Mohd Andalas

Comparison of Apgar scores in breech presentations between vaginal and cesarean delivery

Objective: The mode of delivery in breech presentation (BP) is controversial. Several studies have reported the advantages and disadvantages of delivery mode in BP. The aim of this study was to compare the Apgar scores in BPs between vaginal and cesarean delivery. Materials and Methods: A retrospective study was conducted at Dr. Zainoel Abidin General Hospital from January 2010 to December 2012. Data on the mode of delivery and Apgar scores at 1 and 5 min for infants with a BP were extracted from the medical records. Logistic regression was employed to assess the correlation between mode of delivery and Apgar scores. In addition, a meta-analysis was conducted to summarize findings from other regions. Results: A total of 205 (3.9%) BPs among 5252 deliveries between January 2010 and December 2012 were analyzed for this study. There were 26% (52 cases) vaginal and 74% (153 cases) cesarean deliveries. The mode of delivery for BP had a significant association with Apgar score at 1 min (odds ratio [OR] 95% confidence interval [CI] = 6.462 [2.476–16.870], P = 0.0001) and 5 min (OR 95% CI =7.727 [1.416–42.175], P = 0.018). Our meta-analysis showed that the delivery mode had a significant association with Apgar score in BP (OR: 3.69; 95% CI: 2.18–6.26, P = 0.0001). Conclusions: There was a significant association between Apgar scores in BPs and mode of delivery. Our results suggest better outcomes for cesarean than vaginal delivery in BPs.

Antagonis Soluble Fms-Like Tyrosine Kinase 1 (sFlt-1) dan Soluble Endoglin (sEng) pada Preeklamsia

Proangiogenic factor signal transduction like vascular endothelial growth factor (VEGF), placental growth factor (PlGF) and tissue growth factor â-1 (TGFâ-1) are important to angiogenesis and vascular health in pregnancy. In preeclampsia (PE) concentration of fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) are increase significantly. Base on analysis from resent research shown that sFlt-1 and sEng inhibit angiogenic factor signal transduction by competition in result angiogenic factor can‘t bind to their receptor. sFlt-1 and sEng are potential used as preeclampsia therapy because sFlt-1 and sEng have main role in PE pathogenesis. We suggest that the research to find out effective sFlt-1 and sEng antagonist have to conduct in the next time.