Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. Knowledge of risk factors is crucial for predicting the incidence of preterm births. This study aimed to determine the factors associated with preterm birth at the Hasan Sadikin General Hospital. Method: This study was a cross-sectional analytic using secondary data. Data derived from medical records maternity patients in the Department of Obstetrics and Gynecology Hasan Sadikin General Hospital taken in 2015. 1944 patients' medical records who gave birth met the inclusion criteria. Data analyses used were bivariate (chi square) and multivariate (logistic regression). Result: The result showed that the variables including age (p = 0.043, OR = 1.586), antenatal care (p < 0.001, OR = 1.865), history of preterm birth (p < 0.001, OR = 2.337), anemia (p < 0.001, OR = 1.307), hypertension (p < 0.001, OR = 3.969), and antepartum hemorrhage (p < 0.001, OR = 6.917) had significant result (p < 0.05). Among these variables, antepartum hemorrhage held the strongest correlation with the preterm birth. Conclusion: There is a significant relationship between age, antenatal care, preterm birth history birth, anemia, hypertension, and antepartum hemorrhage with preterm birth as risk factors.
Introduction. Senescent cells have been demonstrated to release High Mobility Group Box 1 (HMGB1) which induces labor through an inflammatory pathway. This research is aimed at demonstrating whether telomere shortening, proinflammatory HMGB1, and oxidative damage marker 8-OHdG play a role in the placenta of preterm birth in comparison to term birth. Method. A cross-sectional study on 67 full thickness of the placenta obtained from mothers with term and preterm birth. Mothers with clinical signs of infection ( fever > 38 ° C , leukocytosis > 18000 / μ L , or abnormal vaginal discharge) and other pregnancy complications were excluded. Real-time polymerase chain reaction was performed to measure T/S ratio and ELISA quantification to measure the amount of HMGB1 and 8-OHdG. Result. A total of 34 placentas from preterm and 33 placentas from term birth were examined. Maternal characteristics were comparable between the two groups. There were no statistical difference of T/S ratio ( p = 0.181 ), HMGB1 ( p = 0.119 ), and 8-OHdG ( p = 0.144 ) between the preterm and term groups. HMGB1 was moderately correlated with 8-OHdG ( r = 0.314 ). Telomere T/S ratio of the placenta did not differ between preterm and term labor despite difference in gestational age, suggesting earlier shortening in the preterm group. It is possible that critical telomere length has been achieved in both term and preterm placenta that warrants labor through senescence process. The result of our study also showed that HMGB1 was not correlated to telomere length, due to the fact that HMGB1 is not upregulated until the critical length of telomere for senescence is exhibited. Conclusion. Similar telomere length might be exhibited due to early telomere shortening in preterm birth that mimics the term placenta. The relationship between placental telomere shortening and HMGB1 release remains to be uncovered. Further research is needed to discover the factors leading to early telomere shortening in the placenta of preterm birth.
Meneliti karakteristik dan luaran pada preeklamsia awitan dini dan awitan lambat di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Metode: Penelitian deskriptif dengan pendekatan potong lintang. Data diambil dari rekam medis. Hasil: Terdapat 347 pasien preeklamsi, 137 preeklamsi awitan dini, 192 awitan lambat dan 18 eklamsi. Distribusi umur preeklamsi awitan dini 20 sampai <30 tahun yaitu 45 orang (32,85%) dan umur >35 tahun 45 orang (32,85%), pada awitan lambat tersering pada umur >35 tahun 64 orang (33,33%). Distribusi paritas preeklamsi awitan dini paritas 1−3 yaitu 102 orang (74,5%) dan awitan lambat 118 orang (61,5%). Luaran bayi menunjukkan bayi yang lahir sesuai usia kehamilan pada preeklamsi awitan dini sebanyak 83,9% dan awitan lambat sebanyak 77,6% dan nilai APGAR 1 menit 7-10 pada preeklamsi awitan dini adalah 46% dan awitan lambat adalah 72,4%. Sindrom HELLP parsial adalah komplikasi terbanyak, yaitu 64 kasus (18,44%), 39 kasus pada preeklamsi awitan dini, dan 22 kasus pada preeklamsi awitan lambat. Kesimpulan: Tidak ada perbedaan signifikan luaran bayi antara preeklamsia awitan dini dan awitan lambat. Komplikasi tersering adalah sindroma HELLP parsial.Kata kunci : Karakteristik, luaran, preeklamsia awitan dini, awitan lambat.
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/UdG0GRk0ZWM Background and purpose: The prevalence of tuberculosis (TB) in Indonesia is still high, whereas the prevalence of extra pulmonary tuberculosis such as female genital tuberculosis (FGTB) affecting infertility is unknown. FGTB caused irreversible severe damaged of tubes and endometrium, resulting in tubal occlusion and partial or total obliteration of the uterine cavity. Diagnosis of FGTB is difficult. Therefore, a prompt diagnosis and treatment of pulmonary TB in women can prevent fertility complications. This study aims to analyze the correlation of clinical features taken from the history, physical examination, investigation of blood laboratory and gynecological ultrasound of pulmonary tuberculosis women with infertility. Patients and methods: This was an observational analytic study with cross-sectional method. Subjects were women with pulmonary TB treated in TB-DOTS (tuberculosisdirectly observed treatment, short-course) services at Dr Hasan Sadikin Hospital Bandung during December 2016 until March 2017. Subjects were divided into two groups consist of 32 TB patients with infertility, and 35 TB patients without infertility. Results: The results showed that clinical features such as intermenstrual bleeding, endometrial synechiae, hydrosalpinx and endometritis appearance were the difference between two groups (p <0.001), those clinical features had a moderate correlation with the incidence of pulmonary tuberculosis women. Conclusion: Clinical features like endometrial synechia and ultrasound imaging such as hydrosalpinx and endometritis encountered in pulmonary and extra pulmonary tuberculosis patients with infertility can be used as a basis for the diagnosis of alleged genital TB.
The risk factors for preeclampsia, extremes of maternal age, changing paternity, concomi-tant maternal autoimmunity, and/or birth intervals greater than 5 years, suggest an underlying immunopathology. We used peripheral blood and lymphocytes from the UteroPlacental Interface (UPI) of 3 rd trimester healthy pregnant women in multicolor flow cytometry-and in vitro suppression assays. The major end-point was the characterization of activation markers , and potential effector functions of different CD4-and CD8 subsets as well as T regulatory cells (Treg). We observed a significant shift of peripheral CD4-and CD8-T cells from naïve to memory phenotype in preeclamptic women compared to healthy pregnant women consistent with long-standing immune activation. While the proportions of the highly sup-pressive Cytokine and Activated Treg were increased in preeclampsia, Treg tolerance toward fetal antigens was dysfunctional. Thus, our observations indicate a long-standing inflammatory derangement driving immune activation in preeclampsia; in how far the Treg dysfunction is caused by/causes this immune activation in preeclampsia will be the object of future studies.
BackgroundPreeclampsia is a major cause of morbidity and mortality, both maternal and perinatal. The etiology and pathophysiology of preeclampsia remain unknown. Research shows the implantation of the placenta in preeclampsia occurs due to incomplete angiogenic imbalance as one of the preeclampsia pathogenesis. PlGF is angiogenic protein which is synthesized in placenta by mRNA PlGF. When damage occurs, mRNA will be released from cell and form cell-free mRNA. This study aims to analyze the differences between the PlGF mRNA expression in severe preeclampsia and normal pregnancy as well as to measure the relationship between cell-free mRNA and levels of PlGF with the incidence of severe preeclampsia.MethodsThe method used in this study is an observational analytic study with cross-sectional design. Blood samples were obtained from patients with preeclampsia and normal pregnancies as the controlling factors in accordance with inclusion and exclusion criterias. Examination of the PlGF level was measured by ELISA method and mRNA PIGF expression was measured by RT-PCR. Physical and laboratory examinations of patients were recorded and collected as data. Calculations were done by statistical analysis.ResultsMean of the cell-free mRNA PlGF expression level in severe preeclampsia is 2.2983 ng/mL within the scale of 1.96–2.83 ng/mL and deviation standard of 0.1897. Using Pearson Analysis Test, the result shows that there is a positive correlation between cell-free mRNA expression and PlGF protein level in severe preeclampsia, with r = 0.640 dan p < 0.004.ConclusionThere is no difference between expression of cell-free mRNA PlGF in severe preeclampsia serum and normal pregnancy. There is a significant correlation between expression of cell-free mRNA and PlGF protein level in severe preeclampsia.
Objective: Cytoreduction has an important role in improving the survival rate of epithelial ovarian cancer (EOC) patients. This study aimed to assess the ability of preoperative serum CA125, FASN and GLS as predictors of cytoreductive surgery for epithelial ovarian cancer (EOC). Results: The average values of serum CA-125, FASN, and GLS in the suboptimal cytoreduction group were higher than those in optimal cytoreduction group. The cut off point (COP) was 248.55 (p = 0.0001) with 73.2% sensitivity and 73.6% specificity for CA-125, 0.445 (p = 0.017) with 62.5% sensitivity and 60.4% specificity for FASN, and 22.895 (p = 0.0001) with 73.2% sensitivity and 75.5% specificity for GLS. The COP of CA-125 and GLS combined was 29.16 (p = 0.0001) with sensitivity 82.1% and specificity 73.6%, while the COP of CA-125, GLS, and FASN combined was 0.83 (p = 0.0001) with 87.5% sensitivity and 73.6% specificity.
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