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FACTORS CONTRIBUTING TO MATERNAL MORTALITY IN TASIKMALAYA CITY Dewi Andariya Ningsih; Wiryawan Permadi; Dinan S. Bratakoesoema; Hadi Susiarno; Henni Djuhaeni; Polar Silumi
Siklus : Journal Research Midwifery Politeknik Tegal Vol 9, No 2 (2020)
Publisher : Pusat Penelitian dan Pengabdian Masyarakat Politeknik Harapan Bersama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30591/siklus.v9i2.1789

Maternal deaths reflect the risks faced by mothers during pregnancy, childbirth, and postpartum were affected by maternal nutritional status, state of ill health during pregnancy, the incidence of various complications in pregnancy, childbirth, and postpartum. Moreover, the availability and use of healthcare facilities, including prenatal and obstetric services, were also very affecting. So it is necessary to minimize the occurrence of maternal deaths. The government had made various efforts to reduce maternal mortality, but the results were still not optimal yet. If maternal mortality could be prevented as early as possible with appropriate identification, it could significantly reduce maternal mortality. The research aims to analyze the cause of maternal death in Tasikmalaya city in 2015. The research design used a quantitative approach in the form of observation. The population was all maternal deaths in Tasikmalaya City Health department in 2015. The study's affordable population was all maternal mortality data with a precise address and recorded in the OVM as many as 20 cases of death. Factors associated with maternal mortality were the problem relating to patients, health professionals, health infrastructure, and referrals. Moreover recording and reporting of maternal mortality also influenced the determination of proper diagnosis to decrease the number of maternal mortality. Maternal mortality was a problem that has never finished with the complexity of the cause. It requires efforts that involve many parties, not only the health authorities alone, but all stakeholders were supported by government regulation. This study could be the basis for further research on maternal mortality and can be used to enhance the knowledge of researchers, health professionals, and stakeholders about the factors that cause maternal deaths. This study's results are expected to know the causes of maternal mortality and used as guidelines in making policy to reduce maternal mortality.Keywords: Maternal mortality, related factors

FACTORS CONTRIBUTING TO MATERNAL MORTALITY IN TASIKMALAYA CITY Dewi Andariya Ningsih; Wiryawan Permadi; Dinan S. Bratakoesoema; Hadi Susiarno; Henni Djuhaeni; Polar Silumi
Siklus : Journal Research Midwifery Politeknik Tegal Vol 9, No 2 (2020)
Publisher : Pusat Penelitian dan Pengabdian Masyarakat Politeknik Harapan Bersama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30591/siklus.v9i2.1789

Maternal deaths reflect the risks faced by mothers during pregnancy, childbirth, and postpartum were affected by maternal nutritional status, state of ill health during pregnancy, the incidence of various complications in pregnancy, childbirth, and postpartum. Moreover, the availability and use of healthcare facilities, including prenatal and obstetric services, were also very affecting. So it is necessary to minimize the occurrence of maternal deaths. The government had made various efforts to reduce maternal mortality, but the results were still not optimal yet. If maternal mortality could be prevented as early as possible with appropriate identification, it could significantly reduce maternal mortality. The research aims to analyze the cause of maternal death in Tasikmalaya city in 2015. The research design used a quantitative approach in the form of observation. The population was all maternal deaths in Tasikmalaya City Health department in 2015. The study's affordable population was all maternal mortality data with a precise address and recorded in the OVM as many as 20 cases of death. Factors associated with maternal mortality were the problem relating to patients, health professionals, health infrastructure, and referrals. Moreover recording and reporting of maternal mortality also influenced the determination of proper diagnosis to decrease the number of maternal mortality. Maternal mortality was a problem that has never finished with the complexity of the cause. It requires efforts that involve many parties, not only the health authorities alone, but all stakeholders were supported by government regulation. This study could be the basis for further research on maternal mortality and can be used to enhance the knowledge of researchers, health professionals, and stakeholders about the factors that cause maternal deaths. This study's results are expected to know the causes of maternal mortality and used as guidelines in making policy to reduce maternal mortality.Keywords: Maternal mortality, related factors

Performance of Pre-Operative IOTA Three-Step Algorithm in Detecting Ovarian Carcinoma in a Referral Center in Indonesia Kurniadi, Andi; Permadi, Wiryawan; Kusuma, Aria Yusti; Kireina, Jessica; Andarini, Mia Yasmina; Winarno, Gatot Nyarumenteng Adhipurnawan; Harsono, Ali Budi
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1044

Background: To assess the diagnostic performance of a three-step algorithm using the International Ovarian Tumor Analysis (IOTA) Group ‘simple rules’, ‘simple descriptors’, and Assessment of Different NEoplasias in the adneXa (ADNEX) model for discriminating benign and malignant adnexal masses. Methods: This was a retrospective observational study, performed at a tertiary-care university hospital, on women diagnosed with adnexal mass on ultrasonography from January 2021 and February 2022. The examiner first classified the mass using ‘simple descriptors’ (first step) and, if not possible, using ‘simple rules’ (second step). For inconclusive masses, an assessment using the ADNEX model was done as the third step. All masses were managed surgically. Histopathology results were used as the reference standard.Results: One hundred and forty-one women were included (median age of 48 years). Histopathology results showed 104 (73.76%) mass to be malignant, and 37 (26.24%) mass to be benign. Twelve (8.51%) of 141 masses could be classified using simple descriptors, 89 (63.12%) masses were classified using simple rules, and 40 (28.37%) masses were classified using the ADNEX model. Overall accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the three-step algorithm were 89.36%, 94.23%, 75.68%, 91.59%, 82.35%, 3.87, and 0.08 respectively.Conclusions: The IOTA three-step algorithm, based on the sequential use of simple descriptors, simple rules, and ADNEX model, performs well for classifying adnexal masses as benign or malignant

Normal Baby Born in Spontaneous Preterm Delivery in Patient with Pregnancy-Associated Breast Cancer: Case Report Disastra, Yuda Putra; Prianto, Adi Setyawan; Sutrisno, Sutrisno; Permadi, Wiryawan
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 1 Maret 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i1.764

Introduction:Breast cancer during pregnancy is rare, with 2.3 to 40 cases per 100,000 women. It is typically defined as cancer diagnosed during pregnancy or within a year post-delivery. While some argue pregnancy accelerates cancer progression, others see no effect or potential protective benefits. Treating pregnant patients requires balancing the mother's cancer stage and fetal health, as surgery and chemotherapy pose risks like teratogenesis or miscarriage. Timing therapy appropriately remains a major challenge.Case Presentation: A patient, P4A0, presented with spontaneous preterm delivery and a prior history of a total left modified radical mastectomy due to left tubular breast carcinoma (T1aN1M0). She had undergone six cycles of chemotherapy with Cyclophosphamide (876 mg/m²), Epirubicin (80 mg/m²), and 5-Fluorouracil (Lipiforin) (759 mg/m²). Despite receiving chemotherapy, the patient discovered she was pregnant at 33 weeks of gestation. She arrived at the Obstetrics and Gynecology Emergency Department of Prof. Dr. Margono Soekarjo General Hospital during the second stage of labor. A female infant was born, weighing 1950 grams and measuring 44 cm in length, with no detectable congenital anomalies. The patient experienced no complications after delivery and was discharged in stable condition.Conclusion: The main challenge is deciding when to start chemotherapy in pregnant patients, considering risks like miscarriage and teratogenic effects. More research is needed to develop safe chemotherapy guidelines that balance maternal treatment and fetal health.Bayi Normal dengan Partus Prematurus Spontan pada Ibu Hamil dengan Kanker Payudara: Sebuah Laporan KasusAbstrakPendahuluan: Kanker payudara selama kehamilan jarang terjadi, dengan 2,3 hingga 40 kasus per 100.000 wanita. Kondisi ini biasanya didefinisikan sebagai kanker yang didiagnosis selama kehamilan atau dalam satu tahun setelah melahirkan. Beberapa ahli berpendapat bahwa kehamilan dapat mempercepat perkembangan kanker, sementara yang lain berpendapat bahwa kehamilan tidak memiliki pengaruh signifikan atau bahkan memberikan manfaat perlindungan tertentu. Penanganan pasien hamil memerlukan keseimbangan antara stadium kanker ibu dan kesehatan janin, karena operasi dan kemoterapi membawa risiko seperti teratogen atau keguguran. Penentuan waktu terapi yang tepat tetap menjadi tantangan utama.Presentasi Kasus: Seorang pasien, P4A0, datang dengan persalinan prematur spontan dan riwayat sebelumnya menjalani mastektomi radikal modifikasi total di sisi kiri karena karsinoma payudara tubular kiri (T1aN1M0). Pasien telah menjalani enam siklus kemoterapi dengan Cyclophosphamide (876 mg/m²), Epirubicin (80 mg/m²), dan 5-Fluorouracil (Lipiforin) (759 mg/m²). Meskipun menjalani kemoterapi, pasien baru mengetahui bahwa dirinya hamil pada usia kehamilan 33 minggu. Pasien tiba di IGD Obstetri dan Ginekologi RSUD Prof. Dr. Margono Soekarjo dalam tahap kedua persalinan. Seorang bayi perempuan lahir dengan berat badan 1950 gr dan panjang 44 cm, tanpa kelainan bawaan yang terdeteksi. Pasien tidak mengalami komplikasi setelah persalinan dan dipulangkan dalam kondisi stabil.Kesimpulan: Tantangan utama adalah menentukan waktu yang tepat untuk memulai kemoterapi pada pasien hamil, dengan mempertimbangkan risiko seperti keguguran dan efek teratogenik. Penelitian lebih lanjut diperlukan untuk mengembangkan pedoman kemoterapi yang aman, yang dapat menyeimbangkan untuk Kesehatan ibu dan janin.Kata kunci: Kanker Payudara, Kehamilan, Kemoterapi, Teratogen

PREOPERATIVE RISK FACTORS FOR SURGICAL SITE INFECTION FOLLOWING CESAREAN SECTION: A CASE-CONTROL STUDY Supriyatin, Dedeh; Irianti, Setyorini; Anwar, Anita Deborah; Permadi, Wiryawan; Sukarsa, M. Rizkar Arev; Susiarno, Hadi
Media Penelitian dan Pengembangan Kesehatan Vol. 35 No. 3 (2025): MEDIA PENELITIAN DAN PENGEMBANGAN KESEHATAN
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/jmp2k.v35i3.3337

Infeksi daerah operasi (IDO) pascaseksio sesarea masih tinggi di Indonesia, termasuk di RSUP Dr. Hasan Sadikin Bandung. Angka kejadian IDO tahun 2022–2024 berkisar 2,34%–3,15%, melebihi standar nasional 2% dan target internal rumah sakit ≤1%, sehingga perlu perhatian terhadap faktor risikonya. Penelitian ini bertujuan untuk menganalisis hubungan faktor risiko praoperasi dengan kejadian infeksi daerah operasi pascaseksio sesarea di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini menggunakan desain observasional analitik kasus-kontrol dengan ukuran sampel sebanyak 180 pasien (45 kasus dan 135 kontrol) yang menjalani seksio sesarea di rumah sakit tersebut dari Januari 2022 hingga Desember 2024, dipilih melalui teknik simple random sampling. Analisis univariat, bivariat (Chi-Square, Fisher’s Exact), dan multivariat (regresi logistik biner) dilakukan untuk menilai hubungan antara variabel independen dengan kejadian IDO. Analisis menunjukkan adanya hubungan signifikan antara kejadian IDO dengan variabel praoperasi seperti tipe operasi (p=0,035), usia (p=0,035), riwayat seksio sesarea (p=0,000), anemia (p=0,000), hipertensi (p=0,013), dan obesitas (p=0,047). Diabetes tidak menunjukkan hubungan signifikan dengan kejadian IDO (p=0,109). Analisis multivariat mengidentifikasi anemia (p=0,000), tipe operasi (p=0,006), riwayat seksio sesarea (p=0,009), usia (p=0,015), dan obesitas (p=0,030) sebagai faktor risiko paling dominan terhadap kejadian IDO. Hasil penelitian menekankan pentingnya penatalaksanaan dini terhadap faktor risiko praoperasi sebagai bagian dari strategi pencegahan IDO dan peningkatan mutu pelayanan kebidanan.

Adolescence Eclampsia and Maternal Mortality within Sociocultural Problem in Indonesia: A Case Report Rosalina, Phang; Nurdiawan, Windi; Judistiani, Raden Tina Dewi; Permadi, Wiryawan; Setiawan, Dani
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.697

Introduction: Preeclampsia and eclampsia in adolescent pregnancy is closely related, especially in low-middle income countries. It becomes a public health issue not only in the present but also in the future due to potential complications and as a reflection of the social conditions of a country. This case aims to highlight adolescence eclampsia and current sociocultural and economic problem in Indonesia.Case Report: A 15-year-old, 9-months primigravida (G1P0A0), was referred to our center due to eclamptic seizure. Blood pressure was 160/110 mmHg and cervical dilation is 4 cm with adequate pelvic diameter. After 4 hours, cervical dilation progressed to 6 cm but followed by infrequent fetal heartbeat and CTG reveals category III with late deceleration. Emergency C-section was performed and patient admitted to ICU for 5 days afterwards. However, she was deteriorated and passed away.Conclusion: In addition to physiological immaturity, adolescence pregnancies often face sociocultural problems that lead to higher rates of hypertensive disorders of pregnancy in this population. Early recognition and knowledge of risk factors for preeclampsia are essential for good management, and a faster referral system will reduce maternal mortality.Eklamsia pada Remaja dan Kematian Ibu dalam Masalah Sosial Budaya di Indonesia: Sebuah Laporan KasusAbstrakPendahuluan: Preeklamsia dan eklamsia pada kehamilan remaja sangat erat kaitannya, terutama di negara-negara berpenghasilan menengah ke bawah. Hal ini menjadi masalah kesehatan masyarakat tidak hanya di masa sekarang, tetapi juga di masa depan karena potensi komplikasi dan sebagai cerminan kondisi sosial suatu negara. Laporan kasus ini bertujuan untuk menyoroti eklamsia pada remaja dalam kaitannya dengan masalah sosial budaya dan ekonomi saat ini di Indonesia.Laporan Kasus: Seorang perempuan berusia 15 tahun, primigravida 9 bulan (G1P0A0), dirujuk ke Rumah Sakit Hasan Sadikin, Bandung karena kejang eklamsia. Tekanan darah 160/110 mmHg dan dilatasi serviks 4cm degan diameter panggul yang memadai. Setelah 4 jam, dilatasi serviks berkembang menjadi 6cm, etapi diikuti oleh detak jantung janin yang jarang dan CTG menunjukkan kategori III dengan deselerasi lambat. Operasi caesar darurat dilakukan dan pasien dirawat di ICU selama 5 hari. Namun, keadaan pasien memburuk dan meninggal dunia. Kesimpulan: Selain imaturitas fisiologis, kehamilan remaja sering menghadapi masalah sosiokultural yang menyebabkan tingginya angka hipertensi kehamilan pada populasi ini. Pengenalan dini dan pengetahuan tentang faktor risiko preeklamsia sangat penting untuk manajemen yang baik, dan sistem rujukan yang lebih cepat akan mengurangi angka kematian ibu.Kata kunci: eklampsia, kehamilan remaja, kematian ibu, masalah sosiokultural

E-MONITORING INTERAKTIF MENINGKATKAN REFLEKSI DIRI, MOTIVASI BELAJAR DAN HASIL BELAJAR MAHASISWA DIII KEBIDANAN Ratnasari, Eka; Permadi, Wiryawan; Hilmanto, Dany
Care : Jurnal Ilmiah Ilmu Kesehatan Vol 7, No 3 (2019): EDITION NOVEMBER 2019
Publisher : Universitas Tribhuwana Tunggadewi

The proportion of practice in Midwifery education has 60% of capacity, more than the proportion of theories which is only 40%. The biggest proportion of practice makes the Clinical Advisor and Academic Advisor try to provide immediate feedback to students in every skill learned in the practice field. Interactive, effective and corrective feedback can help students to do self-reflection so while in the practice field students expected to be motivated to improve learning outcomes. The purpose of this study was to define the effect of Interactive E-Monitoring implementation on self-reflection, motivation and learning outcomes of the student.A research population of this study is students of midwifery diploma program in thirdh semester of 2018/2019 Akademic year who take part in second Laboratory Learning Practices, which are spread over in 13 of independent midwife practice fields (PMB). Samples were taken in based on inclusion criteria, students who were guided by PK that included in the criteria and in aged 19-20 years were 56 students. Data analyzed, if the data is normally distributed then it uses paired t test and if the data is not normally distributed then it uses the Wilcoxon Test.The results showed that students self-reflection increased from 74.9 to 80.5 (p

Correlation of Histological Type, Stage, Age, and Prognosis in Uterine Cervical Cancer at Margono Soekardjo Hospital Purwokerto from January – December 2024 Tambunan, Eka Maranatha; Permadi, Wiryawan; Aditiyono, Aditiyono; Grazielle, Grazielle
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 3 November 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i3.1007

Objective: To evaluate the correlation of histological subtype, stage, age, and prognosis in cervical cancer patients treated at Prof. Dr. Margono Soekarjo Hospital, Purwokerto.Methods: This is a retrospective descriptive cohort study conducted using medical records. Data on cervical cancer staging, age, and histopathological subtype were collected from all patients meeting the inclusion criteria. Statistical analysis was performed, and associations were examined using chi-square tests. The data used in the study were obtained from the medical records of patients at the research site from January to December 2024.Result: Of 582 patients identified, 245 met the inclusion criteria. Squamous cell carcinoma (SCC) accounted for 147 cases, and adenocarcinoma (AC) for 98. Most patients were aged >50 years old and diagnosed at stage II. SCC was most common at stage II, while AC was most frequently found at stage III. Statistical analysis revealed a significant but weak association between age, stage, prognosis, and histological subtype.Conclusion: There was a significant weak correlation of histological subtype and age, stage, and prognosis in cervical cancer.Korelasi Tipe Histologis, Stadium, Usia, dan Prognosis pada Kanker Uterin Serviks di Rumah Sakit Margono Soekardjo pada Januari – Desember 2024AbstrakTujuan: Penelitian ini bertujuan untuk mengetahui korelasi antara subtipe histologis, stadium, usia, dan prognosis kanker serviks uteri pada pasien yang diobati di RSUD Prof. Dr. Soekarjo Margono, Purwokerto, dalam rentang waktu Januari – Desember 2024Metode: Studi ini merupakan studi retrospektif deskriptif kohort dengan data dari rekam medis. Data yang diambil adalah stadium kanker, usia, dan subtipe histopatologis dan didapatkan dari semua pasien yang memenuhi kriteria inklusi. Analisis statistik dilakukan serta asosiasi diuji dengan uji Chi-Square. Data yang digunakan dalam penelitian diperoleh dari rekam medis pasien di RSUD Margono Soekardjo, Purwokerto pada bulan Januari hingga Desember 2024Hasil: Dari 582 pasien, sebanyak 245 pasien memenuhi kriteria inklusi. Karsinoma sel skuamosa (SCC) ditemukan pada 147 kasus, sedangkan adenokarsinoma (AC) pada 98 kasus. Sebagian besar pasien berusia >50 tahun dan didiagnosis pada stadium II. SCC paling banyak ditemukan pada stadium II, sementara AC didapatkan paling banyak pada stadium III. Analisis statistik menunjukkan adanya hubungan bermakna dengan korelasi lemah antara usia, stadium, dan prognosis dengan tipe histologis.Kesimpulan: Terdapat korelasi signifikan antara subtipe histologis dan usia, stadium, serta prognosis kanker serviks.Kata kunci: Kanker serviks; prognosis; subtipe histologis; stadium; usia

ACUPRESSURE IN REDUCING POSTPARTUM PAIN: A SCOPING REVIEW Setiawan, Nurhayati; Rizal, Ahmad; Permadi, Wiryawan; Yunas, Aisya Astri; Shilvia, Shilvia; Adnani, Qorinah Estiningtyas Sakilah; Susiarno, Hadi
Media Penelitian dan Pengembangan Kesehatan Vol. 35 No. 4 (2025): MEDIA PENELITIAN DAN PENGEMBANGAN KESEHATAN
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/jmp2k.v35i4.3344

Nyeri postpartum merupakan tantangan umum yang dihadapi ibu pasca persalinan, sering kali memengaruhi kesejahteraan fisik dan emosional. Pendekatan nonfarmakologis, seperti akupresur, semakin diminati sebagai alternatif untuk mengurangi ketergantungan pada obat-obatan. Penelitian ini bertujuan untuk mengetahui bagaimana akupresur dalam mengurangi nyeri postpartum. Metode yang digunakan adalah analisis literatur yang melibatkan studi-studi terdahulu mengenai pengaruh akupresur dalam mengurangi nyeri postpartum. Metode penelitian yang digunakan adalah pendekatan scoping review dengan menggunakan kriteria inklusi dan eksklusi tertentu. Data dikumpulkan dari berbagai mesin pencarian artikel diantaranya Pubmed 24 artikel, Google Scholar 461 artikel, Science Direct 147 artikel, dan Scopus 47 artikel yang relevan dengan topik yang sama, dan sintesis data dilakukan terhadap 10 artikel yang memenuhi kriteria inklusi. Yang kemudian dianalisis dengan checklist Joanna Briggs Institue (JBI) for RCT melalui proses Critical Appraisal. Hasil penelitian menunjukkan bahwa dari 10 artikel tersebut 5 studi memiliki kualitas tinggi dan 5 studi dengan kualitas sedang. Serta penggunaan akupresur efektif dalam mengurangi nyeri postpartum. Dengan menargetkan titik-titik akupresur tertentu seperti LI4, SP6, LV4, P6, ST 36, BL23, BL25, BL26, dan BL40. Akupresur merupakan metode nonfarmakologis yang mampu mengurasi nyeri postpartum. Hasil ini memberikan dukungan terhadap integrasi akupresur dalam perawatan postpartum sebagai alternatif yang aman dan alami bagi ibu yang ingin mengurangi penggunaan obat-obatan. Dengan demikian, akupresur dapat menjadi bagian yang berharga dalam merawat ibu postpartum, membantu meningkatkan kualitas perawatan dan kesejahteraan ibu serta bayi mereka.

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