Ratnasari Dwi Cahyanti, Ratnasari Dwi
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Faktor Risiko Individu dan Masyarakat serta Gambaran Pelayanan Kesehatan terhadap Kasus Preeklampsia Berat di RSUD Manokwari Kabupaten Manokwari Provinsi Papua Barat (Periode September 2015-Februari 2016) Sugiarti, Endang Sri; Soejoenoes, Ariawan; Cahyanti, Ratnasari Dwi; Hartono, Eddy
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (248.871 KB) | DOI: 10.22146/jkr.35420

Abstract

Background: The high rate of maternal mortality is still a health problem in Indonesia and also reects the uality of health care during pregnancy and childbirth. The main causes of maternal mortality in Indonesia is hypertension (32.4) and postpartum bleeding (28.3). Recently in Manowari eneral Hospital there is an increase trend cases of severe preeclampsia include 12 cases (September 2015), 14 cases (October 2015) and 14 cases (November 2015).Objective: To identify ris factors of the community and health care to cases of severe preeclampsia in the eneral Hospital of Manowari, Papua Barat Province period September 2015 - ebruary 2016. Method: The study was an observational descriptive study, cross sectional design with a retrospective approach. A total of 148 medical records of pregnant women who meet the eligibility criteria for inclusion in this study. Chi-suare test and isher eact was used for statistical analysis. Multivariate analysis using logistic regression with signicance p 0.05.Result and Discussion: A total of 148 medical records of pregnant women from September 2015 - ebruary 2016 met eligibility criteria which consisted of 74 pregnant women with severe preeclampsia and 74 pregnant women without preeclampsia. Chi-suare analysis showed a signicant association between gestational age 20-36 wees with severe preeclampsia cases (p 0.016; RR 1.8; CI 1.2 to 26.6) and a history of hypertension (p 0.000; RR 2.2; CI 3.1 to 21.2). Community ris factors had no signicant relationship with severe preeclampsia. The health care services regarding severe preeclampsia was well implemented and the second phase delay mainly due to geographic factors.Conclusion: There is a signicant association between gestational age 20-36 wees and a history of hypertension in cases of severe preeclampsia.Keywords: severe preeclampsia, gestational age, history of hypertension, ris factor of the community, second phase delay
Faktor yang Berhubungan dengan Penerimaan Alat Kontrasepsi Dalam Rahim Pascasalin di Samarinda Pella Todungbua', Prima Derry; Cahyanti, Ratnasari Dwi; Respati, Supriyadi Hari
JURNAL KESEHATAN REPRODUKSI Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.56939

Abstract

Background: Maternal mortality rate (MMR) in Indonesia is 305 per 100.000 live births. The intervention to suppress MMR according to four pillars of Safe Motherhood is reducing the possibility of woman becoming pregnant with Family Planning. The postpartum period is an important time to start, but underutilized. All contraceptive methods may be used, but the high rate of drop-out in non-long-term methods, counselling is directed to long-term methods like IUD.Objective: To determine factor that related postpartum IUD acceptance in Samarinda.Method: The research method is observational with cross sectional design. Sampling is done by purposive sampling. Data were obtained through questionnaire.Result: There was no significant association between age (p=0.438), parity (RR=0.7; p=0.077), education (RR=1.11; p=0.611), and income (RR=0.69; p=0.105)  with acceptance of postpartum IUD. Employment (RR=1.64; p=0.025), history of family planning counselling (RR=3.37; p<0.001), and husband's approval (RR=28.8; p=<0.001) have significant association with the acceptance of postpartum IUD.Conclusion: Age, parity, education, and income are not related factors of postpartum IUD acceptance, while employment, husband's approval, and history of family planning counselling are related factors of postpartum IUD acceptance in Samarinda.Keywords: Postpartum IUD, family planning counselling, husband's approval.           
Comparison between Insulin-like Growth Factor Binding Protein-1 Level and Bishop Score as Predictor of Successful Labor Induction in Full Term Pregnancy with Preeclampsia Setiyorini, Nurul; Cahyanti, Ratnasari Dwi
Sains Medika: Jurnal Kedokteran dan Kesehatan Vol 11, No 2 (2020): December 2020
Publisher : Faculty of Medicine, Universitas Islam Sultan Agung (UNISSULA), Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2092.55 KB) | DOI: 10.30659/sainsmed.v11i2.10919

Abstract

Introduction: preeclampsia/eclampsia contributed to 30% of maternal mortality in RSUP Dr. Kariadi. Pre-induction bishop score assessment is a standard for cervical maturity estimation. Other predictors currently being developed, including insulin-like growth factor binding protein-1 (IGFBP-1). However, there is no cut-off point for IGFBP-1 examination in full term pregnancy, especially with preeclampsia and its complications. Objective: to find IGFBP-1 levels and Bishop Score differences in preeclampsia women with induction labor.Methods: this prospective observational cohort study was conducted in preeclampsia women with gestational age ≥37 weeks planned labor induction at Obstetrics and Gynecology Ward RSUP Dr. Kariadi Semarang and networking hospital during study period (n=66). History taking, physical examination, proteinuria, cervical mucus IGFBP-1, and bishop score calculation was performed. Statistical analysis was performed with paired-t test, followed by ROC for cut-off value of successful induction prediction, and logistic regression to determine confounding variables effect on IGFBP-1 levels.Results: The average Bishop score of 66 subjects was 2.5±1.81 and 2.6±1.8 for women who deliver ≤24 labor and in labor for ≤12 hours, respectively. Although the bishop score was higher in the successful labor group, there was no significant difference between groups. Mean IGFBP-1 value was 8.29±5.033 mcg/L with median value of 10.8 mcg/L. Successful induction had significant higher IGFBP-1 levels with area-under-curve (AUC) 0.76 and 8.145 cutoff value (p=0.002, RR=5.1).Conclusion: IGFBP-1 level with cutoff point 8.145 can be used as predictor of successful labor induction in term pregnancy with preeclampsia.
Comparison Between Placenta Accreta Index and Tovbin Score as A Predictor of Placenta Accreta Spectrum Disorders (PASD) Dinata, Willy Angga; Hafiz, Alini; Mochtar, Arufiadi Anityo; Dewantiningrum, Julian; Wiyati, Putri Sekar; Cahyanti, Ratnasari Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.980

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Background : The incidence of  Placenta Accreta Spectrum Disorders (PASD) in developed countries has reportedly increased 10-fold in the last 50 years. The significant increase was followed by an increase in the number of caesarean section from 12.5% to 23.5% in the last 10 years. Maternal morbidity related to PASD events reaches 7% in intraoperative and postoperative actions, while the morbidity reaches 60%. In cases of late diagnosis, maternal mortality with placenta accreta reaches 30%. Efforts to prevent maternal morbidity and mortality can be carried out by early detection at antenatal care visits. The Placenta Accreta Index (PAI) and Tovbin scoring systems based on the results of ultrasound examination can be used to screening for placenta accreta. Objective: To analyze the comparison of the accuracy of the PAI and Tovbin scoring systems in predicting the incidence of Placenta Accreta Spectrum Disorder (PASD). Method: The study used an analytic observational with a cross sectional design. Sampling was done by consecutive sampling method. There were 35 subjects who met the inclusion and exclusion criteria. PAI and Tovbin scoring were performed on each selected subject. The accuracy of the PAI and Tovbin scoring systems was confirmed by establishing a diagnosis based on PASD histopathology. Results: The PAI scoring system in predicting PASD has a sensitivity value of 79.31%, a specificity of 83.33%, a positive predictive value (NDP) of 95.83%, a negative predictive value (NDN) of 45.45%, an accuracy of 80.00%. While the Tovbin scoring system obtained a sensitivity value of 86.21%, specificity of 83.33%, NDP of 96.15%, NDN of 55.56%, accuracy of 85.71 %. Conclusion: In the comparison of scoring systems, it was found that the Tovbin scoring system has almost the same sensitivity and accuracy and the same specificity in predicting Placenta Accreta Spectrum Disorder (PASD).
Effect of DLBS3233, Metformin, and Their Combination on the Expressions of VEGF and Endometriosis Implants in Endometriosis Mice (A Mouse Model in Endometriosis Study) Wardana, Setya Girindra; Trisetiyono, Yuli; Hadijono, Raden Soerjo; Mulyantoro, Inu; Cahyanti, Ratnasari Dwi; Dewantiningrum, Julian
Diponegoro International Medical Journal Vol 4, No 2 (2023): December 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v4i2.18393

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Abstract Background: Endometriosis is a gynaecological disorder characterized by the presence of endometrial tissue outside the uterine cavity. The process of angiogenesis is regulated by VEGF which plays an important role in the development of endometriosis implants. Metformin is an insulin sensitizer that is known to have a beneficial effect in the treatment of endometriosis and DLBS3233 is a PPARγ agonist, it is hoped that it can reduce VEGF and reduce endometrial implants..Objective: To explore the effect of DLBS3233, metformin, and combination on VEGF expression and endometrial implant area of endometriosis-induced mice.Methods: This experimental study used 3-months old 28 BALB/c mice of endometriosis that were randomly and equally divided into four groups (K, P1, P2, and P3). On the 15th day, the K group was given a placebo, the P1 group was given DLBS3233 0.25 mg/day for 14 days, the P2 group was given metformin 4 mg/day for 14 days and the P3 group was given a combination. The immunohistochemistry of VEGF expression was performed from the abdominal cavity and pelvic peritoneal tissues of the mice and measured by the Remmele Scale Index, while the extracted mice's endometrial implants were analyzed with a computer tracing method. All data normality tests were calculated with the Shapiro-Wilk test. The mean difference test of all groups was analyzed using the one-way ANOVA test and the Kruskal-Wallis test.Results: There were significant differences in the expressions of VEGF (p=0.005) and endometrial implants (p=0.001). Expression of VEGF in the P3 group was significantly lower compared to others and endometrial implant area in the P2 group was significantly lower compared to others.Conclusion: DLBS3233 and Metformin may be a potentially effective drug treatments for endometriosis by decreasing VEGF expression and endometrial implants. Keywords: DLBS3233, Endometriosis, Metformin, VEGF
Perbandingan Luaran Maternal dan Perinatal Kehamilan Terkonfirmasi Covid-19 antara Gelombang Pertama dan Kedua Pandemi Irsan, Raissa Alifia; Farhanah, Nur; Trisetiyono, Yuli; Cahyanti, Ratnasari Dwi
JURNAL KESEHATAN REPRODUKSI Vol 10, No 3 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.81781

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Background : New cases of COVID-19 continued to emerge due to the new variants. Pregnant women are more susceptible to severe infections.Objective : To compare the effect of COVID-19 infection on maternal and perinatal outcomes in the first and second waves.Method : An analytical observational study with a cross-sectional design was used. Samples were selected by consecutive sampling from the medical record data of RSUP Dr. Kariadi Semarang, Indonesia, with 47 cases during the first wave (1 August 2020 to 14 May 2021) and 47 cases during the second wave (16 May to 30 September 2021). Data were analysed using univariate, chi-square, fisher’s exact, and logistic regression tests with a significant value of p <0,05.Results and Discussion : Pneumonia, ICU admission, and oxygen consumptions were higher in the second than the first wave as 87.23% VS 70.21%; p = 0.044, 36.17% VS 14.89%; p = 0.018, 65.96% VS 12.77%; p < 0.0001 respectively. The severe COVID-19 infection and maternal mortality increased in the second wave (51,06% VS 14,89%; p = 0.009; 29,79% VS 8,51%; p = <0.001). There were no differences in perinatal outcomes between the first and second waves such as fetal distress, fetal growth retardation, low birth weight, nICU admission, and mortality (0.00% VS 8.51%; p = 0.117, 0.00% VS 4.26%; p = 0.495, 12.77% VS 25.53%; p = 0.116, 12.77% VS 21.28%; p = 0.272, 4.26% VS 8.51%; p = 0.677). The incidence of COVID-19 infection in neonates remained low in both waves at 17.02% VS 12.77%; p = 0.562.Conclusion : Even though a high number of severe diseases to maternal deaths were found during the second wave, neonatal COVID-19 infections remained low. 
Perbandingan Karakteristik dan Luaran Maternal pada Unexpected Spektrum Placenta Akreta saat Pandemi Covid -19 Cahyanti, Ratnasari Dwi; Dewantiningrum, Julian; Pramono, Besari Adi; Larasati, Irene Astrid; Wiyati, Putri Sekar
JURNAL KESEHATAN REPRODUKSI Vol 10, No 2 (2023)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.87601

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Latar belakang: Pandemi COVID-19 mempengaruhi sistem pelayanan kesehatan di dunia. Kegawatan maternal yang diakibatkan oleh Spektrum Placenta Akreta (SPA) menjadi tantangan di bidang obstetri, khususnya dalam kinerja multidisplin tim dan dukungan sumber daya fasilitas kesehatan.Tujuan: Membandingkan karakteristik dan luaran dari pasien dengan unexpected dan expected SPA saat pandemi COVID-19.Metode: Desain penelitian secara cross-sectional. Pengambilan sampel kasus SPA secara consecutive sampling dari data rekam medis RSUP Dr. Kariadi, Semarang, pada periode 2020 – 2021.Hasil dan Pembahasan: Limapuluh tiga dari 154 kasus (34,42%) merupakan unexpected SPA. Tidak terdapat perbedaan karakteristik yang meliputi umur, indeks massa tubuh, jumlah riwayat sectio cesarea, jumlah riwayat placenta previa, cara persalinan dan kerjasama tim. Jumlah perdarahan dan kebutuhan transfusi darah yang diberikan tidak terdapat perbedaan pada kedua kelompok. Terdapat risiko untuk Cesarean histerektomi pada unexpected SPA (adjusted OR 4,13 (1,31-55,02)). Case Fatality Rate (CFR) pada unexpeted 5,67%, sedangkan pada expected 0,9%. Pada kasus unexpexted SPA didapatkan 3 kasus dengan terkonfirmasi COVID-19 dan meninggal.Kesimpulan: Tata kelola spektrum placenta akreta di RSUP Dr. Kariadi selama pandemi COVID-19 tidak terdapat perbedaan luaran maternal pada kasus unxpected dan expected dan didapatkan kualitas pelayanan optimal dengan CFR yang rendah.Kata kunci: Spektrum Placenta Akreta (SPA), unxpected dan expected, pandemi COVID-19, luaran maternal
Effect of Vitamin D Supplementation on Aorta Diameter of Pregnant Wistar Rats (Rattus norvegicus) Haryono, Az Zahra Khaiirunnisa; Cahyanti, Ratnasari Dwi; Mundhofir, Farmaditya Eka Putra; Pramono, M.Besari Adi
DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN Vol 16, No 1 (2025): Dinamika Kesehatan: Jurnal Kebidanan dan Keperawatan
Publisher : Universitas Sari Mulia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33859/dksm.v16i1.1019

Abstract

Background: Hypertension is one of the clinical signs of preeclampsia or eclampsia, which is estimated to be seven times higher in developing countries than in developed countries. It can be caused by the differences in nutritional status and nutritional intake, one of which is vitamin D. Vitamin D deficiency (VDD) has a negative impact on pregnancy. It increases the risk of preeclampsia, long-term hypertension, miscarriage, and vascular disorder. Vasoconstriction as the beginning of preeclampsia can be related to the diameter of the aorta which is the largest blood vessel in the human body.Purpose: Determine the effect of vitamin D intake on the aorta diameter of pregnant Wistar rats (Rattus norvegicus).Method: True experimental with post-test only control group design. Research on pregnant Wistar rats (Rattus norvegicus) was divided into control and treatment groups. The treatment group of pregnant Wistar rats was given a standard diet during pregnancy and given a dose of 1000 IU/day (human doses) or 18 IU/day (rat doses) of vitamin D on days 1 to 17. On the 18th day, surgery was performed to take the aorta, and its diameter was measured.Results: The mean aorta diameter of the control group was 1742,04 µm and the treatment group was 1889,30 µm.Conclusion: There is a clinical inclination that the mean aorta diameter of pregnant Wistar rats (Rattus norvegicus) in the treatment group given 18 IU vitamin D is greater than the control group.