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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi The Indonesian Biomedical Journal Jurnal Kesehatan Reproduksi Mandala of Health : A Scientific Journal Medical and Health Journal
Diah Rumekti Hadiati
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Jl. Farmako, Sekip Utara, Yogyakarta 55281
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Faktor-Faktor yang Meningkatkan Prognosis Fetal dan Maternal pada Kehamilan dengan Kanker Ovarium Efriyan Imantika; Shinta Prawitasari; Diah Rumekti Hadiati
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (314.597 KB) | DOI: 10.22146/jkr.51766

Abstract

Background: Pregnancy complicated by ovarian cancer presents relation between controlled growth in pregnancy and uncontrolled growth in cancer. The management of pregnancy illustrate conflict between optimal maternal therapy and fetal life for best prognosis at all. The incidence was low but it occured in reproductive age women and most found in the first pregnancy. It is important to analyze factors that improve the prognosis of pregnancy and appropiate management to prevent fetal and maternal morbidity and mortality. Objectives: To analyze factor on pregnancy complicated by ovarian cancer that improve fetal and maternal prognosisMethods: This is descriptive analytic study with cohort retrospective design using medical records of pregnancy patient complicated by ovarian cancer that underwent treatment at Sardjito Hospital Yogyakarta on 2010, January till 2017, December. All statistical analysis were done by statistic software for computer.Results: There were 18 research subjek had been undergone treatment at Sardjito Hospital for 8 years. Factors on pregnancy related to prognosis of pregnancy complicated by ovarian cancer were late gestational age at the cancer diagnosis and epithelial histopathology type. That factors have better prognosis than early gestational age and non-epithelial histopathology clinically (p=0.18; CI 95% 0.4-104.2; OR 6,5) and (p=0.29; CI 95% 0.36-30.12; OR 3.28). Timing of surgery intervention improve prognosis of pregnancy statistically and clinically significant (p=0.02; OR=4.2). Conclusion: Factors on pregnancy complicated by ovarian cancer that is late gestational age at the cancer diagnosis, epithelial histopathology type and timing of surgery intervention type II-III improved fetal and maternal prognosis. Best management of pregnancy lead to better prognosis.Keywords: prognosis of pregnancy, ovarian cancer. 
Hubungan Kadar β-hCG 12 Hari Pasca Transfer Embryo dengan Luaran Kehamilan Agung Kurniawan; Shofwal Widad; Diah Rumekti Hadiati
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 | Full PDF (406.796 KB) | DOI: 10.22146/jkr.53479

Abstract

Latar Belakang: Subfertilitas merupakan salah satu permasalahan yang sering ditemukan di era modern ini. Berbagai metode ditemukan dan digunakan untuk meningkatkan angka keberhasilan reproduksi pada perempuan. Teknologi reproduksi berbantu memiliki risiko terjadinya keguguran dan kehamilan ektopik. Kadar serum β-hCG 12 hari pasca transfer embryo memiliki peranan penting dalam prediksi luaran kehamilan.Tujuan: Untuk memprediksi luaran kehamilan, sensitivitas, spesifisitas serta nilai ambang kadar β-hCG 12 hari pasca transfer embryo.Metode: Penelitian menggunakan  rancangan penelitian observasional kohort retrospektif di Klinik Permata Hati RSUP. Dr. Sardjito Yogyakarta tahun 2012 – 2015. Subyek penelitian 130 subyek yang terbagi menjadi 65 subyek dengan kadar β-hCG  <76 IU/l dan 65 subyek ≥76 IU/l. Luaran kehamilan diklasifikasikan sebagai viabel (janin hidup pada usia kehamilan ≥ 22 minggu) dan non viabel ( kehamilan biokimia, ektopik, mola dan keguguran).Hasil dan Pembahasan: Median dan minimum kadar β-hCG pada kehamilan viabel 167 IU/l dan 44 IU/l,  dan 53 IU/l dan 16 IU/l pada kehamilan non viabel. Terdapat hubungan yang bermakna antara kadar serum β-hCG 12 hari pasca transfer embryo dengan luaran kehamilan. Kadar  β-hCG  ≥76 IU/l sebanyak 50 (76,9%) pada kehamilan viabel  dan sebanyak 15 (23,1%) subyek pada kehamilan non viabel.  Kadar β-hCG <76 IU/l sebanyak 7 (10,8%) pada kehamilan viabel dan 58 (89,2%) pada kehamilan non viabel (p=0,000). Kadar β-hCG terendah pada kehamilan ganda 300 IU/l.Kesimpulan: Kadar β-hCG 12 hari pasca transfer embryo bermakna secara statistik dalam membantu memprediksi luaran kehamilan viabel dengan cut-off point 71,5 IU/l, sensitivitas 89,1 % dan spesifitas 79,5 %. Nilai positive predictive value (PPV) adalah 76,9 %, dan nilai negative predictive value (NPV) adalah  89,2%.Kata kunci: Teknologi reproduksi berbantu, subfertilitas, kadar β-hCG, transfer embryo, luaran kehamilan. 
EXPRESSION TROPHOBLAST CELL B-CELL LYMPHOMA (BCL2) IN EARLY AND LATE-ONSET PREECLAMPSIA Herman Sumawan; Irwan Taufiqqurachman; Diah Rumekti Hadiati; Dewajani Purnomosari
Mandala Of Health Vol 13 No 2 (2021): Mandala Of Health
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mandala.2021.13.2.8420

Abstract

Background: Anti-apoptotic Bcl-2 has an important role that is involved in the regulation of apoptosis. Abnormal apoptotic activity in preeclampsia is caused by the dysregulation of these proteins. Trophoblast antiapoptotic and proapoptotic imbalance is thought to have different influences on the process of early-onset preeclampsia and late-onset preeclampsia Objective: to analyze the difference in Bcl-2 expression in early and late-onset preeclampsia. Method of study: This method was conducted using a cross-sectional study in early-onset preeclampsia compared to late-onset preeclampsia in RSUP. DR. Sardjito Yogyakarta was conducted from April 2019 to June 2019 with consecutive sampling methods. Placental tissue samples were obtained from 26 pregnancies with early-onset preeclampsia and 33 pregnancies with late-onset preeclampsia. The placental expression of Bcl-2 has been investigated by immunohistochemical staining and used semi-quantitative HSCORE examination. Results: The T-test study showed there was a significant difference in Bcl-2 expression among early onset preeclampsia (2.31±0.66 ) and late-onset preeclampsia (2.61±0.43) with p-value 0.047 (p<0.05). Bcl-2 the expression appears lower in early-onset preeclampsia with a mean value of 0.30 (CI 0.04 – 0.60). Conclusion: Thus we can conclude the expression of Bcl-2 is considered lower in early-onset preeclampsia compared to late-onset preeclampsia
Bax mRNA Expression as A Potential Biomarker of Placental Apoptosis in Early-onset Preeclampsia Muhammad Javedh Iqbal; Diah Rumekti Hadiati; Didik Setyo Heriyanto
The Indonesian Biomedical Journal Vol 15, No 3 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i3.2336

Abstract

BACKGROUND: Early-onset preeclampsia is characterized by higher oxidative stress and apoptosis level than late-onset one. Studies comparing the expression of the Bcl-2 family protein in early and late-onset preeclampsia are still lacking and show inconclusive evidence. This study aimed to compare the expression of Bax and Bcl-2 messenger RNA (mRNA) as a biomarker of placental apoptosis between early-onset and late-onset preeclampsia.METHODS: A cross-sectional study was conducted using formalin-fixed, paraffin-embedded preeclamptic placental samples and dividing them into early-onset and late-onset preeclampsia groups. Bax and Bcl-2 mRNA expressions were assessed using the quantitative real-time polymerase chain reaction method. Apoptosis was assessed through DNA fragmentation examination by the ligation-mediated real-time polymerase chain reaction method.RESULTS: Thirty early-onset and 30 late-onset preeclamptic placental samples were included. The mean fold change Bax mRNA in early-onset was higher than in late-onset preeclampsia (6.02±3.59 vs. 2.82±1.97; p=0.00). The mean fold change Bcl-2 mRNA early-onset was not different from late-onset preeclampsia (31.20±17.94 vs. 31.01±27.60; p=0.98). The mean DNA fragmentation cycle threshold in early-onset preeclampsia was lower than in late-onset preeclampsia (28.07±0.64 vs. 30.63±0.96; p=0.00). A weak negative correlation exists between fold change Bax mRNA and DNA fragmentation cycle threshold (r=-0.30; p=0.02).CONCLUSION: Bax mRNA showed significant correlation in DNA fragmentation compared to Bcl-2 mRNA; hence, might show more role in apoptotic pathway. Early-onset preeclampsia has higher Bax mRNA relative expression and apoptosis than late-onset preeclampsia. Therefore, Bax mRNA can be potential biomarker in early-onset preeclampsia.KEYWORDS: mRNA, Bax, Bcl-2, apoptosis, DNA fragmentation, early-onset, preeclampsia
Changes in CA 125 Level Pre and Post Ovarian Cancer Surgery Aprivinta, Sherlyana Mega; Pradjatmo, Heru; Hadiati, Diah Rumekti
JURNAL KESEHATAN REPRODUKSI Vol 10, No 3 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.79928

Abstract

Background: Ovarian cancer is one of the gynecological cancers that has a fairly high mortality rate and has a poor prognosis. Ovarian cancer management includes optimal operation followed by chemotherapy, which at follow up will have an effect on decreasing CA 125 levels. But in fact there are several studies showing increased CA 125. Given these differences in findings, this study attempted to evaluate the pre and post operation changes in CA 125 levels in ovarian cancer patients.Objective: This study aims to determine the changes in pre and post operation CA 125 levels in ovarian cancer patients. And to find out the optimal relationship between CA 125 level post operation and post operation.Methods: The type of research is an analytic study with a prospective cohort design. The source comes from secondary data taken from Simetris dr. Sardjito Hospital within 6 months.Results: The distribution of the age < 40 years was 11 and 19 were 40 years old. There was a significant change in pre operation log CA 125 levels (mean = 2,53 or 902,03U/ml) and post operation log CA 125 levels (mean = 1,92 or 406,23 U/ml). With a difference or delta mean of 0,61 or 495,80 U/ml and p value = 0.001. There was a significant difference in post operation log CA 125 levels between optimal and non optimal operation. Based on risk factors, there was a significant change or decrease in log CA 125 levels pre and post operation, but there was no significant difference in log CA 125 levels pre and post operation.Conclusion: There was a significant decrease in log CA 125 levels pre and post operation in patients with ovarian cancer who underwent operation. The post operation log CA 125 level in optimal operation is lower than in non-optimal operation.Keywords: CA 125, Ovarian Cancer, Operation, Optimal
Microrna Profile of Plasma Exosomes by Nanostrings in Early Onset Compared Late Onset Preeclampsia: Preliminary Study Sumawan, Herman; Pradjatmo, Heru; Hadiati, Diah Rumekti; Mubarika, Sofia; Giantari, Ifrinda
Medical and Health Journal Vol 5 No 1 (2025): August
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mhj.2025.5.1.17598

Abstract

Research on miRNA biomarkers in preeclampsia as part of screening, diagnosis, and prognosis has been widely conducted, but the results show contradictory results and vary based on the type of preeclampsia. This study aims to compare the profile of plasma exosome miRNA in early onset compared late onset as a preliminary study to identify the miRNA profile of preeclampsia patients in Indonesia. The study was conducted at Margono Hospital,Indonesia using plasma exosomes samples of three patients with early-onset preeclampsia and three patients with late-onset preeclampsia and processed with NanoStrings. KEGG was used to identify preeclampsia pathophysiological pathways by bioinformatic analysis of DIANA-miRPath v3.0 and microT-CDS v5.0. The results showed that the characteristics of parity, hemoglobin, systolic and diastolic blood pressure, proteinuria and BMI did not differ between EOPE and LOPE. Significantly different variables were the age of the EOPE (28 ± 5.29) vs LOPE (38.67 ± 2.06 mmHg), pregnancy weight gain (10.0 vs 15.33), and fetal weight in EOPE (1550 ± 132 g) vs LOPE (2693 ± 716 g). The results showed that the 24 miRNAs differed significantly. The three highest expression miRNAs in the EOPE group were miR-196b-5p, miR-190a-5p, and miR-515-3p. In contrast, the three lowest expression miRNAs are miR-3179, miR-181a-5p, and miR-15b-5p. Pathway analysis of the upregulated miRNA involved the ErbB signalling pathway, Proteoglycan in cancer, and Lysin degradation. Downregulated miRNA targets involved in the HIPPO signalling pathway, fatty acid biosynthesis, and TGF-β signalling pathway. Conclusions: The preliminary study results indicated significant differences in miRNA expression, suggesting that EOPE is influenced by aggressive cellular signaling and metabolic dysregulation, while LOPE is more linked to the disruption of growth-inhibiting pathways and fatty acid metabolism. These unique miRNAs establish a robust foundation for subsequent validation studies utilizing bigger samples as a prospective biomarker panel.
Exosomal miRNAs as Potential Biomarkers for Preeclampsia: miR-1283 Has the Highest Expression, while miR-152-3p Has the Lowest Expression Sumawan, Herman; Giantari, Ifrinda; Mubarika, Sofia; Hadiati, Diah Rumekti; Pradjatmo, Heru
The Indonesian Biomedical Journal Vol 16, No 4 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i4.3197

Abstract

BACKGROUND: Preeclampsia management is necessary, as it is one of the leading causes of death during pregnancy. Exosomal microRNAs (miRNAs) can serve as biomarkers for early detection, diagnosis, and prognosis of preeclampsia. NanoStrings is an effective method for identifying exosomal miRNA due to their high sensitivity and ability to work with small amounts of miRNA; however, the analysis using this method for determining preeclampsia biomarker is still limited. Therefore, this study was conducted to utilize the NanoStrings method in identifying preeclampsia biomarkers related to its underlying pathophysiology.METHODS: This study involved 12 pregnant women at 20–40 weeks of gestation, including 6 preeclampsia women and 6 normotension women. The miRNAs from plasma exosomes were processed using NanoStrings method with NanoString nCounter SPRINT Profiler. Enrichment analysis of The Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways were performed to examine the pathophysiological pathways of preeclampsia, using the DIANA–miRPath v3.0.RESULTS: Forty-eight miRNAs were downregulated and 7 were upregulated (miR-1283, miR-613, miR-520a-3p, miR-3185, miR-556-3p, miR-1973, and miR-598-3p) in women with preeclampsia. The highest expression was observed in miR-1283 (log fold-change: 3.69) and the most lowest expression was in miR-152-3p (log fold-change: 1.41). Enrichment analysis showed that the most upregulated miRNAs pathways was estrogen signaling pathway, and the most downregulated was Hippo signaling pathways.CONCLUSION: miR-1283 has the highest expression, while and miR-152-3p has the lowest expression in preeclampsia women. These miRNAs are shown to be linked to specific pathways, shedding light on the pathophysiology of preeclampsia, and may serve as promising biomarkers.KEYWORDS: exosomes, biomarker, miRNAs, pathophysiology, preeclampsia, pregnancy
Hubungan Nilai Rasio Neutrofil Limfosit Dengan Kejadian Ketuban Pecah Dini Preterm Istantina, Aldila Geri; Attamimi, Ahsanudin; Hadiati, Diah Rumekti
JURNAL KESEHATAN REPRODUKSI Vol 12, No 3 (2025)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.95144

Abstract

Latar Belakang: Di Indonesia, insidensi ketuban pecah dini, juga dikenal sebagai PPROM (preterm premature membranes rupture), mencapai 4,5% dari seluruh komplikasi kehamilan. Kondisi ini meningkatkan risiko infeksi intraamniotik sebesar lima belas hingga tiga puluh lima persen dan infeksi pascapersalinan sebesar lima belas hingga dua puluh lima persen. Sekitar 60% kasus ketuban pecah dini preterm disebabkan oleh infeksi bakteri ascending, yang meningkatkan mortalitas dan morbiditas ibu dan bayi. Dalam kasus ketuban pecah dini preterm, respons inflamasi pada chorion dan amnion menyebabkan pelepasan sitokin yang lebih besar, yang ditandai dengan peningkatan jumlah neutrofil. Rasio neutrofil-limfosit merupakan ukuran penting dari status inflamasi.Tujuan: Tujuan penelitian ini adalah untuk melihat bagaimana rasio neutrofil-limfosit dan insidensi ketuban pecah dini preterm berhubungan satu sama lain.Metode: Studi cross-sectional ini melibatkan ibu hamil 37 minggu atau lebih yang memenuhi kriteria inklusi dan eksklusi di RSUP Dr. Sardjito Yogyakarta antara 1 Januari 2018 dan 31 Desember 2021.Hasil dan Pembahasan: Menurut hasil penelitian terhadap delapan puluh pasien, nilai AUC (area di bawah kurva) sebesar 0,902 menunjukkan bahwa kemampuan untuk memprediksi rasio neutrofil-limfosit (RNL) terhadap kejadian ketuban pecah dini (KPD) preterm mencapai 90,2%. Nilai titik cut-off RNL lebih dari 3,55 menunjukkan nilai sensitivitas, spesifisitas, NPP, NPN, akurasi, dan indeks Youden optimal. Nilai RNL = 3,55 ditetapkan Dengan nilai p = 0,001 dan risiko relatif (RP, 95% CI) = 12,667 (3,285–48,847), hasil penelitian menunjukkan hubungan yang signifikan secara statistik maupun klinis antara RNL dan kejadian KPD preterm.Kesimpulan: Hasil penelitian menunjukkan bahwa pada usia kehamilan yang setara, pasien dengan KPD preterm memiliki nilai RNL 12,6 kali lebih tinggi daripada pasien tanpa KPD.
Co-Authors Agung Kurniawan Agung Kurniawan Ahsanudin Attamimi Andriana Kumala Dewi Andriana Kumala Dewi Aprivinta, Sherlyana Mega Ariantini, Dyah Arsi Palupi Budi Arianto Budi Arianto, Budi Detty Siti Nurdiati Dewajani Purnomosari Didik Setyo Heriyanto Djaswadi Dasuki Djaswadi Dasuki Dyah Ariantini Efriyan Imantika Eny Fatmawati Fatmawati, Eny Fifi Noviana Herman Sumawan Heru Pradjatmo Ide Pustaka Setiawan Ifrinda Giantari Irmitasari Irmitasari Irmitasari, Irmitasari Irwan Taufiqqurachman Istantina, Aldila Geri Moh Nailul Fahmi Mohammad Hakimi Mohammad Lutfi Mohammad Lutfi Muhammad Javedh Iqbal Noviana, Fifi Risanto Siswosudarmo Risanto Siswosudarmo Shinta Prawitasari Shofwal Widad Sofia Mubarika Haryana Sumawan, Herman