Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Risk factors for stress urinary incontinence following vaginal and caesarean delivery: Faktor-faktor risiko stres inkontinensia urin setelah persalinan pervaginam dan perabdominam
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Background: Most of the stress urinary incontinence (SUI) occurs after first delivery and related to the mode of delivery.
Objective: To determine the factors that affects the incidence of stress urinary incontinence post partum
Methods: Women experienced with stress urinary incontinence 3 months after birth vaginally or section caesarean were enrolled in the present cross sectional study. The strength of the pelvic floor muscle measured with perineometer. All of women were assessed for SUI using Sandvix Severity Index (SSI) dan The three incontinence question (3IQ) questionnaire. A person chi-square test was used to analysis with p value <0.05 was considered significant.
Results: Eighty-four women with stress urinary incontinence (SUI) after vaginal delivery or caesarean section enrolled in the study. There was a significant difference between mode of delivery and SUI following delivery (p<0.05). Perineal tear (grade 1-2), BMI, newborn weight and circumference significantly affect the SUI after vaginal or caesarean section. Perineal tear increase SUI after delivery 7-fold compared to other factors (OR=7.367; 95% CI=1.815-29.904).
Conclusion : SUI after delivery affected by Mode of delivery, pelvic muscle floor weakness, perineal tear, BMI, newborn weight and head circumference.
Keywords: stress urinary incontinence, mode of delivery
Abstrak
Latar belakang: Sebagian besar kasus stress inkontinensia urin terjadi setelah partus pertama kali dan berhubungan dengan metode persalinan.
Tujuan: Untuk mengetahui faktor-faktor yang mempengaruhi terjadinya stress inkontinensia urin post partum
Metode: Wanita yang mengalami stres inkontinensia urin 3 bulan postpartum normal atau seksio dilibatkan dalam penelitian cross sectional ini. Kekuatan otot dasar panggul diukur dengan perineometer. Penilaian SUI dilakuakn dengan menggunakan kuesioner Sandvix Severity Index (SSI) dan The three incontinence question (3IQ). Data dianalisis dengan uji Chi-square dengan tingkat kemaknaan p<0,05.
Hasil: Delapan puluh empat wanita dengan SIU postpartum per vaginam atau operasi caesar dilibatkan dalam penelitian ini. Terdapat perbedaan signifikan antara cara persalinan dan SIU setelah postpartum (p<0,05). Ruptur perineum (grade 1-2), IMT, berat bayi lahir dan lingkar kepala secara signifikan mempengaruhi SIU postpartum. Ruptur perineum meningkatkan SUI postpartum 7 kali lipat dibandingkan dengan faktor-faktor lainnya (OR = 7,367; 95% CI = 1,815-29,904).
Kesimpulan: SIU postpartum dipengaruhi oleh cara persalinan, kelemahan dasar otot panggul, robekan perineum, IMT, berat bayi lahir dan lingkar kepala.
Kata kunci : stress inkontinensia urin, metode persalina
The Association between Endometriosis Appearance during Laparoscopic Surgery and Pain Characteristic in Pelvic Endometriosis: HubunganTampilan Susukan Endometriosis pada saat Pembedahan Laparoskopik dengan Karakteristik Nyeri pada Endometriosis Pelvik
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Objective: To evaluate the correlation between the American Society of Reproductive Medicine (ASRM) score in endometriosis and severity pelvic pain in a group of women with endometriosis.
Method: A total of 131 patients with pelvic pain who: conduct laparoscopy for diagnosis and therapy of endometriosis, have pain symptoms>3 months, and absence of pelvic anomalies. Dysmenorrhea, deep dyspareunia, dyschezia, dysuria, and chronic pelvic pain were evaluated using a 10-point visual analogue scale. The data was collected by assessing the medical record, and retrospective analysis was performed. Disease stage according to the American Society of Reproductive Medicine, the presence of adhesion, lesion type (Deep Infiltrating Endometriosis (DIE) or without DIE), and severity of pain symptoms were analysed by Spearman analysis. Different VAS between DIE vs non DIE group was analysed by Mann-Whitney analysis.
Result: Stage IV endometriosis accounts for 79.4%. Based on the macroscopic appearance, ovarian endometriosis accounts for 92.4%, peritoneal endometriosis 82.4%, DIE was 40.5%, and adenomyosis was 19.1%. There was significant correlation between total ASRM, ovarian endometriosis, peritoneal lesion, Douglas pouch obliteration, adnexal adhesion score and VAS dysmenorrhea (r=0.303; 0,187; 0,203; 0,278; 0,266, p<0.05). There was significant VAS difference of DIE vs non DIE group; the difference was on dyspareunia (5.18±2.4 and 4.58±1.0, p<0.001] and dyschezia [5.28±2.2 and 4.86±0.7,p<0.001]
Conclusion: There was a positive correlation between ovarian endometriosis score and severity of dysmenorrhea. There was also a difference in the degree of endometriosis-associated pain between DIE and non DIE group.
Keywords: endometriosis, deep infiltrating endometriosis, dysmenorrhea, dyspareunia, dyschezia
Abstrak
Tujuan: untuk mencari hubungan antara skor endometriosis ASRM dan karakteristik nyeri pelvik pada pasien endometriosis
Metode: Sebanyak 131 pasien dengan nyeri pelvik yang menjalani laparoskopi untuk diagnosis dan terapi endometriosis, memiliki nyeri > 3 bulan, dan tidak mengalami kelainan organ pelvis. Dilakukan evaluasi terhadap dismenorea, dyspareunia dalam, diskezia, dysuria, dan nyeri pelvic kronik dengan menggunakan nilai 1-10 dari skala analog visual. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Rujukan Nasional Dr. Cipto Mangunkusumo, Jakarta. Stadium endometriosis berdasarkan American Society of Reproductive Medicine, kejadian adhesi, jenis lesi (ada Endometriosis Susukan Dalam/ESD atau tanpa ESD), dan derajat keparahan nyeri dianalisis dengan analisis Spearman. Perbedaan skala nyeri antara ESD dan non ESD dianalisis dengan metode Mann-Whitney.
Hasil: Sebanyak 79,4% pasien tergolong ke dalam endometriosis stadium IV. Berdasarkan tampilan makroskopik, endometriosis ovarium terdapat pada 92,4%, endometriosis peritoneal 82,4%, ESD 40,5%, dan adenomiosis pada 19,1%. Terdapat korelasi positif bermakna antara skor ASRM total, sub-skorkista endometriosis, endometriosis superfisial, obliterasi kavum douglas, dan adhesia dneksa dengan VAS dismenorea (r=0,303; 0,187; 0,203; 0,278; 0,266, p<0,05). Pada kelompok ESD dan tanpa ESD, didapatkan perbedaan VAS dismenorea, dispareunia dalam, diskezia, dan nyeri pelvic kronik yang bermakna (6,13±1.7 dan 5,95±1,7, p = 0,560 ; 5,18±2.4 dan 4,58±1,0, p < 0,001; 5,28±2,2 dan 4,86±0,7 , p < 0,001; 2,20±2,8 dan 0,60±1,8, p <0,001)
Kesimpulan:Terdapat korelasi positif bermakna antara skor ASRM dengan VAS dismenorea. Terdapat perbedaan VAS dismenorea, dyspareunia dalam, diskezia, dan nyeri pelvic kronik pada kelompok ESD dan tanpa ESD
Kata kunci: endometriosis, endometriosis susukan dalam, dismenorea, dispareunia dalam, diskezia
 
Manual Vacuum Aspiration versus Sharp Curettage for Incomplete Abortion: Which One is Better? Aspirasi Vakum Manual dibandingkan dengan Kuret Tajam untuk Abortus Inkomplit: Mana yang Lebih Baik?
Get PDFObjective: To acknowledge the effectiveness and safety of MVA compare with SC in management of incomplete abortion below 12 weeks of gestation which compare time to perform procedure, rates of evacuation and infection one week after procedure, and complication during MVA and SC procedure
Methods: A prospective study with 62 subjects with complain incomplete abortion came to ER at RSCM, RS Fatmawati and RS Karawang, divided into 31 subjects on MVA group and 31 subjects on SC group. The data was documented on the time of MVA procedure compare to SC, clinical findings on complication during procedure, completed evacuation and infection symptoms one week after procedure.
Results: Sixty two subjects (31 each group) with average time of procedure was 17,65 ± 4,128 minutes and SC was 22,26 ± 4,611 minutes with p = 0,00 and 95% CI; -4,513(-6,837 to -2,389 with significant statistically difference. The comparison of completed evacuation one week after procedure was 3,2% (n = 1) on MVA and 6,5% (n = 2) on SC with clinical findings, and p = 0,554, RR = 1,034 and 95% CI 0,924 – 1,158 with no statistically difference. On the other comparison, we didn’t find any infection symptoms one week after procedure and complication during procedure on both of procedures.
Conclusion: MVA has more effective than SC on the time of procedure in incomplete abortion with below 12 weeks of gestation. MVA has superiority from completed evacuation but no statistically difference and has equal safety to SC on clinical infection symptoms and complication during procedure.
Keywords: Manual Vacuum Aspiration (MVA), sharp curettage (SC), incomplete abortion.
Tujuan:Mengetahuiefektifitasdankeamanandari AVM dibandingkan dengan kuret tajam pada penanganan abortusin komplit dibawah usia kehamilan 12 minggu dengan melihatdari lama tindakan, proporsi tingkat kebersihan evakuasi sisa konsepsi 1 minggu pasca tindakan, proporsigejala – gejalainfeksi 1 minggu pasca tindakan dan proporsi komplikasi pada saat tindakan AVM dan kuret tajam.
Metode:Penelitian ini merupakan penelitian kohort prospektif (observasional) dengan jumlah sampel 62 subjek yang berkunjung dengan abortusin komplit ke UGD RSCM, RS Fatmawati dan RSUD Karawang terbagi dalam 31 subjek pada kelompok prosedur AVM dan 31 subjek pada kelompok prosedur kuret tajam. Data dikumpulkanmelaluipencatatanwaktu lama prosedur AVM dibandingkankurettajam, pemeriksaan klinis komplikasi selama prosedur berlangsung, pemeriksaan klinis kebersihan sisa konspesi 1 minggu pasca tindakan dan gejala – gejala infeksi 1 minggu pasca tindakan.
Hasil:Sebanyak 62 subjek (masing – masing 31 subjek), dimana didapatkan rerata dan simpang baku prosedur AVM 17,65 ± 4,128 menit dan kuret tajam 22,26 ± 4,611 menit dengan p = 0,00 dan IK 95% -4,513(-6,837 s/d -2,389), bermakna secara statistik. Pada perbandingan proporsi tingkat kebersihan evakuasi sisa konsepsi 1 minggu pasca tindakan didapatkan pada AVM 3,2% (n = 1) dan pada kuret tajam 6,5% (n = 2) terdapat sisa konsepsi dengan penilaian klinis, p = 0,554, RR = 1,034 dan IK95% 0,924 – 1,158 tidak memiliki perbedaan bermakna secara statistik. Pada perbandingan lainnya, tidak ditemukan gejala – gejala infeksi 1 minggu pasca prosedur dan komplikasi selama prosedur berlangsung pada prosedur AVM dan kuret tajam.
Kesimpulan:.AVM juga memiliki keunggulan dalam kebersihan sisa konsepsi namun tidak bermakna secara statitik dan memiliki keamanan yang setara dengan kuret tajam dari tingkat gejala infeksi dan komplikasi selama prosedur.
Kata kunci :Aspirasi Vakum Manual (AVM), kuret tajam, abortusin kompli
The Levels of Zinc, Selenium, Iron and Copper in Preterm Pregnancy do not Differ with those of Healthy Pregnancy: Kadar Seng, Selenium, Besi dan Tembaga pada Kehamilan Prematur tidak Berbeda dengan Kehamilan Sehat
Get PDFObjective: to compare zinc, selenium, iron and copper levels in maternal serum of normal and preterm pregnancy.
Methods: It is a cross sectional study with preterm and normal pregnant woman who will carry delivery in Dr. Cipto Mangunkusumo National Hospital and Budi Kemuliaan Hospital Jakarta from January to April 2017. This study was conducted by comparing the levels of each micronutrient in both groups of subjects.
Result: From January until April 2017, there were 53 subjects divided into 30 normal pregnant women and 23 preterm pregnant women. The levels of zinc, selenium iron and copper in preterm pregnancy were 42 µg/dL, 72,39 µg/L, 74 µg/L, and 2144,52 µg/dL. Levels of zinc, selenium, iron and copper in normal pregnancy were 42 µg/dL, 67,27 µg/L, 70,5 µg/L, and 2221 µg/dL. There was no difference in micronutrients level in both groups.
Conclusion: This study concluded that there was no difference in zinc, selenium, iron and copper levels in normal and preterm pregnancy.
Keywords: pregnancy, zinc, selenium, iron, copper
LatarBelakang:Persalinan preterm adalahpersalinansebelumusiakehamilan 37 minggulengkap. Persalinan preterm inimasihmenjadimasalah di seluruhdunia.Padalaporan World Health Organization (WHO), Indonesia mendudukiperingkatkelimanegaradenganpersalinan preterm terbanyakyakni 675.700 persalinanpadatahun 2010.Berbagaifaktordihubungkandenganpenyebabterjadinyapersalinan preterm, termasuksalahsatunyaadalahgangguannutrisiselamakehamilan, terutamaseng, selenium, besidantembaga.
Tujuan:Penelitianinimembandingkankadarseng, selenium, besidantembagapada serum maternal ibuhamil normal dan preterm.
Metode:Penelitiandilakukandenganujipotong-lintangdengansubjekpenelitianibuhamilbaik preterm maupunaterm yang akanmelaksanakanpersalinan di RSUPN Dr. CiptoMangunkusumodan RS Budi Kemuliaan Jakarta padaJanuarihingga April 2017. Penelitiandilakukandenganmembandingkankadarmasing-masingmikronutrienpadakeduakelompoksubjek.
Hasil:DalamjangkawaktuJanuarihingga April 2017 didapatkan 53 subjekpenelitianyakni 30 ibuhamil normal dan 23 ibudengankehamilan preterm. Seluruhsubjekdimasukkandalamanalisis data.Kadar seng, selenium, besidantembagapadaibudengankehamilan preterm secaraberurutanadalah 42 µg/dL, 72,39 µg/L, 74 µg/L, dan 2144,52 µg/dL.Sedangkankadarseng, selenium, besidantembagapadaibuhamil normal secaraberurutanadalah 42 µg/dL, 67,27 µg/L, 70,5 µg/L, dan 2221 µg/dL. Tidakadaperbedaanbermaknakadarmikronutrienpadakeduakelompoksubjek.
Kesimpulan: Penelitianinimenyimpulkanbahwatidakadaperbedaankadarseng, selenium, besidantembagapadaibuhamil normal danibudengankehamilan preterm.
Kata kunci:kehamilan, seng, selenium, besi, tembag
Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome: Angka Kematian Ibu di RSUD Ogan Komering Ulu Timur (OKU Timur) dalam Periode Empat Tahun: Pola, Faktor yang Berkaitan dan Luaran Neonatus
Get PDFObjective: To determine the MMR trends, its associated factors, and neonatal outcome at East OKU Regional Public Hospital from 2013 until 2016.
Methods: This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East OKU Regional Public Hospital, South Sumatera. Data was collected from medical records. There were 17 maternal deaths, but 1 data was excluded due to lack of data.
Results: We recorded 2,191 pregnancies and 17 maternal deaths. Over 4 years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major etiology of maternal deaths were hypertensive disorder (37.5%), followed by hypertensive disorder + hemorrhage and hypertensive disorder + infection in the same proportion. MMR were higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%).
Conclusion: MMR trends in our hospital were fluctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays significant role in maternal deaths. In addition, most of neonates were born alive. We hope that this study can be a feedback for hospital to do maternal and perinatal audit.
Keywords: Factors, Maternal mortality rate, Neonatal outcome, Regional public hospital, Trends
Tujuan: Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD OKU Timur dari 2013 hingga 2016.
Metode: Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD OKU Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap.
Hasil: Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui sectio caesaria (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%).
Kesimpulan: Pola AKI di RSUD berfluktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifikan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal.
Kata kunci: Angka kematian ibu, Faktor, Luaran neonatus, Pola, Rumah sakit umum daera
Characteristics, Management and Survival Rate of Ovarian Germ Cell Tumor: Karakteristik, Manajmen dan Tingkat Kesintasan Ovarian Germ Cell Tumor
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Objective:To determine the prevalence of malignant ovarian germ cell tumour in term of characteristics, management, and 3-year survival rate in Dr. Cipto Mangunkusumo Hospital Jakarta from 2011 to 2013.
Methods: This is a cross-sectional study. Secondary data were collected from medical record as well as interviewing patients through phone call or home visit.
Results: We collected data from 24 subjects. As many as 54.2% of subjects were between 20 to 40 year old, and 58.3% was single. Around 83.3% of the subjects came with chief complaint of abdominal enlargement. Histopathology finding confirmed dysgerminoma in 50% subjects, mixed ovarian germ cell tumour in 25%, endodermal sinus tumour or yolk sac tumour in 16.7%, and immature teratoma in 8.3%. Half of the cases were found in stage I. The primary therapy was conservative surgical staging and adjuvant chemotherapy.In 2 subjects with dysgerminoma, neoadjuvant chemotherapy (bleomycin, etoposide, cisplatin, and cyclophosphamide-cisplatin regimen) resulted in a good response. The 3-year survival rate was 83.3% in dysgerminoma, 100% in mixed ovarian germ cell tumour, and 50% in immature teratoma.
Conclusion: In malignant ovarian germ cell tumour, conservative surgical staging followed by a complete course of chemotherapy is the treatment of choice with 3-year survival rate exceeding 70%.
Keywords: dysgerminoma, non-epithelial ovarian tumour,ovarian germ cell tumour, survival
Abstrak
Tujuan : Mengetahui sebaran meliputi karateristik, penatalaksanaan dan kesintasan 3 tahun pasien tumor ganas sel germinal ovarium di RSCM tahun 2011 – 2013.
Metode : Penelitian ini menggunakan studi potong lintang dengan mengambil data sekunder dari rekam medis dan mewawancarai pasien atau keluarga pasien via telepon atau kunjugan rumah.
Hasil : Pada penelitian ini, dari 24 subjek penelitian, 54,2% ditemukan pada usia 20-40 tahun dan 58,3% subjek belum menikah. Sebanyak 83,3% datang dengan keluhan perut membesar. Secara histopatologi didapatkan jenis disgeminoma, tumor sel germinal campuran, sinus endodermal (yolk sac) dan teratoma imatur dengan proporsi masing-masing 50%, 25%, 16,7% dan 8,3%, sebagian besar kasus (50%) ditemukan pada stadium I. Conservative surgical staging dan kemoterapi adjuvan tatalaksana pilihan. Terdapat 2 subjek jenis disgerminoma yang diberikan dengan kemoterapi neoadjuvan (regimenbleomycin, etoposide, cisplatin dan cyclophosmide-cisplatin) memberikan respon yang baik. Kesintasan ≥ 3 tahun pada jenis disgerminoma mencapai 83,3%, pada tumor sel germinal campuran 100% dan pada teratoma imatur mencapai 50%.
Kesimpulan : Pada tumor ganas sel germinal ovarium conservative surgical staging diikuti kemoterapi lengkap merupakan pilihan terapi dengan kesintasan ≥ 3 tahun mencapai > 70%.
Kata kunci : disgerminoma,kesintasan, tumor ovarium non epithelial, tumor sel germinal ovarium
Oxytocin 10 IU as Prophylactic for Uterine Atony : a Randomized Clinical Trial: Oksitosin 10 IU sebagai Profilaksis Atonia Uteri : suatu Uji Coba Klinis Acak
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Objective : To compare the effectiveness of oxytocin dose of 10 IU and 20 IU for preventing uterine atony in women undergoing cesarean section.
Methods : This was a double-blind, randomized clinical trial with good matching selection with randomization block of patients who had risk factors for the occurrence of uterine atony such as preeclampsia, patients were receiving MgSO4, oxytocin intrapartum and chorioamnionitis who performed stratified randomization prospectively with two kinds of oxytocin doses which are 10 IU and 20 IU as a prophylaxis for uterine atony in women who performed emergency cesarean section with transverse incision and were using a general anesthesia.
Results : This study found no any significant differences between the use of 10 IU and 20 IU as prophylaxis for uterine atony during cesarean section either in its action at the time or while in recovery room, especially on the cases without chorioamnionitis thus using oxytocin 10 IU regimen can be considered, besides the effectiveness did no differ, it will cost cheaper than oxytocin 20 IU regimen which frequently used.
Conclusions : There were no significant differences in the incidence of blood loss during the cesarean section between the treatment of oxytocin 10 IU group and oxytocin 20 IU group. The additional uterotonic was using during the action of the cesarean section between the treatment of oxytocin 10 IU group, and oxytocin 20 IU group gave no significant differences. The side effects in this study at least form of chills and vomiting found no significant differences between both of groups despite the side effects that arise in oxytocin 20 IU group was higher at 23.08% than oxytocin 10 IU group at 15.19%. Chorioamnionitis would be a risk factor for the occurrence of uterine atony during the action of the cesarean section if it associated with the use of additional uterotonic in oxytocin 10 IU group if compared with oxytocin 20 IU group.
Keywords : cesarean section, oxytocin, uterine atony.
Abstrak
Tujuan : Untuk membandingkan efektifitas penggunaan dosis 10 IU dan 20 IU sebagai profilaksis atonia uteri pada saat seksio sesarea.
Metode : Penelitian ini menggunakan uji klinis acak ganda dengan seleksi yang sesuai dengan blok acak pada pasien-pasien yang memiliki faktor risiko terjadinya atonia uteri seperti preeklamsia, pasien yang diberikana MgSO4 dan oxytocin intrapartum sebelumnya serta chorioamnionitis yang dilakukan pengacakan secara prosfektif bertingkat yang diberikan dua jenis dosis oksitosin yaitu 10 IU dan 20 IU sebagai profilaksis atonia uteri pada perempuan yang dilakukan seksio sesarea darurat dengan insisi transversal dan menggunakan anestesi umum.
Hasil : Penelitian ini menemukan tidak adanya perbedaan yang bermakna antara penggunaan dosis oksitosin 10 IU dan 20 IU sebagai profilaksis atonia uteri pada seksio sesarea baik saat tindakan operasi maupun saat berada di ruang pemulihan, terutama pada kasus-kasus tanpa khorioamnionitis dimana memerlukan oksitosin tambahan pada kelompok 10 IU, selain efektifitasnya tidak berbeda, akan lebih murah dari pada rejimen oksitosin 20 IU yang sering digunakan saat ini.
Kesimpulan : Berdasarkan hasil penelitian ini, tidak ada perbedaan yang bermakna dalam kejadian kehilangan darah selama operasi seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU. Penggunaan uterotonik tambahan selama tindakan seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU tidak memberikan perbedaan yang signifikan. Efek samping dalam penelitian ini yakni menggigil dan muntah, tidak ditemukan perbedaan yang bermakna antara kedua kelompok meskipun efek samping yang muncul pada kelompok oksitosin 20 IU lebih tinggi 23,08% dibandingkan kelompok oksitosin 10 IU pada 15,19%. Khorioamnionitis merupakan faktor risiko terjadinya atonia uteri selama tindakan seksio sesarea jika dikaitkan dengan penggunaan uterotonika tambahan pada kelompok oksitosin 10 IU jika dibandingkan dengan kelompok oksitosin 20 IU.
Kata kunci : atonia uteri, oksitosin, seksio sesarea
Knowledge of Midwives as a Healthcare Provider About Hypertensive Disorders During Pregnancy: Tingkat Pengetahuan Bidan sebagai Petugas Layanan Kesehatan terhadap Tekanan Darah Tinggi dalam Kehamilan
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Objective: To investigate the knowledge of midwives about hypertensive disorders during pregnancy.
Methods: The study design is cross-sectional by evaluating the knowledge of midwives regarding hypertensive disorders during pregnancy by using questionnaire. This study was conducted in Jakarta during the period between September and October 2017. The subject is a midwife member of Indonesian Midwives Association (IBI) practicing in DKI Jakarta, Indonesia.
Results: Total respondents were 639 practicing midwives in Central, South, West and North Jakarta. A total of 323 (50.5%) of the respondents had a sufficient level of knowledge about the basic science of high blood pressure in pregnancy, 372 (58.2%) of respondents had a good level of knowledge related to clinical examination and early diagnosis of high blood pressure in pregnancy, and 385 (60.3%) of respondents had a good level of knowledge about the management of high blood pressure in pregnancy. The location of the clinic, physician attendance, the number of patients treated by the midwives, and the number of midwives attending the clinic had significant association with the knowledge level of the subjects (all P values < 0,05)
Conclusion: The lowest knowledge level was about the basic science of hypertensive disorders during pregnancy. Factors affecting the knowledge levels of the midwives were location of the clinic, physician attendance, the number of patients treated by the midwives, and the number of midwives attending the clinic
Keywords: knowledge, midwive, hypertensive disorders, pregnancy, preeclampsi
Urinary Tract Infection as a Risk Factor for Preterm Delivery: A Tertiary Hospital-Based Study: Infeksi Saluran Kemih (ISK) sebagai Faktor Risiko Persalinan Preterm: Penelitian Berbasis Rumah Sakit Tersier
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Background: Preterm delivery is the leading cause of perinatal morbidity and mortality in developing countries. Urinary tract infection is one of the infectious diseases that often occur in pregnant women. Despite, the correlation between bacteriuria, either symptomatic or asymptomatic, and preterm delivery is still controversial.
Purpose: To investigate the correlation between the incidence of UTI and preterm delivery.
Methods: We conducted a cohort retrospective research using patients medical records. We analyzed the incidence of UTI and preterm delivery from January to December 2015, in Dr. Sardjito Hospital, Yogyakarta.
Results: The sample of this study covers medical records of 45 patients with preterm delivery. From total sampel, only 25 patients (55.6%) underwent urinalysis. Of these 25 patients, 15 (60%) had UTIs and all of them had preterm delivery. The result showed 13 (86.7%) of 15 patients with bacteriuria were asymptomatic. Bacteriuria that was found in 15 subjects was not statistically significant when compared to preterm delivery indicated with relative ratio of 1,083 (p = 0,581 > 0,05). Multivariate logistic regression analysis showed that preterm delivery were not directly related to UTI (p = 0.704), gestational age (p = 0.274), symptom of UTI (0.699), history of UTI (p=0.999), and history of coitus (p = 0.872).
Conclusion: The study revealed that preterm delivery was not related to UTI. Other causes should be considered. However, the discovery of asymptomatic bacteriuria in patients with preterm delivery indicated that this might be one of the risk factors for preterm delivery. Routine urinalysis test for pregnant woman considered for the prevention.
Keywords: UTIs, preterm delivery, bacteriuria
 
The Association of Acceptance Family Planning Acceptor to Contraceptive Tools Interest Usage in the Uterine (IUD): Hubungan Penerimaan Akseptor KB terhadap Minat Penggunaan Alat Kontrasepsi Dalam Rahim (AKDR)
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Objective:to determine acceptance of family planning acceptors from age, numbers ofparity, mother education, spouse’s support, mother's culture and religion, maternalknowledge, gestational age, family income and number of living children to the IUD usage interest in dr. Zainoel Abidin General Hospital (RSUDZA) Banda Aceh.
Method: This research wasa correlative design with analytical survey method with cross sectional approach. 286 respondents were interviewed and filled out a questionnaire that has been prepared, consist ofpatients in the clinic, Emergency Unit, and Delivery Room Hospital RSUDZA Banda Aceh. The data taken related tofactors influencing the acceptance of the family planning acceptors against the IUD usage interests. This study was conducted duringSeptember 18 th to October 18 th 2017.
Results: The chi-square test result showed that there was a significant correlation between family planning acceptor from previous pregnancy distance and IUD usageinterest in RSUDZA Banda Aceh where p-value (0.088) <α (0.1). There was a significant correlation between maternalknowledgeand IUD usage interest in RSUDZA Banda Aceh where p-value (0.067) <α (0.1).
Conclusion: Bivariate analysis results showed there was a strong relationship between previous pregnancy distance and maternal knowledgetoIUD usage interest in RSUDZA Banda Aceh.
Keywords:acceptor family planning, acceptance factor, IUD
Abstrak
Tujuan:untuk mengetahui hubungan penerimaan akseptor KB dari faktor usia, jumlah paritas, pendidikan ibu, izin suami, budaya dan agama ibu, pengetahuan ibu, jarak usia kehamilan, pendapatan keluarga dan jumlah anak hidup terhadap minat penggunaan AKDR di Rumah Sakit Umum dr. Zainoel Abidin (RSUDZA) Banda Aceh.
Metode:Penelitian ini menggunakan desain korelatif dengan metode penelitian survei analitik dengan pendekatan cross sectional. Terdapat 286 responden yang telah diwawancarai dan mengisi kuisioner yang telah disediakan, terdiri dari pasien-pasien di poliklinik, Instalasi Gawat Darurat, dan kamar bersalin RSUDZA Banda Aceh. Data yang diambil mengenai faktor- faktor yang mempengaruhi peneriman akseptor KB terhadap minat penggunaan AKDR. Penelitian ini dilakukan dalam kurun periode tanggal 18 September sampai 18 Oktober 2017.
Hasil: uji chi-square menunjukkan terdapat hubungan secara signifikan penerimaan akseptor KB dari faktor jarak kehamilan ibu sebelumnya terhadap minat penggunaan AKDRdimana p-value (0,088) <α (0,1). Terdapat hubungan pengetahuan ibu dengan terhadap minat penggunaan AKDRdi RSUDZA Banda Aceh dengan nilai p-value (0,067) <α (0,1)
Kesimpulan: Hasil analisis bivariat didapatkan terdapat hubungan yang kuat antara jarak kehamilan ibu dan pengetahuan ibu terhadap minat penggunaan AKDR di RSUDZA Banda Aceh.
Kata kunci: akseptor KB, AKDR, faktor penerimaa