Monica Adyah Permata 22010111120033 Lap.KTI Bab8
59
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.
60
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.
62
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
63
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
69
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
2.
jaringan: formalin adalah 1:10.
Pemberian identitas pot penampung jaringan.
Anatomi.
yang sesuai dengan kriteria penelitian).
Pengiriman sampel ke laboratorium sentral bagian Patologi
Jaringan mentah dipotong menjadi 3 bagian (dipilih bagian
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
Alkohol 70 % , lama perendaman 1 jam
Alkohol 96%, lama perendaman 2 jam
Xylol, lama perendaman 1 jam
Parafin 2, lama perendaman 2 jam
Formalin 10% 2, lama perendaman 2 jam
Alkohol 80%, lama perendaman 1 jam
Etanol, lama perendaman 2 jam
Parafin 1, lama perendaman 2 jam
Parafin 3, lama perendaman 2 jam
Tujuan processing:
4.
Menghilangkan cairan pada jaringan (dehidrasi dg alkohol
bertingkat yakni : alkohol 70%,80%,96% dan etanol).
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.
70
5.
6.
Blok jaringan dipotong dengan mikrotom (ketebalan 2 mikron).
mengembang, kemudian jaringan ditempelkan pada kaca objek.
Hasil pemotongan dimasukkan dalam air hangat agar
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 3, lama perendaman 10 menit
Alkohol 96% , lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Aqua
HCL, lama perendaman 1 menit
Aqua, lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Etanol, lama perendaman 3 menit
Xylol 2, lama perendaman 10 menit
Xylol 2, lama perendaman 10 menit
Etanol , lama perendaman 3 menit
Alkohol 80% , lama perendaman 3 menit
Alkohol 50%, lama perendaman 3 menit
Hematoksilin , lama perendaman 15 menit
Bruing, lama perendaman 10 menit
Alkohol 50%, lama perendaman 3 menit
Eosin, lama perendaman 3 menit
Alkohol 96%, lama perendaman 3 menit
Xylol 1, lama perendaman 10 menit
Xylol 3, lama perendaman 10 menit
Fungsi masing-masing cairan :
Xylol berfungsi untuk melarutkan lilin
71
8.
Aqua, merupakan pelarut hematoksilin fungsi menyamakan pH
dengan hematoksilin
Hematoksilin berfungsi untuk mewarnai inti
pewarnaan tidak terlalu biru
Alkohol 50% dan 70%, merupakan pelarut eosin
Alkohol bertingkat, untuk rehidrasi jaringan
HCL berfungsi untuk mencegah pewarnaan berlebih, agar
Bruing berfungsi untuk memperjelas warna inti
Eosin, berfungsi untuk mewarnai sitoplasma
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)
72
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%
76
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
Std.
Deviation
33.45881
3.95647
30.74823
Median
Minimum
53.4325
30.80
9.0636
6.41
45.7462
23.62
Maximum
154.16
20.69
135.46
Mean
Total
Luas area Wharton's jelly
78
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
: monicaadyahpermata@gmail.com
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
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.
60
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
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23. Neville F. Hacker JGM, Joseph C. Gambone. Essentials of obstetrics and
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24. Minire A, Mirton M, Imri V, Lauren M, Aferdita M. Maternal complications
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25. Romanowicz L, Bańkowski E. Lipid compounds of human wharton's jelly
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photoalbum/thumbnails.php?album=67
29. Willacy H. oligohydramnion: EMIS, 2011:4.
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cases. J Reprod Med 1994;39:561-5.
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63
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
69
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
2.
jaringan: formalin adalah 1:10.
Pemberian identitas pot penampung jaringan.
Anatomi.
yang sesuai dengan kriteria penelitian).
Pengiriman sampel ke laboratorium sentral bagian Patologi
Jaringan mentah dipotong menjadi 3 bagian (dipilih bagian
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
Alkohol 70 % , lama perendaman 1 jam
Alkohol 96%, lama perendaman 2 jam
Xylol, lama perendaman 1 jam
Parafin 2, lama perendaman 2 jam
Formalin 10% 2, lama perendaman 2 jam
Alkohol 80%, lama perendaman 1 jam
Etanol, lama perendaman 2 jam
Parafin 1, lama perendaman 2 jam
Parafin 3, lama perendaman 2 jam
Tujuan processing:
4.
Menghilangkan cairan pada jaringan (dehidrasi dg alkohol
bertingkat yakni : alkohol 70%,80%,96% dan etanol).
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.
70
5.
6.
Blok jaringan dipotong dengan mikrotom (ketebalan 2 mikron).
mengembang, kemudian jaringan ditempelkan pada kaca objek.
Hasil pemotongan dimasukkan dalam air hangat agar
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 3, lama perendaman 10 menit
Alkohol 96% , lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Aqua
HCL, lama perendaman 1 menit
Aqua, lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Alkohol 70%, lama perendaman 3 menit
Etanol, lama perendaman 3 menit
Xylol 2, lama perendaman 10 menit
Xylol 2, lama perendaman 10 menit
Etanol , lama perendaman 3 menit
Alkohol 80% , lama perendaman 3 menit
Alkohol 50%, lama perendaman 3 menit
Hematoksilin , lama perendaman 15 menit
Bruing, lama perendaman 10 menit
Alkohol 50%, lama perendaman 3 menit
Eosin, lama perendaman 3 menit
Alkohol 96%, lama perendaman 3 menit
Xylol 1, lama perendaman 10 menit
Xylol 3, lama perendaman 10 menit
Fungsi masing-masing cairan :
Xylol berfungsi untuk melarutkan lilin
71
8.
Aqua, merupakan pelarut hematoksilin fungsi menyamakan pH
dengan hematoksilin
Hematoksilin berfungsi untuk mewarnai inti
pewarnaan tidak terlalu biru
Alkohol 50% dan 70%, merupakan pelarut eosin
Alkohol bertingkat, untuk rehidrasi jaringan
HCL berfungsi untuk mencegah pewarnaan berlebih, agar
Bruing berfungsi untuk memperjelas warna inti
Eosin, berfungsi untuk mewarnai sitoplasma
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)
72
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%
76
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
Std.
Deviation
33.45881
3.95647
30.74823
Median
Minimum
53.4325
30.80
9.0636
6.41
45.7462
23.62
Maximum
154.16
20.69
135.46
Mean
Total
Luas area Wharton's jelly
78
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
: monicaadyahpermata@gmail.com
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