PENGARUH PAPARAN PARTIKULAT JELAGA TERHADAP PENINGKATAN LIPID PEROKSIDASE, KEJADIAN APOPTOSIS PLASENTA DAN LUARAN KEBUNTINGAN PADA MEKANISME MOLEKULER GANGGUAN KEBUNTINGAN TIKUS (Rattus novergicus)

Pencemaranudaramemberikanpengaruhburukterhadapkesehatanmanusia, tidakterkecualiterhadap proses kehamilandanluarankehamilantersebuLEfek yang ditimbulkan oJeh polutan tergantung dari besarnya pajanan (terkait dosislkadarnya di udara dan lama/waktu pajanan). Polutan berupa partikulat tersuspensiyang disebut juga Particulate Matter(PM) adalah salah satu komponen penting pada polusi udara terkait dengan pengaruhnya terhadap kesehatan. Jelaga (carbon black) merupakan salah satu komponen PM yang berpengaruh terhadap kesehatan karena bersifat sitotoksik dan genotoksik yang dapat memproduksi Reactive Oxygen Species (ROS), dapat mengalami translokasi ke dalam darah dan sistem kardiovaskuler serta dapat melalui plasenta sehingga berpengaruh pada perkembangan janindalam kandungan. ROS yang berada dalam tubuh akan memicu terjadinya suatu reaksi rantai yang disebut peroksidasi lipid dan akan menghasilkan senyawa berbahaya yang salah satu diantaranya adalah malondialdehyde (MDA) yang dapat merusak sel dan juga bersifat mutagenik dan genotoksik. Waktu antara konsepsi dan kelahiran diketahui merupakan satu tahapan kehidupan yang paling penting dalam perkembangan fetus, dimana pada rentang waktu tersebut faktor lingkungan bisa mempunyai pengaruh jangka panjang terhadap kesehatan manusia. Tujuan dilakukannya penelitian ini adalah untuk mempelajari pengaruh pemberian paparan partikulat jelaga (carbon black) terhadap kadar malodialdehyde (MDA) plasenta dan luaran kebuntingan pada tikus berupa berat plasenta, berat fetus, panjang fetus, persentase fetus hidup, persentase kematian intra uterin serta kecacatan eksternal terhadap fetus hidup dan mati

Pengaruh paparan partikulat jelaga terhadap peningkatan lipid peroksidase, kejadian apoptosis plasenta dan luaran kebuntingan pada mekanisme molekular gangguan kebuntingan tikus (Rattus norvegicus)

Partikulat jelaga merupakan salah satu komponen polutan pencemar udara yang diketahui bersifat sitotoksik. Efek yang ditimbulkan oleh polutan ini tergantung dari besarnya pajanan (terkait dosislkadarnya di udara) dan lamalwaktu pajanan. Penelitian ini bertujuan untuk mempelajari pengaruh pemberian paparan partikuiat jelaga pada dosis 532 mg/m3 dan 1064 mg/m3 dengan lama paparan 4 jam dan 8 jam terhadap mekanisme molekuler ganguan kebuntingan. Penelitian ini dilakukan berdasarkan tahapan sebagai berikut : eksplorasi dosis LD 50 dan teratogenik partikulat jelaga pada tikus bunting sebagai hewan model, pengukuran kadar Lipid Peroksidase dengan metode spektrofotometer, pemeriksaan pro-apoptosis Bax, anti-apoptosis Bcl-2, caspase 3, caspase 8 dengan metode immunohistokimia, pemeriksaan sitokin inflamasi NFkb, TNF alfa, MAPK dengan immunohistokimia, menghitung jurnlah sel macrophage sediaan histopatologi plasenta tikus setelah dipapar partikulat jelaga, pemeriksaan penempelan partikulat jelaga dengan elektron mikroskop Luaran penelitian ini adalah mengungkap mekanisme efek paparan partikulat jelaga terhadap mekanisme molekuler gangguan kebuntingan dan publikasi ilmiah di jumal intemasiona

Pengaruh paparan partikulat jelaga terhadap peningkatan lipid peroksidase, kejadian apoptosis plasenta dan luaran kebuntingan pada mekanisme molekular gangguan kebuntingan tikus (Rattus norvegicus)

Partikulat jelaga merupakan salah satu komponen polutan pencemar udara yang diketahui bersifat sitotoksik. Efek yang ditimbulkan oleh polutan ini tergantung dari besarnya pajanan (terkait dosislkadarnya di udara) dan lamalwaktu pajanan. Penelitian ini bertujuan untuk mempelajari pengaruh pemberian paparan partikuiat jelaga pada dosis 532 mg/m3 dan 1064 mg/m3 dengan lama paparan 4 jam dan 8 jam terhadap mekanisme molekuler ganguan kebuntingan. Penelitian ini dilakukan berdasarkan tahapan sebagai berikut : eksplorasi dosis LD 50 dan teratogenik partikulat jelaga pada tikus bunting sebagai hewan model, pengukuran kadar Lipid Peroksidase dengan metode spektrofotometer, pemeriksaan pro-apoptosis Bax, anti-apoptosis Bcl-2, caspase 3, caspase 8 dengan metode immunohistokimia, pemeriksaan sitokin inflamasi NFkb, TNF alfa, MAPK dengan immunohistokimia, menghitung jurnlah sel macrophage sediaan histopatologi plasenta tikus setelah dipapar partikulat jelaga, pemeriksaan penempelan partikulat jelaga dengan elektron mikroskop Luaran penelitian ini adalah mengungkap mekanisme efek paparan partikulat jelaga terhadap mekanisme molekuler gangguan kebuntingan dan publikasi ilmiah di jumal intemasiona

KARAKTERISTIK PREEKLAMSIA-EKLAMSIA INDONESIA SEBAGAI PENYEBAB UTAMA KEMATIAN IBU BERSALIN

Nampaknya berdasarkan pengamatan hasil penelitian preeklamsia sampai saat ini, strategi penelitian preeklamsia di Indonesia memasuki babak baru sesuai pemanfaatan aspek klinis penelitian yang diharapkan. Khususnya manfaat penelitian guna menunjang pelayanan yang mencakup penapisan, pencegahan serta terapi preeklamsia-eklamsia mengingat preeklamsia-eklamsia sebagai penyebab utama tingginya angka kematian ibu. Peran infeksi dalam patofisiologis preeklamsia-eklamsia telah dibuktikan terutama di negara berkembang yang beriklim tropis. Hasil penelitian yang konsisten berupa odds ratio yang signifikan serta antibodi spesifik yang ditemukan ditemukan dalam darah tali pusat ditunjukkan oleh beberapa penyakit infeksi pada kehamilan seperti infeksi periodontal, bakteriuri asimtomatik, infeksi saluran kemih dan vaginitis. Penelitian yang sedang berjalan (on going study) di RSU Dr. Soetomo Surabaya guna mengamati faktor infeksi sebagai risiko preeklamsia-eklamsia adalah kolaborasi studi dengan Adelaide University. Dari studi prospektif ini, sementara mengungkapkan 19 (14,25%) kasus di antara ibu preeklamsia menderita infeksi dental (17), infeksi saluran kencing (1) dan infeksi saluran pernafasan (1), bahkan di antaranya 54% penderita preeklamsia memperlihatkan higiene dental yang buruk

Transabdominal and transvaginal ultrasound findings help to guide the clinical management of placenta accreta spectrum cases

Introduction: The clinical management of placenta accreta spectrum (PAS) depends on placental topography and vascular involvement. Our aim was to determine whether transabdominal and transvaginal ultrasound signs can predict PAS management. Material and methods: We conducted a retrospective cohort study of consecutive prenatally suspected PAS cases in a single tertiary-care PAS center between January 2021 and July 2022. When PAS was confirmed during surgery, abdominal and transvaginal ultrasound scans were analyzed in relation to PAS management. The preferred surgical approach of PAS was one-step conservative surgery (OSCS). Massive blood loss and PAS topography in the lower bladder trigone necessitated cesarean hysterectomy. Transvaginal ultrasound-diagnosed intracervical hypervascularity was split into three categories based on their quantity. Anatomically, the internal cervical os is located at the level of the bladder trigone and was used as landmark for upper and lower bladder trigone PAS. Results:Ninety-one women underwent OSCS and 35 women underwent cesarean hysterectomy (total 126 women with PAS). Abdominal and transvaginal ultrasound features differed significantly between women that underwent OSCS and cesarean hysterectomy: decreased myometrial thickness (&lt;1 mm), 82.4% vs. 100%, p = 0.006; placental bulge, 51.6% vs. 94.3%, p &lt; 0.001; bladder wall interruption, 62.6% vs. 97.1%, p &lt; 0.001; abnormal placental lacunae, 75.8% vs. 100%, p &lt; 0.001; hypervascularity (large lacunae feeding vessels, 57.8% vs. 94.6%, p &lt; 0.001; parametrial hypervascularity, 15.4% vs. 60%, p &lt; 0.001; the rail sign, 6.6% vs. 28.6%, p = 0.003; three-dimensional Doppler intra-placental hypervascularity, 81.3% vs. 100%, p &lt; 0.001; intracervical hypervascularity 60.4% vs. 94.3%, p &lt; 0.001); and cervical length 2.5 ± 0.94 vs. 2.2 ± 0.73, p = 0.038. Other ultrasound signs were not significantly different. The results of multivariable logistic regression showed placental bulge (odds ratio [OR] 9.3; 95% CI 1.9–44.3; p = 0.005), parametrial hypervascularity (OR 4.1; 95% CI 1.541–11.085; p = 0.005), and intracervical hypervascularity (OR 9.2; 95% CI 1.905–44.056; p = 0.006) were weak predictors of OSCS. Intracervical hypervascularity Grade 1 (vascularity &lt;50% of cervical tissue) was more present in OSCS than higher gradings two and three (91% vs. 27.6% vs. 14.3%; p &lt; 0.001). Conclusions: Cesarean hysterectomy is associated with the PAS signs of placental bulge and Grade 2 and 3 intracervical hypervascularity. OSCS is associated with intracervical hypervascularity Grade 1 on transvaginal ultrasound. Prospective validation is required to formulate predictors for PAS management.</p

Decidual killer immunoglobulin-like receptor (kir)2dl1 expression and the onset of preeclampsia, birth weight and placental weight in early and late onset preeclampsia

Introduction Successful remodelling of spiral artery ensures adequate uteroplacental perfusion and sufficient nutrient supply to the fetus. HLA-C interaction with maternal KIR determines the outcome of spiral artery remodelling. Strong inhibitory KIR2DL1 lower the expression of cytokines and angiogenic factors affecting uteroplacental perfusion and nutrient supply. Material and methods We analysed the decidual expression of KIR2DL1 in early and late preeclampsia groups by quantitative immunohistochemistry using anti human-KIR2DL1/CD158a antibody and its correlation with preeclampsia onset, birth weight and placental weight. 35 patients, 14 patients with early onset preeclampsia (EO-PE) and 21 with late preeclampsia (LO-PE) were analysed. Result There was a significant difference between the expression of KIR2DL1 between the EO-PE and LO-PE group (p < 0,001) with a strong negative correlation between decidual expression of KIR2DL1 and preeclampsia onset (p < 0,001, r = −0,723), birth weight (p < 0,001, r = −0,770) and placental weight (p < 0,001, r = −0,770). Conclusion In patients with EO-PE, the higher placental of KIR2DL1 and inhibitory KIR2DL1 contributes to earlier onset of preeclampsia, lower birth weight of the baby and low placental weight. The strong negative correlation might be due to much lower expression of cytokines and angiogenic factors in higher KIR2DL1 expression samples. The different expression of KIR2DL1 between EO-PE and LO-PE is in line with current concepts on different pathophysiologic pathway leading to these different PE phenotypes

Decidual killer immunoglobulin-like receptor (kir)2dl1 expression and the onset of preeclampsia, birth weight and placental weight in early and late onset preeclampsia

Introduction Successful remodelling of spiral artery ensures adequate uteroplacental perfusion and sufficient nutrient supply to the fetus. HLA-C interaction with maternal KIR determines the outcome of spiral artery remodelling. Strong inhibitory KIR2DL1 lower the expression of cytokines and angiogenic factors affecting uteroplacental perfusion and nutrient supply. Material and methods We analysed the decidual expression of KIR2DL1 in early and late preeclampsia groups by quantitative immunohistochemistry using anti human-KIR2DL1/CD158a antibody and its correlation with preeclampsia onset, birth weight and placental weight. 35 patients, 14 patients with early onset preeclampsia (EO-PE) and 21 with late preeclampsia (LO-PE) were analysed. Result There was a significant difference between the expression of KIR2DL1 between the EO-PE and LO-PE group (p < 0,001) with a strong negative correlation between decidual expression of KIR2DL1 and preeclampsia onset (p < 0,001, r = −0,723), birth weight (p < 0,001, r = −0,770) and placental weight (p < 0,001, r = −0,770). Conclusion In patients with EO-PE, the higher placental of KIR2DL1 and inhibitory KIR2DL1 contributes to earlier onset of preeclampsia, lower birth weight of the baby and low placental weight. The strong negative correlation might be due to much lower expression of cytokines and angiogenic factors in higher KIR2DL1 expression samples. The different expression of KIR2DL1 between EO-PE and LO-PE is in line with current concepts on different pathophysiologic pathway leading to these different PE phenotypes

Characteristics shifting of heart disease in pregnancy: A report from low middle-income country

Background: Heart disease in pregnancy is one of the leading causes of maternal mortality and morbidity in developing countries. However, the characteristics of the disease vary between countries and regions. This study aimed to present the characteristics of pregnant women with heart disease in an economically advantageous region of a developing country. Design and methods: A cross-sectional study was conducted using data from the Weekly Report of Obstetrics and Gynaecology Department to assess pregnant women with heart disease characteristics and pregnancy outcomes. A total sample of 69 pregnant women with heart disease regarding their gestational age was included in the study. Variables observed were maternal characteristics, heart disease's clinical parameters, and maternal and neonatal outcomes. Chi-square test was used to examine the different characteristics of congenital and acquired heart disease groups. Results: The prevalence of cardiac disease in pregnancy was 5.19%. Fifty-three point six percent of pregnant women with heart disease were suffered from congenital heart disease (CHD), while 46.4% were acquired heart disease (AHD). Most labor methods were Cesarean delivery, and 69.6% of women experienced cardiac complications. Maternal death was reported in 8.69% of cases. Four cases were CHD complicated by pulmonary hypertension, which leads to Eisenmenger syndrome. Two other cases were AHD complicated by Peripartum Cardiomyopathies. Although statistically insignificant, complications are more common in the AHD group than CHD. Conclusion: Cardiac disease prevalence in pregnancy is considered high, with CHD as the most common case, which significantly differs from other developing countries

Effects of Hyperbaric Oxygen Therapy on II-17, Fetal Body Weight and Total Fetus in Pregnant Rattus Norvegicus Infected with Tachyzoite Toxoplasma Gondii

IL-17 in Toxoplasma gondii infection has an important role in miscarriage and low birth weight with many negative effects. This study explains the effect of hyperbaric oxygen (HBO2) administration on fetal body weight and IL-17 pregnant female rat levels. Rattus norvegicus were divided into four groups. IL-17 concentration was measured by serum ELISA. There was statistically significant reduction of IL-17 levels (79.42±30.36, 125.46±60.05, 201.17±70.33, 158.76±58.48, p = 0.001 for pregnant rats infected by Tachyzoite with HBO2 group, pregnant rats non-infected by Tachyzoit with HBO2 group, pregnant and infected without HBO2 group, and negative control, respectively). Although, there was no significant difference in the number of fetuses among groups (p = 0.096). The HBO2 treatment group had the heaviest of fetal weight among groups (0.98 [0.30 – 6.22] gram, p = 0.046). The results of the Spearman correlation test showed that only group B had a significant negative relationship between IL17 concentration and the mean fetal weight (p = 0.001). HBO2 therapy was found to be able to reduce IL-17 levels and result in rising of fetal weight in pregnant Rattus norvegicus and might prevent the occurrence of abortion. Key words: Toxoplasma gondii, Tachyzoite, HBO2, IL-17, Fetal Weight, Pregnant Rat

Lesson from Indonesia: Covid-19 Testing Strategy In Obstetric Emergency Cases At Low-Resource Health Care Setting

Background: COVID-19 identification in obstetric emergency cases with limited resources is problematic, particularly in asymptomatic cases. Aim: To examine the screening strategies of COVID-19 obstetric emergency cases in low-resource health care settings. Method: A retrospective cohort design was carried out on patients with COVID-19 positive screening results. It was assessed based on symptoms, contact history, lymphocytopenia, chest X-rays, and rapid antibody tests compared to RT-PCR results SARS-COV-2. Result: Out of the 190 cases that came to the delivery room, the staff suspected 69 COVID-19 cases (36.3%) through the first screening protocol. Positive SARS-COV-2 RT-PCR was found in 23 cases with a majority asymptomatic (52.2%). The percentages of sensitivity and specificity from the parameters as follow: 48% and 74% in COVID-19 symptoms (febris or respiratory symptoms); 9% and 100% in contact history; 22% and 83% in lymphocytopenia; 52% and 48% in chest x-ray; 78% and 30% in rapid antibody test. Rapid antibody tests have the highest sensitivity to increase the identification of 12 asymptomatic cases. Conclusion: Other screening beyond symptoms and contact history such as lymphocytopenia, chest x-ray, and rapid antibody test can improve the identification, especially for asymptomatic cases in areas with the limited testing ability and high Covid-19 transmission