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-

Helminth Infection in Pregnancy: Effect on Serum Albumin Level and Pregnancy outcome

Objective: To determine the prevalence of helminth infection in pregnant women and its effect on albumin levels and pregnancy outcome. Method: A prospective cohort study was conducted on third trimester pregnant women presenting for antenatal care in several hospitals in Makassar. Information on subject demography was recorded using short questionnaire. Stool samples were collected to determine the presence of helminth infection. Albumin levels were measured from maternal blood and cord‐blood. Outcome of pregnancy was assessed upon delivery. Result: The prevalence of helminth infection in our subjects was 22.8%. Among 21 infected women, 17 were infected with Ascaris lumbricoides (80.9%), one with Trichuris trichiura and three with both Ascaris and Trichuris. The mean Ascaris lumbricoides intensity was 1769.3 epg (Range = 24‐11.688 epg). Helminth infections have no effect on either maternal or neonatal albumin levels (p=0.748 and p=0.480, respectively). Although it was not found to be significant (p>0.05), helminth infection seems to affect gestational age (OR 2.06, 95% CI 1.48‐2.86) and birth weight (OR 2.18, 95% CI 1.52‐3.14). Neonatal albumin level and pregnancy outcome were not affected by maternal albumin level. Conclusion: Helminth infection seems to affect pregnancy outcome in pregnant women in Makassar, but not through influence of albumin. Factors other than albumin level may responsible for such condition

The Association of Creactive Protein Levels in Second Trimester of Pregnancy with Preeclampsia

Objective: To determine C-reactive protein in second trimester of pregnancy women who preeclamptic and non-preeclamptic women, and to determine the relationship between the level of C-Reactive protein of trimester two pregnancy and preeclampsia occurrence. Methods: This was a prospective study conducted at the policlinics of network of academic hospitals of the Department of Obstetrics and Gynecology of Faculty of Medicine, Universitas Hasanuddin and policlinic of child and mother, and some Public Health Centers in Makassar city from September 2015 - April 2016. The C-reactive protein 115 level of pregnant women in pregnancy age of 24-28 weeks was checked, whether the subjects underwent preeclampsia until the childbirth process. Statistics analysis used Fisher’s exact test and Mann Whitney test. Results: The result indicate that 9 subjects (7.8%) developed preeclampsia and 106 subjects did not become preeclampsia. The level of C-Reactive protein increased in preeclampsia group compared to non preeclampsia group i.e 5.05  1.153 : 3.36  0.265, but statistically the result is not significant (value p>0.05). Conclusion: The average score of C-Reactive protein of preeclampsia group is 33.5% higher than non-preeclampsia group, even though these results cannot be used as the score to predict the preeclampsia occurrence. Keywords: C-reactive protein, preeclampsia, second trimester pregnanc

Obstetric Risk Factors and Anal Incontinence among Women with Previous History of Vaginal Delivery

Objective: To investigate the obstetric risk factors of the anal incontinence in mothers with previous history of vaginal delivery. Methods: The was a case-control study conducted in the Obstetrics and Gynecology Department of Dr.Wahidin Sudirohusodo Hospital, Faculty of Medicine, Universitas Hasanuddin, Makassar, during the period of February 2015 through January 2016. The research instruments were used to evaluate obstetric risk factors and the anal incontinence was the self-administered questionnaire and Fecal Incontinence Severity Index. The data were analyzed statistically using the Chi-square test with the significant value of p<0.05. Results: A total of 300 subjects were recruited in this study. The research results indicated that the parity of  3, the assisted vaginal delivery history (vacuum extraction), and the prolong second stage of labor had a significant correlation with the anal incontinence with p value=0.026, OR (95% CI) = 1.8 (1.07-3.03), p=0.018 with OR (95% CI) =3.65 (1.2-10.7) and p=0.006 with OR (95% CI) = 2.9 (1.2-6.7).The history of episiotomy and the delivery of the baby  4000 gram had no correlation with the anal incontinence. Conclusion: Parity, vacuum delivery and prolong second stage of labor have an association with anal incontinence among women who has history of vaginal delivery. Keywords: anal incontinence, obstetric risk factors, vaginal deliver

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

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.&nbsp; Keywords: HBV DNA, Hepatitis B, intrauterine infection, placental toll-like receptor (TLR) 7,umbilical cord. &nbsp; 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.&nbsp; Kata kunci: HBV DNA, Hepatitis B, infeksi intrauterina, plasenta, tali pusat, &nbsp;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&nbsp; 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&nbsp; 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

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 Risk of Infection Human Papilloma Virus Infection in Acceptors of Depot Medroxyprogesterone Acetate Contraceptions

Objective: Cervical cancer is the second most prevalent cancer in women around the world and the most common cancer in women causing death. This study aims to analyze the connection between infection of human papilloma virus (HPV) 16/18 and cervical changes in the acceptors of Depot Medroxyprogesterone Acetate (DMPA) Contraceptions and nonacceptors of Depot Medroxyprogesterone Acetate (DMPA) Contraceptions. Methods: The research was conducted at the Public Service Institution of Dr. Wahidin Sudirohusodo hospital, and private midwife clinics for seven months from December 2015 to June 2016. The research design is cross-sectional with. The samples were forty acceptors of Depot Medroxyprogesterone Acetate (DMPA) and forty non-acceptors of Depot Medroxyprogesterone Acetate (DMPA) contraception. Prevalence of HPV 16/18 and cervical cytology changes were examine using the polymerase chain reaction and liquid base cervical cytology. Results: The results showed there was no significant relationship between long-term use of DMPA contraceptives with HPV 16 and 18. There was no significant relationship between long-term use of DMPA contraceptives with cervical cytology changes. There was no significant relationship between HPV 16 and 18 infections with the occurrence of cervical cytology changes in long-term use of DMPA contraceptives. Conclusion: The long-term use of DMPA contraceptive does not increase the risk of HPV 16 and 18 infections. Also does not cause cervical cytology changes that lead to cervical malignancy. Keywords: cervical cytology changes, Depot Medroxyprogesterone Acetate (DMPA) contraception, HPV 16/18 infectio

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%; &lt;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 &lt;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: &nbsp;&nbsp; Perempuan menopause dengan POP memiliki perineal body yang lebih pendek (63,3%; &lt;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 &lt;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