Efektifitas Aromaterapi Lavender untuk Mengurangi Mual dan Muntah pada Ibu Hamil

The discomfort of nausea and vomiting is generally experienced by pregnant women. One of the treatments to reduce non-pharmacological therapy is giving lavender aromatherapy. The purpose of this study was to determine the effect of giving lavender aromatherapy to reduce nausea and vomiting in pregnant women during pregnancy. This research uses a pre-experimental approach with a one group pre-test-post-test approach. The population in the study were pregnant women who experienced nausea and vomiting as many as 30 respondents. Thenik sampling used purposive sampling with a sample of 15 respondents. The method of data collection is observation. Univariate data analysis using frequency distribution and Bivariate analysis using Paired sample t-test. the initial frequency was 93.33% for pregnant women who experienced moderate nausea and vomiting and 6.66% experienced nausea and vomiting in the mild category. Bivariate analysis found that there was a significant effect between decreasing the frequency of nausea and vomiting before and after giving lavender aromatherapy, namely p-value .000 with alpha 0.05, then p-value (.000) <α 0.05. It can be concluded that this study shows that giving lavender aromatherapy can reduce nausea and vomiting in pregnant women during pregnancy at PMB Fauziah Hatta Palembang in 2022. Abstrak Emesis gravidarum merupakan kondisi yang terjadi pada kehamilan muda, yang seringnya terjadi di pagi hari yang dikenal dengan morning sickness. Akan tetapi ada yang mengalami mual muntah yang berlebihan. Salah satu penatalaksanaan untuk mengurangi terapi non-farmakologi adalah pemberian aromaterapi lavender. Tujuan penelitian untuk mengetahui efek pemberian aromaterapi lavender untuk mengurangi mual muntah pada wanita hamil dimasa kehamilan. Penelitian ini menggunakan pra-eksperimental dengan pendekatan one group pre test-post test. Populasi dalam penelitian yaitu ibu hamil yang mengalami mual muntah sebanyak 30 responden. Thenik sampling menggunakan purposive sampling dengan jumlah sampel 15 responden. Metode pengumpulan data yaitu observasi. Analisis data univariat menggunakan distribusi frekuensi dan analisi Bivariat menggunakan Uji Paired sampel t-test.Frekuensi awal didapatkan 93,33% untuk ibu hamil yang mengalami mual muntah dikategorikan sedang dan yang mengalami mual muntah pada kategori ringan sebanyak 6,66%. Analisa Bivariat didapatkan bahwa adanya pengaruh yang signifikan antara penurunan frekuensi mual muntah sebelum dan sesudah pemberian aromaterapi lavender yaitu p-value .000 dengan alpha 0,05 maka p-value (.000) <α 0,05. Simpulan penelitian ini menunjukkan bahwa pemberian aromaterapi lavender dapat menurunkan muntah mual pada ibu hamil dimasa kehamilan di PMB Fauziah Hatta Palembang Tahun 2022

Recurrent postmenopausal bleeding:Pathological findings and predictive factors. A multicenter, prospective, observational study

Introduction: Recurrent postmenopausal bleeding (PMB) occurs in 6%–25% of postmenopausal women who have experienced a previous episode of PMB. The question of whether recurrent PMB leads to a higher risk of endometrial cancer (EC) in comparison to a single episode of PMB is, however, controversial. Furthermore, little is known about predictive factors for recurrent PMB. Material and Methods: A multicenter prospective cohort study was conducted over a 5-year period in four hospitals in the Netherlands. Women with PMB undergoing endometrial sampling and aged 40 years and older were included. Occurrence of recurrent PMB was retrospectively determined. Primary outcomes included (1) the incidence of recurrent PMB and (2) differences in pathological findings between patients with a single episode vs recurrent PMB. Secondary outcomes included (1) the association between diagnosis of benign polyps at first PMB and pathological findings at recurrent PMB and (2) factors predictive for recurrent PMB. Results: A total of 437 women with PMB were included, of whom 360 were at risk of recurrent PMB. With a median follow-up of 61 months (IQR (Interquartile range) 44–73), 26.4% experienced recurrent PMB. Patients with recurrent PMB were more often diagnosed with benign polyps (34.7% vs. 25.1%, p-value 0.015) and less frequently with a malignancy (5.3% vs. 17.8%, p-value 0.015), compared to patients with a single episode of PMB. Benign polyps at initial PMB were not associated with a (pre)malignancy at recurrence (OR 4.16, 95% CI 0.75–23.03). Predictive factors for recurrent PMB included use of hormone replacement therapy (HRT) (OR 3.32, 95% CI 1.64–6.72), and benign polyps at initial PMB (OR 1.80, 95% CI 1.07–3.04). Conclusions: Recurrent PMB is common in women with a previous episode of PMB. Compared to patients with a single episode of PMB, patients with recurrent PMB and benign histological outcomes at accurate workup during their first episode were less often diagnosed with malignancies and more frequently with benign polyps. Benign polyps at first PMB are predictive for recurrent PMB, but not for a higher risk of (pre)malignancy.</p

Diagnostic workup of patients with benign or inconclusive reports on office endometrial biopsy after first episode of postmenopausal blood loss

Background: Postmenopausal bleeding carries a risk of endometrial cancer, and office endometrial sampling (OES) is often the first diagnostic approach. Whether further diagnostic procedures such as hysteroscopy or saline infusion sonography (SIS) are required to rule out polyps and malignancies is uncertain. The objective of this study is to evaluate whether clinicians perform further diagnostic tests when OES is benign or inconclusive. Secondary outcomes include the patient characteristics associated with the likelihood of performing further diagnostic tests and the incidence of endometrial intraepithelial neoplasia and endometrial malignancy. Methods: We performed a multicenter, prospective cohort study, evaluating patients with a first episode of postmenopausal bleeding, with an endometrial thickness of &gt;4 mm on 2D vaginal sonography and a benign or inconclusive result of an OES. Patients who underwent further diagnostic or therapeutic procedures (hysteroscopy or SIS) were compared to patients who did not. Univariate and multivariate analyses were performed to identify predictive factors for additional diagnostic procedures and the diagnosis of endometrial malignancy. Results: Of the 350 eligible patients, 197 (56 %) underwent further diagnostic procedures. These patients had a thicker endometrium (median 8.6 mm vs. 6.0 mm; p &lt; 0.001), more frequent suspicion of intracavitary abnormalities (34.0 % vs. 14.4 %; p &lt; 0.001), and more frequent insufficient aspiration samples (20.8 % vs. 11.8 %; p = 0.025) compared to patients who received expectant management. Multivariate regression analysis confirmed these findings. The underlying risk of malignancy was 2.7 % with benign samples and 6.8 % with insufficient samples. Overall, malignancy incidence was higher in those who underwent further diagnostic workup (p = 0.04). Conclusion: In this prospective study, just over half of patients underwent further diagnostic procedures. Endometrial thickness, suspicion of intracavitary abnormality or an insufficient endometrial sample were predictive for further diagnostic workup. The incidence of malignancy was higher in patients who underwent diagnostic workup, which argues for a risk-based strategy in clinical decision-making. Registration: Central study approval was obtained at the Erasmus MC (MEC 2015-740). The study was registered in the Dutch trial register (www.onderzoekmetmensen.nl, NL7608).</p