Elevated sVCAM-1 levels were also seen in Indonesian women with severe pre-eclampsia. The placenta may not be the only source of elevated sVCAM-1 and that endothelial dysfunction persists beyond the postpartum period. Magnesium sulfate together with nifedipine significantly lowered blood pressure. The determination of elevated sVCAM-1 in pregnancy as a risk marker for endothelial dysfunction is therefore suggested.

Red cell distribution width (RDW) has been shown higher with the increase of inflammatory activity. As CD4 count is not available in all cities in Indonesia, RDW was hoped to be the next promising marker to predict the progression of HIV infection. This study aims to find the association of RDW with aCD4 count in HIV-positive reproductive women in Indonesia. It was a prospective cross sectional study enrolled 37 consented outpatients HIV-positive reproductive women in Haji Adam Malik General Hospital, Medan, Indonesia. A 10 mL blood was taken, separated into two tubes for complete blood count and CD4 count. Data were collected and analyzed with SPSS 19.Mean CD4 absolute was lowest in >14.5% RDW group but without statistical significance. By classify CD4 absolute count, CD4 absolute ≤350/mm3 showed significantly higher RDW than CD4 absolute >350/mm3 (13.98±2.10% vs 12.79±0.88%; p=0.02). No correlation was between RDW and CD4 absolute, as well as, with CD4%.In conclusion, high RDW can be a promising marker to predict the low CD4 count in HIV-positive reproductive women within antiretroviral therapy.

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Background: Indonesia is the fourth most populous country in the world, so the government has focused Family Planning Program using contraception. Implants and IUDs are two most effective reversible contraceptive methods and often used in Indonesia. Implant releases progestin, with most common reported side effect of abnormal bleeding. Specically for levonorgestrel implants, changes in menstrual intervals, duration, volume of menstrual ow can occur. Progestins are believed to cause changes in platelet and blood vessel, leading to hypercoagulability state, which can be assessed through coagulation assays (PT, TT, aPTT) and level of AT-III. Objective: This aims to determine the differences in coagulation assays and AT-III levels between levonorgestrel implant versus IUD acceptors. Methods: This study was an observational analytic study with retrospective cross-sectional design. The population were case population (levonorgestrel implant acceptors) and control population (IUD). A total of 74 respondents were chosen by consecutive sampling. Characteristics data were obtained by interview, anthropometric measurements, and medical records; PT, TT, aPTT, and AT-III data were obtained from blood samples by ELISA method. An independent T-test was used to analyze the data. Results: Mean PT was the same for implant and IUD users, 13.11 seconds (SD=0.81 seconds) (p=0.1,000). Mean TT of implant users was 14.78 seconds (SD=1.18 seconds) and IUD 14.58 seconds. (SD=1.18 seconds) (p=0.75). Mean aPTT for implant users was 30.22 seconds (SD=4.65 seconds) and IUD 30.55 seconds (SD=2.79 seconds) (p=0.200). Mean of ATIII in implant users was 92.18% (SD=9.72%) and IUD 84.79% (SD=14.74%) (p=0.250). Conclusion: No signicant mean differences for PT, TT, aPTT, and AT-III between groups of levonorgestrel implant and IUD acceptors (p value> 0.05).

Background: Preeclampsia with severe features is an endothelial disease that causes renal system disorders during pregnancy. Preeclampsia is an important cause of acute kidney injury and risk for chronic kidney disease. Methods: This study was a case series conducted at the Department of Obstetrics and Gynecology, H. Adam Malik General Hospital Medan, Indonesia starting from December 2019 until January 2020. Total sampling technique was employed obtaining 31 subjects with a history of preeclampsia with severe features for at least 3 months to 2 years postpartum, without a history of chronic disease, diabetes mellitus, and congenital kidney disorders. Proteinuria, serum creatinine, and GFR calculations were performed. Results: There were 31 patients who met the inclusion and exclusion criteria. At a time interval of 4 - ≤13 months postpartum, 2 levels of proteinuria +1 (0-2), serum creatinine 0.81 ± 0.21 mg/dl, and levels of GFR 109.57 ± 25.13 (ml/min/1.73 m ). Whereas at the time interval of >13 - 24 months postpartum, levels of proteinuria +1 (0-3), serum creatinine 0.85 ± 0.23 mg/dl, and GFR 2 levels of 104. 41 ± 28.45 (ml/min/1.73 m ). The mean of serum creatinine before delivery was 0.69 ± 0.15 mg/dl and after delivery was 0.83 ± 0.22 mg/dl. The mean of GFR postpartum at group of history of early onset preeclampsia was 103.07 ± 25.23 2 2 (ml/min/1.73 m ) and group of history of late onset preeclampsia was 113.40 ± 28.24 (ml/min/1.73 m ). Conclusion: There was a tendency for a decrease in renal function among women with a history of preeclampsia with severe features with ndings of persistent proteinuria from more than 3 to 24 months postpartum, an increase in mean of serum creatinine levels from before and after delivery and a decrease in GFR, but it was not signicant. This was related to the slow course of chronic kidney disease, so it had to be followed up periodically.