Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Thanatophoric Skeletal Dysplasia Type 2: Diagnostic and Management Dilemmas
Full text linkAbstract (English)
Objective: To report a rare case of thanatophoric skeletal dysplasia type 2 that we diagnosed during prenatal period; and to provide further review of dilemmas in diagnostic methods and management, based on appropriate literatures and guidelines available.
Methods: Case report
Case: A 33-year old primigravida women was diagnosed with pre-term pregnancy (24th weeks of gestation) and intra-uterine singleton live fetus with thanatophoric skeletal dysplasia type 2 via ultrasonography. Pregnancy termination via elected caesarean section at 26th weeks of gestation was performed per the patient request after considering the fetus’s lethality. A female neonate was born weighing 980 grams with frontal bossing (Head Circumference: 26 cm), lower set of ears, hypertelorism, bilateral exopthalmos, short neck, rhizomelic short extremities, and narrow thorax (Thorax Circumference: 17 cm). The newborn was immediately transferred to NICU for post-natal management and observation. The newborn is in stable condition for the first several hours; nevertheless, significant destabilization occurred afterwards and the newborn deceased approximately 10 hours after birth due to cardiorespiratory failure. No further invasive resuscitative efforts and post-mortem examinations were performed on the parent’s request.
Conclusion: Thanatophoric dysplasia is primarily diagnosed using ultrasonography, which has a high detection rate for both diagnosis and prognostications. Even though, There has been a dilemma in performing molecular diagnostic testing, prediction of recurrence risk in future pregnancies can be assessed with its use. Although still remains a challenge in ethical and medicolegal grounds; proper management requires holistic considerations of maternal, fetal, and perinatal aspects.
Keywords: Thanatophoric, Skeletal Dysplasia, FGFR3 mutation
Abstrak (Indonesia)
Tujuan: Melaporkan suatu kasus langka displasia skeletal tanatoforik tipe 2 yang kami diagnosa dalam periode perinatal; serta memberikan ulasan lanjut mengenai dilema dalam metode diagnostik dan manajemen, berdasarkan literatur dan pedoman ilmiah yang tersedia.
Metode: Laporan Kasus
Kasus: Seorang perempuan primigravida berusia 33 tahun di diagnosa dengan kehamilan pre-term (24 minggu gestasi), janin tunggal hidup intrauterin dengan displasia skeletal tanatoforik tipe 2 via ultrasonografi. Terminasi kehamilan dengan Sectio Caesarea dilakukan atas permintaan pasien setelah mempertimbangkan letalitas janin. Lahir bayi perempuan berat 980 gram, dengan ‘frontal bossing’ (lingkar kepala: 26 cm), kedua telinga rendah, hipertelorisme, eksoftalmos bilateral, leher pendek, ektremitas pendek rizomelik, dan rongga dada kecil (lingkar dada: 17 cm). Bayi segera dipindahkan ke NICU untuk manajemen paska-natal dan observasi. Kondisi bayi stabil selama beberapa jam pertama; namun, ketidakstabilan yang signifikan terjadi setelah itu dan bayi dinyatakan meninggal 10 jam paska kelahiran dikarenakan kegagalan kardiorespirasi. Bayi tidak dilakukan tindakan resusitasi invasif dan pemeriksaan paska kematian atas permintaan pasien.
Kesimpulan: Displasia tanatoforik dapat di diagnosa secara primer menggunakan pemeriksaan ultrasonografi (US) dengan tingkat deteksi diagnosis dan prognosis yang tinggi. Meskipun pemeriksaan diagnostik molekular masih menjadi dilema, pemeriksaan ini dapat memprediksi resiko rekurensi pada kehamilan selanjutnya. Walaupun masih merupakan suatu tantangan dalam segi etika dan medikolegal; manajemen ideal perlu mempertimbangkan secara holistik seluruh aspek yang mencakup: ibu, janin, dan paska kelahiran.
Kata Kunci: Tatanoforik, Displasia Skeletal, Mutasi FGFR3
Correspondence: Gezta Nasafir Hermawan, Faculty of Medicine, Sam Ratulangi University. Email: [email protected]
Dinoprostone Gel versus Intra-cervical Foley’s Catheter for Pre-induction Cervical Ripening: An audit
Full text linkBackground One of the common practices in modern obstetrical care is labour induction when foetal and maternal complications arise. We endeavoured to compare the efficacy and safety of the inexpensive mechanical method of induction Foley’s catheter to the more established pharmacological agent Intracervical Prostaglandin E2 gel
Method The present prospective randomised control study was carried out on 200 women with a term singleton pregnancy in cephalic presentation, with an unfavourable cervix and a valid indication for induction of labour. The patients were randomly allocated using the chit method to either Foley’s catheter [group A, n=100] or PGE2 gel [group B, n=100] . Augmentation with oxytocin was done if required and labor was closely monitored till delivery and the perinatal outcome and maternal side effects was recorded Quantitative variables were compared using unpaired t-test/Mann-Whitney Test and qualitative variables were compared using Chi-Square test /Fisher’s exact test. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0
RESULTThe caesarean section rate did not show a significant difference between the Foley’s group(18%) and PGE2 group(11%) The incidence of fetal distress, Meconium stained liquor and APGAR score <7 at 5 minutes was significantly with PGE2 as compared to group A. (P<.05) Incidence of hyperstimulation of uterus was reported in 6% women who received PGE2 as compared to none in Foley’s group. The induction delivery interval did not show any significant difference between the two groups.
CONCLUSION In women undergoing induction of labour at term in resource constraint set ups like ours, Foley catheter is a good alternative to the more established prostaglandin E2 gel, with good efficacy and better neonatal and maternal safety profile.
Keywords: cervical ripening; dinoprostone; obstetric labor, induce
The prevalence of lower urinary tract symptoms in Caesarean section patients’ first and seventh day of postpartum : Perbandingan Prevalensi Gejala Saluran Kemih Bawah pada Ibu Postpartum Hari pertama dan Hari Ketujuh secara Sectio Caesarea
Full text linkObjective: To compare the prevalence of Lower Urinary Tract Symptoms (LUTS) on the first day and the seventh day postpartum in Caesarian section patient
Method: This cross-sectional study utilized the ICIQ-FLUTS LF (ICIQ-Female Lower Urinary Tract Symptoms-Long Form) and a questionnaire to screen for risk factors among postpartum patients who underwent C-section delivery at Santo Antonius Hospital, Pontianak, West Kalimantan. Data were collected twice, 12 hours after urinary catheter removal and on the seventh day of the postpartum period. The study sample consisted of 95 respondents.
Results: Among the 111 total respondents, the majority were under 35 years old, multiparous, classified as obese, had no family history of Lower Urinary Tract Symptoms (LUTS), and had not used diuretics or traditional medicine. Significant differences were observed in the prevalence of LUTS between the first and seventh days of the postpartum period. Most symptoms showed a decrease on the seventh day, except for six symptoms: insensible urinary incontinence, hesitancy, urinary retention, feeling of incomplete emptying, bladder pain, and dysuria, which increased.
Conclusion: In conclusion, our study suggests that the duration of the postpartum period affects the prevalence of LUTS following C-section delivery. However, it's important to acknowledge the limitations of this study, which may impact the understanding of LUTS progression during the postpartum period.
Conclusion: In conclusion, we concluded that the duration of the postpartum period affects the LUTS after delivery with the method of C-section, but this study has many limitations which may affect the progressivity of LUTS in the Postpartum period.
Keywords: Caesarean Section, ICIQ FLUTS Long From, Lower Urinary Tract Symptoms, Postpartum period
Abstrak
Tujuan: Untuk membandingkan prevalensi Gejala Saluran Kemih Bawah di hari pertama dan hari ketujuh postpartum pada pasien Sectio Caesarea.
Metode: Desain penelitian berupa studi potong li.ntang dengan pengumpulan data menggunakan kuesioner terstruktur ICIQ FLUTS-LF dan kuesioner skrining dasar penelitian yang dilakukan 2 kali yaitu 12 jam setelah pelepasan kateter dan postpartum hari ke 7. Subjek penelitian ini adalah semua ibu postpartum dengan metode SC yang memenuhi kriteria inklusi dan eksklusi penelitian di RS Santo Antonius Pontianak, Kalimantan Barat. Jumlah sampel pada penelitian ini adalah 95 responden
Hasil: Pada penelitian ini didapatkan subjek sebesar 111 responden yang mayoritasnya berusia kurang dari sama dengan 35 tahun, multipara, status gizinya obesitas, tidak memiliki riwayat keluarga yang mengalami LUTS, tidak mengkonsumsi obat-obatan tradisional dan obat-obatan diuretik. Terdapat perbedaan signifikan di prevalensi LUTS hari 1 dan 7 postpartum SC dengan mayoritas dari 16 gejala LUTS yang didata mengalami penurunan di hari ketujuh dibanding hari pertama, terkecuali 6 gejala LUTS yang mengalami peningkatan di hari ketujuh yaitu Insensible Urinary Incontinence, Hesitansi, retensio urin, perasaan tidak lampias setelah berkemih, nyeri kandung kemih, serta disuria.
Kesimpulan: Dalam penelitian ini, peneliti menyimpulkan bahwa durasi masa postpartum berpengaruh pada keluhan LUTS yang dialami pasca persalinan secara Sectio Caesarea, akan tetapi, penelitian ini memiliki keterbatasan yang dimana terdapat banyak oleh faktor-faktor risiko tertentu yang dapat berpengaruh terhadap progresivitas LUTS
Kata kunci: Sectio Caesarea, ICIQ FLUTS Long Form, Gejala Saluran Kemih Bawah, Masa Pasca Persalinan, Masa nifas, Postpartu
The Role of Social Obstetrics and Gynecology in the Coverage of Cervical Cancer Screening in the Era of Health Transformation in Indonesia
Full text linkFriedman Curve Positively Correlates with Cesarean Section and Oxytocin Augmentation in Active Phase Delivery as Compared to Partograph: Kurva Friedman Berkorelasi Positif dengan Seksio Sesarea dan Augmentasi Oksitosin pada Fase Aktif Persalinan dibandingkan Partograf
No full textObjective: To investigate the correlation between cesareansection and oxytocin augmentation in childbirth monitoredwith the Friedman curve compared to the World HealthOrganization (WHO) partographs.Methods: An analytic cross-sectional study was conductedfrom March to May 2021, involving mothers giving birthwhose delivery process was monitored using either theFriedman curve or the WHO partograph (n=28 for eachgroup) at Wangaya Hospital in Denpasar City. The durationof the active phase until delivery, occurrence of cesareansection, and administration of oxytocin augmentationwere assessed using the Friedman curve and the WHOpartograph. The normality of the data was tested using theKolmogorov-Smirnov test, and the Spearman correlationtest was employed to measure the direction and strengthof the correlation.Results: There was no signifi cant difference between thegroups in terms of monitoring the active phase until deliveryusing the Friedman curve compared to the WHO partograph(p=1.000 > 0.05). Maternal monitoring with the Friedmancurve showed a positive correlation with the occurrenceof cesarean section compared to the WHO partograph(r=0.296, p=0.027). Additionally, monitoring childbirth withthe Friedman curve exhibited a positive correlation with theadministration of oxytocin augmentation compared to theWHO partograph (r=0.298, p=0.026).Conclusion: The fi ndings suggest a stronger positivecorrelation between the incidence of cesarean section andthe administration of oxytocin augmentation in childbirthmonitored with the Friedman curve compared to the WHOpartograph.Keywords: cesarean section, Friedman curve, oxytocinaugmentation, WHO partograph.AbstrakTujuan: Untuk menentukan korelasi antara operasi sesardan augmentasi oksitosin pada persalinan yang dipantaudengan kurva Friedman dibandingkan dengan partografOrganisasi Kesehatan Dunia (WHO).Metode: Desain penelitian analitik potong lintangdilakukan pada Maret-Mei 2021, dengan melibatkan ibubersalin yang proses persalinannya dipantau menggunakankurva Friedman atau Partograf WHO (n=28 untuk setiapkelompok) di ruang bersalin di Rumah Sakit Wangaya,Kota Denpasar. Waktu fase aktif hingga kelahiran bayi,persalinan seksio sesarea, dan augmentasi oksitosin dinilaidengan menggunakan kurva Friedman dan Partograf WHO.Uji normalitas dilakukan dengan uji Kolmogorov-Smirnov,dilanjutkan dengan uji korelasi Spearman untuk mengukurarah dan kekuatan korelasi.Hasil: Pemantauan ibu bersalin dengan kurva Friedmandibandingkan dengan Partograf WHO dalam hal faseaktif-persalinan bayi menunjukkan tidak ada perbedaanyang signifi kan di antara kedua kelompok (p = 0,000 >0,05). Pemantauan ibu dengan kurva Friedman berkorelasipositif dengan kejadian bedah sesar dibandingkandengan Partograf WHO (r = 0,296, p = 0,027). Selain itu,pemantauan persalinan dengan kurva Friedman berkorelasipositif dengan pemberian oksitosin dibandingkan denganpartograf WHO (r = 0,298, p = 0,026).Kesimpulan: Terdapat korelasi positif yang lebih tinggiantara kejadian bedah sesar dan pemberian augmentasioksitosin pada proses persalinan yang dipantau dengankurva Friedman dibandingkan dengan partograf WHO.Kata kunci: augmentasi oksitosin, kurva friedman, partografWHO, seksio sesare
The Role of Probiotics in Urinary Tract Infections in Women: Peran Probiotik dalam Infeksi Saluran Kemih pada Perempuan
No full textObjective: To review the role of probiotics in urinary tractinfections in womenMethods: Systematic review was conducted by searchingfi ve databases with several keywords, namely “urinary tractinfection”, “cystitis”, “women” and “probiotics”. Articles thathave gone through peer review are included in the studyif they meet the inclusion and exclusion criteria. Reportingfollows the PRISMA rules.Results: The women included in this study varied from earlyadulthood to postmenopausal, most of whom were sexuallyactive, used birth control methods, and had recurrenturinary tract infections. The results showed that the use ofprobiotics in varied outcomes, either positive or not showedsignifi cant results. This is also due to the differences in theoutcomes studied and the additional materials used. Thisalso contributed to the emergence of adverse effects.Conclusion: The use of probiotics in the treatment ofcystitis and urinary tract infections has hope, although notall studies show signifi cant results. The side effects foundare still tolerable although they need to be considered.Keywords: cystitis, probiotic, urinary tract infection, women.AbstrakTujuan: Meninjau peran probiotik dalam infeksi salurankemih pada perempuan.Metode: Tinjauan sistematis dilakukan dengan mencari limadatabase dengan beberapa kata kunci, yaitu “infeksi salurankemih”, “sistitis”, “perempuan” dan “probiotik”. Artikel yangtelah melalui peer review diikutsertakan dalam penelitianjika memenuhi kriteria inklusi dan eksklusi. Pelaporanmengikuti aturan PRISMA.Hasil: Perempuan yang diikutsertakan dalam penelitian inibervariasi mulai dari dewasa awal hingga pascamenopause,sebagian besar aktif secara seksual, menggunakan metodekontrasepsi, dan mengalami infeksi saluran kemih berulang.Hasil penelitian menunjukkan bahwa penggunaan probiotikpada infeksi saluran kemih menunjukkan hasil yang positifmaupun tidak menunjukkan hasil yang signifi kan. Hal inijuga disebabkan perbedaan outcome dan bahan tambahanyang digunakan. Penggunaan bahan juga berkontribusipada munculnya efek samping.Kesimpulan: Penggunaan probiotik dalam pengobatansistitis dan infeksi saluran kemih memiliki harapan, walaupuntidak semua penelitian menunjukkan hasil yang signifi kan.Efek samping yang ditemukan masih dapat ditoleransimeskipun perlu diperhatikan.Kata kunci: infeksi saluran kemih, perempuan, probiotik,sistitis
Resolution of ethical conflicts between medical indications and patient preferences in case of unmarried woman with ovarian cancer: Penyelesaian Konflik Etika antara Indikasi Medik dan Preferensi Pasien pada Kasus Perempuan yang belum Menikah dengan Kanker Ovarium
No full textObjectives: To resolve ethical conflicts in medical decision making in unmarried patients with a diagnosis of ovarian cancer. The ethical issue in this case is the main operative management in cases of ovarian cancer, namely removal of the uterus and both ovaries even though the patient is not married and has never been pregnant. The opportunity for patients to get pregnant no longer exists, so there is an ethical conflict between medical indications and patient preferences.Methods: This case report is about an unmarried woman 38- year with a diagnosis of ovarian cancer. This patient initially underwent right salfingooophorectomy surgery. Anatomical pathology results found adenocarcinoma serosum ovarii. The patient underwent chemotherapy for 3 cycles. Then the patient was re-operated with a planned debulking interval laparotomy.Discussion: From the aspect of patient indications, the results of combination treatment between surgery and chemotherapy have shown a marked increase in the survival rate of patients in five years. The choice of performing a debulking interval laparotomy is a difficult choice. The patient's preference to get pregnant will be difficult to accept, but it can be accommodated by improving the quality of life and paying attention to humanism, social and cultural aspects of its contextual features.Conclusion: Clinical ethical considerations related to uterine removal in unmarried patients is a matter of debate. Clinical ethical theory namely quality of life, patient preferences, medical indications, and contextual features are beneficial in medical decision making.Keywords: debulking intervals, ethical conflicts, medical indications, ovarian cancer, patient preferences.Tujuan: Untuk menyelesaikan konflik etik dalam pengambilan keputusan medik pada pasien yang belum menikah dengan diagnosis kanker ovarium. Isu etik pada kasus ini yaitu manajemen operatif utama pada kasuskanker ovarium yaitu pengangkatan uterus dan kedua ovarium padahal pasien belum menikah dan belum pernah hamil. Kesempatan untuk pasien untuk hamil tidak ada lagi sehingga terjadi pertentangan etik antara indikasi medik dengan preferensi pasien.Metode: Laporan kasus ini tentang seorang pasien perempuan yang belum menikah, berusia 38 tahun dengandiagnose kanker ovarium. Pasien ini awalnya dilakukan operasi salfingoooforektomi kanan. Hasil patologi anatomi ditemukan adenokarsinoma serosum ovari. Pasien menjalani kemoterapi sebanyak 3 siklus. Kemudian pasien dilakukan operasi kembali yang direncanakan tindakan laparotomi interval debulking.Diskusi: Dari aspek indikasi pasien, hasil pengobatan kombinasi antara pembedahan dan kemoterapi telahmenunjukkan peningkatan survival rate yang nyata pada pasien dalam lima tahun. Pilihan melakukan tindakanlaparotomi interval debulking merupakan pilihan sulit. Preferensi pasien untuk dapat hamil akan sulit dikabulkan, namun dapat diakomodir dengan peningkatan kualitas hidup dan memperhatikan aspek humanism, sosial dan kultural pada fitur kontekstualnya.Kesimpulan: Pertimbangan etik klinik yang berhubungan dengan pengangkatan rahim pada pasien yang belum menikah merupakan masalah yang diperdebatkan. Teori etika klinis yaitu indikasi medis, preferensi, kualitas hidup dan fitur kontektual sangat membantu dalam pengambilan keputusan medis yang etis.Kata kunci: indikasi medis, interval debulking, kanker ovarium, konflik etik, preferensi pasie
The Role of Vitamin D in Pregnant Women in Birth Weight of Neonates: Peran Vitamin D pada Ibu Hamil terhadap Berat Badan Lahir Neonatus
No full textObjective: To determine the relationship between serumvitamin D levels in third trimester mothers and newbornbirthttweight.Method: The study was conducted at the maternity wardof Dr. Zainoel Abidin General Hospital in Banda Aceh,Indonesia. Maternal and infant serum vitamin D levelswere measured using the Automatic ChemiluminescenceImmunoassay Analyzer (CLIA) method. Blood samples werecollected from mothers in the third trimester and frominfants after delivery. Spearman's correlation rank test wasemployed with a confi dence level of 95%. Vitamin D levelswere categorized as suffi cient, insuffi cient, and defi cient.Results: A total of 39 pregnant women with an averageage of 30.38 ± 6.21 years participated in the study, with apredominance of 38-39 weeks of gestation (35.9%). Themean vitamin D levels in mothers and neonates were 17.4ng/mL and 17.6 ng/mL, respectively (p = 0.003, R = 0.462).The average birth weight of the babies was 3,100 grams,ranging from 2,100 grams to 4,200 grams (p = 0.185, R =0.217). Both variables showed a positive correlation withvarying strength of the relationship.Conclusion: Maternal serum vitamin D levels in the thirdtrimester exhibited a positive correlation with serum vitaminD levels in neonates with moderate strength, but therewas no correlation with birth weight. The evaluation ofmaternal third-trimester serum vitamin D levels can serve asa predictor of neonatal vitamin D levels.Keywords: birth weight, neonates, pregnancy, vitamin D.
AbstrakTujuan: Untuk menilai pengaruh hubungan kadar vitaminD serum ibu trimester ketiga terhadap kadar vitamin D danberat badan neonatus yang dilahirkan.Metode: Penelitian ini studi observasional korelatif dengandesain potong lintang yang dilakukan pada kamar bersalinRSUD dr. Zainoel Abidin Banda Aceh. Pengukuran kadarvitamin D serum ibu dan bayi dilakukan dengan metodeAutomatic Chemiluminescence Immunoassay Analyzer(CLIA). Analisis data dengan melakukan Uji Spearman’scorrelation rank test untuk menilai kekuatan hubungan duavariabel.Hasil: Sebanyak 39 ibu hamil usia 30,38 ± 6,21 tahun terlibatdalam penelitian ini dengan dominasi usia kehamilan 38–39minggu (35,9%). Rerata kadar vitamin D ibu dan bayi secaraberurutan adalah 17,4 ng/mL dan 17,6 ng/mL (p = 0,003,R = 0,462). Rerata berat badan bayi yang dilahirkan adalahsebesar 3.100 gram dengan rentang 2.100 gram hingga4.200 gram (p = 0,185, R = 0,217). Kedua variabel didapatkankorelasi positif dengan kekuatan hubungan bervariasi.Kesimpulan: Kadar vitamin D serum ibu trimester ketigaberkorelasi positif terhadap kadar vitamin D serum neonatusyang dilahirkan dengan kekuatan sedang namun tidakberkorelasi terhadap berat badan lahir bayi. Kadar vitaminD serum ibu pada trimester ketiga dapat dijadikan prediktorkadar vitamin D neonatus saat dilahirkan.Kata kunci: berat badan lahir, kehamilan, neonatus,vitamin D
Partum Mothers' Experience Regarding Support during the COVID-19 Pandemic: Pengalaman Ibu Bersalin Mengenai Dukungan selama Pandemi COVID-19
No full textObjective: This study aims to investigate the experiences of mothers giving birth with regard to family support and the assistance of health workers during the COVID-19 pandemic.
Methods: A descriptive phenomenological approach was employed for this research, following the framework standards for reporting qualitative research (SRQR). Thirteen individuals participated in the study, comprising seven mothers giving birth, three husbands, two midwives, and one parent. The research was conducted at the Mlati II Health Center in Sleman Regency, specifically in Cabakan Hamlet, Sumberadi, Kec. Mlati, Kab. Sleman, Special Region of Yogyakarta, during January-February 2022. The choice of location was based on specific criteria set by the researchers. Data collection took place online due to practical reasons, with informants being contacted to choose between online or offline interviews. Purposive sampling was used for informant selection, and in-depth interviews lasting approximately one hour each were conducted via WhatsApp, Zoom, or phone calls, with prior agreement from the informants. The interviews followed a semi-structured format.
Results: Two main themes emerged from the data analysis: the emotional experiences of mothers during labor and their various needs. The COVID-19 pandemic had a significant impact, leading to feelings of anxiety, fear, tension, and the need for comfort and confidence. These psychological needs were categorized into verbal support, including encouragement, communication, and reassurance, as well as tactile support, involving gestures such as stroking, holding, and back rubs. Mothers also expressed spiritual needs, such as prayer and maintaining positive thoughts for a smooth delivery and the health of the baby. Nutritional needs, encompassing healthy and balanced eating, were identified as essential during childbirth. Support from husbands, family members, and health workers played a crucial role in reassuring mothers and educating them about COVID-19 prevention, contributing to a positive birthing experience.
Conclusion: The provision of positive support during childbirth can facilitate a normal delivery and instill confidence in mothers.
Keywords: childbirth, covid-19 pandemic, experience, maternity, support.
Abstrak
Tujuan: Untuk mengetahui pengalaman ibu bersalin mengenai dukungan keluarga dan tenaga kesehatan selama pandemi covid-19.
Metode: Desain penelitian ini menggunakan pendekatan fenomenologi deskriptif sehingga untuk melengkapi pelaporan menggunakan framework standards for reporting qualitative research a synthesis of recommendations (SRQR). Jumlah informan yang digunakan dalam penelitian ini yaitu 13 orang, yang terdiri dari 7 ibu bersalin, 3 suami, 2 bidan dan 1 orang tua. Penelitian ini dilakukan di Puskesmas Mlati II di Kabupaten Sleman, di Dusun Cabakan, Sumberadi, Kec. Mlati, Kab. Sleman Daerah Istimewa Yogyakarta. Penelitian ini dilakukan pada bulan Januari-Februari 2022, alasan pemilihan tempat ini adalah berdasarkan kriteria peneliti. Metode dalam penelitian dilakukan secara online. Peneliti memiliki beberapa alasan praktis untuk mengumpulkan data secara online. Peneliti menghubungi informan untuk menanyakan apakah bersedia di wawanacara secara online atau offline. Rekruitmen informan pada penelitian ini menggunakan purposive sampling. Peneliti melakukan indepth interview dengan informan secara online melalui media whatsapp, zoom dan telepon seluler kurang lebih satu jam tiap individu dengan perjanjian terlebih dahulu dengan informan.Wawancara yang digunakan dalam penelitian ini semi structure.
Hasil: Didapatkan 2 tema yaitu tanda-tanda persalinan dan kebutuhan ibu bersalin. Dampak pandemi covid-19 membuat ibu merasa was-was atau kekhawatiran, takut dan cemas, tegang, berusaha nyaman, berusaha tenang dan rasa percaya diri. Kebutuhan psikologis ini terbagi menjadi dua bagian yaitu dukungan secara verbal dan dukungan secara sentuhan. Dukungan secara verbal seperti menyemangati, di ajak ngobrol, memberikan dukungan, mendampingi, ramah, komunasi, percaya diri, siaga, pelayanan bagus, harus kuat, menyayangi dan perhatian. Dukungan secara sentuhan seperti di elus-elus, mengusap keringat, pegang kepala, menggosok-gosok punggung dan menggosok perut.Kebutuhan spiritual yang didapatkan ibu selama proses persalinan yaitu zikir, berdoa, dan selali berpikir positif agar persalinan lancar dan bayi sehat. Kebutuhan nutrisi ibu bersalin seperti makan-makanan yang sehat, makanan bergizi seimbang, minum air putih untuk tenaga mengejan. Dukungan yang diberikan oleh suami, keluarga dan tenaga kesehatan membuat ibu merasa tenang dan mendapatkan edukasi terhadap penyebaran covid-19 agar mendapatkan persalinan yang positif.
Kesimpulan: Dukungan yang positif akan memberikan persalinan normal dan ibu percaya diri.
Kata kunci: dukungan, ibu bersalin, pandemi covid-19, pengalaman, persalinan
