Jurnal Kesehatan Reproduksi
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Hubungan Metode Persalinan dengan Penggunaan IUD Pascasalin di RSUD Panembahan Senopati Bantul
Get PDFLatar Belakang: Periode pascasalin merupakan masa yang penting untuk memulai kontrasepsi, namun masih kurang dimanfaatkan, utamanya untuk penggunaan IUD pascasalin. Hal ini ditunjukkan oleh penggunaan IUD pascasalin hanya 14,06% dari keseluruhan metode kontrasepsi pascasalin. Angka seksio sesarea meningkat signifikan akhir-akhir ini, mencapai 29,6% di Indonesia. Peningkatan angka seksio caesarea (SC) tidak diikuti peningkatan penggunaan IUD pascasalin. Padahal peluang penggunaan IUD pascasalin pada persalinan abdominal/seksio sesarea lebih besar. Tujuan: Penelitian ini bertujuan untuk melihat hubungan antara metode persalinan dengan penggunaan IUD Pascasalin di RSUD Panembahan Senopati. Metode: Penelitian ini merupakan penelitian analitik dengan desain cross sectional atau potong lintang, sampel penelitian diambil dari pasien yang melahirkan di RSUD Panembahan Senopati, data dikumpulkan dengan metode wawancara. Uji Chi square dan prevalence ratio dipakai untuk analisis statistika. Hasil dan Pembahasan: Penelitian ini melibatkan 260 subyek, 161 (61,92%) persalinan vaginal dan 99 (38,08) SC. Total pengguna IUD pascasalin sebanyak 128 (49,23%). Persalinan SC memiliki hubungan bermakna dengan penggunaan IUD pascasalin (p 0,000; PR 1,49; CI 1,19-1,89). Faktor lain yang mempengaruhi penggunaan IUD pascasalin secara bemakna adalah riwayat penggunaan metode kontrasepsi jangka panjang (MKJP) sebelumnya (p 0,002; PR 1,68; CI 1,38-2,06), adanya asuransi Jaminan Kesehatan Nasional (JKN) (p 0,038; PR 1,71; CI 1,04-2,80), dan konseling (p 0,000; PR 2,84; CI 1,85-4,35). Alasan terbanyak subyek menolak penggunaan IUD pascasalin adalah takut efek samping (35%). Kesimpulan: Penggunaan IUD pascasalin lebih tinggi secara bermakna pada seksio sesarea dibandingkan persalinan vaginal. Faktor lain yang mempengaruhi penggunaan IUD pascasalin secara bermakna adalah riwayat penggunaan MKJP, adanya asuransi JKN dan konseling. Kata Kunci: IUD pascasalin; metode persalinan; angka pemasangan; persalinan vaginal, SC
Status Kesehatan Remaja Perempuan yang Mengalami Perkawinan Anak
Get PDFBackground: Indonesia was one of ten countries with the highest child marriage rate, and second highest in ASEAN after Cambodia. According to data, South Sulawesi was province with the 4th position contributing to the marriage of children in Indonesia. In South Sulawesi, age of marriage less than 14 years is 0.5 percent, while age of marriage between 15 years to 19 years is 33.5 percent. Objective: This research aimed to know health status of adolescent girls who have conducted child marriage in Makassar City. Method: This research used descriptive research with quantitative approach. The variables in this research health status from child and mother. The population in this study were all girls aged 15-24 years that chosed by Snowball Sampling nonrandom method with sample size 101 girls. Results and Discussion: Health status in this study form mother and child. For mother, Body Mass Index (BMI) category owned by adolescent girls who experience child marriages, underweight 18 people (17.8%), ideal body weight 66 people (65.3%), and overweight 17 people (16.8%). For child, the status of the weight of the first child at birth, low birth weight (LBW) 8 people (9.9%), not experience LBW 73 people (90.1%). Conclusion: The description of the health status of adolescent girls shows some things that are not good for the health of adolescent girls that can be reviewed in terms of two things, namely the condition of the mother and the condition of the child. The most influential health conditions are the nutritional status of children, immunization of children, nutritional status of mothers, and some knowledge about reproductive health that is still low. Keywords: children; health; marriage; statu
Efektivitas Pendidikan Kesehatan Reproduksi Berbasis Seluler pada Calon Pengantin terhadap Peningkatan Pengetahuan Kesehatan
Get PDFBackground: Every individual needs to know about the issues of sexuality and reproduction before marriage so the reproduction health education is important to give to the prospective bride and groom. Technology-based education is an innovative pathway for providing health information.Objective: to determine the effectiveness of reproduction health education on the improving of knowledge of the prospective bride and groom.Method: Quasi-Experimental research with pretest posttest in Non-equivalent Control Group Design. The data were obtained from a knowledge questionnaire filled out by the prospective bride and groom. This research was conducted at KUA (the Civil Registry Office) Mlati and Gamping, Sleman Regency.Results and Discussion: There was an increase in the average posttest score of knowledge in each group. Based on the results of the data analysis, it was found that the respondents who were given reproduction health education through cellular experienced a greater increase in the post-test score (the difference between the average pretest and post-test score is 5.67) compared to the group who were not given reproduction health education via cellular (the average difference between the pretest and post-test score is 2.2). The Cellular-based reproduction health education significantly (p value = 0.00) influences the prospective bride and groom’s knowledge of the reproduction health.Conclusion: Cellular-based reproduction health education can improve the knowledge of the prospective bride and groom about the reproduction health. Keywords: Reproduction Health; Cellular; Knowledge; Premarital
Hubungan antara Ekspresi P53 Mutan terhadap Operabilitas Kanker Serviks Stadium IIB Pasca Kemoterapi Neoajuvan
Get PDFBackground: The therapy for stage IIB cervical cancer according to FIGO is concurrent chemoradiation. The neoadjuvant chemotherapy followed by radical hysterectomy is an alternative therapy to improve the survival rate of cancer patients. Cervical cancer is mainly caused by the infection of Human Papilloma Virus (HPV), which contains protein E6 and E7 that downregulate the apoptotic function of p53. The absent of p53 wild-type and the present of p53 mutation play roles on the cervical cancer pathogenesis.Objective: To analyze the association between the expression of mutant p53 to the stage IIB cervical cancer operability after neoadjuvant chemotherapyMethod: This study was a prospective cohort, using 40 of 67 patient who met eligibility criteria. The parafin block from cervical tissue were processed for immunohistochemical staining of p53 using Anti-mutant p53 antibody [Y5] ab32049, Abcam, USA. Two study groups were assessed as: 1) weak and 2) strong expression of mutant p53 expression after neoadjuvant chemotherapy based on H-score. Both group (weak and strong) were comparable in term of mutant p53 expression. In this study, the evaluation of operability was performed clinically. Age, BMI, histopathology, grade of differentiation, and regiment were also evaluated as the external variables. Chi square test, and logistic regression analysis were used for statistical analysis.Results and Discussion: The rate of cervical cancer operability after chemotherapy was 19 out of 40 (47.5%). The strong expression of mutant p53 was observed in 6 subjects (15%). There was no significant association between weak vs strong expression of mutant p53 to the operability of the cancer (RR 1.5, CI 95% 0.46-4.88, p 0.45). Multivariate analysis showed that combination (50 mg/m2 dan 5 fluorourasil 450 mg/m2) was significantly correlated the operability (OR 7.02, CI 95% 1.27-40.07, p 0.03). Conclusion: The expression of mutant p53 not correlate with operability after neoadjuvant chemotherapy, but combination regiment was.Keywords: expression of mutant p53, stage IIB of cervical cancer, neoadjuvant chemotherapy, operabilit
Pengetahuan dan Sikap Remaja Sekaa Teruna Teruni di Daerah Urban dan Sub Urban tentang Perilaku Seksual Berisiko
Get PDF Background: Sexual risk behaviors in teenagers, could be a serious problems in health. Geographical clould be influence knowledge and attitudes. Sekaa Teruna Teruni is a Balinese youth organization, they can be found in all traditional villages.Objective: The research aim’s to find out the knowledge and attitudes of Sekaa Teruna Teruni in Urban and Sub Urban areas about risky sexual behavior.Methods: This is an cross-sectional study, respondents are 241 teenagers (15-21 years) sampling methode is consecutive, variables were measured using a questionnaire that had been tested before, analysis uses non-parametric mann whitney.Results adn Discussion:The results showed that p score for knowledge and attitudes <0.05 its means that there are significant.Conclusion: The level of knowledge and attitudes of respondents at the Urban location is higher, that because the flow of information and the organizational activities, efforts are needed to increase knowledge and attitudes especially at the Sub-Urban. Keywords: Risky sexual behavior; Sekaa Teruna Teruni.
Problem Kesehatan Reproduksi Perempuan Usia Subur Eks Pengungsi Timor Timur
Get PDFBackground: The poverty issue affecting refugees, in principle, aggravates the reproductive health of refugee women..Objective: This study aims to capture the reproductive health problems of the eligible women of the former East Timor refugees in 3 refugee camps in Kupang regencyMethod: This study used a mixed method for 81 eligible women. Data were collected by questionnaire and in-depth interview. Data was analysed univariately and explanatively.Results and Discussion: This study found that 80.2% of women in their early teens at the time of their first pregnancy and 53.1% of eligible women who did not use contraception. Meanwhile, only 43.2% of pregnant women regularly did the Antenatal care (ANC), and only 37% of mothers did exclusive breastfeeding. The qualitative findings found 3 main themes; 1) Teenage pregnancy; 2) Pregnancy control; 3) Barriers in accessing reproductive serviceConclusion: Overall, teenage pregnancy has been a serious problem for refugee women, and it has been aggravated by the low awareness to use contraception and to do ANC. Therefore, the government needs to provide comprehensive, tolerant, and congruent reproductive health services based on culture and complexity of the problems in the refugee camp community. Keywords: Reproductive Health; Women; Refugees; East Timo
Faktor yang Berhubungan dengan Penerimaan Alat Kontrasepsi Dalam Rahim Pascasalin di Samarinda
Get PDFBackground: Maternal mortality rate (MMR) in Indonesia is 305 per 100.000 live births. The intervention to suppress MMR according to four pillars of Safe Motherhood is reducing the possibility of woman becoming pregnant with Family Planning. The postpartum period is an important time to start, but underutilized. All contraceptive methods may be used, but the high rate of drop-out in non-long-term methods, counselling is directed to long-term methods like IUD.Objective: To determine factor that related postpartum IUD acceptance in Samarinda.Method: The research method is observational with cross sectional design. Sampling is done by purposive sampling. Data were obtained through questionnaire.Result: There was no significant association between age (p=0.438), parity (RR=0.7; p=0.077), education (RR=1.11; p=0.611), and income (RR=0.69; p=0.105) with acceptance of postpartum IUD. Employment (RR=1.64; p=0.025), history of family planning counselling (RR=3.37; p<0.001), and husband's approval (RR=28.8; p=<0.001) have significant association with the acceptance of postpartum IUD.Conclusion: Age, parity, education, and income are not related factors of postpartum IUD acceptance, while employment, husband's approval, and history of family planning counselling are related factors of postpartum IUD acceptance in Samarinda.Keywords: Postpartum IUD, family planning counselling, husband's approval.
Hubungan antara Preeklampsia Berat Awitan Dini dengan Pertumbuhan Janina Terhambat pada Pasien Preeklamsia Beratdi RSUP Dr. Sardjito Yogyakarta
Get PDFLatar Belakang: Pertumbuhan Janin Terhambat (PJT) merupakan salah satu komplikasi janin yang sering terjadi pada pasien Preeklamsia Berat (PEB) dan eklamsia. Angka kejadian PEB awitan dini berkisar 5-20% dari keseluruhan kasus preeklamsia yang berhubungan dengan neonatal morbiditas dan mortalitas, dimana angka kejadian PJT sendiri berkisar 3-7%, sedangkan angka kejadian PEB awitan lanjut sebesar 75-80% dari keseluruhan kasus preeklamsia yang berhubungan dengan maternal morbiditas.Tujuan: untuk mengetahui hubungan antara PEB awitan dini dan kejadian PJT di rumah sakit Sardjito Yogyakarta.Metode: rancangan penelitian adalah cross sectional study Populasi penelitian adalah pasien preeklamsia dengan janin tunggal yang lahir di RSUP DR. Sardjito Yogyakarta tahun 2013-2015. Sampel penelitian adalah pasien PEB berjumlah 135 subyek, PEB awitan dini 105 subyek, dan awitan lanjut 30 subyek. Uji chi square digunakan untuk menghitung prevalensi PJT pada PEB awitan dini dan lanjut. Stratifikasi mantel-haneszel dilakukan untuk menilai variabel perancu. Multivariat menggunakan regresi logistik.Hasil dan Pembahasan: subyek dengan PEB awitan dini adalah 51 subyek (48,57%) yang mengalami PJT sedangkan awitan lanjut adalah 7 subyek (23,33%). Subyek dengan PEB awitan dini dan preeklamsia genuine memiliki prevalensi PJT lebih tinggi RP (CI 95%)=2,453 (1,170-5,141) dan p=0,007. Prevalensi PJT pada PEB awitan dini, OR (CI95%)=3,257 (1,244-8,530) dan p=0,016; usia OR (CI 95%)=0,488 (0,202–1,178) dan p=0,111; paritas OR (CI 95%)=1,159 (0,461–2,912) dan p=0,11; jenis PE OR (CI 95%)=0,730 (0,294–1,814) dan p=0,498; dan derajat proteinuria OR (CI 95%)=0,955 (0,464–1,968) dan p=0,901. Kesimpulan: PEB awitan dini mempunyai hubungan yang signifikan dengan PJT. Kata kunci: PEB; PEB awitan dini; PEB awitan lanjut; PJT
Hubungan Kadar β-hCG 12 Hari Pasca Transfer Embryo dengan Luaran Kehamilan
Get PDFLatar Belakang: Subfertilitas merupakan salah satu permasalahan yang sering ditemukan di era modern ini. Berbagai metode ditemukan dan digunakan untuk meningkatkan angka keberhasilan reproduksi pada perempuan. Teknologi reproduksi berbantu memiliki risiko terjadinya keguguran dan kehamilan ektopik. Kadar serum β-hCG 12 hari pasca transfer embryo memiliki peranan penting dalam prediksi luaran kehamilan.Tujuan: Untuk memprediksi luaran kehamilan, sensitivitas, spesifisitas serta nilai ambang kadar β-hCG 12 hari pasca transfer embryo.Metode: Penelitian menggunakan rancangan penelitian observasional kohort retrospektif di Klinik Permata Hati RSUP. Dr. Sardjito Yogyakarta tahun 2012 – 2015. Subyek penelitian 130 subyek yang terbagi menjadi 65 subyek dengan kadar β-hCG <76 IU/l dan 65 subyek ≥76 IU/l. Luaran kehamilan diklasifikasikan sebagai viabel (janin hidup pada usia kehamilan ≥ 22 minggu) dan non viabel ( kehamilan biokimia, ektopik, mola dan keguguran).Hasil dan Pembahasan: Median dan minimum kadar β-hCG pada kehamilan viabel 167 IU/l dan 44 IU/l, dan 53 IU/l dan 16 IU/l pada kehamilan non viabel. Terdapat hubungan yang bermakna antara kadar serum β-hCG 12 hari pasca transfer embryo dengan luaran kehamilan. Kadar β-hCG ≥76 IU/l sebanyak 50 (76,9%) pada kehamilan viabel dan sebanyak 15 (23,1%) subyek pada kehamilan non viabel. Kadar β-hCG <76 IU/l sebanyak 7 (10,8%) pada kehamilan viabel dan 58 (89,2%) pada kehamilan non viabel (p=0,000). Kadar β-hCG terendah pada kehamilan ganda 300 IU/l.Kesimpulan: Kadar β-hCG 12 hari pasca transfer embryo bermakna secara statistik dalam membantu memprediksi luaran kehamilan viabel dengan cut-off point 71,5 IU/l, sensitivitas 89,1 % dan spesifitas 79,5 %. Nilai positive predictive value (PPV) adalah 76,9 %, dan nilai negative predictive value (NPV) adalah 89,2%.Kata kunci: Teknologi reproduksi berbantu, subfertilitas, kadar β-hCG, transfer embryo, luaran kehamilan.
Pengaruh Pemberian Parasetamol Intravena untuk Mengurangi Nyeri Persalinan Kala 1 Fase Aktif
Get PDFBackground: Labor was a physiological process, labor pain appeared from regularly uterine contraction, cervix distention and pressure to pelvic floor that stimulate free end nerves. Pain labor can influenced the mother, fetus and the progress of labor. There are various of effort to decrease pain labor by pharmacological or non pharmacological. The best therapy must be safe, effective, and minimal adverse effect to mother and fetus.Objective: To evaluate the effect of paracetamol intraveneous for pain relief in active labor versus saline water.Methods: In randomized controlled trial, with single blinded, 66 primigravid in active labor at RSUD Hj. ANNA LASMANAH Banjarnegara and RSUD Banyumas from November 2016 to January 2017. Sampels divided in two groups, paracetamol group (n=33) and normal saline group (n=33). The primary outcome was the efficacy of paracetamol to relief pain. Intensity of the pain measure by VAS (visual analogue scale), pain measured before drug administration, after 30 minutes, at 1, 2, 3, and 4 hours in both groups. The secondary outcomes include the adverse effect to the mother and baby in both group.Results: The reduction in pain score was significantly greater in paracetamol group than normal saline after 30 minutes, 1, 2, 3, and 4 hours after adiministration of the drug (p<0.05). There was no adverse effect to mother and baby in both groups.Conclusion: Paracetamol intravenous statistically significant decreasing mean pain score than normal saline and safe in active labor.Keywords: Paracetamol, analgesia, active phase in labo