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BACKGROUND Assessment of labor progress via digital vaginal examination is subjective, while intrapartum transperineal ultrasonography is deemed more objective and effective. The angle of descent (AoD) is a reliable intrapartum transperineal ultrasound parameter with minimal inter-observer and intra-observer errors. This study compared intrapartum transperineal ultrasonography with digital vaginal examination in evaluating the angle of descent for vaginal delivery selection in 70 women. MATERIAL AND METHODS This cross-sectional study was conducted at Dr. Mohammad Hoesin Hospital Palembang in Indonesia, using a consecutive sampling method to measure AoD of 70 patients at admission and every 2 h during labor progression. Patients were monitored until childbirth, and outcomes of successful vaginal or cesarean delivery were reported. A diagnostic test determined the optimal AoD for predicting successful vaginal delivery and its predictive value. RESULTS The study included 70 patients with a mean age of 28.29±6.09 years and a body mass index of 30.59±3.49 kg/m². Among them, 29 (41%) had successful vaginal deliveries. Adequate contraction frequency at admission was strongly associated with successful vaginal delivery (P<0.001). The optimal AoD for predicting successful vaginal delivery was 94.5°, with an area under the curve of 0.567 (95% CI 0.425-0.710), sensitivity of 84.2%, specificity of 45.7%, and accuracy of 54.3%. CONCLUSIONS Intrapartum transperineal ultrasonography for measuring AoD can be a valuable adjunct in labor management. Further investigations are needed to validate the optimal AoD in Indonesian pregnant women.

Omphalocele is a congenital anomaly characterized by a structural defect in the abdominal wall that leads to the protrusion of the intestines or other abdominal organs covered by a protective membrane. Approximately 20%-50% of omphalocele cases are associated with trisomy 13, 18, and 21 and result in fetal death. Prenatal diagnosis of omphalocele can be made by late first trimester ultrasound with a sensitivity of 75% and specificity of 95%, or by elevated maternal serum alpha-fetoprotein concentration. Large omphaloceles (>5 cm) are generally present with extracorporeal liver (ECL) herniation, resulting from arrested lateral fold development and failure of abdominal wall closure in the first month of pregnancy. Omphalocele with ECL demonstrated a decreased incidence of congenital anomalies in comparison to those with intracorporeal liver. Nevertheless, ECL is linked to a greater number of life-threatening anatomical and amniotic volume abnormalities. We present a case of omphalocele with extracorporeal liver in 35-36 weeks' gestation and highlight the importance of defect size measurement and extracorporeal liver identification to aid prenatal counseling in making informed decisions about postnatal interventions., (© 2024 The Authors.)

Background and Objectives : Preeclampsia has been linked to an inflammatory response that may be brought on by endothelial cell dysfunction. This paper investigates the pathomechanism of syncytiotrophoblast basement membrane (STBM) damage and Placental Protein 13 (PP13) release, which may have a role in systemic endothelial dysfunction in preeclampsia. Materials and Methods : This comparative cross-sectional study involves 54 preeclampsia patients (27 early-onset preeclampsia and 27 late-onset preeclampsia) and 27 pregnant women with normal blood pressure. An enzyme-linked immunosorbent assay was performed to evaluate maternal blood levels of PP13. Following birth, a portion of the placenta was collected for transmission electron microscope (TEM) and immunohistochemical (IHC) analysis. The data were analyzed using STATA version 15. Results : PP13 expression in the placental syncytiotrophoblast was significantly lower in the early-onset preeclampsia, compared to late-onset preeclampsia and normotensive pregnancy, group ( p < 0.001). In contrast, serum PP13 levels were found to be the highest in the early-onset preeclampsia group, although no significant difference were found in mean maternal serum levels of PP13 between the three groups. The decreased PP13 expression in placental syncytiotrophoblast can be attributed to the greater extent of damage in the STBM in early-onset preeclampsia that leads to the release of a larger amount of PP13 into maternal circulation. The hypothesis aligns with the TEM analysis results. Preeclamptic pregnancies showed placental syncytiotrophoblast aponeurosis, whereas normotensive pregnancies did not. Placental lesions and STBM shedding were found to be more pronounced in early-onset preeclampsia compared to late-onset preeclampsia. Conclusions : PP13 and STBM damage may play a role in systemic endothelial dysfunction in preeclampsia.

Background: Pregelatinizing is processed to modify structure of starch by heating a certain temperature. Increasing of temperature causes the starch to absorb water and swell quickly in order to obtain a larger particle size. Larger particle size will improve the flowability and compressibility of the granules. Pregelatinized taro starch is used as diluent tablets with wet granulation method., Aim: The objective research was to determine the effect of increasing pregelatinized taro starch temperature as diluent on compressibility and comprimability granule of thiamine hidrochloride compression ., Methods: Pregelatinized taro starch is made by heating the suspension of starch at 50°C, 60°C and 70°C for 10 minutes and then dried. Pregelatinized taro starch is used as a filler of Thiamine Hidrocloride tablets which made by wet granulation method. Test wereperformed for each formula such as quality tests of granules and tablets physical properties and assay., Result: Granule compressibility evaluation results show that the formula 1, 2, and 3 qualified with compressibility value is 7.9941 respectively; 6.9929; and 5.9950%. From the results of the one-way ANOVA analysis of the compressibility obtained sig. 0,000 less than 0.05, then there is a significant difference between formula one with the other formulas ., Conclusion: It shows the difference in temperature affect the compressibility pregelatinized taro starch. The higher the temperature of pregelatinized taro starch, produces tablets with low compressibility., (Copyright: © 2019 Pramulani Mulya Lestari, Ari Widayanti, Hani Afifah.)