Maternal Mortality Risk Factors in Dr. Hasan Sadikin General Hospital, Bandung in 2009−2013

Objective: To discover the factors affecting the occurrence of maternal deaths. The high maternal mortality rate (MMR) in Indonesia is still a common problem which needs urgent solution.Methods: This is an analytic observational, cross-sectional study using a case control approach Fifty two cases were selected as cases, another 52 were selected as control. The sampling was performed by simple random sampling. The instruments used in this study were the medical records of mothers who gave birth in Dr. Hasan Sadikin General Hospital Bandung from 1 January 2009–31 December 2013. Data analysis was performed using chi-square test. Results: In this study, the results showed that the risk factors contributing to maternal deaths were pregnancy complication (p<0.001), delivery complication (p<0.001), puerpural complication (p=0.022), age (p=0.030), parity (p=0.427), prior medical history (p<0.001), antenatal care (p=0.007), maternal education (p=0.527), and area of residence (p=0.049).Conclusions: The risk factors that contribute to maternal deaths include pregnancy complication, delivery complication, puerpural complication, maternal age, prior medical history, antenatal care, and area of residence. Keywords: Complication, maternal deaths, risk factors DOI: 10.15850/ijihs.v5n2.99

Faktor Risiko Preeklampsia di Puskemas Dupak Surabaya: Studi Kasus Kontrol

Preeclampsia causes maternal death around 30-40% and tends to increase when accompanied by other organ complications. Preeclampsia is the first target to reduce maternal mortality because screening and prevention can be done. This research aims to analyze the risk factors for the incidence of preeclampsia. This research design is case control using primary data via google form. The research subjects were mothers who had given birth at Dupak Public Health Center Surabaya. Sampling was based on total sampling and simple random sampling technique that met the inclusion and exclusion criterias, each group consisted of 75 peoples. The analysis used was logistic regression and chi square. The results showed multiple pregnancies (AOR 3.89; 95% CI 0.714-21.186), family history of preeclampsia (AOR 5.19; 95% CI 1.287-20.959), previous history of preeclampsia (AOR 7.56; 95% CI 1.999-28.601), obesity (AOR 5.05; 95% CI 1.651-15.470) and chronic hypertension (AOR 5.12; 95% CI 1.294-20.312). The conclusion of this research is the previous history of preeclampsia is the strong risk factors of preeclampsia. Comprehensive antenatal care services and strict supervision of pregnant women with high risk can prevent serious complications for both mother and baby.Preeklampsia adalah penyebab kematian ibu tertinggi sekitar 30-40% dan cenderung meningkat bila ditambah dengan komplikasi organ. Preeklampsia merupakan sasaran pertama untuk menurunkan angka kematian ibu karena dapat dilakukan skrining dan pencegahan. Tujuan riset ini guna menganalisis faktor risiko kejadian preeklampsia. Rancangan riset ini adalah case control menggunakan data primer melalui google form. Subjek riset adalah ibu yang telah melahirkan di Puskesmas Dupak Surabaya. Teknik pengambilan sampelnya dengan total sampling serta simple random sampling yang kriterianya memenuhi kriteria eksklusi serta inklusi, masing-masing kelompok berjumlah 75 orang. Analisis yang dipakai yakni chi square dan regresi logistik. Hasil riset menunjukkan hipertensi kronik (AOR 5,12; CI 95% 1,294-20,312), obesitas (AOR 5,05; CI 95% 1,651-15,470), riwayat preeklampsia sebelumnya (AOR 7,56; CI 95% 1,999-28,601), riwayat preeklampsia keluarga (AOR 5,19; CI 95% 1,287-20,959), dan kehamilan kembar (AOR 3,89; CI 95% 0,714-21,186). Simpulan dari riset ini adalah riwayat preeklampsia sebelumnya merupakan faktor tertinggi terjadinya preeklampsia. Pelayanan antenatal care secara komprehensif dan pengawasan ketat pada ibu hamil risiko tinggi dapat mencegah komplikasi yang berat pada ibu dan bayi

Maternal Mortality Risk Factors in Dr. Hasan Sadikin General Hospital, Bandung in 2009−2013

Objective: To discover the factors affecting the occurrence of maternal deaths. The high maternal mortality rate (MMR) in Indonesia is still a common problem which needs urgent solution.Methods: This is an analytic observational, cross-sectional study using a case control approach Fifty two cases were selected as cases, another 52 were selected as control. The sampling was performed by simple random sampling. The instruments used in this study were the medical records of mothers who gave birth in Dr. Hasan Sadikin General Hospital Bandung from 1 January 2009–31 December 2013. Data analysis was performed using chi-square test. Results: In this study, the results showed that the risk factors contributing to maternal deaths were pregnancy complication (p<0.001), delivery complication (p<0.001), puerpural complication (p=0.022), age (p=0.030), parity (p=0.427), prior medical history (p<0.001), antenatal care (p=0.007), maternal education (p=0.527), and area of residence (p=0.049).Conclusions: The risk factors that contribute to maternal deaths include pregnancy complication, delivery complication, puerpural complication, maternal age, prior medical history, antenatal care, and area of residence. Keywords: Complication, maternal deaths, risk factors DOI: 10.15850/ijihs.v5n2.99

Pengaruh Pemberian Vitamin D3 terhadap Kadar Reactive Oxygen Species (ROS) pada Sel PHM1-41 yang Mengalami Hipoksia

Kelahiran preterm (kurang bulan) merupakan salah satu penyebab kematian bayi yang hingga kini menjadi permasalahan di seluruh dunia. Salah satu mekanisme patofisiologis yang menyebabkan kelahiran kurang bulan adalah aktivitas sumbu hipotalamus-pituitari-adrenal (HPA) pada ibu dan janin. Stres maternal biologis berupa hipoksia merupakan salah satu penyebab terjadi mekanisme kelahiran kurang bulan melalui jalur aktivasi sumbu HPA ibu dan sebagai respons terhadap reactive oxygen species (ROS).  Vitamin D3 sebagai salah satu sumber ion Ca2+ dibutuhkan untuk mekanisme kontraksi dan relaksasi otot halus miometrium. Selain itu, vitamin D diduga berpengaruh terhadap kerja sumbu HPA. Tujuan penelitian ini adalah mengetahui pengaruh penambahan vitamin D3 pada sel lini PHM1-41 yang menjadi model in vitro dari kontraksi miometrium pada ibu hamil yang mengalami stres hipoksia terhadap kadar ROS intraseluler sel PHM1-41. Penelitian dilakukan di Laboratorium penelitian Aretha Medika Utama, Biomolecular and Biomedical Research Centre dengan kurun waktu penelitian dari bulan Desember 2017 hingga Februari 2018. Sel PHM1-41 yang telah dikultur dengan keadaan hipoksia selama 24 jam diberi penambahan vitamin D3, kemudian diukur kadar ROS intraselulernya. Hasil menunjukkan bahwa kadar ROS menurun signifikan pada kelompok sel yang diberi penambahan vitamin D3 dengan konsentrasi 150 nM dibanding dengan kelompok sel kontrol hipoksia. Hal ini menunjukkan  bahwa penambahan vitamin D3 150 nM memiliki potensi mencegah kelahiran kurang  bula

Pregnant Human Myometrial 1-41 Cell Viability Test on Vitamin D Administration

Background: Preterm labor is one of the universal causes of perinatal mortality worldwide. One of the causes of preterm labor is uterine muscle integrity problems. Some mechanistic studies show insight into vitamin D activity’s possible role in the injured muscle. This study aimed to determine whether vitamin D can increase muscle cell viability. Methods: This experimental research used human smooth muscle uterine myometrium cell line pregnant human myometrial (PHM) 1-41. The cells were cultured for 24 hours in hypoxia condition, then incubated with several doses of vitamin D. The PHM1-41 cell viability was measured using spectrophotometry. Data analysis was conducted using IBM SPSS 24.0. A p-value <0.05 was considered statistically significant. Results: The result showed that the minimum level of muscle cell viability after vitamin D incubation was with 300 nM administration, and the maximum level was after 10nM (88.57%+4.48 and 96.21%+2.13 respectively). Conclusions: Vitamin D at a specific dose can improve cell availability. The optimal dose to improve cell viability is 10 nM

Effect of Community Education on Community Knowledge of Premature Rupture of Membranes

Premature rupture of membranes (PROM) is still a health problem with a reasonably high incidence among pregnant women in Indonesia. The PROM is defined as the rupture of membranes before signs of labor are observed. Better knowledge on the causes, signs, symptoms, and complications of PROM is believed to help in reducing maternal and infant mortality caused by PROM. This was a cross-sectional, analytic observational study conducted in Cipacing Village, Sumedang, West Java, Indonesia during the period of June-July 2022. . Community education was held to give better knowledge about PROM for women with an obstetric and gynecology specialist and fetomaternal consultant as the resource person. Total sampling was obtained from 62 women. Data were collection using pre-test and post-tests before and after the education session. The mean pre-test score was 6.48, while the mean post-test score was 7.96. A dependent T-test was used to determine the relationship between scores before and after the community education with a p-value of 0.0001. There was a significant increase in knowledge about PROM after the education session compared to before the session. This means community education is effective and impactful to increase the level of knowledge about PROM among women

Association between Maternal Hemoglobin Level and Incomplete Abortion in A West Java Tertiary Hospital, Indonesia

Objective: To evaluate the association between maternal hemoglobin concentrations and incomplete abortion. Methods: An analytic, cross-sectional study with consecutive sampling method was conducted using medical records of 45 pregnant women aged 18 – 35 years old visiting the Obstetrics and Gynecology Department of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from January 1, 2017 to December 31, 2019. Participants were grouped into incomplete abortion and non-abortion groups. Results: Maternal characteristics in the incomplete abortion group showed that the majority of pregnant women in this group were 25.58 years of age, non-anemic (n=37, 82.22%), had no previous spontaneous abortion (n=40, 88.89%), and were nulliparous (n=25, 55.55%) with a mean interpregnancy interval of 4.03 years. The characteristics in both incomplete abortion group and non-abortion group were homogenous in the level of anemia (p-value=0.380), previous spontaneous abortion (p-value=1.00), and interpregnancy intervals (p-value=0.667). The mean hemoglobin concentration for the incomplete abortion group was 11.81 gr/dL (95% CI, 11.30 to 12.26). Heterogenous data was found in age (p-value=<0.001) and parity (p-value=0.002). Parity was a strong confounder, causing the hemoglobin concentration insignificantly associated to incomplete abortion (p-value=0.884). Conclusion: No statistically significant association is found between hemoglobin concentration and incomplete abortion. Most women with incomplete abortion are around 25 years old, nulliparous, non-anemic with a mean hemoglobin concentration of 11.81 gr/dL with no history of previous abortion, and a rather secure interpregnancy intervals

Perbedaan antara Jenis dan Derajat Kelainan Jantung serta Jenis Persalinan terhadap Outcome Ibu dan Bayi pada Kehamilan dengan Penyakit Jantung

AbstrakTujuan: Penelitian ini dilakukan upaya untuk menilai karakteristik dan outcome kehamilan dengan kelainan jantung baik pada ibu dan bayi di RSUP dr. Hasan Sadikin Bandung dari tahun 2015 sampai 2017.Metode: Penelitian ini merupakan penelitian observasional analitik (cross-sectional). Subjek penelitian adalah semua ibu hamil dengan kelainan jantung yang menjalani persalinan di RSUP dr. Hasan Sadikin Bandung dari tahun 2015 − 2017 dengan menggunakan data sekunder. Hasil: Selama periode penelitian sebanyak 76 sampel penelitian yang diperoleh. Pada penelitian ini usia rata-rata ibu adalah 30 tahun, paling banyak pada paritas 1 dan 3 yaitu sebesar 31,6%. Usia kehamilan saat terjadi persalinan  > 37 minggu sebanyak 53,9%. Lama perawatan pasien rata-rata 7 sampai 8 hari dengan ruang rawat yang paling banyak adalah ICU sebanyak 32,9%, dan ruang rawat biasa sebesar 39.5%. Jenis kelainan jantung yang paling sering adalah kardiomiopati peripartum dan hipertensi, yaitu sebesar 42,1%. Jenis persalinan yang banyak dilakukan adalah seksio sesarea yaitu sebesar 64,5%. Penelitian ini memperoleh bahwa ibu dengan kelainan jantung yang hidup sebesar 88,2% dan meninggal sebesar 11,8% setelah menjalani persalinan.Kesimpulan: Ada perbedaan antara derajat kelainan jantung berdasarkan NYHA (New York Heart Association) dengan outcome ibu dan bayi pada kehamilan dengan kelainan jantung.Differences between Types and Degrees of Heart Disorders and Types of Labor in the Outcome of Mothers and Babies in Pregnancy with Heart DiseaseAbstractObjective: through this research conducted efforts to assess the characteristics and outcome of pregnancy with cardiac disease both in mother and infant in dr dr. Hasan Sadikin Bandung from year 2015 to 2017.Method: an observational analytic (cross-sectional) research with subjects were all pregnant women with cardiac abnormalities who underwent delivery at dr. Hasan Sadikin Bandung from 2015 to 2017 using secondary data.Results:During the research period as many as 76 samples obtained. In this study the average age of the mother is 30 years, most at parity 1 and 3 that is equal to 31.6%, age of pregnancy during labor> 37 weeks by 53.9%. The average length of patient care was 7 to 8 days with the most hospital room was ICU of 32.9% and the regular room was 39.5%. The most common types of heart disorders are peripartum cardiomyopathy and hypertensive heart disease, which is 42.1%. Type of delivery mostly by cesarean section that is equal to 64.5%. The study found that mothers with heart abnormalities were 88.2% alive and died of 11.8% after going through labor.Conclusion: There is a difference between the degree of cardiac abnormalities based on NYHA (New York Heart Association)  classification with maternal and infant outcomes in pregnancy with cardiac abnormalities.Key words: Type and Degree of Heart Abnormality, Type of Birth, Outcome of Mother and Infan

Korelasi antara Kadar 25 Hidroksi Vitamin D3 dengan Kekuatan Levator Ani pada Primipara 42 Hari Pascapersalinan Spontan

AbstrakTujuan: Menganalisis korelasi antara kadar 25 hidroksi vitamin D3 dengan kekuatan kontraksi levator ani pada primipara 42 hari pasca persalinan spontan. Metode : Penelitian observasional analitik dilakukan pada primipara pasca persalinan spontan yang memenuhi kriteria inklusi penelitian (n=48). Penelitian dilakukan di Poliklinik Obstetri dan Laboratorium Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin bulan Agustus-September 2017. Dilakukan pengukuran kadar vitamin D serum, serta pemeriksaan perineometer tonus basal dan kontraksi maksimal levator ani subjek. Data yang didapat diolah menggunakan SPSS 23 untuk windows.   Hasil: Terdapat korelasi positif antara kadar vitamin D dengan tonus basal levator ani (r=0,76, r2 = 0,58) dan antara kadar vitamin D dengan kontraksi maksimal levator ani (r=0,803, r2 = 0,645) yang bermakna secara statistik (p <0,05). Penelitian ini menunjukkan terdapat korelasi kuat dengan arah korelasi positif  antara kadar 25 hidroksi vitamin D3 dengan kekuatan kontraksi levator ani pada primipara 42 hari pasca persalinan spontan. Kesimpulan : Kadar vitamin D yang tinggi diduga akan meningkatkan kontraksi levator ani pada primipara pasca persalinan spontan. Correlation between 25 Hydroxy Vitamin D3 Levels with Levator Any Muscle Strength in Primipara 42 Days After Spontaneous DeleveryAbstract Objective: To analyze the correlation between 25 hydroxy vitamin D3 levels with the strength of levator ani contraction at primipara 42 days post-spontaneous delivery. Method: Observational analytic study  was conducted on spontaneous postpartum primiparas meeting the inclusion criteria (n=48). The research was conducted in Obstetric Polyclinic and Clinical Serology Clinical Pathology Laboratory of Faculty of Medicine Universitas Padjadjaran/ Dr. Hasan Sadikin General Hospital  in August-September 2017. A serum vitamin D assay was performed, vaginal resting tone and maximum contraction of the levator ani was measured with the perineometer on the subject. Data was analyzed by SPSS 23 for windows. Results: There were positive correlation between vitamin D level and vaginal resting tone (r=0,76, r2=0,58) and between vitamin D level with maximum contraction of levator ani (r=0,803, r2=0,645) which was statistically significant (p<0.05). The study showed that there was a strong positive correlation  between the levels of 25 hydroxy vitamin D3 with the strength of levator ani contraction in primipara 42 days post-spontaneous delivery. Consclusion: High levels of vitamin D can supposedly improve levator ani contraction in primipara post spontaneous delivery. Key  words: 25 Hydroxy vitamin D3, levator ani contraction, perineomete

Bankruptcy Prediction Using Genetic Algorithm-Support Vector Machine (GA-SVM) Feature Selection and Stacking

Bankruptcy is an impact caused by a company's financial failure. Financial failure in the company must be avoided so as not to cause losses to the company. In the research that was carried out utilizing a data set from the Taiwan Economic Journal as many as 6,819 to be trained using machine learning algorithms using classification techniques. The goal obtained from the research conducted is to obtain a classification technique with the best accuracy results. The method used in this research is preprocessing using the synthetic minority over-sampling technique to handling unbalanced data sets. Then, the results of the balanced data set will be processed using a genetic algorithm-support vector machine feature selection algorithm to reduce the attributes of the data set. Data sets that have experienced reduced attributes will be trained using the stacking method with a single classifier base learner in the form of k-nearest neighbors, naïve bayes, decision trees with classification and regression tree models, gradient boosting decision trees, and light gradient boosting. The meta-learner used in the stacking method is extreme gradient boosting. The results of the accuracy obtained from the research conducted were 99.22%