Rasio Estriol/ Estradiol Tinggi Sebagai Prediktor Keberhasilan Induksi Persalinan Pada Kehamilan Lewat Waktu

Abstract

Background: Induction of labor is a common procedure performed at 15-20 % of pregnancies. The most common indication was prolonged pregnancy (70 %). The past decade labor induction rate was increased 2-fold as well as the risk of cesarean section. Difficulties to predict the success of induction made predictors of success of induction widely studied. Predictors can be physical or chemical markers. One of the chemical marker is the ratio of estriol to estradiol levels. Objective: To determine the value of the ratio of estriol/ estradiol to predict success of induction of labor in prolonged pregnancy. Method: The design of study are Prospective Cohort. Study two hospitals (Wonosobo District Hospital and Banjarnegara District Hospital) used in this study from September 10, 2013 until December 31, 2013. Blood sampling was drown from the subject before induction to examin the levels of estriol and estradiol the induction which end in vaginal delivery were noted as succesull induction Receiver Operating Characteristic (ROC) method in order to determine the sensitivity, specificity, positive predictive value, negative predictive value and Area Under the Curve. Bivariate and multivariate analyzes also used to determine the correlation between variables. Results and Discussion: This study obtained 76 samples, 69 with successful induction and 7 failed of induction. The research got a cutoff was point 35 the sensitivity was 71% value, specificity value of 71%, positive predictive value 49%, negative predictive value was 55.6%. Area Under the was value of 80,7%. Positive likelihood ratio 1,06 and negative likelihood ratio 0,88. Bivariate and multivariate analysis showed that the ratio of estriol / estradiol ≥ 35 ng / mL significantly associated with successful induction (OR 9,598; 95% CI 1,378-66,859) Bishop score was also associated with a significant induction success (OR 13,481; 95% CI 1,955-92,955) Conclusion: This study shows that the proportion ratio of estriol / estradiol in succeed induction group were higher (≥ 35) compared with induction failure group (<35).

The relationship between consumption of soy milk and the menstrual cycle of midwifery students

“…Normally women experience ovulation once every month. Irregular menstruation indicates an ovulation disorder (Adintyo Rahman et al, 2016).…”