ANALISIS FAKTOR RISIKO ATONIA UTERI

Maternal mortality rate in Indonesia is still relatively high. The biggest cause of maternal mortality in Indonesia is bleeding. Most bleeding in the puerperium (75-80%) is uterine atony. Uterine atony is the most frequent cause of the occurrence of bleeding postpartum. This study aimed to analyze the risk factors for uterine atony in Cut Meutia General Hospital and Health Center PONED in North Aceh district. This study uses a case control design, as a case group, maternal postpartum hemorrhage with uterine atony and control group, maternal postpartum hemorrhage without uterine atony. The sample size for each selected group 69 (the number of cases during the period from 2015 to 2017) while the control selected at random with the same number as many as 69 cases. Data analysis using chi square and multiple logistic regression. The results of the research bivariable indicates a meaningful associated with uterine atony is preeclampsia with OR 10,30 (CI 95%: 2,91-36,41), twin pregnancy with OR 17,31 (CI 95%: 2,21-135,76), induction of labor with an OR 4,39 (CI 95%: 1,0-21,45), grande multipara with OR 4,52 (CI 95%: 1,61-12,73) compared with primipara. Multivariable those associated with uterine atony is the age of the mother with OR 2,98 (CI 95%: 0,56-15,82), preeclampsia with OR 20,27 (CI 95%: 4,66-88,20), induction of labor with an OR 6,69 (CI 95%: 1,12-39,95), twin pregnancy with OR 52,39 (CI 95%: 5,65-486,03), anemia with OR 3,06 (CI 95%: 1,07-8,69). This study concluded that parity, preeclampsia, twin pregnancy and labor induction were risk factors for the incidence of uterine atony with twin pregnancy as the most dominant factor in the incidence of uterine atony. Keywords : Risk factors; Uterine Atony

EFFECT OF PELVIC FLOOR MUSCLE TRAINING ON DEFECATION FUNCTION IN SPONTANEOUS POSTPARTUM MOTHERS.: PENGARUH PELVIC FLOOR MUSCLE TRAINING TERHADAP FUNGSI DEFEKASI PADA IBU POSTPARTUM SPONTAN.

Childbirth is a natural process experienced by every pregnant woman. 60% of puerperal mothers have defecation disorders. Factor that influence the process of defecation in postpartum mothers are lack of physical exercise or immobilization in mothers. One activity that is recommended for mothers after childbirth is the puerperal exercises Pelvic Floor Muscle Treatment (PFMT) or exercises specifically performed for pelvic floor muscles. The research method uses quasy experiment with one group post test design with control. The total sample is 36 people. Sampling technique is done by consecutive sampling with random permutation block. The instrument of data collection that is observational sheet is doing direct observation to the object of research to look closely at the activities carried out. Observation sheet which includes Pelvic Floor Muscle Training . The results of Pelvic Floor Muscle Training  exercises affect the acceleration of the first defecation in Postpartum mothers compared to not doing gymnastics. Health workers should try to provide counseling and counseling about the importance of Pelvic Floor Muscle Training .Persalinan merupakan kejadian alamiah yang dialami oleh setiap ibu hamil. 60% ibu nifas memiliki gangguan defekasi. Faktor yang memengaruhi proses defekasi pada ibu nifas adalah kurang latihan fisik atau imobilisasi pada ibu. Salah satu aktivitas yang dianjurkan untuk dilakukan para ibu setelah melahirkan adalah senam nifas Pelvic Floor Muscle Treatment (PFMT) atau latihan yang dilakukan khusus untuk otot dasar panggul. Penelitian ini bertujuan untuk mengetahui pengaruh Pelvic Floor Muscle Training  terhadap defekasi pertama pada ibu post partum spontan dalam pencegahan gangguan fungsi defekasi pada ibu . Metode penelitian menggunakan quasy experiment dengan one group post test design with control. Jumlah sampel keseluruhan adalah 36 orang. Tenik pengambilan sampel dilakukan secara consecutive sampling dengan permutasi random blok. Intrumen pengumpulan data yaitu Lembar observasional adalah melakukan pengamatan secara langsung ke objek penelitian untuk melihat dari dekat kegiatan yang dilakukan. Lembar observasi yang meliputi gerakan Senam Otot dasar panggul (Pelvic Floor Muscle Training ). Hasil Senam Pelvic Floor Muscle Training  berpengaruh terhadap percepatan defekasi pertama pada ibu Postpartum dibandingkan dengan tidak melakukan senam. Tenaga kesehatan hendaknya berupaya memberikan penyuluhan dan konseling tentang pentingnya Pelvic Floor Muscle Training

Hubungan Umur Ibu, Paritas dan Penolong Persalinan dengan Kematian Neonatal di Wilayah Kerja Puskesmas Kabupaten Banjarnegara tahun 2013

Background: 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

Heme Oxygenases1 (Hmox1) and Serum Ferritin Level between Preeclampsia and Normal Pregnancy

Objective: To determine the comparison of Hmox-1 to serum ferritin level between patients with preeclampsia and normal pregnancy. Methods: This study used analytic observational with cross sectional design. We included 30 subjects with preeclampsia and the other 30 people with normal pregnancy in accordance with inclusion and exclusion criteria. Examination of Hmox-1 and ferritin level was performed through ELISA method. The data consisted of physical and laboratory examination and they would be continued to the calculation in the statistical analysis. Results: The average of Hmox-1 level in normal pregnancy and preeclampsia was 1.2 (SD 1.6) ng/ml and 0.3 (SD 0.2) ng/ml (

FAKTOR YANG MEMENGARUHI TINGKAT KELULUSAN MAHASISWA D-III KEBIDANAN PADA UJI KOMPETENSI DI POLTEKKES KEMENKES PALU

Penelitian ini bertujuan untuk mengeksplorasi faktor yang memengaruhi kelulusan pada uji kompetensi bidan dan memperoleh instrumen baku berdasarkan hasil studi eksploratif yang telah diuji validitas dan reliabilitas. Desain penelitian yang dipergunakan adalah mixed methods dengan strategi sequential exploratory. Eksplorasi faktor dilakukan melalui analisis tematik dan untuk memperoleh instrumen yang valid dan reliable dilakukan melalui analisis dengan menggunakan rasch model. Subyek penelitian adalah 6 alumni yang tidak lulus uji kompetensi, 3 alumni yang lulus uji kompetensi, dan 3 dosen D III di Jurusan kebidanan Poltekkes Kemenkes Palu. Hasil eksplorasi yang diperoleh menunjukkan bahwa faktor-faktor yang memengaruhi kelulusan mahasiswa pada uji kompetensi bidan dari diri mahasiswa yaitu minat dan motivasi belajar yang sangat rendah, kurang percaya diri, ketelitian dalam mengisi lembar jawaban komputer dan ketidakjujuran selama proses pendidikan. Kesimpulan, tingkat kelulusan mahasiswa pada uji kompetensi masih rendah dikarenakan rendahnya motivasi dan minat belajar mahasiswa, ketidakjujuran dalam membuat laporan dan belum ada bimbingan belajar khusus menghadapi uji kompetensi. Disarankan Dosen agar memotivasi mahasiswa untuk belajar dan menfasilitasi mahasiswa dalam menghadapi uji kompetens

Oxytocin 10 IU as Prophylactic for Uterine Atony : a Randomized Clinical Trial: Oksitosin 10 IU sebagai Profilaksis Atonia Uteri : suatu Uji Coba Klinis Acak

Abstract Objective : To compare the effectiveness of oxytocin dose of 10 IU and 20 IU for preventing uterine atony in women undergoing cesarean section. Methods : This was a double-blind, randomized clinical trial with good matching selection with randomization block of patients who had risk factors for the occurrence of uterine atony such as preeclampsia, patients were receiving MgSO4, oxytocin intrapartum and chorioamnionitis who performed stratified randomization prospectively with two kinds of oxytocin doses which are 10 IU and 20 IU as a prophylaxis for uterine atony in women who performed emergency cesarean section with transverse incision and were using a general anesthesia. Results : This study found no any significant differences between the use of 10 IU and 20 IU as prophylaxis for uterine atony during cesarean section either in its action at the time or while in recovery room, especially on the cases without chorioamnionitis thus using oxytocin 10 IU regimen can be considered, besides the effectiveness did no differ, it will cost cheaper than oxytocin 20 IU regimen which frequently used. Conclusions : There were no significant differences in the incidence of blood loss during the cesarean section between the treatment of oxytocin 10 IU group and oxytocin 20 IU group. The additional uterotonic was using during the action of the cesarean section between the treatment of oxytocin 10 IU group, and oxytocin 20 IU group gave no significant differences. The side effects in this study at least form of chills and vomiting found no significant differences between both of groups despite the side effects that arise in oxytocin 20 IU group was higher at 23.08% than oxytocin 10 IU group at 15.19%. Chorioamnionitis would be a risk factor for the occurrence of uterine atony during the action of the cesarean section if it associated with the use of additional uterotonic in oxytocin 10 IU group if compared with oxytocin 20 IU group. Keywords : cesarean section, oxytocin, uterine atony.   Abstrak Tujuan : Untuk membandingkan efektifitas penggunaan dosis 10 IU dan 20 IU sebagai profilaksis atonia uteri pada saat seksio sesarea. Metode : Penelitian ini menggunakan uji klinis acak ganda dengan seleksi yang sesuai dengan blok acak pada pasien-pasien yang memiliki faktor risiko terjadinya atonia uteri seperti preeklamsia, pasien yang diberikana MgSO4 dan oxytocin intrapartum sebelumnya serta chorioamnionitis yang dilakukan pengacakan secara prosfektif bertingkat yang diberikan dua jenis dosis oksitosin yaitu 10 IU dan 20 IU sebagai profilaksis atonia uteri pada perempuan yang dilakukan seksio sesarea darurat dengan insisi transversal dan menggunakan anestesi umum. Hasil : Penelitian ini menemukan tidak adanya perbedaan yang bermakna antara penggunaan dosis oksitosin 10 IU dan 20 IU sebagai profilaksis atonia uteri pada seksio sesarea baik saat tindakan operasi maupun saat berada di ruang pemulihan, terutama pada kasus-kasus tanpa khorioamnionitis dimana memerlukan oksitosin tambahan pada kelompok 10 IU, selain efektifitasnya tidak berbeda, akan lebih murah dari pada rejimen oksitosin 20 IU yang sering digunakan saat ini. Kesimpulan : Berdasarkan hasil penelitian ini, tidak ada perbedaan yang bermakna dalam kejadian kehilangan darah selama operasi seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU. Penggunaan uterotonik tambahan selama tindakan seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU tidak memberikan perbedaan yang signifikan. Efek samping dalam penelitian ini yakni menggigil dan muntah, tidak ditemukan perbedaan yang bermakna antara kedua kelompok meskipun efek samping yang muncul pada kelompok oksitosin 20 IU lebih tinggi 23,08% dibandingkan kelompok oksitosin 10 IU pada 15,19%. Khorioamnionitis merupakan faktor risiko terjadinya atonia uteri selama tindakan seksio sesarea jika dikaitkan dengan penggunaan uterotonika tambahan pada kelompok oksitosin 10 IU jika dibandingkan dengan kelompok oksitosin 20 IU. Kata kunci : atonia uteri, oksitosin, seksio sesarea

Hubungan Kadar Asam Urat, Laktat Dehidrogenase, Aspartat Aminotransferase Serum Penderita Preeklamsi Berat Disertai Komplikasi dan tanpa Komplikasi

Tujuan: penelitian ini untuk mencari perbedaan kadar asam urat, laktat dehydrogenase (LDH) dan aspartat aminotransferase (AST) pada serum penderita preeklamsi berat disertai komplikasi dan tanpa komplikasi dan mengukur kuatnya hubungan peningkatan kadar asam urat, LDH dan AST dengan peningkatan risiko terjadinya komplikasi pada pasien preeklamsi berat. Metode: Rancangan penelitian ini adalah penelitian comparative cross sectional dengan metode consecutive sampling. Subjek penelitian adalah penderita preeklamsi berat disertai komplikasi dan tanpa komplikasi (n=68). Hasil: Hasil penelitian didapatkan perbedaan kadar asam urat, LDH dan AST pada kedua kelompok secara bermakna dengan nilai p ≤ 0,05. Peningkatan kadar asam urat, LDH dan AST berhubungan dengan peningkatan risiko terjadinya komplikasi dengan nilai cut off kadar asam urat > 6,5 mg/dL sebesar 33 kali, LDH > 573 U/L sebesar 8,95 kali dan AST > 30 U/L sebesar 5,19 kali. Jika terjadi peningkatan seluruh kadar asam urat, LDH dan AST diatas nilai cut off maka risiko terjadinya komplikasi sebesar 98,1%.Kesimpulan: Penelitian ini menyimpulkan kadar asam urat, LDH, AST pada preeklamsi berat disertai komplikasi lebih tinggi dibandingkan preeklamsi berat tanpa komplikasi dan peningkatan kadar asam urat, LDH, AST berhubungan dengan peningkatan risiko terjadinya komplikasi pada preeklamsi berat. Relations of Uric Acid, Lactat Dehydrogenase, and Aspartat Aminotransferase Serum LevelIn Severe Preeclampsia with and Without ComplicationsAbstractObjective: This study compared level of uric acid, LDH, and AST level between severe preeclampsia patients with complication and without complication, and measured correlation between the rise level of uric acid, LDH and AST towards the increased risk of complication in patient with severe preeclampsia.Method: The study design was comparative cross sectional study with consecutive sampling method that compare the results of laboratorium uric acid, LDH, AST between complications and without complications group. Subjects of this study were severe preeclampsia patients with and without complication that fulfilled study criteria (n=68). Result:    It is revealed that the differences level of uric acid, LDH, and AST in both groups were significant with p value ≤ 0.05. Increase level of uric acid, LDH, and AST were related to inreased risk of complication in severe preeclampsia occurence with cut off point of uric acid level of > 6.5 mg/dL by 33 times, LDH level of > 573 U/L by 8.95 times, and AST level of > 30 U/L by 5.19 times. If all uric acid, LDH, and AST level rise above the cut off value so the risk of complication of severe preeclampsia will rise by 98.1%. Conclusion: It is concluded that level of uric acid, LDH, and AST in severe preeclampsia with complication were higher than severe preeclampsia without complication and the rise of uric acid, LDH, and AST were related with the rise of complication risk on severe preeclampsia.     Key word: Severe preeclampsia, complication, uric acid, LDH, AST

Follow-up study among IUD acceptors of Java

As of April 1993, an estimated 5.3 million women in Indonesia were using IUDs. In 1991, the IUD was the second most commonly used family planning method in Indonesia (13.4 percent). According to the Indonesia Demographic and Health Survey, in 1994 it became the third most commonly used method among currently married women (10.3 percent), primarily on the islands of Java and Bali. The National Family Planning Coordinating Board (BKKBN), in collaboration with the Faculties of Medicine, Diponegoro University in Semarang, Airlangga University in Surabaya, and BKS-Penfin in Bandung, conducted a Follow-up Study Among IUD Acceptors of Java,” from November to December 1994. As this report states, 1,825 IUD acceptors who had their IUD inserted from April 1989 to March 1994 were interviewed. The study collected data on follow-up mechanisms; frequency, type, and management of side-effects; switching of method and clinic; and use-effectiveness of IUD, by type

Obstetri patologi: ilmu kesehatan reproduksi

Vlll, 236 hlm. : ilus. ; tab. ; 24 cm