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Preeklamsia: Pencegahan hingga Pengelolaan Berbasis Bukti Surya, Raymond; Irwinda, Rima; Sungkar, Ali
Cermin Dunia Kedokteran Vol 46, No 1 (2019): Obstetri - Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Mekanisme pasti preeklamsia masih tidak diketahui, sering dikaitkan dengan faktor imunologi, genetik, kerentanan terhadap sindrom metabolik, inflamasi/infeksi kronik, hipertensi sebelumnya, penyakit ginjal kronik. Uji prediksi preeklamsia dapat dilakukan dengan melihat faktor risiko demografi, penemuan biofisik, ataupun kombinasi keduanya. Pencegahan preeklamsia di antaranya aspirin dosis rendah pada populasi risiko tinggi dan suplementasi kalsium pada populasi rendah asupan kalsium. Penatalaksanaan preeklamsia yang baik terdiri dari antihipertensi, magnesium sulfat, kortikosteroid, penentuan saat terminasi kehamilan, hingga metode persalinan.The exact mechanism of preeclampsia is unknown; it is associated with immunological, genetic factor, susceptibility to metabolic syndrome, chronic inflammation/infection, history of previous hypertension, and chronic renal disease. Preeclampsia prediction test can be conducted through demographic risk factors, biophysical findings, or both. The prevention measures include low dose aspirin in high risk population and calcium supplementation in low calcium intake population. Good management of preeclampsia consists of antihypertensive, magnesium sulphate, corticosteroid, pregnancy termination, and delivery methods.

Plasma Folate, Vitamin B6 and B12 in Their Relationship to the Presence of Probiotic Strain Bifidobacterium animalis subsp. Lactis HNO19 (DR10TM) Among Indonesian Pregnant Women in Their Third Semester Saptawati Bardosono; Noroyono Wibowo; Luciana Budiati Sutanto; Rima Irwinda; Rebecca Cannan; Angela Rowan; James Dekker
World Nutrition Journal Vol. 2 No. 2 (2019)
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V02.i2.0009

Introduction Vitamin B12 plays a role during pregnancy in maintaining folate metabolism. Together with folate and vitamin B6, B12 is involved as a coenzyme in DNA synthesis and various methylation reactions in developing embryos. This study aims to compare plasma folate, vitamin B6 and B12 blood levels with respect to the presence of probiotic strain Bifidobacterium animalis subsp. lactis HNO19 (DR10TM) among pregnant women in Indonesia. Methods: This study is part of a larger study entitled “Effects of Bifidobacterium animalis subsp. lactis HNO19 (DR10TM), inulin, and micronutrient fortified milk on fecal DR10TM, immune markers, and maternal micronutrients among Indonesian pregnant women.” Further analyses were performed using independent-t test or Mann Whitney test, GLM-repeated measures and chi-square test, to compare folate, vitamin B6 and B12 intake and blood concentration during pregnancy with presence (n=22) and absence (n=55) subjects of fecal DR10TM at third trimester. Results: At the first trimesters there was no difference in plasma vitamin B6 and vitamin B12 levels between the two groups, based on the presence or absence of fecal DR10TM. However, at the second and third trimester, vitamin B6 blood concentration (p=0.034 and p=0.001) and vitamin B12 blood concentrations at the third trimester (p=0.035) were significantly higher in the fecal DR10TM positive group, while having a similar vitamin B6 and B12 intake. Conclusion: Consumption of pre- and probiotics during the periconceptional period may be a useful strategy for improving maternal vitamin B’s vitamins, especially vitamin B6 and B12 status and therefore provide benefits for the offspring’s quality of life.

The Role of Obstetrician in Reducing the Risks of Childhood Allergy Related to Cesarean Birth: A Literature Review Rima Irwinda; Febriansyah Darus; Peby Maulina
World Nutrition Journal Vol. 4 No. S2 (2020)
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V04.S2.0007

Women’s decision on birth mode should consider its risks and benefits, including long-term risks of caesarean among children. This study aims to present the current available evidences on the risks of caesarean towards childhood allergy and how an obstetrician could prevent this outcome through nutrition and education. We searched articles from several online databases about the link between caesarean, childhood allergy, and prenatal intervention. There were significant risks of childhood asthma and food allergy, but it was still unclear for allergic rhinitis and atopic dermatitis. Nutritional intervention could be done for pregnant women with consumption of probiotics and vitamin D supplementation. In addition, prenatal education is necessary to prepare better childhood outcomes.

The awareness of urinary tract infection management in pregnant women. A qualitative study Budi Iman Santoso; Raymond Surya; Farah Asyuri Yasmin; Rima Irwinda
Majalah Obstetri dan Ginekologi Vol. 25 No. 3 (2017): December
Publisher : Universitas Airlangga

Objectives: to identify knowledge, attitude, and practice of health providers including GPs and gynecologists to the implementation of the national guideline on the treatment of UTI among pregnant women.Materials and Methods: A cross-sectional study design was used. Subjects were women who attended the International Sym-posium of UTI. Questionnaires consisting ofregarding demo-graphic characteristics, knowledge, attitude, and practice were given to the subjects. The questionnaires had been tested for valid-ity and reliability by applying the Pearson correlation and Cronbach’s alpha test. Statistical analyses were performed using SPSS 23.0 for Windows.A two-tailed p value less than 0.05 was considered to be statistically significant.Results: A total of 140 subjects were recruited in this study. Of these, 104 subjects (74.3%) returned the questionnaire, and 99 subjects (70.7%) were eligible for this study. Nine (9.1%), 69 (69.7%), and 21(21.2%) subjects had good, fair, and poor know-ledge, respectively. Sixty-five (65.7%) and 64 subjects (64.6%) showed a positive attitude and had positive practice, respectively.Conclusion: Knowledge, attitude, and practice among respon-dents are good enough, despite only a few of them have read the updated guideline. Continuous medical education through online update or symposium may be one effective method to disseminate new update in guidelines.

A Significant Increase in Maternal Blood Uric Acid Levels Accompanies the Severity of Hypertensive Disorders in Pregnancy: Peningkatan Signifikan Kadar Asam Urat Darah Ibu menyertai Keparahan Gangguan Hipertensi pada Kehamilan Yuyun Lisnawati; Jimmy Sakti; Rima Irwinda; Kindy Agustin; Nadia Nurfauziah
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1491

Objective: To asses the relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes.Methods: A cross sectional study was conducted at Persahabatan Hospital from January 2014 to December 2018. Subject were pregnant women with hypertensive disorder. Serum uric acid levels were taken from a venous blood sample at the time the patient came for delivery. The severity of hypertensive disorders in pregnancy were grouped into chronic hypertension, gestational hypertension, preeclampsia without severe feature, preeclampsia with severe feature, and preeclampsia with severe feature and organ involvement. The perinatal outcomes were the gestational age at birth, birth weight, and the first minute APGAR score. The relationship between maternal serum uric acid level and severity of hypertensive disorders in pregnancy and perinatal outcomes were analyzed using Mann Whitney and Kruskall Wallis test.Result: A total of 704 out of 880 pregnant women with hypertensive disorder have met the criteria as research subjects. Maternal uric acid levels were found to increase significantly (p <0.001) with increasing severity of hypertensive disorders in pregnancy. Maternal who experienced preterm delivery had significantly higher blood uric acid levels (p <0.001) than those who experienced a term delivery. Maternal blood uric acid levels of infants with small birth weight for gestational age and first minute Apgar score <7 were slightly higher but not significant compared to maternal blood uric acid levels of normal birth weight infants and first minute Apgar score >7.Conclusions: Maternal blood uric acid levels increased significantly accompanying the severity of hypertensive disorders in pregnancy. Blood uric acid levels tend to be higher in maternal who have poor perinatal outcomes.Keywords: APGAR score, hypertensive disorders in pregnancy, preeclampsia, uric acid. AbstrakTujuan: Untuk menilai hubungan antara kadar asam urat serum ibu dan keparahan gangguan hipertensi pada kehamilan dan luaran perinatal.Metode: Studi potong lintang dilakukan Rumah Sakit Persahabatan periode Januari 2014 sampai Desember 2018. Subjek penelitian adalah ibu hamil dengan gangguan hipertensi. Kadar asam urat darah diambil dari sampel darah vena pada saat ibu hamil datang untuk melahirkan. Tingkat keparahan gangguan hipertensi pada kehamilan dikelompokkan menjadi hipertensi kronik, hipertensi gestasional, preeklamsia tanpa gejala berat, preeklamsia dengan gejaka berat, dan preeklamsia dengan gejala berat dan keterlibatan organ. Luaran perinatal adalah usia kehamilan saat lahir, berat badan bayi lahir, dan skor APGAR menit pertama. Hubungan antara kadar asam urat darah ibu dan tingkat keparahan gangguan hipertensi pada kehamilan dan luaran perinatal dianalisis menggunakan uji Mann Whitney atau uji Kruskall Wallis.Hasil: Sebanyak 704 dari 880 ibu hamil penderita hipertensi telah memenuhi kriteria sebagai subjek penelitian. Kadar asam urat darah ibu meningkat secara signifikan (p <0,001) dengan meningkatnya keparahan gangguan hipertensi pada kehamilan. Ibu yang melahirkan preterm memiliki kadar asam urat darah yang lebih tinggi secara bermakna (p < 0,001) dibandingkan ibu yang melahirkan aterm. Kadar asam urat darah ibu dari bayi dengan berat lahir kecil untuk usia kehamilan dan skor Apgar menit pertama < 7, sedikit lebih tinggi tetapi tidak signifikan, dibandingkan kadar asam urat darah ibu dari bayi berat lahir normal dan skor Apgar menit pertama pertama > 7.Kesimpulan: Kadar asam urat darah ibu meningkat secara signifikan menyertai beratnya gangguan hipertensi pada kehamilan. Kadar asam urat darah cenderung lebih tinggi pada ibu yang memiliki luaran perinatal kurang baik.Kata kunci: APGAR, asam urat, hipertensi dalam kehamilan, preeklamsia.

Preeklamsia: Pencegahan hingga Pengelolaan Berbasis Bukti Raymond Surya; Rima Irwinda; Ali Sungkar
Cermin Dunia Kedokteran Vol 46, No 1 (2019): Obstetri - Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.536

Mekanisme pasti preeklamsia masih tidak diketahui, sering dikaitkan dengan faktor imunologi, genetik, kerentanan terhadap sindrom metabolik, inflamasi/infeksi kronik, hipertensi sebelumnya, penyakit ginjal kronik. Uji prediksi preeklamsia dapat dilakukan dengan melihat faktor risiko demografi, penemuan biofisik, ataupun kombinasi keduanya. Pencegahan preeklamsia di antaranya aspirin dosis rendah pada populasi risiko tinggi dan suplementasi kalsium pada populasi rendah asupan kalsium. Penatalaksanaan preeklamsia yang baik terdiri dari antihipertensi, magnesium sulfat, kortikosteroid, penentuan saat terminasi kehamilan, hingga metode persalinan.The exact mechanism of preeclampsia is unknown; it is associated with immunological, genetic factor, susceptibility to metabolic syndrome, chronic inflammation/infection, history of previous hypertension, and chronic renal disease. Preeclampsia prediction test can be conducted through demographic risk factors, biophysical findings, or both. The prevention measures include low dose aspirin in high risk population and calcium supplementation in low calcium intake population. Good management of preeclampsia consists of antihypertensive, magnesium sulphate, corticosteroid, pregnancy termination, and delivery methods.

Maternal Characteristics, Pregnancy, and Neonatal Outome in Preeclampsia and HELLP Syndrome: a Comparative Study Ali Sungkar; Rima Irwinda; Raymond Surya; Andrew Pratama Kurniawan
eJournal Kedokteran Indonesia Vol 9, No. 1 - April 2021
Publisher : Faculty of Medicine Universitas Indonesia

HELLP syndrome is a complication in pregnancy which may increase maternal morbidity and mortality risk. This study aims to compare maternal characteristics, pregnancy and neonatal outcome between preeclampsia and HELLP syndrome. All preeclampsia without or with severe features and HELLP syndrome using ACOG criteria coming to dr. Cipto Mangunkusumo Hospital from January 2015 to December 2017 were recruited into this cross-sectional study. Demographic, clinical, laboratories parameters, and neonatal outcomes were compared between HELLP and preeclampsia patients. The SPSS 20 for Windows was used for all analyses. There were 676 deliveries which was complicated by preeclampsia without or with severe features and 113 patients with HELLP syndrome. Gestational age, history of hypertension systolic and diastolic blood pressure, hemoglobin, hematocrit, urea, creatinine, uric acid, and albumin are different significantly between HELLP and preeclampsia patients. History of hypertension in previous pregnancy is considered as a significant risk factor for HELLP syndrome (p=0.001); RR 2.33 (95% CI 1.41–3.9). Based on data of gestational age at delivery which lower in HELLP syndrome, it showed lower median birth weight in HELLP syndrome (1442.5 g) compared with preeclampsia (1442.5 g vs 2400 g, p=; 95%CI There is significant difference in gestational age at delivery, nullipara, blood pressure, and laboratory findings (urea, creatinine, uric acid, albumin) between preeclampsia and HELLP syndrome group. History of hypertension in previous pregnancy is a significant risk factor for HELLP syndrome. Regarding neonatal outcome, baby born from HELLP syndrome has lower median birth weight. Keywords: HELLP syndrome, preeclampsia, risk factor, neonatal outcome. Karakteristik Maternal, Luaran Kehamilan, dan Neonatal pada Preeklamsia dan Sindrom HELLP: Studi Komparatif Abstrak Sindrom HELLP merupakan komplikasi kehamilan yang meningkatkan morbiditas dan mortalitas maternal. Studi ini bertujuan untuk mengetahui perbedaan karakteristik antara sindrom HELLP dan preeklamsia serta luaran neonatus. Studi potong lintang ini melibatkan seluruh pasien preeklamsia dengan atau tanpa perburukan dan sindrom HELLP berdasarkan kriteria ACOG yang datang ke RS dr. Cipto Mangunkusumo pada bulan Januari 2015 sampai Desember 2017. Analisis bivariat digunakan untuk mengetahui hubungan karakteristik demografi, klinis, laboratorium antara pasien HELLP dan preeklamsia sedangkan analisis multivariat untuk mengetahui karakteristik yang memengaruhi sindrom HELLP. Data dianalisis menggunakan SPSS 20. Terdapat 676 persalinan pada kelompok preeklamsia dengan atau tanpa perburukan dan 113 pasien dengan sindrom HELLP. Usia kehamilan, tekanan darah sistolik dan diastolik, hemoglobin, hematokrit, ureum, kreatinin, asam urat, dan albumin berbeda bermakna antara pasien sindrom HELLP dan preeklamsia. Riwayat hipertensi pada kehamilan sebelumnya dianggap sebagai faktor risiko terhadap sindrom HELLP (p=0,001); RR 2,33 (IK 95% 1,41-3,9). Berdasarkan usia kehamilan saat persalinan yang lebih awal dan bayi lahir lebih rendah pada sindrom HELLP (1442,5 g) dibandingkan preeklamsia (2400 g). Terdapat perbedaan bermakna pada usia kehamilan saat persalinan, tekanan darah, dan parameter laboratorium (ureum, kreatinin, asam urat, albumin) antara kelompok preeklamsia dan sindrom HELLP. Berdasarkan luaran neonatus, bayi dari sindrom HELLP lebih rendah berat lahirnya. Kata kunci: sindrom HELLP, preeklamsia, faktor risiko, luaran neonatus

Trace elements in maternal serum and their relationships with preterm birth and fetal growth restriction Irwinda, Rima; Sungkar, Ali; Surya, Raymond; Guinto, Valerie Tiempo
Makara Journal of Health Research Vol. 24, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Preterm birth (PTB) and fetal growth restriction (FGR) contribute to high hospital costs. An imbalance in the concentration of the four trace elements (i.e., copper, zinc, iron, and calcium) was shown to be associated with complications during pregnancy. This study aimed to analyze the role of these trace elements in the occurrence of PTB and FGR. Methods: A search was conducted in PubMed, Cochrane Library, and Ovid. The articles were filtered based on the inclusion and exclusion criteria, and further screening was based on the association of articles with the clinical question. The risk of bias in each of the studies was assessed using the Cochrane risk of bias table. Forrest plots were created and analyzed using Review Manager 5.3e. Results: Three studies were included in the risk of bias assessment and meta-analysis. Maternal serum levels of copper and iron were lower in the FGR group (p < 0.05), while copper, zinc, iron, and calcium were lower in the PTB group (p < 0.05). The included studies had a low degree of homogeneity (I2 < 50%). Conclusion: Maternal iron deficiency was associated with FGR, while low levels of the trace elements copper, zinc, iron, and calcium were associated with PTB.

Preeklamsia: Pencegahan hingga Pengelolaan Berbasis Bukti Raymond Surya; Rima Irwinda; Ali Sungkar
Cermin Dunia Kedokteran Vol 46 No 1 (2019): Obstetri-Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.525

Mekanisme pasti preeklamsia masih tidak diketahui, sering dikaitkan dengan faktor imunologi, genetik, kerentanan terhadap sindrom metabolik, inflamasi/infeksi kronik, hipertensi sebelumnya, penyakit ginjal kronik. Uji prediksi preeklamsia dapat dilakukan dengan melihat faktor risiko demografi, penemuan biofisik, ataupun kombinasi keduanya. Pencegahan preeklamsia di antaranya aspirin dosis rendah pada populasi risiko tinggi dan suplementasi kalsium pada populasi rendah asupan kalsium. Penatalaksanaan preeklamsia yang baik terdiri dari antihipertensi, magnesium sulfat, kortikosteroid, penentuan saat terminasi kehamilan, hingga metode persalinan. The exact mechanism of preeclampsia is unknown; it is associated with immunological, genetic factor, susceptibility to metabolic syndrome, chronic inflammation/infection, history of previous hypertension, and chronic renal disease. Preeclampsia prediction test can be conducted through demographic risk factors, biophysical findings, or both. The prevention measures include low dose aspirin in high risk population and calcium supplementation in low calcium intake population. Good management of preeclampsia consists of antihypertensive, magnesium sulphate, corticosteroid, pregnancy termination, and delivery methods.

FAKTOR-FAKTOR YANG MEMPENGARUHI KUALITAS DIET PADA IBU HAMIL: TINJUAN LITERATUR Tazkia Putri Kagami; Rima Irwinda; Okky Lupita Sari
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 7 No. 2 (2023): AGUSTUS 2023
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v7i1.18336

Kehamilan merupakan periode yang sangat penting. Kualitas diet merupakan salah satu alat ukur yang dapat digunakan untuk dapat menghindari hasil kehamilan yang tidak diinginkan. Penelitian ini bertujuan untuk menganalisis artikel dari berbagai jurnal agar dapat memberikan informasi yang terpercaya mengenai faktor-faktor yang mempengaruhi kualitas diet selama masa kehamilan. penelitian ini menggunakan metode literature review. Penelusuran literatur dilakukan melalui Google Scholar dan Pubmed dengan kata kunci ‘kualitas diet ibu hamil. Kriteria inklusi yaitu publikasi nasional dan internasional free full text, publikasi yang bertujuan untuk mengetahui faktor yang mempengaruhi kualitas diet pada ibu hamil, dan publikasi yang diterbitkan dalam 5 tahun terakhir. Berdasarkan hasil telaah dari lima jurnal yang relevan dengan tujuan penelitian, terdapat dua faktor utama yang mempengaruhi kualitas diet pada ibu hamil, yaitu status sosial ekonomi dan pengetahuan terkait gizi. Perlu adanya pertimbangan terkait kesenjangan sosial ekonomi dalam program intervensi kepada ibu hamil, dan diperlukan pemberian edukasi gizi, baik sebelum kehamilan dan selama masa kehamilan.

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