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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

LABOR CHARACTERISTICS OF LOW BIRTH WEIGHT BABIES (LBW) AT PUSKESMAS BATURITI I TABANAN 2018-2020 Ni Putu Yoni Prastini Kaesasih; Tjokorda Gde Agung Suwardewa; Endang Sri Widiyanti; Jaqueline Sudiman
E-Jurnal Medika Udayana Vol 11 No 5 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i5.P02

ABSTRAK Kejadian BBLR dapat menyebabkan peningkatan masalah pada sistem metabolik, ginjal, kardiovaskular, dan sistem saraf pada bayi. Penyebab BBLR bersifat multifaktoral dengan faktor penyebab terbanyak berdasarkan penelitian adalah usia ibu dan penyakit yang diderita ibu. Penelitian ini bertujuan untuk mengetahui karakteristik persalinan dengan bayi BBLR di Puskesmas Baturiti I Tabanan tahun 2018-2020. Penelitian ini menggunakan metode deskriptif cross sectional dengan data sekunder. Sebanyak 56 sampel BBLR dilakukan pencatatan berdasarkan kategori BBL bayi, usia ibu, BMI ibu, LiLA, pendidikan ibu, pekerjaan ibu, paritas, riwayat abortus, jarak kelahiran, kadar Hb, jenis kelamin anak, bayi kembar, cara kelahiran/bersalin, dan penolong persalinan, dan kemudian akan dilakukan analisis secara perhitungan jumlah (n), persentase (%), dan proporsi yang ditampilkan dengan tabel deskriptif dan proporsi. Data yang hilang dilakukan penanganan dengan mean substitution menggunakan rata-rata setiap kelompok kategori. Hasil analisis data secara proporsi dari populasi bayi lahir, didapatkan bahwa BBLR terbanyak terjadi pada ibu berumur <20 tahun, BMI 18,5-22,9 kg/m2, LiLA <23,5 cm, tamat diploma, pedagang, ibu nullipara, abortus >1x, kadar Hb <11 g/dL, anak laki-laki, ibu dengan kehamilan ganda, persalinan seksio, dan penolong persalinan adalah bidan/perawat. Dapat disimpulkan bahwa, berdasarkan proporsi populasi sebagian besar hasil penelitian berada pada risiko tinggi BBLR menurut teori yang ada. Kata kunci : BBLR, usia ibu, BMI, LiLA, pendidikan ibu, pekerjaan ibu, paritas, riwayat abortus, jarak kelahiran, kadar Hb, jenis kelamin anak, bayi kembar, cara bersalin, penolong persalinan

Alobar holoprosencephaly: a case report Tjokorda Gde Agung Suwardewa; Ryan Saktika Mulyana; William Alexander Setiawan
Indonesian Journal of Perinatology Vol. 3 No. 1 (2022): Available online : 1 June 2022
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v3i1.23

Introduction: Holoprosencephaly (HPE) is a rare congenital malformation of the brain; the incidence rate was 0.49-1.2 cases per 10,000-20,000 term births. HPE occurs due to failure of the prosencephalon division at the stage of brain development during the 4-5 weeks of pregnancy. Alobar HPE is one of the most severe types compared to other types. Most of the fetuses affected by this anomaly will die, and those born alive generally cannot survive for more than a year. This study presented a rare case of a baby with alobar HPE. Case report: A 33-year-old woman referred from Karang asem hospital Bali, G3P0020, 23 weeks gestation, has a poor obstetric history. The ultrasound examination results show no falx cerebri, even cerebellum and hypoechoic picture of the cerebrum. Ultrasound of the face was found a flat nose and hypotelorism. Termination at 28 weeks gestation, a baby boy was born 1000 g with the Apgar score 1-1. Multiple congenital abnormalities were found: flat nose, labiopalatoschizis, polydactyly manus dextra and omphalocele. Conclusion: Alobar HPE is a very rare congenital anomaly. The cause of the disease has not been fully explained. Current therapy is just supportive and has not been able to resolve the source of the problem. Alobar HPE disease has a poor prognosis.

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.

Tingginya rasio neutrofil terhadap limfosit serum darah ibu sebagai faktor risiko persalinan preterm spontan Tjokorda Gde Agung Suwardewa; I Nyoman Bayu Mahendra; Anak Agung Gede Putra Wiradnyana; Made Bagus Dwi Aryana; I Gde Sastra Winata; I Wayan Megadhana; Daniel Hadinata Susanto
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Introduction: Preterm delivery is still a major problem in pregnancy and causes 70% of all perinatal deaths. The immaturity of the organ systems of preterm infants increases neonatal morbidity and mortality compared to term infants. The incidence of preterm delivery at Sanglah Hospital in 2015 was 285 cases out of 1198 births or 23.7%. Inflammation is thought to be the cause of 40% cases of preterm labor and as much as 70-80% of spontaneous preterm births has a significant relationship with the incidence of infection in the vagina and cervix. The physiological immune response to inflammation is characterized by an increase in the number of circulating neutrophils and a decrease in the number of lymphocytes. There is a controversy regarding the relationship between an increase of neutrophils to lymphocytes ratio in maternal serum and the threatened preterm delivery. This study aims to determine that a high neutrophils to lymphocytes ratio in maternal blood serum is a risk factor for spontaneous preterm delivery. Method: This research was an analytic case control study with 56 samples, and divided into two groups, 28 preterm delivery samples as a case group and 28 preterm pregnancy samples as a control group. This research was conducted at the Obstetric and Gynecology Outpatient clinic as well as the delivery room at Sanglah Hospital Denpasar in the period of November 2020 to April 2021. Result: Analysis results of this study found a statistically significant difference (p = 0.003) between the case and control groups. The group of patients with high maternal neutrophil to lymphocyte serum ratio had a chance of preterm labor 5.6 times higher compared to the group of patients with low maternal neutrophil to lymphocyte serum ratio (OR = 5.6; CI 95% = 1.74-18.42; p=0.003). Conclusion: The conclusion of this study is that the high maternal neutrophils to lymphocytes serum ratio is a risk factor for 5.6 times the occurrence of spontaneous preterm labor. Pendahuluan: Persalinan preterm masih menjadi masalah utama pada ibu hamil dan menyebabkan 70% dari seluruh kasus kematian perinatal. Imaturitas sistem organ tubuh bayi prematur meningkatkan morbiditas dan mortalitas neonatal dibandingkan dengan bayi lahir cukup bulan. Angka kejadian persalinan preterm di RSUP Sanglah pada tahun 2015 sebesar 285 kasus dari 1198 kelahiran atau sebesar 23,7%. Inflamasi diduga sebagai penyebab dari 40% kasus persalinan preterm dan sebanyak 70-80% persalinan preterm spontan mempunyai hubungan bermakna dengan kejadian infeksi pada vagina dan serviks. Respon imun fisiologis terhadap inflamasi ditandai oleh peningkatan jumlah neutrofil yang beredar dan penurunan jumlah limfosit. Terdapat kontroversi hubungan antara peningkatan rasio neutrofil terhadap limfosit serum darah ibu dan ancaman persalinan preterm, sehingga penelitian ini bertujuan untuk mengetahui bahwa tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko persalinan preterm spontan. Metode: Penelitian ini merupakan penelitian analitik dengan rancangan kasus kontrol dengan jumlah sampel sebanyak 56 sampel, dan dibagi menjadi dua kelompok, yaitu 28 sampel persalinan preterm sebagai kelompok kasus dan 28 sampel kehamilan preterm sebagai kelompok kontrol. Penelitian ini dilakukan di Poliklinik Obstetri dan Ginekologi serta kamar bersalin IGD RSUP Sanglah Denpasar periode November 2020 hingga April 2021. Hasil: Hasil analisis dari penelitian ini didapatkan perbedaan yang signifikan secara statistik (p = 0,003) antara kelompok kasus dan kontrol. Kelompok pasien dengan nilai rasio neutrofil terhadap limfosit serum darah ibu yang tinggi memiliki kemungkinan sebesar 5,6 kali mengalami persalinan preterm dibandingkan dengan kelompok pasien dengan rasio neutrofil terhadap limfosit serum darah ibu yang rendah (OR = 5,6, IK 95% = 1,74-18,42, p = 0,003). Simpulan: Simpulan dari penelitian ini adalah tingginya rasio neutrofil terhadap limfosit serum darah ibu merupakan faktor risiko 5,6 kali terjadinya persalinan preterm spontan.

Skor assessment of different neoplasias in the adnexa (ADNEX) untuk memprediksi keganasan ovarium di RSUP Sanglah Denpasar I Nyoman Gede Budiana; Ketut Suwiyoga; Tjokorda Gde Agung Suwardewa; Anom Suardika; Made Bagus Dwi Aryana; Heni Sunyoto
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.v13i1.1328

Introduction: Ovarian cancer is cancer of the female reproductive organs with the highest mortality and is in the third position of female cancer after mammary and cervical cancer. The mortality rate and survival rate of ovarian cancer is mainly determined by the stage at which ovarian cancer is diagnosed. Until now there is no method for early detection of ovarian cancer with good sensitivity and specificity. Assessment of different neoplasias in the adnexa (ADNEX) is a model proposed by international ovarian tumor analysis (IOTA) to help distinguish benign or malignant adnexa tumors.Methods: This study is a observational clinical test to find out the accuracy of ADNEX model to predict ovarian malignancy conducted at the Obstetric and Gynecology Outpatient Ward in Sanglah hospital, Denpasar from November 2019 to April 2020. Consecutive sampling was done and 88 sample was recruited with a diagnosis of ovarian tumors. Then the research sample was sent to the Pathology Anatomy laboratory of Sanglah Hospital for histopathological examination. This result would then be compared to the prediction results of the ADNEX model.Results: 35 samples of benign ovarian tumors and 53 samples of ovarian cancer were found with the ADNEX method. There were 46 samples with malignant tumor both by the ADNEX model and histopathology results, 7 samples of malignant tumor at histopathology result but benign by the ADNEX model, 6 samples of benign tumor according to histopathology but malignant using the ADNEX model, and 29 samples of benign tumor according to histopathology and the ADNEX model. Using cut off of 49,6%, the study reported a sensitivity level of 86.8%, specificity 82.6%, positive predictive value 88.5%, negative predictive value 80.6%, and 85.2% accuracy.Conclusion: The ADNEX model has a high level of specificity, sensitivity and diagnostic accuracy in diagnosing ovarian cancer and can be used in combination with other clinical markers for early detection of malignancy in ovarian tumors. Pendahuluan: Kanker ovarium merupakan salah satu jenis kanker organ reproduksi wanita dengan mortalitas tertinggi dan berada pada posisi ke-tiga kanker perempuan setelah kanker mammae dan serviks. Angka mortalitas dan survival rate kanker ovarium sangat ditentukan oleh stadium saat kanker ovarium terdiagnosis. Hingga saat ini belum tersedia metode pemeriksaan untuk deteksi dini kanker ovarium dengan sensitivitas dan spesifisitas yang memadai. Assessment of different neoplasias in the adnexa (ADNEX) adalah model yang diajukan oleh International Ovarian Tumor Analysis (IOTA) untuk membantu membedakan tumor adnexa sebagai tumor jinak atau ganas. Metode: Penelitian ini merupakan penelitian observasional uji klinik untuk mengetahui akurasi model ADNEX untuk memprediksi keganasan ovarium yang dilakukan di Poliklinik Kebidanan dan Penyakit Kandungan RSUP Sanglah, Denpasar pada bulan November 2019 hingga April 2020. Sampling dilakukan secara consecutive dan didapatkan 88 orang dengan diagnosis tumor ovarium. Sampel penelitian dikirimkan ke laboratorium Patologi Anatomi RSUP Sanglah dan dilakukan pemeriksaan histopatologi untuk kemudian dibandingkan dengan hasil prediksi dari model ADNEX.Hasil: Dalam penelitian ini didapatkan 35 sampel dengan tumor jinak ovarium dan 53 sampel dengan kanker ovarium dengan menggunakan metode ADNEX. Terdapat 46 sampel dengan hasil pemeriksaan model ADNEX ganas dan hasil pemeriksaan histopatologi ganas, 7 sampel histologi ganas namun model ADNEX jinak, 6 sampel histopatologi jinak namun model ADNEX ganas, dan 29 sampel histopatologi jinak dan model ADNEX jinak. Hasil penelitian memperlihatkan tingkat sensitifitas 86,8%, spesifisitas 82,6%, nilai prediksi positif 88,5%, nilai prediksi negatif 80,6%, dan akurasi 85,2%.Simpulan: Model ADNEX memiliki tingkat spesifisitas, sensitivitas dan akurasi diagnostik yang tinggi dalam mendiagnosis kanker ovarium dan dapat digunakan bersama dengan penanda klinis lain untuk deteksi dini keganasan pada tumor ovarium.

Kadar heat shock protein 70 (HSP 70) yang tinggi pada serum ibu sebagai faktor risiko persalinan preterm Tjokorda G. A. Suwardewa; Ketut Surya Negara; Anak Agung Ngurah Anantasika; I Wayan Artana Putra; I Gde Sastra Winata; Piere Emanuel Yoltuwu
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.v13i1.1329

Introduction: Preterm birth defined as parturition that occurs less than 37 completed weeks of gestation is still being a big problem in obstetrics, especially in perinatology. Preterm delivery is one of the most common causes of neonatal morbidity and mortality. This study examined serum HSP 70 levels as a risk factor for preterm delivery.Method: The research design was analytic with a case-control method at Sanglah Hospital from February to June 2021. The samples were divided into two groups which are in the case group was 30 samples and the control group was 30 samples. In both groups, HSP 70 levels were collected by taking 5cc of blood sample from cubital vein. Furthermore, the examination was carried out using the enzyme-link immunosorbent assay (ELISA) method at Biomedik Terpadu Laboratory service.Result: Based on the data on the characteristics of the subjects, respectively maternal age, gestational age, BMI, and parity there was no significant differences between two group. Serum HSP levels were significantly different between the two groups with OR 4.030 (95%CI: 1,372-11,84; p-value 0.01). The cut-off value for serum HSP 70 levels was 12.85 ng/ml, with a sensitivity of 70%, specificity of 63.3%, and an area under the curve (AUC) value of 0.807 (95% CI 0.697 – 0.916, p-value <0.001).Conclusion: This study revealed that high levels of HSP 70 in serum is a risk factor of preterm labor. High blood serum levels of HSP 70 could be a reference in determining high risk of preterm labor in pregnant women. Pendahuluan: Persalinan preterm didefinisikan kelahiran sebelum usia gestasi kurang dari 37 minggu masih menjadi masalah besar dalam bidang obstetri khususnya dibidang perinatologi. Persalinan preterm merupakan salah satu penyebab utama tingginya angka morbiditas dan mortalitas neonatus. Penelitian ini meneliti mengenai kadar HSP 70 pada serum ibu sebagai faktor risiko persalinan preterm.Metode: Rancangan penelitian yang digunakan adalah analitik dengan metode kasus-kontrol, dilakukan di RSUP Sanglah pada periode Februari 2021 sampai Juni 2021. Sampel dibagi menjadi 2 kelompok yakni kelompok kasus sebanyak 30 sampel dan kontrol 30 sampel. Pada kedua kelompok, pemeriksaan kadar HSP 70 dilakukan melalui pengambilan sampel darah 5 ml pada vena cubiti. Selanjutnya dilakukan pemeriksaan dengan metode enzyme-link immunosorbent assay (ELISA) di Unit Laboratorium Biomedik Terpadu.Hasil: Data karakteristik subyek yaitu usia ibu, usia kehamilan, IMT dan jumlah paritas, tidak ditemukan adanya perbedaan bermakna. Kadar serum HSP yang tinggi berbeda bermakna antara kedua kelompok dengan nilai OR 4.030 (IK 95%: 1,372-11,84; nilai p 0.01). Nilai cut off kadar serum HSP 70 sebesar 12.85 ng/ml, dengan sensitifitas sebesar 70%, spesifisitas 63,3%, dan nilai area under the curve (AUC) sebesar 0,807 (IK 95% 0,697 – 0,916, nilai p <0,001).Simpulan: Penelitian ini menunjukkan bahwa kadar HSP 70 yang tinggi pada serum ibu sebagai faktor risiko kejadian terjadinya persalinan preterm. Nilai kadar HSP 70 yang tinggi dapat menjadi suatu acuan dalam menentukan risiko tinggi kejadian persalinan preterm pada ibu hamil.

Hubungan antara kadar homosistein (Hcy) dengan kejadian ketuban pecah dini (KPD) pada kehamilan preterm Agrifa Eko Albert Sembiring; Tjokorda Gde Agung Suwardewa; Ketut Surya Negara; I Nyoman Gede Budiana; Ida Bagus Putra Adnyana; Evert Solomon Pangkahila
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Premature rupture of membranes (PROM) has been a problem in obstetrics since ancient times until now. The incidence of PROM in the world ranges from 5% - 15% of all pregnancies, while the incidence in developing countries, especially Indonesia ranges from 4.5% to 7.6% of all pregnancies. Preterm is one of the highest contributors to perinatal mortality and morbidity. The incidence of preterm pregnancy in the world is around 9.6% of all births, while in Southeast Asia is around 11.1% It has been shown to have a significant effect on vascular endothelial pathology. Methods: The study was conducted with an analytic cross-sectional design involving 70 respondents of pregnant women with gestational age of 20 - < 37 weeks with and without PPROM who came to the outpatient clinic and maternity ward of Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar from May 2021 – July 2021. Results: The results of the analysis of this study found a statistically significant relationship between homocysteine (Hcy) levels and the incidence of preterm premature rupture of membranes (p = 0.001). The prevalence ratio value of 2.2 means that high homocysteine levels is a risk factor for premature rupture of membranes in preterm pregnancy (RP = 2.2; 95% CI = 1.33-2.94; p = 0.001). Conclusion: High homocysteine level is a risk factor for premature rupture of membranes in preterm pregnancy. Latar Belakang: Ketuban pecah dini (KPD) preterm merupakan masalah di bidang obstetrik sejak dahulu sampai sekarang. Insiden KPD di dunia berkisar antara 5% - 15% dari seluruh kehamilan. Insiden KPD di negara berkembang khususnya Indonesia berkisar 4,5% - 7,6% dari seluruh kehamilan. Kehamilan preterm menjadi salah satu penyumbang tertinggi angka mortalitas dan morbiditas perinatal. Insiden kehamilan preterm di dunia sekitar 9.6% dari semua kelahiran, sedangkan di Asia tenggara terdapat sekitar 11,1%. Hcy telah terbukti signifikan berpengaruh pada patologi endotel pembuluh darah. Metode: Penelitian dilakukan dengan rancangan cross sectional analitik dengan melibatkan 70 responden wanita hamil dengan usia gestasi 20 - <70 minggu dengan atau tanpa KPD yang dating ke poliklinik dan ruang bersalin RSUP Prof. Dr. I.G.N.G. Ngoerah bulan Mei 2021 – Juli 2021. Hasil: Diperoleh hubungan bermaksana secara statistik antara kadar homocycteine dengan kejadian ketuban pecah dini pada kehamilan preterm (p = 0, 001), dan rasio prevalensi 2,2 berarti kadar homosisteine yang tinggi merupakan faktor risiko terjadinya ketuban pecah dini pada kehamilan preterm (RP = 2.2; 95% CI = 1.33-2.94; p = 0.001). Kesimpulan: Kadar homosistein yang tinggi merupakan faktor risiko terjadinya ketuban pecah dini pada kehamilan preterm.

Rasio platelet-limfosit serum ibu pada kehamilan preterm dan kehamilan preterm dengan Ketuban Pecah Dini (KPD): suatu studi potong-lintang Tjokorda Gde Agung Suwardewa; Anak Agung Gede Putra Wiradnyana; Made Suyasa Jaya; I Nyoman Bayu Mahendra; Ryan Saktika Mulyana; Alfonso Anggriawan
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Background: Preterm Premature Rupture of Membranes (PPROM) is one of the obstetric problems that needs special attention, apart from the high prevalence, cases of PPROM also often cause neonatal morbidity and mortality. Inflammation is thought to be the cause of the incidence of PPROM and has a relationship with the incidence of ascending genital tract infection. The physiological immune response to inflammation is characterized by an increase in the number of circulating platelets and a decrease in the number of lymphocytes. This study aims to evaluate the high ratio of platelets to lymphocytes of maternal blood serum is a risk factor for the occurrence of preterm PROM. Methods: This study is a cross-sectional study with a sample size of 70 samples, and is divided into a risk group (preterm pregnancy with PROM) and a no-risk group (preterm pregnancy without PROM). This research was conducted in the Emergency Room maternity ward and Obstetrics and Gynecology outward patient at Sanglah Hospital Denpasar for the period December 2020 to May 2021. Data were analyzed using SPSS version 26 for Windows. Results: The results of the analysis of this study obtained a statistically significant difference (p = 0.000). The group with a high maternal blood serum platelet to lymphocyte ratio had a higher risk of developing preterm PROM compared to the group with a low maternal blood serum platelet to lymphocyte ratio (PR = 2.4, 95% CI = 1.60-3.69, p = 0.000). Conclusion: The conclusion of this study is the high maternal blood serum platelet to lymphocyte ratio is a risk factor for the occurrence of preterm PROM. Latar Belakang: Ketuban pecah dini (KPD) preterm merupakan salah satu masalah obstetri yang perlu mendapat perhatian khusus, selain karena prevalensi yang besar, kasus KPD preterm juga sering menyebabkan morbiditas dan mortalitas neonatus. Inflamasi diduga sebagai penyebab dari kejadian KPD preterm dan mempunyai hubungan dengan kejadian infeksi ascending traktus genital. Respon imun fisiologis terhadap inflamasi ditandai oleh peningkatan jumlah platelet yang beredar dan penurunan jumlah limfosit. Penelitian ini bertujuan untuk mengetahui bahwa tingginya rasio platelet terhadap limfosit serum darah ibu merupakan faktor risiko terjadinya KPD preterm. Metode: Penelitian ini merupakan penelitian cross-sectional dengan jumlah sampel sebanyak 70 sampel, dan terbagi menjadi kelompok berisiko (kehamilan preterm dengan KPD) dan kelompok tanpa risiko (kehamilan preterm tanpa KPD). Penelitian ini dilakukan di kamar bersalin IGD serta Poli Obstetri dan Ginekologi RSUP Sanglah Denpasar periode Desember 2020 hingga Mei 2021. Data dianalisis dengan SPSS versi 26 untuk Windows. Hasil: Hasil analisis dari penelitian ini didapatkan perbedaan yang bermakna secara statistik (p = 0,000). Kelompok dengan nilai rasio platelet terhadap limfosit serum darah ibu yang tinggi memiliki risiko mengalami kejadian KPD preterm dibandingkan dengan kelompok dengan rasio platelet terhadap limfosit serum darah ibu yang rendah (PR = 2,4, IK 95% = 1,60-3,69, p = 0,000). Kesimpulan: Simpulan dari penelitian ini adalah rasio platelet terhadap limfosit serum darah ibu yang tinggi merupakan faktor risiko terjadinya kejadian KPD preterm.

High Level of Uterine Endocervical Interleukin-8, Matrix Metalloproteinase-8, and Interleukin 1Β as a Risk Factor for Preterm Labor Suwardewa TGA; Suwiyoga K K; Mantik Astawa N; Sutirta Yasa IWP
Journal of Global Pharma Technology Vol. 9 Issue 7 : 2017
Publisher : Journal of Global Pharma Technology

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The preterm birth is a birth that takes place on a gestational age between 20–36 weeks and six days. The preterm birth is the leading cause of neonatal mortality and morbidity. Despite the current treatment procedures, the incidence of preterm birth has not changed in the last two decades. Incomplete understanding of the pathophysiological mechanisms underlying preterm labor is the major obstacle to prevent preterm birth. Recently, endocervical inflammation has been thought as a risk factor of a preterm labor. Several important substances such as endocervical IL-8, MMP-8, and IL-1β, has been considered to play a key role on preterm birth through cervical ripening. With those assumptions, the detection of a higher level of uterine endocervical IL-8, MMP-8, and IL-1β can be used to predict preterm labor. The design of this study is an observational case control study with a case group, which consisted of pregnant women with 20–36 weeks and six days of gestational age who had signs of labor, and the control group consisted of pregnant women with 20–36 weeks and six days of gestational age who had no signs of labor. The material used for this study is cervical mucous, and the enzyme-linked immunosorbent assay method was used to assess the level of IL-8, MMP-8, and IL-1β at laboratory of Veterinary Medicine of Udayana University Denpasar. In this study we used 48 samples, among which 24 were case group, and 24 as a control group. The mean age of the women, gestational age, and parity from both group are (27.04 vs 28.62 years old), (31.8 vs 29.50 weeks), and (0.96 vs 1.29) respectively, which are statistically homogenous (p > 0.05). Each level of interleukin-8, matrix metalloproteinase, and interleukin-1β suggests a risk factor of a preterm labor for: 35 times (OR = 35.00; CI 95% = 6.95–176.39; p = 0.001); 6.6 times (OR = 6.60; CI 95% = 1.25–34.95; p = 0.016), and 8.3 times (OR = 8.3; CI 95% = 2.15–32.3; p = 0.001), orderly. Among these cytokines, one that contributes most through a preterm birth is interleukin-8 (61%), followed by matrix metalloproteinase-8 (27%), and interleukin-1β (12%).Conclusion: Endocervical inflammation with high level of IL-8, MMP-8, and IL-1β is a risk factor for preterm labor. IL -8 gives the most contribution on preterm labor.Keywords: Preterm birth, Endocervical IL-8, MMP-8, and IL-1β.

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