Background: Preeclampsia is one of the main causes behind maternal and perinatal mortarity and morbidity. The pathogenesis remains unclear but recently many that the failure of spiral arteries remodeling will eventually lead to placental hypoxia. On preeclampsia complicated-pregnancy, the trophoblast apoptosis is considered being excesive.
Eventhought this hypothesis is till understudy, it is believed that trophoblast apoptosis regulation play a role in preeclampsia complicatedpregnancy pathophysiology. Molecular apoptosis mechanism in human is very complex and involves many signaling molecules, among
them is Bcl-2. Bcl-2 group consist of proapptosis (Bax)) and apoptosis inhibitor (Bcl- 2 and Bcl-XL).
Objective: To compare the expression of Bcl-XL protein on prcgnancy trophoblast between severe preeclampsia complicated-pregnancy and
normotension pregnancy.
Method: This cross sectional study involves population of severe preeclampsia and normotension patient that being treated at RSUP
Sardjito from October 2011 until March 2012. Placenta samples were obtained from 43 severe preeclampsia complicated-pregnancy and 38
placentas from normotension pregnancy. Bcl-XL protein expression was observed using immunohistochemistry technique. statistical
analysis was done using independent t-test (p<0.05).
Result: There was significant difference Bcl-XL protein expression on trophoblast cells in severe preeclampsia, complicated-pregnancy group
1.29±0.12 compared to normotension pregnancy group 1.71±0.14 with p=0.00. From the logistic regression analysis reveals that the presence of severe preeclamsia has a consistent statistically
significant role to the Bcl-XL protein expression with p= 0.000.
Conclusion: Bcl-XL protein expression is lower in severe preeclampsia complicated- pregnancy compared to normotension pregnancy.
Keyword : trophoblast, severe preeclampsia,Bcl-XL protein, apoptosis.

Abstract
Objective: To understand the correlation between serum estradiol levels with bone density status and using estradiol serum as a predictor of osteoporosis in
perimenopausal and postmenopausalwomen.
Method: An observational study with cross sectional design of 54 perimenopausal and postmenopausal women aged over 45 years conducted in June- August 2010 in RSUP dr. Sardjito Yogyakarta. Pearson correlation statistical test was used to determine the correlation between serum estradiol levels with bone density. Categorical variables were compared by using Chi-square test, whereas continuous variables were analyzed by One Way Anova and Student t-test. To assess the serum estradiol levels as a predictor of osteoporosis, Receiver Operator Curve (ROC) was used.
Result: There was a significant positive correlation between serum estradiol levels with bone density status (score of Bone Mineral Density / BMD) (r =
0.456, p = 0.001). Bone density is also influenced by age, Body Mass Index (BMI), and menopausal status (p <0.05), whereas physical activity, fracture
history, smoking, consumption of coffee, milk, calcium supplements, and steroids had no effect in this study (p> 0.05). ROC test produce an Area Under
Curve (AUC) of 86.32%. Cut-off point (threshold value) of estradiol as a predictor of osteopenia / osteoporosis is 18.31 with a specificity of 94.12%
and specificity of 70%.
Conclusion: Serum estradiol levels and bone density status is positively correlated and can be used as a predictor of osteopenia/osteoporosis Keywords: osteoporosis, estradiol, bone mineral density, menopause

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