DI
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DAFTAR ISI Halaman SAMPUL LUAR........................................ SAMPUL DALAM....................................... HALAMAN PERNYATAN ................................. LEMBARAN PERSETUJUAN............................... HALAMAN PENGESAHAN PANITIA......................... KATA PENGANTAR..................................... UCAPAN TERIMA KASIH................................ RINGKASAN.......................................... SUMMARY............................................ ABSTRAK............................................ ABSTRACT........................................... DAFTAR ISI......................................... DAFTAR TABEL....................................... DAFTAR GAMBAR...................................... DAFTAR LAMPIRAN.................................... BAB. PENDAHULUAN............................... 1.1Latar belakang...........................1 1.2Rumusan masalah..........................9 1.3Tujuan penelitian........................10 1.4Manfaat penelitian.......................10 BAB II. TINJAUAN PUSTAKA...........................12 2.1 Persalinan prematur......................12 2.2 Insidensi dan Prevalensi.................12 2.3 Komplikasi...............................14 2.4 Gejala dan tanda-tanda...................15 2.5 Penyebab dan faktor prediposisi..........16 2.6 Patogenesis..............................18 2.6.1....................................Inf lamasi...............................20
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DAFTAR ISI
HalamanSAMPUL LUAR............................................................................................... SAMPUL DALAM........................................................................................... HALAMAN PERNYATAN ............................................................................ LEMBARAN PERSETUJUAN....................................................................... HALAMAN PENGESAHAN PANITIA........................................................ KATA PENGANTAR...................................................................................... UCAPAN TERIMA KASIH............................................................................ RINGKASAN.................................................................................................... SUMMARY.......................................................................................................ABSTRAK..........................................................................................................ABSTRACT......................................................................................................DAFTAR ISI.....................................................................................................DAFTAR TABEL.............................................................................................DAFTAR GAMBAR........................................................................................DAFTAR LAMPIRAN....................................................................................
BAB. PENDAHULUAN...............................................................................1.1 Latar belakang............................................................................11.2 Rumusan masalah.......................................................................91.3 Tujuan penelitian........................................................................101.4 Manfaat penelitian......................................................................10
BAB II. TINJAUAN PUSTAKA.....................................................................122.1 Persalinan prematur..................................................................122.2 Insidensi dan Prevalensi............................................................122.3 Komplikasi................................................................................142.4 Gejala dan tanda-tanda..............................................................152.5 Penyebab dan faktor prediposisi...............................................162.6 Patogenesis................................................................................18
2.6.1 Inflamasi..........................................................................202.6.2 Hormonal.........................................................................22
2.6.2.1 Prostaglandin......................................................232.6.2.2 Estrogen..............................................................242.6.2.3 Oksitosin.............................................................242.6.2.4 Progestron...........................................................25
2.7 Pemeriksaan..............................................................................262.8 Pencegahan...............................................................................282.9 Pengobatan dan pengelolaan.....................................................292.10 Mekanisme persalinan normal..................................................32
2.11 Nuclear Factor kapp Beta (NF-kB).........................................362.11.1 Definsi........................................................................36 2.11.2 Konsep dasar protein NF-kB dan Gen NF-kB...........372.11.3 Stuktur NF-kB............................................................372.11.4 Letak dan ukuran Gen................................................372.11.5 Fungsi protein NF-kB ( Gen NF-kB).........................382.11.6 Kelainan NF-kB.........................................................382.11.7 Mekanisme kerja NF-kB............................................382.11.8 Aktivasi NF-kB..........................................................392.11.9 Jalur sinyal aktivasi NF-kB........................................432.11.10 Faktor yang mempengaruhi NF-kB...........................442.11.11 Peranan NF-kB...........................................................442.11.12 Faktor penghambat NF-kB........................................46
2.12 Tumor Nekrosis Factor (TNFα)..............................................482.12.1 Definisi.......................................................................482.12.2 Fungsi TNFα..............................................................492.12.3 Tumor Necrosing Factor Receptor.............................492.12.4 Apoptosis...................................................................50
2.13 Cyclooxygenase-2 (COX2)....................................................512.13.1 Definisi.......................................................................512.13.2 Fungsi COX-2............................................................512.13.3 Faktor penghambat COX-2........................................52
BAB III. KERANGKA KONSEPTUAL DAN BAB III. HIPOTESIS PENELITIAN............................................................54
3.1 Kerangka konseptual...............................................................543.2 Hipotesis..................................................................................56
BAB IV. METODE PENELITIAN................................................................574.1 Jenis dan desain penelitian......................................................574.2 Populasi dan sampel................................................................57
4.2.1 Populasi penelitian.....................................................574.2.2 Sampel penelitian.......................................................574.2.3 Jumlah sampel............................................................57
4.3 Kriterian inklusi dan eksklusi..................................................584.3.1 Kriterian inklusi.........................................................584.3.2 Kriteria eksklusi.........................................................58
4.4 Variabel penelitian..................................................................584.4.1 Variabel penelitian.....................................................584.4.2 Variabel bebas............................................................584.4.3 Variabel terikat...........................................................59
4.4.4 Definisi Operasional variabel penelitian.....................594.4.4.1 Variabel bebas................................................594.4.4.2 Variabel terikat...............................................604.4.4.3 Variabel perancu............................................60
4.5 Bahan dan instrumen penelitian....................................................614.5.1 Bahan yang diperlukan dalam penelitian....................614.5.2 Pemeriksaan kadar TNFα............................................61
4.5.2.1 Prinsip pemeriksaan.......................................614.5.2.2 Penanganan reagen.........................................624.5.2.3 Prosedur kerja................................................624.5.2.4 Perhitungan....................................................634.5.2.5 Pemeriksaan ekspresi NF-kB.........................63
4.6 Persyaratan etik penelitian4.7 Pemantapan mutu ( quality assurance )........................................66
4.7.1 Persyaratan subyek......................................................674.7.2 Pengambilan sampel....................................................674.7.3 Penyimpanan sampel...................................................674.7.4 Pengiriman sampel......................................................674.7.5 Pemeriksaan sampel....................................................684.7.6 Pencatatan sampel.......................................................68
4.8 Tempat dan waktu penelitian........................................................684.8.1 Tempat penelitian........................................................684.8.2 Waktu penelitian..........................................................684.8.3 Prosedur pengambilan dan pengumpulan data............684.8.4 Jadwal kegiatan...........................................................704.8.5 Kerangka operasional penelitian.................................70
4.9 Penelolaan data..............................................................................71
BAB V. HASIL PENELITIAN.......................................................................79BAB VI.PEMBAHASAN.................................................................................89
6.1 Prinsip pemeriksaan......................................................................896.2 Perbedaan antara TNFα pada persalinan prematur
dan persalinan normal...................................................................906.3 Perbedaan antara NF-KB pada persalinan prematur dengan
persalinan normal.........................................................................916.4 Perbedaan antara COX-2 pada persalinan prematur dengan
Persalinan normal..........................................................................926.5 Korelasi kadar NF-kB dengan TNFα dan COX-2
Pada Persalinan prematur..............................................................93
BAB VII. KESIMPULAN DAN SARAN.......................................................947.1 Kesimpulan...............................................................................947.2 Saran.........................................................................................94
DAFTAR PUSTAKA.......................................................................................95LAMPIRAN…………………………………………………………………105
