Perbedaan Ekspresi Sel Natural Killer Desidua (dNK) pada Plasenta Kelainan Spektrum Plasenta Akreta dengan Wanita Hamil Normal di RSUP H. Adam Malik Medan

Abstract

Background: Placenta Accreta Spectrum Disorder (PASD) is a condition characterized by abnormal adhesion and/or placental trophoblastic invasion of the uterine myometrium. This spectrum includes placenta accreta, increta and percreta. The incidence of PASD in Indonesia has increased dramatically over the last few years, namely 156 cases. DNK cells are known to play a major role in controlling trophoblastic extra villous function of the placenta through many receptors, killer cell immunoglobulin-like receptors (KIR), growth factors and cytokines in the receptor-ligand interaction process which is thought to be related to PASD. Method: Observational analytic research with a case-control design was performed in this study. Paraffin blocks from the placenta of pregnant women with PASD for cases and the placenta of normal pregnant women for controls were stained with hematoxylin eosin staining and cuts for IHC staining were read. Immunohistochemical expression was assessed by proportion score (PS) and intensity score (IS). The data is then analyzed by Fisher's Exact Test. Results: The research sample is dominated by multigravida parity. From the results of 24 pregnant women with PASD, no dNK cell expression scores were found, but 2 scores were found in normal pregnant women without PASD, so they were not statistically related (p=0.234). Based on APGAR and LBW scores, there was also no association with PASD (p>0.05) and dNK cell expression scores (p=1.000). Conclusion: There is no relationship between the comparison of dNK cell expression in the placenta of normal pregnant women and PASD.