Effect of L- Arginin on Placental Hipoxia Inducible Factor -1-Alpha (HIF-1-A) Expression at Preeclampsia Mice Models

Background: Placental hypoxia is one of the theories that cause preeclampsia. In placental hypoxia of preeclampsia, there is an increase of Hipoxia Inducible Factor 1 Alpha (HIF-1-A) expression as a response to hypoxia. L-Arginine administration through the L-Arginine-Nitric Oxide pathway is expected to improve placental hypoxia. This study aimed to examine the effect of L- Arginin on placental HIF-1-A expression at preeclampsia mice models.Subjects and Method: Experimental study with parallel group post-test only design. The study was carried out at the Veterinary Medicine Faculty of Airlangga University. Thirty six preeclampsia mice models were made with intravenous injection 10ng anti-Qa-2 on day 1-4 of pregnancy. They were divided into 2 groups: (1)18 mice without treatment (control) and (2) 18 mice were given L-Arginin 200 mg/kgBW/day on day 7-15 of pregnancy. They were terminated on day 16 then immunohistochemistry examination of HIF-1-A expression was done on the placental samples. The dependent variable was placental Hipoxia Inducible Factor-1-Alpha (HIF-1-A) expression. The independent variables were L-Arginin administration. HIF-1-A expression was measured by H-Score method. The data were analyzed by t-test. Results: The mean of placental HIF-1-A expressions of treatment group was lower (Mean= 7.98; SD=9.35) than control group (Mean=41.95; SD= 32.20), and it was statistically significant (p <0.001).Conclusion: L-Arginin reduces the Placental Hypoxia Inducible Factor Alpha (HIF-1-A) expression on preeclampsia mice model.Keywords: L-Arginine, HIF-1-A, PreeclampsiaCorrespondence: Nutria Widya Purna Anggraini. Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java, Indonesia. Email: [email protected]. Mobile: 08122651819.Indonesian Journal of Medicine (2020), 05(03): 191-199https://doi.org/10.26911/theijmed.2020.05.03.03

Perbandingan Faktor Risiko antara Pertumbuhan Janin Terhambat Onset Dini dan Lambat di RSUD Dr. Moewardi

Tujuan: Mengetahui perbandingan faktor risiko antara pertumbuhan janin terhambat onset dini dan lambat di RSUD Dr. Moewardi.Metode: Penelitian observasional analitik dengan pendekatan cross sectional menggunakan data sekunder rekam medis ibu dengan pertumbuhan janin terhambat di RSUD Dr. Moewardi mulai 1 Januari 2020–31 Desember 2021. Pengambilan data menggunakan teknik total sampling, Data diolah menggunakan SPSS dan dianalisis menggunakan uji univariat, kemudia bivariat yaitu uji Chi Square.Hasil: Hasil analisis bivariat menunjukkan bahwa tidak terdapat perbedaan bermakna pada variabel usia, paritas, Indeks Massa Tubuh (IMT), pekerjaan ibu, hipertensi, preeklamsi, diabetes melitus, anemia, asma antara pertumbuhan janin terhambat onset dini dan onset lambat (p>0,05).Kesimpulan: Tidak terdapat perbedaan yang bermakna pada usia ibu, paritas, Indeks Massa Tubuh (IMT), pekerjaan ibu, preeklamsi, hipertensi, diabetes melitus, anemia, asma antara kejadian pertumbuhan janin terhambat onset dini dan lambat di RSUD Dr. Moewardi.Comparison of Risk Factor For Early and Late Onset Intrauterine Growth Restriction in RSUD Dr. MoewardiAbstract Objective: To find out the comparison of risk factors between early-onset and late onset intrauterine growth restriction at RSUD Dr. Moewardi.Method: This research is an analytical observational with a cross sectional approach was done by using medical records of pregnant woman with intrauterine growth restriction at RSUD Dr. Moewardi from January 1, 2020– December 31, 2021. Data was collected using a total sampling technique. And processed by SPSS then analyzed using univariate test, and Chi Square test.Results: The results of bivariate analysis showed that there was no significant differences of age, maternal employment, parity, Body Mass Index (BMI), maternal employment, hypertension, preeclampsia, diabetes mellitus, anemia, asthma between early-onset and late-onset with intrauterine growth restriction (p>0,05).Conclusion: There were no significant differences of maternal age, parity, Body Mass Index (BMI), preeclampsia, maternal employment, hypertension, diabetes mellitus, anemia, asthma between early and late onset intrauterine growth restriction at RSUD Dr. Moewardi.Key words: Risk Factor, Intrauterine Growth Restriction, Early Onset, Late Onse

Prenatal Diagnosis and Management of Advanced Abdominal Pregnancy in Dr. Moewardi Hospital Surakarta: A Case Series

Background: The abdominal pregnancy is a pregnancy anywhere in the abdominal cavity other than the tube, ovary, and broad ligament. Abdominal pregnancy has 7.7 times greater risk than tubal pregnancy and 90 times greater than intrauterine pregnancy. This study aims to reveal the diagnosis and treatment of abdominal pregnancy in Dr. Moewardi Hospital Surakarta.Subjects and Method: This was a case series study conducted at Dr. Moewardi Hospital Surakarta. This study report three cases of advanced abdominal pregnancy at Dr Moewardi Hospital (2019 – 2020), that consisted of two cases of advanced abdominal pregnancy to term, and one advanced abdominal pregnancy with acute abdomen.Case presentation: Case 1 (it was found abdominal pregnancy at 30 weeks), the condition of the mother and the fetus was good, the pregnancy was continued until the gestational age was term. The patient was given corticosteroids for lung maturation and magnesium sulfate for neuro­protection. Case 2 (an abdominal pregnancy was found at term), it was decided to immediately terminate it with good preoperative preparation. Both patients in case 1 and case 2 had good result in both the mother and the fetus. The placenta was left in situ in both cases to prevent massive bleeding and injury to the gastrointestinal organs. Case 3 (advanced abdominal pregnancy with acute abdominal symptoms) decided to undergo an emergency laparotomy and removal of the placenta.Conclusion: Abdominal pregnancy must be diagnosed and managed properly to reduce maternal mortality and morbidity. In advanced abdominal pregnancy, it could be considered to continue the pregnancy until the term. The placenta management of in situ without methotrexate might be considered in cases of abdominal pregnancy.Keywords: abdominal pregnancy, prenatal diagnosis, treatmentCorrespondence: Uchti Akbar. Departement of Obstetrics & Gynaecology, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Jl. Kolonel Sutarto, Surakarta 57126, Central Java. Email : [email protected]. Mobile: 081397167176.Journal of Maternal and Child Health (2021), 06(04): 516-522https://doi.org/10.26911/thejmch.2021.06.05.01

The Effectiveness of Letrozole-Electroacupuncture Adjuvant Therapy in Reducing Resistance and Pulsatility Indices in Women with Polycystic Ovarian Syndrome

Background: Polycystic Ovarian Syndrome (PC­­­­OS) is a complex endocrine disorder and the cau­­­­se of 40% of infertility cases. In recent years, let­­­ro­zole as an aromatase inhibitor has been report­ed to be effective for ovulation induction. In addi­­tion, electro acupuncture therapy can redu­ce tonic activity in the sympa­thetic vaso­constric­tor path­­way to the uterus. This stu­dy aimed to determine the effectiveness of Let­ro­zo­le-Electroacupuncture adjuvant therapy in reducing the Resistance Index and Pul­sa­ti­li­ty Indices in women with Polycystic Ovary Syn­dro­me (PCOS).Subjects and Method: This was an analytical ob­servational study with a cohort approach. The sub­jects of the study were women aged 20-45 years based on age, body mass index (BMI), and pe­riod of infertility aspects. The sample con­sisted of 30 people who were divided into 2 groups, name­­ly group 1 with letrozole therapy, while group 2 with additional electro­acu­punc­ture therapy and then carried out pre- and post-interven­tion exa­mi­nations on day 19 and 21. The depen­dent variables were the Resist­ance Index value and the Pulsaitility Index value. The inde­pendent vari­­ables were Letro­zole and Electro­acupuncture therapies. The Resistance and Pulsatility Indices we­re measured using USG transabdominal Color Dop­­pler Voluson P6. The data were analyzed using the Mann Whitney test.Results: The Pul­satility Index for group 1 on day 21 (Mean= 2.69; SD= 0.87) was higher than group 2 (Me­an= 1.97; SD= 0.57), and it was statistically sig­ni­fi­cant (p= 0.013).Conclusion: Letrozole-EA therapy reduce the Resistance and Pulsatility In­dices.Keywords: Letrozole, acupuncture, endo­metrial re­ceptivity, Polycystic Ovarian SyndromeCorrespondence: Dhamayanti Eka Octavia. Department of Obs­tetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Ma­­ret/ Dr. Moewardi Hos­pital, Sura­kar­ta 57126, Central Java. Email: dhama­yan­ti­[email protected]. Mobile: 08125­0355886.Journal of Maternal and Child Health (2020), 05(04): 422-429https://doi.org/10.26911/thejmch.2020.05.04.0

Placental damage comparison between preeclampsia with COVID-19, COVID-19, and preeclampsia: analysis of caspase-3, caspase-1, and tumor necrosis factor-alpha expressionAJOG Global Reports at a Glance

BACKGROUND: Some studies have reported that preeclampsia with COVID-19 significantly increases the risk of adverse perinatal outcomes to nearly 3-fold in normal pregnancy. In theory, the pathophysiology of preeclampsia increases perinatal mortality and morbidity starting from placental injury, which is also believed to share a common pathway with COVID-19. Moreover, major placental injuries could be apoptotic, necrotic, or pyroptotic. OBJECTIVE: This study aimed to compare the placental damage between Preeclampsia with COVID-19, COVID-19, and preeclampsia in apoptotic, necrotic, or pyroptotic injuries. STUDY DESIGN: This was an observational analytical study with a cross-sectional setting. A total of 72 pregnant women were admitted to the hospital with diagnoses of preeclampsia with COVID-19, preeclampsia, and COVID-19. The diagnosis for preeclampsia was following the International Federation of Gynecology and Obstetrics criteria with at least 1 of the severe features. Patients with COVID-19 were eligible if they had a confirmatory polymerase chain reaction test with moderate to severe clinical degree. The placentas were taken after delivery, and the parameters were quantified with immunohistochemistry tests for caspase-3, caspase-1, and tumor necrosis factor-alpha representing apoptotic, pyroptotic, and necrotic pathways, respectively. RESULTS: Pregnancies complicated by both COVID-19 and preeclampsia, preeclampsia, and COVID-19 significantly had the highest placental damage on apoptotic, pyroptotic, and necrotic pathways shown from caspase-3, caspase-1, and tumor necrosis factor-alpha expressions in the placenta (P<.05). Moderate to severe degree of COVID-19 resulted in higher placental damage than preeclampsia in all 3 forms (P<.05). The apoptotic process was the most prominent among the pathways. CONCLUSION: Preeclampsia with COVID-19 showed significant placental damage, with major changes related to apoptosis, inflammation, and necrosis. Our data support poor perinatal outcomes of pregnancies complicated by both preeclampsia and COVID-19