Jurnal Kesehatan Reproduksi
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Hubungan Umur Ibu, Paritas dan Penolong Persalinan dengan Kematian Neonatal di Wilayah Kerja Puskesmas Kabupaten Banjarnegara tahun 2013
Get PDFBackground: The neonatal mortality rate is Banjarnegara district is high compared with a target of IMR in Central Java province. In 2012 the neonatal mortality rate in Banjarnegara reached 316 cases, whereas in 2013 there were 115 cases in all health centers working area. The high neonatal mortality rate in Banjarnegara influenced by the persistence of early marriage in woman, birth attendant by non skilled health worker (dukun bayi) and women’s parity more than 4.Objective: The purpose of this study is to analyze the correlation between maternal age, parity and birth attendants with the incidence of neonatal mortality and examine the most dominant factors influencing the incidence neonatal mortality in the Health Center working area in Banjarnegara.Method: This study is a case control study design with retrospective approach. The data consists of perinatal verbal autopsy and medical records as many as 136 respondents consisting of 68 mothers who gave birth to her child and neonatal death and 68 maternal and child alive. Subjects were mothers who gave birth a baby who died aged 0-28 days.Result and Discussion: Statistical analysis using Chi Square, Mann Whitney, and multiple logistic regression. The results showed maternal age and parity variables were not significantly corerelated with neonatal mortality (p> 0.05), the variables significantly corerelated with neonatal mortality was birth attendants with p = 0.001. The results of logistic regression showed the strength of the corerelation from the most dominant variable to the smallest variable were birth attendants with OR: 5.64 (95% CI: 1.81 to 17.4), maternal age OR 3.97 (CI 95%, from 1.54 to 10.22), and parity OR: 0.32 (CI 95% 0.12 to 0.87).Conclusion: In conclusion, there was no relationship between maternal age and parity with neonatal mortality but there was a relationship between birth attendants with neonatal mortality. Based on the results of the multivariable analysis, birth attendants’ effect on the incidence of neonatal deaths was 5 times greater than mother’s age and parity.Keywords: Neonatal mortality, maternal age, parity, birth attendant
HUBUNGAN KADAR ANTI MULLERIAN HORMONE (AMH) DENGAN KEBERHASILAN STIMULASI OVARIUM PADA FERTILISASI IN VITRO METODE PROTOKOL PANJANG
Get PDFHUBUNGAN KADAR ANTI MULLERIAN HORMONE (AMH)DENGAN KEBERHASILAN STIMULASI OVARIUM PADAFERTILISASI IN VITRO METODE PROTOKOL PANJANGRidho Permana, Shofwal Widad, M. LutfiABSTRACTBackground: Patient with decline oocyte number and quality assumed has lower Anti Mullerian hormone(AMH). AMH concentration which expressed by the granulosa cells of preantral and small antral folliclesindirectly determine the ovarian reserve. Therefore, AMH may be used as a marker of ovarian ageing andassociated with ovarian response in in vitro fertilization (IVF).Objective: To determine the effect of Anti Mullerian Hormone (AMH) on ovarian response in IVF longprotocol method.Method: This research is a retrospective cohort study in Permata Hati Fertility Clinic, IVF program-Dr.Sardjito Hospital, Yogyakarta, Indonesia. Seventy one cycle enrolled in an IVF program conducted fromJanuary 2011 through December 2013 at the Permata Hati Fertility Clinic.Result and Discussion: ROC curve were used to determine cut-off AMH. With cut-off point 2.59 ng/ml,subject divided into two groups (high AMH level: ≥2.59 ng/ml and low AMH level: <2.59 ng/ml). Totaldose gonadotropin was significantly different in two groups (p=0.02). High AMH and low AMH levelwere significantly associated with ovarian response (RR 2,05; CI 95% 1,32 – 2,20 ; p< 0,01). BesideAMH, multivariate analysis shows basal LH level (p=0,04; OR 7,22; CI 95% 1,09 – 47,87) and peritonealendometriosis (p=0,03; OR 7,80; IK 95% 1,15–52,81) were significantly influenced ovarian response in IVF.Conclusion: high AMH level influence ovarian response in IVF. Total dose gonadotropin on low AMH levelswas greater than high AMH level. In addition to AMH, ovarian response were influenced by basal LH leveland peritoneal endometriosis.Keywords: Anti Mullerian hormone (AMH), ovarian response, long protocol stimulation, in vitro fertilization(IVF).ABSTRAKLatar belakang: Pasien dengan penurunan jumlah dan kualitas oosit diduga mempunyai kadar AntiMullerian Hormone (AMH) lebih rendah. Konsentrasi Anti Mullerian Hormone (AMH) yang dihasilkanfolikel ovarium secara tidak langsung menggambarkan cadangan ovarium yang tersisa. Karenanya kadarAnti Mullerian Hormone (AMH) dapat digunakan sebagai prediktor yang akurat dari cadangan ovarium danrespons stimulasi ovarium pada fertilisasi in vitro.Tujuan: Untuk mengetahui pengaruh kadar Anti Mullerian Hormone (AMH) terhadap keberhasilanstimulasi ovarium pada fertilisasi in vitro pada metode protokol panjang.Metode: Penelitian ini menggunakan rancangan kohort retrospektif observasional.Hasil dan Pembahasan: Sebanyak 71 siklus dari 71 pasangan yang menjalani fertilisasi in vitro disertakandalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Dengan cut off point AMH ditetapkan 2,59 ng/ml, maka subyek ini dibagi menjadi 2 kelompok yaitu ≥2,59 ng/ml sebagai kelompok AMH tinggi dan <2,59 ng/ml sebagai kelompok AMH rendah. Perbedaan bermakna antara dua kelompok ditemukan pada dosistotal gonadotropin (p=0,02).Terdapat perbedaan bermakna respons stimulasi ovarium antara AMH tinggidan AMH rendah (RR 2,05; IK 95% 1,32 – 2,20 ; p< 0,01). Kadar LH basal (p=0,04; OR 7,22; IK 95% 1,09 –47,87) dan endometriosis peritoneal (p=0,03; OR 7,80; IK 95% 1,15–52,81) juga mempengaruhi respons terhadap stimulasi ovarium.Kesimpulan : AMH tinggi mempengaruhi respons terhadap stimulasi ovarium. Dosis total gonadotropinpada AMH rendah dibutuhkan lebih banyak dibandingkan dengan AMH tinggi. Selain AMH, responsterhadap stimulasi ovarium juga dipengaruhi oleh kadar LH basal, dan endometriosis peritoneal.Kata kunci : kadar Anti Mullerian hormone (AMH), stimulasi ovarium protokol panjang, fertilisasi in vitro.Bagian Obstetri Ginekologi, Fakultas Kedokteran, Universitas Gadjah Mada Yogyakart
Perbandingan Skala Nyeri pada Kuretase antara Pemberian Lidokain Paraservikal dan Intraservikal
Get PDFBackground: Curettage is a gynecological diagnostic and therapeutic procedures. Curettage actions causing sensation of pain although the pain threshold is different for each person. Local anesthesia is an effective choice for various minor gynecological procedures. One of them is paracervical block. Paracervical block reduces pain by blocking nerve impulses across the uterovaginal plexus. Another method is the injection of local anesthetic trough intracervical who works as an anesthetic infiltrating agent, distending the tissue, causing mechanical disruption of nerve impulses. Theoritically, intracervical lidocaine injection will require a lower level of precision than the blockade of peripheral nerves directly, more reliable and reproducible. We measured patient’s pain during curettage usingthe Visual Analogue Scale (VAS). Method: RCT Location of study: Bantul District Hospital, Wonosari District Hospital, and Banjarnegara Distric Hospital. Result and Discussion: The study included 60 patients who got curettage within inclusion criteria. Every time patients came, we performed randomization and divided the patients into two groups, the control group (paracervical) and intervention group (intracervical), 30 subjects each. VAS was measured 5 minute after curettage was started. Characteristics of subjects in curettage frequency, curettage indication, parity and educational level for both groups are equal, did not differ statistically. The results of the mean pain scale (VAS). In the control group was 42,33±16,583 and 34,33±18,880 on the treatment group. Mean difference was 8 mm, with 95% CI -1.124 to 17.124 and p=0.408. The difference was not significant statistically. The intracervical group has mild pain scale (VAS<44 mm) in 27 of 30 patient, compared to 15 of 30 patients in paracervical group. It result in Relative Risk (RR) of 1,532. Conclusion: Intracervical lidocaine injection can be considered as an alternative local anesthetic on curettage. The average pain scale did not differ significantly with paracervical block. And both of it located in VAS < 44mm (mild pain). Intracervical lidocaine injection even have RR= 1,532 compared with paracervical block to produce mild pain scale (VAS < 44 mm). Keywords: curettage; paracervical;intracervical ;VAS
Pengetahuan tentang Infeksi Menular Seksual dengan Perilaku Seksual Tidak Aman pada Remaja Putri Maluku Tenggara Barat di Daerah Istimewa Yogyakarta
Get PDFBackground: Based on the Indonesian Demographic and Health Survey (IDHS, 2012), adolescents’ knowledge (females aged 15-24 years) about STI (Sexually Transmitted Disease) is still low under 50%. A total of 16.46% Indonesian adolescents have had sex, 46.26% of them have been doing it actively, first sex occurred in below 20 years of age.Objective: To determine the relationship between knowledge about sexually transmitted infections with unsafe sexual behavior.Method: This study is a quantitative and qualitative with cross-sectional study design. Subjects in this study were all female adolescents of West Southeast Moluccas who are continuing education in Yogyakarta. Univariable and bivariable data analysis was conducted using chi-square test statistic. Multivariable analysis was conducted using logistic regression to estimate the effective model.Result and Discussion: Low knowledge STI is practically and statistically related to unsafe sexual behavior with a p-value <0.05, RP 1.71 and CI 1.07 to 2.70. Low knowledge about STIs in adolescents increase the risk by 1.7 times for unsafe sexual behavior. Conclusion: 67,1% female adolescent who have unsafe sexual behavior. Female adolescents who have knowledge about STIs low 65.7%. Low knowledge STI significantly increases unsafe sexual behavior in adolescent girls. Unsafe sexual behavior conducted by adolescent female are sexual intercourse before the age of 20 not using condoms during sexual intercourse, and multiple sexual partner.Keywords: Knowledge of Sexually Transmitted Infections, Unsafe Sexual Behavior, Female Adolescen
Efek Minyak Esensial Lavender Dibandingkan dengan Minyak Esensial Jahe terhadap Intensitas Nyeri Menstruasi pada Remaja
Get PDFBackground: Menstrual pain is the pain in the abdomen which is perceived before or during menstruation, that even when the menstrual pain is heavily painful, the sufferers leave their activities. Research in 2011 showed that the rate of occurrence of primary menstrual pain in Indonesian adolescences was about 54.89%. Various therapies have been used to cure the pain, both pharmacologically and nonpharmacologically. Pharmacologically, it is done by the usage of NSAID, and non-pharmacologically is done by using essential oil.Objective: To know about the effects of lavender essential oil compared to ginger essential oil toward the intensity of menstrual pain in the adolescences of SHS 1 Muncar.Method: True experimental design, with randomized pretest posttest design plan. Time of data retrieval was August-September 2014 in SMA 1 Muncar, Banyuwangi, East Java. Population in this research were female adolescences in class of X and XI, with the amount of 260 students, with samples’ amount of 30 for each treatment group. The sampling technique was simple random sampling. The dependent variable are the giving of lavender and ginger essential oils, meanwhile the independent variable are the reduction of the intensity of menstrual pain. Instrument which was used was Numerical Rating Scale. The data analysis used the Wilcoxon and Mann-Whitney Test.Result and Discussion: The intensity of pain before and after intervention of essential oil of lavender and ginger are 5,47±1,19 vs 2,93±1,53, P=0,00 and 5,40±0,96 vs 2,93±1,43, P=0,00, respectively. Comparison of the effects essential oil of lavender and ginger have P >0,05.Conclusion: Both lavender essential oil and ginger essential oil are effective in reducing the intensity of menstrual pain in adolescences. Keywords: Menstrual pain, Essential oils, Lavender, Ginger, Adolescence
Interaksi Sosial dalam Kejadian Abortus Provokatus Kriminalis di Kabupaten Bulukumba Provinsi Sulawesi Selatan
Get PDFBackground: Many factors influence the decision to commit abortions, among all are marital status and educational status which most are still in school, economic pressure, multiparity or contaception failure. The social interaction is a connection between t the people who perform abortion and their suggestive environment.Objective: to observe the social interaction that happend among the person who perform abortion and the surrounding society.Method: This research makes use of qualitative method to understand the motives behind abortion practice, through an indepth interview. The sample collection is performed on H. A. Sulthan Dg Radja Hospital and Daffiku Hospital Bulukumba.Result and Discussion: Subject who performed abortion was influenced by internal and external factors. The internal factors include anxiousness, financial worrisome to support the child and fear of embarrassing the family in an unmaried women. As for the external factor includes pressure from families and friends who insist on performing abortion and the help from traditional healer on performing abortion. These two factors are not independent, and between them there are interactions to materialize abortion practice.Conclussion: Social interaction between individuals and between individual and the environment are an important role against abortion in decision making to have an provocative abortion.Keywords: Social interaction, abortion, factors for abortio
Robekan Perineum pada Persalinan Vaginal di Bidan Praktik Swasta (BPS) Daerah Istimewa Yogyakarta Indonesia Tahun 2014-2016
Get PDFBackground: Vaginal delivery is the most preffered mode of delivery by all women, and the birth attendants. The vaginal delivery assistance was conducted by various health professionals such as midwives, physicians, and obstetricians. Various complaints of pelvic floor dysfunction and complaints related to the perineum as a result of vaginal perineal laceration during childbirth can affect the quality of life of a woman.Objective: To identify and conduct an analysis of maternal factors (maternal age, parity, gestational age), fetal factor (birth weight), and the labor factor (duration of 2nd stage of labor), with the occurrence of perineal rupture in vaginal delivery at the 5 Midwife’s Private Clinic (MPC), Yogyakarta, Indonesia.Method: Retrospective medical record searching, from January 2014 until December 2016.Result and Discussion: There were 1595 obtained samples of data that met the criteria for inclusion and exclusion. Number of perineal laceration reached 1201 (75.3%), with 1.9% of them are grade 3. Perineal rupture occurred in 80.55% of vaginal deliveries at young age, 69.14% in more than 35 years old women, and 85.05% primiparas. There was significant negative correlation (0.186) between parity and perineal rupture (p=0.000). The less the parity, the higher the incidence of perineal rupture (p=0.002). There was significant correlation between baby’s weight less than 2500 gram and perineal rupture but not for the baby’s weight more than 4000grams (p=0.304). The correlation was positive which meant that the heavier the baby’s weight the higher the incidence of perineal rupture. There was significant positive correlation (p=0,018) for the duration of 2nd stage of labor between 30-60 minutes and perineal rupture(0.061). The correlation was positive as well (0.092) for the duration of 2nd stage of labor more than 60 minutes and perineal rupture( p=0.002). The longer the duration of the 2nd stage of labor the higher the incidence of perineal rupture.Conclusion: There was significant relationship between parity, and duration of the 2nd stage of labor and perineal rupture in vaginal delivery.Keywords: perineal rupture, vaginal delivery, parity, duration of the 2nd stage of labo
PRESERVASI FERTILITAS PADA PENDERITA KANKER
Get PDFPRESERVASI FERTILITAS PADA PENDERITA KANKER*Heru Pradjatmo1ABSTRACTBackground: Young women who survive from cancer as candidates to face reproductive problemsassociated with cytotoxic cancer therapy. Side effects that alter the quality of life becomes unacceptable.Advances in reproductive medicine enables previously infertile women can obtain offspring.Objective: To recognize the effort that can be done to prevent adverse effects on fertility patients due tocancer therapyMethod: Literature studyResult and Discussion: In general, women age 40 years or less with cancer who received chemotherapy tobe likely ovarian function will cease. Studies show that many technique performed before chemotherapyallows women to have babies would be greater. Women prior to treat chemotherapy should be consultedto physicians in the field of reproductive and endocrinology for fertility preservation methods to deal withoncologist who take care the patient. All methods that can be performed should be included in counselingand all counseling and treatment including possible complications should be documented and recorded.Keywords : infertility, chemotherapy, adverse effect, preservationABSTRAKLatar Belakang: Perempuan muda yang survive dari penyakit kanker menjadi kandidat menghadapimasalah reproduksi berkaitan dengan terapi kanker yang bersifat sitotoksik. Sehingga efek samping yangmerubah kualitas kehidupan menjadi tidak dapat diterima. Kemajuan dalam kedokteran reproduksimemungkinkan wanita yang sebelumnya infertil akibat prngobatan penyakit kanker sekarang dapatmemperoleh keturunan.Tujuan: Untuk memahami upaya yang dapat dilakukan untuk mencegah terjadinya efek samping terhadapfertilitas penderita akibat terapi kanker.Metode: Studi literaturHasil dan Pembahasan: Secara umum perempuan penderita kanker sampai umur 40 tahun yangmendapat kemoterapi kemungkinan dapat berhenti fungsi ovariumnya. Studi menunjukkan bahwabeberapa teknik yang dilakukan sebelum kemoterapi memungkinkan wanita memperoleh keturunan lebihbesar. Seharusnya sebelum terapi dikonsulkan ke dokter dibidang reproduksi untuk metode preservasifertilitas dengan kesepakatan ahli onkologi yang menangani. Semua metode yang dapat dilakukan harusdimasukkan dalam konseling. Semua konseling dan pengobatan termasuk komplikasi yang mungkin terjadiseharusnya di dokumentasikan dan dicatat.Kata Kunci: infertilitas, khemoterapi, efek samping, preservasi1 Bagian Obstretika & Ginekologi Fakultas Kedokteran UGM/RSUP Dr. Sardjito Yogyakarta* Dipresentasikan pada seminar in vitro maturation (IVM) in vitro fertilization andlaparoskopic surgery, Yogyakarta, 8-9 November 201
Perilaku Ibu dalam Memilih Tenaga Penolong Persalinan di Wilayah Kerja Puskesmas Tembilahan Hulu Tahun 2016
Get PDFBackground: Maternal Mortality Rate (MMR) is an indicator of health development in Indonesia. Some effort have been done to decrease maternal mortality ie to increase range labor by health personnel. The target coverage of labor by health personnel in Tembilahan Hulu Public health center has yet to reach the target of 80%. its coverage was only 45%. The number of maternal mortality in Tembilahan Hulu Health center in 2016 was 1 cases and the number of infant maternal mortality was 5 cases.Objective: The purpose of this study was to determine the mother’s behavior in selecting birth attendants in health center in the region of the upstream Tembilahan Hulu.Method: This research used qualitative method to gain the in depth information on how to Mother’s Behavior In Selecting Birth Attendants In Health Centers Working Area Tembilahan Hulu 2016. The data are analysed by using content analysis, which is comparing the result from the research with the theories in the literature.Result and Discussion: There were 13 informants in this research. This study’s result showed that the decision for birth attendants were closely related to knowledge, attitude, socio-cultural, access to health center, and support from family. Advise to relevant agencies, namely health centers Tembilahan Hulu order to further increase coverage deliveries by health care and in personels villages to which access is far from health facilities to build Birth Waiting Homes (BWH).Conclusion: The Decision for birth attendants were closely related to knowledge, attitude, socio cultural, acces to health center and support from family.Keywords: birth attendant, community health center, pregnant women behavio
KESEHATAN REPRODUKSI MAHASISWA : KEBUTUHAN INFORMASI DAN PELAYANAN Studi Kualitatif di Jakarta Barat
Get PDFKESEHATAN REPRODUKSI MAHASISWA : KEBUTUHANINFORMASI DAN PELAYANANStudi Kualitatif di Jakarta BaratRaditya Wratsangka1ABSTRACTBackground: Young people comprise students are a considerably large segment of the world populationwith important future roles, who face reproductive health-associated risks, such as sexually transmitteddiseases, HIV/AIDS, sexual violence, unwanted pregnancy, and unsafe abortion. They are less informed,less experienced, and less comfortable in accessing reproductive health services and even face resistancefrom adults when attempting to do so.Objective: To assess the reproductive health information, types, access and models of services requiredby students.Method: This was a qualitative study involving students from three universities in West Jakarta. Datacollection was by focus group discussion and indepth interviews. Data were validated by triangulation ofinformation sources and method. Data analysis was performed by content analysis method to extract theroot of the problem.Result and Discussion: Fourteen unmarried students were involved as informants/respondents. Severalhad inadequate knowledge of reproductive health and difficulties in accessing appropriate informationsources, so that they engaged in risky behavior for various reasons. The informants expressed their needfor reliable information, accessible and friendly professional counselling and clinical reproductive healthservices, and also that guarantee their privacy.Conclusion: Information, counselling and clinical services should be instituted that meet the requirementsof students for improving their reproductive health.Key words: reproductive health, information, counselling, servicesABSTRAKLatar Belakang: Kaum muda -termasuk mahasiswa- dengan populasi yang besar dan peran yang penting dimasa depan, menghadapi berbagai risiko yang berkaitan dengan kesehatan reproduksinya, seperti: infeksimenular seksual, HIV/AIDS, kekerasan seksual, kehamilan yang tidak diinginkan dan aborsi yang tidakaman. Selama ini kaum muda kurang mendapatkan informasi, kurang berpengalaman, dan kurang nyamanmengakses pelayanan kesehatan reproduksi, bahkan mendapat tentangan dari kelompok dewasa, ketikamereka mencoba untuk memperoleh informasi dan pelayanan kesehatan reproduksi yang dibutuhkan.Tujuan: Mendapatkan gambaran tentang informasi, jenis, akses dan model pelayanan kesehatan reproduksiyang dibutuhkan oleh mahasiswa.Metode: Penelitian ini merupakan studi kualitatif dengan melibatkan mahasiswa dari 3 Universitas diJakarta Barat. Pengumpulan data dilakukan dengan teknik diskusi kelompok terarah dan wawancara mendalam. Validasi data dilakukan dengan teknik triangulasi sumber informasi dan metode. Analisis datadilakukan dengan content analysis method untuk menggali akar permasalahan.Hasil dan Pembahasan: Sebanyak 14 mahasiswa dilibatkan sebagai informan/responden yang semuanyabelum menikah. Sebagian informan kurang pengetahuannya di bidang kesehatan reproduksi, mengalamikesulitan mengakses informasi dan sumber yang tepat, sehingga terlibat dalam perilaku berisiko. Parainforman umumnya menyatakan kebutuhannya terhadap pelayanan konseling dan klinis kesehatanreproduksi yang profesional, mudah diakses, ramah dan tetap bisa menjaga privacy mereka.Kesimpulan: Dibutuhkan pelayanan informasi, konseling dan klinis yang sesuai kebutuhan mahasiswauntuk meningkatkan kesehatan reproduksinya.Kata kunci: kesehatan reproduksi, informasi, konseling, pelayanan1 Bagian Obstetri dan Ginekologi - Fakultas Kedokteran Universitas Trisakti /Pusat Konseling, Informasi dan Edukasi Kesehatan Reproduksi Universitas Trisakt