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"Background: Placental morphology and cellular arrangement can be altered in maternal diseases. Rheumatic heartdisease (RHD) is a chronic heart condition that can lead to death in pregnant women. The aim of this study is todetermine the histological changes of the placenta in pregnant women suffering from RHD. Methods: Placentae werecollected from 10 healthy pregnant women, and 31 pregnant women with heart conditions (26 with RHD and 5 withNRHD) who had been admitted to the Baghdad Teaching Hospital. Placental tissues were fixed in10% formal-salineand were processed for light microscopy. Measurements including the placental weight and diameter of the chorionicvilli capillaries were recorded. Results: The results indicate that there are many histological changes in pregnantwomen with RHD such as hyalinisation, fibrosis of the chorionic villi, proliferation of trophoblastic cells, andthickening of its membrane. Additionally, expectant mothers with RHD experience a reduction in capillary diameterand thickening of the capillary walls, and decreased size and weight of their placenta when compared with the control.Conclusions: Heart diseases, especially RHD, are associated with developmental damage of the placenta in pregnantwomen by injuring the endothelial cells of the placentas capillaries."

"Latar Belakang: Terlepas dari kemajuan perawatan perinatal, preeklampsia masih menjadi penyebab utama mortalitas dan morbiditas ibu dan janin di dunia. Namun, etiologi utama dan patofisiologi preeklampsia tetap diperdebatkan. Asosiasi antara preeklampsia dengan stres oksidatif tidak diragukan lagi. Hal ini telah dibuktikan dengan banyaknya publikasi yang mengukur biomarker ROS dan enzim antioksidan yang ditemukan pada plasenta dan sirkulasi darah ibu. Studi tersebut menunjukkan bukti biologis produksi berlebihan spesies oksigen reaktif sebagai konsekuensi kapasitas pertahanan antioksidan radikal bebas yang tidak memadai. Katalase adalah salah satu enzim antioksidan yang bekerja secara efisien untuk melawan spesies oksigen reaktif. Tujuan : Penelitian ini bertujuan untuk menguji apakah terdapat perbedaan yang signifikan dari tingkat aktivitas enzim katalase pada jaringan plasenta manusia pada kehamilan normal, Early Preeclampsia and Late Preeclampsia. Metode : Rancangan penelitian ini adalah penelitian cross sectional-observational untuk mengetahui tingkat rata-rata aktivitas spesifik enzim katalase yang berperan sebagai antioksidan pada plasenta baik pada kehamilan normal maupun preeklampsia. Aktivitas katalase spesifik diukur dengan menggunakan metode spektrofotometri dan kemudian dibagi dengan tingkat protein. Kegiatan kemudian dianalisis dengan menggunakan uji Kruskal-Wallis untuk menguji normalitas. Selanjutnya data dianalisis dengan menggunakan uji post hoc (Mann-Whitney). Hasil : Secara statistic, ditemuka perbedaan yang signifikan antara aktivitas spesifik enzim katalase pada jaringan plasenta late-preeclampsia dibandingkan dengan kehamilan normal. Pola ini tidak terdeteksi dalam plasenta kehamilan normal ketika dibandingkan dengan early preeclampsia, atau pada preeklamsia dini dibandingkan preeklamsia akhir. Diskusi : Ada korelasi antara stres oksidatif dan penurunan aktivitas spesifik katalase pada preeklampsia dibandingkan dengan jaringan plasenta kehamilan normal. Penurunan aktivitas spesifik enzim katalase pada kelompok preeklamsia mungkin disebabkan oleh perubahan protein akibat stres oksidatif. Oleh karena itu, enzim katalase tidak dapat bekerja dengan baik. Kesimpulan : Ketidakseimbangan antara stres oksidatif dan aktivitas katalase, dimana ini dibuktikan oleh penurunan aktivitas spesifik katalase pada preeklampsia dibandingkan dengan jaringan plasenta kehamilan normal mungkin merupakan faktor kunci terjadinya preeklamsia.

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Background : Despite the advance progress of perinatal care, preeclampsia still remains as a major cause of maternal and perinatal mortality and morbidity in the world. However, the main etiology and pathophysiology of preeclampsia remains debatable. The association of preeclampsia with oxidative stress is established beyond doubt. This has been proven by many publications which measure the biomarkers of ROS and antioxidant enzymes found in the placenta and maternal blood circulation. The study showing biological evidence of excessive production of reactive oxygen species as a consequence of inadequate capacity of antioxidant defense mechanism. Catalase is one of antioxidant enzymes which work efficiently combating reactive oxygen species.

Purpose : This present study is aimed to examine whether there is significant difference of the specific catalase activity in the human placental tissue of normal pregnancy, early preeclampsia and late preeclampsia.

Methods : The design of this research is cross sectional-observational study to determine the average level of specific activity of catalase enzyme which act as antioxidant in the placenta of both normal pregnancy and preeclampsia. The specific activity of catalase was measured by using spectrophotometry method and then divided with protein level. The activity then analyzed by using Kruskal-Wallis test to examine the normality. Furthermore, the data was analyzed by using post hoc (Mann-Whitney) test.

Results : The specific activity of catalase enzyme was found to be statistically significant difference between the placental tissue of late preeclampsia compared to normal pregnancy. This pattern was not detected in catalase specific activity of normal pregnancy versus early preeclampsia, nor in early preeclampsia versus late preeclampsia.

Discussion : There is correlation between oxidative stress and decreased specific activity of catalase in the preeclampsia compared to the normal pregnancy placental tissue. The decreased specific activity of catalase enzyme in preeclampsia groups may due to protein alteration by oxidative stress. Hence, the catalase enzyme cannot work properly.

Conclusion : Imbalanced between oxidative stress and catalase specific activity which has proven by the decreased in the preeclampsia compared to the normal pregnancy placental tissue may be the key factor in the occurrence of preeclampsia."

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Vitamin D memiliki peran dalam implantasi plasenta dan meningkatkan sensitivitas insulin di sel target.  Pada plasenta, VDR ditemukan di vili trofoblas, desidua, otot polos sel pembuluh darah plasenta, dan nukleus sel stroma vili plasenta. Melalui peningkatan sensitivitas insulin, vitamin D dapat memengaruhi kadar glukosa di jaringan plasenta. Insulin akan menstimulasi GLUT4 pada plasenta untuk pengambilan glukosa ke dalam sel. Penelitian ini bertujuan untuk mengetahui hubungan kadar vitamin D dan kadar glukosa dalam jaringan plasenta. Penelitian ini merupakan studi awal dengan desain potong lintang dengan sampel berupa 10 jaringan plasenta kehamilan normal. Setiap sampel diukur kadar vitamin D dan kadar glukosanya lalu dilakukan uji korelasi. Kadar vitamin D diukur dengan metode ELISA sedangkan kadar glukosa diukur dengan metode spektofotometri. Uji korelasi dilakukan dengan uji Pearson menggunakan SPSS versi 20. Hasil uji korelasi kadar vitamin D dan kadar glukosa menunjukkan kecenderungan korelasi positif lemah menuju sedang dengan korelasi Pearson r=0,397. Namun, hasil uji memberikan p=0,128 sehingga secara statistika tidak bermakna. Hasil penelitian ini dapat digunakan sebagai acuan untuk penelitian selanjutnya dengan besar sampel minimal, yaitu 48 sampel. 

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Vitamin D has a role in placental implantation and increases insulin sensitivity in target cells. In the placenta, VDR is found in trophoblast villi, decidua, smooth muscle cells of the placental vessels, and nuclei of placental villous stromal cells. Through increased insulin sensitivity, vitamin D can affect glucose levels in placental tissue. Insulin stimulates GLUT4 on the placenta for glucose intake. This study aimed to determine the relationship of vitamin D levels and glucose levels in placental tissue. This study was a preliminary study with a cross-sectional design with a sample of 10 normal pregnancy placental tissues. Vitamin D levels were measured by the ELISA method while glucose levels were measured by spectrophotometric methods. Then performed a correlation test. Correlation test was carried out by Pearson test using SPSS version 20. The results of the correlation test of vitamin D levels and glucose levels showed a weak-to-moderate positive correlation with Pearson correlation r=0.397. However, the test results give p=0.128 that means statistically it’s not significant. The results of this study can be used as a reference for further research with a minimum sample size, which is 48 samples. 

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"Pendahuluan: Laktat Dehidrogenase (LDH) merupakan sebuah enzim yang terdapat padaglikolisis anaerob yang berfungsi untuk mengubah piruvat menjadi laktat. Dalam halkehamilan, terdapat kondisi anaerob pada jaringan plasenta dimana glukosa dirubahmenjadi laktat. Namun, data mengenai aktivitas spesifik LDH pada jaringan plasentakehamilan normal serta terkait dengan karakteristik maternal masih kurang memadai.Untuk menambah data, penelitian ini bertujuan untuk mengukur aktivitas spesifik LDHpada plasenta normal.Metode: Jaringan plasenta diperoleh dari wanita dengan kehamilan normal dan cukupbulan. Pengukuran aktivitas spesifik LDH dilakukan dengan menggunakanspectrophotometer. Formula untuk pengukuran beserta reagen diperoleh dariElabscienceâ Lactate Dehydrogenase (LDH) assay kit. Analisis statistik dilakukandengan menggunakan IBM SPSS versi 20.Hasil: Hasil menunjukkan bahwa nilai median (min – max) dari aktivitas spesifik LDHadalah 0,31 (0,06 – 1,19) U/mgprot. Berdasarkan karakteristik subjek, wanita < 35 tahunmenunjukkan aktivitas spesifik LDH yang lebih tinggi dibandingkan wanita ≥ 35 tahun,dengan nilai 0,38 (0,06 – 1,19) U/mgprot dan 0,17 (0,1 – 0,4) U/mgprot, secara berurutan.Berdasarkan usia gestasional, aktivitas spesifik LDH tertinggi terdapat pada early termpregnancy pada 0,46 (0,17 – 1,19) U/mgprot, dengan nilai terendah pada late termpregnancy pada 0,25 (0,16 – 0,46) U/mgprot. Riwayat graviditas menunjukan bahwawanita primigravida menunjukan aktivitas spesifik LDH yang lebih tinggi dibandingdengan wanita multigravida, dengan nilai 0,35 (0,06 – 1,19) U/mgprot dan 0,30 (0,09 -0,99) U/mgprot, secara berurutan. Bayi dengan berat <3 kg menunjukan nilai yang lebihtinggi yaitu pada 0,51 (0,06 – 0,99) U/mgprot. Sebaliknya, bayi dengan berat > 3,5 kgmenunjukan nilai yang lebih rendah yaitu 0,27 (0,06 – 0,51) U/mgprot.Kesimpulan: Secara singkat, penelitian ini menemukan bahwa nilai median (min – max)dari aktivitas spesifik LDH adalah 0,31 (0,06 – 1,19) U/mgprot. Perolehan nilai aktivitasspesifik LDH yang lebih tinggi ditemukan pada wanita < 35 tahun, early term pregnancy,wanita primigravida, dan bayi dengan berat <3 kg saat lahir.

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Introduction: Lactate Dehydrogenase (LDH) is an enzyme that is usually present under

anaerobic glycolysis, which functions to convert pyruvate into lactate. In correlation to

pregnancy, there is an anaerobic state on placental tissue in which glucose is metabolized

into lactate. However, data regarding specific activity of LDH in placental tissue from

normal pregnancy as well as according to maternal characteristic is lacking. To provide

more data, this research aims to study the specific activity of LDH on normal placenta.

Methods: Placenta tissue were taken from women who undergone normal term

pregnancy. Measurement of LDH specific activity was done using spectrophotometer.

The formula and reagents were obtained from Elabscienceâ Lactate Dehydrogenase

(LDH) assay kit. Statistical analysis was done through IBM SPSS version 20.

Results: Result shows that the median (min – max) value of LDH specific activity is 0,31

(0,06 – 1,19) U/mgprot. Based on subject characteristic, women who aged < 35 years old

have higher specific activity of LDH compared to ≥ 35 years old mother, the values are

0,38 (0,06 – 1,19) U/mgprot and 0,17 (0,1 – 0,4) U/mgprot, respectively. According to

gestational age, highest LDH specific activity is shown on early term pregnancy at 0,46

(0,17 – 1,19) U/mgprot, with the lowest on late term pregnancy at 0,25 (0,16 – 0,46)

U/mgprot. History of gravidity result shows, primigravida women shows higher LDH

specific activity compared to multigravida, the values are 0,35 (0,06 – 1,19) U/mgprot

and 0,30 (0,09 – 0,99) U/mgprot, respectively. Newborn weigh <3 kg has highest value

on 0,51 (0,06 – 0,99) U/mgprot. In contrary, those born with > 3,5 kg shows lowest value

on 0,27 (0,06 – 0,51) U/mgprot.

Conclusion: In summary, our study found that the median (min – max) value of LDH

specific activity is 0,31 (0,06 – 1,19) U/mgprot. With higher value of LDH specific

activity observed on < 35 years old mother, early term pregnancy, primigravida women,

and <3 kg newborn."

"Hypoxia-inducible factor-1a (HIF-1a) adalah faktor transkripsi yang bertanggung jawab pada kondisi hipoksia seperti preeklampsia. Studi ini membandingkan konsentrasi HIF-1a pada kehamilan preeklampsia di bawah 32 minggu gestasi dan kehamilan normal. Sebagai penelitian observasional potong lintang pendahuluan, 10 sampel digunakan untuk masing-masing grup. Konsentrasi HIF-1a diukur menggunakan kit enzyme-linked immunosorbent assay (ELISA). Analisis statistik menunjukkan adanya perbedaan yang insignifikan (p>0.05) antara konsentrasi HIF-1a pada kehamilan preeklampsia awal dan kehamilan normal walaupun terdapat kecenderungan untuk konsentrasi yang lebih tinggi pada kehamilan preeklampsia awal. HIF-1a kemungkinan tidak terlibat pada perkembangan preeklampsia awal. Sebaliknya, konsentrasi HIF-1a pada plasenta dipengaruhi oleh kerusakan syncytiotrophoblast akibat modifikasi arteri spiralis yang inadekuat dan berujung pada kurangnya jumlah HIF-1a.

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Hypoxia-inducible factor-1a (HIF-1a) is a transcription factor that is expressed by cytotrophoblast in the placenta during hypoxic condition of preeclampsia. This study compares the level of placental HIF-1a in preeclampsia pregnancies under 32 weeks old of gestation and normal pregnancies. As an observational cross-sectional preliminary study, 10 samples were used for each group. The level of placental HIF-1a was measured by using enzyme-linked immunosorbent assay (ELISA) kit. Statistical analysis revealed insiginificant difference (p>0.05) of placental HIF-1a concentration between the early preeclampsia pregnancies and the normal ones although there’s a tendency of the level being higher for the former. HIF-1a might not be involved in the development of early preeclampsia. Instead, its level in the placenta is affected by the syncytiotrophoblast damage due to inadequate spiral arteries remodeling that leads to a reduced amount of HIF-1a."

"Latar belakang: Preeklampsia mengakibatkan 225 kematian dari 100.000 kelahiran di Indonesia. Salah satu teori terjadinya preeklampsia adalah peningkatan antioksidan yang tidak adekuat, contohnya glutation peroksidase GPx , untuk mengimbangi peningkatan stres oksidatif yang terjadi selama kehamilan. GPx adalah antioksidan enzimatik yang mengubah peroksida menjadi tidak berbahaya, sehingga mengurangi stres oksidatif. Beberapa penelitian yang menyelidiki GPx menghasilkan hasil yang bertentangan, dan belum ada yang dilakukan di Indonesia. Penelitian ini bertujuan untuk membandingkan aktivitas spesifik GPx pada kehamilan normal, preeklampsia onset awal, dan preeklampsia onset akhir. Metode: Studi ini adalah penelitian observasional dengan menggunakan desain potong lintang komparatif. Jaringan plasenta diperoleh dari Rumah Sakit Ibu dan Anak Budi Kemuliaan dan RSUPN Cipto Mangunkusumo pada tahun 2015. Aktivitas umum U/mL GPx diukur dengan menggunakan GPx Randox Ransel Kit berdasarkan metode Paglia dan Valentine, yang kemudian dibagi dengan determinan protein mg/mL untuk mendapatkan aktivitas spesifik U/mg . Data kemudian dianalisis dengan menggunakan SPSS 20 dengan uji Kruskal-Wallis. Hasil: Kehamilan normal memiliki aktivitas spesifik tertinggi 8.562 3.93320.00 , diikuti oleh preeklamsia onset akhir 6.655 2.646-32.93 dan preeklampsia onset dini 6.328 5.873-13.17. Namun, perbedaan ini tidak signifikan menurut uji Kruskal-Wallis p = 0,399. Kesimpulan: Tidak ada perbedaan yang signifikan antara aktivitas spesifik GPx antara kehamilan normal, preeklampsia onset awal, dan preeklampsia onset akhir.

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Background: Preeclampsia is responsible for the mortality rate of 225 out of 100,000 deliveries in Indonesia. It is theorized that preeclampsia is caused by inadequate increase of antioxidant, one of which is glutathione peroxidase GPx, to compensate with increasing oxidative stress during pregnancy. GPx is an enzymatic antioxidant which converts peroxides to its harmless counterparts, thus limiting oxidative stress. Several studies investigating GPx produced conflicting results, and none of them were done in Indonesia. This study aimed to compare GPx specific activity in normal pregnancy, early onset, and late onset preeclampsia.

Methods: This was an observational study using comparative cross sectional design. The placental tissues were obtained from Budi Kemuliaan Hospital and Cipto Mangunkusumo Hospital in 2015. General activity U mL was measured using GPx Randox Ransel Kit based on Paglia and Valentine method, which was then divided by protein determinant mg ml to find out the specific activity U mg. The data was then analyzed using SPSS 20 with Kruskal Wallis test.

Results: Normal pregnancy had the highest specific activity 8.562 3.93320.00, followed by late onset preeclampsia 6.655 2.646 32.93 and earlyonset preeclampsia 6.328 5.873 13.17 . However, these differences were ruled insignificant using Kruskal Wallis test p 0.399 .

Conclusion There was no significant difference of GPx specific activity between normal pregnancy, early onset preeclampsia, and late onset preeclampsia."

"Salah satu penyebab tingginya angka kematian ibu adalah komplikasi kehamilan yang dapat muncul melalui tanda bahaya kehamilan. Pengetahuan ibu hamil dalam mengenali tanda bahaya dapat menjadi salah satu penentu perawatan kehamilan untuk mencegah komplikasi. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan tanda bahaya kehamilan dengan perilaku perawatan kehamilan pada ibu hamil trimester III. Penelitian ini menggunakan desain deskriptif korelatif dengan pendekatan cross sectional. Pengambilan sampel menggunakan teknik consecutive sampling dengan responden berjumlah 96 ibu hamil trimester III yang sedang melakukan kunjungan antenatal care di Puskesmas Cimanggis dan Puskesmas Sukmajaya. Hasil penelitian menunjukkan tidak ada hubungan yang signifikan secara statistik antara pengetahuan tanda bahaya kehamilan dengan perilaku perawatan kehamilan pada ibu hamil trimester III (p value: 0,135; α = 0,05). Peneliti memberikan rekomendasi kepada petugas kesehatan agar lebih memotivasi ibu hamil untuk merawat kehamilan dengan baik.

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One of causes of high maternal mortality rate is obstetric complications which rise through obstetric danger signs. Women knowledge in recognizing danger signs can be one of the determinations of pregnancy care behavior to prevent further complications.

The aim of this study was to determine the relationship between knowledge of obstetric danger signs and pregnancy care behavior among third trimester pregnant women. This study used descriptive correlative design with cross sectional approach. Consecutive sampling used as sampling technique. Samples of this study were 96 third trimester pregnant women who attended antenatal care in Puskesmas Cimanggis and Puskesmas Sukmajaya.

This study showed that there was no statistically significant relationship between knowledge of obstetric danger signs and pregnancy care behavior among third trimester pregnant women (p value: 0,135; α = 0,05). This study recommended health care professional to motivate pregnant women in practicing better pregnancy care."

"Latar belakang: Ketuban pecah dini (KPD) adalah pecahnya kantung ketuban sebelum persalinan. KPD dapat menyebabkan komplikasi yang dapat mengancam nyawa baik bagi ibu maupun bayi. Penelitian ini akan memberikan gambaran yang faktual, sistematis, dan terbaru mengenai fakta terkait kejadian ketuban pecah dini di RSCM dengan karakteristik demografi yang diselidiki. Metode: Penelitian observasional deskriptif ini mengggunakan desain potong lintang. Populasi penelitian adalah Ibu hamil yang bersalin di Rumah Sakit Cipto Mangunkusumo Jakarta selama periode Agustus hingga Desember 2021 dengan besar sampel sebanyak 80 subjek yang dalam rekam medis terdiagnosis mengalami ketuban pecah dini, diambil dengan teknik purposive sampling. Hasil: Pada penelitian ini didapatkan umur pasien diantara 16—46 tahun dengan rata-rata 29.4541 6.559. Lama pendidikan formal yang ditempuh mayoritas pasien maupun pasangannya, yakni 7 – 12 tahun baik pasien (60%) maupun pasangannya (72.5%). Jenis pekerjaan pasien didominasi oleh yang tidak bekerja (62.5%) sedangkan untuk pasangan didominasi oleh karyawan swasta (52.5%). Alamat asal tempat tinggal pasien yang memiliki persentase terbesar berasal dari Jakarta Timur (33.8%). Sebagian besar pasien multigravida (63.7%), tetapi hampir setengahnya nullipara (46.3%), dan hampir seluruh pasien tidak memiliki riwayat KPD sebelumnya (96.3%). Kesimpulan: Mayoritas pasien KPD pada penelitian ini memiliki ciri-ciri: lulusan SMA/sederajat (48.8%), tidak bekerja (62.5%), bertempat tinggal di Kota Jakarta Timur (27%), multigravida (63.7%), nullipara (46.3%), dan tidak memiliki riwayat KPD (96.3%).

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Introduction: Premature rupture of membrane (PROM) is defined as the rupture of the amniotic sac before the onset of labor. PROM may cause complications that threaten the mother's and her baby's lives. This research will give factual, systematic, and newest information on the case of premature rupture of membrane at RSCM. Methods: This cross-sectional study used a descriptive observational approach. The population are pregnant women that gave birth at RSCM from August to December 2021. Total of 80 samples was obtained using purposive sampling from secondary data in the medical records that were diagnosed with premature rupture of membrane. Result: In this study, the patient's age was between 16 and 46 years with an average of 29.4541 ± 6.559. The length of formal education taken by the majority of patients and their partners is 7-12 years, both patients (60%) and their partners (72.5%). The type of jobs of patients is dominated by those who do not work (62.5%) while for couples it is dominated by private employees (52.5%). The patient's residence address which has the largest percentage comes from East Jakarta (33.8%). Most of the patients were multigravida (63.7%), but almost half were nulliparous (46.3%), and almost all patients had no previous history of PROM (96.3%). Conclusion: The majority of PROM patients in this study had the following characteristics: high school graduates/equivalent (48.8%), not working (62.5%), residing in East Jakarta City (27%), multigravida (63.7%), nullipara (46.3%), and had no history of PROM (96.3%)"

"Placental morphology and cellular arrangement can be altered in maternal diseases. Rheumatic heart disease (RHD) is a chronic heart condition that can lead to death in pregnant women. The aim of this study is to determine the histological changes of the placenta in pregnant women suffering from RHD. Methods: Placentae were collected from 10 healthy pregnant women, and 31 pregnant women with heart conditions (26 with RHD and 5 with NRHD) who had been admitted to the Baghdad Teaching Hospital. Placental tissues were fixed in10% formal-saline and were processed for light microscopy. Measurements including the placental weight and diameter of the chorionic villi capillaries were recorded. Results: The results indicate that there are many histological changes in pregnant women with RHD such as hyalinisation, fibrosis of the chorionic villi, proliferation of trophoblastic cells, and thickening of its membrane. Additionally, expectant mothers with RHD experience a reduction in capillary diameter and thickening of the capillary walls, and decreased size and weight of their placenta when compared with the control. Conclusions: Heart diseases, especially RHD, are associated with developmental damage of the placenta in pregnant women by injuring the endothelial cells of the placentas capillaries."

"Salah satu cara menurunkan angka kematian ibu adalah meningkatkan kualitas pelayanan antenatal. Penelitian ini mencari hubungan kualitas pelayanan antenatal dengan pengetahuan, sikap, dan perilaku ibu hamil mengenai pemeriksaan kehamilan. Penelitian ini menggunakan desain cross-sectional. Penelitian dilakukan di Puskesmas Kecamatan Koja pada Maret 2013. Sampel diambil sebanyak 109 orang dengan metode konsekutif. Kualitas pelayanan antenatal dinilai melalui daftar tilik. Sedangkan pengetahuan, sikap, dan perilaku melalu kuesioner. Data dianalisis dengan uji chi-square. Mayoritas ibu hamil dalam golongan tidak berisiko, berpendidikan lebih tinggi, tidak bekerja, beban finansial keluarga di bawah rata-rata, paritas tidak lebih dari dua, dalam trimester ketiga, memiliki kunjungan yang lebih, ditemani saat berkunjung, dan tidak memiliki pengalaman pemeriksaan kehamilan. Kualitas pelayanan antenatal yang baik 42,2% dan tenaga kesehatan belum mencuci tangan, menggunakan sarung tangan, dan memberi edukasi menyusui. Pengetahuan, sikap, dan perilaku ibu hamil baik. Ada hubungan kualitas pelayanan antenatal (p=0,010) dan pendidikan (p=0,020) serta pekerjaan (p=0,039) ibu hamil terhadap pengetahuan mengenai pemeriksaan kehamilan. Ditambah, ada hubungan antara pendidikan (p=0,017) ibu hamil dengan perilaku mengenai pemeriksaan kehamilan. Kualitas pelayanan antenatal di Puskesmas Kecamatan Koja perlu ditingkatkan dengan memperketat aturan mencuci tangan dan menggunakan sarung tangan serta edukasi menyusui untuk meningkatkan keamanan dan wawasan pasien.

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One way to reduce maternal mortality rate is to improve antenatal care (ANC) quality. This research finds association between quality of ANC with knowledge, attitude, and practice about pregnancy assessment. Research design is cross-sectional. Data collection was performed at Puskesmas Kecamatan Koja on March 2013 and 109 subjects taken with consecutive sampling method. Quality of ANC is valued in checklist, while knowledge, attitude, and practice is valued by questionnaire. Data was analyzed with chi-square test. The majority of pregnant women there are in unrisk, higher education level, unemployed, below average finance, not more than two parities, in third trimester, have more visits, accompanied while visiting ANC, and no pregnancy assessment?s experience. Good quality of ANC is 42,2% and healthcare giver haven?t washed their hands, wore gloves, and given lactacy education. Knowledge, attitude, and practices is good. There is significant difference between quality of ANC (p=0,010), education level (p=0,020), and occupation (p=0,039) with knowledge about pregnancy assessment. In addition, there is siginificant differences between education level and pregnant women?s knowledge (p=0,017). Quality of ANC at Puskesmas Kecamatan Koja needs improving by strict policy in washing hands, wearing gloves, and lactacy education in order to increase patient safety and knowledge."