Diagnostic tests of placenta accreta index score (PAIS) as supporting prenatal diagnosis and outcomes of maternal neonatal in abnormally invasive placenta management at general hospital of Hasan Sadikin Bandung

Background: The incidence of abnormally invasive placenta increases tenfold as the number of caesarian section increases in the past 50 years. Placenta previa accreta is strongly associated with massive bleeding and leads to maternal death. Prenatal diagnosis helps in planning the delivery to reduce the risk of bleeding and possible complications. This study aims to find out diagnostic value of Placenta Accreta Index Score (PAIS) as supporting tool in prenatal diagnostic of abnormally invasive placenta.Methods: The diagnostic test was undertaken in May 2017 at General Hospital of Hasan Sadikin, identifying patients with placenta previa with history of caesarian section between May 2016-May 2017. PAIS were obtained and compared with histopathological findings.Results: Among 21 placenta previa patients with post caesarian section, 10 (47.6%) of them histopathologically proven as abnormally invasive placenta. With statistical analysis accuracy values obtained PAIS and histopathological findings in patient with placenta previa is 0.762 (good). Diagnostic value of PAIS with histopathological findings in placenta previa patient had a sensitivity 70%, a specificity 81,8%, positive predictive value (PPV) 77.8%, and negative predictive value (NPV) 75% by PAIS cut off point is 3.125. No maternal death. Mean duration of postoperative care was 5 days. Average total bleeding during surgery is 2622 ml with lowest postoperative hemoglobin 8.36g/dl. All babies born with appropriate to gestational birth weight with average first minute APGAR was 7 and without fetal anemia.Conclusions: PAIS can be used to help to predict the risk of abnormally

Soursop Leaves (Annona muricata Folium) on Mice (Mus musculus) Fetus

Background: Soursop leaf ethanol extract (Annona muricata (L) Folium) contains acetogenins which are cytotoxic and have the ability to halt cell growth. This study aimed to understand whether acetogenins have teratogenic effects on mice fetus (Mus musculus).Methods: This study was performed at the Pharmacology and Therapy Laboratory of the Faculty of Medicine, Universitas Padjadjaran, Bandung, between October and November 2012. The study  was an experimental laboratory study  utilizing 27 pregnant mice which were divided into 3 groups. The first group was the negative control, the second was given soursop leaf ethanol extract at pre-implantation phase (day 1 to 5) and the third had the extract provided in the organogenesis phase (day 6 to 15). Laparotomy was performed on the 19th day of pregnancy. The parameters used were the number of implantation, the number of live and dead or resorbed fetus, the weight and length of the fetus, as well as the macroscopic external morphology abnormalities. The data gained from test subjects were compared to those of the control group. The statistical test used was the normality tes with the Kolmogorov-Smirnov method which was then followed by T-test or Mann-Whitney statistical tests.Results: The experiment exhibited significant differences in the weight and length of the fetus (p-value 0.000), proving that soursop leaf ethanol extract could inhibit intrauterine growth. Aside from that, external morphological abnormalities such as hemorrhage on the head, face, neck, back, forelimbs, hindlimbs, and microcephaly were also found.Conclusion: The soursop leaf ethanol extract (Annona muricata (L) Folium) has a teratogenic effect on mouse (Mus musculus) fetus. [AMJ.2014;1(1):48–53]Key words: Acetogenins, Soursop leaf ethanol extract, TeratogenicEfek Teratogenik Ekstrak Etanol Daun Sirsak (Annona muricata Folium) terhadap Fetus Mencit (Mus musculus) Latar belakang: Ekstrak etanol daun sirsak (Annona muricata Folium) mengandung senyawa aktif Acetogenins yang bersifat sitotoksik atau dapat menghambat pertumbuhan sel. Penelitian ini dilakukan untuk mengetahui efek teratogenik Acetogenins terhadap fetus mencit (Mus musculus).Metode: Penelitian ini dilakukan di Laboratorium Farmakologi dan Terapi Fakultas Kedokteran Universitas Padjadaran periode Oktober–November 2012. Penelitian bersifat eksperimental laboratorik dengan metode sampel acak menggunakan 27 ekor mencit hamil yang dibagi dalam 3 kelompok. Kelompok 1 sebagai kontrol negatif, kelompok 2 diberikan ekstrak etanol daun sirsak pada masa praimplantasi (hari ke-1 sampai ke-5), dan kelompok 3 menerima ekstrak pada masa organogenesis (hari ke-6 sampai ke-15). Laparotomi dilakukan pada hari ke-19 kehamilan. Parameter yang digunakan berupa jumlah hasil implantasi, jumlah fetus hidup, jumlah fetus mati atau resorbsi, berat dan panjang badan fetus, serta abnormalitas morfologi eksternal fetus yang dinilai secara makroskopis. Data yang didapat pada kelompok perlakuan dibandingkan dengan kelompok kontrol. Uji statistik yang digunakan adalah uji normalitas data dengan uji Kolmogorov-Smirnov dan dilanjutkan dengan uji T- atau Mann-Whitney.Hasil: Hasil penelitian menunjukkan perbedaan signifikan pada berat dan panjang fetus mencit (nilai p 0,000), sehingga ekstrak etanol daun sirsak terbukti menghambat pertumbuhan intrauteri. Selain itu ditemukan juga kelainan morfologi eksternal seperti perdarahan pada kepala, wajah, leher, punggung, tangan, kaki, dan mikrosefali.Simpulan: Ekstrak etanol daun sirsak (Annona muricata Folium) memiliki efek teratogenik terhadap fetus mencit (Mus musculus).Kata kunci: Acetogenins, ekstrak etanol daun sirsak, teratogenik DOI: 10.15850/amj.v1n1.29

Serum Adiponectin Level is Lower in Patients with Endometriotic Cyst

Objectives: To analyse the difference of serum adiponectin level between patients with endometriotic cyst and those with non-endometriotic cyst, and its difference between endometriosis stages. Methods: This is a cross-sectional comparative analytical study involving 25 women with endometriotic cyst and 25 women with nonendometriotic cyst, which had undergone laparoscopy or laparotomy surgery. Blood samples were withdrawn and checked for serum adiponectin level in PRODIA laboratory in Jakarta. Serum adiponectin level of both groups were then measured and compared. The study was conducted in Dr. Hasan Sadikin Hospital in September- December 2012. Results: Shows no significant difference in subjects’ characteristic which are age (p = 0.994) and BMI (p = 0.267). There is a significant difference (p < 0.0001) between serum adiponectin level in endometriosis group (mean = 3.91 ± 1.976) with level of which in nonendometriosis group (mean = 8.59 ± 1.977). There is no significant difference (p = 0.384) of serum adiponectin level between stage III endometriosis (mean = 4.24 ± 1.8168) and stage IV endometriosis (mean = 3.54 ± 2.1531). Conclusion: Serum adiponectin level in patients with endometriotic cyst is significantly lower compared to level of which in patients with non-endometriotic cyst. There is no significant difference of serum adiponectin level between endometriosis stages. [Indones J Obstet Gynecol 2013; 1-3: 119-23] Keywords: adiponectin, endometriotic cyst, non-endometriotic cyst, endometriosis stag

The Hemoglobin Levels and Hematocrit Decrement is less in Severe Preeclampsia Patients Undergoing Caesarean Section with B-Lynch as Prophylaxis

Objective: To analyze the differences between the reduction in hemoglobin and hematocrit level in severe preeclampsia patients who have had Caesarean section with and without B-Lynch prophylaxis. Method: The design of the study was an experimental analytic with Randomized Control Trial (RCT). Thirty patients who came to Dr. Hasan Sadikin Hospital, Soreang Hospital, and Cibabat Hospital during 11 July - 25 September 2012 and met inclusion criteria were selected and divided into two groups. The first group were caesarean section with B-Lynch prophylaxis, the second one were without BLynch prophylaxis. The sample were taken with simple random sampling. Each patient were examined for hemoglobin and hematocrit level before and 6 hour after C section. The data was analyzed by t-test and Mann Whitney test. Result: There were significant differences (p <0.05) on the decrease of hemoglobin and hematocrit level between patient who were performed B-Lynch prophylaxis and those who were not (7.98% vs 19.75%; p = 0.001 and 9.02% vs 18.28%, p = 0.013, respectively). Conclusion: The decreasing hemoglobin and hematocrit level before and 6 hour after C section is less in patient with severe preeclampsia who had caesarean section with B-Lynch prophylaxis compared to cesarean section without B-Lynch prophylaxis. [Indones J Obstet Gynecol 2013; 1-3: 139-44] Keywords: B-Lynch, postpartum haemorrhage, preeclampsi

Soursop Leaves (Annona muricata Folium) on Mice (Mus musculus) Fetus

Background: Soursop leaf ethanol extract (Annona muricata (L) Folium) contains acetogenins which are cytotoxic and have the ability to halt cell growth. This study aimed to understand whether acetogenins have teratogenic effects on mice fetus (Mus musculus).Methods: This study was performed at the Pharmacology and Therapy Laboratory of the Faculty of Medicine, Universitas Padjadjaran, Bandung, between October and November 2012. The study  was an experimental laboratory study  utilizing 27 pregnant mice which were divided into 3 groups. The first group was the negative control, the second was given soursop leaf ethanol extract at pre-implantation phase (day 1 to 5) and the third had the extract provided in the organogenesis phase (day 6 to 15). Laparotomy was performed on the 19th day of pregnancy. The parameters used were the number of implantation, the number of live and dead or resorbed fetus, the weight and length of the fetus, as well as the macroscopic external morphology abnormalities. The data gained from test subjects were compared to those of the control group. The statistical test used was the normality tes with the Kolmogorov-Smirnov method which was then followed by T-test or Mann-Whitney statistical tests.Results: The experiment exhibited significant differences in the weight and length of the fetus (p-value 0.000), proving that soursop leaf ethanol extract could inhibit intrauterine growth. Aside from that, external morphological abnormalities such as hemorrhage on the head, face, neck, back, forelimbs, hindlimbs, and microcephaly were also found.Conclusion: The soursop leaf ethanol extract (Annona muricata (L) Folium) has a teratogenic effect on mouse (Mus musculus) fetus. [AMJ.2014;1(1):48–53]Key words: Acetogenins, Soursop leaf ethanol extract, TeratogenicEfek Teratogenik Ekstrak Etanol Daun Sirsak (Annona muricata Folium) terhadap Fetus Mencit (Mus musculus) Latar belakang: Ekstrak etanol daun sirsak (Annona muricata Folium) mengandung senyawa aktif Acetogenins yang bersifat sitotoksik atau dapat menghambat pertumbuhan sel. Penelitian ini dilakukan untuk mengetahui efek teratogenik Acetogenins terhadap fetus mencit (Mus musculus).Metode: Penelitian ini dilakukan di Laboratorium Farmakologi dan Terapi Fakultas Kedokteran Universitas Padjadaran periode Oktober–November 2012. Penelitian bersifat eksperimental laboratorik dengan metode sampel acak menggunakan 27 ekor mencit hamil yang dibagi dalam 3 kelompok. Kelompok 1 sebagai kontrol negatif, kelompok 2 diberikan ekstrak etanol daun sirsak pada masa praimplantasi (hari ke-1 sampai ke-5), dan kelompok 3 menerima ekstrak pada masa organogenesis (hari ke-6 sampai ke-15). Laparotomi dilakukan pada hari ke-19 kehamilan. Parameter yang digunakan berupa jumlah hasil implantasi, jumlah fetus hidup, jumlah fetus mati atau resorbsi, berat dan panjang badan fetus, serta abnormalitas morfologi eksternal fetus yang dinilai secara makroskopis. Data yang didapat pada kelompok perlakuan dibandingkan dengan kelompok kontrol. Uji statistik yang digunakan adalah uji normalitas data dengan uji Kolmogorov-Smirnov dan dilanjutkan dengan uji T- atau Mann-Whitney.Hasil: Hasil penelitian menunjukkan perbedaan signifikan pada berat dan panjang fetus mencit (nilai p 0,000), sehingga ekstrak etanol daun sirsak terbukti menghambat pertumbuhan intrauteri. Selain itu ditemukan juga kelainan morfologi eksternal seperti perdarahan pada kepala, wajah, leher, punggung, tangan, kaki, dan mikrosefali.Simpulan: Ekstrak etanol daun sirsak (Annona muricata Folium) memiliki efek teratogenik terhadap fetus mencit (Mus musculus).Kata kunci: Acetogenins, ekstrak etanol daun sirsak, teratogenik DOI: 10.15850/amj.v1n1.29

Relationship between Maternal Vitamin D Level and Small for Gestational Age Infant in West Java, Indonesia

Small for gestational age (SGA) infants is one of the unfavorable outcomes of pregnancy that needs to be prevented. There are not many studies available on the association of maternal vitamin D levels during pregnancy and SGA infants. This study aimed to discover the association between maternal vitamin D level and SGA infants in West Java. A cohort study was performed from February 2018 to January 2019 by recruiting 304 pregnant women in Bandung, Cimahi, Waled, and Sukabumi, West Java Province, Indonesia. Of that number, 203 women were followed until the delivery date. Data were collected from the results of serial ultrasonography examinations and maternal vitamin D level measurements. Bivariate analysis and logistic regression were then performed to determine the relationship between variables. This study showed that 30 of 203 (14.78%) infants were born as SGA infants. The mothers of these SGA infants had a lower maternal vitamin D level at the beginning of the second trimester and smaller anthropometric measurements at the beginning of the third trimester. However, no significant difference was found between normal infants and SGA infants when the overall values for all trimesters were compared. It can be inferred that the maternal vitamin D level has a negative relationship with SGA infants in West Java, Indonesia. Further studies are required to prove the relationship between maternal vitamin Dl level and SGA infants.Hubungan Kadar Vitamin D Ibu dan Bayi Kecil Masa Kehamilan di Jawa BaratBayi kecil masa kehamilan (KMK) adalah luaran kehamilan yang perlu dicegah. Informasi tentang hubungan kadar vitamin D ibu dengan kejadian bayi KMK di Indonesia masih terbatas. Kadar vitamin D dan karakteristik ibu diduga berpengaruh dalam kejadian bayi KMK. Tujuan penelitian ini adalah mengetahui hubungan kadar vitamin D ibu dengan kejadian KMK pada bayi. Studi kohort dilakukan dari Februari 2018 hingga Januari 2019 dengan merekrut 304 ibu hamil di Bandung, Cimahi, Waled, dan Sukabumi, Provinsi Jawa Barat, Indonesia.  Dari jumlah 203 orang diantaranya berhasil diikuti sejak trimester satu hingga persalinan dan terpilih menjadi  subjek penelitian kasus kontrol. Pemeriksaan ultrasonografi, kadar vitamin D dan hemoglobin ibu dilakukan serial tiap trimester. Dilakukan analisis bivariat dan regresi logistik untuk menentukan hubungan antar variabel yang diteliti. Dari penelitian ini didapatkan sebanyak 30 dari 203 (14,78%) persalinan  dengan luaran bayi KMK.  Bayi KMK cenderung  mempunyai riwayat kadar vitamin  D yang lebih rendah pada awal trimester kedua dan hasil antropometri yang lebih rendah pada awal trimester tiga, namun secara statistik tidak berbeda signifikan. Simpulan penelitian ini bahwa kadar vitamin D ibu hamil memiliki korelasi negatif dengan bayi KMK. Penelitian lebih lanjut diperlukan untuk membuktikan hubungan antara kadar vitamin D ibu dan bayi KMK.

Soursop Leaves (Annona muricata Folium) on Mice (Mus musculus) Fetus

Background: Soursop leaf ethanol extract (Annona muricata (L) Folium) contains acetogenins which are cytotoxic and have the ability to halt cell growth. This study aimed to understand whether acetogenins have teratogenic effects on mice fetus (Mus musculus). Methods: This study was performed at the Pharmacology and Therapy Laboratory of the Faculty of Medicine, Universitas Padjadjaran, Bandung, between October and November 2012. The study was an experimental laboratory study utilizing 27 pregnant mice which were divided into 3 groups. The first group was the negative control, the second was given soursop leaf ethanol extract at pre-implantation phase (day 1 to 5) and the third had the extract provided in the organogenesis phase (day 6 to 15). Laparotomy was performed on the 19th day of pregnancy. The parameters used were the number of implantation, the number of live and dead or resorbed fetus, the weight and length of the fetus, as well as the macroscopic external morphology abnormalities. The data gained from test subjects were compared to those of the control group. The statistical test used was the normality tes with the Kolmogorov-Smirnov method which was then followed by T-test or Mann-Whitney statistical tests. Results: The experiment exhibited significant differences in the weight and length of the fetus (p-value 0.000), proving that soursop leaf ethanol extract could inhibit intrauterine growth. Aside from that, external morphological abnormalities such as hemorrhage on the head, face, neck, back, forelimbs, hindlimbs, and microcephaly were also found. Conclusion: The soursop leaf ethanol extract (Annona muricata (L) Folium) has a teratogenic effect on mouse (Mus musculus) fetus. [AMJ.2014;1(1):48–53

Relationship between Maternal Vitamin D Level and Small for Gestational Age Infant in West Java, Indonesia

Small for gestational age (SGA) infants is one of the unfavorable outcomes of pregnancy that needs to be prevented. There are not many studies available on the association of maternal vitamin D levels during pregnancy and SGA infants. This study aimed to discover the association between maternal vitamin D level and SGA infants in West Java. A cohort study was performed from February 2018 to January 2019 by recruiting 304 pregnant women in Bandung, Cimahi, Waled, and Sukabumi, West Java Province, Indonesia. Of that number, 203 women were followed until the delivery date. Data were collected from the results of serial ultrasonography examinations and maternal vitamin D level measurements. Bivariate analysis and logistic regression were then performed to determine the relationship between variables. This study showed that 30 of 203 (14.78%) infants were born as SGA infants. The mothers of these SGA infants had a lower maternal vitamin D level at the beginning of the second trimester and smaller anthropometric measurements at the beginning of the third trimester. However, no significant difference was found between normal infants and SGA infants when the overall values for all trimesters were compared. It can be inferred that the maternal vitamin D level has a negative relationship with SGA infants in West Java, Indonesia. Further studies are required to prove the relationship between maternal vitamin Dl level and SGA infants.Hubungan Kadar Vitamin D Ibu dan Bayi Kecil Masa Kehamilan di Jawa BaratBayi kecil masa kehamilan (KMK) adalah luaran kehamilan yang perlu dicegah. Informasi tentang hubungan kadar vitamin D ibu dengan kejadian bayi KMK di Indonesia masih terbatas. Kadar vitamin D dan karakteristik ibu diduga berpengaruh dalam kejadian bayi KMK. Tujuan penelitian ini adalah mengetahui hubungan kadar vitamin D ibu dengan kejadian KMK pada bayi. Studi kohort dilakukan dari Februari 2018 hingga Januari 2019 dengan merekrut 304 ibu hamil di Bandung, Cimahi, Waled, dan Sukabumi, Provinsi Jawa Barat, Indonesia.  Dari jumlah 203 orang diantaranya berhasil diikuti sejak trimester satu hingga persalinan dan terpilih menjadi  subjek penelitian kasus kontrol. Pemeriksaan ultrasonografi, kadar vitamin D dan hemoglobin ibu dilakukan serial tiap trimester. Dilakukan analisis bivariat dan regresi logistik untuk menentukan hubungan antar variabel yang diteliti. Dari penelitian ini didapatkan sebanyak 30 dari 203 (14,78%) persalinan  dengan luaran bayi KMK.  Bayi KMK cenderung  mempunyai riwayat kadar vitamin  D yang lebih rendah pada awal trimester kedua dan hasil antropometri yang lebih rendah pada awal trimester tiga, namun secara statistik tidak berbeda signifikan. Simpulan penelitian ini bahwa kadar vitamin D ibu hamil memiliki korelasi negatif dengan bayi KMK. Penelitian lebih lanjut diperlukan untuk membuktikan hubungan antara kadar vitamin D ibu dan bayi KMK.

Comparison of Vitamin D₃ Serum and Method of Deliveries among Pregnant Women Who Did and Did not Performe Regular Outdoor Aerobic Activities

The maternal mortality rate in Indonesia is still very high. One of the main factors is postpartum hemorrhage and an increase in the cesarean section rate (CSR). The American College of Obstetrics and Gynecology has recommended aerobic exercise. We assumed that outdoor aerobic exercise could be useful for the advancement of labor and the reduction of CSR. This study aimed to assess whether regular exercise can have a good impact on reducing labor and CSR, which is likely to be affected by an increase in vitamin D3 levels. It was an experimental study involving 40 patients at Al Islam Awibitung Hospital and Ibrahim Adjie Healthcare Center in Bandung in February–April 2018, who met the inclusion criteria and divided into two groups, who performed regular outdoor aerobic activity and those who did not. Patient characteristics, work progress, and vitamin D3 levels recorded. The data collected was then tested and compared between pre-and post-treatment, a paired t test was done. There was a relationship between the increase in-vitamin D3 and the ease of childbirth in the treatment group (p<0.05). The comparison of vitamin D3 levels among the two groups was −18.8% vs −26.8% respectively (p<0.05). Method of delivery were spontaneous delivery 80% vs 25%, vacuum extraction 15% vs 55%, and cesarean section 5% vs 20%, respectively (p<0.05). In conclusion that regular outdoor aerobic exercise in a pregnant woman could increase vitamin D3 levels, ease labor, and reduce CSR.   PERBANDINGAN KADAR VITAMIN D3 SERUM DAN METODE PERSALINAN ANTARA IBU HAMIL YANG MENJALANKAN DAN TIDAK MENJALANKAN AKTIVITAS AEROBIK DI RUANG TERBUKA SECARA RUTIN Saat ini angka kematian maternal di Indonesia masih sangat tinggi. Salah satu faktor penyebab utama adalah perdarahan pasca salin dan meningkatnya insidensi seksio sesarea. Aktivitas aerobik telah direkomendasikan oleh American College of Obstetrics and Gynecology (ACOG). Kami mempunyai hipotesis bahwa aktivitas aerobik rutin di udara terbuka dapat memengaruhi kadar vitamin D3 serum ibu yang dapat meningkatkan kelancaran persalinan dan menurunkan risiko seksio sesarea. Penelitian ini bertujuan membuktikan hipotesis di atas. Metode penelitian adalah studi eksperimental terhadap 40 ibu hamil di RS Al Islam Awibitung dan Puskesmas Ibrahim Adjie Bandung pada bulan Februari–April 2018 yang memenuhi kriteria inklusi, serta dibagi dalam 2 grup, yaitu grup perlakuan yang melaksanakan aktivitas aerobik di udara terbuka secara rutin dan grup kontrol yang tidak melaksanakan aktivitas aerobik. Dilakukan pencatatan karakteristik pasien, kemajuan persalinan, metode persalinan, dan kadar vitamin D3 sebelum dan setelah perlakuan, serta dilakukan analisis statistik dengan paired t test. Terdapat hubungan bermakna antara perubahan kadar vitamin D3 dan metode persalinan (p<0,05). Perbandingan perubahan kadar vitamin D3 antara kedua kelompok adalah −18,8% vs −26,8% (p<0.05). Metode persalinan adalah persalinan spontan 80% vs 25%, ekstraksi vakum 15% vs 55%, dan seksio sesarea 5% vs 20% (p<0,05). Simpulan, aktivitas aerobik rutin di udara terbuka pada ibu hamil berdampak terhadap kadar vitamin D3 serum ibu dan dapat memperlancar proses persalinan serta menurunkan risiko seksio sesarea