CONTOH PENERJEMAHAN JURNAL ILMIAH - KEBIDANAN & PENYAKIT KANDUNGAN

RESIKO PERTUMBUHAN JANIN TERHAMBAT TERHADAP GANGGUAN FUNGSI GINJAL JANIN & KELANJUTANNYA SETELAH KELAHIRAN

Abstrak

Tujuan

Mengetahui besar volume ginjal dan fungsinya pada janin PJT dan normal intra uterine dan segera setelah lahir

Metode 

Telah dilakukan penelitian studi kohort terhadap 20 janin PJT sampai 36 minggu dibandingkan dengan janin normal dengan melakukan pemeriksaan volume ginjal, volume sekresi urin, indek cairan amnion dan pemeriksaan arus darah umbilikalis.

Setelah lahir pada hari ke 7 dilakukan pemeriksaan mikroalbumin, kreatinin dan cystatin-c darah

Sampel penelitian ini berasal dari Rs. H. Adam Malik dan Rs. Pirngadi serta praktek dokter obstetric dan ginekologi

Hasil

Rerata  volume ginjal kiri janin PJT 6,47 ml dengan SD 1,85 dan pada janin normal 11,09 ml dengan SD 2,91 secara statistik dengan uji Mann-Whitney berbeda bermakna dengan p 0,001, rerata volume ginjal kanan janin PJT adalah 6,07 ml dengan SD 1,9 sedang janin normal 10,75ml dengan SD 3,35 yang secara statistic berbeda bermakna.

Rerata volume urine janin PJT tiap jam adalah 8,21cc SD3,48 dan janin normal 19,23 cc SD 5,79 yang secara statistic berbeda bermakna. Meskipun belum mencapai oligohidramnion namun jumlah air ketuban janin PJT lebih sedikit dibanding janin normal, masing-masing 6,57 SD 2,28 dibanding normal 11,85 SD 2,53 dan secara statistic berbeda bermakna dengan p 0,001.

Rerata arus darah umbilikalis janin PJT RI 0,85 SD 0,72; SD rasio 3,38 SD 0,67 dan PI 1,25 SD 0,21 sedang janin normal RI 0,59 SD 0,07; SD rasio 2,56 SD 0,46 dan   PI 0,89 SD 0,26 dan secara statistic arus darah arteri umbilical janin PJT dan normal berbeda bermakna.

Setelah lahir pada hari ke 7 dilakukan pemeriksaan mikroalbumin urin janin PJT 15,83 mg/ml SD 31,32 sedang janin normal 1,9 mg/ml SD 0,97 secara statistic berbeda bermakna dengan p 0,001. Sedang kadar kreatinin urin janin PJT 17,19 mg SD 9,84 dan janin normal 8,22 mg SD 2,85 kadar kretinin ini berbeda bermakna. Didapati kadar albumin/kreatinin rasio janin PJT 198,0 µg/ml SD 627,63 sedang janin normal 24,75 µg/ml sd 14,07 dan hal ini berbeda bermakna.

Pada pemeriksaan Cystatin-C darah didapati pada janin PJT 1,47 mg/ml SD 0,28 dan pada janin normal 1,45 mg/ml SD 0,19 secara statistic tidak berbeda bermakna

Kesimpulan

Didapat volume ginjal kiri dan kanan janin PJT lebih kecil dibanding janin normal begitu juga sekresi urin janin PJT lebih sedikit dibanding janin normal diikuti dengan volume indek cairan amnion janin PJT lebih rendah dibanding janin normal.

Arus darah arteri umbilikalis janin PJT lebih lambat dibanding janin normal dan secara statistic berbeda bermakna.

Terjadi gangguan fungsi ginjal janin PJT segera setalah lahir dengan terjadinya mikroalbuminuria, peningkatan albumin/kretinin rasio dan peningkatan kadar kreatinin urin.

TRANSLATION

THE RISK OF INTRAUTERINE GROWTH RESTRICTION (IUGR) ON THE RENAL IMPAIRMENT & ITS SUBSEQUENT BIRTH OUTCOME 

Abstract

Objective

To determine the volume and function of kidney of Intrauterine Growth Restriction (IUGR) fetuses and normal intrauterine fetuses subsequently after birth.

Methods

A cohort research was conducted on 20 IUGR fetuses up to 36 weeks compared with normal fetuses by examining the volume of kidney and secretion of urine, amniotic fluid index and umbilical blood flow.

On day 7 after birth, examination was performed on microalbumin, creatinine and Cystatin-c Test

The research samples were derived from RS. H. Adam Malik, RS. Pirngadi and obstetrician and gynecologist practices.

Results

The mean volume of the left kidney of IUGR fetuses was 6.47 ml with SD 1.85 and in normal fetuses were 11.09 ml with SD 2.91 using Mann-Whitney test was statistically different at p 0.001, the mean volume of the right kidney of IUGR fetuses was 6,07 ml with SD 1.9 whereas normal fetuses was 10,75ml with SD 3.35. it was statistically different.

The mean of urine volume per hour of IUGR fetuses was 8,21cc with SD 3,48 and normal fetuses was 19.23 ml, SD 5.79 ml  and it was statistically different. Although it had not reached oligohydramnios but the amount of amniotic fluid of IUGR fetuses was less than the normal fetuses 6.57 ml with SD 2.28 ml compared with that of the normal ones 11.85  with SD 2,53 ml and it was statistically different with p = 0.001.

The mean of umbilical blood flow of IUGR fetuses Resistance Index (RI) was 0.85, SD 0.72; SD ratio 3.38, SD 0.67 and PI 1.25, SD 0.21  whereas normal fetuses was RI 0.59 SD 0.07; SD ration2.56, SD 0.46 and PI 0.89,  SD 0.26. Umbilical artery blood flow between normal fetuses and IUGR fetuses was statistically different.

 On day 7 after birth, microalbumin urine of the examination of IUGR fetuses was 15.83 mg/ml, SD 31.32 but the normal ones was 1.9 mg/ml, SD 0.97 and it was statistically different with p = 0.001. Whereas the mean creatinine urine level of IUGR fetuses was 17.19 mg, SD is 9.84 and normal fetuses was 8.22 mg, SD 2.85. These creatinine levels were statistically different. It was found that the level of albumin/creatinine ratio of IUGR fetuses was 198.0 µg/ml, SD 627.63 whereas the normal fetuses was 24.75 ug/ml, SD is 14.07 and it was statistically different.

On examination of blood Cystatin-C it was found  that IUGR fetuses was 1.47 mg/ml and SD was 0.28 and in normal fetuses was 1.45 mg/ml, SD 0.19, it was not statistically different.

Conclusions

it was obtained that the volume of left and right kidneys of IUGR fetuses was smaller than normal fetuses as well as urine secretion of IUGR fetuses was less than  the urine secretion of normal fetuses. Meanwhile, the volume of amniotic fluid index of IUGR fetus was also lower than that of the normal ones.

Fetal umbilical artery blood flow of IUGR fetuses was slower than that of the normal ones and it was statistically a significant difference.

Impairment of renal function occured immediately after the IUGR fetus was born with the onset of microalbuminuria, the increase of albumin/creatinine ratio and urinary creatinine level.