• Tidak ada hasil yang ditemukan

BAB IV HASIL DAN PEMBAHASAN

5.2 Saran

Dengan mengetahui adanya perbedaan kadarinterferon gamma serum pada ibu hamil trimester ketiga normotensi dan ibu hamil trimester ketiga dengan preeklampsia, maka perlu dilakukan penelitian lebih lanjut untuk mencari marker yang lebih spesifik dalam mencegah terjadinya preeklamsia.

DAFTAR PUSTAKA

1. WHO. Trends in Maternal Mortality: 1990 to 2015 estimates by WHO, UNICEF, UNFPA, World Bank Group and The United Nations Population Division. Geneva: WHO Press. 2015

2. Sutarjo US, dkk. 2015. Profil Kesehatan Indonesia. Kementerian Kesehatan Republik Indonesia: Jakarta.

3. Badan Perencanaan dan Pembangunan Nasional. Report on the achievement of millenium development goals Indonesia. Jakarta: Bappenas; 2010:67

4. Say L, Chou D, Gemmill A, Tuncalp O, Moller AB, Daniels JD. Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health.

2014;2(6) : e323-333.

5. Osungbade KO, Ige OK. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening Journal of Pregnancy. 2011.

6. Villar J, Bertran AP, Gulmezoglu M. Epidemiological basis for the planning of maternal health services. WHO. 2001

7. Statistics by country for

preeclampsiahttp://www.rightdiagnosis.com/p/preeclampsia/stats-country.htm#extrapwarning

8. Wilson BJ, Watson MS, Prescott GJ. Hypertensive Diseases of Pregnancy and Risk of Hypertension and Stroke in Later Life: Result From Cohort Study. BMJ.

2003;326:1-7.

9. Task Force on Hypertension in Pregnancy. American College of Obstetric and Gynecologist. Hypertension in Pregnancy. Washington: ACOG. 2013

10. Canadian Hypertensive Disorders of Pregnancy Working Group, Diagnosis, Evaluation and Management of the Hypertensive Disorders of Pregnancy:

Executive Summary. Journal of Obstetrics Gynecology Canada. 2014: 36(5);

416-438.

11. Tranquili AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, Zeeman GG, Brown MA. The Classfication, Diagnosis and Management of the Hypertensive Disorders of Pregnancy: a revised statement from ISSHP. Pregnancy Hypertension: An International Journal of Womans Cardiovascular Health.

2014: 4(2): 99-104.

12. Ozkan ZS, Simsek M, Ilhan F, Deveci D, Godekmerdan A, Sapmaz E. Plasma IL-17, IL-35, interferon gamma, SOCS3 and TGF-β in pregnant women with preeclampsia and their relation with severity of disease. Journal of Maternal Fetal and Neonatal Medicine. 2013: 1-16.

13. Tarnowska-Madra U, Leibschang J, Kowalska B, et al. Levels of immunoreactive cytokines in serum of women with preeclampsia or severe pregnancy hypertension. Ginekol Pol 2010;81: 192-6.

14. Mansouri R, Akbari F, Vodjgani M, Mahboudi F, Kalantar F, Mirahmadian M.

Serum cytokines profiles in Iranian patients with preeclampsia. Iran J Immunol 2007;4: 179-185.

15. Duckitt K, Harrington D. Risk factors for preeclampsia at antenatal booking:

systematic review of controlled studies. BMJ. 2005; 330: 549-50.Kuo VS, Koumantakis G, Gallery ED. Proteinuria and its assessment in normal and hypertensive pregnancy. Am J Obstet Gynecol. 1992; 167: 723-8

16. Lee CJ, Hsieh TT, Chiu TH, Chen KC, Lo LM, Hung TH. Risk factors for preeclampsia in an Asian population. International Journal of Gynecology and Obstetrics. 2000; 70: 327-333.

17. The Guideline Advisory Group. Urinalysis by dipstick for proteinuria. 3 Centres Consensus Guidelines on Antenatal Care. 2006

18. Raghupathy R. Cytokines as Key Players in the Pathophysiology of Preeclampsia. Medical Principles and Practice. 2013;22:8-19.

19. Arikan DC, Aral M, Coskun A, Ozer A. Plasma IL_4, IL-12, interefron gamma and CRP levels in pregnant women with preeclampsia, and their severity of disease and fetal birth weight. Journal of Maternal Fetal and Neonatal Medicine.

2012; 25(9): 1569-1573.

20. Hansson SR, Naav A, Erlandsson L. Oxidative stress in preeclampsia and the role of free fetal hemoglobin. Frontiers in physiology Department of obstetrics and gynecology, Lund University Sweden. 2015; 516(5): 1-11.

21. Jones DSC, et al. Placental hypoxia, endoplasmic reticulum stress and maternal endothelial sensitisation by sFLT1 in preeclampsia. Journal of Reproductive Immunology. 2016; 114; 81-85.

22. Schroder K, Hertzog PJ, Ravasi T, Hume d. Interferon Gamma: an Overview of Signals, Mechanismas and Functions. Journal of Leukocyte Biology 2004;75:163-178.

23. Laresgoiti-Servitje E, Gomez-Lopez N, Olson DM. An Immunological insight into the Origins of Preeclampsia. Human Reproduction Update. 2010;16:510-524.

24. Varea AM, Pellicer B, Marin AP, et al. Relationship Between Maternal Immunological Response during Pregnancy and Onset of Preeclampsia. Journal of Immunology Research. 2014;1-15.

25. I.Munno, L.M. Chiechi, G. Lacedra, C. Berardesca, C. Patimo, L.Marcuccio, P.

Nardelli, P. Loizzi. Evaluation of Nonspecific Immunity and Plasma Levels of Intereron-γ, Interleukin-6 and Tumor Necrosis Factor-α in Preeclampsia.

Immunopharmacology and Immunotoxicology, 21(3), 55 1-564 (1999).

26. Gathiram P, Moodley J. Pre-eclampsia: its pathogenesis and pathophysiolgy.

Cardiovasc J Afr. 2016;27(2):71–8. Available from:

http://cvja.co.za/onlinejournal/vol27/vol27_issue2/#17/z

27. Ashkar AA, Di Santo JP, Croy BA. Interferon γ Contributes to Initiation of Uterine Vascular Modification, Decidual Integrity, and Uterine Natural Killer Cell Maturation during Normal Murine Pregnancy. J Exp Med.

2000;192(2):259–70. Available from:

http://www.jem.org/lookup/doi/10.1084/jem.192.2.259

28. Liu Y, Yao CJ, Tao FB, Luo CM, Cao Y, Su-Juan Z, et al. Association between maternal tumor necrosis factor-α G308A polymorphism and interferon-γ A874T polymorphism and risk of preterm birth: A meta-analysis. Eur J Obstet Gynecol

Reprod Biol. 2015;190:11–9. Available from:

http://dx.doi.org/10.1016/j.ejogrb.2015.04.003

29. Murphy SP, Tayade C, Ashkar AA, Hatta K, Zhang J, Croy BA. Interferon Gamma in Successful Pregnancies1. Biol Reprod. 2009;80(5):848–59. Available from: https://academic.oup.com/biolreprod/article-lookup/doi/10.1095/biolreprod.108.073353

30. Szarka A, Rigó J, Lázár L, Beko G, Molvarec A. Circulating cytokines, chemokines and adhesion molecules in normal pregnancy and preeclampsia determined by multiplex suspension array. BMC Immunol. 2010;11:1–9.

31. Abdullah E, Idris A, Saparon A. Papr reduction using scs-slm technique in stfbc mimo-ofdm. Vol. 12, ARPN Journal of Engineering and Applied Sciences.

2017. 3218-3221 p.

32. Ashkar AA, Croy BA. Functions of uterine natural killer cells are mediated by interferon gamma production during murine pregnancy. Semin Immunol.

2001;13(4):235–41.

33. Cemgil Arikan D, Aral M, Coskun A, Ozer A. Plasma IL-4, IL-8, IL-12, interferon-γ and CRP levels in pregnant women with preeclampsia, and their relation with severity of disease and fetal birth weight. J Matern Neonatal Med.

2012;25(9):1569–73.

34. Miwa N, Hayakawa S, Miyazaki S, Myojo S, Sasaki Y, Sakai M, et al. IDO expression on decidual and peripheral blood dendritic cells and monocytes/macrophages after treatment with CTLA-4 or interferon-γ increase in normal pregnancy but decrease in spontaneous abortion. Mol Hum Reprod.

2006;11(12):865–70.

35. Comba C, Bastu E, Dural O, Yasa C, Keskin G, Ozsurmeli M, et al. Role of

inflammatory mediators in patients with recurrent pregnancy loss. Fertil Steril.

2015;104(6):1467–1474.e1.

36. Lash GE, Otun HA, Innes BA, Kirkley M, De Oliveira L, Searle RF, et al.

Interferon- inhibits extravillous trophoblast cell invasion by a mechanism that involves both changes in apoptosis and protease levels. FASEB J.

2006;20(14):2512–8. Available from:

http://www.fasebj.org/cgi/doi/10.1096/fj.06-6616com

37. Lockwood CJ, Basar M, Kayisli UA, Guzeloglu-Kayisli O, Murk W, Wang J, et al. Interferon-γ protects first-trimester decidual cells against aberrant matrix metalloproteinases 1, 3, and 9 expression in preeclampsia. Am J Pathol

[Internet]. 2014;184(9):2549–59. Available from:

http://dx.doi.org/10.1016/j.ajpath.2014.05.025

38. Piccinni MP, Lombardelli L, Logiodice F, Kullolli O, Romagnani S, Bouteiller P Le. T helper cell mediated-tolerance towards fetal allograft in successful pregnancy. Clin Mol Allergy. 2015;13(1):3–7.

39. Schatz F, Guzeloglu-Kayisli O, Arlier S, Kayisli UA, Lockwood CJ. The role of decidual cells in uterine hemostasis, menstruation, inflammation, adverse pregnancy outcomes and abnormal uterine bleeding. Hum Reprod Update.

2016;22(4):497–515.

40. Sones JL, Lob HE, Isroff CE, Davisson RL. Role of decidual natural killer cells, interleukin-15, and interferon- in placental development and preeclampsia. AJP Regul Integr Comp Physiol [Internet]. 2014;307(5):R490–2. Available from:

http://ajpregu.physiology.org/cgi/doi/10.1152/ajpregu.00176.2014

41. Ozkan ZS, Simsek M, Ilhan F, Deveci D, Godekmerdan A, Sapmaz E. Plasma IL-17, IL-35, interferon-γ, SOCS3 and TGF-β levels in pregnant women with preeclampsia, and their relation with severity of disease. J Matern Neonatal Med. 2014;27(15):1513–7.

42. Tangerås LH, Austdal M, Skråstad RB, Salvesen KA, Austgulen R, Bathen TF, et al. Distinct First Trimester Cytokine Profiles for Gestational Hypertension and Preeclampsia. Arterioscler Thromb Vasc Biol. 2015;35(11):2478–85.

43. Tanghetti EA. The role of inflammation in the pathology of preeklampsia. J Clin Aesthet Dermatol. 2013;6(9):27–35.

44. Liu W, Liu X, Luo M, Liu X, Luo Q, Tao H, et al. dNK derived IFN-γ mediates VSMC migration and apoptosis via the induction of LncRNA MEG3: A role in uterovascular transformation. Placenta. 2017;50:32–9.

45. Weel IC, Baergen RN, Romão-Veiga M, Borges VT, Ribeiro VR, Witkin SS, et al. Association between placental lesions, cytokines and angiogenic factors in pregnant women with preeclampsia. PLoS One. 2016;11(6):1–15.

46. Yang L, Wang Y, Li S, Zhu M, He K, Yao X, et al. Differential expression of interferon-gamma, IL-4 and IL-10 in peripheral blood mononuclear cells during early pregnancy of the bovine. Reprod Biol [Internet]. 2018;(September 2017):0–1. Available from: https://doi.org/10.1016/j.repbio.2018.06.005

47. Black KD, Horowitz JA. Inflammatory Markers and Preeclampsia: A Systematic Review. Nurs Res. 2018;67(3):242–51.

48. Borges LE, Bloise E, Dela Cruz C, Galleri L, Apa R, Petraglia F, et al. Urocortin 1 expression and secretion by human umbilical vein endothelial cells: In vitro

effects of interleukin 8, interferon γ, lipopolysaccharide, endothelin 1, prostaglandin F-2α, estradiol, progesterone and dexamethasone. Peptides

[Internet]. 2015;74:64–9. Available from:

http://dx.doi.org/10.1016/j.peptides.2015.10.010

49. Chen C-P, Piao L, Chen X, Yu J, Masch R, Schatz F, et al. Expression of Interferon gamma by Decidual Cells and Natural Killer Cells at the Human Implantation Site: Implications for Preeclampsia, Spontaneous Abortion, and Intrauterine Growth Restriction. Reprod Sci. 2015;22(11):1461–7.

50. Liu X, Hu Y, Liu X, Zheng Y, Luo M, Liu W, et al. EPHB4, a down stream target of IFN-γ/STAT1 signal pathway, regulates endothelial activation possibly contributing to the development of preeclampsia. Am J Reprod Immunol.

2016;76(4):307–17.

51. Sohlberg S, Stephansson O, Cnattinqius S, Wilkstrom AK. Maternal Body Mass Index, Height and Risk of Preeclampsia. Am J Hypertens. 2012; 25(1):120-5.

52. Sonia HD, Toh S, Cnattingius S. Risk of preeclampsia in first and subsequent pregnancies. BMJ. 2009; 338:b2255.

LEMBAR PENJELASAN KEPADA CALON SUBYEK PENELITIAN Ibu-ibu Yth,

Nama saya dr. Ahmad Syauki, saat ini saya sedang menjalani program pendidikan dokter spesialis Obstetri dan Ginekologi di Fakultas Kedokteran – Universitas Sumatera Utara.

Saat ini saya sedang melakukan penelitian yang berjudul :

“KADAR SERUM INTERFERON GAMMA PADA WANITA HAMIL TRIMESTER KETIGA PREEKLAMPSIA DAN NORMOTENSI”

Tata cara penelitianya sebagai berikut:

1. Setelah mendapat persetujuan dari Komite Etik Fakultas Kedokteran Universitas Sumatera Utara untuk melakukan penelitian, penelitian dimulai dengan mengumpulkan subyek penelitian.

2. Setelah mendapat penjelasan mengenai tujuan, manfaat dan prosedur penelitian serta menandatangani persetujuan untuk mengikuti penelitian, dilakukan wawancara dengan kuesioner untuk mengetahui data yang dibutuhkan peneliti.

3. Dilakukan pengambilan darah vena sebanyak 5 cc dari peserta untuk mengukur kadarserum interferon gamma dengan menggunakan ELISA kit for Human Interferon Gamma binding protein, yang akan diperiksa di laboratorium Prodia.

4. Data dikumpulkan kemudian dianalisis secara statistik.

Penelitian ini dilakukan oleh saya sendiri. Penelitian ini sendiri tidak memiliki efek samping disebabkan penelitian hanya mengambil sampel darah.

Adapun tujuan penelitian ini adalah:

Untuk mengetahui kadar serum interferon gamma pada wanita hamil dengan preeklamsia dan normotensi.

Pada penelitian ini, saya akan memberikan kuesioner kepada ibu-ibu. Data yang diperoleh selanjutnya dianalisa menurut statistika. Kerahasiaan pribadi ibu-ibu tetap saya pelihara.

Penelitian ini tidak berbahaya, dan biaya penelitian ini sepenuhnya tidak dibebankan kepada ibu-ibu.

Setelah memahami berbagai hal yang menyangkut penelitian ini, diharapkan ibu-ibu yang bersedia ikut sebagai subjek penelitian dalam penelitian ini dapat mengisi lembar persetujuan turut serta dalam penelitian yang telah disiapkan.

Terimakasih saya ucapkan kepada ibu yang telah berpartisipasi di dalam penelitian ini. Jika selama menjalani penelitian ini terdapat hal-hal yang kurang jelas maka ibu-ibu dapat menghubungi dr. Ahmad Syauki, Departemen Obgin FK-USU

Apabila sewaktu-waktu ibu-ibu ingin bertanya mengenai penelitian, ibu-ibu dapat menghubungi saya di no 081318938355.

Terima kasih.

Medan, Januari 2017

Hormat saya

dr. Ahmad Syauki

Dokumen terkait