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KADAR HUMAN LEUKOCYTE ANTIGEN-G (HLAG) DAN TUMOR NERCROSIS FAKTOR ALPHA (TNF-a) PADA ABORTUS DAN KEHAMILAN NORMAL
Get PDFKADAR HUMAN LEUKOCYTE ANTIGEN-G (HLAG) DAN TUMOR NERCROSIS FAKTOR ALPHA (TNF-a) PADA ABORTUS DAN KEHAMILAN NORMALKresno Condro Adhi1, Sri Sulistyowati2, Supriyadi Hari Respati3ABSTRACTBackground: Abortion is one of the causes of maternal morbidity and mortality. Rejection of the fetusdue to recognition of paternal antigens by the maternal immune system, is suspected to be a cause ofunexplained pregnancy loss. Human Leukocyte Antigen G (HLA-G) expressed by thropoblast and TumorNecrosis Factor α (TNF-α) suspected as one of important inflammatory mediators associated with abortion.Objective : To analyze levels of the HLA-G and TNF-α in the serum of abortion and normal pregnancy.Method: Observational analytic with Cross sectional approach at the Obstetric and Gynecology DepartmentDr. Moewardi hospital Surakarta and Prodia laboratory since August - November 2014. Number of samplestudied was 40 sample divided into 2 groups, 20 sample abortion and 20 sample normal pregnancy. Allthe sample were examined the HLA-G and TNF-α serum level by ELISA method and analyze by t test withCI 95%.Result and Discussion: Average value of HLA-G in abortion group was 55,0246±26,01 ng/ml and normalpregnancy group with an average 76,7200±32,18 ng/ml with p=0,024 (p≤0,05). Average value of TNF-α inabortion group was 3,83±1,52 ng/ml and normal pregnancy group with an average 2,76±1,49 ng/ml withp=0,032 (p≤0,05).Conclusion: In the abortion serum level of HLA-G is lower and TNF-α is higher than normal pregnancy.Keywords: Abortion, HLA-G, TNF-α.ABSTRAKLatar Belakang : Abortus merupakan salah satu penyebab morbiditas dan mortalitas maternal. Adanyapenolakan janin karena adanya antigen paternal oleh sistim imun ibu, diduga menjadi salah satu penyebabterjadinya abortus. Human Leukocyte Antigen G (HLA-G) yang dihasilkan oleh trofoblas dan Tumor NecrosisFactor Alpha (TNF-α) diduga sebagai salah satu mediator yang berhubungan dengan terjadinya abortus.Tujuan : Mengetahui kadar HLA-G dan TNF-α serum pada abortus dan kehamilan normalMetode: Penelitian ini merupakan penelitian observasional analitik menggunakan pendekatan CrossSectional yang dilakukan di RSUD Dr. Moewardi Surakarta pada bulan Agustus - November 2014. Totalsampel 40 dibagi menjadi 2 kelompok, 20 sampel kelompok abortus dan 20 sampel kelompok kehamilannormal. Semua sampel dilakukan pemeriksaan serum kadar HLA-G dan TNF-α dengan menggunakanmetode ELISA. Analisis menggunakan uji t dengan nilai kepercayaan 95%.Hasil dan Pembahasan: Rerata kadar serum HLA-G pada kelompok abortus adalah 55,0246±26,01 ng/ml dan kelompok kehamilan normal 76,7200±32,18 ng/ml, dengan nilai p=0,024 (p≤0,05). Rerata kadarserum TNF-α pada kelompok abortus 3,83±1,52 ng/ml dan kelompok kehamilan normal 2,76±1,49 ng/mldengan nilai p=0,032 (p≤0,05).Kesimpulan: Pada abortus kadar serum HLA-G lebih rendah dan TNF-α lebih tinggi bila dibandingkandengan kehamilan normal.Kata kunci : Abortus, HLA-G, TNF-α.1,2,3 Bagian Obstetri dan Ginekologi FK UNS/RSUD Dr. Moewardi Surakart
PERBANDINGAN ANTARA PEMBERIAN ANTIBIOTIKA PROFILAKSIS PADA SEKSIO SESAR SESUAI ALUR KLINIS RSUP DR SARDJITO DENGAN ANTIBIOTIKA DOSIS MULTIPEL TERHADAP KEJADIAN INFEKSI LUKA OPERASI
Get PDFBackground: Clinical pathway recommend the use of short-term prophylaxis antibiotics for cesarean section. Long-term antibiotics or multiple doses was found in clinical practice. There are differences in the mode of administration and the number of doses administered at sardjito hospital.Objective: To determine the effectiveness of short-term antibiotic prophylaxis in cesarean section appropriate to clinical pathway in the prevention of surgical site infection (ssi), the incidence of fever, dysuria events, length of stay.Method: The study used randomized clinical trial. The study subjects who underwent cesarean section and meet the inclusion and exclusion criteria in the period July 2013 to January 2014 divided into an intervention group (n = 52) who received ampicillin 2 gram pre and post-cesarean section, and a control group (n = 54) who received ampicillin 2 gram pre cesarean section and 1 gram every 8 hours for 6 times. Observed on days 3 and 10 post-cesarean section. The primary outcomes assessed were the incidence of surgical wound infection based on the criteria of surgical site infection from Centers for Disease Controland Prevention. Secondary outcomes assessed were the incidence of fever, dysuria events, length of stay. Homogeneity analysis were conducted on subject. Outcome analysis performed bivariate with t test and chi squared test.Results and Discussion : A total of 106 subjects can be analyzed. SSI events in the intervention group at day 3 was 3.8% (n = 52) and control group was 1.84% (n = 54) with p>0.05 RR 2.077 (95% CI 0.194 to 22.219). SSI on day 10 of 7.7% (n = 52) in the intervention group versus 9.3% (n = 54) in controls with p0.05 RR 1.558 (95% CI 0.271 to 8.948) and on day 10 was 3.8% versus 3.7 % with p>0.05 RR 1.038 (95% CI 0.152 to 7.102). Dysuria not found on day 3 and but on 10 found 5.8% in the intervention group versus 11.1% with p>0.05 RR 0.519 (IK95% 0.137 to 1.968). Length of stay after cesarean section for 3.21 ± 0.412 days in the intervention group and 3.26 ± 0.442 days in the control group with p>0.05 (95% CI -0.213 - 0.117).Conclusion: There is no significant difference in the incidence of surgical wound infections, the incidence of fever, dysuria, length of stay between short-term prophylaxis antibiotics ampicillin appropriate to clinical pathway and long-term or multiple doses prophylaxis antibiotics. Short term antibiotics prophylaxis are more efficiently with the same effectiveness in preventing outcomes research.Keywords: prophylaxis antibiotics, ampicillin, short term regimen, long term regimen, cesarean section, surgical site infection.
Impact of Obstetrician/Gynecologist Hospitalists on Response Time of Obstetric Emergency Operation in Sardjito Hospital Yogyakarta Indonesia: A Retrospective Cohort Study
No full textBackground: The hospitalist model in obstetric care which was introduced over the last decades now has an important role in care delivery management with the potential positive impact on maternal and neonatal outcomes.Objective: The aim of this study was to evaluate the effect of hospitalist model towards surgical emergency response time.Method: This research design was cohort a retrospective study. Participants included were the patient in the time before and after implementation of obstetrician/gynecologist full-hospitalist policy during October 2013 until September 2014. The outcome measured were mean response time and possible hospital factors which contribute to response time.Result and Discussion: We included a total of 71 patients (30 on-call obstetrician group and 41 full-time hospitalist group). Univariate analysis indicated mean response time was significantly differ in full-time hospitalist group when compared to the on-call obstetrician group (65.3 + 25.89 vs. 84 + 22.29 mins; p = 0.002). Multivariable analysis determined that hospital factors which contribute to response time are readiness of operating theatre.Conclusion: Implementation of full-time hospitalist model is associated with a significant improvement of response time in emergency obstetric care.Keywords: Maternal mortality, Obstetrician/Gynecology Hospitalist, C-section, Response Tim
HUBUNGAN EPISIOTOMI TERHADAP INKONTINENSIS URIN: SUATU STUDI EPIDEMIOLOGI
Get PDFHUBUNGAN EPISIOTOMI TERHADAP INKONTINENSIS URIN: SUATU STUDI EPIDEMIOLOGINovita Sari1, Edi Patmini2, Agung Nugroho3, Muhammad Nurhadi Rahman4ABSTRACTBackground:The mortality rate of urinary incontinence is low but it greatly affects a person’s quality oflife as can cause embarrassment and discomfort. Consequently it affects psychosocial impact of patient.Urinary incontinence 2-3 times more often experienced by women in comparison with men because oftrauma risk to the connective tissue, muscle, and nerve during childbirth.Objective: To assess association between episiotomy and nonepisiotomy vaginal delivery method onurinary incontinence among postpartum woman.Method: A cross sectional study was conducted toward women with post vaginal delivery in BantulHospital during the period of March-August 2014. After considering the inclusion and exclusion criteria,there were 95 women included in the study (44 women with episiotomy vaginal delivery and 51 womenwith nonepisiotomy vaginal delivery). Questionnaire for Urinary Incontinence Diagnosis (QUID)wasadministered to measure urinary incontinence in postpartum women. Data were analyzed using SPSSsoftware version 19.Result and Discussion: The occurrence of urinary incontinence in this research was 45.3%, among these39.5% were women with episiotomy vaginal delivery, and 60.5% were women with nonepisiotomy vaginaldelivery method (p=0.228 and RP =0.76).Conclusion: Urinary incontinence among postpartum women is not significantly different among womenwho delivered with episiotomy and non episiotomy.Keyword: Urinary incontinence, vaginal delivery, episiotomy, nonepisiotomyABSTRAKLatar Belakang:Inkontinensi urin bukan masalah yang mematikan tetapi inkontinensi urin mempengaruhikualitas hidup seseorang karena menimbulkan rasa malu dan tidak nyaman, sehingga memberikandampak psikososial pada pasien inkontinensi urin. Inkontinensi urin 2-3 kali lebih sering dialami olehwanita dibandingkan dengan pria karena adanya risiko terjadinya trauma pada jaringan ikat, otot, dancedera saraf saat melakukan persalinan.Tujuan: Mengetahui hubungan antara persalinan vaginal dengan tindakan episiotomi dan nonepisiotomiterhadap kejadian inkontinensi urin pada wanita postpartum.Metode: Penelitian ini menggunakan desain Cross Sectional dengan 44 subjek pada kelompok persalinanvaginal episiotomi dan 51 subjek pada kelompok persalinan vaginal nonepisiotomi. Kuesioner QUID(Questionnaire for Urinary Incontinence Diagnosis) digunakan untuk mengukur inkontinensi urin padawanita postpartum. Data kemudian dianalisis menggunakan software SPSS versi 19.Hasil:Angka kejadian inkontinensi urin pada subjek penelitian yaitu 45,3%, sedangkan pada kelompokpersalinan vaginal episiotomi 39,5% dan persalinan vaginal nonepisiotomi 60,5% (p=0,228 dan RP=0,76).Kesimpulan:Tidak ada hubungan yang signifikan antara persalinan vaginal dengan tindakan episiotomidan nonepisiotomi terhadap terjadinya inkontienesi urin postpartum.Kata kunci:Inkontinensi urin, persalinan vaginal, episiotomy dan nonepisiotomi.1 Mahasiswa S1 Pendidikan Dokter Fakultas Kedokteran UGM2,4 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM / RSUP Dr. Sardjito3 Bagian Kesehatan Ibu dan Anak, Ilmu Kesehatan Masyarakat, Fakultas Kedokteran UG
PERBANDINGAN COMPLETE RESPONSE PENDERITA KANKER OVARIUM STADIUM LANJUT YANG MENDAPAT REJIMEN PACLITAXEL-CARBOPLATIN DENGAN REJIMEN CYCLOPHOSPHAMIDE-ADRIAMYCIN-CISPLATIN SEBAGAI KEMOTERAPI LINI PERTAMA
Get PDFPERBANDINGAN COMPLETE RESPONSE PENDERITAKANKER OVARIUM STADIUM LANJUT YANG MENDAPATREJIMEN PACLITAXEL-CARBOPLATIN DENGAN REJIMENCYCLOPHOSPHAMIDE-ADRIAMYCIN-CISPLATIN SEBAGAIKEMOTERAPI LINI PERTAMAM. Sibuea1, M. Lutfi2, M. Hakimi3ABSTRACTBackground: Introduction of Platinum and Paclitaxel has increased survival rate in advanced epithelialovarian cancer. Several studies have been tried to establish the better combination with those anticancerdrugs.Objectives: Comparing complete response (CR) and progression-free survival (PFS) between Paclitaxel-Carboplatin and CAP as a first line treatment in advanced epithelial ovarian cancer.Method: This research used cohort retrospective study. Fifthy-three subjects with epithelial ovarian cancerFIGO stage III and IV were collected from Dr.Sardjito Hospital’s medical record analysis between January2009 and December 2013, and divided into two groups according to chemotherapy regimens. Completeresponse and progression-free survival were determined after cytoreductive surgery and total 6 coursesof chemotherapy.Result and Discussion: The frequency of complete response was similar, 61,5% in Paclitaxel Carboplatingroup as compared with 63% in CAP group (RR 0,977, 95% CI 0,642-1,487, p=1,000). Kaplan-Meier curvesshowed no difference in progression-free survival between the groups, with median PFS was 15 months(95% CI 13,228-16,772) on Paclitaxel-Carboplatin and 14 months on CAP (95% CI 7,686-20,314) (p logrank=0,741). Patients undergo optimal cytoreductive surgery attained more complete response (OR 8,274,95% CI 1,775-38,559, p=0,007) and had a longer PFS than the suboptimal group (17 vs 13 months, p logrank=0,046).Conclusion: Paclitaxel-Carboplatin was not superior compared with CAP regimen as first line chemotherapyin advanced epithelial ovarian cancer. Further evaluation of survival, toxicity profile, and quality of lifewere needed to determine superiority of Paclitaxel-Carboplatin compared with CAP. Optimal cytoreductivesurgery was an independent predictor for a better prognosis.Keywords: advanced ovarian cancer, chemotherapy, Paclitaxel-Carboplatin, CAPABSTRAKLatar belakang: Survival rate penderita kanker ovarium epitelial stadium lanjut meningkat sejakdiperkenalkannya Platinum dan Paclitaxel. Beberapa penelitian telah berusaha untuk menentukankombinasi yang lebih baik dari obat-obatan tersebut.Tujuan: Membandingkan complete response (CR) dan progression-free survival (PFS) antara Paclitaxel-Carboplatin dengan CAP sebagai terapi lini pertama pada kanker ovarium epitelial stadium lanjut.Metode: Penelitian ini menggunakan studi cohort retrospective. Lima puluh tiga subyek dengan kankerovarium epitelial stadium III-IV (FIGO) didapatkan dari analisis rekam medis RSUP Dr. Sardjito mulai Januari2009 hingga Desember 2013, yang terbagi menjadi dua kelompok berdasarkan jenis kemoterapi yang diterima. Complete response dan PFS ditentukan setelah pasien menjalani operasi sitoreduksi dan total 6 siklus kemoterapi.Hasil dan Pembahasan: Frekuensi CR kelompok Paclitaxel Carboplatin (61,4%) serupa dengan kelompokCAP (63%) (RR 0,977, 95% CI 0,642-1,487, p=1,000). Kurva Kaplan-Meier tidak menunjukkan perbedaanPFS di antara kedua kelompok, dengan median PFS Paclitaxel-Carboplatin 15 bulan (95% CI 13,228-16,772)dan CAP 14 bulan (95% CI 7,686-20,314) (p log-rank=0,741). Pasien dengan operasi sitoreduksi optimalmencapai CR lebih banyak (OR 8,274, 95% CI 1,775-38,559, p=0,007) dan median PFS lebih panjang dibandingkan dengan kelompok suboptimal (17 vs 13 bulan, p log-rank=0,046).Kesimpulan: Paclitaxel-Carboplatin tidak lebih superior dibandingkan dengan CAP sebagai kemoterapi linipertama pada kanker ovarium epitelial stadium lanjut. Namun, masih diperlukan pengukuran survival, profiltoksisitas, dan kualitas hidup guna menentukan keunggulan rejimen Paclitaxel-Carboplatin dibandingkan dengan CAP. Operasi sitoreduksi yang optimal merupakan prediktor independen dari prognosis yang lebih baik.Kata kunci: kanker ovarium stadium lanjut, kemoterapi, Paclitaxel-Carboplatin, CAP1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr. Sardjito Yogyakart
PERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADA PREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSI
Get PDFPERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADAPREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSIBudi Arianto1, Diah Rumekti H2, Detty S Nurdiati3ABSTRACTBackground: The state of hypoxia in severe preeclampsia cause placental oxidative stress that can leadexcessive trophoblast apoptosis through the mitochondrial pathway. Apoptosis stimuli occurs throughmodulation of p53 and Bcl-2 family expression which has antiapoptosis and proapoptosis function.Antiapoptosis protein consist of Bcl-2 and Bcl-XL and is expressed lower in apoptosis.Objective: To compare the mean difference of the expression of antiapoptosis proteins Bcl-2 & Bcl-XL andidentify the type of protein that can be used as indicators of increased apoptosis.Method: A cross-sectional study which consisted of 43 severe preeclampsia pregnancies and 38 thirdtrimester normotensive pregnancies, recruited between October 2011 - March 2012. Observation ofprotein expression Bcl-2 and Bcl-XL used immunohistochemical techniques. Statistical analysis appliedindependent t test (P<0.05).Result and Discussion: There were significant differences (p<0.05)between the mean expression of Bcl-2protein in trophoblast tissue among severe preeclampsia group (1.03 ± 0.04) compared to normotensivegroup (1.10 ± 0.08). The mean expression of Bcl-XL protein in trophoblast tissue severe preeclampsiagroup (1.29 ± 0.12) compared to normotensive group (1.71 ± 0.14) were significantly difference (p<0.05).The mean difference in protein expression of Bcl-2 (0076; 95% CI 0.046 to 0.104) was lower than Bcl-XLprotein (0.42; 95% CI 0.47 to 0.36). The mean protein expression of Bcl-2 and Bcl-XL were lower in severepreeclampsia group compared with normotensive group, either in preterm or full-term gestation age withp value <0.05.Conclusion: The mean difference in protein expression of Bcl-2 and Bcl-XL is lower in severe preeclampsiapregnancies than normotensive pregnancies. The mean difference in protein expression of Bcl-2 is lowerthan Bcl-XL. Severe preeclampsia affects protein expression of Bcl-2 and Bcl-XL more than influence ofgestational age.Keywords: severe preeclampsia, trophoblast, Bcl-2 , Bcl-XL, apoptosis.ABSTRAKLatar belakang: Keadaan hipoksia pada preeklamsia berat akan menyebabkan stress oksidatif plasentayang dapat memicu terjadi peningkatan apoptosis trofoblas melalui jalur mitokondria. Stimulus apoptosisterjadi melalui modulasi ekspresi P53 dan ekspresi protein Bcl-2 family yang memiliki fungsi antiapoptosisdan proapoptosis. Protein antiapoptosis terdiri atas Bcl-2 dan Bcl-XL akan diekspresikan lebih rendah padakeadaan apoptosis.Tujuan: Untuk melihat perbedaan rerata ekspresi protein antiapoptosis Bcl-2 dan Bcl-XL dan mengidentifikasijenis protein yang dapat dijadikan indikator peningkatan apoptosis.Metode: Rancangan penelitian ini potong lintang dengan populasi penderita kehamilan preeklamsia beratdan normotensi yang dirawat di RSUP Sardjito antara bulan Oktober 2011 hingga Maret 2012. Didapatkansampel plasenta sebanyak 43 kehamilan preeklamsia berat dan 38 kehamilan normotensi. Pengamatanekspresi protein Bcl-2 dan Bcl-XL dengan teknik imunohistokimia. Analisis statistik menggunakanindependent t test (p<0.05).Hasil dan Pembahasan: Terdapat perbedaan yang bermakna (p<0,05) rerata ekspresi protein Bcl-2 padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,03 ± 0,04) dibandingkan kelompok kehamilannormotensi (1,10 ± 0,08). Terdapat perbedaan yang bermakna (p<0.05) rerata ekspresi protein Bcl-xL padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,29 ± 0,12) dibandingkan kelompok kehamilannormotensi (1,71 ± 0,14). Beda rerata ekspresi protein untuk Bcl-2 (0,076; CI 95% 0,046 – 0,104) lebihrendah dibandingkan beda rerata ekspresi protein Bcl-xL (0,42; CI 95% 0,47- 0,36). Rerata ekspresi proteinBcl-2 dan Bcl-XL lebih rendah pada kelompok preeklamsia berat dibandingkan dengan normotensi baikpada umur kehamilan preterm maupun aterm yang ditunjukkan dengan nilai p<0,05.Kesimpulan: Beda rerata ekspresi protein Bcl-2 dan Bcl-xL lebih rendah pada kehamilan preeklamsia beratdibandingkan kehamilan normotensi. Beda rerata ekspresi protein Bcl-2 lebih rendah dibandingkan bedarerata ekspresi protein Bcl-xl. Preeklamsia berat lebih berpengaruh terhadap ekspresi protein Bcl-2 danBcl-XL dibandingkan umur kehamilanKata Kunci: preeklamsia berat, trofoblas, protein Bcl-2, protein Bcl-xl, apoptosis1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr. Sardjito, Yogyakart
Pemaknaan Menopause pada Perempuan Bangsawan Keraton Jawa
Get PDFBackground: In most cases, women experience menopause with various kind of physical and psychological symptoms. Women’s understanding on menopause is influenced by their cultural background. Royal Javanese women are not sepatared from various Javanese traditions, such as “pitutur-pitutur”, “laku Jawa”, et cetera. Such traditions are the foundation they construct menopause experience.Objective: The purpose of this research is to obtain the meaning of menopause as experienced by Royal Javanese Women.Method: A qualitative method with in-depth interview is used in this research. Informants are seven Royal Javanese Women from three Javanese palaces: Solo, Yogyakarta and Cirebon; who were selected with purposive sampling technique.Result and Discussion: Based on this research, the meaning of menopause as experienced by Royal Javanese Women is significantly influenced by their construction of Javanese culture. Menopause is understood as an important event occurred to woman’s body. As an important event, Royal Javanese Women carry out several preparations and anticipative efforts prior to Menopause. Preparations are outer and inner treatment and applied in day-to-day activities such as taking Javanese traditional herbs (jamu) and carry out Javanese traditions or rituals (fasting, meditation, et cetera).Conclusion: The Acceptance of manapausal symptoms are the result of cultural exposure and aaptation in royal live enviroments.Keywords: Menopause, Javanese Culture, Royal Javanese Women, Meanin
Kinerja Bidan Desa dalam Deteksi Dini Kasus Malaria pada Kehamilan di Kabupaten Bengkulu Tengah
Get PDFBackground: Malaria has become the health problem that cause mortality especially in high risk group such as infants, children below 5 years old and pregnant women. The incidence of malaria in Central Bengkulu, Bengkulu Province is quite high, the last three years there is an increase compared to year 2011 – 2013. Annual Malaria Incidence in 2011 was 75.68/00, where the incidence in 2012 was 66.13/00. The Annual Parasite Incidence in 2013 was 52.34/00. In 2013, the amount of pregnant women who underwent malaria screening during 1st antenatal care (K1) only 784 from 2016 pregnant women(39%).Objective: To understand the malaria screening achievement among pregnant women by village midwives in Central Bengkulu District.Method: The study was observational with cross sectional design. The subjects was all of the village midwives in Central Bengkulu District. The dependent variable in this study was midwives achievement in malaria screening during pregnancy. The independent variables were training for malaria screening during pregnancy and the availability of rapid diagnostic test (RDT). The disturbing variables were age, level of education, and the duration of work. The study’s instrument was questionnare and observational sheet. The data analysis was done with t test, correlation method, chi square and linear regression.Result and Discussion: The achievement in malaria’s screening during pregnancy by village midwives was better in the group who received training compared with the group who didn’t (RR 2.2 ; 95% CI 1.71 – 2.51). The achievement also was better in the group of midwives who had good supply of RDT compared with the group who didn’t (RR 1.5; 95% CI 1.01 – 1.94).Conclusion: The achievement of malaria’s screening during pregnancy among village midwives who received training was better compared to midwives who didn’t. The achievement was also better among midwives who had good supply of RDT compared with midwives who didn’t. There is relation between level of midwivery education and the achievement in screening b ut there was no relation between age and duration of work and achievement during screening.Keywords: Achievement of Village Midwives, Screening, Training and Availability of RD
PENGARUH KONSELING LAKTASI PADA IBU HAMIL TRIMESTER III TERHADAP PEMBERIAN PRELAKTAL BAYI BARU LAHIR
Get PDFPENGARUH KONSELING LAKTASI PADA IBU HAMILTRIMESTER III TERHADAP PEMBERIAN PRELAKTAL BAYIBARU LAHIRHappy Dwi Aprilina1, Risanto Siswosudarmo2, Wahyu Ikka Setiyarini3ABSTRACTBackground: Exclusive breastfeeding’s rate in Indonesia is still low. One of the causes of this failure is theprelacteal feeding in infants’ early life. Prelacteal feeding can cause the infants reluctance to suckle theirmothers’ breasts, diarrhea, allergy, ear infections and respiratory disorders in infants. One of the efforts toprevent prelacteal feeding is providing lactation counselingto women in the third trimester of pregnancy.Objective: To assess the impact of lactation counseling to women in the third trimester of pregnancytoward prelacteal feeding to newborn infants.Method: This research design usedrandomized controlled trial (RCT) which is divided into treatment group(pregnant women class and individual lactation counseling) n=33 and control group (pregnant women classonly) n=34. The subjects are woman in the third trimester of pregnancy in the work area of PuskesmasSokaraja 1, Banyumas. The sampling technique is simple random sampling. Chi square, relative risk (RR)and logistic regression analysis is used for statistical analysis.Result and Discussion: Proportion mothers who did not give prelacteal feeding wassignificantly higher inintervention group than in control group, 69% vs 30% with RR = 1.69 (95% CI: 1.06 to 2.68) p = 0.01.Conclusion: Mothers who received counseling lactation in the third trimester of pregnancy had a 1.69times greater chance to not give prelacteal than mothers who did not receive counseling lactation.Keywords: Exclusive Breastfeeding, Lactation Counseling, Prelacteal, Health Education, BreastfeedABSTRAKLatar Belakang: Cakupan pemberian ASI Eksklusif di Indonesia masih dalam rendah. Salah satu penyebabkegagalan ASI Eksklusif adalah pemberian prelaktal pada awal kehidupan bayi. Pemberian prelaktal dapatmenyebabkan bayi malas menyusu, diare, alergi, infeksi dan gangguan pernapasan pada bayi. Salah satuupaya dalam mencegah pemberian prelaktal yaitu dengan memberikan konseling laktasi pada ibu hamiltrimester ketiga.Tujuan: mengetahui pengaruh konseling laktasi pada ibu hamil trimester ketiga terhadap pemberianprelaktal bayi baru lahir.Metode: Desain penelitian menggunakan randomized controlled trial (RCT),dibagi menjadi kelompokperlakuan (kelas ibu hamildan konseling laktasi) n=33 dan kelompok kontrol (kelas ibu hamil saja) n=34.Subjek penelitian yaitu ibu hamil trimester ketiga di wilayah kerja Puskesmas Sokaraja 1 Banyumas. Teknikpengambilan sampel menggunakan simple random sampling. Chisquare, risiko relatif (RR) dan analisisregresi logistik digunakan untuk analisis statistik.Hasil dan Pembahasan: Proporsi ibu tidak memberikan prelaktal pada kelompok intervensi lebih tinggidibandingkan dengan kelompok kontrol; 69% vs 30% dengan RR=1,69 (95% CI: 1,06-2,68), sehingga terdapat perbedaan yang bermakna secara statistik pada kelompok perlakuan dibandingkan dengankelompok kontrolKesimpulan: Proporsi ibu yang mendapatkan konseling laktasi pada kehamilan trimester ketiga 1,69 kaliberpeluang lebih besar tidak memberikan prelaktal daripada ibu yang tidak mendapatkan konseling laktasi.Kata kunci: ASI Eksklusif, Konseling laktasi, Prelaktal, Pendidikan Kesehatan, Menyusui1 E-mail: [email protected]; Program Studi Magister Keperawatan Universitas Gadjah Mada2 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada3 Rumah Sakit Umum Daerah Banyuma
Evaluasi Clinical Pathway Seksio Sesarea: Keefektifan Penggunaan Antibiotika Injeksi Cefotaxime 2 Gram dalam 24 Jam untuk Mencegah Terjadinya Infeksi Luka Operasi
Get PDFBackground: The usage of prophylactic antibiotics in Dr. Sardjito Hospital, Yogyakarta, is still diverse. Previously, prophylactic antibiotics that were given would be in a form of multidose and or multidrug regimen. Recently, a clinical pathway for c-section had been set up to uniform the antibiotics given. Cefotaime 2g, given intravenously, in 24 hours is the antibiotic of choice. Unfortunately, there was no data about the effetiveness of cefotaime that can be used as a basis of clinical pathway. Objective: Comparing the incidence of surgical site infection (SSI) between cefotaime 2g,/24 hours (clinical pathway or CP) with previous regimen of prophylactic antibiotics (non-clinical pathway or nonCP) and also identify the risk factors.Method: This is a retrospective cohort study with 129 subjects, divided into two groups. The CP group consists of 63 subjects, while non-CP group consists of 66 subjects. The surgical site infection was observed in the day 3 and day 10 aer C-section. Multivariat analysis was used to determine the risk factors of SSI.Result and Discussion: SSI incidence in the CP group at day 3 was higher compared to non-CP group, but it was not statistically significant (OR 4,73 95% CI 0,52 43,04), eukocytosis (>17000/mcl) was the independent risk factor for SSI (OR 7,54 95% CI 1,25 45,39).Conclusion: SSI incidence between two groups was not statistically significant but was clinically significant. The presence of leukocytosis is becoming the risk factor for SSI.Keywords: prophylactic antibiotic, c-section, cesarean section, surgical site infecti