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"Tujuan: Membandingkan aktivitas angiogenik plasenta preeklampsia dengan dan tanpa pemberian kurkumin dan vitamin E.Rancangan Penelitian: Penelitian ini merupakan studi eksperimental in vitro. Plasenta dari ibu hamil preeklampsia (n=11) dibagi dalam 3 kelompok: kelompok kontrol, kelompok pemberian kurkumin dosis 0,01 mM, dan kelompok pemberian vitamin E dosis 20 mg/L Aktivitas angiogenesis ditentukan dengan menilai skor migrasi sel-sel endotel menuju plasenta. Analisis perbedaan aktivitas angiogenesis antar kelompok digunakan tes wilcoxon.Hasil: Aktivitas angiogenik kelompok pemberian kurkumin dosis 0,01 mM tidak berbeda bermakna dibandingkan kelompok kontrol (p>0,05). Sedangkan, aktivitas angiogenik kelompok pemberian vitamin E dosis 20 mg/L berbeda secara bermakna dibandingkan kelompok kontrol (p< 0,05).Kesimpulan: Pemberian vitamin E meningkatkan aktivitas angiogenik pada plasenta dari ibu hamil preeklampsia.

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Objective: To compare angiogenic activity in preeclamptic placenta with and without supplementation of curcumin and vitamin E.Study design: The study was an in vitro experimental study. Placentae were obtained from woman with preeclampsia (n=11) divided into three groups. The first was control, to the second group 0,01 mM curcumin was added and the third with 20 mg/I, vitamin E. Angiogenic activity was assayed using an endothelial cell migration assay. Differences in placental angiogenic activity between three groups were analysed using the Wilcoxon test.Results: The angiogenic activity in the 0,01 mM curcumin supplementation group was not significantly different than in the control group (p>0,05). While, angiogenic activity in the 20 mg/I, vitamin E group was significantly different than in the control group (p< 0,05).Conclusion: Vitamin E supplementation increased angiogenic activity in the placenta from women with preeclampsia."

"Preeklamsia (PE) selama ini selalu menjadi salah satu masalah terbesar di dunia kesehatan. Tidak hanya karena kondisi ini meyebabkan tingginya angka kematian ibu, namun keadaan ini juga dapat memicu berbagai efek negatif pada bayi. Fokus dari studi ini adalah untuk melihat peran dari prorenin dalam patogenesis PE dengan membandingkan konsentrasi prorenin pada plasenta normal dan plasenta yang diambil dari pasien PE. Sampel plasenta diperoleh dari 69 ibu hamil yang berumur sekitar 30 tahun dengan umur kehamilan bekisar 26-41 minggu. Jaringan plasenta terdiri atas 12 sampel normal, 12 sampel PE onset akhir, dan 1 sampel PE onset awal. Kit ELISA digunakan pada prosedur ini untuk meneliti konsentrasi prorenin pada jaringan secara langsung serta hasilnya diinterpretasikan bedasarkan nilai absorbansi. Normalitas distribusi data dinilai menggunakan metode SHAPIRO WILK dan ditemukan bahwa distribusi data merupakan data nonparametrik. Oleh karena itu, MANN-WHITNEY dipilih sebagai metode untuk melihat signifikansi dari perbedaan level prorenin pada sampel jaringan normal dan PE. Hasil yang didapatkan adalah p=0.932 yang berarti bahwa tidak ada perbedaan yang signifikan akan level prorenin pada sampel normal dan sampel PE. Bedasarkan penemuan ini, dapat dispekulasikan bahwa prorenin tidak secara langsung berpartisipasi dalam patogenesis PE.

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Preeclampsia (PE) has always been regarded as one of the most deteriorating burdens in the world of medicine. Not only it contributes to high maternal mortality, but it also impose numerous drawbacks to the babies. The focus of this study is to investigate the involvement of prorenin in the pathogenesis of preeclampsia by comparing its concentration in the placenta sample of normal pregnancy and both early and late onset PE. The placenta was taken from 69 pregnant women ageing around 30 years old whose gestational age ranging between 26-41 weeks. The placental tissue were consisting of 12 normal samples, 12 late-onset PE samples, and 1 early-onset PE sample. ELISA kit was used to directly observe the concentration of prorenin and the result was interpreted based on the absorbance value.  The normality of the data distribution was assessed by SHAPIRO WILK method from which the data was found to be nonparametric. Therefore, Mann-Whitney method was used in order to found the significance of prorenin level difference in normal and preeclamptic pregnancy and the obtained value was p=0.932, meaning that no significant difference was observed between prorenin level of normal and preeclamptic placenta sample. Based on this finding, it can be speculated that prorenin does not directly participate in the pathogenesis of PE."

"Pendahuluan Adanya hipertensi pada kehamilan yang diinduksi oleh preeklampsia merupakan salah satu alasan yang menyebabkan kenaikan angka kematian ibu hamil di Indonesia. Penyebab preeklampsia masih berkembang, tetapi satu gagasan menyiratkan bahwa iskemia plasenta hadir karena akumulasi stres oksidatif selama trimester terakhir kehamilan, sehingga menyebabkan hipoksia persisten. Salah satu faktor akumulasi stres oksidatif diinduksi oleh peningkatan FOXO-3. Tujuan dari penelitian observasional menggunakan desain potong lintang ini adalah untuk melihat bagaimana gen FOXO-3 mempengaruhi stres oksidatif pada plasenta normal dan pada preeklampsia onset dini (EOPE). Metode Dalam penelitian desain potong lintang ini, sampel terdiri dari 31 plasenta kehamilan normal dan 31 plasenta EOPE. RT-PCR digunakan untuk menentukan ekspresi relatif dari FOXO-3 mRNA. Hasil Antara kelompok normal dan EOPE, ekspresi relatif FOXO-3 mRNA menunjukkan ekspresi yang sama dengan normal dengan distribusi homogen antara dua kelompok, p>0.05. Kesimpulan Dapat disimpulkan bahwa ekspresi FOXO-3 pada jaringan plasenta preeklampsia onset dini lebih besar dibandingkan pada kehamilan aterm normal berdasarkan percobaan. Namun, hasilnya tidak signifikan secara statistik.......Introduction The presence of hypertension in pregnancy induced by preeclampsia is amongst the causative reason of increased maternal mortality in Indonesia. The preeclampsia etiology is still developing, but one idea implies that placental ischemia is present due to the oxidative stress accumulation during the last trimester of gestation, hence leading to persistent hypoxia. One of the factors of oxidative stress accumulation is induced by the increase of FOXO-3. The goal of this observational study using casecontrol design is to look at how the FOXO-3 gene affects oxidative stress in the normal placenta and in early onset preeclampsia (EOPE). Methods The sample consisted of 31 normal pregnancy placentas and 31 EOPE placentas in this case control research. The relative expression of FOXO-3 mRNA was determined using RT-PCR. Results Between the normal and EOPE groups, there are no differences in the relative expression of FOXO-3 mRNA in preeclamptic when being compared to normal with a homogenic distribution between two groups, p>0.05. Conclusion To conclude, the FOXO-3 expression in early onset preeclamptic placental tissue is greater than in normal term pregnancy based on the experiment. However, the result were insignificant in a statistical manner."

"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."

"Pathology of the human placenta remains the most comprehensive and authoritative text in the field. It provides extensive information on the normal placenta, encompassing physiology, metabolism, and endocrinology, and covers the full range of placental diseases in great detail. Further chapters are devoted to abortions, molar pregnancies, multiple pregnancies, and legal considerations. This sixth edition of the book has been extensively revised and expanded to reflect the most recent progress in the field, and a brand new chapter has been added on artificial reproductive technology. Some 800 illustrations are included, many of them in color. The detailed index has been further improved and tables updated."

"ABSTRAKPreeklampsia merupakan sindrom sistemik yang terjadi pada 3-5 % kehamilan wanita yang disebabkan oleh gangguan faktor migrasi dan faktor seluler  yang berdampak pada gangguan diferensiasi dan invasi trofoblas yang penting dalam proses perkembangan plasenta dan mempertahankan kehamilan. Protein Cullin-1 merupakan salah satu kandidat protein yang berperan dalam proses mempertahankan kehamilan, perkembangan dan invasi trofoblas di dalam  plasenta. Hingga saaat ini belum ada penelitian yang menghubungkan ekspresi Cullin-1 pada pasien preeklampsia dengan waktu terminasi kehamilan. Oleh karena itu pada penelitian ini dilakukan analisis ekspresi Cullin-1 pasien preeklampsia dan hubungannya dengan waktu terminasi kehamilan. Sampel plasenta diambil dari pasien preeklampsia yang terdiri dari tiga kelompok usia kehamilan, kemudian dilakukan perwarnaan imunohistokimia untuk dilihat dinamika ekspresi dan distribusi Cullin-1 pada berbagai kelompok usia kehamilan dan hubungannya dengan waktu terminasi kehamilan. Cullin-1 terekspresi pada sinsitiotrofoblas dan  sitotrofoblas. Kadar Cullin-1 terendah didapatkan pada kelompok usia kehamilan very preterm, dan paling tinggi didapatkan di kelompok usia kehamilan moderate preterm. Terdapat perbedaan bermakna antara ekspresi optical density (OD) Cullin-1 dengan   waktu terminasi  kehamilan, dan terdapat perbedaan bermakna  (OD) Cullin-1 pasien preeklampsia usia kehamilan very preterm dengan usia kehamilan moderate preterm. Disimpulkan bahwa Cullin-1 terekspresi pada sinsitiotrofoblas dan sitotrofoblas dan berhubungan dengan waktu terminasi kehamilan.

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ABSTRACT

Preeclampsia is a systemic syndrome that occurs in 3-5% of female pregnancies caused by disorders of migration factors and cellular factors that have an impact on the disruption of trophoblast differentiation and invasion that is important in the process of developing the placenta and maintaining pregnancy. Protein Cullin-1 is one candidate protein that plays a role in the process of maintaining pregnancy, development and trophoblast invasion in the placenta. Until now there have been no studies linking the expression of Cullin-1 in preeclamptic patients with the timing of pregnancy termination. Therefore in this study an analysis of Cullin-1 expression in preeclamptic patients and their relationship to the timing of pregnancy termination was carried out. Placental samples were taken from preeclampsia patients consisting of three gestational age groups, then immunohistochemical staining was performed to see the dynamics of expression and distribution in each age group of pregnancy and to find out their relationship with  the timing of pregnancy termination. Cullin-1 was expressed in syncytiotrophoblasts and cytotrophoblasts. The lowest Cullin-1 level was obtained in the very preterm age group, and the highest was found in the moderate preterm gestational age group. There was a significant difference between Cullin-1 optical density (OD) expression and termination time of pregnancy, and there was a significant difference (OD) in Cullin-1 preeclamptic patients with very preterm gestational age with moderate preterm gestational age. It was concluded that Cullin-1 was expressed both in syncytiotrophoblasts and cytotrophoblasts and was associated with the timing of pregnancy termination."

"[ABSTRAKLatar belakang: Prematuritas merupakan salah satu kelainan yang masih menjadimasalah global. Kejadian prematuritas tidak hanya terjadi di negara berkembangtetapi juga di negara maju. Beberapa kondisi ibu hamil dapat memicu keadaanhipoksia dalam rahim sehingga menyebabkan kelahiran prematur. Keadaanplasenta menggambarkan kesejahteraan janin intra uteri. Kondisi hipoksia selulermemicu ekspresi HIF-1α yang menjadi faktor transkripsi bagi CA9 sebagaipenanda hipoksia. Penelitian ini bertujuan menganalisis pengaruh hipoksiaterhadap plasenta prematur.Metode: Sampel menggunakan plasenta prematur yang hipoksia (H) dan nonhipoksia(N) sebagai kontrol. Parameter yang dinilai adalah struktur histologisplasenta (Hematoksilin-Eosin), regulator hipoksia HIF-1α (imunohistokimia), danpenanda hipoksia CA9 (ELISA).Hasil: Penilaian struktur histologis menunjukkan adanya perbedaan jumlahpembuluh darah fetus antara kedua kelompok secara bermakna, dimana padakelompok hipoksia jumlah pembuluh darah fetus lebih banyak dibandingkankelompok non-hipoksia. Distribusi intensitas ekspresi HIF-1α kedua kelompokjuga berbeda bermakna. Rerata kadar CA9 kedua kelompok tidak berbedabermakna, namun terdapat kecenderungan rerata kadar CA9 kelompok hipoksialebih tinggi 28% dibandingkan yang non-hipoksia.Kesimpulan: Pengaruh hipoksia terhadap plasenta prematur pada tingkatmolekuler berupa stabilitas protein HIF-1α yang menyebabkan peningkatanjumlah pembuluh darah fetus dan terjadi kecenderungan peningkatan sintesisprotein CA9.

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ABSTRACTBackground: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.;Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein., Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.]"

"Ekstrak plasenta mengandung berbagai zat bioaktif dan terbukti memiliki beberapa efek farmakologi diantaranya sebagai penumbuh rambut. Ekstrak plasenta bersifat hidrofilik, sehingga memiliki kemampuan penetrasi melalui kulit yang rendah. Penelitian ini bertujuan untuk meningkatkan efek penumbuhan rambut dari ekstrak plasenta sapi dengan yang dienkapsulasi ke dalam vesikel novasom. Dibuat 8 formula novasom, dilakukan evaluasi untuk memilih formula optimal, selanjutnya, formula optimal terpilih digunakan untuk uji in vivo. Untuk mendapatkan formula optimum dibuat delapan formula dengan memvariasikan jenis surfaktan yakni Span 60 dan Span 80, jenis asam lemak yakni asam oleat dan asam stearat, serta rasio surfaktan terhadap asam lemak. Variabel terikat yang diuji meliputi efisiensi penjerapan (%EE), ukuran partikel, indeks polidispersitas (IPD), dan potensial zeta. Formula yang terdiri dari Span 60, kolesterol dan asam oleat dengan perbandingan 10:10:3 menunjukkan karakteristik optimal dengan ukuran partikel 155,0 nm; IPD 0,139; potensial zeta -63,73mV dan Efisiensi penjerapan 79,68%. Hasil uji dengan mikroskop elektron transmisi (TEM) dari novasom optimal menunjukkan nanovesikel berbentuk sferis, oligolamelar non-agregat. Novasom menunjukkan sifat elastis dan stabil selama penyimpanan 90 hari pada suhu 4oC. Studi in vivo menunjukkan bahwa novasom yang mengandung ekstrak plasenta memberikan efek pertumbuhan rambut yang lebih baik dibandingkan dengan ekstrak plasenta dalam liposom dan larutan minoksidil 2%.......Placenta extract contains numerous bioactive substances and has multiple pharmacological effects, including as a hair growth agent. Placenta extract is hydrophilic, so its ability to penetrate the epidermis is limited. This study aims to improve the hair-growing effect of bovine placenta extract (PE) by loading it into a novasome. Placental extract was formulated into eight novasome formulations, evaluated to determine the optimal formula, and then used for in vivotesting with the selected optimal formula. PE-loaded novasome was prepared by thin layer hydration method. By variying the type of surfactants, the type of free fatty acid (FFA), and the ratio of surfactants to FFA, eight novasome formulations were created. The resulting PE-loaded novasomes were characterized by entrapment efficiency, particle size, polydispersity index, and zeta potential. PE-loaded novasome composed of Span 60, cholesterol and oleic acid (10:10:3) demonstrated the most optimum characteristics with PS 155.0nm; PDI 0.139; ZP -63.73 and EE 79.68%. Transmission electron microscopy of the optimum novasome revealed non-aggregating oligo-lamellar nanovesicles. In addition, novasome showed ultra-deformable properties and good stability during 90 days storage at 4oC. A hair growth study in rats showed that the PE-loaded novasome demonstrated better hair-growing effect compared to PE-loaded liposome and minoxidil 2% solution."

"Latar belakang: Spektrum plasenta akreta (SPA) adalah plasentasi abnormal yang dapat menyebabkan perdarahan masif yang mengancam nyawa wanita hamil dan kasusnya telah meningkat dalam beberapa dekade terakhir. Diagnosis dan pembedaan SPA prenatal sangat krusial untuk merencanakan manajemen multidisiplin. Magnetic Resonance Imaging (MRI) plasenta sekuens Half-Fourier Acquisition Single-shot Turbo spin Echo (HASTE) adalah pencitraan prenatal yang mempunyai resolusi baik dengan minimal artefak gerakan fetus dan ibu sehingga dapat mengevaluasi derajat invasi plasenta abnormal. Metode: Studi asosiatif dilakukan secara potong lintang melibatkan pasien dengan diagnosis SPA secara histopatologi di RSUP Fatmawati pada periode Januari 2017 hingga Februari 2023 yang menjalani pemeriksaan MRI plasenta sekuens HASTE. MRI plasenta dievaluasi secara blinded (pasien akan diberi kode dan identitas pasien disembunyikan ketika evaluasi dilakukan) oleh peneliti dan dikonfirmasi oleh dokter radiologi urogenital. Sediaan histopatologi dibaca ulang oleh dokter patologi anatomi secara blinded yang tidak mengetahui hasil USG dan MRI plasenta. Uji hipotesis menggunakan uji McNemar. Hasil: SPA berdasarkan MRI plasenta ditemukan plasenta akreta 17%; plasenta inkreta 53,2%; plasenta inkreta dan perkreta 14,9%; plasenta perkreta 14,9%. SPA berdasarkan hasil histopatologi yaitu plasenta akreta 18%; plasenta inkreta 51,1%; plasenta perkreta 10,6%. Kesesuaian MRI plasenta dengan histopatologi pada plasenta akreta R=0,138; plasenta inkreta dengan R=0,203; plasenta perkreta R=0,189. Kesimpulan: Tidak ditemukan kesesuaian antara MRI plasenta sekuens HASTE dan histopatologi yang kemungkinan disebabkan oleh signal to noise ratio (SNR) pada MRI plasenta tidak optimal; spesimen histopatologi yang diambil dari derajat invasi plasenta yang berbeda dan kurangnya informasi lokasi pengambilan spesimen; spesimen tidak berwujud vesika urinaria tetapi bagian perlekatan sehingga mungkin spesimennya tidak jelas; kurang komunikasi aktif antara operator dengan dokter patologi anatomi.......Background: Placenta accreta spectrum (PAS) is abnormal placentation associated with severe, life-threatening maternal hemorrhage that increased in last few decades. Prenatal differentiation of placenta accreta spectrum (PAS) is essential for planning multidisciplinary management. Half-Fourier Acquisition Single-shot Turbo spin Echo (HASTE) sequence of preoperative placental Magnetic Resonance Imaging (MRI) is prenatal imaging with good resolution, minimal artifacts of fetus and pregnant woman movement to evaluate abnormal placentation. Methods: Associative cross-sectionally study involved patients with PAS histopathology diagnosis at the General Hospital of Fatmawati in the period January 2017 to February 2023 who underwent HASTE sequence of placental MRI. Placental MRI evaluated blinded (patient with coded and hidden identity) by investigator and confirmed by genitourinary radiologist. Histopathology sample were reviewed by pathologist blinded (did not know results of ultrasound nor placental MRI). The compatibility of placental MRI will be assessed with histopathology findings. Test hypothesis using the McNemar’s test. Results: PAS according placenta MRI: placenta accreta 17%; placenta increta 53,2%; placenta increta and percreta 14,9%; placenta percreta 14,9%. PAS according histopathology are placenta accreta 18%; placenta increta 51,5%; placenta percreta 10.6%. The compatibility of placental MRI with histopathology the highest was placenta increta (R = 0.203) followed by placenta percreta (R = 0.189) and placenta accreta (R = 0.138). Conclusions: There was no compatibility found between HASTE sequence of preoperative placental MRI and histopathology which may be due to suboptimal signal to noise ratio (SNR) on placental MRI; histopathological specimen taken from different degree of placental invasion and lack information regarding location of specimens; specimen attached to chorionic villi not in form of urinary bladder; lack active communication between operator and pathologist. Keywords: HASTE; histopathology; placental MRI; placenta accreta spectrum."

"Latar Belakang: Spektrum Plasenta Akreta (SPA) merupakan salah satu komplikasi obstetri dengan tingkat morbiditas yang tinggi. 3D Power Doppler telah banyak digunakan untuk meningkatkan diagnosis SPA, seperti menggunakan Plasenta Akreta Indeks, tetapi hanya mengukur secara kualitatif. Oleh karena itu, penelitian ini bertujuan untuk memahami hubungan kuantitatif indeks vaskularisasi plasenta terhadap temuan makroskopik, grading histopatologi, dan perdarahan intraoperatif pada kasus SPA.Tujuan: Mengetahui hubungan indeks vaskular (vascular index / VI), indeks aliran (flow index / FI), dan indeks aliran vaskular (vascular flow Index / VFI) dengan diagnosis klinis, jumlah perdarahan dan temuan histopatologi SPA di Rumah Sakit Cipto Mangunkusumo.Metode: Sebuah studi cross-sectional dilakukan pada 34 wanita, yang secara klinis didiagnosis dengan SPA. Power Doppler 3D yang dikombinasikan dengan perangkat lunak VOCAL II digunakan untuk mengukur tingkat indeks vaskularisasi (VI), indeks aliran (FI), dan indeks aliran vaskularisasi (VFI). Gambaran gross anatomy dan hasil histopatologi yang dikategorikan sebagai akreta, inkreta, dan perkreta. Tingkat kehilangan darah intra-operatif diukur dan diklasifikasikan sebagai perdarahan masif diatas 1500 ml. Data kemudian dianalisis menggunakan Statistical Package for Social Sciences (SPSS) versi 25.Hasil: Median (min-max) untuk semua indeks vaskularisasi sebagai berikut: VI = 44,2 (23,7-74,9), FI = 35,4 (24,9-57), dan VFI = 15,3 (8,5-41,7). Nilai FI ditemukan signifikan dalam membandingkan tahap makroskopis (p =0,015) dan memiliki korelasi positif sedang dalam kaitannya dengan perdarahan (r =0,449). hasil analisa AUC of ROC VI, FI, dan VFI nilai batas terbukti sangat terkait dengan kehilangan darah 1500cc yaitu dengan hasil FI dengan nilai AUC of ROC 0.784, nilai cut off ≥38.9, OR: 10.00 (IK95% [1.58-63.09], p =0.014),VI dengan nilai AUC of ROC 0.712, nilai cut off ≥60.4, OR: 7.00 (IK95% [1.23-39.56], p =0.031), danVFI dengan nilai AUC of ROC 0.779, nilai cut off ≥23.2, OR: 9.16 (IK95% [1.53-54.59], p =0.015).Kesimpulan. Indeks Vaskularisasi Plasenta (FI) yang diukur dengan Power Doppler 3 dimensi dapat menjadi pemeriksaan tambahan Diagnostik SPA yang berpotensi dapat memprediksi kedalaman invasi SPA secara intra-pembedahan, jumlah perdarahan dan kemungkinan akan didapatkannya perdarahan masif pada pembedahan SPAKata Kunci. Plasenta akreta, 3D Power Doppler, indeks vaskular, indeks aliran, indeks aliran vaskular, perdarahan intraoperasi, histologi akreta......Background: Placenta Accreta Spectrum (PAS) is an obstetrical complication with a high level of morbidity. The 3D Power Doppler method has been widely used to improve the PAS diagnosis, such as using Placenta Accreta Index, but it only measures qualitative features. Therefore, this study aims to understand the relationship of quantitative placental vascular indices towards macroscopic findings, histopathological grading, and intra-operative blood loss in cases of PAS disorder.Objectives: Knowing the relationship between vascular index (VI), flow index (FI), and vascular flow index (VFI) with clinical diagnosis, amount of bleeding and histopathological findings of SPA at Cipto Mangunkusumo Hospital.Methods: A cross-sectional study was conducted in 34 women, who were clinically diagnosed with PAS. The 3D Power Doppler in combination with VOCAL II software was used to measure the level of vascularization index (VI), flow index (FI), and vascularization flow index (VFI). Gross anatomical appearance and histopathology results were categorized as accreta, increta, and percreta. Intra-operative blood loss level was measured and classified as massive hemorrhage if it was≥1500 ml. Data were then analyzed using Statistical Package for Social Sciences (SPSS) version 25.Results: The median (min-max) for all vascularity indexes as follows: VI = 44.2 (23.7-74.9), FI = 35.4 (24.9-57), and VFI = 15.3 (8.5-41.7). FI value was found to be significant in comparing gross pathological stages (p=0.015) and had a moderate positive correlation in relation to blood loss (r= 0.449). the results of the AUC of ROC VI, FI, and VFI analysis above the cut-off values were shown to be strongly associated with blood loss ≥1500cc the results obtained:FI with AUC of ROC value of 0.784, cut off value 38.9, OR: 10.00 (IK95% [1.58-63.09], p = 0.014),VI with AUC of ROC value of 0.712, cut off value 60.4, OR: 7.00 (IK95% [1.23-39.56], p = 0.031), andVFI with AUC of ROC value of 0.779, cut off value 23.2, OR: 9.16 (CI95% [1.53-54.59], p = 0.015).Conclusion: Flow index (FI) value from 3D Power Doppler ultrasound may become a potential diagnostic marker to predict the depth of PAS invasion prior to surgery, along with the level of blood loss intra-operatively.Keywords: Placenta accreta spectrum (PAS), Ultrasound markers, Vascularization, Macroscopic, Histopathology, Blood loss, 3D Power Doppler Biopsy, Vascular Index, Flow Index, Vascular Flow Index"