ANALISIS FAKTOR RISIKO TERHADAP LUARAN MATERNAL DAN PERINATAL PADA KASUS EKLAMPSIA DI RSUP DR KARIADI TAHUN 2011 - 2012

LatarBelakang : Eklampsia merupakan salah satu penyebab utama kematian ibu dan masih merupakan masalah dalam pelayanan obstetri di Indonesia karena angka morbiditasnya yang tinggi baik untuk ibu maupun anak. Tujuan : Mengetahui hubungan antara faktor risiko terhadap luaran maternal dan perinatal pada persalinan dengan eklampsia. Metode : Penelitian deskriptif analitik dengan metode cross sectional dan uji Chi Square menggunakan data sekunder dari catatan medic pasien eklampsia di RSUP dr. Kariadi periodet ahun 2011 – 2012 yang memenuhi criteria inklusi dan eksklusi. Data disajikan dalam bentuk tabe lfrekuensi dan hasil uji Chi Square. Hasil : terdapat 58 sampel ibu dan 64 sampel bayi yang memenuhi criteria inklusi dan eksklusi. Dari hasil uji Chi Square didapatkan hubungan bermakna antara variable usia ibu dengan kematian perinatal (p=0,003) , paritas dengan BBL (0,019) dan kematian perinatal (0,015), pendidikan dengan BBL (0,014) dan IUGR (0,018), BMI dengan IUGR (0,021), dan gemelli dengan prematuritas (0,010) dan kematian perinatal (0,002). Simpulan : Penelitian ini menunjukkan buhubungan bermakna faktor usia ibu dengan kematian perinatal, paritas dengan BBL dan kematian perinatal, pendidikan dengan BBL dan IUGR, BMI dengan IUGR, gemeli dengan prematuritas dan kematian perinatal secara langsung. Kata kunci : eklampsia, luaran maternal, luaran perinatal. 1Mahasiswa program pendidikan S-1 Kedokteran UmumUniversitas Diponegoro 2Staff pengajar Bagian Kebidanan dan Penyakit Kandungan Fakultas Kedokteran Universitas Diponegor

Pregnancy with Hypothyroid Secondary to Treatment of Thyroid Carcinoma: A Case Report

Background: Thyroid malignancy is one of the most common malignancies in women of reproductive age. One of the normal physiological change in pregnancy is an increase in total maternal thyroid levels. According to 2015 DATIN information, the prevalence of hypothyroidism in women of reproductive age was 2.2%. Method of delivery in patients with thyroid disorders are mostly by cesarean section due to complications of the mother and/or fetus. Fetal outcome usually associated with low birth weight and poor APGAR Score.Objective : Reporting a case of pregnancy with hypothyroidism secondary to thyroid carcinoma treatmentCase: A 37-year-old woman Gravida 3 Parity 2 Abortion 0 with 18 weeks pregnancy after thyroid ablation treatment with a history of Papillary Thyroid Carcinoma – Follicular Variant, following a complete thyroidectomy in August 2016. The patient was given 6-dose ablation therapy, the last therapy was performed in April 2019. On clinical examination, the patient have no sign and symptoms suggesting hypothyroidism. On laboratory examination, the thyroid stimulating hormone (TSH) level was increased. Levothyroxine dosage was adjusted until the patient in euthyroid status in the early 3rd trimester of pregnancy until the delivery period. The fetal examination suggests that the Bio-Physical Profile was normal according to gestational age. The patient underwent vaginal delivery following 38 weeks of gestation with good maternal outcomes and low birth weight neonatal outcomes, no thyroid nodules, and slightly increased thyroid function.Conclusion : Management of counselling about preconception, contraception, and initial screening of patients with a history of thyroid carcinoma are the initial steps to help a better outcome in pregnancies with thyroid disorders.

The Association of Cervical Length, Bacterial Vaginosis, Urinary Tract Infection and Premature Rupture of Membranes to The Imminent Preterm Labour

Background: Research conducted at the Central General Hospital (RSUP) Dr. Kariadi Semarang in 2013 stated that out of 1,719 deliveries, 82 (5%) were preterm labor cases. Although there are many predictors for predicting imminent preterm labour, the complete prediction and prevention have not been established. Prevention of preterm labor through screening is the key to antenatal care. Good early prediction on a premature labor will provide adequate antenatal surveillance and special interventions.Objective: to analyze the relationship between cervical length, bacterial vaginosis, urinary tract infections, and premature rupture of membranes with the incidence of preterm labor.Methods: It is an observational analytic study in the form of the design of cross sectional with subject of pregnant women who experienced imminent preterm labour at gestational age 28-34 weeks and were treated at the ward of Obstetrics Gynecology Hospital Dr. Kariadi Semarang and network hospital during the study period (n=112). Subjects were assessed for the clinical risk (BV, premature rupture of the membrane, urinary tract infection) and sonography (cervical length). Statistical analysis was performed with paired t-test for normally distributed data and Mann Whitney if otherwise. Analysis of the relationship between variables and the incidence of preterm labor was carried out by the X 2 testResults: From 112 subjects, it was found that the Prevalence Ratio (PR) for cervical length, bacterial vaginosis, urinary tract infections and premature rupture of membranes to the incidence of imminent preterm labor was 2.2;2.32;1.99 and 2.36 respectively. From the multivariate analysis, it was found that bacterial vaginosis and premature rupture of membranes were the most influencing factors for the incidence of imminent premature labor with Odd Ratios of 6.497 and 21.362, respectively.Conclusion: There is a relationship between cervical length (≤25 mm ), bacterial vaginosis, urinary tract infections and premature rupture of membranes in the incidence of preterm labor

PENGARUH INDEKS KOIL TALI PUSAT TERHADAP INDEKS PONDERAL BAYI BARU LAHIR KEHAMILAN ATERM

Background : Umbilical cord is a connective tissue between the placenta and fetus which has an important function in interaction between mother and fetus during pregnancy. Circulatory disorders on umbilical cord can cause asphyxia of the fetus’ organs and metabolisms, which can be acute or chronic, so that it will affect outcomes of the newborn. Aims : To know the influences between coiling index of the umbilical cord to ponderal index of the newborn on an aterm pregnancy. Methods : This study was a cross sectional observational research. The samples are pregnant women which has aterm baby’s delivery (37-42 weeks) who were treated in Obstetrics and Gynecology Unit in RSUP Dr. Kariadi Semarang, Bunda Maternity Hospital Semarang, Puskesmas Halmahera Semarang and Puskesmas Ngesrep Semarang. The data collected was secondary data in the form of a ratio scale which was determined by the newborn’s ponderal index and the primary data which was determined by umbilical cord’s coiling index measurement. Statistical tests using normality data test using Saphiro Wilk and followed by non-parametric Spearman Rank Correlation Test. Results : from 50 research data showing result of the mean of umbilical coiling index was 0,35 ± 0,09. The mean of ponderal index was 2,64 ± 0,24. There is a significant negative correlation between umbilical coiling index and ponderal index in newborn with correlation coefficient -0,627 (p < 0,01). Conclusions : There is a significant negative correlation between umbilical cord’s coiling index and newborn’s ponderal index. It shows the higher of umbilical cord’s coiling index or hypercoiling, the lower ponderal index which be measured in newborns. Keys : Umbilical cord’s coiling index, Newborn’s Ponderal inde

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN PROLAPSUS UTERI DI RSUP Dr. KARIADI SEMARANG

Background: Uterine prolapse is a form of pelvic organ prolapse and ranks the second most common after cystourethrocele. The prevalence of pelvic organ prolapse is 41-50% in women aged over 40 years old and will increase in line with life expectancy increase. Although uterine prolapse rarely cause mortality and severe morbidity, but it can affect women’s quality of life. Prolapse etiology has not known certainly, but there are several factors that are considered as the cause. Objective: To determine the incidence of uterine prolapse, uterine prolapse patient characteristics and factors related to the incidence of uterine prolapse in Dr. Kariadi Hospital Semarang. Methods: An analytic observational study with cross-sectional design used medical records of uterine prolapse patients in Dr. Kariadi Hospital, during the years 2013 to 2014. Sampling was done by consecutive sampling and 56 medical records of uterine prolapse patients who met the inclusion criteria were obtained. Descriptive analysis was shown in the form of frequency and percentage distribution table, while the analytic analysis used Chi-square test and logistic regression. Results: There were 56 cases of uterine prolapse during the years 2013 to 2014. Most uterine prolapse patients aged over 50 years old (80.4%), multiparous (82.1%), post-menopausal (83.9%) and BMI < 25 kg/m2 (51.8%). Based on Chi-square test, there was a significant association between parity, age and menopause with uterine prolapse incidence (p = 0.000) however there was no significant association between BMI with uterine prolapse incidence (p = 0.643). The final result using multivariate logistic regression analysis found that age was the most influential factor on the incidence of uterine prolapse (p = 0.000) and OR = 102.5 (10.3-1020.058, CI 95%). Conclusions: There was association between parity, age and menopause with uterine prolapse incidence and age was the factors most associated with uterine prolapse incidence. Key words: uterine prolapse, parity, age, menopause, BM

PERBANDINGAN PROFIL HEMATOLOGI PADA PREEKLAMPSIA/ EKLAMPSIA DENGAN KEHAMILAN NORMOTENSI DI RSUP DR. KARIADI SEMARANG

Background: Preeclampsia is hypertension accompanied by proteinuria and edema which was one of the major cause of maternal death in Indonesia. There are changes hematological profile in preeclampsia. Aim: To compare the hematological profile of preeclampsia and eclampsia with normotensive pregnancies at RSUP Dr. Kariadi Semarang. Methods: This was a cross-sectional with observational analysis. Data was taken from the medical records of pregnant and labor women in Hospital Dr. Kariadi 2014. The assessment of hematogical profile consisted of the number of erythrocytes, hemoglobin concentration, hematocrit levels, levels of MCV, MCH, MCHC, leukocyte count, and platelet count. The data were statistically analized using the comparative test of One Way ANOVA and Kruskal-Wallis as alternative test. Results: There were 13 patients with mild preeclampsia, 56 patients with severe preeclampsia, eclampsia 16 patients and 85 patients with normotensive. Hematocrit increased significantly in severe preeclampsia compared with mild preeclampsia and controls (p < 0.000). Leukocyte levels were significantly higher in severe preeclampsia compared with controls (p < 0.000). Hematocrit and leukocytes in mild preeclampsia and eclampsia showed no significant difference compared with normotensive pregnancies. There was a significant difference in the number of erythrocytes (p < 0.000) and hemoglobin (p < 0.001). There is no significant difference in MCH level (p < 0.870), MCV level (p < 0.770), MCHC level (p < 0.300), and platelets count (p < 0.425). Conclusion: Hematocrit in patients with severe preeclampsia was higher than mild preeclampsia and normotensive pregnancies. There was an increase in the number of leukocytes in patients with severe preeclampsia compared with normotensive pregnancies. There is no difference in hematocrit and leukocytes in mild preeclampsia and eclampsia than normotensive pregnancy. There were differences in the number of erythrocytes and hemoglobin. There was no differences in the levels of MCH, MCV, MCHC and platelets. Keywords: preeclampsia, eclampsia, hematological profil

KARAKTERISTIK IBU HAMIL YANG MENGALAMI ABORTUS DI RSUP DR. KARIADI SEMARANG TAHUN 2010

Background: Abortion is one of the causes of maternal deaths are often found. Abortion is the end of a pregnancy before 20 weeks gestation or the fetal weight is less than 500 grams. Factors that influence the occurrence of abortion are fetal factors, maternal factors, and lifestyle factors. Objective: To know the characteristic of pregnant women on abortion patients, especially in RSUP Dr. Kariadi Semarang. Methods: This was a descriptive study. The sample of this study was the total number of abortions that had occurred in RSUP Dr. Kariadi Semarang at period January 2010 until December 2010. The total number of samples which fullfilled include and exclude criteria was 173 samples. The data was retrieved from medical records of abortion patients. The data was collected in April-June 2011. The data was collected and processed in the form of a frequency distribution table of each variable, and then the data was compared with theory and previous research. Results: From the 173 samples processed, there was founded that pregnant women who experienced abortion was 76.9% did not have anemia, 67.65 had normal body mass index, 82.1% had no history of abortion, 28.9% was above 35 years, 32% occurred in the first pregnancy, and 41.3% had distance of pregnancy over 5 years. Conclusion: Most of the abortion patient has a body mass index and hemoglobin levels are normal, no history of abortion, over 35years, primigravida, and occurs at a distance of pregnancy over 5 years. Keywords: abortion, characteristic of pregnant wome

PERBANDINGAN ANGKA KEJADIAN BAKTERIURIA DAN LEUKOSITURIA ANTARA PERSALINAN ATERM DAN PRETERM Studi Kasus di RSUP Dr. Kariadi Periode 2013

Latar Belakang: Infeksi saluran kemih menyumbang 30% kejadian prematuritas. Kultur urin merupakan gold standar dalam penegakan diagnosis ISK, namun kultur urin tidak umum dilakukan apabila tidak ada indikasi. Berkaitan dengan hal itu, dipilih pemeriksaan urinalisis sebagai preskrining ISK sebelum ditegakkan dengan kultur. Pada pemeriksaan urinalisis, dapat diketahui ada tidaknya bakteri dan leukosit pada urin. Tujuan: Mengetahui angka kejadian bakteriuria dan leukosituria pada persalinan preterm dan aterm. Metode: Penelitian ini merupakan penelitian analitik deskriptif dengan rancangan penelitian cross-sectional. Data diambil dari catatan medik ibu yang bersalin di RSUP Dr. Kariadi periode 1 Juli-31 Desember 2013 dan tercatat memiliki hasil pemeriksaan urinalisis bakteriuria dan leukosituria. Subjek dipilih secara consecutive sampling. Analisis menggunakan Chi-square. Hasil: Angka kejadian bakteriuria pada ibu hamil sebesar 81,6%, sementara angka kejadian leukosituria sebesar 5,3%. Tidak ada perbedaan yang bermakna antara kejadian bakteriuria dengan persalinan (p=0,752). Namun, ditemukan perbedaan yang bermakna antara leukosituria dengan persalinan (p=0,008). Kesimpulan: Terdapat perbedaan yang bermakna antara leukosituria dengan persalinan preterm dan aterm. Kata kunci: Persalinan preterm, persalinan aterm, bakteriuria, leukosituria

FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP LUARAN MATERNAL DAN PERINATAL PADA IBU HAMIL DI USIA TUA Studi Kasus di RS. Adhyatma Semarang selama Tahun 2012

Latar Belakang: Kehamilan di usia tua merupakan kehamilan berisiko tinggi yang diduga berperan meningkatkan Angka Kematian Ibu. Berkaitan dengan itu, perlu dipelajari lebih lanjut mengetahui faktor-faktor apa yang berpengaruh terhadap luaran maternal dan perinatal pada kehamilan di usia tua. Tujuan: Mengetahui faktor-faktor apa yang berpengaruh terhadap luaran maternal dan perinatal pada kehamilan di usia tua. Metode: Penelitian ini merupakan penelitian observasional analitik dengan desain cross sectional. Data diambil dari catatan medik pasien ibu hamil yang melahirkan di RS. Adhyatma Semarang selama periode tahun 2012. Subjek dipilih secara consecutive sampling. Analisis menggunakan Chi-square. Analisis multivariat menggunakan uji regresi logistik. Hasil: Faktor risiko terbesar pada ibu hamil usia tua ialah ketuban pecah dini (23,3%) dan preeklampsia (22,8%). Hasil uji regresi logistik menunjukkan ketuban pecah dini berhubungan terhadap kejadian persalinan tindakan (OR 1,92 dengan 95% CI 1,112-3,333]). Sementara plasenta pervia (OR 8,06 dengan 95% CI 2,681-24,238) dan kelainan letak (OR 2,78 dengan 95% CI 1,532-5,050) berhubungan terhadap lama rawat inap Kesimpulan: Ketuban pecah dini berhubungan terhadap persalinan tindakan. Sementara plasenta previa dan kelainan letak berhubungan dengan lama rawat inap pada ibu hamil usia tua. Kata kunci: Ibu hamil usia tua, Faktor risiko, Luaran maternal, Luaran perinata

HUBUNGAN PENINGKATAN BERAT BADAN TRIMESTER III TERHADAP BERAT BADAN PASCA SALIN < 6 BULAN

Latar Belakang : Obesitas dan overweight merupakan suatu permasalahan yang sering dihadapi oleh negara-negara di dunia. Salah satu penyebab terjadinya Obesitas dan overweight adalah kejadian peningkatan berat badan pasca salin. Peningkatan berat badan pascasalin biasanya disebabkan karena adanya retensi berat badan. Peningkatan berat badan tertinggi saat hamil adalah peningkatan berat badan pada trimester III. Tujuan : Mencari hubungan peningkatan berat badan trimester III kehamilan dengan berat badan pasca salin < 6 bulan Metode : Penelitian ini menggunakan desain cross sectional. Sampel penelitian diambil dengan cara sample random sampling dari wilayah puskesmas dikotamadya Semarang yang mengikuti penelitian 1000 HPK. Terdapat 80 sampel yang termasuk kriteria inklusi dan eksklusi dengan rincian 24 responden kelompok BB kembali seperti sebelum hamil dan 56 responden kelompok BB tidak kembali seperti sebelum hamil. Uji hipotesis dianalisis dengan uji chi-square. Signifikan bila p <0,05. Hasil : Berdasarkan hasil uji chi square test, nilai p pada analisa hubungan peningkatan berat badan trimester III dengan berat badan pascasalin 0,05) yaitu tidak signifikan. Kesimpulan : Tidak terdapat hubungan antara peningkatan berat badan trimester III terhadap berat badan pascasalin < 6 bulan. Kata Kunci : Peningkatan berat badan trimester III, berat badan pasca salin < 6 bulan, retensi berat badan