Abnormal uterine bleeding (AUB) is defined as the abnormal bleeding from the uterine corpus in term of duration, volume, frequency and/or regularity. This condition occurs in 37% of adolescents and may affect the quality of life and increased hospitalization. Etiology is divided into structural and non-structural causes, known as PALM-COEIN. The most common etiology in adolescents is anovulatory menstruation due to immature hypothalamus-hypophysis axis. Diagnostic evaluation should include investigation in the etiology of AUB, anemia signs, and hemodynamic status. Treatment of AUB consists of hormonal and non-hormonal therapy. Therapy in adolescent is given based on the severity of bleeding, grading of anemia, and hemodynamic stability. Follow-up is required after therapy. Understanding AUB in adolescents can help clinicians deliver appropriate and comprehensive treatment. This review was aimed to explain about definition, epidemiology, etiology, pathophysiology, diagnosis, and treatment of abnormal uterine bleeding in adolescent.

A B S T R A C TIntroduction. Preeclampsia is one of the leading causes of maternal and perinatalmorbidity and mortality and is still a disease of theory. Klotho is a new gene, inseveral biological processes in the pathophysiology of preeclampsia that play a rolein regulating endothelial nitric oxide production, angiogenesis, production ofantioxidant enzymes and protection against endothelial dysfunction. The Klotho G-395A genotype AA promoter polymorphism is the cause of hypertension. This studyaims to determine the relationship of the Klotho G-395A promoter polymorphism tothe incidence of preeclampsia. Methods. This study is an analytical study with acase-control design. The research was conducted at Pembina community healthcentre of Palembang and the public hospital of Prabumulih in February - July 2020and involving 50 case group and 50 control group. To determine the genotype andallotype of the Klotho G-395A gene promoter polymorphism, using polymerase chainreaction examination. Result. The results showed that the risk factors for maternalage and maternal gestational age had a significant relationship with the incidence ofpreeclampsia (p-value 0.015; p-value 0.000). There was a significant relationshipbetween the Klotho G-395A genotype GA + AA promoter polymorphism and theincidence of preeclampsia (p-value 0.024; OR = 2.571; 95% CI = 1.122-5.895), whileallotypes in the study sample also had a significant relationship with the incidenceof preeclampsia. preeclampsia (p-value 0.025; OR = 1.978; 95% CI = 1.087-3.599).Conclusion: There is a significant relationship between the Klotho G-395A genepromoter polymorphism and the incidence of preeclampsia.

Bleeding that occurs in intramural myoma to date have not revealed the clear mechanism. Presumably, the decrease of progesteron and estrogen by the time of menstruation occurs (progesterone withdrawal) wil decrease the TIMP which inhibit the production and release of MMP. TIMP reduction will lead escalation of MMP expression. This study aims to analyze the expression of MMP-9 in intramural myoma. Crosssectional study involve two group of study, case and control (intramural uterine myoma women without heavy mestrual bleeding[HMB]), Endometrial biopsy were performed on both group, and the expression of MMP-9 were checked using immunohistochemistry. This study shows t-test analysis was performed on case group and MMP-9 was found to be significantly affecting the bleeding outcome (p = 0,003) with pravalence ratio of 1,047 (1,016 – 1,079) which indicate that MMP-9 increase 1,047 the risk of bleeding.

Angka kematian ibu akibat preeklamsia baik di dunia maupun di Indonesia masih tinggi. Preeklamsia merupakan penyakit multifaktorial yang memiliki berbagai faktor risiko, diantaranya usia ibu, jumlah anak (paritas) dan riwayat preeklamsia pada kehamilan sebelumnya. Polimorfisme Gen Klotho C1818T dapat menyebabkan terjadi kelainan vaskularisasi plasenta yang akan mengakibatkan disfungsi endotel sehingga terjadi preeklamsia. Tujuan dari penelitian ini adalah untuk mengetahui hubungan polimorfisme gen Klotho C1818T dengan kejadian preeklamsia. Penelitian ini merupakan penelitian analitik dengan desain kasus kontrol, yaitu dengan cara membandingkan antara kelompok kasus yaitu ibu hamil dengan preeklamsia sebanyak 55 subjek dan kelompok kontrol yaitu ibu hamil normal sebanyak 55 subjek. Total sampel pada penelitian ini sebanyak 110 subjek. Hasil analisis statistik dengan menggunakan uji Chi-Square didapatkan hasil pada variabel usia nilai p value 0,022 ;