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The Relationship between the Ratio of Neutrophil and Lymphocyte in Preeclampsia Patients Ayuni, Intan Nabilla; Yeni, Cut Meurah; Husnah, Husnah; Sakdiah, Sakdiah
Asian Journal of Healthcare Analytics Vol. 4 No. 1 (2025): May 2025
Publisher : PT FORMOSA CENDEKIA GLOBAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55927/ajha.v4i1.14391

Abstract

Preeclampsia is a hypertensive disorder with elevated blood pressure and proteinuria after 20 weeks of gestation, often involving an exaggerated inflammatory response. This study examined the relationship between the neutrophil-to-lymphocyte ratio (RNL) and preeclampsia. A retrospective analytic study with a cross-sectional approach analyzed medical records of 106 inpatients at Zainoel Abidin Hospital Banda Aceh from January to December 2020. Most patients were aged 20-35 years (64.2%), college-educated (38.8%), housewives (68.9%), and multiparas (62%). RNL analysis showed 8.6% normal and 91.4% abnormal in severe preeclampsia cases. The Spearman correlation test showed p=0.367 (p>0.05), indicating no significant relationship between RNL and preeclampsia. The mean RNL was 6.5267 in preeclampsia and 8.3106 in severe cases, both exceeding the normal cut-off of 4.8. There was no relationship between RNL and preeclampsia, but the mean RNL values were above normal.
Ethnopharmacological insights and clinical prospects of ten Indonesian medicinal plants for pregnancy, postpartum, and lactation: a systematic review Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Rahardjo, Theresia Monica; Suryawan, Aloysius; Rahardjo, Bambang; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.77

Abstract

Background: The perinatal period involves significant physiological and metabolic transitions, particularly concerning hypertensive disorders, preeclampsia, hemorrhage, lactation challenges, and oxidative stress. Although pharmacological therapies are available, their safety and accessibility remain inconsistent, especially in resource-limited settings. Indonesia’s extensive biodiversity and deep-rooted ethnomedicinal traditions offer promising yet underutilized botanical alternatives. This study aimed to review the efficacy of Indonesian medicinal plants used in pregnancy, postpartum, and lactation. Methods: This systematic review investigates ten Indonesian medicinal plants traditionally used during pregnancy, postpartum recovery, and lactation: Sauropus androgynus, Curcuma longa, Moringa oleifera, Nigella sativa, Centella asiatica, Orthosiphon aristatus, Syzygium polyanthum, Andrographis paniculata, Solanum nigrum, and Zingiber officinale. Literature from 2000 to 2025 was reviewed using PRISMA guidelines across global and regional databases. Phytochemical composition, mechanisms of action, therapeutic effects (e.g., antihypertensive, antidiabetic, galactagogue, hemostatic, antioxidant), and clinical relevance were critically evaluated. Results: All ten plants demonstrated pharmacological potential relevant to perinatal health challenges. Notably, Zingiber officinale offers antiemetic and anti-inflammatory benefits during early pregnancy, complementing the lactogenic, antihypertensive, and wound-healing properties of other species. However, gaps persist in human trials, dosage standardization, and regulatory oversight. Conclusion: The review highlights the importance of integrating validated traditional botanicals into perinatal care through interdisciplinary research, targeted clinical trials, and culturally responsive health policies. Bridging ethnopharmacology with maternal health systems offers a scalable, sustainable pathway toward maternal wellness and equity in Indonesia and comparable global settings.
Blood Cadmium and Preterm Birth: A Systems Toxicology Review of Molecular Mechanisms, Placental Disruption, and Translational Obstetric Implications Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Bachnas, Muhammad Adrianes; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Pribadi, Adhi; Sulistyowati, Sri; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.949

Abstract

Objectives: Preterm birth (PTB) remains a leading global cause of neonatal morbidity and mortality, with multifactorial origins including inflammation, endocrine disruption, and placental dysfunction. Recent evidence identifies cadmium (Cd), a persistent environmental toxicant, as a modifiable contributor to PTB. This review aims to integrate the mechanistic, molecular, and clinical literature on maternal blood cadmium exposure and its role in the pathogenesis of PTB.Methods: A systematic and integrative review was conducted following PRISMA 2020 guidelines. Literature from 2000 to 2025 was retrieved using PubMed, Scopus, Embase, and Web of Science. Eligible studies included molecular toxicology, animal models, human epidemiological data, and placental mechanistic research addressing cadmium exposure and preterm birth. Inclusion criteria emphasized mechanistic clarity, gestational outcome relevance, and measurable cadmium biomarkers. Figures, tables, and mechanistic diagrams were used to illustrate toxicological convergence pathways.Results: Cadmium disrupts placental homeostasis via oxidative stress, endothelial dysfunction, impaired trophoblast invasion, progesterone suppression, and activation of inflammatory cascades such as the NLRP3 inflammasome. Consistent associations between maternal cadmium burden and PTB risk were found across animal, cellular, and human population studies. However, heterogeneity in exposure assessment, absence of unified risk thresholds, and confounding from co-exposures challenge causal inference. Literature remains fragmented, lacking integration between mechanistic insights and clinical risk models.Conclusions: Cadmium should be reclassified as a central agent in the pathophysiology of PTB. We propose a precision obstetrics framework that includes environmental cadmium screening in high-risk pregnancies, implementation of exposome-informed policies, and prospective multicenter studies with molecular endpoints. Obstetric care must evolve to include toxicological risk profiling as standard practice in the prevention of PTB.Kadmium dalam Darah dan Kelahiran Prematur: Tinjauan Toksikologi Sistemik terhadap Mekanisme Molekuler, Disrupsi Plasenta, dan Implikasi Obstetri TranslasiAbstrakTujuan: Kelahiran Prematur (preterm birth/PTB) tetap menjadi penyebab utama morbiditas dan mortalitas neonatal di seluruh dunia dengan etiologi multifaktorial yang mencakup inflamasi, gangguan endokrin, dan disfungsi plasenta. Bukti terbaru mengidentifikasi kadmium (Cd), suatu toksikan lingkungan persisten, sebagai faktor kontribusi yang dapat dimodifikasi terhadap PTB. Tinjauan ini bertujuan untuk mengintegrasikan literatur mekanistik, molekuler, dan klinis mengenai paparan kadmium dalam darah maternal dan perannya dalam patogenesis PTB.Metode: Tinjauan sistematis dan integratif dilakukan sesuai pedoman PRISMA 2020. Literatur dari tahun 2000 hingga 2025 dikumpulkan melalui database PubMed, Scopus, Embase, dan Web of Science. Studi yang memenuhi syarat mencakup toksikologi molekuler, model hewan, data epidemiologi manusia, dan penelitian mekanistik plasenta yang mengevaluasi hubungan antara paparan kadmium dan kelahiran prematur. Kriteria inklusi menekankan kejelasan mekanistik, relevansi terhadap hasil kehamilan, serta penggunaan biomarker kadmium yang terukur. Gambar, tabel, dan diagram mekanistik digunakan untuk mengilustrasikan jalur konvergensi toksikologis.Hasil: Kadmium mengganggu homeostasis plasenta melalui stres oksidatif, disfungsi endotel, gangguan invasi trofoblas, supresi progesteron, dan aktivasi jalur inflamasi seperti inflammasom NLRP3. Hubungan konsisten antara beban kadmium maternal dan risiko PTB ditemukan dalam studi hewan, seluler, dan populasi manusia. Namun, adanya heterogenitas dalam penilaian paparan, belum adanya ambang risiko yang seragam, serta pengaruh faktor pajanan lainnya menjadi tantangan dalam penarikan kesimpulan kausal. Literatur masih terfragmentasi dan belum mengintegrasikan temuan mekanistik dengan model risiko klinis secara menyeluruh.Kesimpulan: Kadmium seharusnya diklasifikasikan ulang sebagai agen sentral dalam patofisiologi PTB. Kami mengusulkan suatu kerangka kerja obstetri presisi yang mencakup skrining lingkungan terhadap kadmium pada kehamilan berisiko tinggi, menerapkan kebijakan berbasis exposome, serta studi prospektif multisentra dengan titik akhir molekuler. Pelayanan kebidanan harus berkembang dengan mengadopsi profil risiko toksikologis sebagai bagian dari praktik standar dalam pencegahan kelahiran prematur.Kata kunci: Disrupsi Plasenta; Interaksi Endokrin-Inflamasi; Kesehatan Reproduksi Lingkungan; Mekanisme Kelahiran Prematur; Toksisitas Kadmium,
Water Birth as Neuroendocrine Medicine: A Critical and Integrative Review of Hormonal and Psychophysiological Impacts on Maternal and Neonatal Outcomes Sanjaya, I Nyoman Hariyasa; Andonotopo, Wiku; Dewantiningrum, Julian; Pramono, Mochammad Besari Adi; Mulyana, Ryan Saktika; Pangkahila, Evert Solomon; Akbar, Muhammad Ilham Aldika; Yeni, Cut Meurah; Aldiansyah, Dudy; Bernolian, Nuswil; Wiradnyana, Anak Agung Gede Putra; Darmawan, Ernawati; Stanojevic, Milan; Kurjak, Asim
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.79

Abstract

Background: Water birth, defined as labor and/or delivery conducted in warm water, has gained increasing recognition as a patient-centered and physiologically supportive birth practice. Beyond analgesia, growing evidence indicates that water immersion during labor modulates maternal neuroendocrine regulation, psychological well-being, and neonatal physiological adaptation. Nevertheless, these hormonal and psychophysiological mechanisms remain insufficiently integrated into conventional perinatal research and clinical frameworks. This review aims to synthesize current evidence on the neuroendocrine, psychophysiological, obstetric, and neonatal effects of water birth and to evaluate its clinical effectiveness and safety in low-risk pregnancies. Methods: An integrative review was conducted using a PRISMA-guided approach to identify peer-reviewed studies published between 2000 and 2025. Literature searches retrieved 3,287 records from major biomedical databases, of which 44 studies (12 randomized controlled trials, 19 cohort studies, 6 case–control studies, and 7 systematic reviews) met inclusion criteria. Data were synthesized thematically, focusing on maternal hormonal responses (oxytocin, β-endorphins, cortisol, prolactin), labor outcomes, breastfeeding, postpartum mood, neonatal adaptation, and safety considerations. Results: Across study designs, water immersion during labor was associated with increased endogenous oxytocin and β-endorphin activity and reduced stress-related hormonal responses. Clinically, first-stage labor was shortened by approximately 42–78 minutes, and epidural analgesia use was reduced by 30–50% compared with conventional land birth. Episiotomy rates were generally below 5%, and maternal satisfaction scores were consistently higher. Early breastfeeding initiation occurred in 86–92% of water birth cases, with exclusive breastfeeding rates at six weeks ranging from 66–77%. Neonatal outcomes, including 5-minute Apgar scores and NICU admission rates, were comparable to or slightly better than conventional birth in low-risk populations, with no consistent increase in infection or respiratory complications when standardized protocols were applied. Conclusion: Water birth supports a hormonally optimized and psychologically protective labor environment, with measurable benefits for labor efficiency, maternal experience, breastfeeding success, and neonatal physiological transition. When implemented under evidence-based guidelines, it represents a credible non-pharmacological option within contemporary, physiology-informed maternity care.
Kehamilan Dini Setelah Sleeve Gastrectomy pada Pasien dengan Triple Metabolic Burden: Kasus Kompleks Diabetes Tipe 2, Hipotiroid, dan Preeklampsia Berat dengan Pertumbuhan Janin Terhambat Amal Bahrum Penas; Cut Meurah Yeni; Yusra Septivera; Cut Rika Maharani; Fara Julyta Aliyah
JURNAL RISET RUMPUN ILMU KEDOKTERAN Vol. 5 No. 2 (2026): Agustus: Jurnal Riset Rumpun Ilmu Kedokteran
Publisher : Lembaga Pengembangan Kinerja Dosen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jurrike.v5i2.9152

Abstract

Bariatric surgery is effective in treating obesity and type 2 diabetes mellitus (T2DM); however, pregnancy occurring within 12–24 months after surgery carries significant risks. This report presents a complex pregnancy case in a patient with a history of sleeve gastrectomy, post-hemithyroidectomy hypothyroidism, and T2DM. A 29-year-old primigravida conceived 2 months after undergoing sleeve gastrectomy, which successfully induced T2DM remission, with HbA1c decreasing from 11% to 5.5%. Although glycemic control and euthyroid status were maintained throughout pregnancy, the patient developed severe preeclampsia at 35–36 weeks of gestation, complicated by intrauterine growth restriction (IUGR) and oligohydramnios. An emergency cesarean section delivered a male infant weighing 2000 grams with Apgar scores of 8 and 9 at the first and fifth minutes, respectively. The neonate required 14 days of NICU care due to respiratory distress syndrome, respiratory failure, and hyperbilirubinemia. Maternal gestational weight gain was suboptimal at only 4 kg, below the recommended range for pregnant women with obesity. This case highlights the importance of adhering to the recommended surgery-to-conception interval following bariatric surgery. Early pregnancy after surgery, combined with multiple metabolic comorbidities, may contribute to adverse maternal and neonatal outcomes. Multidisciplinary management, comprehensive nutritional monitoring, and optimization of comorbidities before conception are essential to improve pregnancy outcomes in this population.