Jurnal Kesehatan Reproduksi
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Perbandingan Kualitas Hidup Penderita Kanker Ovarium Epitelial yang Diberikan Kemoterapi Regimen Paclitaxel dan Carboplatin dengan Regimen Cyclophospamide, Adriamicyn dan Cisplatin di RSUP Dr. Sardjito
Get PDFBackground: Epithelial ovarian cancer is the dominant type of ovarian cancer. Platinum and Taxane regiment has been proved to increase the survival rate of ovarian cancer patientsObjective: To compare the quality of life of ovarian cancer patients who got Paclitaxel and Carboplatin regiments with Cyclophosphamide, Adriamycin and Cisplatin regiments and risk factors which influence themMethod: The design of the study was retrospective cohort. The total subjects were 156 ovarian cancer patients who consisted of 79 patients with paclitaxel and carboplatin regiments and dan 77 patients who got cyclophospamide, adriamicyn dan cisplatin regiments in DR. Sardjito hospital, Yogyakarta. The quality of life was measured with EORTC QLQ-C30. The data distribution were tested with KolmogorovSmirnov and analysed with D Chi-Squaretest for categorical data and Mann-Whitney for continuous data. Multivariable Analysis was done with logistic regression.Result and Discussion: The bivariable analysis of ovarian cancer stage and the quality of life showed that early stage of ovarian cancer patients had quality of life 19,068 times higher than advance stage of ovarian cancer patients (RR 19,068; 95% CI 2,590-140,362). There were signicant differences in quality of life in ovarian cancer patients with low body mass index <18,5 compared to normal body mass index as well as the titer of tumor marker Ca125. Multivariable analysis showed that there was no significant difference in quality of life between ovarian cancer patients who got Paclitaxel plus Carboplatin and ovarian cancer patients who got Cyclophospamide, Adriamicyn plus Cisplatin.Conclusion: there was no significant difference in quality of life between ovarian cancer patients who got Paclitaxel plus Carboplatin and ovarian cancer patients who got Cyclophospamide, Adriamicyn plus Cisplatin in DR. Sardjito Hospital, Yogyakarta.Keywords: Quality of life, ovarian cancer, paclitaxel plus carboplatin regiment, cyclophospamide, adriamicyn plus cisplatin regiment
Perubahan Nilai BA pada Pelvic Organ Prolaps Quantification (POPQ) terhadap Kualitas Berkemih Pre dan Pasca Opreasi Kolporafi Anterior paa Pasien Sistokel
Get PDFBackground: Anterior colporrhaphy is used to correct anatomical abnormalities of POP, especially cystocele. In the cystocele, POPQ is focused on Ba point. However, no reference value has been established during evaluation on the changes of Ba’s pre and post operation. A measurement is required to describe the value of Ba in POPQ to the quality of patients’s micturition who have undergone anterior colporrhaphy on cystocele indication.Objective: To determine whether a change of Ba value more than 4 cm post anterior colporrhapy can improve voiding quality.Method: This study used a pretest-posttest design by measuring the value of Ba and voiding quality (UDI6 score) in cystocele patients before and after anterior colporrhapy. Ba value changes compared with changes in postoperative voiding quality.Result and Discussion: There were 20 subjects recruited from January until July 2016 who met the inclusion criteria. There were significant differences between the voiding quality and changes of Ba value before and after surgery for 2nd and 6th week (p 4 cm compared ≤4 cm (p = 0.34; RR 1.43; 95% CI 0.61-3.37). Age, BMI and parity had no significant affects the voiding quality before and after surgery (p= 0.12, p= 0.62, p=0.27). From a logistic regression analysis of variables change in value of Ba and external variables of age, BMI and parity were not statistically significant influence the voiding quality.Conclusion: Changes in the value of Ba more than 4 cm from baseline in patients who undergo anterior colporrhapy does not improve the voiding quality.Keywords: Ba value, voiding quality, anterior colporrhapy
Karakteristik Pasien Prolaps Uteri di RSUP Dr. Sardjito Yogyakarta Tahun 2013
Get PDFBackground: Uterine prolaps suffer by nearly half population of women. Many factors related to the causes of prolaps. The pattern varies in different country and ages.Objective: To evaluate the characteristic of uterine prolaps patient in Sardjito Hospital in the period January – December 2013.Method: This is an analytic descriptive study that reviewed medical record of Sardjito Hospital within January - December 2013. Data was reported, tabulated dan presented in the form of risk factors, chief complains, grade of uterine prolaps and treatment, finally analysed.Result and Discussion: There were 30 cases of uterine prolaps from Obstetrics and Gynecology Sardjito Hospital within January-December 2013. Most of the patient age were 45-64 year (48.4%), parity more than 2 (73.3%), menopause (73%), vaginal delivery more than 2 (73%). Symptoms that mostly revealed was lump on the delivery passage (73.3%). Patient were mostly suffered from grade 4 uterine prolaps (43%). There were two types of treatment i.e. conservative and operative. Conservative treatment used Kegel exercises and pessarium. Operative treatment used total vaginal hysterectomy, colpocleisis, anterior and posterior colporaphy.Conclusion: The risk factors for uterine prolaps were older age, menopause, multiparity, vaginal delivery. The treatment mostly used total vaginal hysterectomy.Keywords: uterine prolaps, risk factors, vaginal hysterectom
Hubungan antara Saat Penanganan Kegawatdaruratan Maternal di Luar atau Saat Jam Kerja dengan Waktu Tanggap di RSUD LA Temmamala Kabupaten Soppeng, Sulawesi Selatan
Get PDFBackground: The national maternal mortality rate is still high at 228 per 100.000 live births. Three late allegedly related to high maternal mortality rate, are 1)too late for decision making, 2) too late for access service and 3) too late for get treatment at referral health facility. Response time for maternal emergency treatment in the hospital plays an important role, since it affects the final result.Objective: To determine the relationship between the time of obstetric emergency management and response time.Method: This study used cross sectional design with the population of study was obstetric emergency patients. One hundred and forty-five subjects were divided into two group: group treated outside of working hours as exposed groups and groups treated during working hours as control groups. Delay of response time were observed. Data was processed by statistical program using computer. Chi square test and logistic regression analysis were used to perform statistical tests.Result and Discussion: From September 1st 2015 to April 30th 2016, there were 145 cases with obstetric emergency handled. A total 82 cases among 145 (56,6%) received emergency management outside working hours. It was found that the 1st response time was delayed in handling outside work hours compared to handling during working hours (RR 2,22; 95% CI 164-3,00). The same was obtained at 2nd response time (RR 1,39; 95% CI 1,04-1,86) and 3rd response time (RR 1,65; 95% CI 1,14-2,31). Multivariate analysis was found that time of the emergency handling was the most dominant variable that affect all response time [1st response time (OR 12,61; 95% CI 4,82-32,03), 2nd response time (OR 2,17; 95% CI 1,05-4,47), 3rd response time (OR 7,70; 95% CI 1,91-31,10)]. PONEK with midwife on duty also influence 1st response time (OR 3,28; 95% CI 1,21-8,93).Conclusion: Obstetric emergency management outside of work hours increased the occurence of response time delay.Keywords: Time of management, Obstetric emergency, 1st, 2nd and 3rd response time
Faktor Risiko Individu dan Masyarakat serta Gambaran Pelayanan Kesehatan terhadap Kasus Preeklampsia Berat di RSUD Manokwari Kabupaten Manokwari Provinsi Papua Barat (Periode September 2015-Februari 2016)
Get PDFBackground: The high rate of maternal mortality is still a health problem in Indonesia and also reects the uality of health care during pregnancy and childbirth. The main causes of maternal mortality in Indonesia is hypertension (32.4) and postpartum bleeding (28.3). Recently in Manowari eneral Hospital there is an increase trend cases of severe preeclampsia include 12 cases (September 2015), 14 cases (October 2015) and 14 cases (November 2015).Objective: To identify ris factors of the community and health care to cases of severe preeclampsia in the eneral Hospital of Manowari, Papua Barat Province period September 2015 - ebruary 2016. Method: The study was an observational descriptive study, cross sectional design with a retrospective approach. A total of 148 medical records of pregnant women who meet the eligibility criteria for inclusion in this study. Chi-suare test and isher eact was used for statistical analysis. Multivariate analysis using logistic regression with signicance p 0.05.Result and Discussion: A total of 148 medical records of pregnant women from September 2015 - ebruary 2016 met eligibility criteria which consisted of 74 pregnant women with severe preeclampsia and 74 pregnant women without preeclampsia. Chi-suare analysis showed a signicant association between gestational age 20-36 wees with severe preeclampsia cases (p 0.016; RR 1.8; CI 1.2 to 26.6) and a history of hypertension (p 0.000; RR 2.2; CI 3.1 to 21.2). Community ris factors had no signicant relationship with severe preeclampsia. The health care services regarding severe preeclampsia was well implemented and the second phase delay mainly due to geographic factors.Conclusion: There is a signicant association between gestational age 20-36 wees and a history of hypertension in cases of severe preeclampsia.Keywords: severe preeclampsia, gestational age, history of hypertension, ris factor of the community, second phase dela
The Impact of Obstetrician/Gynecologist Hospitalists on Maternal Quality of Care in Yogyakarta Indonsia: A Cohort Study
Get PDFBackground: The hospitalist is defined by 24-hour a day/7 day a week physician who assists or is employed by the hospital to manage patients, triage and emergencies. The hospitalist model in obstetric care that was introduced over the last decades now has an important role in care delivery management with the potential positive impact on maternal outcomes. Unfortunately, in Indonesia there were limited data available related to the implementation of hospitalist model and the impact on maternal quality of care.Objective: To determine the impact of obstetrician/gynecologist hospitalist on maternal quality care. Method: This research design was a retrospective cohort. Participants included were the patients in the time before and after implementation of obstetrician/gynecologist hospitalist policy during October 2013 until September 2014. Univariate and multivariate analysis were conducted to evaluate and determine the factors, which significantly contribute to maternal outcomes.Result and Discussion: We included a total of 71 patients (30 in the on-call group and 41 in the full time hospitalist group). Univariate analysis indicated mean response time was significantly different in the hospitalist group compared to the on-call group (65.3 ± 25.89 vs 84 ± 22.29 mins; p = 0.002). Implementation of full-time hospitalists did not impact the ICU admission and transfusion incidence.Conclusions: Implementation of the full-time hospitalist model was associated with a significant improvement of response time in emergency obstetric care without affecting maternal outcomes.Keywords: Maternal mortality, obstetrician/gynecologist hospitalist, labor and delivery, maternal care, ICU response tim
Peran Penambahan Misoprostol pada Penatalaksanaan Aktif Kala Tiga dalam Menurunkan Perdarahan Pasca Persalinan
Get PDFBackground: Postpartum haemorrhage is the leading cause of maternal mortality in both developed and developing countries, which is almost 80 % due to the failure of the uterus to contract. Misoprostol is a powerful uterotonic agent used as an alternative in preventing postpartum haemorrhage.Objective: The purpose of this study was to determine whether administration of misoprostol adjunctive therapy in active management of the third stage of labor influenced postpartum blood loss.Method: This study was a non-blinding randomized controlled trial that divided subjects into two groups. The treatment group was the group who received misoprostol 600 mcg orally for adjunctive treatment in active management of the third stage of labor and the control group did not receive misoprostol, each group also got routine oxytocin 10 IU intramuscularly. Both group were assessed of the number of blood loss in the fourth stage of labor, decreased levels of hemoglobin and hematocrit within 24 hours after delivery. Chi square test was conducted to determine the strength of the relationship between the two groups.Result and Discussion: The study recruited 104 subjects, there were significant difference for the mean number of blood loss in the fourth stage of labor and the decrease in hemoglobin levels within 24 hours of postpartum between treatment and control group (OR 2.45; 95% CI 1.05-5.71, p=0.04), (OR 2.99; 95% CI 1.26-7.11, p=0.01). The mean of the decreasing hematocrit levels was statistically not significant between the two groups (OR 0.87; 95% CI 0.38-1.99, p=0.75).Conclusion: The addition of misoprostol to the routine active management of the third stage of labor was statistically significant to decrease amount of postpartum blood loss.Keywords: misoprostol, active management of the third stage of labor, postpartum blood loss, postpartum hemorrhage
Hubungan Pengetahuan, Sikap dan Perilaku Bidan Desa terhadap Kanker Leher Rahim dan Pencegahannya di Kabupaten Sragen
Get PDFBackground: Cervical cancer (cervix) is the second most common type of cancer in women, with an estimated of 530,000 new cases and more than 270,000 deaths each year. In 2012, cervical cancer cases in Central Java was 2,259 cases. Cervical cancer is easily recognizable and can be prevented with screening. A village midwife as the closest healthcare provider to the community is expected to function better in encouraging the prevention of cervical cancer.if they receive appropriate knowledge and attitude toward screening.Objective: to understand the correlation of knowledge, attitude and behavior of village midwife against cervical cancer and its prevention in Sragen district.Method: This analytic study is using quantitative and qualitative approach. Quantitative studies was done with cross-sectional study. The population of this research were 208 village midwifes from 20 sub-districts in Sragen and the subjects were 118 midwives whom randomly sampled. Data were analyzed using univariate and bivariate analysis.The qualitative study was done using depth interview.Result and Discussion: There is no correlation between age, level of education as well as work duration with their knowledge about cervical cancer prevention (P = 0.787; 0.344; 0.822); there is no correlation between village midwives’ knowledge with their behavior towards cervical cancer prevention (P = 0.664); there is no correlation between the village midwives’ attitudes and behavior towards prevention of cervical cancer (P = 0.460). Qualitative results support the quantitative results.Conclusion: There is no correlation between village midwives’ knowledge, attitudes and behavior towards cervical cancer prevention.Keywords: Cervical cancer, knowledge, attitude, behavio
Incidence of Unintended Pregnancy after Laparoscopic Tubal Sterilization at Dr.Sardjito Hospital
Get PDFBackground: Laparoscopic tubal ligation is one of the most commonly performed sterilization procedures and has many advantages such as high success rate and early return to normal activity. In Indonesia, the incidence of unintended pregancy in a study was 0,15 %. This rate is comparable with pregnancy rates for women using another contraceptive method.Objective: To assess the incidence of unintended pregnancy on women who underwent laparoscopic tubal sterilization at Dr. Sardjito Hospital.Method: A descriptive observational study with retrospective cross-sectional design was conducted. The data were acquired from medical record from January 2009 to April 2015. Reports of unintended pregnancy within two years after procedure were recorded.Result and Discussion: 55 women met the inclusion criterion and none were excluded. Method failures resulting on pregnancy occured in 3 cases (5.45 %), so the success rate of the procedure was 94.55 %. All of the reported pregnancies happened within two years after the procedures. There was no major complication occured in the procedure, but minor bleeding (<50 cc) did occur in some cases.Conclusion: The incidence of unintended pregnancy on women who underwent laparoscopic tubal sterilization at Dr. Sardjito Hospital was higher than the average incidence reported on another studies.Keyword: female sterilization, laparoscopic tubal sterilization, unintended pregnancy
Faktor Risiko Transmisi Virus HIV pada Ibu Hamil di Papua
Get PDFBackground: Human Immunodeficiency Virus (HIV) has been transmitted all over the world and attack people including pregnant women and their fetus. HIV-AIDS has become the main cause of maternal death. The transmission is started from Africa to Indonesia, specifically to Papua Island. In Papua, HIV is a serious threat for pregnant women’s life because of its fast transmission, even faster from other regions in Indonesia. Until present, there has no research about HIV transmission on pregnant women in Papua Island.Objective: To conduct analysis on risk factors related to HIV transmission on pregnant women in Papua Island.Method: Cross sectional continued with retrospective cohort. Data was taken from medical record of all patients delivering in eight state-owned hospitals in Papua and West Papua provinces started from 1 January 2013 to 31 December 2013. Inclusion criteria were all pregnant women who delivered vaginally or by caesarean sections with HIV and non HIV diagnosis and had complete medical record data. Data being taken included mother’s age when delivered the baby, mother’s education, parents’ social economic status, mother’s ethnicity, parents’ domicile, prematurity and infant’s birth weight. The two research groups were HIV (+) and HIV (-) groups. Data were statistically analyzed using Pearson Chi Square for univarian and logistic regression for multivarian.Result and Discussion: In Papua island, prevalence of pregnant women with HIV was 15.3%, and mostly occurred in reproductive age ( 85.1%). The main transmission source was heterosexual (100%). Univarian analysis found that mothers’s age 20 years old but it’s statistically insignificant (p=0.53). Mothers education 9 years (p=0.01). The husband’s low socioeconomic status increase the risk of 5.51 times compared with husband’s high socioeconomic status (p<0.01). The wife’s low socioeconomic status increase the risk of 1.22 times, in which statistically insignificant (p=0.14). Native Papuanese pregnant women has significantly 3.05 times higher risk for HIV transmission compared to non Papuanese (p<0.01). Pregnant women’s domicile in villages increase the transmission significantly 2.21 times compared to cities’ domiciles (p<0.00). Premature delivery increased HIV transmission by 1.7 times (p<0.01). Low infant body weight increased the transmission by 1.64 times significantly (p<0.01). Multivarian analysis showed that husband’s low socioeconomic status, Papuanese ethnicity and domicile in villages are the most dominant factors influencing HIV transmission on pregnant women in Papua Island.Conclusion: Varied risk factors on HIV transmission resulted in the occurrence of HIV (+) cases in Papua Island, while the most dominant factors are husband with low socioeconomic status, Papua ethnicity and domicile in villages.Keywords: HIV, risk factors, birthing mothers, Papua Island