Outcome findings of COVID-19 vaccine among 31 977 pregnant women in Indonesia.

OBJECTIVE: We provide an overview of the safety of messenger RNA and inactivated coronavirus disease 2019 (COVID-19) vaccine and monitoring of pregnant women after COVID-19 vaccination. The vaccine safety outcome profile is beneficial for further recommendations of COVID-19 vaccination in pregnancy. METHODS: This research was conducted as descriptive research. Sampling was performed using an online questionnaire to be filled out voluntarily and distributed to all pregnant women in Indonesia who received the COVID-19 vaccination. Data collection was performed and descriptive statistics were obtained. RESULTS: Among 31 977 pregnant women, 24 212 (75.7%) received the first dose, 7619 (23.8%) received the second dose, and 146 (4.5%) received the third dose of the COVID-19 vaccine. Sinovac vaccine is the most administered vaccine to pregnant women (27 122 [84%]). Most pregnant women (78.7%) who were vaccinated had no adverse effects after immunization, while the most reported adverse effects were mild symptoms. CONCLUSION: The current study contributed evidence that COVID-19 vaccination during pregnancy has minimal adverse effects. These findings may help pregnant women and healthcare providers to make informed decisions regarding vaccination.

Prevalence Oncogenic Human Papillomavirus in Cervical Cancer Patients in Riau Province Indonesia.

Background: Cervical cancer is the fourth most deadly cancer in the world, and it is caused by infection of high-risk subtypes of Human PapillomaVirus (HPV) in most cases. The aims of this study were to determine the prevalence oncogenic HPV in cervical cancer patients in Riau Province Indonesia and to determine the clinical manifestation of HPV in cervical cancer patients in Riau Province Indonesia. Methods: This research was a descriptive study conducted at Arifin Achmad General Hospital Riau from February to August 2018 which aimed to analyze HPV genotype prevalence oncogenic of cervical cancer patients. Results: This study showed out 86 of 110 women (78.1%) were found HPV positive, and the most common genotype of HPV was HPV 16 (38.2%). The average age of cervical cancer patient was 50 years old, and the average number of parities was 4 times. The majority of participants were married at the age before 20 years (77.3%) and had low educational background (64.5%). Vaginal bleeding happened in more than half of the participant as major clinical manifestation (72.7%), followed by fluor albus (72.7%), pelvic pain (60.2%) and fatigue (65.9%). Conclusion: The most common HPV genotype in Riau Province was HPV type 16 and the most common clinical symptoms of cervical cancer patient were vaginal bleeding, fluor albus, pelvic pain and fatigue.

The Reactivity Levels of Progesterone, Nitric Oxide and Nuclear Factor Kappa-B on the Serum of Term and Post-Term Pregnancy, Clinical Study in Padang, West Sumatera, Indonesia.

BACKGROUND: A variety of recent evidence exists about the clinical implication of low level of Pregnancy-associated plasma protein A (PAPP-A) in pregnancy. This glycoprotein is a protease, which releases the Insulin-like growth factor from IGFBP 4. Its role is a trophoblastic invasion of decidua, stimulation of cell mitosis and differentiation. It has an immunosuppressive effect in the placenta, inhibition of coagulation and complex role for integration of all these processes in the placenta. Level of PAPP-A (under 0.4 MoM-Multiple of Medians) in first-trimester screening in chromosomally and morphologically normal fetuses, could influence fetal weight, preeclampsia, premature birth and stillbirth. As a result of the complications as mentioned earlier, there is implication on timing, mode of delivery and condition of the newborn. AIM: The study aims to evaluate the influence of low PAPP-A, measured in the first trimester on the outcome of pregnancy, with accent disorders, which are the result of placental insufficiency. Also, gestational week, mode of delivery and condition of newborn secondary underlying conditions will be evaluated. MATERIAL AND METHODS: After given information and consultation about the expectation from the screening, pregnant women with a singleton pregnancy were tested for First Trimester Screening to estimate the risk for Trisomy 21, 13, 18- the most frequent chromosomopathies. After exclusion of chromosomopathies and congenital malformations, one hundred and fourteen patients enrolled in the study. The target group (n = 64) with PAPP-A below 0.4 MoM and control group (n = 50) with PAPP-A equal and above 0.4 MoM. An assessment of mode and time of delivery and presence of small for gestational age newborns, preeclampsia, premature birth and newborn condition at delivery was made. RESULTS: The percentage of the patients delivered in term was similar between the target group (n = 64) and the control group (n = 50), 82.81% vs 82.0% respectively. The rate of cesarean section was 29.7 % in the target group vs 32% in the control group. A significant difference was found about elective vs urgent cesarean section in favour of the target group. The difference was present about the complication in pregnancy before delivery, 56% vs 22%, p = 0.023, which were the main indication for cesarean section. The difference in newborn outcome was not significant. CONCLUSION: There is a difference in frequency of complications, in the cases with PAPP-A under 0.4 MoM, such as premature birth, preeclampsia compound with SGA fetuses versus the control group. The difference for SGA newborn and premature birth among the groups has statistical significance. The patients delivered with cesarean section were with the main indications SGA or elevated blood pressure, often occurred combined with prematurity. Apgar score and birth weight were similar in target and control group, but the newborns with a birth weight under 2500 g. were more frequent in the target group. Because these results did not show another significance among two groups, probably lower cut-off is needed, combining with another test (Doppler of uterine arteries in the first trimester, biochemical test). Presence of other diseases which could hurt placental function should be emphasised.