Tesis

Hubungan Kadar Progesteron dan Estradiol Maternal Terhadap Keberhasilan Induksi Persalinan: Suatu Studi Pendahuluan = The Role of Maternal Progesterone and Estradiol Levels in Predicting the Success of Induction of Labour: A Preliminary Study.

LATAR BELAKANG: Perimbangan antara hormon progesteron (P4) dan estrogen (E) diketahui memiliki peranan penting dalam mekanisme inisiasi persalinan sebagai pemicu kontraksi dan dapat menentukan waktu terjadinya persalinan. Penurunan rasio P4:E2 pada akhir kehamilan menunjukan kesuksesan untuk terjadinya persalinan normal. Sehingga penelitian ini akan mencoba mempelajari apakah terdapat hubungan antara kadar P4 dan E2 dengan tingkat keberhasilan induksi persalinan. TUJUAN: Mengetahui hubungan antara kadar progesteron dan estradiol maternal terhadap keberhasilan induksi persalinan DESAIN DAN METODE: Penelitian ini menggunakan desain potong lintang yang berlangsung pada bulan Mei 2016 hingga April 2017 di Poliklinik dan IGD Kebidanan, RSCM. Pasien hamil aterm yang dilakukan induksi persalinan dan memenuhi kriteria penelitian akan diambil sampel darah untuk pemeriksaan kadar hormon progesteron dan estradiol pada sebelum memulai induksi. Subjek kemudian dinilai keberhasilan induksi persalinannya. HASIL: Dari 44 subjek yang mengikuti penelitian, 24 subjek berhasil dilakukan induksi persalinan dan 20 subjek gagal. Tidak terdapat perbedaan bermakna kadar progesteron di atas 60 ng/ml pada kelompok gagal induksi maupun berhasil induksi (66,7% vs 75%, p=0,55). Kadar estradiol pada pasien yang berhasil dilakukan induksi memiliki rata-rata 16.916,28 + 2.574,75 pg/mL yang tidak berbeda jauh dengan kadar estradiol pasien yang gagal induksi yaitu 14.832,24 + 2374,47 pg/mL (p=0.65). KESIMPULAN: Tidak terdapat perbedaan bermakna antara kadar progesteron dan estradiol maternal terhadap keberhasilan induksi persalinan. Penelitian lebih lanjut di multisenter dan dengan melakukan penyesuaian terhadap faktor-faktor lain perlu dilakukan untuk mengkonfirmasi hasil penelitian ini.
Kata Kunci: Kadar Progesteron Maternal, Kadar Estradiol Maternal, Rasio Progesteron Estradiol dalam persalinan, Keberhasilan Induksi Persalinan



BACKGROUND: The ratio between progesterone (P4) and estrogen (E) hormones is known to have an important role in the mechanism of initiation of labor as a contraction trigger and can determine the time of birth. Decrease in P4: E2 ratio at the end of pregnancy could predict successful vaginal delivery. OBJECTIVE: This study was performed to evaluate the association of maternal P4 and E2 levels in patients who underwent labor induction and assess its success rate. METHOD: This cross-sectional study was conducted in outpatient clinic and emergency room, Cipto Mangunkusumo General Hospital, between May 2016 and April 2017. Term pregnancy women who fulfilled the study criteria were recruited and blood sample was taken initially before labor induction was conducted. The outcome of labor induction was then followed up. RESULTS: 44 women were recruited in this study, 24 subjects had successful labor induction while the other 20 subjects were failed. There was no significant difference of progesterone level above 60 ng/ml between failed of induction group and successful induction group (66,7% vs 75%, p=0,55). Estradiol levels in subjects who successfully performed induction had an average of 16,916.28 ± 2,574.75 pg/mL which did not differ significantly from the failed of induction group with estradiol levels of 14,832.24 ± 2374.47 pg/mL (p = 0.65). CONCLUSION: There is no significant association between maternal progesteron and estradiol level to the success rate of labor induction. A multi-center study perfoming adjustment to external factors is needed to confirm current data.
Keywords: Maternal Progesterone Level, Maternal Estradiol Level, Progesterone/Estradiol Ratio in labor, Success Rate of Labor Induction.