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BACKGROUND: Reducing maternal mortality is one of the targets in the Millennium Development Goals (MDGs). In a systematic review, 4.6 per cent (95% CI 2.7-8.2) of pregnancies were complicated by preeclampsia worldwide. Preeclampsia occurs in around 10% of pregnancies in the world whereas developing countries contribute more than developed countries. In developing countries, there are 13 cases of preeclampsia in every 1,000 births, whereas in developed countries only 2-3 cases of preeclampsia are found in every 10,000 deliveries. Variations in prevalence among countries reflect, at least in part, differences in the distribution of maternal age and the proportion of nulliparous pregnant women in the population. AIM: We aimed to investigate the role of placental growth factor, soluble endoglin, and uterine artery diastolic notch to predict the early onset of preeclampsia. METHODS: This study used an analytical study with a nested case-control design. The study was conducted at Bunda Thamrin Hospital, Tanjung Mulia Mitra Medika Hospital, Sundari Hospital and a private clinic, from March to November 2018 with a total sample of 70 research subjects. RESULTS: Uterine artery diastolic notch was not found in 50% of subjects. A total of 27 subjects (38.6%) had a unilateral diastolic notch, and 8 subjects (11.4%) had a bilateral diastolic notch. Cut-off point PIGF levels was 441 pg/ml, and Area Under Curve (AUC) 82.5% (95% CI 61.5%-100%), with sensitivity 80% and specificity 87.7%. The levels sEng in this study could not predict the incidence of early-onset preeclampsia (p = 0.113). Combined PlGF and pulsatile index of uterine arteries may predict early onset preeclampsia with sensitivity 40% and specificity 90.77%. From these results, pregnant women o 22-24 weeks of pregnancy, the levels of PlGF and the uterine artery pulsatility index can be a predictor of early-onset preeclampsia. Examination of PlGF levels alone is sufficient as a predictor of early-onset preeclampsia. CONCLUSION: From these results, it can be concluded that in pregnant women of 22-24 weeks, the diastolic notches in uterine arteries cannot predict the incidence of early-onset preeclampsia. PlGF levels and pulsatile index of uterine arteries can be used as predictors of early-onset preeclampsia although examination of PlGF levels alone is sufficient as a predictor of early-onset preeclampsia.

Objective: Preeclampsia characterized systematically by extensive vascular endothelial dysfunction and microangiopathy on mother, dNK is very important for the success of placentation. They are the key mediator of maternal immune system interactions with fetal cells. dNK cells are also involved in the modulation of EVT and the remodeling of spiral arteries. Methods: Analytic research with cross-sectional study, with samples of pregnant women who suffer from severe PE and aterm pregnancy which came to H. Adam Malik Hospital and Networking Hospital, November 2015-April 2016. The samples are 46 women, who met the inclusion criteria. Results: Immunohistochemistry examination dNK cell in the severe PE case group and control group, statistically found p<0,05. dNK placenta expression in the severe preeclampsia case group gives an overview of expression with a mean of 2.55±2.31, while the control group of normal pregnancy had higher mean is 8.66±3.16. Conclusion: The examination of immunohistochemistry of dNK cells showed there is a significant difference in the expression of Immuno-histochemistry dNK cells between severe PE case group and non severe PE.

BACKGROUND: Weekly consumption of iron supplementation is preferred to daily consumption of iron supplementation because of its minimal side effects and higher level of compliance. AIM: This study is to compare the maternal outcomes in pregnant women with daily and weekly consumption of iron supplementation in coastal region. METHODS: This prospective cohort study was conducted from July 2018 to January 2019 in Belawan Health Center and Medan Deli Health Center. Sixty-two pregnant women who met inclusion and exclusion criteria were given iron supplement everyday (Group 1, n = 29) and twice a week (Group 2, n = 33). Hemoglobin levels, hematocrit, and ferritin serum are tested before starting the iron supplementation. All numerical data were analyzed using t-test. RESULTS: There is no significant difference in mean hemoglobin and hematocrit before and after iron supplementation p = 0.222 and p = 0.793, respectively, however, decreasing level of ferritin serum from 41.21 to 26.29 ng/ml (p = 0.001) is found. Hemoglobin, hematocrit, and ferritin serum means, before and after supplementation were not statistically different between daily and weekly group (p = 0.421, p = 0.197, p = 0.917). CONCLUSION: To prevent iron deficiency anemia in pregnant women, weekly or daily iron supplementation show similar effectiveness although continuous consumption of iron supplementation during breastfeeding period is needed to restore iron loss during pregnancy.