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This article presents seven cases of maternal deaths attributed to COVID-19 during the first year of the pandemic wave. These cases provide insights into the natural progression of COVID-19 in pregnant women who were not vaccinated. This study showed that COVID-19 significantly increased maternal and neonatal mortality and morbidity. All of the patients exhibited symptoms of fever, cough, and dyspnea upon admission to the hospital. They were admitted with elevated respiratory rates (26-32 times/minute) and low oxygen saturation (<95%). Four patients had obesity, while one patient had pregestational diabetes. The COVID-19 diagnosis was established using a rapid antibody or antigen test and chest X-ray, which indicated pneumonia. Medical interventions administered to the patients included antiviral therapy (5 patients), antibiotics (6 patients), and anticoagulants (4 patients). From a total of five babies delivered, four babies were delivered via cesarean section. Two babies were not delivered due to previability and maternal deaths before delivery. The patients passed away within 3-10 days of hospital admission. In conclusion, adequate and early intervention and management of pregnant women infected with COVID-19 are crucial in preventing maternal and neonatal deaths, especially in unvaccinated women. [ABSTRACT FROM AUTHOR]

The reduction of neonatal mortality is part of the third goal of the Sustainable Development Goals that by the end of 2030 it is expected that neonatal mortality will decrease to 12 per 1000 live births. This study aims to organize risk factors for neonatal mortality through a traditional review. Information was obtained from previous studies around the world, from 2009 to 2021. The selection of articles was based on the researchers' justification, followed by a comparison of the articles and ending with a synthesis in order to answer the research questions. The study results show that the risk factors associated with pregnancy included: age, height, parity, interval between pregnancies, antenatal care, past pregnancy and childbirth (giving birth to dead babies, cesarean section, hypertension, abortion, bleeding), problems in pregnancy (anemia, tuberculosis, asthma, hyperthyroidism, hypertension, malnutrition) and pregnancy complications (hyperemesis gravidarum, abortion, degenation of trophoblast disease, ectopic pregnancy, prematurity, antepartum hemorrhage, premature rupture of membranes, fetal death in utero, pre-eclampsia / eclampsia, post date, meconeal membranes, fetal position abnormalities, multiple pregnancies and prolonged labor); while the factors related to childbirth were place, mode and assistant of delivery. [ABSTRACT FROM AUTHOR]

Introduction: Stress during gestation can lead to inappropriate fetal brain development, especially psychological stress. Psychological stress play pivotal role in offsprings' brain development. Objective: The aim of this study was to investigate the effects of maternal exposure to physical and psychological stress during pregnancy on the cerebrum in mice offspring. Method: This study was an analytical experiment study with the subject were 24 female mice Mus musculus. The sample were divided into treatment and control group. Treatment groups divided into three conditions, 1 group was given physical stress, 1 group with psychological stress, and 1 group was given combination of physical and psychological stress intervention. The data were analyzed with ANOVA test then followed by LSD to find the differences between all groups. Results: The ANNOVA test results showed significant differences of the expression of synapsin with p = 0.0000. The number of neuronal cells also represented significant differences with p = 0.000 on the cerebrum. Conclusion: Stress exposure during pregnancy can induce bad impacts in brain development, especially the expression of synapsin and the number of neuronal cells on the cerebrum in mice offspring. [ABSTRACT FROM AUTHOR]

Background: Recent studies in the field of Fertomaternal Medicine show that stimulation in the uterus can support brain growth and development. If in previous studies stimulation using several types of music, this study uses human voice which aims to analyze the effect of stimulation of male and female voices on differences in the expression of Brain Derived Neutrotrophic Factor (BDNF) in cerebellum of newborn Rattus norvegicus. Methods: This type of research is true experimental with post test only control group design. Rattus norvegicus was given stimulation of men voice and women voice on 6th day until 17th day of pregnancy. The expression of BDNF was examined using immunohistochemistry. Results: The mean ± standard deviation of the expression of BDNF in the cerebellum is 4.20 ± 1.75 (without stimulation), 6.04 ± 1.58 (male voice stimulation), and 5.60 ± 2.43 (female voice stimulation). The results of statistical tests show that there is a significant difference on BDNF expression between the control group and the group stimulated with male voice with a significance value <0.05 of 0.045 Conclusion: Giving stimulation using the male voice during pregnancy shows a significant increase in the expression of BDNF in cerebellum of newborn Rattus norvegicus. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy is the golden period to prepare children for the future. Stimulation is needed during pregnancy, one of which is brain stimulation. This can be done with Al Qur'an Murrotal Surah Ar-Rahman stimulation. This study aims to analyze expression of synapsin 1 in the cerebrum of newborn Rattus norvegicus when given murrotal Surah Ar-Rahman stimulation by qari, qariah, and not given any stimulation during pregnancy. Methods: Experimental with post-test only control group design. Sampling in this study was considered homogeneous because it met the inclusion criteria. The samples obtained were distributed randomly to each experimental group and randomized into 3 groups, including control group, group stimulated by qari, and group stimulated by qariah. The treatment was given on the 6th day of pregnancy for 1 hour in a soundproof room with an intensity of 65 dB. Results: The highest mean expression of synapsin 1 in the cerebrum is qari group (6.96 ± 2.59), then qariah group (5.84 ± 2.90), and the lowest is control group (5.74 ± 2.32). There is no significant difference in expression of synapsin 1 in the cerebrum between control and qari groups (p = 0.306), control and qariah groups (p = 0.932), qari and qariah groups (p = 0.347). Conclusion: The highest expression of Synapsin 1 in the cerebrum of newborn Rattus norvegicus is the group stimulated by qari. [ABSTRACT FROM AUTHOR]

Introduction: Prenatal stress prevalence is almost half of the population of pregnant women worldwide. Stress will stimulate glucocorticoids which can disrupt the PI3K-Akt cascade. PI3K-Akt deficiency will cause impaired fetal brain growth and development. Objective: To compare the Akt expression in the cerebrum and cerebellum of newborn Mus musculus exposed to physical stress, psychological stress, the combination of psychological and physical stress, and without stress exposure. Method: This study was experimental laboratory research. Twenty-four female mice were used as samples and divided into four groups: physical stress exposure group, psychological stress exposure group, the combination of psychological and physical stress exposure group, and control group. Akt expression was tested by immunohistochemistry (IHC) staining. Statistical analysis used the One Way Anova and Kruskal Wallis test. Results: There were significant differences in cerebrum Akt expression (p = 0.008) and cerebellum Akt expression (p = 0.047) between the control and stress exposure groups. Conclusion: There were statistically significant decreases in mean Akt expression in the cerebrum and cerebellum of newborn Mus musculus exposed to stress during pregnancy. [ABSTRACT FROM AUTHOR]

The quality of human resources should be prepared since in early stage. Pregnancy is one of a significant period which can take advantage to by providing proper nutrition and adequate stimulation. For instance, sound and music, the most harmonious combination and easily accepted by the fetus(1). Experimental analytic type with post-test only control group design was employed on 30 pregnant Rattus norvegicus which were divided randomly into 3 groups, namely the control group, qari group, and qariah group. Each of the groups had stimulation starting 6th to 17th days of pregnancy for 60 minutes. At 18 days of pregnancy, the mother of Rattus Norvegicus was sacrificed and bring forth with Sectio Caesarea (SC). As a result, the number of astrocyte glia cells in the cerebrum was higher in the qaria recitation stimulation group (22.62 ± 3.75), compared with the group that was listened to qari recitation stimulation group (19.84 ± 2.48), while the control group (16.54 ± 2.78). A significant difference found in the number of astrocyte glia cells in the Cerebrum Rattus norvegiccus newborn that were listened to the qari and qariah recitation stimulation group and the control group. The highest number of Glia cells is obtained from the stimulation of qariah recitation. [ABSTRACT FROM AUTHOR]

Background: Prenatal stress affects fetal development including brain development. When a stressor is felt, the brain as the main target for stress will release a hormone that stimulates the release of pro-apoptotic proteins and activate caspase-3 which acts as an executioner caspase in the cell death process. The aim of the study was to analyze the effect of combined stress during pregnancy on the expression of caspase-3 cerebrum and cerebellum of newborn Mus musculus. Methods: An experimental study using 24 pregnant mice (Mus musculus). Subjects were randomized into four groups, consisting of physical stress exposure group (forced swimming) (G1), psychological stress exposure group (noise) (G2), combination stress exposure group (forced swimming + noise) (G3), and control group (G4). Stress exposure was given on 6th-15th days of pregnancy. From each mother, three Newborn of Mus musculus were taken to make preparations from brain tissue. Immunohistochemical examination was performed to assess caspase-3 expression. Results: The study shows that the mean and standard deviation of the expression of caspase-3 cerebrum and cerebellum in the physical stress exposure group is 5.70 ± 0.99 and 5.80 ± 1.35, the psychological stress exposure group is 7.23 ± 1.39 and 7.40 ± 1.24, the combined stress exposure group is 8.67 ± 1.09 and 9.30 ± 1.12, and the control group 4.17 ± 1.18 and 3.90 ± 1.06. ANOVAs statistical test results show significant differences among groups with a value of p = 0.000 in the cerebrum and p = 0.000 in the cerebellum. Conclusion: Exposure to physical and psychological stress during pregnancy increases the expression of caspase-3 in the cerebrum and cerebellum of newborn mice. [ABSTRACT FROM AUTHOR]

Background: The human development index (HDI) illustrates how superior human resources are. The stimulation of Murotal during growth and development has been shown to increase cell growth in plants. The aim of the study was to analyze the effect of the differences againts the number of neuron cell's in the cerebrum and cerebellum Rattus norvegicus offspring between those who received Al-quran Murottal surah Ar-Rahman stimulation, Qori and Qoriah sounds voice in pregnancy day of 6th. Methods: An Experimental study using 30 pregnant (Rattus norvegicus). Subjects were randomized into three groups, control group (Q1), voice of Qori group (Q2), and voice of Qoriah group (Q3). sound stimulation was given on 6th-17th days of pregnancy. From each mother, two Newborn of Rattus norvegicus were taken to make preparations from brain tissue. Eosin Hematocycline was performed to assess number of neuron cells. Results: The study shows that the mean and standard deviation of the number neuron cells cerebrum and cerebellum in the control group is 9.88 ± 1.71 and 21.10 ± 2.11, the voice qori group is 10.16 ± 1.01 and 22.46 ± 1.71, and the voice qoriah group 11.12 ± 1.52 and 22.50 ± 1.76. ANOVAs statistical test results show there is no significant differences among groups with a value of p = 0.152 in the cerebrum and p=0.183 in the cerebellum. Conclusion: Murotal sound stimulation during pregnancy increased the number of neuron cells in the cerebrum and cerebellum of newborn rats. [ABSTRACT FROM AUTHOR]

The increasing number of people with diabetes melitus (DM) will increase the possibility of the number of pregnancies with pregestational DM. In pregestational DM, HbA1c examination is required, which tends to be more expensive to predict the possibility of complications and prognosis. The purpose of this study was to determine the examination of fasting blood glucose and 2-hours postprandial glucose (PPG) compare to HbA1c as predictor of fetal outcome. Data were collected from pregestational DM patients at Dr. Soetomo Hospital, Surabaya, through medical records. Data were in the form of HbA1c, fasting blood glucose and 2-hour PPG values for preterm fetal outcomes. In the first trimester, we only obtained one patient with normal HbA1c (<6.5%), normal PPG (<90 mg/dl), but 2-hour PPG was above normal (> 120 mg/dl). Of the 42 cases of Pregestational DM, a 5% HbA1c value had sensitivity (91.67%) and specificity (33.33%) on the results of fasting blood glucose and PPG, where fasting blood glucose values with sensitivity and specificity were best for predicting preterm fetal outcomes, with an accuracy of 76.67%, while 2-hour PPG with an accuracy of 83.33%. The fasting blood glucose value with good sensitivity and specificity to predict preterm fetal outcomes was 74 mg/dl with an accuracy of 76.67% whereas 2-hour PPG is worth 99 mg/dl with an accuracy of 83.33%. At this time, HbA1c is still a predictor of fetal outcomes (preterm) in Pregestational DM patients better than fasting blood glucose and 2-hour PPG. [ABSTRACT FROM AUTHOR]

Apoptosis or programmed cell death also occurs in the human brain and has occurred since the fetus in the womb. Mozart's music influences the number of cells causing more temporary intelligence in children and adults. This study aimed to compare the level of newborns Brain-derived neurotrophic factor (BDNF) umbilical cord serum between maternal exposed and non-exposed groups to the sequence of Mozart compositions during pregnancy. This was an experimental analytic study. The subjects were with low-risk pregnancies in 32 weeks of gestational age. The exposed group was given with Mozart compositions by headphones abdominally for 1 hour every day until delivery. The level of BDNF infant umbilical cord blood was measured by ELISA methods as soon as the babies born. Serum BDNF levels were 12221.33 pg/ml in the group exposed to Mozart's music and 8577.60 pg/ml in control group. There were significant differences in BDNF levels between female and male newborns between groups but not intra groups. P-value was <0.05 There were no differences between modes of delivery, gestational age, birth weight, length, one-minute Apgar score, and five-minute Apgar score p >0.05. BDNF serum levels of umbilical cord newborns showed significantly higher exposure than those without Mozart composition exposure. [ABSTRACT FROM AUTHOR]

L-Arginine is a semi-essential amino acid, which is one of the nitric oxide (NO) synthesis substrates. This compound has a role in the L-Arginine-NO pathway in preeclampsia. This study determined the effect of LArginine on the diameter of the spiralis artery and fetal weight in normal pregnant mice and preeclampsia mice model. A true experimental study with randomized post-test-only control group using Swiss Mus musculus divided into 3 groups. There were normal pregnant mice group (K-), preeclampsia mouse model group (K+), and preeclampsia mouse models with L-Arginine group (P). The mean of fetal weight of each mouse was calculated and measured the diameter of the spiralis artery from placental. The mean diameter of the spiral arteries of the groups (K-), (K+) and (P) was 221.7500±70.2498µm, 159.4333±30.2653µm, and 277.3222±54.5503µm, respectively. There were significant differences between groups (K-) and (K+) (p = 0.024), groups (K-) and (P) (p = 0.047), and between groups (K+) and (P) (p = 0.000). Meanwhile, the mean fetal weight of the groups (K-), (K+) and (P) was 0.6733±0.3145g, 0.6222±0.2838g, and 0.7589±0.3444g, respectively. There were no significant differences between groups (K-) and (K+) (p = 0.722), between groups (K-) and (P) (p = 0.590), and between groups (K +) and (P) (p = 0.372). L-Arginine has been proven effective in repairing endothelial damage and was seen from the diameter of the spiralis artery and fetal weight in preeclampsia mouse models. [ABSTRACT FROM AUTHOR]

L-Arginine has a role in the L-Arginine-nitric oxide pathway in preeclampsia, where in preeclampsia, it has been known to decrease the bioavailability of nitric oxide (NO). This study analyzed the effect of L-arginine on Placental Growth Factor (PlGF) levels in mouse models with preeclampsia. This study used a true experimental design with a randomized posttest-only control group. The sample of the study was Swiss Mus musculus, divided into three groups, namely normal pregnant mice, preeclampsia models without L-arginine and preeclampsia models with Larginine. The mean serum of PlGF levels of the preeclampsia mouse models with L-Arginine was 962.431±158.211 pg/ml. This level was higher than the normal pregnant mice (947.339±208.267 pg/ml) and the preeclampsia mouse models without L-Arginine administration (861.985±161.960 pg/ml). There were no differences in PlGF levels between the group of normal pregnant mice and preeclampsia mice models without L-Arginine (p = 0.346). There were no significant differences between PlGF levels between the group of normal pregnant mice and the preeclampsia mouse models with L-Arginine (p = 0.865), and no significant differences were found between the groups of preeclampsia pregnant mouse models without and with L-Arginine administration (p = 0.202). Higher levels of PlGF were found in mouse models of preeclampsia with L-Arginine administration. However, there was no difference in PlGF levels between three groups. [ABSTRACT FROM AUTHOR]

Preeclampsia still becomes an important topic related to cardiovascular system health in more than 300 million women worldwide and has both short-term and long-term morbidity. This study aimed to learn maternal cardiovascular risk after 5 years after the diagnosis of early- and late-onset of severe preeclampsia. A retrospective cohort study involved all women meeting the inclusion criteria, who treated from January 2013 to January 2014, with early- and late-onset of severe preeclampsia diagnosis and get pregnancy termination in Dr. Soetomo General Hospital, Surabaya. The mean age of the subjects was in the range of 20-35 years, where age in the early-onset of severe preeclampsia group was older than the late-onset ones (32.12±6.827 years vs 28.2±7.890 years). There was a higher and significant cardiovascular risk factor related to hypertension and/or metabolic syndrome (p = 0.031) in the early-onset of severe preeclampsia group and supported an increase of 1.47 times cardiovascular risk factors (RR 1.471; CI 95 [1.071-2.019]) compared to the late-onset of severe preeclampsia group. The body mass index (BMI) and waist circumference of subjects were found higher in early-onset of severe preeclampsia (28.176±4.342 kg/m2 vs 25.892±3.956 kg/m2; 90.47±9.288 cm vs 83.48±9.283 cm). The maternal cardiovascular risks were hypertension and metabolic syndrome, which are more severe in the early onset of severe preeclampsia compared to the late-onset at 5 years after diagnosis. [ABSTRACT FROM AUTHOR]

Background: Newborn Rattus norvegicus expose to Mozart’s music prove lower than those expose to Javanese, Sundanese and Balinese music. Exposure to classical music such as Mozart, Javanese, Sundanese and Balinese gamelan can increase waves of brain activity. Mozart’s music during pregnancy proved to reduce neuronal cell apoptosis. Objective: The purpose of this study was to analyze differences in the index of neuronal apoptosis in the cerebrum and the newly born Rattus norvegicus cerebellum between those exposed to Mozart music, Javanese, Sundanese, Balinese and those who were not exposed to music during pregnancy. Method: The female subjects of pregnant Rattus norvegicus were divided into 5 groups randomly each with 5 samples, 1 control group and 4 treatment groups. after the 10th day of pregnancy music was played for 1 hour in a dark soundproof box with a intensity of 65dB. The 19th day of the parent was sacrificed and sectio caesarea was taken, 3 newborn Rattus norvegicus children were taken with the heaviest, moderate and mildest and brain tissue was taken for preparation. Result: The ANNOVA test results showed significant differences between groups with p = 0.01 in the cerebrum and p = 0.000 in the cerebellum. Conclusion: It can be concluded that the apoptosis index of cerebrum neuron cells and the newly born Rattus norvegicus cerebellum exposed to Mozart’s music proved to be lower than those exposed to Javanese, Sundanese and Balinese gamelan music. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is diabetes that is first diagnosed during pregnancy. Uncontrolled GDM or late found can increase mortality for both mother and baby. Not only bad medical conditions, but also it can decline the community productivity, affect socio-economic and increasing financial health. Early detection of GDM is crucial to be implemented by providers, especially in the primary health care. Objective: to determine the framework of early detection in gestational diabetes mellitus at primary health care Methods: The method used is a literature review, which was published in 2008-2018. The literature were collected using some keywords such as “detection”, “gestational diabetes mellitus”, and “primary health care” using PubMed and another electronic journal website. Furthermore, the findings were filtered based on our inclusion criteria and analyzed qualitatively. Results: Early detection of GDM in primary health care with risk factor assessment (age of pregnant women ≥ 35 years, some of bad history namely GDM in previous pregnancies, anti-diabetic drug use, diabetes mellitus in the family, congenital of infants, IUFD, preeclampsia, macrosomia, blood pressure examination, calculation of body mass index and random blood sugar examination). Furthermore, early detection of GDM is carried out by examining blood glucose accompanied by the provision of appropriate glucose solution interventions (OGCT and OGTT). Conclusion: primary health care can take more action in early detection of GDM through quality antenatal care, which can be done by applying the framework of early detection in gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]

Context: Maternal death occured in pregnancy period up to 42 days after giving birth. Maternal death could cause early life stress in newborns which activated HPA axis and glucocorticoid secretion as stress hormone marker. The developing brain was very sensitive to the initial exposure to stressors that would affected the Brain Derived Neurotrophic Factor (BDNF) expression, which was one of the most important endogenous mediators of stress responses in the brain. This study aimed to analyze BDNF expression in the cerebrum and cerebellum of Rattus norvegicus newborn with maternal death model. The control group (K1) consisted of newborns Rattus norvegicus which were not separated from the mother until 3 days old and the treatment group (K2) is maternal death model consisted of newborns Rattus norvegicus which were separated immediately from the mother after birth until 3 days old and fed with animal milk as a substitute nutrient. After 3 days treatments, 3 newborns with heaviest, medium, and lowest weights were taken from each mother to sacrifice. The BDNF expression examination was carried out on cerebrum and cerebellum by imunohistochemical method. The results showed that the mean BDNF expression in the cerebrum and cerebellum of 3 days old Rattus norvegicus with maternal death model which separated from the mother were lower than the mean BDNF expression of control group though there were no significant different based on statistical analysis. [ABSTRACT FROM AUTHOR]

The loss of bonding attachments to maternal deaths as a cause of neonatal stress had an impact on brain growth and development in early life. HPA axis activation responsed to secrete corticotropin releasing hormone which stimulated adrenocorticotropic hormonessecretion. These hormones induced the adrenal gland cortex to secrete glucocorticoids. Excessive release of glucocorticoids would suppress BDNF expression resulting in BDNF hypofunction resulting in neuronal cell apoptosis which was characterized by an increase in neuronal cell apoptosis index. This study aimed to analyze the apoptosis index of neuron cells in the cerebrum and cerebellum of newborn Rattus norvegicus that were not separated from the mother until 3 days old as the control group (K1) and the cerebrum and cerebellum of newborn Rattus norvegicus that were separated from the mother by giving animal milk as replacement nutrition until 3 days old as a group treatment (K2). 3 Rattus norvegicus newborn with heaviest, medium, and lowest weights were taken from each mother then sacrificed for the brain histochemical preparations. Imonohistochemical examination was carried out to calculate the neuronal apoptosis index. The analysis results showed that the apoptotic index of neuron cells in the cerebellum and cerebellum of newborn Rattus norvegicus which separated from the mother were higher than those not separated from the mother. [ABSTRACT FROM AUTHOR]