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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi Jurnal Kebidanan Nusantara Medical Science Journal Jurnal Ilmiah Kedokteran Wijaya Kusuma Health Notions Jurnal Surya Medika Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) JNKI (Jurnal Ners dan Kebidanan Indonesia) (Indonesian Journal of Nursing and Midwifery) Jurnal Gizi Klinik Indonesia Jurnal Kesehatan Reproduksi Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Media Ilmu Kesehatan Journal of Maternal and Child Health Jurnal Kesehatan Ibu dan Anak Jurnal Medikes (Media Informasi Kesehatan) Journal of Community Empowerment for Health Journal of Nursing and Health (JNH) Akper Yakpermas Banyumas JURNAL KESEHATAN SAMODRA ILMU Berita Kedokteran Masyarakat Jurnal Kebidanan dan Keperawatan Aisyiyah Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)

Detty Siti Nurdiati

Department Of Obstetrics And Gynecology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia

Author-ID : 508977

Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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BIAYA PASIEN JAMINAN KESEHATAN NASIONAL YANG MENJALANI SEKSIO SESAREA DI RSUP DR. SARDJITO YOGYAKARTA Rahmawan, Adi; Nurdiati, Detty Siti; Sofoewan, Sulchan
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (216.299 KB)

Adi Rahmawan1, Detty Siti Nurdiati2, Sulchan Sofoewan3Â ABSTRACTÂ Background: Ease of access and timeliness in reaching emergency obstetric care is necessary to save the mother and newborn. Delivery by emergency caesarean section aims to save the mother and newborn. The amount of cost from the emergency obstetric care particularly caesarean section, was significantly higher compared to childbirth without complications. The implementation JKN (Jaminan Kesehatan Nasional) aims to overcome this programs. Government hospitals have a dilemma between the mission of serving the lower middle class society and the limited financial resources, as well as a variety of rules and bureaucracy. Casemix system on INA-CBGâs (Indonesian Case Base Groups) is grouping similar patient characteristics. Hospital will receive payments based on the average amount of cost by a group of diagnosis.Â Objective: Knowing the cost of the JKN patient who underwent cesarean section in Dr. Sardjito Hospital. Method: The study design is a descriptive. JKN patients undergoing Caesarean section in January-July 2014 at the Hospital Dr. Sardjito included in the study. Patients who moved to the VIP, VVIP, and suites classes are excluded. Patient cost data will be averaged and be detailed by characteristics.Â Result: A total of 136 patients underwent Caesarean section with JKN during January-July 2014. Average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Patient with severe preeclampsia had average cost of 3,050,776 rupiahs higher than patients without severe preeclampsia. Patients with 4 disesases and complications had the difference in cost 16,995,952 rupiahs higher than patients without the disease. Patients with ICU care had higher average cost than non-admission to the ICU in the amount of 3,340,288 rupiahs. Difference in the higher average costs also occur on length of stay. Class treatment, duration stay in the delivery room, the induction or stimulation in the delivery room. History of cesarean section was not the leading cause of higher cost.Conclusion: The average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Complications of the disease and the patientâs condition, severe preeclampsia, long hospitalization, ICU care, led to high costs in patients underwent Caesarean section.Keyword: seksio sesarea, cost, JKN, INA-CBGâABSTRAKLatar belakang: Kemudahan akses dan ketepatan waktu dalam menjangkau pelayanan kegawadaruratan obstetri sangat diperlukan demi menyelamatkan ibu dan neonatal. Persalinan dengan seksio sesarea pada kedaruratan obstetrik bertujuan untuk menyelamatkan ibu dan neonatal. Biaya yang dihabiskan dari pelayanan kedaruratan obstetri operasi sesar, secara signifikan lebih tinggi dibandingkan dengan persalinan tanpa penyulit. Terselenggaranya program Jaminan Kesehehatan Nasional (JKN) mempunyai tujuan untuk mengatasi hal tersebut. Rumah sakit pemerintah menghadapi dilema antara misi melayani masyarakat kelas menengah ke bawah dengan adanya keterbatasan sumber dana, serta berbagai aturan dan birokrasi yang harus dihadapi. Sistem casemix pada INA-CBGâs merupakan pengelompokan karakteristik pasien yang sejenis. Rumah Sakit akan mendapatkan pembayaran berdasarkan rata-rata biaya yang dihabiskan oleh suatu kelompok diagnosis.Tujuan: Mengetahui besarnya biaya pasien Jaminan Kesehatan Nasional (JKN) yang menjalani operasi seksio sesarea di RSUP Dr. SardjitoÂ Metode: Rancangan penelitian yang akan digunakan adalah deskriptif. Pasien JKN yang menjalani seksio sesarea pada Januari-Juli 2014 di RSUP Dr. Sardjito diikutsertakan dalam penelitian ini. Pasien yang pindah perawatan ke kelas VIP, VVIP, dan suite di eksklusi. Data biaya pasien akan dirata-rata dan dirinci besarnya berdasarkan karakteristikÂ Hasil & Pembahasan: Sebanyak 136 pasien JKN menjalani seksio sesarea selama Januari-Juli 2014. Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. Pasien preeklamsia berat mempunyai ratas-rata biaya yang lebih tinggi 3.050.776 rupiah dibandingkan pasien tanpa preeklamsia berat. Pasien dengan 4 penyakit dan komplikasi mempunyai selisih biaya 16.995.952 rupiah lebih tinggi dibandingkan pasien tanpa penyakit. Pasien dengan perawatan ICU mempunyai rata-rata biaya yang lebih tinggi dibanding yang tidak dirawat di ICU yaitu sebesar 3.340.288 rupiah. Selisih rata-rata biaya yang lebih tinggi juga terjadi pada lama rawat inap. Kelas perawatan, lama perawatan di kamar bersalin, tindakan induksi atau stimulasi di kamar bersalin, riwayat seksio sesarea saat ini tidak menyebabkan semakin tingginya biaya seksio sesarea.Kesimpulan: Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. kondisi penyakit dan komplikasi pasien, preeklamsia berat, lama rawat inap, dan perawatan ICU menyebabkan tingginya biaya pada pasien yang menjalani seksio sesarea.Â Kata kunci: seksio sesarea, biaya, JKN, INA-CBGâs1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta

The influence of iron supplementation in pregnant women to the occurrence of low birth weight (LBW) babies in Palu, Central Sulawesi R. Detty Siti Nurdiati Z, Sri Restu Djaswadi Dasuki
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Universitas Gadjah Mada

Low birth weight (LBW) babies remains a major problem world wide as it causes a high rate ofneonatal morbidity and mortality. One effort to reduce the prevalence of LBW babies is byproviding iron supplementation to the pregnant women. The aim of this study was to examinethe relationship between iron supplementation program and prevalence of LBW babies in Palu,Central Sulawesi. This was an observational study with case control design. Subjects were allLBW babies from mothers that had accepted iron supplementation during pregnancy. Samplesize in this study was 87 for case and 87 for control. Bivariate analysis showed that ironsupplementation that not comply the program had a significant correlation with prevalence ofLBW babies (p=0.01). Other significant factors include abnormal hemoglobin level (p=0.01),body mass index (BMI) (p=0.02), educational level (p=0.02), multiparity (p=0.03), andgestational age (prematurity) (p=0.03). Multivariate analysis revealed that the strongest riskfactor for the occurrence of LBW babies was iron supplementation that not comply the program(OR= 3.82; 95% CI: 1.77- 8.22). Other risk factors were hemoglobin level (OR= 3.45; 95% CI:1.59-7.49), BMI (OR= 2.27; 95% CI: 1.05-4.91), gestational age (OR= 3.11; 95% CI: 1.45-6.67), multiparity (OR= 2.98, 95% CI: 1.36-6.51), and educational level (OR= 2.38, 95% CI:1.12-5.03). Based on the analysis, the strongest risk factors that affected the prevalence of LBWwas iron supplementation, abnormal hemoglobin level, gestational age, multiparity and educationlevel. In conclusion, iron supplementation during pregnancy that not comply with the programwas the strongest risk factor of LBW babies. The prevalence of LBW babies can be reduced bycontrolling of iron supplementation, hemoglobin level, BMI, gestational age, parity and education.

Effectiveness of Effleurage and Counter-Pressure Massages in Reducing Labor Pain Santiasari, Retty Nirmala; Nurdiati, Detty Siti; Lismidiati, Wiwin; Saudah, Noer
Health Notions Vol 2 No 7 (2018): July 2018
Publisher : Humanistic Network for Science and Technology (Address: Cemara street 25, Ds/Kec Sukorejo, Ponorogo, East Java, Indonesia 63453)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (186.802 KB)

labor. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counter-pressure massage were complementary treatment to relieve pain. This study aimed to analyze effectiveness of effleurage and counter-pressure massages for reducing labor pain in stage 1 of active labor phase. This study used quasi experiment design with pre-post test non-equivalent control group. Research subjects were 68 mothers in stage 1 of active labor phase, which were divided evenly to two groups. Sampling collection technique used consecutive sampling. Independent variables were effleurage and counter-pressure, while dependent variables were decline of labor pain. Instrument to assess labor pain was Numeric Rating Scale (NRS). Data were analyzed using Wilcoxon and Mann Whitney. Labor pain before and after intervention in effleurage group were 9.26Â±1.05 and 6.88Â±1.22, respectively (p=0.00). Meanwhile, the respective numbers in counter-pressure groups were 9.00Â±0.98 and 6.59Â±1.28 (p=0.00). Average labor pain decline in effleurage and counter-pressure groups were 2.38 and 2.41, respectively (p=0.74). There was no significant difference between effleurage and counter-pressure in reducing labor pain. Keywords: Labor pain, Effleurage, Counter-pressure

PERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADA PREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSI Arianto, Budi; Hadiati, Diah Rumekti; Nurdiati, Detty Siti
JURNAL KESEHATAN REPRODUKSI Vol 2, No 2 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

PERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADAPREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSIBudi Arianto1, Diah Rumekti H2, Detty S Nurdiati3ABSTRACTBackground: The state of hypoxia in severe preeclampsia cause placental oxidative stress that can leadexcessive trophoblast apoptosis through the mitochondrial pathway. Apoptosis stimuli occurs throughmodulation of p53 and Bcl-2 family expression which has antiapoptosis and proapoptosis function.Antiapoptosis protein consist of Bcl-2 and Bcl-XL and is expressed lower in apoptosis.Objective: To compare the mean difference of the expression of antiapoptosis proteins Bcl-2 & Bcl-XL andidentify the type of protein that can be used as indicators of increased apoptosis.Method: A cross-sectional study which consisted of 43 severe preeclampsia pregnancies and 38 thirdtrimester normotensive pregnancies, recruited between October 2011 - March 2012. Observation ofprotein expression Bcl-2 and Bcl-XL used immunohistochemical techniques. Statistical analysis appliedindependent t test (P<0.05).Result and Discussion: There were significant differences (p<0.05)between the mean expression of Bcl-2protein in trophoblast tissue among severe preeclampsia group (1.03 Â± 0.04) compared to normotensivegroup (1.10 Â± 0.08). The mean expression of Bcl-XL protein in trophoblast tissue severe preeclampsiagroup (1.29 Â± 0.12) compared to normotensive group (1.71 Â± 0.14) were significantly difference (p<0.05).The mean difference in protein expression of Bcl-2 (0076; 95% CI 0.046 to 0.104) was lower than Bcl-XLprotein (0.42; 95% CI 0.47 to 0.36). The mean protein expression of Bcl-2 and Bcl-XL were lower in severepreeclampsia group compared with normotensive group, either in preterm or full-term gestation age withp value <0.05.Conclusion: The mean difference in protein expression of Bcl-2 and Bcl-XL is lower in severe preeclampsiapregnancies than normotensive pregnancies. The mean difference in protein expression of Bcl-2 is lowerthan Bcl-XL. Severe preeclampsia affects protein expression of Bcl-2 and Bcl-XL more than influence ofgestational age.Keywords: severe preeclampsia, trophoblast, Bcl-2 , Bcl-XL, apoptosis.ABSTRAKLatar belakang: Keadaan hipoksia pada preeklamsia berat akan menyebabkan stress oksidatif plasentayang dapat memicu terjadi peningkatan apoptosis trofoblas melalui jalur mitokondria. Stimulus apoptosisterjadi melalui modulasi ekspresi P53 dan ekspresi protein Bcl-2 family yang memiliki fungsi antiapoptosisdan proapoptosis. Protein antiapoptosis terdiri atas Bcl-2 dan Bcl-XL akan diekspresikan lebih rendah padakeadaan apoptosis.Tujuan: Untuk melihat perbedaan rerata ekspresi protein antiapoptosis Bcl-2 dan Bcl-XL dan mengidentifikasijenis protein yang dapat dijadikan indikator peningkatan apoptosis.Metode: Rancangan penelitian ini potong lintang dengan populasi penderita kehamilan preeklamsia beratdan normotensi yang dirawat di RSUP Sardjito antara bulan Oktober 2011 hingga Maret 2012. Didapatkansampel plasenta sebanyak 43 kehamilan preeklamsia berat dan 38 kehamilan normotensi. Pengamatanekspresi protein Bcl-2 dan Bcl-XL dengan teknik imunohistokimia. Analisis statistik menggunakanindependent t test (p<0.05).Hasil dan Pembahasan: Terdapat perbedaan yang bermakna (p<0,05) rerata ekspresi protein Bcl-2 padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,03 Â± 0,04) dibandingkan kelompok kehamilannormotensi (1,10 Â± 0,08). Terdapat perbedaan yang bermakna (p<0.05) rerata ekspresi protein Bcl-xL padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,29 Â± 0,12) dibandingkan kelompok kehamilannormotensi (1,71 Â± 0,14). Beda rerata ekspresi protein untuk Bcl-2 (0,076; CI 95% 0,046 â€“ 0,104) lebihrendah dibandingkan beda rerata ekspresi protein Bcl-xL (0,42; CI 95% 0,47- 0,36). Rerata ekspresi proteinBcl-2 dan Bcl-XL lebih rendah pada kelompok preeklamsia berat dibandingkan dengan normotensi baikpada umur kehamilan preterm maupun aterm yang ditunjukkan dengan nilai p<0,05.Kesimpulan: Beda rerata ekspresi protein Bcl-2 dan Bcl-xL lebih rendah pada kehamilan preeklamsia beratdibandingkan kehamilan normotensi. Beda rerata ekspresi protein Bcl-2 lebih rendah dibandingkan bedarerata ekspresi protein Bcl-xl. Preeklamsia berat lebih berpengaruh terhadap ekspresi protein Bcl-2 danBcl-XL dibandingkan umur kehamilanKata Kunci: preeklamsia berat, trofoblas, protein Bcl-2, protein Bcl-xl, apoptosis1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr. Sardjito, Yogyakarta

Dampak Konseling Individu dan Konseling Berpasangan terhadap Penggunaan Kontrasepsi Pascasalin: Randomized Controlled Trials (RCT) Shintiana, Linda; Nurdiati, Detty Siti; Sumarni, Sumarni
JURNAL KESEHATAN REPRODUKSI Vol 4, No 3 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: The achievement of Contraceptive Prevalence Rate (CPR) is 57.9%, which indicates that the Family Planning has not run optimally one of which concerns the utilization of family planning counseling as an attempt to avoid an unplanned pregnancy. The postpartum period is a period appropriate in using contraception. Some studies suggest that the counseling given by health workers will increase the interest of potential acceptors of contraception.Objective:The objective of this research is to increase the utilization of postpartum contraception counseling.Method: This research used Randomised Controlled Trial (RCT) method to provide counseling to couples and individuals. The subject of this study were the final trimester pregnant women with Simple Random Sampling and technique then were randomized to determine the intervention and control groups. Bivariable analysis use statistical test Chi Square with CI 95 % and P value <0.05 and binomial logistic regression multivariable analysis.Result and Discussion:The proportion of postpartum contraceptive utilization in the intervention group compared with the control group was 86% the percentage difference. Variable wife age and information have a significant influence on the utilization of contraception postpartum.Conclusion:The use of counseling in pairs in pregnant women effectively increases the utilization of postpartum contraception.Â Keywords: Counseling, postpartum contraception

Prestasi Belajar pada Remaja yang Mengalami Dismenorea Primer Fajarini, Yuniar Ika; Nurdiati, Detty Siti; Padmawati, Retna Siwi
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Primary dysmenorrhea occurs in approximately 50% of teenage girls and cause serious disruptions in the quality of life and daily activities. Primary dysmenorrhea makes teenagers difficult to concentrate in school which will decrease their academic achievement.Objective: to investigate whether there is a correlation between Primary dysmenorrhea and academic achievement of students of SMP Islam Terpadu Pondok Pesantren Tahfidzul Qurâ€™an (SMP IT PPTQ) Ibnu Abbas Klaten.Method: This study is a case-control study through a quantitative approach and was supported with qualitative data. The research sample is 68 teenage girls of SMP IT PPTQ Ibnu Abbas Klaten who fulfilled the inclusion criteria. The cases groups are female students with low learning achievement, while the control group was female students with high learning achievement. The samples were taken using simple random sampling. Researcher used a structured questionnaire, interview and secondary data to collect the data. The data analysis was using descriptive and inferential analysis including bivariate analysis using chi-square test and multivariate analysis using logistic regression with 95% confidence intervals (CI) and a significance level of p <0.05.Result and Discussion: The bivariate and multivariate analysis showed a significant correlation between primary dysmenorrhea and learning achievement. The possibility of finding girls with primary dysmenorrhea in the group of students who received a low learning achievement is 3 times larger than the group of students who received high learning achievement. Below-average intelligence is greater in the group of low-achieving students than the group of high-achieving students. There is a correlation between the variables of intelligence, stress level and frequency of dysmenorrhea and academic achievement. The variable of absences frequency not related to learning achievement.Conclusion: There is correlation between primary dysmenorrhea and learning achievement (p=0.026). This study indicates that women and their school should pay attention to their menstrual function and dysmenorrhea phenomenon.Keywords: learning achievement, primary dysmenorrhea, teenage, menstrual disorder

Memeriksa Striae Gravidarum untuk Memperkirakan Laserasi Perineum Khrisnamurti, Sinta; Nurdiati, Detty Siti; Setiyarini, Wahyu Ikka
JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Striae gravidarum is a common phenomenon that occurs in pregnant women and a marker of decrease in skin elasticity. Poor elasticity of the perineum can result perineal laceration in vaginal childbirth. This study was to determine the relationship of striae gravidarum perinenum with the occurrence lacerations in normal labor, and the factors that most influence the occurrence of mild and severe perineal lacerations.Method: Used a cross sectional design, with a sample of 188 respondents. Assessment striae gravidarum using Atwal et al (2006) which has been modified, assessment of perineal lacerations used RCOG (2006). Data collection was done during the months of April to July 2015 in the maternity room Panembahan Senopati Bantul Hospital.Results: Factors that influence the occurrence of mild laceration were striae gravidarum moderate-severe (RP 1,230: CI 95% 1,23053-1,23066), primiparous (RP 1,2675: CI 95% 1,13709-1,41298). Factors that influence the occurrence of severe laceration were striae gravidarum moderate-severe (RP 1,676: CI 95% 1,246-2,255), primiparous (RP 1,117: CI 95% 1,1172-1,1175), the lithotomy position (RP 1,012: CI 95% 1,011-1,0629).Conclusion: Striae gravidarum is factor that influence the occurance of perineal laceration. Checking of striae gravidarum can be to estimate the severity of perineal laceration, the more scores striae gravidarum more severe perineal laceration that may be experienced by childbirth mothers.Â Keywords: striae gravidarum; perineal laceration; childbirth

Pengaruh Preeklamsia dan Hipertensi Kronis terhadap Kejadian Bayi Kecil Masa Kehamilan (KMK) Irmitasari, Irmitasari; Nurdiati, Detty Siti; Hadiati, Diah Rumekti
JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Preeclampsia and chronic hypertension are associated with a large number of cases of small infants during pregnancy (SIP) and perinatal deaths. There are conflicting inconsistencies between research on the effect of preeclampsia and chronic hypertension on KMK. The data showed that preeclampsia had a very significant effect on the occurrence of KMK, but in reality not all infants of preeclampsia mothers gave birth to babies with KMK. This raises the assumption that there are other factors that inhibit the influence of preeclampsia and chronic hypertension on birth weight.Objective: to determine the effect of preeclampsia and chronic hypertension on KMK in Dr. Sardjito Yogyakarta.Method: Retrospective cohort. Data of maternity patients with preeclampsia, maternity patients with chronic hypertension, and weight data of babies born at RSUP Dr. Sardjito were recorded. Also noted parity, maternal age, employment and education. Data were taken from medical records and classified into normotension, preeclampsia, and chronic hypertension using consecutive sampling methods.Result and Discussion: There were 81 samples for each normotension group, preeclampsia, and chronic hypertension. Preeclampsia is significantly at risk of experiencing SIP 7,43 times (95% IK 3,13-17,66). Chronic hypertension is significantly at risk of experiencing 5,15 times SIP% IK 2,15-12,36). Multigravida subjects were at risk of experiencing SIP 1,92 times (IK 95% 1,04-3,55) There was no significant difference in the proportion of SIP in subjects based on age, occupation, and education.Conclusion: Preeclampsia, chronic hypertension, and multigravida parity significantly provide a higher risk of the incidence of SIP. If the three factors work together, they will reinforce the effect on increasing the risk of SIP.Keywords: Small gestational period; preeclampsia; chronic hypertension

EFEKTIVITAS PIJAT EFFLEURAGE DAN COUNTERPRESSURE TERHADAP KEMAJUAN DILATASI SERVIKS PADA KALA I FASE AKTIF Santiasari, Retty Nirmala; Nurdiati, Detty Siti; Lismidiati, Wiwin
Media Ilmu Kesehatan Vol 7 No 3: MIK Desember 2018
Publisher : Pusat Penelitian dan Pengabdian kepada Masyarakat FKes Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v7i3.293

Backgraound: Labor process begins with the process of cervical dilatation, which is commonly accompanied by pain. Labor pain caused by uterine contractions can cause thinning of the cervix. Effects of labor pain includes inflammation in uterus and labor dystocia. Effleurage and counterpressure are complementary treatment to stimulate uterine contractions. Objective: To analyze the effectiveness of effleurage and counterpressure massages on the progress of cervical dilatation. Method: This was a quasi-experiment study with pre-post test nonequivalent control group. Population was the women in labor in stage I active phase. Research subjects were 68 people that were divided into two groups. Sampling technique was consecutive sampling. Instrument used in this study was the internal examination. Data were analyzed using Wilcoxon and Mann Whitney. Results: The progress of cervical dilatation before and after the intervention of the effleurage was 4.74±0.83 vs 7.47±1.21 with p=0.00 and the result for the counterpressure group was 4.59±0.66 vs 8.03±0.96 with p=0.00. The average improvement of cervical dilatation on the effleurage and counterpressure groups was 2.73 vs 3.44 with p=0.00. Conclusion: The counterpressure has the more significant effect than the effleurage on improving the cervical dilatation.   Keywords: Cervical dilatation, counterpressure, effleurage

Adi Rahmawan1, Detty Siti Nurdiati2, Sulchan Sofoewan3Â ABSTRACTÂ Background: Ease of access and timeliness in reaching emergency obstetric care is necessary to save the mother and newborn. Delivery by emergency caesarean section aims to save the mother and newborn. The amount of cost from the emergency obstetric care particularly caesarean section, was significantly higher compared to childbirth without complications. The implementation JKN (Jaminan Kesehatan Nasional) aims to overcome this programs. Government hospitals have a dilemma between the mission of serving the lower middle class society and the limited financial resources, as well as a variety of rules and bureaucracy. Casemix system on INA-CBGâ€™s (Indonesian Case Base Groups) is grouping similar patient characteristics. Hospital will receive payments based on the average amount of cost by a group of diagnosis.Â Objective: Knowing the cost of the JKN patient who underwent cesarean section in Dr. Sardjito Hospital. Method: The study design is a descriptive. JKN patients undergoing Caesarean section in January-July 2014 at the Hospital Dr. Sardjito included in the study. Patients who moved to the VIP, VVIP, and suites classes are excluded. Patient cost data will be averaged and be detailed by characteristics.Â Result: A total of 136 patients underwent Caesarean section with JKN during January-July 2014. Average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Patient with severe preeclampsia had average cost of 3,050,776 rupiahs higher than patients without severe preeclampsia. Patients with 4 disesases and complications had the difference in cost 16,995,952 rupiahs higher than patients without the disease. Patients with ICU care had higher average cost than non-admission to the ICU in the amount of 3,340,288 rupiahs. Difference in the higher average costs also occur on length of stay. Class treatment, duration stay in the delivery room, the induction or stimulation in the delivery room. History of cesarean section was not the leading cause of higher cost.Conclusion: The average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Complications of the disease and the patientâ€™s condition, severe preeclampsia, long hospitalization, ICU care, led to high costs in patients underwent Caesarean section.Keyword: seksio sesarea, cost, JKN, INA-CBGâ€™ABSTRAKLatar belakang: Kemudahan akses dan ketepatan waktu dalam menjangkau pelayanan kegawadaruratan obstetri sangat diperlukan demi menyelamatkan ibu dan neonatal. Persalinan dengan seksio sesarea pada kedaruratan obstetrik bertujuan untuk menyelamatkan ibu dan neonatal. Biaya yang dihabiskan dari pelayanan kedaruratan obstetri operasi sesar, secara signifikan lebih tinggi dibandingkan dengan persalinan tanpa penyulit. Terselenggaranya program Jaminan Kesehehatan Nasional (JKN) mempunyai tujuan untuk mengatasi hal tersebut. Rumah sakit pemerintah menghadapi dilema antara misi melayani masyarakat kelas menengah ke bawah dengan adanya keterbatasan sumber dana, serta berbagai aturan dan birokrasi yang harus dihadapi. Sistem casemix pada INA-CBGâ€™s merupakan pengelompokan karakteristik pasien yang sejenis. Rumah Sakit akan mendapatkan pembayaran berdasarkan rata-rata biaya yang dihabiskan oleh suatu kelompok diagnosis.Tujuan: Mengetahui besarnya biaya pasien Jaminan Kesehatan Nasional (JKN) yang menjalani operasi seksio sesarea di RSUP Dr. SardjitoÂ Metode: Rancangan penelitian yang akan digunakan adalah deskriptif. Pasien JKN yang menjalani seksio sesarea pada Januari-Juli 2014 di RSUP Dr. Sardjito diikutsertakan dalam penelitian ini. Pasien yang pindah perawatan ke kelas VIP, VVIP, dan suite di eksklusi. Data biaya pasien akan dirata-rata dan dirinci besarnya berdasarkan karakteristikÂ Hasil & Pembahasan: Sebanyak 136 pasien JKN menjalani seksio sesarea selama Januari-Juli 2014. Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. Pasien preeklamsia berat mempunyai ratas-rata biaya yang lebih tinggi 3.050.776 rupiah dibandingkan pasien tanpa preeklamsia berat. Pasien dengan 4 penyakit dan komplikasi mempunyai selisih biaya 16.995.952 rupiah lebih tinggi dibandingkan pasien tanpa penyakit. Pasien dengan perawatan ICU mempunyai rata-rata biaya yang lebih tinggi dibanding yang tidak dirawat di ICU yaitu sebesar 3.340.288 rupiah. Selisih rata-rata biaya yang lebih tinggi juga terjadi pada lama rawat inap. Kelas perawatan, lama perawatan di kamar bersalin, tindakan induksi atau stimulasi di kamar bersalin, riwayat seksio sesarea saat ini tidak menyebabkan semakin tingginya biaya seksio sesarea.Kesimpulan: Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. kondisi penyakit dan komplikasi pasien, preeklamsia berat, lama rawat inap, dan perawatan ICU menyebabkan tingginya biaya pada pasien yang menjalani seksio sesarea.Â Kata kunci: seksio sesarea, biaya, JKN, INA-CBGâ€™s1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta

Co-Authors - Pujiatun Adi Rahmawan Adi Rahmawan, Adi Agung Dewanto Ahsanudin Attamimi Alifia Salsabila Amdad Amdad Amelia, Dwirani Anggoro Budi Hartopo Anindya K Zahra Anis Widyasari Anjarwati Anjarwati Anjarwati Anjarwati, Anjarwati Ari Purwoko Widji Utomo Armalya Pritazahra Asri C. Adisasmita Atik Tri Ratnawati Atik Triratnawati Budi Arianto Budi Arianto, Budi Darwin Nasution Depari, Irmanda Terbelluh Sembiring Dessy Hertati Dewanto, Agung Dewi Rokhanawati Dewi Rokhanawati, Dewi Dhesi Ari Astuti, Dhesi Ari Dhesy Ari Astuti Dhesy Ari Astuti, Dhesy Ari Diah Rumekti Hadiati Djaswadi Dasuki Dyah Wulan Anggrahini Eka Rati Astuti Ely Yulianus Musa Limbu Emy Huriyati Erna Ashlihah Rochmat Eugenius Phyowai Ganap Fajarini, Yuniar Ika Fauzan Achmad Maliki Febriana Sari Febriana Sari, Febriana Fika Humaeda Assilmi Fitri Haryanti Fitriana K, Herlin Fitriana K., Herlin Ganap, Eugenius Phyowai Hamam Hadi Herlin Fitriana K Husnah Husnah Indria Laksmi Gamayanti Indria Laksmi Gamayanti Intan Agustina Anggraeni Irmitasari Irmitasari Irmitasari, Irmitasari Irwan Taufiqur Rachman Iswanti, Tutik Iswanti1, Tutik Johariyah - Johariyah Juli Sitorus Kamsiah . Kartika Wahyuningtyas Utami Kemal N. Siregar Khairina Hashifah Khrisnamurti, Sinta Kristiana Tri Warsini Kusuma, Raden Aditya Lidia Aditama Putri Linda Shintiana Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati Lucia Kris Dinarti Mae Sri Hartati Wahyuningsih Muhammad Gahan Satwiko Muhammad Nurhadi Rahman Muhammad Reyhan Hadwiono Musa Limbu, Ely Yulianus Nasution, Darwin Nirmala Santiasari, Retty Noer Saudah Noer Saudah, Noer Nu Pravitasari Nur Falah Setyawati Nur Khamidah Nuring Pangastuti Ori Pertami Enardi Ova Emilia Pramudji Hastuti, Pramudji Prihesti, Uce Siswi Priyatin Sulistyowati Rachmawati Widyaningrum Ratna Widhiastuti Retty Nirmala Santiasari Retty Nirmala Santiasari Ririn Ariyanti Ririn Ariyanti, Ririn Santiasari, Retty Nirmala Santiasari, Retty Nirmala Saputro, Christina Sarah Ayu Andari Setiarsih, Dini Setiyarini, Wahyu Ikka Shintiana, Linda Sinta Khrisnamurti Sitorus, Juli Sitorus, Melina Ebtarina Sitorus, Melina Ebtarina Sri Juana Sri Restu Sulchan Sofoewan Sulchan Sofoewan, Sulchan Sulistyaningsih, Sulistyaningsih - Sumarni Sumarni Sumarni Sumarni Tutik Iswanti Uce Siswi Prihesti Untung S. Widodo Utomo, Muhammad Wahyu Vera Dewanto Wahyu Ikka Setiyarini Wahyu Ikka setyarini Wahyu Widayati Wahyu Widayati, Wahyu Widyaningrum, Rachmawati Widyawati Widyawati Widyawati Widyawati Wiwin Lismidiati Yanuarti Petrika Yayi Suryo Prabandari Yuniar Ika Fajarini

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