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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.

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