EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN
Iron deficiency is a nutritional problem of pregnant women with high prevalence in Indonesia, even in Yogyakarta. At term pregnancy had a higher risk of iron deficiency due to highest iron needs in the third trimester and risk of hemorrage during labour, so when entering the lactation period, there...
| Main Authors: | , |
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| Format: | Thesis |
| Published: |
[Yogyakarta] : Universitas Gadjah Mada
2014
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| Subjects: |
| _version_ | 1826048512967573504 |
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| author | , Dinne Fitriya , dr. Tri Ratnaningsih, M.Kes, SpPK-K |
| author_facet | , Dinne Fitriya , dr. Tri Ratnaningsih, M.Kes, SpPK-K |
| author_sort | , Dinne Fitriya |
| collection | UGM |
| description | Iron deficiency is a nutritional problem of pregnant women with high
prevalence in Indonesia, even in Yogyakarta. At term pregnancy had a higher risk
of iron deficiency due to highest iron needs in the third trimester and risk of
hemorrage during labour, so when entering the lactation period, there is
potentially serious disruption on maternal health and the golden period of growth
and development of babies born. Gold standard diagnosis of iron deficiency is a
direct assessment iron reserves of bone marrow which are invasive, indirect
examination by conventional hematological parameters can only detect advanced
stages, whereas biochemical parameters able to detect the early stages but less
practical, influenced many factors, relatively high cost and limited avaibility. The
Sysmex XT-2000i is capable of displaying a new parameter reticulocyte
hemoglobin equivalent (RET-He) which measures the hemoglobin content of
reticulocytes in the bone marrow is removed 24-48 hours in circulation, so it is
considered more actual in describing the iron status of the bone marrow but there
is no global agreement about the cut-off. This study aims to determine to the cutoff
value of Ret-He who has the optimal sensitivity and specificity for screening
for iron deficiency at term pregnancy who will delivery in Yogyakarta,
This diagnostic study with a cross-sectional design, using the gold
standard ferritin cut-off value of <15 ng / ml with negative results of C-Reactive
Protein (CRP). The study involved women at term pregnancy who came in PKU
Muhammadiyah Bantul Hospital and then undergo a complete blood count and
RET-He test using automatic hematology analyzer Sysmex XT-2000i with
flowcytometry method, measurement of ferritin serum using a mini vidas (enzyme
linked fluorescence assay method/ ELFA) and CRP qualitatively using Avitex.
This study was followed by 189 subjects, only 97 subjects meet the
inclusion and exclusion criteria with age range 20-43 year. Based on feritin serum,
there are 50 subjects with iron deficiency, no difference subject characteristics
between two grups, but there are significant lower mean values in the of
hemoglobin concentration, hematocrit, MCV, MCH, and RET-He and higher
mean RDW-CV in iron deficiency group. Using ROC curve, we found that Ret
He had Area under curve (AUC) value of 0.71 which shows that the RET-He has
good enough as a diagnostic tools to detecting iron deficiency. The optimal cutoff
value as a screening test of iron deficiency at term pregnancy in labour was
<35.5 pg obtained in the range from 30.69 to 36.17 pg, has 68%, sensitivity, 66%
specificity, with Positive predictive value (PPV), 66% Negative Predictive Value
(NPV), positive likelihood ratio (LR) 2.00, negative LR 0.49. Further research is
needed to assess the role of Ret-he as a iron deficiency screening test at maternal
involving subjects from various trimesters of pregnancy by comparing various
parameters as a gold standard (eg, transferrin saturation, or ferritin with different
cut-off values ).
Keywords : iron deficiency, Ret-He, screening, at term pregnancy |
| first_indexed | 2024-03-13T23:31:12Z |
| format | Thesis |
| id | oai:generic.eprints.org:130894 |
| institution | Universiti Gadjah Mada |
| last_indexed | 2024-03-13T23:31:12Z |
| publishDate | 2014 |
| publisher | [Yogyakarta] : Universitas Gadjah Mada |
| record_format | dspace |
| spelling | oai:generic.eprints.org:1308942016-03-04T07:55:19Z https://repository.ugm.ac.id/130894/ EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN , Dinne Fitriya , dr. Tri Ratnaningsih, M.Kes, SpPK-K ETD Iron deficiency is a nutritional problem of pregnant women with high prevalence in Indonesia, even in Yogyakarta. At term pregnancy had a higher risk of iron deficiency due to highest iron needs in the third trimester and risk of hemorrage during labour, so when entering the lactation period, there is potentially serious disruption on maternal health and the golden period of growth and development of babies born. Gold standard diagnosis of iron deficiency is a direct assessment iron reserves of bone marrow which are invasive, indirect examination by conventional hematological parameters can only detect advanced stages, whereas biochemical parameters able to detect the early stages but less practical, influenced many factors, relatively high cost and limited avaibility. The Sysmex XT-2000i is capable of displaying a new parameter reticulocyte hemoglobin equivalent (RET-He) which measures the hemoglobin content of reticulocytes in the bone marrow is removed 24-48 hours in circulation, so it is considered more actual in describing the iron status of the bone marrow but there is no global agreement about the cut-off. This study aims to determine to the cutoff value of Ret-He who has the optimal sensitivity and specificity for screening for iron deficiency at term pregnancy who will delivery in Yogyakarta, This diagnostic study with a cross-sectional design, using the gold standard ferritin cut-off value of <15 ng / ml with negative results of C-Reactive Protein (CRP). The study involved women at term pregnancy who came in PKU Muhammadiyah Bantul Hospital and then undergo a complete blood count and RET-He test using automatic hematology analyzer Sysmex XT-2000i with flowcytometry method, measurement of ferritin serum using a mini vidas (enzyme linked fluorescence assay method/ ELFA) and CRP qualitatively using Avitex. This study was followed by 189 subjects, only 97 subjects meet the inclusion and exclusion criteria with age range 20-43 year. Based on feritin serum, there are 50 subjects with iron deficiency, no difference subject characteristics between two grups, but there are significant lower mean values in the of hemoglobin concentration, hematocrit, MCV, MCH, and RET-He and higher mean RDW-CV in iron deficiency group. Using ROC curve, we found that Ret He had Area under curve (AUC) value of 0.71 which shows that the RET-He has good enough as a diagnostic tools to detecting iron deficiency. The optimal cutoff value as a screening test of iron deficiency at term pregnancy in labour was <35.5 pg obtained in the range from 30.69 to 36.17 pg, has 68%, sensitivity, 66% specificity, with Positive predictive value (PPV), 66% Negative Predictive Value (NPV), positive likelihood ratio (LR) 2.00, negative LR 0.49. Further research is needed to assess the role of Ret-he as a iron deficiency screening test at maternal involving subjects from various trimesters of pregnancy by comparing various parameters as a gold standard (eg, transferrin saturation, or ferritin with different cut-off values ). Keywords : iron deficiency, Ret-He, screening, at term pregnancy [Yogyakarta] : Universitas Gadjah Mada 2014 Thesis NonPeerReviewed , Dinne Fitriya and , dr. Tri Ratnaningsih, M.Kes, SpPK-K (2014) EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN. UNSPECIFIED thesis, UNSPECIFIED. http://etd.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=71327 |
| spellingShingle | ETD , Dinne Fitriya , dr. Tri Ratnaningsih, M.Kes, SpPK-K EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN |
| title | EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN |
| title_full | EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN |
| title_fullStr | EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN |
| title_full_unstemmed | EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN |
| title_short | EVALUASI PARAMETER RETICULOCYTE HEMOGLOBIN EQUIVALENT (Ret-He) SEBAGAI UJI SKRINING DEFISIENSI BESI PADA IBU HAMIL ATERM DALAM PERSALINAN |
| title_sort | evaluasi parameter reticulocyte hemoglobin equivalent ret he sebagai uji skrining defisiensi besi pada ibu hamil aterm dalam persalinan |
| topic | ETD |
| work_keys_str_mv | AT dinnefitriya evaluasiparameterreticulocytehemoglobinequivalentrethesebagaiujiskriningdefisiensibesipadaibuhamilatermdalampersalinan AT drtriratnaningsihmkessppkk evaluasiparameterreticulocytehemoglobinequivalentrethesebagaiujiskriningdefisiensibesipadaibuhamilatermdalampersalinan |