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Abstrak :
Latar belakang. Prevalensi preeklampsia masih tinggi pada ibu hamil dan janin di negara berkembang. Patofisiologi preeklampsia masih belum dapat dipahami sepenuhnya. Stres oksidatif, inflamasi dan malnutrisi masih menjadi hipotesis utama yang dihubungkan dengan kejadian preeklampsia. Koenzim Q10 merupakan komponen penting dalam tubuh sebagai antioksidan. Tujuan. Studi ini merupakan studi potong lintang komparatif pertama di Indonesia. Subjek penelitian diambil dari dua rumah sakit di Jakarta. Studi untuk menilai status gizi ibu hamil di Indonesia, asupan koenzim Q10, dan kadar koenzim Q10 plasma pada ibu hamil yang dihubungkan dengan kejadian preeklampsia. Metode. Sebanyak 72 subjek preeklampsia dan non-preeklampsia direkrut dari RS Cipto Mangunkusumo dan Koja, Jakarta pada bulan September 2018 sampai November 2018. Kriteria inklusi meliputi subjek usia >18 tahun, usia kehamilan >34 minggu dan in partu, kehamilan tunggal, intrauterin, hidup, dan kriteria ekslusi meliputi riwayat penyakit kronik misalnya hipertensi kronik, diabetes mellitus, dan penyakit ginjal sebelum dan saat hamil. Data karakteristik, data klinis, sampel plasma darah, kuesioner food recall 1x24 jam dan FFQ semikuantitatif diambil pada peneltian ini. Data dianalisis statistik menggunakan SPSS versi 20.0. Hasil. Kejadian preeklampsia lebih banyak terjadi pada usia yang lebih tua yaitu >35 tahun (p = 0,001). Tingkat pendidikan, pekerjaan, usia kehamilan, riwayat obstetri yaitu paritas, dan status gizi antara perempuan hamil dengan preeklampsia dan non-preeklampsia secara statistik tidak berbeda bermakna. Semua subjek pada kelompok preeklampsia dan non-preeklampsia (termasuk hamil normal) memiliki kadar koenzim Q10 plasma yang rendah. Kadar koenzim Q10 di plasma pada kelompok preeklampsia cenderung lebih rendah daripada non-preeklampsia tetapi secara statistik tidak berbeda bermakna. Kesimpulan. Semua subjek pada kelompok preeklampsia dan non-preeklampsia (termasuk hamil normal) memiliki kadar koenzim Q10 plasma yang rendah, walaupun asupan koenzim Q10 adalah kategori cukup namun kualitasnya rendah pada sebagian besar subjek preeklampsia dan non-preeklampsia. ...... Background: Preeclampsia remains a major issue in developing countries. Studies on this disease have yet to clearly elucidate the precise mechanism of its pathogenesis. Oxidative stress, inflammation, and malnutrition have been correlated with preeclampsia. Coenzyme Q10 (CoQ10) is a vital nutrient for pregnant women as an antioxidant. Aim: This was the first comparative cross-sectional study in two hospitals in Jakarta to investigate the nutrition status of pregnant women in Indonesia, CoQ10 intake and plasma levels during pregnancy, and correlation with the incidence of preeclampsia. Methods: Seventy-two preeclamptic and non-preeclamptic pregnant mothers were enrolled in this study. We included patients above 18 years old, gestational age >34 weeks, singleton pregnancy, and excluded patients with history of chronic hypertension, diabetes mellitus, and renal diseases before or during current pregnancy. Clinical data and 24-hour food recall and semi-quantitative food frequency questionnaire were collected. Plasma CoQ10 levels were also obtained. Data was statistically analyzed using SPSS version 20.0. Results: Age (above 35 years old) was significant when comparing preeclampsia and non-preeclampsia group (p = 0.001). Education, work status, gestational age, pregnancy history, BMI, dietary intake, and nutrition status were not statistically significant between both groups. The plasma CoQ10 levels in preeclampsia group were lower than non-preeclampsia group, albeit not statistically significant. The main results show all subjects were patients with severe late-onset preeclampsia with decreased plasma CoQ10 level. Conclusions: Both preeclamptic and non-preeclamptic subjects in Indonesia show reduced plasma CoQ10 levels. Despite adequate intake, plasma CoQ10 levels in pregnant women remain low.

Abstrak :
Latar Belakang : Preeklamsia terjadi akibat adanya gangguan pada proses implantasi dan desidualisasi pada awal kehamilan. Vitamin D memainkan peranan penting pada proses desidualisasi, implantasi dan plasentasi. Penelitian terbaru menunjukkan bahwa kadar 25(OH)D yang rendah dalam serum merupakan faktor risiko preeklamsia. Bukti terbaru mendukung peran suplementasi vitamin D yang dimulai pada saat sebelum, awal dan selama kehamilan dalam mengurangi risiko preeklamsia. Tujuan penelitian ini adalah untuk mengetahui peranan suplementasi vitamin D 5000 IU/hari pada implantasi dan plasentasi melalui pemeriksaan PI A. Uterina dan PlGF serum maternal pada wanita hamil trimester pertama. Metode : Uji klinis paralel acak tersamar tunggal. Subjek wanita hamil usia 7-11 minggu yang dibagi 2 kelompok, yaitu normal dan risiko tinggi berdasarkan kriteria risiko tinggi ACOG. Tiap kelompok dibagi lagi menjadi kontrol yang hanya mendapat obat standar dan perlakuan yang mendapat vitamin D 5000 IU/hari. Semua pasien diperiksa kadar 25(OH)D awal, kemudian diberikan intervensi selama 1 bulan dan diperiksa ulang kadar 25(OH)D akhir, PlGF serum maternal dan PI. A. Uterina. Menilai perbandingan kenaikan kadar 25(OH)D, PlGF, dan PI A. Uterina diantara semua kelompok Hasil : Subjek awal berjumlah 92 orang, dieksklusi sebanyak 12 orang dan tersisa 80 subjek yang menyelesaikan penelitian. Semua subjek mengalami defisiensi vitamin D. Dibandingkan pasien kontrol kenaikan kadar 25(OH)D pada kelompok perlakuan normal masih lebih tinggi dibandingkan dengan kelompok perlakuan risiko tinggi yaitu 12,33±6,26 ng/mL dan 10,45±5,09 ng/mL dengan nilai p<0,001. Kelompok normal, penurunan PI A. Uterina dibandingkan antara kontrol dan perlakuan bermakna sebesar 0,57±0,36 dan 1,08±0,29 (p<0,001) sedangkan kadar PlGF juga berbeda bermakna antara kontrol (84,27±10,02) dan perlakuan (107,87±31,97) dengan nilai p 0,005. Pada kelompok risiko tinggi, perbadingan rerata kadar PlGF pada kontrol dan perlakuan berbeda bermakna yaitu 37,59±9,67 dan 70,53±18,32) nilai p<0,001. Pada pasien intervensi baik kelompok normal dan risiko tinggi rerata penurunan PI A. Uterina (1,08±0,29 vs 0,43±0,26; nilai p<0,001) dan kadar PlGF (107,87±31,97 vs 70,53±18,32; nilai p<0,001) berbeda bermakna. ......Background : Preeclampsia occurs due to disruption of the implantation and decidualization in early pregnancy. Vitamin D plays an important role in decidualization, implantation, and placentation. Recent evidence supports the role of vitamin D supplementation initiated before, early and during pregnancy in reducing the risk of preeclampsia. The study aim is to determine the effect of vitamin D supplementation of 5000 IU/day on implantation and placentation through examination of Uterine Artery PI (UtA-PI) and maternal serum PlGF in first trimester pregnant women. Methods: Using a single-blind, randomized parallel clinical trial. Subjects were pregnant women 7-11 weeks gestation and divided into 2 groups, normal and high risk, based on ACOG preeclampsia high risk criteria. Each group was further divided into controls who received the standard drug and interventions who received 5000 IU of vitamin D/day. Subjects were examined for 25(OH)D levels before and after the 1 month intervention, including maternal serum PlGF and UtA-PI levels. Both groups were compared for the difference of 25(OH)D levels, mean PlGF, and UtA-PI. Results: We have 80 subjects who have vitamin D deficiency. The normal and high-risk intervention group showed the increase of 25(OH)D levels, 12.33±6.26 ng/mL and 10.45±5.09 ng/mL with p<0.001 accordingly. For the normal group, the decrease of UtA-PI compared between control and intervention was significant 0,57±0,36 and 1,08±0,29 (p<0.001) while PlGF levels were also significantly different between control (84,27±10,02) and intervention (107,87±31,97) with p<0.05. While in high-risk group, the PlGF levels of control and intervention were significantly different, 37.59±9.67 and 70.53±18.32 with p<0.001. In intervention patients, both normal and high-risk groups, the decrease of UtA-PI (1.08±0.29 vs 0.43±0.26; p<0.001) and PlGF levels (107.87±31.97 vs 70.53±18.32; p<0.001) were significantly different.

Abstrak :
Latar Belakang: Asam lemak rantai panjang Omega-3 dan Omega-6 selain penting untuk perkembangan otak janin, diketahui juga dapat mempengaruhi kejadian preeklamsia. Derivat omega-3 seperti DHA dapat membantu stimulasi Vascular Endothelial Growth Factor (VEGF) yang berperan dalam angiogenesis saat implantasi trofoblas. Belum tersedianya data pengaruh asam lemak rantai panjang terhadap kejadian preeklamsia mendorong untuk dilakukannya penelitian ini. Tujuan: Mengetahui perbedaan kadar Omega-3 dan Omega-6 pada ibu hamil dengan preeklamsia dan normal Metode: Penelitian dilakukan dengan uji potong-lintang menggunakan sampel ibu hamil preeklamsia dan tidak preeklamsia yang telah dikumpulkan sebelumnya pada tahun 2018 di RSUPN Dr. Cipto Mangunkusumo dan RSU Budi Kemuliaan dan RSUD Koja, kemudian dilakukan pengolahan pada Januari 2020. Hasil: Diperoleh 60 subjek penelitian dengan 30 subjek pada masing – masing kelompok. Pada kelompok preeklamsia didapatkan hasil Omega-3 lebih rendah dengan median kadar ALA 39 μmol/L dan EPA 9 μmol/L dengan perbedaan yang bermakna (p=0,01). Sedangkan kadar Omega-6 ditemukan lebih tinggi pada preeklamsia, dengan kadar LA 4726 μmol/L dan AA 558 μmol/L. Indeks omega-3 pada kelompok preeklamsia juga rendah yaitu 2%, begitu pula rasio Omega-6/Omega-3 yang tinggi (17 μmol/L) dan rasio AA/EPA 61 μmol/L. Kesimpulan: Ketidakseimbangan antara Omega-3 dan Omega-6, indeks Omega-3 rendah, rasio Omega-6/Omega-3 dan rasio AA/EPA yang tinggi didapatkan pada preeklamsia. ......Background: Omega-3 and Omega-6 long-chain fatty acids, besides being important for fetal brain development, are also known to influence the incidence of preeclampsia. Omega-3 derivatives such as DHA can help stimulate Vascular Endothelial Growth Factor (VEGF) which plays a role in angiogenesis during trophoblast implantation. The unavailability of data on the effect of long-chain fatty acids on the incidence of preeclampsia is encouraging this study. Objective: To determine differences in levels of Omega-3 and Omega-6 in pregnant women with preeclampsia and normal Methods: The study was carried out by cross-sectional testing using samples of preeclampsia and non-preeclampsia pregnant women that had been collected earlier in 2018 at Dr. RSUPN. Cipto Mangunkusumo and Budi Kemuliaan Hospital and Koja District General Hospital then processed in January 2020. Results: Obtained 60 research subjects with 30 subjects in each group. Results with low category were obtained in the preeclampsia group with median levels of Omega-3, ALA 39 μmol / L, EPA 9 μmol / L with significant differences (p = 0.01). While high levels of Omega-6 in preeclampsia, LA 4726 μmol / L and AA 558 μmol / L. The omega-3 index in the preeclampsia group was also low at 2%, as was the high Omega-6 / Omega-3 ratio (17 μmol / L) and the 61 μmol / L AA / EPA ratio in the preeclampsia group. Conclusion: An imbalance between Omega-3 and Omega-6, low index of Omega-3, a ratio of Omega-6 / Omega-3, and ratio of high AA / EPA is found in preeclampsia.

Abstrak :
Preeklamsia merupakan salah satu penyebab kematian utama ibu dan perinatal di dunia. Inflamasi disertai tingginya indeks apoptosis di syncytiotrophoblast dan ekspresi Cyclophilin A diduga berperan pada preeklamsia. Faktor tersebut diasumsikan menyebabkan jejas jantung/pembuluh darah yang meningkatkan risiko morbiditas dan mortalitas ibu dan perinatal. Tujuan penelitan ini adalah menganalisis peran inflamasi, indeks apoptosis dan Cyclophilin A terhadap jejas jantung/pembuluh darah pada preeklamsia awitan dini, lanjut dan kehamilan normal. Sebanyak 47 wanita hamil yang terpilih dilakukan pemeriksaan hematologi, ekokardiografi dan ultrasonografi Doppler. Plasenta diperiksa secara histopatologis untuk mengukur ekspresi NF-KB dan PARP-1, indeks apoptosis berdasarkan pemeriksan TUNEL, ekspresi Cyclophilin A dan pemeriksaan ultrastruktur mikroskopik pada syncytiotrophoblast. Analisis Anova digunakan untuk mengidentifikasi perbedaan antara ketiga kelompok, sedangkan regresi linier digunakan untuk mengetahui korelasi faktor yang diduga terhadap jejas jantung/pembuluh darah menggunakan SPSS 20. Usia ibu, indeks massa tubuh (IMT), hitung trombosit, NF- KB dan indeks apoptosis lebih tinggi disertai Cyclophilin A lebih rendah pada preeklamsia awitan dini dibandingkan preeklamsia awitan lanjut dan kehamilan normal. Hitung leukosit lebih tinggi pada preeklamsia awitan lanjut dibandingkan awitan dini dan normal. Total peripheral resistance (TPR) paling tinggi pada kelompok awitan dini dibandingkan awitan lanjut dan kehamilan normal, sedangkan cardiac index (CI) tidak berbeda bermakna pada ketiga kelompok. Resistensi indeks (RI) lebih tinggi pada preeklamsia awitan dini dibandingkan awitan lanjut dan kehamilan normal. Berdasarkan analisis regresi linier multivariat, membuktikan indeks apoptosis dan Cyclophilin A memiliki hubungan dengan jejas jantung/pembuluh darah. Hal tersebut menunjukkan inflamasi, indeks apoptosis, Cyclophilin A disertai pemeriksan ekokardiografi dan ultrasonografi Doppler merupakan metode yang cepat, tepat dan noninvasif faktor risiko terhadap jejas jantung/pembuluh darah pada preeklamsia. Penelitian yang dianjurkan di masa datang adalah menilai geometri jantung dengan ekokardiografi dan volumetri plasenta dengan ultrasonografi. ...... Preeclampsia is one of the leading cause of maternal and perinatal death in the world. Inflammation accompanied by a high apototic index of syncytiotrophoblast and Cyclophilin A were speculated to play a role in preeclampsia. Those response were assumed to cause cardiovascular injury which lead to the risk of maternal and perinatal morbidity and mortality in preeclampsia. The objective of the study was to investigate the role of inflammation, apoptotic index and Cyclophilin A in cardiovascular injury in early and late onset preeclampsia compared to normal pregnancy. A total of 47 pregnant women were selected, consisting almost the same size of each group (30%) and assessed for maternal hematology, echocardiography and Doppler ultrasound. Placentae were assessed histopathologically by measuring nuclear factor kappa-light-chain-enhancer of activated B cells (NF- KB) and Poly (ADP-ribose) polymerase 1 (PARP-1) expression for inflammation marker, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay for apoptotic index and Cyclophilin A. Confirmation by transmission electron microscopy (TEM) was done. Anova analysis was used to identify the differences between the three groups while linier regression was employed to assess the correlation between factors on cardiovascular injury using SPSS 20. Maternal age, body mass index (BMI), platelet count, NF- KB and apoptotic index, resistance index (RI) were higher supported by low Cyclophilin A in early onset preeclampsia (EOP) than in late onset preeclampsia (LOP) and normal pregnancy. Leukocyte count was higher in late onset preeeclampsia than in early and normal pregnancy. Total peripheral resistance (TPR) was highest in the EOP compared to LOP and normal pregnancy, while the cardiac index (CI) was not significantly different in all groups. Based on multivariate linear regression analysis, the apoptotic index and Cyclophilin A correlated to cardiovascular injury. Assesing inflammation, apoptotic index, Cyclophilin A, echocardiography examination and Doppler ultrasound examination might indicated timely and non-invasive detection as an alarm entry point for cardiovascular injury in both early and late onset preeclampsia. Cardiac geometry by echocardiography and placental volumetry by Doppler ultrasound should be performed in future research.

Abstrak :
Latar Belakang: Prevalensi preeklamsia dalam kehamilan di Indonesia sebesar 7-10%, Asam asetilsalisilat yang mengandung senyawa aktif asam salisilat diketahui dapat mencegah terjadinya preeklamsia awitan dini terutama bila diberikan sebelum usia kehamilan 16 minggu. Tubuh memiliki asam salisilat natural yang didapatkan dari konsumsi sayuran yang mengandung asam salisilat. Asam salisilat merupakan senyawa aktif yang berperan sebagai anti inflamasi. Penelitian ini bertujuan menilai apakah kejadian preeklamsia dipengaruhi oleh kadar asam salisilat natural serum dan urin. Metode: Penelitian ini menggunakan disain case-control berpasangan. Subjek adalah pasien hamil dengan preeklamsia awitan dini (PEAD) dibandingkan dengan hamil normotensi 20-34 minggu terdiri atas 35 pasien/kelompok, preeklamsia awitan lambat (PEAL) dibandingkan dengan hamil normotensi 34-40 minggu terdiri atas 39 pasien/ kelompok. Pemeriksaan kadar asam salisilat (SA) dan asam salisilurat (SUA) dalam serum diperiksa dari sampel darah vena, kadar SA dan SUA urin diperiksa dari sampel urin sewaktu yang terkoreksi dengan kadar kreatinin urin, semuanya diperiksa menggunakan kromatografi. Seluruh subjek dilakukan wawancara FFQ (Food Frequent Questionnaire) untuk mengetahui asupan makanan selama hamil. Analisis statistik yangdigunakan adalah uji Mann Whitney . Hasil: Median usia kehamilan pasien PEAD adalah 31 minggu, kelompok normal adalah 30 minggu. Kadar SUA serum pada PEAD berbeda bermakna dibandingkan hamil normal dengan median 1,43 (min-max 0,001-9,32) vs 0,21 (0,002-15,78) nilai p<0,001. Kadar albumin pada PEAD berbeda bermakna dengan hamil normal median 3 (2,1 – 3,8) vs 3,7 (3,4-4,3) p<0,001. Kadar Asupan protein berbeda bermakna (13% vs 14%, p<0,001)Kadar serat pangan pada PEAD berbeda bermakna dibandingkan hamil normal (8 gram/hari vs 9,6 g/hari, p<0,001). Kadar SA dalam serum dan urin, SUA urin pada kelompok ini tidak berbeda bermakna. Median usia kehamilan PEAL dan normotensi adalah 37 minggu. Kadar SA serum dan urin dan SUA serum tidak berbeda bermakna antara kedua kelompok. Kadar albumin pada PEAL berbeda bermakna dengan median (3 (2,4-3,6) vs 3,4 (2,9-4,1) p<0,001). Simpulan : Tidak terdapat perbedaan bermakna kadar asam salisilat dan asam salisilurat pada serum dan urin pada kehamilan preeklamsia dan normotensi. Kelompok PEAD terdapat kadar SUA serum yang lebih tinggi dan berkorelasi dengan kadar albumin dan asupan protein yang rendah. Asupan serat pangan berhubungan dengan kejadian PEAD, tetapi tidak berhubungan dengan kadar asam salisilat dan asam salisilurat ......Background: The prevalence of preeclampsia in pregnancy in Indonesia is 7-10%. Acetylsalicylate which contains the active compound salicylic acid is known to prevent early onset preeclampsia, especially if given before 16 weeks of gestation. The body has natural salicylic acid which is obtained from the consumption of vegetables that contain salicylic acid. Salicylic acid is an active compound that acts as an anti-inflammatory. This study aims to assess whether the incidence of preeclampsia is influenced by the levels of natural salicylic acid in the blood and urine. Methods: : A matched case-control was adopted in this study. Subjects were pregnant patients with early onset preeclampsia (EOP) compared to normotensive pregnancies of 20-34 weeks consisting of 35 patients/group, late onset preeclampsia (LOP) compared with normotensive pregnancies of 34-40 weeks consisting of 39 patients/group. Examination of salicylic acid (SA) and salicylic acid (SUA) levels in serum was examined from venous blood samples, urine SA and SUA levels were examined from urine samples while corrected by urine creatinine levels, all were examined using chromatography. . To measure food intake during pregnancy, all subject were interviewed using the FFQ (Food Frequent Questionnaire). The Mann Whitney test was utilized in the statistical analysis. Objective: The goal of this study is to see if natural blood and urine levels of salicylic acid affect the risk of preeclampsia. Result :EOP subject had a median gestational age of 31 weeks, while normal group 30 wga. Serum SUA levels in EOP were considerably different from normal pregnant women, with a median of 1.43 (min-max 0.001-9.32) versus 0.21 (0.002-15.78) p value <0.001, while albumin levels in EOP were significantly different from normal pregnant women, with a median of 3 (2.1-3.8) vs. 3.7 (3.4-4.3) p<0.001, and protein intake significantly lower than normal (13 vs 14%, p<0,001).. Dietary fiber in EOP was significantly different compared to normal pregnancy (8 g/day vs 9.6 g/day, p<0.001) SA levels in serum and urin, as well as urine SUA, were not substantially different in this group. LOP and normotensive gestational age were both 37 weeks. The levels of SA and SUA in the serum and urine were not substantially different between the two groups. With a median of 3 (2.4-3.6) vs. 3.4, albumin levels in PEAL were substantially different (2.9-4.1). Conclusion: In preeclampsia and normotensive pregnancies, there was no significant difference in salicylic acid and salicyluric acid levels in blood and urine. The serum SUA levels in the EOP group were greater and associated with low albumin levels and low protein intake. Fiber intake was linked to the development of EOP, but not to salicylic acid levels or salicyluric acid levels.

Abstrak :
Salah satu penyebab tingginya angka kematian ibu di Indonesia adalah adanya hipertensi pada kehamilan yang disebabkan oleh preeklampsia. Hingga saat ini, penyebab preeklampsia masih belum diketahui secara pasti, namun teori yang berkembang menyebutkan adanya iskemia plasenta. Iskemia plasenta disebabkan adanya kegagalan pada proses angiogenesis. Penelitian yang menggunakan desain potong lintang ini bertujuan untuk melihat perbedaan protein yang mempengaruhi proses angiogenesis pada plasenta normal dan preeklampsia serta melihat interaksinya. Sampel yang digunakan adalah 34 plasenta kehamilan normal dan 34 plasenta kehamilan preeklampsia. Kadar protein TGF- , TGF- Reseptor dan SMAD2 diperiksa menggunakan metode ELISA dan ekspresi relatif mRNA SMAD2 dan TSP-1 diperiksa menggunakan metode RT-qPCR.Kadar protein TGF- , TGF- Reseptor 1, TGF- Reseptor 2 dan protein SMAD2 meningkat pada preeklampsia p=0,0001, p=0,004, p=0,0001, p=0,0001 . Ekspresi mRNA SMAD2 dan TSP-1 pada preeklampsia juga mengalami peningkatan p=0,033, p=0,002 . Didapatkan korelasi positif kuat antara kadar protein TGF- Reseptor 1 dan TGF- Reseptor 2 pada plasenta normal p=0,0001 R=0,799 dan preeklampsia p=0,0001 R=0,783 . Korelasi positif sedang pada korelasi TGF- dan protein SMAD2 pada plasenta normal p=0,0001 R=0,672 dan korelasi positif ringan pada plasenta preeklampsia p=0,028 R=0,331 . Ada korelasi positif kuat antara TGF- Reseptor 1 dan protein SMAD2 0,0001 R=0,704 pada plasenta normal dan korelasi positif sedang pada plasenta preeklampsia p=0,0001 R=0,675 . Pada korelasi antara TGF- Reseptor 2 dengan protein SMAD2 plasenta normal diperoleh korelasi sedang p=0,0001 R=0,650 begitu juga pada plasenta preeklampsia 0,0001 R=0,675 . Kemudian pada uji korelasi antara protein TGF- dengan mRNA SMAD2 diperoleh korelasi positif ringan pada plasenta normal p=0,022 R=0,347 dan tidak ada korelasi pada plasenta preeklampsia. Pada uji korelasi antara protein TGF- Reseptor 1 dengan mRNA SMAD2 diperoleh korelasi positif ringan pada plasenta normal p=0,016 R=0,370 dan tidak ada korelasi pada plasenta preeklampsia. Tidak ditemukan korelasi antara TGF- Reseptor 2 dengan mRNA SMAD2 pada kedua kelompok. Kemudian tidak ditemukan korelasi protein SMAD2 dengan mRNA TSP-1 pada plasenta normal namun terdapat korelasi positif kuat pada plasenta preeklampsia p=0,0001 R=0,774 . Dari penelitian ini disimpulkan bahwa ada pengaruh peningkatan kadar TGF- , TGF- Reseptor, dan protein SMAD2 dengan ekspresi relatif TSP-1 pada proses angiogenesis.

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One of the causes of high maternal mortality in Indonesia is the presence of hypertension in pregnancy caused by preeclampsia. Until now, the cause of preeclampsia is still not known, but the theory suggests the presence of placental ischemia. Placental ischemia is caused by failure of angiogenesis. This cross sectional study aims to examine the differences in proteins that affect angiogenesis in normal placenta and preeclampsia and see their interactions. The sample used was 34 placentas of normal pregnancy and 34 placental preeclampsia pregnancy. TGF protein levels, TGF receptors and SMAD2 were examined using the ELISA method and the relative expression of SMAD2 and TSP 1 mRNA was examined using the RT qPCR method.Levels of TGF protein, TGF Receptor 1, TGF Receptor 2 and protein SMAD2 increased in preeclampsia p 0.0001, p 0.004, p 0.0001, p 0.0001 . SMAD2 and TSP 1 mRNA expression in preeclampsia also increased p 0.033, p 0.002 . There was a strong positive correlation between protein content of TGF receptor 1 and TGF receptor 2 in normal placenta p 0.0001 R 0,799 and preeclampsia p 0.0001 R 0,783 . Moderate positive correlations in TGF and SMAD2 protein correla tion on normal placenta p 0.0001 R 0.672 and mild positive correlation of placenta preeclampsia p 0.028 R 0.331 . There was a strong positive correlation between TGF receptor 1 and the SMAD2 protein 0.0001 R 0.704 in normal placenta and moderately positive correlation in the preeclampsia placenta p 0.0001 R 0.675 . In the correlation between TGF Receptor 2 with normal placental SMAD2 protein obtained moderate correlation p 0.0001 R 0.650 as well as on preeclampsia placenta 0.0001 R 0.675 . Then the correlation test between TGF protein and SMAD2 mRNA obtained a mild positive correlation on normal placenta p 0,022 R 0,347 and no correlation on placenta preeclampsia. In the correlation test between TGF protein Receptor 1 and SMAD2 mRNA obtained a mild positive correlation on normal placenta p 0.016 R 0.370 and no correlation in placenta preeclampsia. No correlation was found between TGF receptor 2 and SMAD2 mRNA in both groups. Then there was no correlation of SMAD2 protein with TSP 1 mRNA in normal placenta but there was a strong positive correlation in placenta preeclampsia p 0.0001 R 0.774 . From this study it was concluded that there was an effect of increased levels of TGF , TGF receptor, and SMAD2 protein with relative expression of TSP 1 in angiogenesis process.