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DAFTAR PUSTAKA
1. 2. 3. 4. 5. 6. 7.
8. 9. 10. 11.
12. 13.
14. 15.
16.
17.
Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. The Lancet Global health 2014;2:e323-33. Maternal mortality: WHO, 2014:1. Infodatin. Jakarta: Kementrian Kesehatan RI, 2014:1-8. Administrator. Expanding maternal and neonatal survival (EMAS) 2012 – 2016: Kementrian Kesehatan Republik Indonesia, 2013. Profil kesehatan provinsi jawa tengah tahun 2013: Dinas kesehatan provinsi jawa tengah, 2014:1-222. Anna LK. Angka kematian ibu tertinggi ada di jawa barat: Kompas, 2014. Raras AA. Pengaruh preeklampsia berat pada kehamilan terhadap kelauran maternal dan perinatal di RSUP Dr. Kariadi Semarang tahun 2010. Program Pendidikan Sarjana Kedokteran Fakultas Kedokteran Semarang: Diponegoro, 2011:2. Aagaard-Tillery KM, Belfort MA. Eclampsia: morbidity, mortality, and management. Clinical obstetrics and gynecology 2005;48:12-23. Robert N. Taylor JMR, F. Gary Cunningham. Chesley's hypertensive disorders in pregnancy: Elsevier Science, 2014. F. Cunningham KL, Steven Bloom. Williams obstetrics: 23rd edition: 23rd edition, 23 ed: McGraw Hill Professional, 2009: p.706-47. Ardini DS. Efek pemberian kombinasi vitamin e dan vitamin c terhadap kadar nitric oxide (no) pada preeklampsia. Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Diponegoro Semarang. Semarang: Diponegoro, 2005:1. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: Current concepts. Am J Obstet Gynecol 1998;179:1359-1375. Kim K. S. KYS, Lim J. I. Jung, M. H., Park H. K. Nanoscale imaging of morphological changes of umbilical cord in pre-eclampsia. Microscopy research and technique 2012;75:1445-51. Myatt, Xiaolan, Leslie. Oxidative stress in the placenta. Histochem Cell Biol 2004;122:369-382. Bankowski E, Romanowicz L, Jaworski S. Collagen of umbilical cord arteries and its alterations in EPH-gestosis. Journal of perinatal medicine 1993;21:491-8. Inan S SM, Can D, Vatansever S, Oztekin O,Tinar S. Comparative morphological differences between umbilical cords from chronic hypertensive and preeclamptic pregnancies. Acta medica Okayama 2002;56:177-86. Di Naro E GF, Raio L, Franchi M, D'Addario V. Umbilical cord morphology and pregnancy outcome. European journal of obstetrics, gynecology, and reproductive biology 2001;96:150-7.
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18. Manisha Barnwal SR, S Chhabra, S Nanda. Histomorphometry of umbilical cord and its vessels in pre- eclampsia as compared to normal pregnancies. Nepal Journals OnLine 2012;7:28-32. 19. WHO. Who recommendations for prevention and treatment of pre-eclampsia and eclampsia, 2011:4. 20. Naljayan MV. New developments in the pathogenesis of preeclampsia. 2013;20:265-70. 21. Prawirohardjo S. Ilmu kebidanan, 4 ed. Jakarta: PT Bina Pustaka Sarwono Prawirohardjo, 2010:981. 22. Bisseling TM, Maria Roes E, Raijmakers MT, Steegers EA, Peters WH, Smits P. N-acetylcysteine restores nitric oxide-mediated effects in the fetoplacental circulation of preeclamptic patients. Am J Obstet Gynecol 2004;191:328-33. 23. Neville F. Hacker JGM, Joseph C. Gambone. Essentials of obstetrics and gynecology. 2004:197-207. 24. Minire A, Mirton M, Imri V, Lauren M, Aferdita M. Maternal complications of preeclampsia. Medical archives (Sarajevo, Bosnia and Herzegovina) 2013;67:339-41. 25. Romanowicz L, Bańkowski E. Lipid compounds of human wharton's jelly and their alterations in preeclampsia. Int J Exp Pathol 2010;91:1-9. 26. Bimpong S. Quantitative evaluation of umbilical cord and placental indices and pregnancy outcom. Theoretical And Applied Biology: Kwame Nkrumah University, 2012:109. 27. Umbilical cord cross section. Available from:http://iheartautopsy.com/ wpcontent/uploads/2011/11/tumblr_lixqqarFj81qatgtyo1_400.jpg 28. Histology world. Available from: http://www.histology-world.com/ photoalbum/thumbnails.php?album=67 29. Willacy H. oligohydramnion: EMIS, 2011:4. 30. Hallak M, Pryde PG, Qureshi F, Johnson MP, Jacques SM, Evans MI. Constriction of the umbilical cord leading to fetal death. A report of three cases. J Reprod Med 1994;39:561-5. 31. Carolyn Salafia EP. Mechanical Pathophysiology of the Placenta: GLOWM, 2008. 32. Botdorf J, Chaudhary K, Whaley-Connell A. Hypertension in Cardiovascular and Kidney Disease. Cardiorenal Medicine 2011;1:183-192. 33. Hughes A. Pregnancy complications: Fastbleep notes, 2013. 34. Damian Hutter JK, Edgar Jaeggi. Causes and mechanisms of intrauterine hypoxia and its impact on the fetal cardiovascular system: A review. Int J Pediatr 2010;2010:9. 35. Eadara Murthy IR, Metelko. Review: diabetes and pregnancy. Diabetologia croatica 2002:131-146. 36. Profil Kesehatan Indonesia tahun 2008. Jakarta: Depkes RI, 2009:50. 37. Baptiste-Roberts K, Salafia CM, Nicholson WK, Duggan A, Wang N-Y, Brancati FL. Maternal risk factors for abnormal placental growth: the national collaborative perinatal project. BMC pregnancy and childbirth 2008;8:44.
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38. Wiknjosastro. Ilmu Kebidanan edisi ketiga Cetakan ke 7. Jakarta: EGC, 2005. 39. Marino T. Viral infections and pregnancy: Medscape, 2014. 40. Schmidt W. Oxygent transport properties in malaria-infected rodents- a comparison between infected and noninfected erythrocytes. The american society of hematology 1994;83:3746-3752. 41. Burd I. HELLP syndrome. Baltimore: A.D.A.M., Inc, 2012. 42. Eclampsia (seizures) and preeclampsia WebMD, 2012. 43. Irnawati MH, Wibowo T. Ibu hamil Perokok Pasif sebagai Faktor Risiko Bayi Berat Lahir Rendah. Jurnal Gizi Klinik Indonesia 2011;8:54-59. 44. Annette E. Bombrys DO, John R. Barton MD, Mounira Habli MD, Baha M. Sibai MD. Expectant management of severe preeclampsia at least than 27 weeks' gestation : Maternal and perinatal outcome according to gestational age by weeks at onset of expectant management. Am J Perinatol 2009;26:441-446. 45. Simona Corrao GLR, Melania Lo Iacono. Umbilical cord revisited: From wharton’s jelly myofibroblasts to mesenchymal stem cells. Histol Histopathol 2013:1235-1244. 46. Romanowicz L, Sobolewski K. Extracellular matrix components of the wall of umbilical cord vein and their alterations in pre-eclampsia. Journal of perinatal medicine 2000;28:140-6. 47. Constantin Ilie NH, Rodica Ilie, Ileana Enatescu, Elena Bernad, Iulian Velea, Virgil Radu Enatescu ZP, Delia Checiu. Histological modification of the umbilical cord in pregnancy induced hypertension. Jurnul Pedriatulul 2007;10:39-40. 48. Romanowicz L, Galewska Z. Extracellular matrix remodeling of the umbilical cord in pre-eclampsia as a risk factor for fetal hypertension. J Pregnancy 2011;2011:542695. 49. Bankowski E, Palka J, Jaworski S. Preeclampsia is associated with alterations in insulin-like growth factor (IGF)-1 and IGF-binding proteins in Wharton's jelly of the umbilical cord. Clin Chem Lab Med 2000;38:603-8. 50. Parvin Bastian KH, Hossein Najfi. Risk factors for preeclampsia in multigravida women. Research Journal of Biological Sciences 2008;3:148153. 51. Wiyono S. Hubungan antara serum ferritin dengan tebal dan diameter arteri umbilikalis pada preeklampsia berat dan hamil normotensi. Obstetric and gynecology. Semarang: Diponegoro University, 2014. 52. Herbert Valensise BV, Giulia Gagliardi, Gian Paolo Novelli. Early and late preeclampsia: Two different maternal hemodynamic states in the latent phase of the disease. American Heart Association, In 2008;52:873-880. 53. Sibai BM. Maternal and uteroplacental hemodynamics for the classification and prediction of preeclampsia American Heart Association, In 2008;52:805-806.
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54. Manuel Vazquez Blanco HRV, Roberto A. Histopathology and histomorphometry of umbilical cord blood vessels. Finding ini normal and high risk pregnancies. Elsevier 2010;5:50-57. 55. Uteroplacental ischemia in early-and late-onset reeclampsia: a role for the fetus? Ultrasound Obstet Gynecol 2012;40:373-382. 56. Babbette LaMarca JB, Kendra Wallace. IL-6- induced pathophysiology during pre-eclampsia: potential therapeutic role for magnesium sulfate. NIH Public Access 2011;3:59-64. 57. Jun Sugimoto AMR, Alice M, Valentin Torres, Angel A. Luciano Magnesium decrease inflammatory cytokine production : A novel innate immunomodulatori mechanism. the Journal of Immunology 2012. 58. Imunohistochemistry guide. Available from: http://www.mdbioproducts.com/resources/protocols/immunohistochemistry
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LAMPIRAN Lampiran 1. Ethical Clearance
64
Lampiran 2. Izin penelitian
65
Lampiran 3. Informed Consent
66
Lampiran 3. Informed Consent (lanjutan)
67
Lampiran 3. Informed Consent (lanjutan)
68
Lampiran 3. Informed Consent (lanjutan)
Lampiran 4. Prosedur pembuatan preparat jaringan
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Pengecatan : Hematoksilin Eosin 1.
Tali pusat dipotong sepanjang 2 cm.
Potongan tali pusat diimasukkan ke dalam pot penampung berisi buffer formalin 10% dengan perbandingan volume jaringan: formalin adalah 1:10.
Pemberian identitas pot penampung jaringan.
Pengiriman sampel ke laboratorium sentral bagian Patologi Anatomi.
2.
Jaringan mentah dipotong menjadi 3 bagian (dipilih bagian yang sesuai dengan kriteria penelitian).
Potongan jaringan dimasukkan dalam kaset.
Kaset jaringan kemudian direndam kembali dalam wadah berisi formalin 10% hingga Processing jaringan siap dilakukan.
3.
Kaset jaringan dimasukkan ke dalam keranjang alat processing jaringan yakni Microm STP 120 (1 keranjang bisa memuat hingga 80 kaset). Processing jaringan selama 17, 5 jam. Microtom STP 120 terdiri dari beberapa tabung, yaitu :
Formalin 10% 1, lama perendaman 2 jam
Formalin 10% 2, lama perendaman 2 jam
Alkohol 70 % , lama perendaman 1 jam
Alkohol 80%, lama perendaman 1 jam
Alkohol 96%, lama perendaman 2 jam
Etanol, lama perendaman 2 jam
Xylol, lama perendaman 1 jam
Parafin 1, lama perendaman 2 jam
Parafin 2, lama perendaman 2 jam
Parafin 3, lama perendaman 2 jam
Tujuan processing:
Menghilangkan cairan pada jaringan (dehidrasi dg alkohol bertingkat yakni : alkohol 70%,80%,96% dan etanol).
4.
Xylol untuk clearing.
Parafin untuk mematangkan jaringan.
Pembuatan blok jaringan matang dengan alat Histocenter . Digunakan cairan paraffin panas yang kemudian didinginkan untuk membekukan blok jaringan.
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5.
Blok jaringan dipotong dengan mikrotom (ketebalan 2 mikron).
Hasil pemotongan dimasukkan dalam air hangat agar mengembang, kemudian jaringan ditempelkan pada kaca objek.
6.
Preparat diberi identitas
Preparat dipanaskan dalam oven 70 derajat selama 10 menit (untuk melelehkan parafin)
Setelah selesai preparat dinginkan, kemudian ditata pada rak jaringan untuk persiapan proses pengecatan.
7.
Pengecatan dilakukan dengan alat Veristein dengan total waktu 2,5 jam. Veristein terdiri dari beberapa tabung, yaitu :
Xylol 1, lama perendaman 10 menit
Xylol 2, lama perendaman 10 menit
Xylol 3, lama perendaman 10 menit
Etanol , lama perendaman 3 menit
Alkohol 96% , lama perendaman 3 menit
Alkohol 80% , lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Alkohol 50%, lama perendaman 3 menit
Aqua
Hematoksilin , lama perendaman 15 menit
HCL, lama perendaman 1 menit
Bruing, lama perendaman 10 menit
Aqua, lama perendaman 3 menit
Alkohol 50%, lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Eosin, lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Alkohol 96%, lama perendaman 3 menit
Etanol, lama perendaman 3 menit
Xylol 1, lama perendaman 10 menit
Xylol 2, lama perendaman 10 menit
Xylol 3, lama perendaman 10 menit
Fungsi masing-masing cairan :
Xylol berfungsi untuk melarutkan lilin
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Aqua, merupakan pelarut hematoksilin fungsi menyamakan pH dengan hematoksilin
Hematoksilin berfungsi untuk mewarnai inti
HCL berfungsi untuk mencegah pewarnaan berlebih, agar pewarnaan tidak terlalu biru
8.
Bruing berfungsi untuk memperjelas warna inti
Alkohol 50% dan 70%, merupakan pelarut eosin
Eosin, berfungsi untuk mewarnai sitoplasma
Alkohol bertingkat, untuk rehidrasi jaringan
Xylol untuk proses clearing
Preparat yang sudah diwarnai ditetesi Ez Mount kemudian ditutup dengan deck glass .
Ez Mount berfungsi untuk merekatkan deck glass dan mengawetkan reparat jaringan (dengan pengawetan ini bisa disimpan hingga 10 tahun)
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73
74
Lampiran 6. Hasil analisis statistik Explore Case Processing Summary Cases Valid N
Missing Percent
N
Total Percent
N
Percent
Umur ibu
32
100.0%
0
0.0%
32
100.0%
Umur kehamilan
32
100.0%
0
0.0%
32
100.0%
Cara persalinan
32
100.0%
0
0.0%
32
100.0%
Paritas
32
100.0%
0
0.0%
32
100.0%
Tests of N ormality Kolmogorov-Smirnova Statistic
Df
Shapiro-Wilk Sig.
Statistic
df
Sig.
Umur ibu
.135
32
.143
.941
32
.079
Umur kehamilan
.254
32
.000
.852
32
.000
Cara persalinan
.282
32
.000
.753
32
.000
Paritas
.402
32
.000
.615
32
.000
a. Lilliefors Significance Correction
T-Test Group Statistics Diagnosis
N
Mean
Std. Deviation
Std. Error Mean
Preeklampsia berat
16
33.00
6.563
1.641
Kehamilan normotensi
16
28.31
5.582
1.396
Umur ibu
Independent Samples Test Levene's Test for Equality of Variances
Upper
Std. Error Difference
Mean Difference
Sig. (2-tailed)
4.688
2.154
.289
9.086
2.176
29.248
.038
4.688
2.154
.284
9.091
.084
.774
2.176
Df
.038
t
Lower
Equal variances not assumed
95% Confidence Interval of the Difference
30
Sig.
Equal variances assumed
F Umur ibu
t-test for Equality of Means
75
Lampiran 6. Hasil analisis statistik (lanjutan) Mann-Whitney Test Test Statisticsa Umur kehamilan Mann-Whitney U Wilcoxon W Z
Cara persalinan
Paritas
85.500
123.500
80.000
221.500
259.500
216.000
-1.697
-.182
-2.156
.090
.855
.031
.110b
.867b
.073b
Asymp. Sig. (2-tailed) Exact Sig. [2*(1-tailed Sig.)] a. Grouping Variable: Diagnosis b. Not corrected for ties.
Means Report Diagnosis
Preeklampsia berat
Kehamilan normotensi
Total
Umur ibu
Umur kehamilan
Mean
33.00
38.06
Std. Deviation
6.563
.854
Median
35.00
38.00
Minimum
18
37
Maximum
40
39
Mean
28.31
38.88
Std. Deviation
5.582
1.258
Median
27.00
38.00
Minimum
20
38
Maximum
39
42
Mean
30.66
38.47
Std. Deviation
6.449
1.135
Median Minimum
32.00 18
38.00 37
Maximum
40
42
Explore Case Processing Summary Cases Valid N
Missing
Percent
N
Total
Percent
N
Percent
Luas area tali pusat
32
100.0%
0
0.0%
32
100.0%
Luas area pembuluh darah
32
100.0%
0
0.0%
32
100.0%
Luas area Wharton's jelly
32
100.0%
0
0.0%
32
100.0%
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Lampiran 6. Hasil analisis statistik (lanjutan) Tests of Normality Kolmogorov-Smirnova Statistic
Df
Shapiro-Wilk Sig.
Statistic
df
Sig.
Luas area tali pusat
.198
32
.003
.879
32
.002
Luas area pembuluh darah
.202
32
.002
.845
32
.000
Luas area Wharton's jelly
.180
32
.010
.875
32
.002
a.
Lilliefors Significance Correction
Mann-Whitney Test Test Statisticsa Luas area pembuluh Luas area tali pusat
Luas area Wharton's jelly darah
Mann-Whitney U Wilcoxon W Z
61.000
41.000
67.000
197.000
177.000
203.000
-2.525
-3.279
-2.299
.012
.001
.022
b
b
.021b
Asymp. Sig. (2-tailed) Exact Sig. [2*(1-tailed Sig.)] a. Grouping Variable: Diagnosis b. Not corrected for ties.
.011
.001
Means Case Processing Summary Cases Included N Luas area tali pusat * Diagnosis Luas area pembuluh darah * Diagnosis Luas area Wharton's jelly * Diagnosis
Excluded
Percent
N
Total
Percent
N
Percent
32
100.00%
0
0.00%
32
100.00%
32
100.00%
0
0.00%
32
100.00%
32
100.00%
0
0.00%
32
100.00%
77
Lampiran 6. Hasil analisis statistik (lanjutan) Report Luas area tali pusat 85.2857
Luas area pembuluh darah 12.6448
38.14485
4.23282
35.68374
81.9518
11.8321
70.1197
Minimum
30.81
7.19
23.62
Maximum
154.16
20.69
135.46
52.0836
8.4818
43.6018
16.45145
2.27845
15.19417
46.3182
7.8793
38.2380 23.74
Diagnosis Mean Std. Deviation Preeklampsia berat
Median
Mean Kehamilan normotensi
Std. Deviation Median
72.6410
Minimum
30.80
6.41
Maximum
89.18
15.91
79.07
68.6847
10.5633
58.1214
33.45881
3.95647
30.74823
53.4325 30.80
9.0636 6.41
45.7462 23.62
154.16
20.69
135.46
Mean
Total
Luas area Wharton's jelly
Std. Deviation Median Minimum Maximum
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Lampiran 7. Dokumentasi
Gambar 9. Pengambilan sampel tali pusat
Gambar 10. Processing jaringan
Lampiran 6. Dokumentasi (lanjutan)
Lampiran Dokumentasi (lanjutan) Gambar 11.6.Preparat penelitian
79
Gambar 12. Pembacaan dan perhitungan preparat
80
Lampiran 8. Biodata mahasiswa
Identitas Nama
: Monica Adyah Permata
NIM
: 22010111120033
Tempat/tanggal lahir : Karawang, 25 September 1992 Jenis kelamin
: Wanita
Alamat
: Gg. Madi 2, RT01/01, Ds.Pucung, Kec. Kotabaru, Kab. Karawang, Jawa Barat
Nomor Hp
: 083875162522
e-mail
:
[email protected]
Riwayat Pendidikan Formal 1. SD 2. SMP 3. SMA 4. FK UNDIP
: SD Negeri Cikampek Utara II : SMP Negeri II Cikampek : Hopewell High School SMA Negeri 1 Karawang : Masuk tahun : 2011
Lulus tahun :2004 Lulus tahun :2007 Lulus tahun :2010 Lulus tahun :2011
Keanggotaan Organisasi 1. 2. 3. 4.
Staf Hubungan Luar HIMA KU Ketua Financial ROHIS KU Paduan suara mahasiswa KU Volunteer Bina Antar Budaya
Pengalaman Penelitian -
Tahun : 2011 s.d. 2014 Tahun : 2012 s.d. 2013 Tahun : 2011 s.d. 2014 Tahun : 2011 s.d. sekarang
