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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN BALI MEDICAL JOURNAL (BMJ) Medicina Jurnal Studi Jender SRIKANDI Buletin Udayana Mengabdi INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Jurnal Farmasi Klinik Indonesia E-Journal Obstetric & Gynecology Udayana Indonesian Journal of Cancer Syntax Literate: Jurnal Ilmiah Indonesia Indonesian Journal of Obstetrics & Gynecology Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Patologi Indonesia Neurologico Spinale Medico Chirurgico JURNAL USM LAW REVIEW Babali Nursing Research Indonesian Journal of Perinatology Indonesian Journal of Cancer Public Health and Preventive Medicine Archive INCOME: Indonesian Journal of Community Service and Engagement Journal of Global Pharma Technology Cermin Dunia Kedokteran

I Ketut Suwiyoga

Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

Author-ID : 397979

Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Elevated Serum Ferritin and Interleukin-6 Level as the Risk Factor in Preterm Labor: Kadar Feritin dan Interleukin-6 Serum yang Tinggi Merupakan Faktor Risiko Terjadinya Persalinan Preterm Stella Kawilarang; I Ketut Suwiyoga; Tjokorda GA Suwardewa
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective : To investigate the association ofserum ferritin and Interleukin-6 (IL-6) elevation as the risk factors for preterm labor. Method : This study was a case-control study conducted at the Obstetrics and Gynecology Outpatient and Emergency Department at Sanglah General Hospital Denpasar, Bali in November 2014 until June 2015. The sample selection was done by consecutive sampling with total sample as many as 20 case samples (women with preterm labor) and 20 control samples (women with normal preterm pregnancy). Results : Based on the analysis, there was no significant difference of patient demografic such as age, gestational age, and parity among the two groups. Chi-square analysis showed that the increased serum ferritin level had 5 fold increased risk of developing preterm labor (OR = 4.89, 95% CI = 1.20-19.94; p = 0.022), and increased serum IL-6 level had 9 fold increased risk of developing preterm labor (OR = 9.33, 95% CI = 2.18-39.96; p = 0.001) compared to normal preterm pregnancy. Conclusion : It can be concluded that level of IL-6 and serum ferritin was the risk factor for preterm labor. Keywords: Interleukin-6, preterm labor, serum ferritin Abstrak Tujuan :Untuk membuktikan hubungan kadar ferritin dan Interleukin-6 (IL-6) serum yang tinggi sebagai faktor risiko terjadinya persalinan preterm. Metode :Penelitian ini bersifat observasional dengan studi case-control yang dilakukan di Poliklinik dan IRD Kebidanan dan Penyakit Kandungan RSUP Sanglah Denpasar, yang dilakukan mulai bulan November 2014 hingga Juni 2015. Pemilihan sampel dilakukan dengan cara berurutan dengan sampel penelitian sebanyak 20 sampel kasus (ibu dengan persalinan preterm) dan 20 sampel kontrol (ibu hamil preterm normal). Hasil :Tidak didapatkan perbedaan bermakna dari demografik pasien yaitu usia, umur kehamilan, dan paritas pada kedua kelompok. Analisa chi-square menunjukkan peningkatan kadar ferritin serum memiliki peningkatan risiko 5 kali terjadinya persalinan preterm (OR = 4,90, IK 95% = 1,20-19,94; p = 0,022), dan peningkatan kadar IL-6 serum memiliki peningkatan risiko 9 kali terjadinya persalinan preterm (OR = 9,33, IK 95% = 2,18-39,96; p = 0,001) dibandingkan dengan kelompok ibu hamil preterm normal. Kesimpulan : Kadar feritin dan IL-6 serum adalah faktor risiko terjadinya persalinan preterm. Kata kunci: Interleukin-6, persalinan preterm, ferritin serum

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

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.

Mixed Adeno and Neuroendocrine Carcinoma of The Ovary: Case Report KADE YUDI SASPRIYANA; I NYOMAN BAYU MAHENDRA; KETUT SUWIYOGA; LUH PUTU IIN INDRAYANI MAKER; JOHANA SENSY LENI MANNA
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : National Cancer Center - Dharmais Cancer Hospital

Reporting two cases of mixed adenocarcinoma and neuroendocrine carcinoma of the ovary. A case report two cases of an ovarian cyst suspect malignancy after complete surgical staging in woman aged 39 year old and 72 year old. By this case report, we want to know prognosis of the malignancy. Mixed adenocarcinoma and neuroendocrine carcinoma of the ovary of the first case arised from mature cystic teratoma, and second case as metastatic process from gastrointestinal tract. Mixed adenocarcinoma and neuroendocrine carcinoma is rare hystologic type of ovarian cancer. Need further exploration to know the survival of this hystologic type.ABSTRAKArtikel ini melaporkan dua kasus, yaitu mixed adenocarcinoma dan neuroendocrine carcinoma ovarium, dua kasus kista ovarium curiga ganas pada pasien berusia 39 tahun dan 72 tahun. Terhadap kedua pasien dilakukan komplit surgical staging. Melalui laporan kasus ini, diharapkan bisa diketahui prognosis kasus. Mixed adenocarcinoma dan neuroendocrine carcinoma ovarium pada kasus pertama timbul dari teratoma matur kistik, sedangkan kasus kedua merupakan penyebaran dari traktus digestivus. Mixed adenocarcinoma dan neuroendocrine carcinoma merupakan tipe histologi kanker ovarium yang jarang. Ia membutuhkan eksplorasi lebih lanjut untuk mengetahui survival dari tipe histologi ini.

The low level of plasma vitamin C as a risk factor of preterm premature rupture of membrane Muhammad Freddy Candra Sitepu; Ketut Suwiyoga; Anak Agung Ngurah Jaya Kusuma; I Gusti Putu Mayun Mayura; Made Darmayasa; I Wayan Artana Putra
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Preterm premature rupture of membrane (PPROM) still becomes a problem related with perinatal morbidity and mortality which is caused by multifactorial risk factor; especially strength of foetal membrane. Collagen is the main component of foetal membraneâ€™s extracellular matrix whereas plasma vitamin C roles as a collagen biosynthesis enzyme-dependent co-factor, down-regulator activity of MMP-1, MMP-2, and MMP-9 and also as antioxidant in remodelling and preventing structural damage extracellular matrix. The purpose of this study is to prove the low plasma level of vitamin C as a risk factor for PPROM on preterm pregnancy.Method: This study was an analytical observational unpaired case-control performed from March 23rd until August 23rd 2018 at Polyclinic and Emergency Unit of Obstetrics and Gynaecology Sanglah Central General Hospital, Buleleng General Hospital, Mangusada General Hospital, Sanjiwani General Hospital, Wangaya General Hospital, and Prodia Clinical Laboratory Denpasar. The samples were preterm pregnancy women with premature rupture of membrane (PROM) as a case group and without premature rupture of membrane as a control group. The samples were taken from peripheral venous blood and level of plasma vitamin C is measured by HPLC method. The data were analysed by SPSS for Windows 20.0 version program then presented as table and narrative.Result: Forty subjects were divided into 2 groups, 20 preterm pregnancy with PROM as a case group and 20 preterm pregnancy without PROM as a control group. Characteristic subject based on maternal age, gestational age, parity of both groups was 27.4 and 26.1 years old, 31 and 31 weeks, and also 1 and 1 time (p>0.05), not significantly different. The mean level of plasma vitamin C on case and control group were 3.90 Â± 1.61 dan 9.24 Â± 2.31 mg/L (p=0.001). On the case group the low level of plasma vitamin C was 51 times (OR= 51; CI 95% = 7.57â€“343.73; p=0,001) higher than the control group.Conclusion: The low level of plasma vitamin C is a risk factor of PPROM.

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.

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.Â 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.Â Â 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 â€“ 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.

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 Â 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 concludedÂ that high expression of tenascin-C in the sacrouterine ligament is a risk factor of III-IV degree uterine prolapse.Â Â 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 setiapÂ 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 dewasaÂ seperti cedera jaringan dan tumorigenesis. Berdasarkan penelitian saat ini,Â 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. TerdapatÂ 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 danÂ 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.

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) -Î², 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.Â 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)-Î², 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

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.

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.

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.

Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat Leony Lim; Ketut Suwiyoga; I Wayan Artana Putra; Anak Agung Ngurah Jaya Kusuma; I Gede Mega Putra; Anom Suardika; I Wayan Megadhana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Preeclampsia is a health problem because it contributes to high rates of maternal and baby morbidity and mortality. The pathogenesis of preeclampsia is still unknown, but vitamin D deficiency and low HDL-LDL serum ratio are thought to play an important role. Therefore, a study was conducted on low 25(OH)D serum level and low HDL-LDL serum ratio as risk factors for preeclampsia with severe features.Methods: This study has a case-control design, conducted at Obstetric and Gynecology emergency room at Sanglah Hospital from January 2020 to June 2020. Subjects were 44 pregnant women, consisting 22 normal pregnant women as controls and 22 pregnant women with preeclampsia with severe features as cases, selected by purposive consecutive sampling and analyzed using SPSS 21.Results: Preeclampsia with severe features was found 5 times higher in pregnant women with low 25(OH)D serum level than in normal pregnant women (OR = 4,91, CI 95% = 1,33-18,21, p = 0,014). Preeclampsia with severe features was found 8 times higher in pregnant women with low HDL-LDL serum ratio than in normal pregnant women (OR = 7,88, CI 95% = 1,96-31,57, p = 0,002).Conclusion: Low 25(OH)D serum level and low HDL-LDL serum ratio are risk factors for Preeclampsia with severe features. Pendahuluan: Preeklamsia merupakan masalah kesehatan karena berkontribusi terhadap tingginya angka morbiditas dan mortalitas ibu dan bayi. Patogenesis preeklamsia sampai saat ini masih belum diketahui secara pasti, namun kadar vitamin D dan rasio HDL–LDL serum yang rendah diduga berperan penting dalam mekanisme terjadinya preeklamsia. Penelitian kemudian dilakukan terhadap kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.Metode : Desain penelitian ini adalah kasus kontrol (case control) yang dilakukan di Instalasi Gawat Darurat Obstetri dan Ginekologi RSUP Sanglah, Denpasar mulai Januari 2020 sampai Juni 2020. Subyek penelitian berjumlah 44 orang ibu hamil, yang terdiri dari 22 ibu hamil normal sebagai kontrol dan 22 ibu hamil dengan preeklamsia dengan gambaran berat sebagai kasus, yang dipilih secara purposive consecutive sampling, dan dianalisis menggunakan SPSS 21.Hasil: Risiko terjadinya preeklamsia dengan gambaran berat adalah 5 kali lebih tinggi pada ibu hamil dengan kadar 25(OH)D serum yang rendah dibandingkan ibu hamil normal (OR = 4,91, IK 95% = 1,33-18,21, p = 0,014). Risiko terjadinya preeklamsia dengan gambaran berat adalah 8 kali lebih tinggi pada ibu hamil dengan rasio HDL-LDL serum yang rendah dibandingkan ibu hamil normal (OR = 7,88, IK 95% = 1,96-31,57, p = 0,002).Simpulan : Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah merupakan faktor risiko preeklamsia dengan gambaran berat.

Co-Authors Anak A. A. W. P. Dewi Anak Agung Gede Duwira Hadi Santosa Anak Agung Ngurah Jaya Kusuma Analysa, Analysa and I G. Alit-Artha Anom Suardika Anwar, Meirisa Afifah Nurmalia Arthawan Arthawan Aryana, Made Bagus Dwi Astawa, I Made Mulya Budiana, Nyoman Budiman, Ardelia Clara Candijaya, Gita Sirini Christyani, Fenyta Danny Aguswahyudi Darmayasa, Putu Bagus Desak Putu Oki Lestari Deviyanti, Gery Puspa Dewi, Anak A. A. W. P. E. Joewarini Evert Solomon Pangkahila Feliciano Pinto, Feliciano Ferry Santoso Fido Anggli, Fido Fransiskus C Raharja Gde Ari Putra, Orion Reffa Gede Fajar Manuaba, Ida Bagus Hadisubroto, Yona S. Hanny Aditanzil Hanny Aditanzil Harrista, Daniel Victor Heni Sunyoto I Dewa Made Sukrama I Gde Adnyana Sudibya I Gde Raka Widiana I Gde Sastra Winata I Gede Adnyana Sudibya, I Gede Adnyana I Gede M Putra I Gede Mahendra Adiguna Dira I Gede Mega Putra I Gede Putu Surya I Gusti Ayu Putri Kartika, I Gusti Ayu I Gusti Ayu Sri Mahendra Dewi I Gusti Putu Mayun Mayura I Ketut Labir I Ketut Labir I Ketut Surya Negara I Ketut Tunas I Made Darmayasa I Nyoman Gede Budiana I Nyoman H Sanjaya I NYOMAN MANTIK ASTAWA I Putu Kusuma Yudasmara, I Putu Kusuma I Wayan Artana Putra I Wayan Megadhana I Wayan Putu Sutirta Yasa I Wayan Suranadi I. F. W. Putra I. Lesmana I.W. Weta Ida Bagus Gde Fajar Manuaba Ida Bagus Putra Adnyana Ika Widi Astuti, Ika Widi Ines Kurniaty Hartono Intan Puspa Intizam, Marwa Humaira IPG Wardhiana IPG Wardhiana, IPG Janet Sumampouw Jessica Nathalia JOHANA SENSY LENI MANNA K Tangking Widarsa KADE YUDI SASPRIYANA Kadek Fajar Marta Kerans, Fransiscus Anthony Ketut S. Negara Kirana, Ni Wayan Prabasiwi Kusuma, I Komang Wira Ananta L.S. Ani Leonardo ., Leonardo Leony Lim Lidia Widianti, Lidia Luh Putu Iin Indrayani Maker Luh Seri Ani Made Bagus Dwi Aryana Mahendrata, Prayascita MANNA, JOHANA SENSY LENI Mantik AN Manuaba, Ida Bagus Gede Fajar Marta, Kadek Fajar Moestikaningsih . Mona Mariana Mona Mariana Muhammad Freddy Candra Sitepu Muliawan, Erlin Purnama N.W.A. Utami Nathalia, Jessica Negara, Ketut S. Ngurah Harry Wijaya Surya, I Gede Ni Ketut Karneli Ni Ketut Karneli Ni Ketut Supasti Dharmawan Ni Made Suciani Nyoman Bayu Mahendra Pramana, Bagus Andika Pratama, I Gede Bayu Adi Puspa, Intan Putra, I Gede M Putra, Ida Bagus Agung Widnyana Putri, Desak Agung Istri Padma Putu Adi Sujana Putra Putu Ayu Indrayathi Putu Doster Mahayasa R. Niruri Raharja, Fransiskus C Rasmaya Niruri Rasmaya Niruri Rasmaya Niruri Rastiti, Ni Putu Riasa, I Nyoman Putu Rini Noviyani Riza Firman Satria Sanjaya, I Nyoman H Santoso, Ferry Sari, Jayanti Purnama Satriawan, Nyoman Gede Dikawijaya Setiawan, William Alexander Stella Kawilarang Stella Kawilarang, Stella Sugianto Sugianto Sumampouw, Janet Tjokorda Gde Agung Suwardewa Wenas, Yongki Widia, Made Yudha Ganesa Wikantyas William Alexander Setiawan Wiraputri, Anak Agung Ratih Kusumadewi Yona S. Hadisubroto Yongki Wenas Yosevangelika Hutabarat

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