were 46 pregnant women aged 20-36 weeks 6 days who experienced PPROM. The selection of research subjects was carried out using the consecutive sampling method, namely the selection of research subjects based on research criteria and the subjects signed an agreement to participate in the research. The independent variables in this study were preterm PPROM ≤ 6 hours and > 6 hours, the dependent variables in this study were bacteria patterns and antibiotic sensitivity. The data that has been obtained is analyzed using the SPSS program. Results are significant if p<0.05.Results: Escherichia coli and Candida albicans are the most found pathogens. The antibiotics vancomycin, meropenem, and amphotericin B are effective in patients with PPROM. Women who experienced PPROM ≤ 6 hours and > 6 hours did not have significant differences in bacteria patterns and antibiotic sensitivity results.Conclusion: The gram-negative rod-shaped bacteria Escherichia coli and the fungus Candida albicans are the main pathogens that cause PPROM. The administration of vancomycin, meropenem, and amphotericin B has high effectiveness in PPROM patients at RSUP dr. Kariadi Semarang.
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 chorioamnionitis 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.
Co-Authors AA Sudharmawan, AA Agoes Oerip Poerwoko Bachrudin, Rizky Aditya Budi Irawan Dewi Astri Purnaningtyas Hadijono, Raden Soerjo Herman Kristanto Julian Dewantiningrum Kristiawan, Endy Cahyono Larasati, Irene Astrid Mangkoesoebroto, Arjatya Pramadita MIRZA ISKANDAR, MIRZA Mochtar, Arufiadi Anityo Mochtar, Aruman Yudanto Ariwibowo Binarso Mulyantoro, Erwinanto Mulyantoro, Inu Muniroh, Muflihatul Munthe, Rio Bornfry Haro Nani Maharani Notohatmodjo, Puspitasari Nugraha, Eka Djatnika Nutria Widya Purna Anggraini Putri Sekar Wiyati Qolby, Qonita Nur Ratnasari Dwi Cahyanti, Ratnasari Dwi Riantyoko, Yoshi Simangunsong, Ragam Pesona Sri Sulistyowati Syarief Thaufik, Syarief Teuku Mirza Iskandar, Teuku Mirza Yuli Trisetiyono, Yuli