The Comparison of Creatinine and Cystatin C Value in Preeclampsia Severity and Neonatal Outcome

Objectives: to compare the levels of creatinine and cystatin C with the severity of preeclampsia, and assess neonatal outcomes.Materials and Methods: Creatinine, cystatin C, and neonatal outcomes were assesed in 17 normotensive samples, 17 samples of mild preeclampsia and 17 samples of severe preeclampsia. Analysis of data with statistical tests of ANOVA and t test differences between 2 proportions.Results: The mean levels of creatinine in the normotensive group, mild preeclampsia, severe preeclampsia are 0.56 mg/dL, 0.67 mg/ dL, and 0.75 mg/dL, p=0.138; While on cystatin C are 0.82 mg/L, 1.03 mg/L and 1.32 mg/L, p=0.000. The adverse neonatal out-come wasn't found in the normotensive group. In mild pre-eclampsia obtained 1 preterm birth and 1 intrauterine fetal death (IUFD), whereas in severe preeclampsia obtained 3 babies born preterm, 1 IUFD, and 1 intrauterine growth restriction (IUGR).Conclusion: levels of cystatin C was increased significantly in line with increased severity of preeclampsia, whereas creatinine was not increased significantly. Cystatin C is better than crea-tinine as a marker of renal dysfunction in preeclampsia patients. There was an increase in adverse neonatal outcomes in the group of preeclampsia

Hubungan Indeks Massa Tubuh Ibu Dan Peningkatan Berat Badan Saat Kehamilan Dengan Preeklampsia

: Preeclampsia is a health problem that occurs when a pregnancy reaches 20 weeks or more, preeclampsia is accompanied by hypertension and protenuria as main signs. Women with obesity before pregnancy are known to have higher risk to get preeclampsia during pregnancy than those with normal IMT. Excessive weight gain during pregnancy can also increase the risk of preeclampsia in pregnant woman. The purpose of this research is to examine the relationship between maternal body mass index and weight gain during pregnancy with preeclampsia.This research used observasional-analytic method through case-control approach. The number of case group is 38 people and the number of control group is 38 people. The result shows that at risk women were four times more likely to develop preeclampsia during pregnancy than those with normal IMT (OR= 4,32 95% CI= 1,15-16,12), and obese women were five times more likely to develop preeclampsia during pregnancy than those with normal IMT (OR= 5,06 95% CI= 1,46-12,67). The result also shows that women with excessive weight gain during pregnancy were almost three times more likely to develop preeclampsia during preeclampsia than women with normal weight gain during pregnancy (OR=2,53 95% IK= 0,99-31,81). The results show that there is a significant association between maternal IMT and weight gain during pregnancy with preeclampsia

Karakteristik Dan Luaran Preeklampsi Di Rsup Prof. Dr. R.d. Kandou Manado

: Maternal mortality is still one of the world health problems. It was estimated that more than 536,000 women per year died due to labor. In 2007, Indonesia maternal mortality rate (MMR) was 248 per 100,000 live births, which was the highest among SoutheastAsia countries. The most frequent cause of maternal mortality is hypertension in pregnancy. The insidence of pre-eclampsia in Indonesia is approximately 3-10% of all cases of pregnancies, which is 23.6 per 1,000 births. This study aimed to determine the characteristics and outcomes of pre-eclampsia in Prof. Dr. R.D Kandou General Hospital Manado. This was a retrospective descriptive study. Data were obtained from the medical records of pre-eclampsia patients from January 1 until December 31, 2011 at the Department of Obstetrics Gynecology Clinic. There were 328 patients admitted to the hospital with a diagnosis of pre-eclampsia or eclampsia. The data consisted of 121patients with mild pre-eclampsia, 103 patients with severe pre-eclampsia, 86 patient with superimposed pre-eclampsia, and 18 patients with eclampsia. Maternal deaths were 11.1 %. Perinatal deaths in mild preeclampsia were 1.6%; in severe preeclampsia 3.8%; in super-imposed pre-eclampsia 3.5%; and in eclampsia 11.1%. Conclusion: The most frequent cases of pre-eclampsia were mild pre-ecxlampsia, followed by severe pre-eclampsia, super-imposed pre-eclampsia, and eclampsia respectively. Perinatal deaths were the highest in eclampsia cases

Vaginal Microorganism Pattern in Premature Rupture of Membrane: Pola Mikroorganisme Vagina pada Ketuban Pecah Dini

Objective: To determine the pattern of vaginal microorganisms in pregnant women and risk factors for premature rupture of membranes (PROM) in Manado.Methods: This is a case-control study. Samples was 40, divided into 20 pregnant with PROM and 20 control samples. Samples were taken from Kandou Manado Hospital and network hospitals within the inclusion criteria. Samples were taken from vaginal swab for microorganism culture.Results: The highest age distribution in the case of PROM was in the reproductive age group of 20-35 years, 19 people (95%, p = 1,000). Primiparas were dominant in the PROM were 11 people (55%, p = 0.204). The distribution of BMI mostly from the overweight and obesity groups of 11 people (55%, p = 0.527). In the PROM, 19 people (95%, p = 0.605) did not smoke. Escherichia coli was the most microorganisms in swab vaginal of PROM: 7 people  (29.17%).Conclusion: The most microorganisms found in PROM are Escherichia coli, Enterobacter cloacae and Staphyloccocus aureus and in non-PROM are Klebsiella oxytoca, Staphylococcus epidermidis, Staphylococcus saprophyticus and Pseudomonas fluorescens. There was no relationship between BMI, age, parity, smoking, and gestational age with the incidence of PROM in this study.Keywords: PROM , vaginal microorganisms pattern,  vaginal swab.   Abstrak Tujuan: Untuk mengetahui pola mikroorganisme vagina pada kultur vaginal swab wanita hamil dan faktor risiko pada KPD di Kota Manado.Metode : Studi ini bersifat case control. Total sampling 40 sampel dibagi menjadi 20 sampel hamil dengan KPD dan 20 kontrol. Sampel diambil dari RSUP Kandou Manado dan RS jejaring yang memenuhi kriteria inklusi. Semua pasien dilakukan pengambilan sampel swab vagina untuk dilakukan kultur mikroorganisme.Hasil : Hasil sebaran usia pada KPD paling banyak pada usia reproduksi 20-35 tahun yaitu 19 orang (95%, p = 1,000). Primipara dominan pada KPD yaitu 11 orang (55%, p = 0,204). Hasil sebaran IMT paling banyak kelompok overweight dan obesitas yaitu 11 orang (55%, p = 0,527). Pada KPD sebanyak 19 orang (95%, p = 0,605) tidak merokok. Mikroorganisme terbanyak pada swab vagina KPD adalah Escherichia coli sebanyak 7 orang (29,17%). Kesimpulan: Mikroorganisme terbanyak pada KPD adalah Escherichia coli, Enterobacter cloacae dan Staphyloccocus aureus dan pada non KPD adalah Klebsiella oxytoca, Staphylococcus epidermidis, Staphylococcus saprophyticus  dan Pseudomonas fluorescens. Tidak ada hubungan antara IMT, usia, paritas, merokok, dan umur kehamilan dengan kejadian KPD pada penelitian ini.Kata kunci: pola mikroorganisme vagina, ketuban pecah dini, swab vagina. &nbsp

Lipid Profile, Blood Glucose Level and Body Mass Index (BMI) in Second Trimester of Pregnancy: Screening with Gestational Diabetes: Profil Lipid, Gula Darah dan Indeks Massa Tubuh (IMT) pada Kehamilan Trimester II: Skrining Kejadian Kehamilan dengan Diabetes Melitus

Abstract Objective: To find out lipid profile data, blood sugar and Body Mass Index in trimester II pregnancy to the incidence of pregnancy with diabetes mellitus. Methods: This study is a cross sectional study. The number of samples obtained was 42 samples where all were taken in the second trimester. Samples taken from RSUP Prof. Dr. R. D. Kandou Manado and networking hospitals around Manado that meet the inclusion and exclusion criteria. All patient patients were explained about the research procedure and the signing of consent information. Blood samples were taken for examination of blood sugar (fasting blood sugar and 2 hours post-prandial blood sugar) and lipid profiles (total cholesterol, HDL, LDL, triglycerides). After the data is collected, it is included in the SPSS version 22.0 program for data analysis. Results: Found 2 subjects (4.76%) who had abnormal fasting blood sugar and found 4 subjects (9.53%) who had abnormal 2-prandial 2-hour blood sugar. For lipid profiles, it was found 16 subjects (38.1%) who had abnormal total cholesterol levels, for LDL there were 13 subjects (30.96%) who had abnormal levels, for HDL there were 4 subjects (11.9%) who had abnormal levels and for triglycerides there were 23 subjects (54.76%) who had abnormal levels. There was a significant negative correlation between LDL cholesterol and fasting blood sugar (p = 0.002; r = - 0.455), and so did total cholesterol with fasting blood sugar (p = 0.047; r = - 0.302). There was a significant correlation between BMI and total cholesterol (p = 0.013; r = 0.371). There was 1 subject (2.38%) diagnosed with gestational diabetes melt and fasting blood sugar at 190 mg / dL, for prandial 2 hours post blood sugar at 309 mg / dL and for triglycerides at 617 mg / dL. Conclusions: Based on this study found the incidence of gestational diabetes mellitus 2.38% of all trimester II pregnancies. There is a positive but not significant correlation between blood sugar and triglycerides, whereas there is no significant relationship between blood sugar and other lipid profiles. There is a positive but not significant correlation of BMI in trimester pregnancy with total cholesterol. Keywords: Blood sugar, Body Mass Index (BMI), lipid profile Abstrak Tujuan: Untuk mengetahui data profil lipid, gula darah dan Indeks Massa Tubuh pada kehamilan trimester II terhadap kejadian kehamilan dengan diabetes melitus. Metode: Studi ini merupakan studi potong lintang. Jumlah sampel yang didapatkan sebesar 42 sampel di mana seluruhnya diambil pada trimester II. Sampel diambil dari RSUP Prof. Dr. R. D. Kandou Manado dan rumah sakit jejaring sekitar Manado yang memenuhi kriteria inklusi dan eksklusi. Semua pasien-pasien dijelaskan mengenai prosedur penelitian dan penandatanganan inform consent baru dilakukan pengambilan sampel darah untuk pemeriksaan gula darah (gula darah puasa dan gula darah 2 jam postprandial) dan profil lipid (Kolesterol total, HDL, LDL, Trigliserida). Setelah data dikumpulkan, maka dimasukkan ke dalam program SPSS versi 22.0 untuk data analisis. Hasil: Ditemukan 2 subjek (4,76%) yang memiliki gula darah puasa abnormal dan ditemukan 4 subjek (9.,53%) yang memiliki gula darah 2 jam postprandial yang abnormal. Untuk profil lipid, ditemukan 16 subjek (38,1%) yang memiliki kadar kolesterol total abnormal, untuk LDL ditemukan sebanyak 13 subjek (30,96%) yang memiliki kadar abnormal, untuk HDL ditemukan 4 subjek (11,9%) yang memiliki kadar abnormal dan untuk trigliserida ditemukan 23 subjek (54,76%) yang memiliki kadar abnormal. Terdapat korelasi negatif signifikan antara kolesterol LDL dengan gula darah puasa (p = 0,002 ; r = – 0,455), dan begitu juga dengan kolestrol total terhadap gula darah puasa (p = 0,047 ; r = – 0,302). Terdapat korelasi signifikan antara IMT dengan kolesterol total (p = 0,013 ;r = 0,371). Terdapat 1 subjek (2,38%) yang terdiagnosis diabetes melitus gestasional di mana gula darah puasa sebesar 190 mg/dL, untuk gula darah 2 jam postprandial sebesar 309 mg/dL dan untuk trigliserida sebesar 617 mg/dL. Kesimpulan: Berdasarkan penelitian ini ditemukan kejadian diabetes melitus gestasional 2,38% dari seluruh kehamilan trimester II. Terdapat korelasi positif tetapi tidak bermakna antara gula darah dengan trigliserida, sedangkan tidak terdapat hubungan bermakna antara gula darah dengan profil lipid lainnya. Terdapat korelasi positif tetapi tidak bermakna IMT pada kehamilan trimester dengan kolestrol total. Kata kunci: gula darah, Indeks Massa Tubuh (IMT), profil lipi

Germ Patterns and Antibiotic Susceptibility in Pregnancy and Labor with Risk of Infections : Pola Kuman dan Sensitivitas Antibiotik pada Kehamilan dan Persalinan dengan Faktor Risiko Infeksi

Objective: To determine the pattern of germs and antibiotic susceptibility tests in pregnant women related to risk factors for infection in preterm PROM cases, the threat of preterm labor, pathological fluor albus, and prolonged labor in Manado city. Method: This study is a cross-sectional descriptive study. A total of 21 samples were obtained, consisting of six preterm PROM cases, five premature contraction cases, five pathological fluor albus cases, and five prolonged labor cases. The study was conducted in Kandou General Hospital and Affiliated Hospitals, Manado. All patients were informed about the study and signed informed consent. Germ pattern and antibiotics susceptibility data were analyzed. Results: Of 21 samples, the detected microorganisms included Staphylococcus aureus (12), Coagulase-negative staphylococcus (2), mixed microorganisms (Staphylococcus aureus + Candida sp, Coagulase-negative staphylococcus + Candida sp), Bacillus sp and Candida sp. The susceptible and safe antibiotics for pregnancy were Ampicillin / Sulbactam and Meropenem. The resistant antibiotics were Ceftriaxone, Tetracycline, and Neomycin. Conclusion: The most common type of bacteria found in pregnant women and women in labor was Staphylococcus aureus. Susceptible and safe antibiotics for pregnancy were Ampicillin / Sulbactam and Meropenem. Keywords: antibiotic sensitivity test, germ pattern, pregnancy and labor infection.   Abstrak Tujuan: Mengetahui pola kuman dan uji sensitivitas antibiotik pada perempuan hamil terkait faktor risiko infeksi pada kasus KPD preterm, ancaman partus prematurus, fluor albus patologis dan partus lama di kota Manado. Metode: Studi ini merupakan studi deskriptif potong lintang. Jumlah sampel yang didapatkan sebesar 21 sampel di mana terbagi pada masing-masing kasus KPD preterm 6 sampel, ancaman partus prematurus 5 sampel, fluor albus patologis 5 sampel dan partus lama 5 sampel. Sampel diambil dari RSUP Prof. Dr. R. D. Kandou Manado dan Rumah Sakit Jejaring di kota Manado yang memenuhi kriteria inklusi dan eksklusi. Semua pasien dijelaskan mengenai prosedur penelitian dan penandatanganan inform consent baru dilakukan pengambilan sampel. Data dianalisis dengan cara deskriptif tentang pola kuman dan uji sensitivitas antibiotik pada kehamilan dan persalinan dengan faktor risiko infeksi. Hasil: Dari 21 sampel, sebaran jenis mikroorganisme diantaranya Staphylococcus areus (12), Staphylococcus non koagulase (2), mikroorganisme campuran (Staphylococcus aureus + Candida sp, Staphylococcus non koagulase + Candida sp), Bacilus sp dan Candida sp. Hasil uji sensitivitas antibiotik yang sensitif dan aman untuk kehamilan di antaranya Ampicillin/Sulbactam dan Meropenem. Hasil uji sensitivitas antibiotik yang resisten adalah Ceftriaxone, Tetracycline dan Neomycin. Kesimpulan: Jenis mikroorganisme paling banyak adalah Staphylococcus aureus. Hasil uji sensitivitas antibiotik yang sensitif dan aman untuk kehamilan di antaranya Ampicillin/Sulbactam dan Meropenem. Kata kunci: infeksi kehamilan dan persalinan, pola kuman, uji Sensitivitas antibioti

Placental Growth Factor Levels in Preeclampsia Compared to Normal Pregnancy

Objective: To identify and analyze the differences in the levels of PlGF in preeclampsia and normal pregnancy. Method: This was a cross-sectional observational qualitative study of PlGF in preeclampsia and normal pregnancy. The number of samples in case and control group was 30 in each groups. Result: We found that mean of maternal age in the preeclampsia group was 28.53 years and 25.23 years in the control group. Mean parity in preeclampsia and control group was 2.33 and 1.56, respectively. Mean hemoglobin level in preeclampsia and control group was 11.97 and 11.99, respectively. Mean maternal blood glucose level was 87.0 in the preeclampsia group, and 87.9 in the control group. In the preeclampsia group mean urea concentration was 16.45, while it was 22.78 in the control group. Mean creatinine level was 0.92 in the preeclampsia group and 0.64 in the control group. Mean SGPT and SGOT in the preeclampsia group was 23.36 and 21.97, while in the control group was 29.86 and 26.20. Test results showed that PlGF levels was significantly different between the preeclampsia and control group. Mean PlGF in the preeclampsia and control group was 42.10 and 452.33 respectively, with

PANDANGAN REMAJA PUTRI TERHADAP ABORTUS

Remaja merupakan kelompok penduduk yang cukup besar. Secara global, sekitar seperempat penduduk dunia adalah remaja, sedangkan kelompok usia remaja (10-25 tahun) berjumlah hampir separuh dari penduduk Indonesia. Remaja memiliki potensi yang besar namun bila tidak cukup perhatian potensi tersebut dapat berdampak buruk. Di Indonesia ada 2.5 juta abortus, dimana 1.5 juta diantaranya adalah abortus yang dilakukan remaja. Menurut BKKBN, berdasarkan survei, 63% remaja SMP dan SMA di Indonesia pernah berhubungan seks. Sebanyak 21% diantaranya melakukan abortus. Kondisi ini ada kaitan dengan kurang memadainya pengetahuan remaja tentang kesehatan reproduksi sehingga berpengaruh terhadap sikap remaja dalam menghadapi kasus abortus. Peneitian ini bertujuan untuk mengetahui pengetahuan dan sikap remaja putri terhadap abortus. Penelitian ini merupakan jenis penelitian deskriptif dengan sampel berjumlah 200 orang yang merupakan siswi dari 3 SMA di kota Manado. Hasil dari penelitian didapatkan pengetahuan remaja putri terhadap abortus yaitu baik 39%, sedang 18%, dan kurang 43% diikuti dengan sikap negatif 43,5%, netral 55%, dan positif terhadap aborsi 1,5%.   Kata Kunci: Abortus, Remaja Putri, Pengetahuan, Sika

Heme Oxygenase1 Level in Normotensive Pregnancy and Preeclampsia with Severe Features

Objective: To understand the relationship of heme oxygenase-1 (HO-1) level between normotensive pregnancy and preeclampsia with severe features. Method: The cross sectional study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sam Ratulangi/Prof. Dr. R. D. Kandou General Hospital Manado. The subjects consisted of 26 pregnant women with normal blood pressure and 26 women with severe features of preeclampsia. We took the patients’ history, general physical examination, and laboratory assessment. The blood samples were taken from normotensive women more than 20 weeks of pregnancy and preeclamptic women with severe features more than 20 weeks of pregnancy. The data obtained was processed using SPSS 20.0 software. We did the nonparametric Mann-Whitney test to analyze the relationship between heme oxygenase-1 (HO-1) level in normotensive pregnancy and preeclampsia with severe features. Result: The level of heme oxygenase-1 (HO-1) in normotensive pregnant women was at 3.24 (SD 0.58) ng/ml (95% CI 3.00-3.47), and the level of heme oxygenase-1 (HO-1) of preeclamptic women with severe features was 3.92 (SD 0.73) ng/ml (95% CI 3.62-4.21). The result of Mann-Whitney test showed p value of 0.001 which meant that there was significant difference in the level of heme oxygenase- 1 (HO-1) between normotensive women and pre-eclamptic women with severe features. Conclusion: There was the relationship between the level of heme oxygenase-1 (HO-1) and the incidence of preeclampsia with severe features. Keywords: heme oxygenase-1 (HO-1), normotensive pregnancy, preeclampsia with severe feature

Endothelin1 Levels in Pregnant Women with Severe Preeclampsia and Normal Pregnant Women

Objective: To determine the ratio of serum endothelin-1 levels between severe preeclampsia and normotensive pregnancy. Methods: Observational analytic study using cross-sectional. Sixteen woman with normal pregnancy and sixteen others with severe preeclampsia who met the inclusion and exclusion criteria, were tested for ET-1. The serum was analyzed at Prodia Laboratory, Manado. The ET-1 level was examined using ELISA (R&D Systems, Inc., Minneapolis, MN 55413, USA). The data obtained was analyzed using SPSS software version 20.0.and discussions were held using the existing literature theory. Results: The mean and median levels of endothelin-1 plasma in patients with severe preeclampsia is 2:46 ± 1:44 pg/ml, 1:09 ±  0:26 pg/ml, whereas in normotensive pregnancy is 1:03 ±  0:26 pg/ml, 1.95 ± 1:44 pg/ml with p < 0:05 (0000). Conclusion: There was a significant difference between endothelin- 1 level in severe preeclampsia and normotensive pregnancies. [Indones J Obstet Gynecol 2017; 5-2: 77-82] Keywords: endothelin-1, normotensive, preeclampsi