DAFTAR ISI

Hal

HALAMAN JUDUL
LEMBAR PROMOTOR DAN CO-PROMOTOR
UCAPAN TERIMAKASIH
RINGKASAN
SUMMARY
ABSTRAK
ABSTRACT
DAFTAR ISI...............................................................................................................ii
DAFTAR SINGKATAN............................................................................................iv
DAFTAR TABEL......................................................................................................vii
DAFTAR GAMBAR.................................................................................................viii
DAFTAR LAMPIRAN..............................................................................................ix
BAB I PENDAHULUAN....................................................................................... 1
1.1 Latar belakang ........................................................................................ 1
1.2 Rumusan masalah .................................................................................. 7
1.3 Tujuan penelitian ................................................................................... 7
1.3.1 Tujuan umum ................................................................................ 7
1.3.2 Tujuan khusus ............................................................................... 7
1.4 Manfaat penelitian ................................................................................. 8
1.4.1 Manfaat ilmiah .............................................................................. 8
1.4.2 Manfaat praktis ............................................................................. 9
1.4.3 Manfaat bagi masyarakat luas ....................................................... 9
1.5 Potensi orisinalitas .................................................................................. 9
1.6 Potensi hak atas kekayaan intelektual (HAKI) ....................................... 9
BAB II TINJAUAN PUSTAKA ............................................................................... 11
2.1 Preeklampsia .......................................................................................... 11
2.1.1 Definisi.......................................................................................... 11
2.1.2 Epidemiologi preeklamsia ............................................................ 12
2.1.3 Patofisiologi ................................................................................. 13
2.1.4 Gejala klinis preeklampsia ............................................................ 19
2.1.5 Penanda biologis (biomarker) preeklampsia ................................ 25
2.1.5.1 Penanda inflamasi .............................................................. 33
2.1.5.1.1 Cyclooxcygenase 2 (COX-2) ………...…….…..33
2.1.5.1.2 Vaskular interleukin 10 (IL-10).......................... 35
2.1.5.2 Penanda stress oksidatif ..................................................... 36
2.1.5.2.1 Malondialdehyde (MDA).................................... 36
2.1.5.2.2 Superoxide dismutase (SOD) ............................. 37
2.1.5.3 Penanda faktor angiogenesis ............................................. 38
2.1.5.3.1 SolublefFms liike tyrosine kinase-1 (sFlt-1) ...... 38
2.1.5.3.2 Vascular endothelial growth factor (VEGF) ..... 39
2.1.6 Penatalaksanaan preeklampsia...................................................... 40
2.1.6.1 Terminasi kehamilan........................................................ 40
2.1.6.2 Teknik anestesi obstetri .................................................... 42
2.2 Curcumin .............................................................................................. 44
2.2.1 Farmakologi curcumin ................................................................. 46
 2.2.2 Mekanisme kerja ............................................................................ 49
2.2.3 Waktu dan kadar faktor pengencer darah....................................... 50
2.2.4 Efek analgetik................................................................................. 51
2.2.5 Aktifitas antiinflamasi .................................................................... 52
2.2.6 Aktifitas antioksidan ...................................................................... 55
2.2.7 Aktivitas angiogenesis ................................................................... 56
2.2.8 Efek curcumin terhadap faktor pengencer darah, VAS, kadar
COX-2, IL-10, MDA, SOD, sFlt-1 dan VEGF .............................. 58
2.3 Kerangka teori ......................................................................................... 61
2.4 Kerangka konsep ..................................................................................... 63
2.5 Hipotesa penelitian .................................................................................. 64
2.5.1 Hipotesa mayor .............................................................................. 64
2.5.2 Hipotesa minor ............................................................................... 64

BAB III METODE PENELITIAN ............................................................................ 65

3.1 Disain penelitian.................................................................................... 65
3.2 Tempat dan waktu penelitian ................................................................ 65
3.3 Populasi penelitian ................................................................................ 65
3.3.1 Populasi sasaran ........................................................................... 65
3.3.2 Populasi sampel ........................................................................... 66
3.4 Kriteria inklusi ...................................................................................... 66
3.5 Kriteria eksklusi .................................................................................... 66
3.6 Kriteria drop out .................................................................................... 66
3.7 Besar sampel ......................................................................................... 67
3.8 Pemilihan sampel .................................................................................. 68
3.9 Cara kerja .............................................................................................. 68
3.9.1 Persiapan ...................................................................................... 68
3.9.2 Pelaksanaan.................................................................................. 68
3.10 Identifikasi variabel .............................................................................. 70
3.10.1 Variabel independen .................................................................. 70
3.10.2 Variabel dependen ..................................................................... 71
3.10.3 Variabel perancu ........................................................................ 75
3.11 Diagram Alur Penelitian ...................................................................... 77
3.12 Pengolahan dan Analisa Data............................................................... 78
BAB IV HASIL........................................................................................................80
4.1. Karakteristik Subjek...............................................................................81
4.2. Uji Normalitas Data................................................................................84
4.2.1 Data hemodinamik........................................................................84
4.2.2 Data darah rutin.............................................................................85
4.2.3 Data penelitian...............................................................................86
4.3 Waktu dan kadar faktor pengencer darah................................................87
4.3.1 Clotting time (CT).........................................................................87
4.3.2 Bleeding time (BT)........................................................................89
4.3.3 Trombosit...................................................................................... 91
4.4 Nilai Visual Analog Scale (VAS).............................................................93
4.5 Kadar Serum Penanda Inflamasi..............................................................94
4.5.1 Serum cyclooxcygenase 2 (COX-2)................................................94
4.5.2 Serum vaskular interleukin 10 (IL-10)............................................97
 4.6 Kadar Serum Penanda Stres Oksidatif.....................................................99
4.6.1 Serum malondialdehyde (MDA)....................................................99
4.6.2 Serum superoxide dismutase
(SOD).............................................101
4.7 Kadar serum penanda faktor angiogenik.................................................103
4.7.1 Serum soluble fms like tyrosine kinase-1 (sFlt-1)..........................103
4.7.2 Serum vascular endothelial growth factor (VEGF)......................105
BAB V PEMBAHASAN...........................................................................................108
5.1 Karakteristik Subjek................................................................................108
5.2 Uji Normalitas Data.................................................................................108
5.3 Waktu dan Kadar Faktor Pengencer Darah.............................................112
5.4 Kadar serum penanda Inflamasi..............................................................115
5.4.1 Serum cyclooxcygenase 2 (COX-
2)...................................................115
5.4.2 Serum vaskular interleukin 10 (IL-10)...........................................117
5.5 Kadar serum penanda stres oksidatif.......................................................118
5.5.1 Serum malondialdehyde (MDA).....................................................118
5.5.2 Serum superoxide dismutase (SOD)...............................................119
5.6 Kadar Serum Penanda faktor angiogenik.................................................120
5.6.1 Serum soluble fms like tyrosine kinase-1 (sFlt-1)...........................120
5.6.2 Serum vascular endothelial growth factor (VEGF)........................121
BAB VI SIMPULAN DAN SARAN..........................................................................122
6.1 Simpulan..................................................................................................122
6.2 Saran.........................................................................................................123
DAFTAR PUSTAKA
LAMPIRAN