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"Bayi prematur berisiko tinggi mengalami sepsis neonatorum awitan lambat pada minggu-minggu pertama pasca kelahiran. Tujuan dari studi ini adalah mengaplikasikan Teori Konservasi Levine dalam menurunkan kejadian sepsis neonatorum awitan lambat pada bayi baru lahir prematur dengan pemberian oral care ASI. Proses asuhan keperawatan menggunakan pendekatan Teori Konservasi Levine berdasarkan empat konservasi yaitu konservasi energi, konservasi integritas struktural, konservasi integritas personal dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan gangguan pertukaran gas, pola nafas tidak efektif, defisit nutrisi, termoregulasi tidak efektif, risiko infeksi dan risiko gangguan perlekatan. Hasil implementasi pemberian oral care ASI dapat menurunkan kejadian sepsis awitan lambat, mempercepat bayi minum penuh dan mempercepat proses penyapihan alat bantu pernafasan. Intervensi ini dapat menjadi standar prosedur operasional bagi perawat dalam memberikan asuhan keperawatan pada bayi baru lahir.

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Premature infants are at high risk for late onset neonatal sepsis in the first few weeks after birth. The aim of this study was to apply the Levine rsquo s Conservation Theory to decrease the incidence of late onset neonatal sepsis in preterm newborns by oral care of ASI. The nursing care process uses the Levine rsquo s Conservation Theory approach based on four conservation, such as conservation of energy, conservation of structural integrity, conservation of personal integrity and conservation of social integrity. Five selected cases indicate nursing problems of gas exchange disorders, ineffective breathing patterns, nutritional deficits, ineffective thermoregulation, infection risk and risk of attachment disturbance. The results of ASI oral care implementation may decrease the incidence of late onset sepsis, accelerate full feed and accelerate the weaning process of respiratory aids. This intervention can be standard operating procedure for nurses in providing nursing care to newborns."

"Sepsis neonatorum awitan lambat (SNAL) masih menjadi penyebab penting kematian dan kesakitan pada bayi kurang bulan. Diagnosis yang cepat penting untuk penatalaksanaan yang sesuai. Diperlukan alat diagnostik yang sederhana, tidak mahal dan cepat hasilnya untuk mendiagnosis SNAL.Tujuan penelitian ini adalah untuk mendapatkan nilai diagnostik rasio netrofil limfosit (RNL) dan kombinasi RNL dan rasio I/T untuk mendiagnosis SNAL. Data penelitian cross sectional ini diambil dari rekam medis pasien bulan januari 2018-Desember 2019 di Divisi Neonatologi Rumah Sakit Cipto Mangunkusumo. Subyek penelitain adalah bayi kurang bulan >30-36 minggu, berusia 7-28 hari dengan klinis sepsis. Dari kultur darah, neonatus dibagi menjadi 2 kelompok, yaitu: proven sepsis dan unproven sepsis. Rasio netrofil limfosit dihitung dari data hitung jenis limfosit. Rasio I/T didapat dari rekam medis. Dari semua 126 subyek penelitian 70 termasuk kelompok proven sepsis dan 56 unproven sepsis. Analisis kurva Receiver operating characteristic RNL didapatkan area under the curve 0.953. Dengan cut off RNL 1.785 didapatkan sensitivitas 78,57%, spesifisitas 92,86%, nilai dugan positif (NDP) 93,22% dan nilai duga negative (NDN) 77,61%. Dengan titik potong rasio I/T > 0,2, didapatkan sensitivitas 55,70 %, spesifitas 83,70%, NDP 81,25% dan NDN 60,26%. Gabungan RNL dan rasio I/T meningkatkan sensitivitas dan NDP rasio I/T berturut-turut menjadi 90% dan 84,44%. Sebagai kesimpulan, RNL dengan titik potong 1,785 mempunyai nilai diagnostik yang baik untuk mendiagnosis SNAL. Kombinasi RNL dan rasio I/T akan meningkatkan nilai diagnostik rasio I/T.

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Late-onset neonatal sepsis (LOS) remains an important cause of death and morbidity among preterm infants. Early diagnostic is important for appropiate management. The simple, inexpensive, and rapid diagnostic tool is required to diagnose LOS. The objective of this study is assesing diagnostic value of NLR and combination of NLR and I/T ratio for diagnosis LOS. The data for this retrospective cross-sectional study was collected from medical record from January 2018 to December 2019 at Neonatology Division Cipto Mangunkusumo Hospital. Preterm infants with >30 -36 gestational weeks, 7-28 days of postnatal age and clinically sepsis were eligible for this study. According to the result of blood cultures, all enrolled infant were classified into 2 groups: proven sepsis and unproven sepsis. The NLR was calculated as the ratio of neutrophil count to lymphocyte count. Immature-to-total neutrophil ratio was taken from medical record. A total of 126 subjects were involved: 70 proven sepsis and 56 unproven sepsis. Receiver operating curve analysis for NLR calculated and area under the curve of NLR corresponded to 0.953. Using a cut off point of 1.785 for NLR, the sensitivity was 78,57%, the specificity was 92,86%, positive predictive value (PPV) 93,22% and negative predictive value (NPV) 77,61%. Using cut off > 0,2, I/T ratio has sensitivity 55,70 %, specificity 83,70%, PPV 81,25% and NPV 60,26%. The combination NLR and ratio I/T increased sensitivity and PPV of ratio I/T became 90% and 84,44%, respectively.As conclusion The NLR with cut off 1,785 has good diagnostic value for SNAL. Combination NLR and I/T ratio can increase diagnostic value of I/T ratio."

"Bayi prematur mempunyai banyak risiko gangguan kesehatan yang dapat dialami akibat fungsi dan sistem tubuh yang belum sempurna. Mandi merupakan tindakan non invasif yang dilakukan setiap hari dan dapat mengakibatkan stres pada bayi. Respon stres yang ditunjukkan oleh bayi prematur selama prosedur memandikan dapat berupa menangis, tremor, kehilangan suhu tubuh, dan perubahan tanda-tanda vital. Tujuan penelitian ini adalah memberikan gambaran penerapan Model Konservasi Levine pada asuhan keperawatan bayi prematur dengan risiko gangguan termoregulasi melalui teknik memandikan swaddled bath. Penelitian ini menggunakan metode studi kasus terhadap lima bayi prematur yang berisiko mengalami gangguan termoregulasi melalui pendekatan proses keperawatan. Gangguan termoregulasi dapat menghambat proses adaptasi bayi prematur dalam mencapai keutuhannya, sehingga diperlakukan intervensi berbasis Model Konservasi Levine melalui empat prinsip konservasi. Hasil penelitian menunjukkan bahwa Model Konservasi Levine dapat digunakan dalam asuhan keperawatan bayi prematur dengan masalah termoregulasi melalui penggunaan teknik memandikan swaddled bath.

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Premature babies have many risks of health problems that can be experienced due to immature body functions and systems. Bathing is a non-invasive action that is performed every day and can cause stress to the baby. The stress respone shown by premature babies during the bathing procedure can be in the form of crying, tremors, loss of body temperature, and changes in vital signs. The purpose of this study was to provide an overview of the application of the Levine Conservation Model in nursing care of premature infants with a risk of thermoregulation disorders through the swaddled bath technique. This research used a case study method of five premature babies who were at risk of experiencing thermoregulation disorders through the nursing process approach. Disorders of thermoregulation can hinder the adaptation process of premature babies in achieving their wholeness, so interventions based on the Levine Conservation Model are treated through four principles of conservation. The results of this study indicate that the Levine Conservation Model can be used in nursing care of premature infants with thermoregulation problems through the use of the swaddled bath technique."

"Pengosongan lambung merupakan masalah yang sering terjadi pada bayi prematur akibat imaturitas sistem gastrointestinal. Tujuan dari studi kasus ini adalah melakukan analisis penerapan Teori Konservasi Levine pada lima bayi prematur yang mengalami masalah pemenuhan kebutuhan nutrisi melalui pemberian posisi miring kanan, pronasi dan miring kiri bergantian selama tiga hari. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil penerapan intervensi pengaturan posisi pronasi dengan pendekatan Teori Konservasi Levine dapat menurunkan kejadian muntah, distensi abdomen dan pengeluaran residu lambung. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami masalah pengosongan lambung.

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Gastric emptying is a common problem in premature infants due to immaturity of the gastrointestinal system. The objective of this case study was to analyze the application of Levine's Conservation Theory to five premature infants who had problems in fulfilllment the nutritional needs through giving alternate position in the right lateral position, pronation and left lateral position for three days. Levine's Conservation Theory was used by applying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. The results showed that the implementation of pronation positioning using Levine's Conservation Theory can reduce the frequency of vomiting, abdominal distension, and gastric residual. Nurses can apply the intervention as a standard operating procedure in premature infants who experience gastric emptying."

"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."

"Secara global, sebanyak 15 juta bayi lahir secara prematur setiap tahunnya. Indonesia menempati peringkat kelima negara dengan angka kelahiran prematuritas tertinggi di dunia. Salah satu komplikasi utama pada bayi prematur adalah sepsis neonatorum. Sepsis neonatorum adalah respon inflamasi sistemik yang dapat terjadi pada neonatus diakibatkan oleh transmisi infeksi secara vertikal maupun melalui lingkungan. Dikarenakan oleh temuan klinis sepsis yang variatif, menyebabkan upaya mendiagnosis sepsis menjadi sullit dilakukan. Oleh karena itu, perlu diberlakukan profilaksis sepsis neonatorum pada bayi prematur, sehingga muncul prosedur oral care. Pemahaman mengenai kebermanfaatan dan keamanan prosedur oral care masih diperlukan untuk dapat menggunakan prosedur ini secara optimal. Tujuan. (1) Mengetahui karakteristik subjek penelitian berdasarkan karakteristik jenis kelamin, usia gestasi, berat lahir, usia ibu, dan jenis persalinan. (2) Mengetahui angka kejadian sepsis neonatorum pada bayi prematur yang mendapat dan tidak mendapat oral care. (3) Mengetahui hubungan antara pemberian oral care dengan kejadian sepsis neonatorum pada bayi prematur. Metode penelitian. Sebuah studi cross-sectional dilakukan pada populasi bayi prematur yang lahir di RSCM pada tahun 2015-2017. Sebanyak 42 sampel yang dipilih secara simple random sampling. Pengambilan data dilakukan pada bulan Januari hingga Agustus 2018 dengan melihat rekam medis subjek penelitian yang dilanjutkan dengan analisis bivariat. Hasil penelitian. Jumlah total subjek yang memenuhi kriteria inklusi dan eksklusi pada penelitian ini adalah 42 bayi prematur. Karakteristik penelitian ini adalah jenis kelamin laki-laki sebesar 52,4%, rerata usia gestasi 33 (24-36) minggu, rerata berat lahir 1569,24±493,3 gram, rerata usia ibu 30,5238±6,67 tahun, dan jenis persalinan sectio caesaria sebesar 85,7%. Didapatkan hubungan bermakna antara pemberian oral care dengan kejadian sepsis neonatorum (P=0,030 ; RR=0,533 ; IK 95%=0,290-0,980). Didapatkan hubungan bermakna antara usia gestasi dengan kejadian sepsis neonatorum pada subjek yang mendapat oral care (UG: 32-37 minggu = 91,7% subjek tidak sepsis ; P=0,003), serta hubungan bermakna antara berat lahir dengan kejadian sepsis neonatorum pada subjek yang mendapat oral care (BL: 1500-2499 gram = 100% subjek tidak sepsis ; P=0,002). Kesimpulan. Terdapat hubungan yang signifikan antara pemberian oral care dengan kejadian sepsis neonatorum pada bayi prematur di RSCM, terdapat penurunan kemungkinan terkena sepsis neonatorum sebesar 0,533 kali lipat.

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Introduction. Globally, it is estimated that there are 15 million premature infants born every year. Indonesia ranks fifth in the incidence of prematurity worldwide. One of the major complications of premature infants is neonatal sepsis. Neonatal sepsis is a systemic inflammatory response on infants caused by infections acquired vertically and enviromentally. Sepsis has a wide range of clinical findings, therefore it is hard to diagnose precisely. Therefore, profilactic measures to prevent neonatal sepsis is needed, and oral care rises as one of the solution. The understanding in regards of efficacy and safety of oral care is needed in order to be able to optimally utilize this procedure.

Objectives. (1) To determine the subject characteristic based on gender, gestational age, birth weight, maternal age, and mode of delivery. (2) To determine the incidence of neonatal sepsis in premature infants with or without the administration of oral care. (3) To determine the association between oral care administration and the incidence of neonatal sepsis in premature infants.

Methods. A cross-sectional study is done to premature infants born in RSCM in 2015-2017. 42 samples are chosen by simple random sampling. Data is collected from January to August 2018 by observing the medical records of the subject, and then continued to be analyzed using bivariate analysis.

Results. There are 42 subjects that met the inclusion and exclusion criteria. The characteristics of this study are, 52,4% subject is male, mean gestational age is 33 (24-36) weeks, mean birth weight is 1569,24±493,3 gram, mean maternal age is 30,5238±6,67 years, and 85,7% subject delivered by sectio caesaria mode. There is a significant association between oral care administration and the incidence of neonatal sepsis (P=0,030 ; RR=0,533 ; CI 95%=0,290-0,980). There is a significant association between gestational age and the incidence of neonatal sepsis in subjects receiving oral care (GA: 32-37 weeks = 91,7% subjects without neonatal sepsis ; P = 0,003), and a significant association between birth weight and the incidence of neonatal sepsis in subjects receiving oral care (BW: 1500-2499 gram = 100% subjects without neonatal sepsis ; P = 0,002).

Conclusion. There is a significant association between oral care administration and the incidence of neonatal sepsis in premature infants in RSCM, with the reduction of probability of the incidence of neonatal sepsis as much as 0,533 times higher."

"Pengontrolan suhu tubuh sangat penting pada bayi prematur karena fluktuasi suhu meningkatkan ketidakseimbangan tingkat metabolisme bayi baru lahir. Pengaturan suhu tubuh yang buruk menjadi sasaran faktor lingkungan yang dapat menyebabkan kehilangan panas yang cepat sehingga rentan terhadap peningkatan risiko morbiditas dan mortalitas akibat hipotermia. Tujuan dari penelitian ini untuk mengetahui penerapan teori Konservasi  Levine dalam mengatasi masalah risiko termoregulasi tidak efektif pada bayi baru prematur di ruang Perinatologi. Model Konservasi Levine berfokus pada peningkatan adaptasi dan mempertahankan integritas diri (wholeness) dengan menggunakan prinsip konservasi. Masalah risiko termoregulasi tidak efektif merupakan salah satu gambaran terganggunya konservasi energi mencakup ketersediaan dan pengeluaran energi bayi baru lahir dan menyebabkan terjadinya peningkatan konsumsi oksigen dengan mempertahankan fungsi normal termogenesis

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Body temperature control is very important in preterm infant because temperature fluctuations improve the balance. Poor body temperature regulation is the target of environmental factors that can cause rapid heat loss, making them susceptible to an increased risk of morbidity and mortality due to hypothermia. The purpose of this study was to determine the application of Levine's Conservation theory in overcoming the problem of ineffective thermoregulation risk in premature newborns in the Perinatology room. Levine's Conservation Model focuses on increasing adaptation and maintaining wholeness using conservation principles. The problem of the risk  ineffective thermoregulation is one of the features of the disruption energy conservation and energy expenditure of baby and causes an increase in oxygen consumption by maintaining normal thermogenesis function.

 

"

"Bayi prematur dengan alat bantu nafas ventilasi mekanik memerlukan tindakan bersihan jalan napas. Penelitian menggunakan quasy experiment pada dua kelompok A dan B untuk mengetahui perubahan saturasi sebelum, selama dan setelah tindakan bersihan jalan napas. Kelompok A open suction dan B closed suction masing-masing 30 dan 10 bayi prematur. Analisis menggunakan uji statistik repeated Anova yang dilanjutkan dengan post hoc paired wise comparison. Tindakan bersihan jalan napas menggunakan open suction nilai p kurang 0,001 secara statistik terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi, sedangkan closed suction nilai p kurang 0,001 terdapat perbedaan rerata yang bermakna terhadap perubahan saturasi. Penggunaan alat pengisap lendir closed suction menunjukan keadaan saturasi oksigen lebih stabil, sehingga lebih disarankan untuk tindakan bersihan jalan napas pada bayi prematur. Penggunaan closed suction akan efektif pada keadaan sekret yang encer.

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Premature infant with a mechanical ventilation need airway clearance. The study used quasy experiment in two groups A and B to provide information before and after airway clearance. Group A open suction and B closed suction each of 30 and 10 premature infants. The analysis used the statistical repeated Anova test followed by post hoc paired wise comparison. Airway clearance using an open suction with p.value 0.001, statistically, there is a mean actually oxygen saturation, while closed suction p value of less than 0.001 is the average actually oxygen saturation. The used closed suction shows a more stable oxygen saturation state, more for airway clearance in premature infants. The use of the closed suction will be effective in the state of dilute secretions."

"Masalah pernapasan merupakan masalah krusial pada bayi prematur dan memerlukan penanganan segera. Pemberian asuhan keperawatan pada bayi prematur dengan gangguan oksigenasi dapat dioptimalkan melalui intervensi fasilitated tucking. Efek positif dari fasilitated tucking adalah mempromosikan bayi dalam kestabilan fungsi fisiologis, sehingga membantu proses oksigenasi bayi menjadi lebih baik. Penggunaan Teori Konservasi Levine dapat diaplikasikan dalam penerapan asuhan keperawatan yang menerapkan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan pemenuhan gangguan oksigenasi. Praktik keperawatan berbasis pembuktian yang dilakukan melalui fasilitated tucking terbukti efektif terhadap laju perubahan yang konstan terhadap parameter fisiologis yaitu nadi dan saturasi oksigen. Intervensi fasilitated tucking berbasis teori Konservasi Levine dapat diterapkan dalam pemberian asuhan keperawatan yang berkualitas pada bayi prematur dengan gangguan pemenuhan oksigenasi.

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Respiratory distress is the crucial problem in preterm infants and appropriate management soon. Providing nursing care for preterm infants with impaired oxygenation fulfillment can be optimalized by applying fasilitated tucking intervention. Positive effect of fasilitated tucking can promoth physiological function stability, therefore it helps oxygenation process better. Levine's Conservation Theory was used by appliying the principle of energy conservation, structural integrity conservation, personal integrity conservation, and social integrity conservation. Five cases were selected due to nursing problems in impaired oxygenation fulfillment. Evidenced done by doing fasilitated tucking effective for changes physiologic parameters constantly namely heart rate and oxygen saturation. Fasilitated tucking intervention with Levine's Conservation Theory can be applied for quality nursing intervention in preterm infants with impaired oxygenation fulfillment."

"[ABSTRAKLatar belakang: Prematuritas merupakan salah satu kelainan yang masih menjadimasalah global. Kejadian prematuritas tidak hanya terjadi di negara berkembangtetapi juga di negara maju. Beberapa kondisi ibu hamil dapat memicu keadaanhipoksia dalam rahim sehingga menyebabkan kelahiran prematur. Keadaanplasenta menggambarkan kesejahteraan janin intra uteri. Kondisi hipoksia selulermemicu ekspresi HIF-1α yang menjadi faktor transkripsi bagi CA9 sebagaipenanda hipoksia. Penelitian ini bertujuan menganalisis pengaruh hipoksiaterhadap plasenta prematur.Metode: Sampel menggunakan plasenta prematur yang hipoksia (H) dan nonhipoksia(N) sebagai kontrol. Parameter yang dinilai adalah struktur histologisplasenta (Hematoksilin-Eosin), regulator hipoksia HIF-1α (imunohistokimia), danpenanda hipoksia CA9 (ELISA).Hasil: Penilaian struktur histologis menunjukkan adanya perbedaan jumlahpembuluh darah fetus antara kedua kelompok secara bermakna, dimana padakelompok hipoksia jumlah pembuluh darah fetus lebih banyak dibandingkankelompok non-hipoksia. Distribusi intensitas ekspresi HIF-1α kedua kelompokjuga berbeda bermakna. Rerata kadar CA9 kedua kelompok tidak berbedabermakna, namun terdapat kecenderungan rerata kadar CA9 kelompok hipoksialebih tinggi 28% dibandingkan yang non-hipoksia.Kesimpulan: Pengaruh hipoksia terhadap plasenta prematur pada tingkatmolekuler berupa stabilitas protein HIF-1α yang menyebabkan peningkatanjumlah pembuluh darah fetus dan terjadi kecenderungan peningkatan sintesisprotein CA9.

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ABSTRACTBackground: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.;Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein., Background: Prematurity is a disorder that is still a global problem. Incidence ofprematurity is a problem in developing and also in developed countries. Certaincondition accompanying pregnancies may trigger uterine hypoxia, causingpremature birth. The placental condition is related with the intra-uterine fetalcondition. Cellular hypoxic condition caused by systemic chronic hypoxia, lead tostabilization of HIF-1α protein, a transcription factor of CA9. This study aimed toanalyze the effect of hypoxia on the premature placenta.Methods: Samples from hypoxic premature placenta (H) and non-hypoxicpremature placenta (N) were collected. Parameters assessed were histologicalstructure of the placenta (Hematoxylin-Eosin), expression of HIF-1α(immunohistochemistry) and the level of CA9 (ELISA).Results: Assessment of histological structure showed the number of fetal bloodvessels were differed significantly between the two group, wherein the hypoxiagroup was more than the non-hypoxia. The distributions of HIF-1α expressionbetween the two groups were also differed significantly. The average level of CA9between two groups were not significant, but there is a tendency of higher level ofCA9 in the hypoxia group (28% higher compared to the non-hypoxia group).Conclusion: It is concluded that the effect of the hypoxia on premature placentain this study occured at molecular level and lead to HIF-1α protein stability thatcauses an increase of the number of fetal blood vessel and synthesis of CA9protein.]"