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Hubungan ekspresi matriks metaloproteinase-9 (mmp-9) pada sel amnion dengan terjadinya ketuban pecah dini



Abstract

Introduction: Premature rupture of membranes (PROM) is an obstetric problem that can significantly increase maternal and perinatal morbidity and mortality due to complications caused. The occurrence of PROM is caused by many factors, one of which is the increased degradation of amniotic membrane collagen. The Matrix Metalloproteinase-9 (MMP-9) is the main mediator of collagen degradation from the amniotic membrane, which has a high proteolytic activity against the amniotic membrane. The aim of the study is to prove that the expression of MMP-9 on amniotic cells plays a role in the mechanism of PROM in term pregnancy.

Methods: The study design is a comparative analytic observational study with a cross-sectional design using 20 samples of amniotic tissue from a term pregnant women with PROM and 20 samples without PROM. The study was conducted at Sanglah Hospital Denpasar. The research material was taken after delivery from the amniotic tissue. MMP-9 immunohistochemical study was conducted at the Histology Laboratory of the Faculty of Medicine, Udayana University, Bali. Characteristics of the sample are tested by compare mean. The prevalence ratio (PR) of MMP-9 expression was tested with the Chi Square Test.

Result:There were no significant differences in maternal age, gestational age, BMI, and parity of the two groups (p> 0.05). MMP-9 expression was associated with premature rupture of membranes with a prevalence ratio of 2.85 (95% CI = 1.62-5.02; p = 0.001).

Conclusion: The conclusion of this study is that positive MMP-9 expression in amniotic cells is associated with premature rupture of membranes.


Pendahuluan: Ketuban pecah dini (KPD) merupakan masalah obstetri dapat meningkatkan morbiditas dan mortalitas maternal maupun perinatal secara signifikan akibat komplikasi yang ditimbulkan. Terjadinya KPD disebabkan oleh banyak faktor, salah satunya adalah meningkatnya degradasi kolagen membran ketuban. Matrik Metaloproteinase-9 (MMP-9) adalah mediator utama degradasi kolagen dari membran ketuban, dimana mempunyai aktivitas proteolitik yang tinggi terhadap membrane ketuban. Tujuan penelitian adalah untuk membuktikan ekspresi MMP-9 pada sel amnion berperan dalam mekanisme terjadinya KPD pada kehamilan aterm.

Metode: Rancangan penelitian ini studi observasional analitik komparatif dengan desain cross-sectional menggunakan 20 sample jaringan amnion ibu hamil aterm dengan KPD dan 20 sampel tanpa KPD. Penelitian dilakukan di RSUP Sanglah Denpasar. Bahan penelitian diambil setelah persalinan dari jaringan amnion. Imunohistokimia (IHK) MMP-9 dilakukan di Laboratorium Histologi Fakultas Kedokteran, Universitas Udayana, Bali. Karakteristik sampel diuji dengan compare mean. Rasio prevalensi (RP) ekspresi MMP-9 diuji dengan Chi Square Test.

Hasil: Tidak ada perbedaan bermakna pada umur ibu, usia kehamilan, IMT, dan gravida kedua kelompok (p>0,05). Ekspresi MMP-9 berhubungan dengan terjadinya ketuban pecah dini dengan rasio prevalensi sebesar 2,85 (IK 95% = 1,62-5,02; p = 0,001).

Kesimpulan: Kesimpulan penelitian ini adalah ekspresi MMP-9 positif pada sel amnion berhubungan dengan terjadinya ketuban pecah dini.


Keywords: Ketuban pecah dini (KPD) Ekspresi MMP-9

References

  1. Budijaya, Surya Negara, K. 2016. Profil persalinan dengan ketuban pecah dini di RSUP Sanglah Denpasar Periode 1 Januari – 31 Desember 2015. Laporan Penelitian Deskriptif.
  2. Brian M. M. 2007. Premature Rupture of the Membranes. In : Gabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed, 714.
  3. Klein,T. Bischoff.R. 2011. Physiology and Pathophysiology of Matrix Metalloproteinases. Amino Acid. 2011. 41;P. 271-90
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  5. Sulistyowati S., Yuniarsih Zakia, Soetrisno. High MMP-9 and TNF-α expression increase in preterm premature rupture of membranes. Universa Medicina. Jan-Apr 2016 Vol 35-1.
  6. Athayde. 2014. A role for matrix metalloproteinase-9 in spontaneous rupture of the fetal membranes. Am J Obstet Gynecol. Vol.179, Number 5. P 1248-53
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How to Cite

Artha, I. B. R. K., Surya, I. G. P., Negara, K. S., Sanjaya, I. N. H., Manuaba, I. B. G. F., Putra, I. G. M., Suwardewa, T. G. A., & Megadhana, I. W. (2020). Hubungan ekspresi matriks metaloproteinase-9 (mmp-9) pada sel amnion dengan terjadinya ketuban pecah dini. Medicina, 51(2), 104–107. https://doi.org/10.15562/medicina.v51i2.882
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Ida Bagus Rendra Kurniawan Artha
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I Gede Putu Surya
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