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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi Jurnal Kebidanan Nusantara Medical Science Journal Jurnal Ilmiah Kedokteran Wijaya Kusuma Health Notions Jurnal Surya Medika Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) JNKI (Jurnal Ners dan Kebidanan Indonesia) (Indonesian Journal of Nursing and Midwifery) Jurnal Gizi Klinik Indonesia Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Media Ilmu Kesehatan Journal of Maternal and Child Health Jurnal Kesehatan Ibu dan Anak Jurnal Medikes (Media Informasi Kesehatan) Journal of Community Empowerment for Health Journal of Nursing and Health (JNH) Akper Yakpermas Banyumas JURNAL KESEHATAN SAMODRA ILMU Berita Kedokteran Masyarakat Jurnal Kebidanan dan Keperawatan Aisyiyah Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)

Detty Siti Nurdiati

Department Of Obstetrics And Gynecology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia

Author-ID : 508977

Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Tren dan Faktor Risiko Kematian Maternal di RSUP Dr.Sardjito Yogyakarta tahun 2012-2017 Prihesti, Uce Siswi; Nurdiati, Detty Siti; Ganap, Eugenius Phyowai
JURNAL KESEHATAN REPRODUKSI Vol 6, No 2 (2019)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Latar Bakang: Kematian maternal merupakan masalah obstetrik besar di Indonesia. Pada tahun 2015 MDGâ€™s menargetkan angka kematian ibu di Indonesia sebesar 102 per 100.000 kelahiran hidup.Tujuan: Untuk mengetahui tren dan menganalisis faktor risiko yang menyebabkan kematian maternal di RSUP dr. Sardjito tahun 2012-2017.Metode :Penelitian ini menggunakan metode kasus kontrol di RSUP Dr. Sardjito dengan sampel kasus maternal yang meninggal pada tahun 2012-2017 yang memenuhi kriteria inklusi dan eksklusi. Kontrol diambil dengan melakukan matching dengan umur kehamilan dan tanggal masuk rumah sakit, besarnya masing-masing 100 sampel. Data dianalisis menggunakan uji statistik chi-square dan regresi logistik.Hasil dan pembahasan: Pada tahun 2012 â€“ 2017 terdapat 100 kematian maternal dengan penyebab utama adalah preeklampsia 29%, penyakit jantung 25%, penyakit lain 19%, infeksi (sepsis) 16%, dan perdarahan 11%. Dengan penyebab kematian langsung 43% dan tidak langsung 57%. Pada penelitian ini tren angka kematian ibu per 100.000 kelahiran hidup cenderung meningkat, tertinggi pada tahun 2016 sebesar 2670 per 100.000 kelahiran hidup. Sedangkan penyebab kematian maternal terbanyak pada tahun 2012, 2015, 2016 dan 2017 adalah preeklampsia sedangkan pada tahun 2013 dan 2014 adalah penyakit jantung. Kasus rujukan (OR 11,67; CI 95% 4,51-30,19), infeksi (OR 7,42; CI 95% 2,21-24,87) dan penyakit jantung (OR 4,02; CI95% 1,65-9,80) berpengaruh secara signifikan terhadap kejadian kematian maternal.Kesimpulan: Tren kematian maternal di RSUP Dr. Sardjito Yogyakarta tahun 2012-2017 cenderung meningkat. Kasus rujukan, infeksi dan penyakit jantung berpengaruh meningkatkan kejadian kematian maternal di RSUP Dr. Sardjito Yogyakarta tahun 2012-2017.Kata kunci: Kematian maternal; tren dan faktor risiko

EFEKTIVITAS PIJAT EFFLEURAGE DAN COUNTERPRESSURE TERHADAP KEMAJUAN DILATASI SERVIKS PADA KALA I FASE AKTIF Nirmala Santiasari, Retty; Siti Nurdiati, Detty; Lismidiati, Wiwin
MEDIA ILMU KESEHATAN Vol 7 No 3 (2018): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Backgraound: Labor process begins with the process of cervical dilatation, which is commonly accompanied by pain. Labor pain caused by uterine contractions can cause thinning of the cervix. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counterpressure are complementary treatment to stimulate uterine contractions. Objective: To analyze the effectiveness of effleurage and counterpressure massages on the progress of cervical dilatation. Method: This was a quasi-experiment study with pre-post test nonequivalent control group. Population was the women in labor in stage I active phase. Research subjects were 68 people that were divided into two groups. Sampling technique was consecutive sampling. Instrument used in this study was the internal examination. Data were analyzed using Wilcoxon and Mann Whitney. Results: The progress of cervical dilatation before and after the intervention of the effleurage was 4.74Â±0.83 vs 7.47Â±1.21 with p=0.00 and the result for the counterpressure group was 4.59Â±0.66 vs 8.03Â±0.96 with p=0.00. The average improvement of cervical dilatation on the effleurage and counterpressure groups was 2.73 vs 3.44 with p=0.00. Conclusion: The counterpressure has the more significant effect than the effleurage on improving the cervical dilatation. Keywords: Cervical dilatation, counterpressure, effleurage

Pengaruh Pemberian Parasetamol Intravena untuk Mengurangi Nyeri Persalinan Kala 1 Fase Aktif Sitorus, Juli; Emilia, Ova; Nurdiati, Detty Siti
JURNAL KESEHATAN REPRODUKSI Vol 7, No 1 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.53482

Background: Labor was a physiological process, labor pain appeared from regularly uterine contraction, cervix distention and pressure to pelvic floor that stimulate free end nerves. Pain labor can influenced the mother, fetus and the progress of labor. There are various of effort to decrease pain labor by pharmacological or non pharmacological. The best therapy must be safe, effective, and minimal adverse effect to mother and fetus.Objective: To evaluate the effect of paracetamol intraveneous for pain relief in active labor versus saline water.Methods: In randomized controlled trial, with single blinded, 66 primigravid in active labor at RSUD Hj. ANNA LASMANAH Banjarnegara and RSUD Banyumas from November 2016 to January 2017. Sampels divided in two groups, paracetamol group (n=33) and normal saline group (n=33). The primaryÂ outcome was the efficacy of paracetamol to relief pain. Intensity of the pain measure by VAS (visual analogue scale), pain measured before drug administration, after 30 minutes, at 1, 2, 3, and 4 hours in both groups. The secondary outcomes include the adverse effect to the mother and baby in both group.Results: The reduction in pain score was significantly greater in paracetamol group than normal saline after 30 minutes, 1, 2, 3, and 4 hours after adiministration of the drug (p<0.05). There was no adverse effect to mother and baby in both groups.Conclusion: Paracetamol intravenous statistically significant decreasing mean pain score than normal saline and safe in active labor.Keywords: Paracetamol, analgesia, active phase in labor

Pengaruh Pemahaman Kangaroo Mother Care (KMC) Pada Perawat Terhadap Perkembangan Bayi Premature di Rumah Sakit Prof. Dr. Margono Soekarjo Sulistyowati, Priyatin; Haryanti, Fitri; Nurdiati, Detty Siti
Journal of Nursing and Health Vol. 2 No. 1 (2017): Journal of Nursing and Health
Publisher : Yakpermas Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52488/jnh.v2i1.54

Latar belakang : Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) merupakan indikator kualitas kesehatan masyarakat di suatu negara. Di Indonesia pada tahun 2012, AKI 359 per 100.000 kelahiran hidup sedangkan AKB sebesar 32 per 1000 kelahiran hidup, atau ada lebih dari 200.000 balita Indonesia yang meninggal setiap tahunnya. Perawatan ekstra untuk bayi prematur dengan menggunakan Kangaroo Mother Care (KMC). . KMC merupakan cara yang efektif untuk memenuhi kebutuhan bayi yang paling mendasar yaitu kehangatan, air susu ibu, perlindungan dari infeksi, stimulasi, keselamatan dan kasih sayang. Metode: ini merupakan salah satu teknologi tepat guna yang sederhana, murah dan sangat dianjurkan untuk perawatan BBLR. KMC tidak hanya sekedar menggantikan peran inkubator, namun juga memberikan berbagai keuntungan yang tidak dapat diberikan incubator. Berdasarkan fakta di atas maka dapat dirumuskan masalah penelitian bagaimanakah pelaksanaan KMC oleh perawat pada ibu yang memiliki BBLR di RSUD Prof. Dr. Margono Soekarjo Purwokerto. Hasil observasi pelaksanaan KMC menemukan adanya perbedaan signifikan pada pelaksanaan KMC setelah intervensi dibandingkan dengan sebelum intervensi dengan p=0,000 (<0,05). Yang berarti hubungan yang signifikan antara pengetahuan dengan pelaksanaan tindakan perawat dalam KMC. Kata Kunci: Bayi Premature, Kangaroo Mother Care (KMC), Kematian Bayi

Perbandingan Luaran Ibu dan Bayi pada Khamilan dengan DM Gestasional dan DM Pregestasional di RSUP Dr.Sardjito Musa Limbu, Ely Yulianus; Nurdiati, Detty Siti; Dewanto, Agung
JURNAL KESEHATAN REPRODUKSI Vol 7, No 3 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.63114

Latar Belakang: Diabetes mellitus dapat terjadi pada 3-5% dari seluruh kehamilan. Hiperglikemia pada saat konsepsi dan pada awal kehamilan secara khusus selama organogenesis mengakibatkan enam kali lipat peningkatan risiko kecacatan pada perkembangan embrio. Bahkan peningkatan kadar glukosa yang ringan selama kehamilan dapat mempengaruhi ibu dan janin.Â Tujuan: Mengetahui gambaran dan prevalensi kehamilan dengan DM pregestasional dan DM gestasional di RSUP Sardjito. Membandingkan luaran ibu dan bayi pada kehamilan dengan DM pregestasional dan DM gestasional di RSUP SardjitoÂ Metode Penelitian: Penelitian ini merupakan penelitian kohort retrospektif. Data diambil dari rekam medis, subyek penelitian yang memenuhi kriteria inklusi dan eksklusi. Data penelitian dikumpulkan, diolah dan dianalisis dengan menggunakan SPSS 23. Dilakukan analisis data univariat, bivariat dan multivariat untuk mengetahui pengaruh antar variabelHasil: Penelitian ini melibatkan 74 subyek. Terdapat luaran ibu dengan ketoasidosis sebanyak 35 orang (47,30%), luaran bayi dengan makrosomia 15 kasus (20,27%), kelainan jantung 7 kasus (9,46%), dan mortalitas neonatal sebanyak 6 kasus (8,11%). Riwayat ANC < 4 kali berpengaruh secara signifikan terhadap kejadian mortalitas neonatal (OR 10,548; 95% CI 1,700-65,437; p = 0.011).\ Kesimpulan: Angka kejadian PGDM sebesar 44 kasus (59,46%) sedikit lebih tinggi dibandingkan GDM sebesar 30 kasus (40,54%) yang melakukan persalinan di RSUP Sardjito selama 5 tahun dari total 8857 kasus persalinan. KAD yang merupakan luaran ibu kejadiannya sebesar 47,30%, dan luaran bayi yang berupa makrosomia sebesar 20,27%, kelainan jantung pada bayi 9,46%, serta mortalitas neonatal 8,11%. Luaran ibu dan luaran bayi pada kehamilan dengan pregestasional diabetes yang dibandingkan dengan gestasional diabetes tidak berbeda bermakna pada penelitian ini.Â Kata kunci: pregestasional diabetes mellitus, gestasional diabetes mellitus, ketoasidosis diabetik, makrosomia, mortalitas neonatal, kelainan jantung pada bayi.Â

Effectiveness of Effleurage and Counter-Pressure Massages in Reducing Labor Pain Retty Nirmala Santiasari; Detty Siti Nurdiati; Wiwin Lismidiati; Noer Saudah
Health Notions Vol 2, No 7 (2018): July
Publisher : Humanistic Network for Science and Technology (HNST)

Labor pain was an emotional experience and involves both physiological and psychological mechanisms during labor. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counter-pressure massage were complementary treatment to relieve pain. This study aimed to analyze effectiveness of effleurage and counter-pressure massages for reducing labor pain in stage 1 of active labor phase. This study used quasi experiment design with pre-post test non-equivalent control group. Research subjects were 68 mothers in stage 1 of active labor phase, which were divided evenly to two groups. Sampling collection technique used consecutive sampling. Independent variables were effleurage and counter-pressure, while dependent variables were decline of labor pain. Instrument to assess labor pain was Numeric Rating Scale (NRS). Data were analyzed using Wilcoxon and Mann Whitney. Labor pain before and after intervention in effleurage group were 9.26±1.05 and 6.88±1.22, respectively (p=0.00). Meanwhile, the respective numbers in counter-pressure groups were 9.00±0.98 and 6.59±1.28 (p=0.00). Average labor pain decline in effleurage and counter-pressure groups were 2.38 and 2.41, respectively (p=0.74). There was no significant difference between effleurage and counter-pressure in reducing labor pain. Keywords: Labor pain, Effleurage, Counter-pressure

Perbandingan Pelaksanaan Pelayanan Kolaborasi Masa Nifas terhadap Kejadian Postpartum Blues di Puskesmas Sewon I & Banguntapan II Kabupaten Bantul Tahun 2020 Dessy Hertati; Detty Siti Nurdiati; Sulistyaningsih Sulistyaningsih; Djaswadi Dasuki
Jurnal Surya Medika (JSM) Vol 8 No 1 (2022): Jurnal Surya Medika (JSM)
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/jsm.v8i1.3440

Postpartum blues is a mild mood disorder syndrome often ignored by postpartum mothers, families, or health workers. Postpartum blues can develop into depression and even psychosis. The incidence varies significantly in Asia, between 26-85%, whereas the incidence is around 50-70% in Indonesia. Postpartum blues also affect the interaction between the baby and the mother, especially during the first year. In mental health, collaborative practice can increase patient and health team satisfaction, reduce the duration of treatment, reduce the cost of care, reduce the incidence of suicide, and reduce outpatient visits. The study aimed to analyze the differences between the implementation of postpartum collaboration services and postpartum blues at Sewon I & Banguntapan II Primary Health Center of Bantul Regency in 2019. This study applied a comparative study with a prospective cohort approach, and the sampling technique used consecutive sampling. Data analysis employed the Wilcoxon test, Mann-Whitney, and binary regression. Wilcoxon test p=0,000 means a difference in the initial and final EPDS score reduction between the two Primary Health Centers and the postpartum blues incidence. The number of postpartum blues in Sewon I Primary Health Center reached 52 (44.83%), while in Banguntapan II, there were 45 (42.45%). Fisher exact test results pregnancy relationship p = 0.642 and history of depression p = 0.078 meaning that there was no relationship. The binary regression test of the age obtained p = 0.000 and parity p = 0.007, meaning a relationship. It can be concluded that Inter-professional Collaboration has become an effective and efficient strategy to improve the quality of services and patient health outcomes due to the increasing diversity of professions in the health sector and the increasingly complex patient problems.

The influence of iron supplementation in pregnant women to the occurrence of low birth weight (LBW) babies in Palu, Central Sulawesi Sri Restu; Djaswadi Dasuki; R. Detty Siti Nurdiati Z
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Low birth weight (LBW) babies remains a major problem world wide as it causes a high rate ofneonatal morbidity and mortality. One effort to reduce the prevalence of LBW babies is byproviding iron supplementation to the pregnant women. The aim of this study was to examinethe relationship between iron supplementation program and prevalence of LBW babies in Palu,Central Sulawesi. This was an observational study with case control design. Subjects were allLBW babies from mothers that had accepted iron supplementation during pregnancy. Samplesize in this study was 87 for case and 87 for control. Bivariate analysis showed that ironsupplementation that not comply the program had a significant correlation with prevalence ofLBW babies (p=0.01). Other significant factors include abnormal hemoglobin level (p=0.01),body mass index (BMI) (p=0.02), educational level (p=0.02), multiparity (p=0.03), andgestational age (prematurity) (p=0.03). Multivariate analysis revealed that the strongest riskfactor for the occurrence of LBW babies was iron supplementation that not comply the program(OR= 3.82; 95% CI: 1.77- 8.22). Other risk factors were hemoglobin level (OR= 3.45; 95% CI:1.59-7.49), BMI (OR= 2.27; 95% CI: 1.05-4.91), gestational age (OR= 3.11; 95% CI: 1.45-6.67), multiparity (OR= 2.98, 95% CI: 1.36-6.51), and educational level (OR= 2.38, 95% CI:1.12-5.03). Based on the analysis, the strongest risk factors that affected the prevalence of LBWwas iron supplementation, abnormal hemoglobin level, gestational age, multiparity and educationlevel. In conclusion, iron supplementation during pregnancy that not comply with the programwas the strongest risk factor of LBW babies. The prevalence of LBW babies can be reduced bycontrolling of iron supplementation, hemoglobin level, BMI, gestational age, parity and education.

BIAYA PASIEN JAMINAN KESEHATAN NASIONAL YANG MENJALANI SEKSIO SESAREA DI RSUP DR. SARDJITO YOGYAKARTA Adi Rahmawan; Detty Siti Nurdiati; Sulchan Sofoewan
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Adi Rahmawan1, Detty Siti Nurdiati2, Sulchan Sofoewan3 ABSTRACT Background: Ease of access and timeliness in reaching emergency obstetric care is necessary to save the mother and newborn. Delivery by emergency caesarean section aims to save the mother and newborn. The amount of cost from the emergency obstetric care particularly caesarean section, was significantly higher compared to childbirth without complications. The implementation JKN (Jaminan Kesehatan Nasional) aims to overcome this programs. Government hospitals have a dilemma between the mission of serving the lower middle class society and the limited financial resources, as well as a variety of rules and bureaucracy. Casemix system on INA-CBG’s (Indonesian Case Base Groups) is grouping similar patient characteristics. Hospital will receive payments based on the average amount of cost by a group of diagnosis. Objective: Knowing the cost of the JKN patient who underwent cesarean section in Dr. Sardjito Hospital. Method: The study design is a descriptive. JKN patients undergoing Caesarean section in January-July 2014 at the Hospital Dr. Sardjito included in the study. Patients who moved to the VIP, VVIP, and suites classes are excluded. Patient cost data will be averaged and be detailed by characteristics. Result: A total of 136 patients underwent Caesarean section with JKN during January-July 2014. Average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Patient with severe preeclampsia had average cost of 3,050,776 rupiahs higher than patients without severe preeclampsia. Patients with 4 disesases and complications had the difference in cost 16,995,952 rupiahs higher than patients without the disease. Patients with ICU care had higher average cost than non-admission to the ICU in the amount of 3,340,288 rupiahs. Difference in the higher average costs also occur on length of stay. Class treatment, duration stay in the delivery room, the induction or stimulation in the delivery room. History of cesarean section was not the leading cause of higher cost.Conclusion: The average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Complications of the disease and the patient’s condition, severe preeclampsia, long hospitalization, ICU care, led to high costs in patients underwent Caesarean section.Keyword: seksio sesarea, cost, JKN, INA-CBG’ABSTRAKLatar belakang: Kemudahan akses dan ketepatan waktu dalam menjangkau pelayanan kegawadaruratan obstetri sangat diperlukan demi menyelamatkan ibu dan neonatal. Persalinan dengan seksio sesarea pada kedaruratan obstetrik bertujuan untuk menyelamatkan ibu dan neonatal. Biaya yang dihabiskan dari pelayanan kedaruratan obstetri operasi sesar, secara signifikan lebih tinggi dibandingkan dengan persalinan tanpa penyulit. Terselenggaranya program Jaminan Kesehehatan Nasional (JKN) mempunyai tujuan untuk mengatasi hal tersebut. Rumah sakit pemerintah menghadapi dilema antara misi melayani masyarakat kelas menengah ke bawah dengan adanya keterbatasan sumber dana, serta berbagai aturan dan birokrasi yang harus dihadapi. Sistem casemix pada INA-CBG’s merupakan pengelompokan karakteristik pasien yang sejenis. Rumah Sakit akan mendapatkan pembayaran berdasarkan rata-rata biaya yang dihabiskan oleh suatu kelompok diagnosis.Tujuan: Mengetahui besarnya biaya pasien Jaminan Kesehatan Nasional (JKN) yang menjalani operasi seksio sesarea di RSUP Dr. Sardjito Metode: Rancangan penelitian yang akan digunakan adalah deskriptif. Pasien JKN yang menjalani seksio sesarea pada Januari-Juli 2014 di RSUP Dr. Sardjito diikutsertakan dalam penelitian ini. Pasien yang pindah perawatan ke kelas VIP, VVIP, dan suite di eksklusi. Data biaya pasien akan dirata-rata dan dirinci besarnya berdasarkan karakteristik Hasil & Pembahasan: Sebanyak 136 pasien JKN menjalani seksio sesarea selama Januari-Juli 2014. Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. Pasien preeklamsia berat mempunyai ratas-rata biaya yang lebih tinggi 3.050.776 rupiah dibandingkan pasien tanpa preeklamsia berat. Pasien dengan 4 penyakit dan komplikasi mempunyai selisih biaya 16.995.952 rupiah lebih tinggi dibandingkan pasien tanpa penyakit. Pasien dengan perawatan ICU mempunyai rata-rata biaya yang lebih tinggi dibanding yang tidak dirawat di ICU yaitu sebesar 3.340.288 rupiah. Selisih rata-rata biaya yang lebih tinggi juga terjadi pada lama rawat inap. Kelas perawatan, lama perawatan di kamar bersalin, tindakan induksi atau stimulasi di kamar bersalin, riwayat seksio sesarea saat ini tidak menyebabkan semakin tingginya biaya seksio sesarea.Kesimpulan: Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. kondisi penyakit dan komplikasi pasien, preeklamsia berat, lama rawat inap, dan perawatan ICU menyebabkan tingginya biaya pada pasien yang menjalani seksio sesarea. Kata kunci: seksio sesarea, biaya, JKN, INA-CBG’s1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta

PERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADA PREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSI Budi Arianto; Diah Rumekti Hadiati; Detty Siti Nurdiati
JURNAL KESEHATAN REPRODUKSI Vol 2, No 2 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.12639

PERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADAPREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSIBudi Arianto1, Diah Rumekti H2, Detty S Nurdiati3ABSTRACTBackground: The state of hypoxia in severe preeclampsia cause placental oxidative stress that can leadexcessive trophoblast apoptosis through the mitochondrial pathway. Apoptosis stimuli occurs throughmodulation of p53 and Bcl-2 family expression which has antiapoptosis and proapoptosis function.Antiapoptosis protein consist of Bcl-2 and Bcl-XL and is expressed lower in apoptosis.Objective: To compare the mean difference of the expression of antiapoptosis proteins Bcl-2 & Bcl-XL andidentify the type of protein that can be used as indicators of increased apoptosis.Method: A cross-sectional study which consisted of 43 severe preeclampsia pregnancies and 38 thirdtrimester normotensive pregnancies, recruited between October 2011 - March 2012. Observation ofprotein expression Bcl-2 and Bcl-XL used immunohistochemical techniques. Statistical analysis appliedindependent t test (P<0.05).Result and Discussion: There were significant differences (p<0.05)between the mean expression of Bcl-2protein in trophoblast tissue among severe preeclampsia group (1.03 ± 0.04) compared to normotensivegroup (1.10 ± 0.08). The mean expression of Bcl-XL protein in trophoblast tissue severe preeclampsiagroup (1.29 ± 0.12) compared to normotensive group (1.71 ± 0.14) were significantly difference (p<0.05).The mean difference in protein expression of Bcl-2 (0076; 95% CI 0.046 to 0.104) was lower than Bcl-XLprotein (0.42; 95% CI 0.47 to 0.36). The mean protein expression of Bcl-2 and Bcl-XL were lower in severepreeclampsia group compared with normotensive group, either in preterm or full-term gestation age withp value <0.05.Conclusion: The mean difference in protein expression of Bcl-2 and Bcl-XL is lower in severe preeclampsiapregnancies than normotensive pregnancies. The mean difference in protein expression of Bcl-2 is lowerthan Bcl-XL. Severe preeclampsia affects protein expression of Bcl-2 and Bcl-XL more than influence ofgestational age.Keywords: severe preeclampsia, trophoblast, Bcl-2 , Bcl-XL, apoptosis.ABSTRAKLatar belakang: Keadaan hipoksia pada preeklamsia berat akan menyebabkan stress oksidatif plasentayang dapat memicu terjadi peningkatan apoptosis trofoblas melalui jalur mitokondria. Stimulus apoptosisterjadi melalui modulasi ekspresi P53 dan ekspresi protein Bcl-2 family yang memiliki fungsi antiapoptosisdan proapoptosis. Protein antiapoptosis terdiri atas Bcl-2 dan Bcl-XL akan diekspresikan lebih rendah padakeadaan apoptosis.Tujuan: Untuk melihat perbedaan rerata ekspresi protein antiapoptosis Bcl-2 dan Bcl-XL dan mengidentifikasijenis protein yang dapat dijadikan indikator peningkatan apoptosis.Metode: Rancangan penelitian ini potong lintang dengan populasi penderita kehamilan preeklamsia beratdan normotensi yang dirawat di RSUP Sardjito antara bulan Oktober 2011 hingga Maret 2012. Didapatkansampel plasenta sebanyak 43 kehamilan preeklamsia berat dan 38 kehamilan normotensi. Pengamatanekspresi protein Bcl-2 dan Bcl-XL dengan teknik imunohistokimia. Analisis statistik menggunakanindependent t test (p<0.05).Hasil dan Pembahasan: Terdapat perbedaan yang bermakna (p<0,05) rerata ekspresi protein Bcl-2 padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,03 ± 0,04) dibandingkan kelompok kehamilannormotensi (1,10 ± 0,08). Terdapat perbedaan yang bermakna (p<0.05) rerata ekspresi protein Bcl-xL padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,29 ± 0,12) dibandingkan kelompok kehamilannormotensi (1,71 ± 0,14). Beda rerata ekspresi protein untuk Bcl-2 (0,076; CI 95% 0,046 – 0,104) lebihrendah dibandingkan beda rerata ekspresi protein Bcl-xL (0,42; CI 95% 0,47- 0,36). Rerata ekspresi proteinBcl-2 dan Bcl-XL lebih rendah pada kelompok preeklamsia berat dibandingkan dengan normotensi baikpada umur kehamilan preterm maupun aterm yang ditunjukkan dengan nilai p<0,05.Kesimpulan: Beda rerata ekspresi protein Bcl-2 dan Bcl-xL lebih rendah pada kehamilan preeklamsia beratdibandingkan kehamilan normotensi. Beda rerata ekspresi protein Bcl-2 lebih rendah dibandingkan bedarerata ekspresi protein Bcl-xl. Preeklamsia berat lebih berpengaruh terhadap ekspresi protein Bcl-2 danBcl-XL dibandingkan umur kehamilanKata Kunci: preeklamsia berat, trofoblas, protein Bcl-2, protein Bcl-xl, apoptosis1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr. Sardjito, Yogyakarta

Co-Authors - Pujiatun Adi Rahmawan Adi Rahmawan, Adi Agung Dewanto Ahsanudin Attamimi Alifia Salsabila Amdad Amdad Amelia, Dwirani Anggoro Budi Hartopo Anindya K Zahra Anis Widyasari Anjarwati Anjarwati Anjarwati Anjarwati, Anjarwati Ari Purwoko Widji Utomo Armalya Pritazahra Asri C. Adisasmita Atik Tri Ratnawati Atik Triratnawati Budi Arianto Budi Arianto, Budi Darwin Nasution Depari, Irmanda Terbelluh Sembiring Dessy Hertati Dewanto, Agung Dewi Rokhanawati Dewi Rokhanawati, Dewi Dhesi Ari Astuti, Dhesi Ari Dhesy Ari Astuti Dhesy Ari Astuti, Dhesy Ari Diah Rumekti Hadiati Djaswadi Dasuki Dyah Wulan Anggrahini Eka Rati Astuti Ely Yulianus Musa Limbu Emy Huriyati Erna Ashlihah Rochmat Eugenius Phyowai Ganap Fajarini, Yuniar Ika Fauzan Achmad Maliki Febriana Sari Febriana Sari, Febriana Fika Humaeda Assilmi Fitri Haryanti Fitriana K, Herlin Fitriana K., Herlin Ganap, Eugenius Phyowai Hamam Hadi Herlin Fitriana K Husnah Husnah Indria Laksmi Gamayanti Indria Laksmi Gamayanti Intan Agustina Anggraeni Irmitasari Irmitasari Irmitasari, Irmitasari Irwan Taufiqur Rachman Iswanti, Tutik Iswanti1, Tutik Johariyah - Johariyah Juli Sitorus Kamsiah . Kartika Wahyuningtyas Utami Kemal N. Siregar Khairina Hashifah Khrisnamurti, Sinta Kristiana Tri Warsini Kusuma, Raden Aditya Lidia Aditama Putri Linda Shintiana Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati Lucia Kris Dinarti Mae Sri Hartati Wahyuningsih Muhammad Gahan Satwiko Muhammad Nurhadi Rahman Muhammad Reyhan Hadwiono Musa Limbu, Ely Yulianus Nasution, Darwin Nirmala Santiasari, Retty Noer Saudah Noer Saudah, Noer Nu Pravitasari Nur Falah Setyawati Nur Khamidah Nuring Pangastuti Ori Pertami Enardi Ova Emilia Pramudji Hastuti, Pramudji Prihesti, Uce Siswi Priyatin Sulistyowati Rachmawati Widyaningrum Ratna Widhiastuti Retty Nirmala Santiasari Retty Nirmala Santiasari Ririn Ariyanti Ririn Ariyanti, Ririn Santiasari, Retty Nirmala Santiasari, Retty Nirmala Saputro, Christina Sarah Ayu Andari Setiarsih, Dini Setiyarini, Wahyu Ikka Shintiana, Linda Sinta Khrisnamurti Sitorus, Juli Sitorus, Melina Ebtarina Sitorus, Melina Ebtarina Sri Juana Sri Restu Sulchan Sofoewan Sulchan Sofoewan, Sulchan Sulistyaningsih, Sulistyaningsih - Sumarni Sumarni Sumarni Sumarni Tutik Iswanti Uce Siswi Prihesti Untung S. Widodo Utomo, Muhammad Wahyu Vera Dewanto Wahyu Ikka Setiyarini Wahyu Ikka setyarini Wahyu Widayati Wahyu Widayati, Wahyu Widyaningrum, Rachmawati Widyawati Widyawati Widyawati Widyawati Wiwin Lismidiati Yanuarti Petrika Yayi Suryo Prabandari Yuniar Ika Fajarini

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