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All Journal Majalah Kedokteran Bandung The Indonesian Biomedical Journal Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia
Damar Prasmusinto
Department Of Obstetrics And Gynecology, Faculty Of Medicine Universitas Indonesia-dr. Cipto Mangunkusumo Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Fetus dengan Massa Lidah Besar, Prosedur EXIT pada Seksio Sesarea Darurat: Laporan Kasus Nugroho, Arya Ady; Damar Prasmusinto; Ummu Hani; Widyastuti
JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol 12 No 1 (2025): JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol. 12.1 (2025)
Publisher : BAPIN-ISMKI (Badan Analisis Pengembangan Ilmiah Nasional - Ikatan Senat Mahasiswa Kedokteran Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53366/jimki.v12i1.904

Abstract

Pendahuluan: Prosedur Ex Utero Intrapartum Treatment (EXIT) adalah teknik penting untuk mendukung fungsi kardiopulmoner janin selama seksio sesarea dengan mempertahankan sirkulasi plasenta. EXIT digunakan dalam berbagai indikasi, seperti manajemen jalan napas (EXIT-to-airway), reseksi tumor (EXIT-to-resection), dan ECMO. Meskipun prosedur ini banyak dilaporkan untuk kasus-kasus tertentu, keberhasilan pada kasus massa lidah besar dengan ketuban pecah dini sangat jarang dilaporkan. Kasus ini bertujuan untuk menambah pemahaman tentang aplikasi EXIT dalam situasi darurat dan dampaknya pada hasil neonatal. Ilustrasi Kasus: Wanita hamil 25 tahun dengan usia kehamilan 38 minggu, didiagnosis dengan massa besar pada lidah janin. Dilakukan seksio sesarea darurat dengan prosedur EXIT untuk mengamankan jalan napas neonatus. Durasi EXIT adalah 3 menit 30 detik, dengan intubasi endotrakeal yang berhasil. Pasca-lahir, MRI mengonfirmasi massa lidah yang melibatkan otot dan vaskularisasi arteri lingual, dengan diagnosis tumor vaskular. Diskusi: Prosedur EXIT berhasil mengamankan jalan napas neonatus dan mempertahankan sirkulasi plasenta. Kasus ini menyoroti pentingnya pendekatan multidisiplin dalam menangani massa fetal besar dan ketuban pecah dini. Keberhasilan EXIT dalam kasus ini menambah wawasan terkait penerapan prosedur ini untuk situasi darurat yang tidak terduga. Simpulan: EXIT dapat digunakan untuk menangani massa lidah besar pada janin dengan ketuban pecah dini, memberikan hasil neonatal yang baik dengan tim multidisiplin yang terkoordinasi.
Higher Trace Elements and Lower Fatty Acids Levels in Erythrocytes as Predictors of Preeclampsia Putri, Ruth Widhiati Raharjo; Prasmusinto, Damar; Wibowo, Noroyono; Irwinda, Rima; Purwosunu, Yuditiya; Saroyo, Yudianto Budi
The Indonesian Biomedical Journal Vol 16, No 6 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i6.3256

Abstract

BACKGROUND: Preeclampsia is one of the common causes of maternal death in Indonesia. Many studies only focus on the diagnosis and pharmacological treatment of preeclampsia. However, predictors of preeclampsia need to be observed to add more focus on the etiology and prevention of preeclampsia. The imbalances of trace elements and fatty acids play an important role in preeclampsia. Therefore, this study was conducted to evaluate the status of trace elements and fatty acids in preeclampsia patients as predictors of preeclampsia.METHODS: A cross-sectional study was conducted in 3 hospitals, and involving 40 pregnant women classified into severe preeclampsia and normotensive groups. Trace elements and fatty acids were measured in serum and erythrocytes using Inductively Coupled Plasma and Gas Chromatography-Mass Spectrometry. Serum and erythrocytes fatty acid levels' cut-off value, sensitivity, and specificity were analyzed using Receiver Operating Characteristic (ROC) curve and Area Under the Curve (AUC) value.RESULTS: Serum selenium, manganese, and iron levels were significantly different in the preeclampsia group than in the controls (p<0.05). Of all the heavy metals, higher concentrations of cadmium, arsenic, lead, and mercury were found in preeclampsia groups compared to control. Linoleic acid showed the highest predictive value to increase severe preeclampsia with AUC of 0.8. The ratio of high omega-6/omega-3 increases the risk of preeclampsia.CONCLUSION: Selenium, manganese, iron, cadmium, arsenic, lead, and mercury levels are higher in the serum of preeclampsia patients. Almost all erythrocyte fatty acids were significantly higher in the control group compared to preeclampsia. Measurement of trace elements and fatty acids is needed as a predictor of preeclampsia. Erythrocyte fatty acids measurement is considered better than serum.KEYWORDS: trace elements, fatty acids, preeclampsia
Lower Ferrum, Selenium, and Cadmium; Higher Chromium and Lead Levels in Preeclampsia Patients’ Erythrocyte: A Cross-Sectional Study Sandhy Prayudhana; Damar Prasmusinto; Noroyono Wibowo; Rima Irwinda; Yuditiya Purwosunu; Yudianto Budi Saroyo
The Indonesian Biomedical Journal Vol 17, No 1 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i1.3257

Abstract

BACKGROUND: Oxidative stress and trace elements in erythrocytes are linked to impaired nitric oxide that can lead to endothelial dysfunction in preeclampsia patients. The morphology of erythrocytes could also be affected by oxidative stress and trace elements. While the relationships between erythrocyte index, superoxide dismutase (SOD) activity, and oxidative stress in preeclampsia have been well established, less attention has been given to the erythrocyte trace elements and their role in disease progression. This study was performed to examine the erythrocyte trace element profile in women with preeclampsia, comparing it with controls. Additionally, it will explore the correlations between erythrocyte trace element levels, the erythrocyte index, and SOD activity.METHODS: A cross-sectional study was conducted involving 40 pregnant women consisting of those with severe preeclampsia and normotensive. Erythrocytes was isolated from blood samples, and analysis of erythrocyte SOD activity and trace elements were performed using the enzyme linked immunosorbent assay (ELISA) and inductively coupled plasma mass spectrometry (ICP-MS), respectively.RESULTS: Among 15 examined erythrocyte trace elements, the levels of ferrum (Fe), selenium (Se), and cadmium (Cd) were significantly lower, meanwhile, the levels of chromium (Cr) and lead (Pb) were significantly higher in preeclampsia subjects. Additionally, preeclampsia subjects exhibited smaller erythrocyte sizes compared to the normotensive subjects. The erythrocyte SOD activity was significantly elevated in the preeclampsia subjects than the normotensive subjects.CONCLUSION: Erythrocyte trace element levels of Fe, Se, Cd, Cr, and Pb were significantly altered in preeclampsia compared to normotensive controls. These findings suggest that these trace elements may serve as potential predictors for preeclampsia.KEYWORDS: preeclampsia, trace elements, antioxidant, oxidative stress, superoxide dismutase, erythrocyte index
Effect of High-Dose Vitamin D on Angiogenesis Markers in High-Risk Pregnant Women Nunki Febriastuti; Rima Irwinda; Noroyono Wibowo; Damar Prasmusinto; Yudi B. Saroyo; Yuditiya Purwosunu
Majalah Kedokteran Bandung Vol 58, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v58.4544

Abstract

Preeclampsia is characterized by impaired trophoblast invasion and angiogenesis. Recent evidence suggests that vitamin D supplementation may reduce the risk of preeclampsia by optimizing angiogenesis. This study aimed to evaluate the effect of high-dose vitamin D on angiogenesis markers in the first trimester by evaluating serum maternal placental growth factor (PlGF) and uterine artery pulsality index (UtA-PI) in pregnant women with a high risk for preeclampsia. A single-blind, randomized controlled trial was conducted on 80 pregnant women from April 2021 to April 2022 at Dr. Cipto Mangunkusumo National General Hospital and Koja District Hospital. Pregnant women at 7–11 weeks of gestation were divided into low-risk and high-risk preeclampsia groups. Each group was then randomized into a control group (multi-micronutrient supplementation/MMS) and an intervention group (MMS + vitamin D at 5,000 IU/day). Maternal serum 25(OH)D levels and PlGF levels, as well as Doppler UtA-PI, were measured at baseline and after one month of intervention. All participants had vitamin D deficiency at baseline. After one month, the increase in 25(OH)D level was significantly higher in the low-risk group (12.3±6.3 ng/mL vs 10.5±5.1 ng/, p<0.001). Mean UtA-PI was significantly reduced in both low-risk (-1.1±0.3) and high-risk (-0.43±0.26) intervention groups. PlGF level increasedwas significantly in both intervention groups (low-risk 107.9±32.0 vs. high-risk 70.5±18.3, p<0.001). High-dose vitamin D supplementation (5,000 IU/day) improves angiogenesis in the first trimester, suggesting potential benefits for improving pregnancy outcomes in women at risk for preeclampsia.
Non-Severe Preeclampsia and Subclinical Inflammation: A Study of Cyclophilin A, NF-κB, PARP- 1, and Apoptosis in Human Placentas Novi Resistantie; Noroyono Wibowo; Damar Prasmusinto; Sri Widia Azraki Jusman; Muhammad Yamin; Nurjati Chairani Siregar; Joedo Prihartono; Johannes Cornelius Mose; Suhendro Suhendro; Ferdiana Yunita; Lis Rosmanah; Nur Ita Margyaningsih; Labibah Qotrunnada; Cindy Fawwaz Roviqoh; Saidah Rauf
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.947

Abstract

Objective: To compare the expression of CyP-A, NF-κB, PARP-1, and apoptotic index in Non-Severe Preeclampsia (NS-PE) and Normal Pregnancy (NP) and explore their roles in inflammation during preeclampsia.Methods: Conducted in Depok, Indonesia, the cross-sectional study involved 28 participants divided into NS-PE and NP groups based on ISSHP criteria. NP was defined as uncomplicated pregnancies at 38–40 weeks gestation. Placental weight was measured, and ELISA was used to assess biomolecule levels. Data were analyzed using T-tests or Mann-Whitney tests.Result: Maternal gestational age, body mass index, and leukocyte levels were significantly higher in NS-PE. The apoptotic index, measured by TUNEL assay, was also significantly elevated in NS-PE (41.56 ±24.87) compared to NP (23.96 ±18.79; p = 0.044). While CyP-A, PARP-1, and NF-κB levels were higher in NS-PE eventhough they were not statistically significant. Immunohistochemistry confirmed an overall increase in these molecules, supporting their clinical relevance.Conclusion: Despite the lack of statistical significance, increased inflammation and apoptosis in NS-PE may contribute to placental dysfunction and adverse pregnancy outcomes.Non-Severe Preeclampsia dan Inflamasi Subklinis: Studi CyP-A, NF-κB, PARP-1, dan Apoptosis pada Plasenta ManusiaAbstrak Tujuan: Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi CyP-A, NF-κB, PARP-1, dan indeks apoptosis antara preeklamsia non-severe (NS-PE) dan kehamilan normal (NP), serta perannya dalam proses inflamasi pada preeklamsia.Metode: Metode penelitian yang digunakan dalam penelitian ini adalah cross-sectional. Penelitian ini dilakukan di Depok, Indonesia, dengan 28 partisipan yang dikelompokkan menjadi NS-PE dan NP berdasarkan kriteria ISSHP. Berat plasenta diukur dan kadar biomolekul dianalisis menggunakan ELISA. Uji T dan alternatif Mann-Whitney digunakan untuk analisis statistik.Hasil: Hasil penelitian menunjukkan bahwa usia kehamilan, indeks massa tubuh (IMT), dan kadar leukosit secara signifikan lebih tinggi pada NS-PE. Indeks apoptosis (TUNEL) juga lebih tinggi secara signifikan pada NS-PE (41,56 ±24,87) dibandingkan NP (23,96 ±18,79; p = 0,044). Kadar CyP-A, PARP-1, dan NF-κB lebih tinggi pada NS-PE meskipun tidak signifikan secara statistik, pemeriksaan IHK mengonfirmasi relevansi klinis peningkatan pada keseluruhan biomolekul tersebut. Kesimpulan: Meskipun signifikansi statistik rendah, peningkatan peradangan dan apoptosis pada NS-PE dapat menyebabkan disfungsi plasenta dan dampak buruk pada kehamilan.Kata kunci: Apoptosis; inflamasi; preeklamsia.
Placental Vitamin D, Oxidative Stress, and Senescence Markers in Spontaneous Preterm Birth: A Comparative Cross-Sectional Study Yudianto Budi Saroyo; Noroyono Wibowo; Damar Prasmusinto; Yuditiya Purwosunu; Rima Irwinda; Mohammad Adya Firmansha Dilmy; Atikah Sayogo Putri; Arya Ivan Mahendra; Lysandra Olivia Prasanti Putri
Indonesian Journal of Obstetrics and Gynecology Volume 14. No. 1 January 2026
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v14i1.2928

Abstract

AbstractObjective: To evaluate the associations between vitamin D metabolism markers and biomarkers of oxidative stress and placental senescence among women with spontaneous preterm labor compared with those with term labor. Methods: We conducted a comparative cross-sectional study between 2017 and 2019 in two hospitals in Jakarta, Indonesia. Maternal serum and placental samples were collected from women with term labor and spontaneous preterm labor. Markers of the vitamin D pathway 25-hydroxyvitamin D (25[OH]D), 1,25-dihydroxyvitamin D? (1,25[OH]?D?), vitamin D receptor (VDR), and CYP27B1 along with oxidative stress (8-hydroxy-2--deoxyguanosine [8-OHdG]) and placental senescence markers (GLB1 and HMGB), were measured using ELISA, LC–MS/MS, and ICP–MS. Between-group comparisons were performed using parametric or nonparametric tests, as appropriate, and correlations were assessed using Pearson’s or Spearman’s correlation coefficients. Results: A total of 67 women were included (term labor, n = 34; spontaneous preterm labor, n = 33), and both groups were vitamin D deficient. Placental 1,25(OH)?D? levels were significantly lower in the preterm group than in the term group (4.58 ± 2.90 vs 5.57 ± 3.50 pg/ng, p = 0.037). Placental VDR levels also differed significantly between groups {21.70 (6.06–73.40) vs 16.48 (1.87–74.67), p = 0.041}. Across all participants, 8-OHdG and placental senescence markers were negatively correlated with placental 25(OH)D and 1,25(OH)?D? levels and positively correlated with placental CYP27B1 and VDR expression. Conclusion: In this comparative cross-sectional cohort, placental vitamin D metabolites were associated with lower levels of oxidative stress and placental senescence biomarkers, whereas VDR and CYP27B1 showed positive associations with these biomarkers. These patterns may reflect compensatory regulatory mechanisms in the context of maternal vitamin D deficiency. These findings are hypothesis-generating and warrant confirmation in prospective studies and mechanistic investigations. Keywords: oxidative stress, placental senescence, spontaneous preterm labor, vitamin D.
Co-Authors Arya Ady Nugroho Arya Ivan Mahendra Atikah Sayogo Putri Bangun T. Purwaka, Bangun T. Cindy Fawwaz Roviqoh Dilmy, Mohammad Adya Firmansha Ferdiana Yunita Herman Kristanto Joedo Prihartono Johanes C. Mose Johannes Cornelius Mose Juneke J. Kaeng Labibah Qotrunnada Lis Rosmanah Lysandra Olivia Prasanti Putri Made K. Karkata, Made K. Maisuri T. Chalid, Maisuri T. Makmur Sitepu, Makmur Muhammad Yamin Noroyono Wibowo Noroyono Wibowo Novi Resistantie Nunki Febriastuti Nur Ita Margyaningsih Nurjati Chairani Siregar Nuswil Bernolian Putri, Ruth Widhiati Raharjo Rima Irwinda Saidah Rauf Sandhy Prayudhana Saroyo, Yudianto Budi Sri Widia A.Jusman Suhendro Suhendro Ummu Hani WIDYASTUTI Yudi B. Saroyo Yuditiya Purwosunu Yusrawati Yusrawati