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Lumentut, Anastasia Mariane
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Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Tuberculosis in Pregnancy Lumentut, Anastasia Mariane; Tendean, Hermie; Najoan, Rizki; Islamy, Nurul; Khaerunnisa, Maya; Wirawan, Wahyudi; Maelissa, Merlin
Journal La Medihealtico Vol. 6 No. 2 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i2.1870

Abstract

Tuberculosis (TB) during pregnancy presents significant risks to both the mother and fetus, including complications such as abortion, preterm birth, low birth weight, and postpartum hemorrhage. The immune changes in pregnancy, particularly the shift in TH1/TH2 balance, increase the risk of latent TB reactivation. Diagnosing TB in pregnant women is challenging due to overlapping symptoms with normal pregnancy changes. However, early diagnosis is crucial for effective management, with molecular tests offering assistance, although bacterial culture remains the gold standard. High-risk pregnant women include those with close contact with active TB patients, HIV, immunosuppressive conditions, or severe immunocompromised states such as lymphoma, leukemia, or organ transplant recipients. These women should undergo sputum testing for acid-fast bacilli smear, mycobacterial culture, and nucleic acid amplification testing if TB is suspected. Immunosuppressed patients may require further testing, even if interferon-gamma release assays or tuberculin skin tests are negative. Retesting is recommended eight weeks after exposure to infectious TB. The management of TB in pregnancy involves a multidisciplinary approach, including obstetricians, infectious disease specialists, and neonatologists. First-line anti-TB medications are safe during pregnancy and help prevent maternal and perinatal complications. Treatment for latent TB infection (LTBI) is generally delayed until after delivery. Breastfeeding is safe for mothers on first-line anti-TB medications, as drug levels in breast milk are too low to harm the infant. Early diagnosis, prompt treatment, and proper care are essential to reduce TB-related risks during pregnancy.
Folate Metabolism and Its Implications in Pregnancy Puspitasari, Maya Khaerunnisa; Irianti, Setyorini; Pramatirta, Akhmad Yogi; Wirawan, Wahyudi; Islamy, Nurul; Maelissa, Merlin Margreth; Lumentut, Anastasia Mariane
Journal La Medihealtico Vol. 6 No. 2 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i2.1885

Abstract

The impact of folate nutritional status on a variety of pregnancy outcomes has been acknowledged for a considerable period of time. Folate is increasingly recognized not just as a nutrient required to prevent megaloblastic anemia during pregnancy, but also as a vitamin necessary for reproductive health. Folate plays an important role in several metabolic processes including DNA synthesis and methylation. Changes in folate status can affect the stability and integrity of DNA or affect the methylation patterns of some tissues. Folate is required for cell division and cell maintenance, as it acts as a co-enzyme in the transfer and processing of carbon units and plays an important role in the synthesis of nucleotides (thymidine) that are essential for de novo construction or DNA repair. The purpose of this article is to examine the function of folic acid in human health especially in pregnancy and to evaluate the benefits, concerns, and epigenetic effects of maternal FA in light of recent discoveries that are crucial for the development of future research.
Acute Fatty Liver in Pregnancy Wirawan, Wahyudi; Setiawan, Dani; Maelissa, Merlin Margreth; Islamy, Nurul; Lumentut, Anastasia Mariane; Puspitasari, Maya Khaerunnisa
Journal La Medihealtico Vol. 6 No. 2 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i2.1890

Abstract

Acute fatty liver in pregnancy (AFLP) is a rare, life-threatening condition that typically occurs in the third trimester, characterized by fat accumulation in the liver. It is associated with high maternal and fetal morbidity, although mortality rates have decreased with improved obstetric care. AFLP's exact cause remains unclear, though it is linked to impaired fatty acid metabolism in the liver. Key risk factors include multiple pregnancies, male fetuses, and metabolic disorders. The condition presents with non-specific symptoms like nausea, jaundice, and abdominal pain, with progression to liver failure and encephalopathy in severe cases. Early diagnosis is critical, and the Swansea Criteria have proven useful. Management focuses on early delivery and supportive care, with cesarean section preferred due to the risk of fetal distress. Liver transplantation may be necessary for severe cases. While maternal and fetal survival rates have improved, the condition still poses significant challenges, emphasizing the need for prompt diagnosis and treatment.
Endocrine Control of Fetal Growth, the Delivery Process, and the Physiology of Childbirth Maelissa, Merlin Margreth; Siddiq, Amillia; Islamy, Nurul; Puspitasari, Maya Khaerunnisa; Lumentut, Anastasia Mariane; Wirawan, Wahyudi
Journal La Medihealtico Vol. 6 No. 2 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i2.1903

Abstract

Childbirth is a complex physiological process characterized by the expulsion of the fetus from the uterus, marked by uterine contractions and cervical changes. The timing of labor is crucial for favorable pregnancy outcomes and is regulated by the neuroendocrine maturation of the fetus. Hormones like estrogen, progesterone, and human placental lactogen play key roles in fetal growth regulation, with fluctuations influencing birth weight and placental development. Progesterone inhibits labor by relaxing the uterus, while estrogen promotes labor by stimulating uterine contractions and cervical changes. The transition from uterine quiescence to active labor involves multiple stages, from myometrial relaxation to enhanced contractility. Labor progresses through phases, starting with quiescence, followed by the onset of rhythmic contractions, active labor, and concluding with involution. Uterine stretching and the role of fetal lung maturation also contribute to labor initiation, as fetal lung surfactant activates macrophages, leading to inflammation and progesterone withdrawal. This process synchronizes labor timing with fetal lung development. In conclusion, labor is influenced by a combination of endocrine and mechanical factors, including prostaglandins, cytokines, and hormones such as oxytocin and CRH. Proper endocrine regulation ensures timely labor, while disruptions in this system, such as premature or prolonged pregnancies, can lead to increased fetal morbidity and mortality.
Co-Authors Akhmad Yogi Pramatirta, Akhmad Yogi Amillia Siddiq, Amillia Dani Setiawan Hermie Tendean Khaerunnisa, Maya Maelissa, Merlin Maelissa, Merlin Margreth Najoan, Rizki Nurul Islamy Puspitasari, Maya Khaerunnisa Setyorini Irianti Wirawan, Wahyudi