The Role of Matrix Metalloproteinase2 (MMP2) in Serum and Peritoneal Fluid of Endometriotic Patients

Objective: To determine the role of matrix metalloproteinase-2(MMP-2) in serum and peritoneal fluid of endometrioticpatients.Methods: Research’s design using cross-sectional method in Dr.Wahidin Sudirohusodo hospital and several other hospitals inMakassar within May 2015 until May 2016. Subjects were chosenusing consecutive sampling technique. The examination usingthe ELISA method. The data were analysed using Fisher exact,t-independent, Mann-Whitney, and Spearman association.Results: A total of 50 subjects were recruited in this study. Mostlythe value of MMP-2 serum and peritoneal fluid in endometriosisgroup was higher compare to study control. There was significantdifferent between the total of MMP-2 serum and peritoneal fluid.There was also a significant association between the value ofMMP-2 serum and peritoneal fluid with endometriosis.Conclusion: The value of MMP-2 serum and peritoneal fluid werehigher in endometriotic patients compared to those withoutendometriosis. The higher the value of MMP-2 serum andperitoneal fluid, the higher the stage of endometriosis.[Indones J Obstet Gynecol 2018; 6-2: 104-109]Keywords: endometriosis, matrix metalloproteinase-2, MMP-

Changes of Body Mass Index and Lipid Profile in Injectable Depot Medroxyprogesterone Acetate and Levonorgestrel Implant Acceptors

Objective: To determine the comparison of body mass index (BMI) among acceptors of injectable depot medroxyprogesterone acetate (DMPA) with levonorgestrel implant acceptors for 1 year and comparison of lipid profiles between depot medroxyprogesterone acetate acceptors with levonorgestrel implants for 1 year. Method: This study was conducted at dr. Wahidin Sudirohusodo hospital, Makassar and its satellite hospitals as well as family planning social service cooperation between the National Family Planning Coordinating Board with the Department of Obstetrics and Gynecology Hasanuddin University. Result: The results showed the increase in BMI of levonorgestrel implant acceptors (1.25 kg/m2) was greater than DMPA acceptors (0.74 kg/m2). HDL cholesterol and triglycerides did not change significantly in either groups. LDL cholesterol was increased in DMPA acceptors (9.63 mg/dl) and decreased in implant acceptors (1.62 mg/dl). Total cholesterol increased in DMPA acceptors at 8.67 mg/dl) while in the levonorgestrel implant acceptors it was decreased by 5.37 mg/dl. Conclusion: Weight gain occured among acceptors of DMPA and implant however the weight gain is more profound among the implant acceptors.  Keywords: body mass index, DMPA, levonorgestrel implant, lipid profil

Hypertriglyceridemia is associated with the incidence of preeclampsia

Abstract Objective: to find out  the correlation between lipid profille at trimester II of pregnancy and the incidence.of preeclampsia Method : The research  was conducted in the Polyclinic of Hasanuddin University Teaching Hospital, Department of Obstetrics and Gynecology of the Faculty of Medicine, and it network in Makassar city from March, 2015 through March, 2016. The research used was the prospective cohort design. Results : The examination of the lipid levels of 115 pregnant mothers, aged 24-28 weeks. The mothers were then observed whether they experienced preeclampsia up to the time they gave birth or not. In the end, 8 subjects (6.9%) experienced preeclampsia and 107 subjects (93.1%) have no preeclampsia. The statistical analyses used Fisher’s Exact test and Mann Whitney test. The research results indicated that the mean value of the total cholesterol and Low Density Lipoprotein (LDL) was higher in the preeclampsia group compared to the non-preeclampsia group: 267.37 ± 64.12 : 238 ± 37.98; 177.38 ± 55.38 : 157.24 ± 35.08 (p>0.05). The mean value of High Density Lipoprotein (HDL) was lower in the preeclampsia group compared to the non-preeclampsia group: 64.75 ± 14.64 : 67.86 ± 16.72 (p>0,05). The mean value of trigliserida in preeclampsia group was significantly higher (19,5%) compared thanin the non-preeclampsia group: 260.12 ± 58.86 vs 209.14 ± 65.10 (p=0,027). Conclusion : The hypertrigliseridemia was correlated with the preeclampsia incidence. Keywords:preeclampsia, lipid profile, trimester II of pregnancy   Abstrak Tujuan: mengetahui hubungan antara profil lipid kehamilan trimester II dengan kejadian preeklamsia. Metode : Penelitian dilaksanakan di Poliklinik RS jejaring pendidikan Departemen Obstetri dan Ginekologi Fakulltas Kedokteran Universitas Hasanuddin dan Poliklinik Kesehatan Ibu dan Anak di beberapa Puskesmas Kota Makassar selama Maret 2015 sampai dengan Maret 2016. Rancangan penelitian yang digunakan adalah prospektif  kohort. Hasil: dari 115 ibu hamil dilakukan pemeriksaan  kadar lipid, 115 ibu hamil pada usia kehamilan 24 – 28 minggu, kemudian diamati apakah subyek mengalami preeklamsia hingga proses persalinan. Terdapat delapan subyek (6,9%) berkembang menjadi preeklampsia dan 107 subyek tidak preeklamsia. Data dianalisis secara statistik dengan menggunakan uji Fisher’s Exact dan uji Mann Whitney. Hasil penelitian menunjukkan bahwa nilai mean kolesterol total dan Low Density Lipoprotein (LDL) lebih tinggi pada kelompok preeklampsia dibandingkan kelompok tidak preeklamsia, yaitu 267,37 ± 64,12 : 238,01 ± 37,98; 177,38 ± 55,38 : 157,24 ± 35,08 (p>0,05). Nilai mean High Density Lipoprotein (HDL) lebih rendah pada kelompok preeklamsia dibandingkan tidak preeklamsia yaitu 64,75 ± 14,64 : 67,86 ± 16,72 (p>0,05). Nilai mean trigli seri daripada kelompok preeklamsia secara signifikan lebih tinggi 19,5 % dibandingkan kelompok tidak preeklamsia, yaitu 260,12 ± 58,86 : 209,14 ± 65,10 (p=0,027). Kesimpulan : Hiper trigli seridemia berhubungan dengan kejadian preeklamsia. Kata kunci : preeklamsia, profil lipid, kehamilan trimester I

The Role Placental TLR-7 Expression with Cord Blood HBV DNA and Placental HBV DNA: Peran Ekspresi TLR-7 Plasenta dengan HBV DNA Tali Pusat dan HBV DNA Plasenta

Abstract Objective: To determine the role of TLR-7 expression on intrauterine vertical transmission in pregnancy through identification of serum hepatitis B markers in both maternal and umbilical cord blood. Methods: Analysis of TLR expression was performed on 38 paraffin block samples of placental tissue acquired from mothers with HBV using TLR immunohistochemical staining. Results: 16 of 38 samples were acquired from mothers aged 26-30 years-old. Most of the samples were from primiparous mothers (52.6%). This study found no significant association between TLR-7 expression and HBV DNA in the placenta and cord blood (p = 1.000). However, we found a significant association between placental TLR-7 expression and maternal HBV DNA (p = 0.034). Meanwhile, placental HBeAg and HBV DNA were not associated with placental TLR-7 expression (p = 0.082; p = 1.000). Conclusion: There was no significant association between TLR-7 expression and HBV DNA in the placenta and cord blood, but we found a significant association between TLR-7 expression and maternal HBV DNA.  Keywords: HBV DNA, Hepatitis B, intrauterine infection, placental toll-like receptor (TLR) 7,umbilical cord.   Abstrak Tujuan: untuk melihat peran ekspresi TLR-7 terhadap transmisi vertikal intrauterina pada kehamilan melalui identifikasi marker serum hepatitis B pada darah ibu dan talipusar. Metode: Analisis ekspresi TLR dilakukan pada 38 sampel blok paraffin jaringan plasenta ibu yang menderita HBV dengan memakai pewarnaan imuhohistokimia TLR. Hasil: 16 dari 38 sampel berusia 26-30 tahun. Sebagian besar sampel merupakan kelompok primipara (52.6%). Penelitian ini tidak menemukan hubungan yang signifikan antara ekspresi TLR-7 di plasenta dan HBV DNA darah tali pusat (p = 1.000). Tapi, kami menemukan hubungan yang signifikan antara ekspresi TLR-7 plasenta dan HBV DNA ibu (p = 0,034). Sedangkan HBeAg dan HBV DNA plasenta tidak berhubungan dengan ekspresi TLR-7 plasenta (p = 0,082; p = 1.000). Kesimpulan: Tidak ada hubungan yang signifikan antara ekspresi TLR-7 dan DNA HBV di plasenta dan tali pusat, tetapi kami menemukan hubungan yang signifikan antara ekspresi TLR-7 dan DNA HBV ibu.  Kata kunci: HBV DNA, Hepatitis B, infeksi intrauterina, plasenta, tali pusat,  toll-like receptor (TLR)

Elective versus Emergency Cesarean Sections : Mother and Fetal Outcome: Luaran Ibu dan Bayi pada Operasi Sesar Elektif dan Emergensi

Objective: To compare the outcomes of mothers and newborns in emergency cesarean section and elective cesarean section.Methods: A prospective cohort study included 120 pregnant women consists of 60 women who performed an emergency cesarean section and 60 women who underwent elective cesarean section. Age, education level, occupation, income, history of comorbidities, history of abortion or miscarriage, antenatal care history, decision-making time until surgery is performed along with other components required, duration of operation, outcome of mother and fetal were obtained through interviews and questionnaires. Data were analyzed regarding fetal outcome and cesarean sections indications.Results: The maternal and fetal outcome between emergency and elective cesarean section were not significantly  different regarding on hospital stay, dehiscence, NICU admission, Apgar score and newborn status (dead or alive). Blood transfusion is the main difference signifi cant indication for maternal outcome between emergency and elective procedure (p less than 0.05). The total duration of procedure  less than 60 or more than 60 minutes and maternal-fetal outcome not signifi cantly different between two type of procedures.Conclusions: Emergency cesarean section at preterm gestational age with an operating time less than equal to 60 minutes leads to greater transfusion blood requirements compared with elective cesarean section.Keywords: emergency cesarean section, elective cesareansection, mother-infant outcome. AbstrakTujuan: Membandingkan luaran ibu dan bayi baru lahir di seksio sesarea emergensi dan elektif.Metode: Penelitian kohort prospektif melibatkan 120 perempuan hamil terdiri atas 60 perempuan yang melakukan operasi seksio sesarea emergensi dan 60 perempuan melakukan operasi elektif. Usia, tingkatpendidikan, pekerjaan, pendapatan, riwayat komorbiditas, riwayat aborsi atau keguguran, riwayat asuhan antenatal, waktu pengambilan keputusan sampai operasi dilakukan bersamaan dengan komponen lain yang diperlukan, lamanya operasi, luaran ibu dan bayi diperoleh melalui wawancara dan kuesioner. Data yang dianalisis mengenai luaran ibu dan bayinya.Hasil: Luaran ibu dan bayi antara seksio sesarea emergensi dan elektif tidak berbeda bermakna dalam hal lama rawat inap, dehisensi, admisi, skor Apgar dan status bayi baru lahir (meninggal atau hidup). Transfusi darah adalah indikasi penting utama yang berbeda untuk luaran ibu antara prosedur emergensi dan elektif (p kurang dari 0,05). Durasi total prosedur kurang dari 60 atau lebih dari 60 menit dan luaran ibu tidak berbeda secara signifikan antara kedua jenis seksio sesarea.Kesimpulan: Tindakan seksio sesarea emergensi pada usia gestasi prematur dengan waktu operasi kurang dari sama dengan 60 menit menyebabkan kebutuhan transfusi darah lebih besar dibandingkan seksio sesarea elektif.Kata kunci: luaran ibu-bayi, seksio sesarea elektif, seksio sesarea emergensi

Perineal Body Length and Pelvic Organ Prolapse in Menopausal Women: Panjang Perineal Body dan Prolaps Organ Panggul pada Wanita Menopause

Abstract Objective: To determine the correlation between the perineal body length and the pelvic organ prolapse (POP) in menopausal women. Methods: The total vaginal length (TVL), genital hiatus (GH), and perineal body (PB) length as the POP-Q component were measured at 60 menopausal women enrolled in a cross-sectional study. Results: Menopausal women with POP have the shorter perineal body (63.3%; <3 cm) compared with menopausal women without POP (36.7%; ≥3 cm). The mean length of the perineal body in menopausal women who suffer POP 2.81 ± 0.26 cm while in women without POP is 3.23±0.17 cm. POP risk was 25 times in menopausal women with a perineal body length <3 cm compared with longer perineal body (p = 0.01; OR = 25.4; 95% CI 3.1-209.1).Conclusion: Perineal body length is a risk factor for pelvic organ prolapse in menopausal women.Keywords: perineal body, prolapse, pelvic organ prolapsed Abstrak Tujuan: Menentukan korelasi panjang perineal body dengan kejadian prolaps organ panggul (POP) pada perempuan menopause. Metode: Pengukuran komponen POP-Q meliputi total vaginal length (TVL), genital hiatus (GH), dan panjang perineal body (PB) dilakukan pada 60 perempuan menopause yang dilibatkan dalam penelitian potong lintang. Hasil:    Perempuan menopause dengan POP memiliki perineal body yang lebih pendek (63,3%; <3 cm) dibandingkan dengan perempuan menopause tanpa POP (36,7%; ≥3 cm). Panjang rata-rata perineal body pada perempuan menopasue yang menderita POP 2,81 ± 0,26 cm sedangkan pada perempuan tanpa POP adalah 3,23 ± 0,17 cm. Risiko POP 25 kali pada perempuan menopause dengan panjang perineal body <3 cm dibandingkan dengan tubuh perineum yang lebih panjang (p = 0,01; OR = 25,4; 95% CI 3,1-209,1). Kesimpulan: Panjang perineal body merupakan faktor risiko prolaps organ panggul pada perempuan menopause. Kata kunci : perineal body, prolapsed, prolaps organ panggu

The Effect of Cyclophosphamide Chemotherapy on Ovarian AntiMüllerian Hormone Levels in Breast Cancer Patients

Objective: To evaluate cyclophosphamide effects on Anti- Müllerian hormone (AMH) levels in breast cancer patients treated with cyclophosphamide chemotherapy. Methods: This cohort prospective study was conducted in Dr. Wahidin Sudirohusodo Hospital in the Department of Obstetrics and Gynecology in collaboration with Department of Surgery, Faculty of Medicice, Universitas Hasanuddin between September 2015 and June 2016. Serum levels of AMH from forty breast cancer patients received three series of cyclophosphamide chemotherapy determined by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Serum AMH levels decreased significant in the first series (from 2.092.04 ï­g/ml to o.651.06 ï­g/ml; p<0.05) through the third series (from 1.531.34 ï­g/ml to 0.50.65 ï­g/ml; p<0.05) of cyclophosphamide chemotherapy. Conclusion: AMH levels decreased significant after cyclophosphamide indicated that cyclosphosphamide decrease ovarian reserve. [Indones J Obstet Gynecol 2018; 6-1: 64-67] Keywords: anti-müllerian hormone, breast cancer, cyclophosphamide, ovarian reserveObjective: To evaluate cyclophosphamide effects on Anti- Müllerian hormone (AMH) levels in breast cancer patients treated with cyclophosphamide chemotherapy. Methods: This cohort prospective study was conducted in Dr. Wahidin Sudirohusodo Hospital in the Department of Obstetrics and Gynecology in collaboration with Department of Surgery, Faculty of Medicice, Universitas Hasanuddin between September 2015 and June 2016. Serum levels of AMH from forty breast cancer patients received three series of cyclophosphamide chemotherapy determined by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Serum AMH levels decreased significant in the first series (from 2.092.04 ï­g/ml to o.651.06 ï­g/ml; p<0.05) through the third series (from 1.531.34 ï­g/ml to 0.50.65 ï­g/ml; p<0.05) of cyclophosphamide chemotherapy. Conclusion: AMH levels decreased significant after cyclophosphamide indicated that cyclosphosphamide decrease ovarian reserve. Keywords: anti-müllerian hormone, breast cancer, cyclophosphamide, ovarian reserv

Effect of Artesunate on Peripheral Parasitaemia in Pregnant Women with Plasmodium Falciparum Infection

Objective: To determine the effect of artesunate on peripheral parasitaemia in pregnant women with Plasmodium falciparum infection. Methods: Pregnant women in second and third trimester with Plasmodium falciparum infection and their newborns were included in cohort prospective study in Sorong West Papua from September 2015 to February 2016. All pregnant women received 200 mg orally artesunate monotherapy for 7 days. Their newborns examined for weight at delivery and parasitaemia in placenta and cord blood. Parasitaemia diagnosis by Rapid Diagnostic Test and blood smear microscopy. Results: After artesunatemonotherapy, 82.5% (33/40) malariainfected pregnant women had negative parasitaemia (p=0.000) although 17.5% (7/40) of the pregnant women had positive parasitaemia. Parasitaemia also found in 10% (4/40) of placenta and 7.5% (3/40) of umbilical cord from newborns of malaria-infected pregnant women treated with artesunate. 70% (28/40) of the newborns in this study had normal weight. Conclusion: Artesunate reduces peripheral parasitaemia in the second and third trimester of pregnancy, and is associated with normal birth weight. [Indones J Obstet Gynecol 2017; 5-3: 135-138] Keywords: artesunate, low birth weight, peripheral parasitaemi

Concordance of Human Papillomavirus Type 16 and 18 in Cervical and Oral Specimen of Cervical Cancer Patients

Abstract Objective : To determine the conformity of HPV type 16 and 18 in cervical and oral/buccal specimens from cervical cancer patients. Methods :A cross-sectional study was conducted in March - September 2016 at several hospitals in Makassar. HPV 16 and 18 genotyping in cervical and oral fluid of 77 patients with cervical cancer performed with PCR method. Results : The prevalence of HPV type 18 infection both in the cervical and the oral fluid was higher than HPV type 16 [9(47.4%) vs 5(26.3%)]. The aggreement of HPV type 18 infection (r=0.328;p=0.000) in the cervical-oral sites was higher than HPV type 16 (r=0.194;p=0.042). Conclusion : HPV type 16 and 18 could infect both cervix and oral cavity although type-specific concordance is low. Keywords :Human papillomavirus,servix, oral cavity   Abstrak Tujuan: Mengetahui tingkat kesesuaian hasil pemeriksaan HPV tipe 16 dan 18 antara spesimen serviks dan oral/buccal pada penderita kanker serviks. Metode: Penelitian cross sectional ini dilakukan pada Maret – September 2016 pada beberapa rumah sakit di Makassar. Pemeriksaan HPV 16 dan 18 pada cairan serviks dan oral dari 77 orang penderita kanker serviks menggunakan teknik PCR. Hasil: Prevalensi infeksi bersama pada serviks dan oral HPV tipe 18 lebih tinggi dibandingkan HPV tipe 16 [9(47,4%) vs 5(26,3%)]. Tingkat kesesuaian antara HPV tipe 18 (r=0,328;p=0,000) pada serviks dan oral lebih tinggi dibandingkan tipe 16 (r=0,194;p=0,042). Kesimpulan: HPV tipe 16 dan 18 dapat menginfeksi serviks dan oral meskipun tingkat kesesuaian kedua tipe ini lemah. Kata kunci : Human papillomavirus, serviks, kavum ora

A1298C Polymorphism of Fetal Methylenetetrahydrofolate Reductase (MTHFR) Gene as a Risk Factor for Spontaneous Abortion

Objective: To investigate the role of A1298C polymorphism of fetal methylenetetrahydrofolate reductase (MTHFR) gene in spontaneous abortion. Method: The case control study design recruited 96 subjects in Siti Fatimah and Pertiwi mother and child hospital, Dr. Wahidin Sudirohusodo, Pelamonia, Bhayangkara, Syekh Yusuf, Haji and Labuang Baji hospital from March to September 2014. All subjects fulfilling the inclusion criteria were taken tissue samples from mothers experiencing spontaneous abortion and blood samples from normally born baby. The data were analyzed using Pearson chi-square with significant rate of 5% (