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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi The Indonesian Biomedical Journal Jurnal Kesehatan Reproduksi Mandala of Health : A Scientific Journal Medical and Health Journal
Diah Rumekti Hadiati
Department Of Obstetrics And Gynecology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Jl. Farmako, Sekip Utara, Yogyakarta 55281
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Hubungan Kadar β-hCG 12 Hari Pasca Transfer Embryo dengan Luaran Kehamilan Kurniawan, Agung; Widad, Shofwal; Hadiati, Diah Rumekti
JURNAL KESEHATAN REPRODUKSI Vol 7, No 1 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.53479

Abstract

Latar Belakang: Subfertilitas merupakan salah satu permasalahan yang sering ditemukan di era modern ini. Berbagai metode ditemukan dan digunakan untuk meningkatkan angka keberhasilan reproduksi pada perempuan. Teknologi reproduksi berbantu memiliki risiko terjadinya keguguran dan kehamilan ektopik. Kadar serum β-hCG 12 hari pasca transfer embryo memiliki peranan penting dalam prediksi luaran kehamilan.Tujuan: Untuk memprediksi luaran kehamilan, sensitivitas, spesifisitas serta nilai ambang kadar β-hCG 12 hari pasca transfer embryo.Metode: Penelitian menggunakan  rancangan penelitian observasional kohort retrospektif di Klinik Permata Hati RSUP. Dr. Sardjito Yogyakarta tahun 2012 – 2015. Subyek penelitian 130 subyek yang terbagi menjadi 65 subyek dengan kadar β-hCG  <76 IU/l dan 65 subyek ≥76 IU/l. Luaran kehamilan diklasifikasikan sebagai viabel (janin hidup pada usia kehamilan ≥ 22 minggu) dan non viabel ( kehamilan biokimia, ektopik, mola dan keguguran).Hasil dan Pembahasan: Median dan minimum kadar β-hCG pada kehamilan viabel 167 IU/l dan 44 IU/l,  dan 53 IU/l dan 16 IU/l pada kehamilan non viabel. Terdapat hubungan yang bermakna antara kadar serum β-hCG 12 hari pasca transfer embryo dengan luaran kehamilan. Kadar  β-hCG  ≥76 IU/l sebanyak 50 (76,9%) pada kehamilan viabel  dan sebanyak 15 (23,1%) subyek pada kehamilan non viabel.  Kadar β-hCG <76 IU/l sebanyak 7 (10,8%) pada kehamilan viabel dan 58 (89,2%) pada kehamilan non viabel (p=0,000). Kadar β-hCG terendah pada kehamilan ganda 300 IU/l.Kesimpulan: Kadar β-hCG 12 hari pasca transfer embryo bermakna secara statistik dalam membantu memprediksi luaran kehamilan viabel dengan cut-off point 71,5 IU/l, sensitivitas 89,1 % dan spesifitas 79,5 %. Nilai positive predictive value (PPV) adalah 76,9 %, dan nilai negative predictive value (NPV) adalah  89,2%.Kata kunci: Teknologi reproduksi berbantu, subfertilitas, kadar β-hCG, transfer embryo, luaran kehamilan. 
Comparison of Bcl-xL protein expression in placental trophoblast cells between pregnancy complicated by severe preeclampsia and normotensive pregnancy Diah Rumekti Hadiati; Arsi Palupi; Mohammad Hakimi; Sofia Mubarika Haryana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (373.436 KB) | DOI: 10.19106/JMedSci005001201804

Abstract

Preeclampsia is one of the main causes of maternal and perinatal mortality and morbidity.The pathogenesis of preeclampsia remains unclear until now. It is believed thatregulation of apoptosis in trophoblast cells plays an important role in the pathophysiologyof preeclampsia. Failure of spiral arteries remodeling will eventually lead to placentalhypoxia lead to excessive trophoblast apoptosis. The molecular mechanism of apoptosisis very complicated involving many signaling molecules included Bcl-2 proteins. The Bcl-2 protein group consists of proapoptosis proteins (Bax) and apoptosis inhibitor proteins(Bcl-2 and Bcl-xL). The aimed of this stuty was to compare the expression of Bcl-xLprotein in placental trophoblast cells of pregnancy complicated by severe preeclampsiawith that normotensive pregnancy. This study was an observational study with crosssectional design involving 43 pregnancy patients with severe preeclampsia and 38normotensive pregnancy who treated in Dr. Sardjito General Hospital, Yogyakarta fromOctober 2011 until March 2012. Placenta samples were obtained from all subjects forBcl-xL protein expression analysis using immunohistochemistry technique. Data wereanalyzed using independent t-test, chi-square test, and logistic regression. A p value<0.05 was considered significant. Significant difference in Bcl-xL protein expressionin trophoblast cells of pregnancy complicated by severe preeclampsia (1.29 ± 0.12)compared to that normotensive pregnancy (1.71 ± 0.14) was reported (p = 0.00). Inaddition, logistic regression test showed that diagnosis of severe preeclampsia had astatistically significant role in Bcl-xL protein expression (p= 0.000). In conclusion, theexpression of Bcl-xL protein is lower in pregnancy complicated by severe preeclampsiacompared to normotensive pregnancy.
DENSITAS MASSA TULANG PADA PENGGUNA KONTRASEPSI IMPLAN LEVONORGESTREL Andriana Kumala Dewi; Djaswadi Dasuki; Diah Rumekti Hadiati
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.123 KB) | DOI: 10.22146/jkr.5349

Abstract

DENSITAS MASSA TULANG PADA PENGGUNA KONTRASEPSI IMPLAN LEVONORGESTREL Andriana Kumala Dewi1 , Djaswadi Dasuki2, Diah Rumekti Hadiati3  ABSTRACT Background: BKKBN reported that implant as a long term method of contraception was the most widely used among new users in 2012. The contraceptive action is mainly by inhibition of ovulation and production of estrogen is supressed. Estrogen is one of the most important factors related to bone remodelling. Thus, it has raised concerns regarding the adverse effect of long term use of this contraceptive method on the bone status of women who use them. So, it is necessary to study the effects of long term use of progestogens on bone mineral density.Objective: Comparing bone mass density in contraceptive implant users and non-hormonal users.Methods: Cross sectional study. This study was conducted in Kontap, outpatient department, Sardjito Hospital in August-December 2013. The participants’ age were 20-50 years who met the inclusion criteria and regardless of the exclusion criteria. Total of 110 women were divided into 2 groups, contraceptive implant users and non-hormonal contraceptive users. Bone mass density was measured using ultrasound densitometry on the calcaneus bone.Results: Bivariate Chi-square analysis showed that there was no significant association between the use of the contraceptive implant with incidence of abnormal bone density (RP 1.75; 95% CI (0.80-3.83), p = 0.23). BMI as confounding variable provide a significant relationship with bone density with OR 23.24; 95% CI (4.26 to 126.86), p <0.001Conclusion: In this study, there was no significant difference of bone mass density between contraceptive implant group and non hormonal group. BMI were significantly related to bone mass density. Keyword: Bone mineral density, contraceptive implant, contraceptive progestin-only, levonorgestrel  ABSTRAK Latar belakang: Data BKKBN menunjukkan bahwa implan merupakan metode kontrasepsi jangka panjang terbanyak dipakai oleh peserta baru KB tahun 2012. Cara kerja utama implan levonorgestrel dengan inhibisi ovulasi sehingga terjadi supresi produksi estrogen. Estrogen adalah salah satu faktor penting dalam remodelling tulang. Hal inilah yang memunculkan kekhawatiran tentang pengaruh penggunaan implan terhadap status kesehatan tulang pemakainya.Tujuan: Membandingkan densitas massa tulang pada pengguna kontrasepsi implan levonorgetrel dan non hormonal.Metode penelitian: Studi potong lintang. Penelitian dilakukan di Poliklinik Kontap, RSUP Dr. Sardjito. Jumlah peserta penelitian 110 wanita berusia 20-50 tahun yang memenuhi kriteria inklusi dan terlepas dari kriteria eksklusi, terbagi menjadi 2 kelompok, yaitu kelompok pengguna kontrasepsi implan dan pengguna kontrasepsi non hormonal. Densitas massa tulang diukur dengan menggunakan alat densitometri ultrasonografi pada tulang kalkaneus.Hasil: Analisis bivariat Chi-square menunjukkan bahwa tidak ada hubungan bermakna antara penggunaan kontrasepsi implan dengan kejadian densitas tulang yang tidak normal (RP 1,75; IK 95% (0,80-3,83), p=0,23). BMI sebagai variabel luar memberikan hasil analisis yang bermakna terhadap kejadian densitas tulang tidak normal dengan nilai OR 23,24; IK 95% (4,26-126,86), p<0,001.Kesimpulan: Tidak ada perbedaan densitas massa tulang yang bermakna antara kelompok pengguna kontrasepsi implan dan non hormonal. BMI kategori underweight secara signifikan memiliki hubungan dengan kejadian densitas tulang tidak normal. Kata kunci: densitas massa tulang, kontrasepsi implan, kontrasepsi progestin-only, levonorgestrel 1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr.Sardjito Yogyakarta
PERBANDINGAN RERATA EKSPRESI Bcl-2 DAN Bcl-XL PADA PREEKLAMSIA BERAT DAN KEHAMILAN NORMOTENSI Budi Arianto; Diah Rumekti Hadiati; Detty Siti Nurdiati
JURNAL KESEHATAN REPRODUKSI Vol 2, No 2 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.12639

Abstract

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 ± 0.04) compared to normotensivegroup (1.10 ± 0.08). The mean expression of Bcl-XL protein in trophoblast tissue severe preeclampsiagroup (1.29 ± 0.12) compared to normotensive group (1.71 ± 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 ± 0,04) dibandingkan kelompok kehamilannormotensi (1,10 ± 0,08). Terdapat perbedaan yang bermakna (p<0.05) rerata ekspresi protein Bcl-xL padajaringan trofoblas kelompok kehamilan preeklamsia berat (1,29 ± 0,12) dibandingkan kelompok kehamilannormotensi (1,71 ± 0,14). Beda rerata ekspresi protein untuk Bcl-2 (0,076; CI 95% 0,046 – 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
Accuracy of Risanto's Formula Compared with Johnson's to Estimate Fetal Weight in Overweight Mothers Fifi Noviana; Risanto Siswosudarmo; Diah Rumekti Hadiati
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.13873

Abstract

Background: Estimated fetal weight (EFW) is becoming important because it is used as a guidence for determining mode of delivery. The use of estimated fetal weight based on fundal height has been widely used, but its use in overweight pregnant mothers was still limitted.Objective: To compare the accuracy of Risanto’s and Johnson’s formulas in estimating fetal weight based on fundal height in overweight mothers.Method: It was a cross-sectional study, conducted from March 2013 to July 2014 in Sardjito hospital and hospital networks. All pregnant mothers meeting the elligibility criteria were used as study subjects. Overweight mother was defined based on body mass index (BMI) and skinfold thickness on suprailiaca region. Fundal height (FH) was measured from the symphysis pubis to the midle of the upper border of the pregnant uterus. Accuracy of Risanto’s and Johnson’s formulas was dtermined by comparing the difference between EFW and actual infant birth weight (AIBW). Paired t-test was used for statistical analysis.Result and Discussion: There were 395 overweight pregnant mothers fulfilling the inclusion and exclusion criteria. The mean AIBW was 3060.3 ± 322.5 grams (ranged from 2360 to 3940 grams). The mean EFW using Risanto formula (R_EFW) was 3095.8 ± 320.3 grams (ranged from 2370 to 3870 grams ) while that of Johnson (J_EFW) was 3273,7 ± 378,1 grams (ranged from 2325 to 4185 grams). The mean difference between between AIBW and ∆R) EFW (was 109.85 grams while that of AIBW and J_EFW∆J) (was 198.41 grams ∆.RIt was clear that significantly smaller ∆J than with the mean difference minus 88.56 grams (95% CI -98.76 to -78.35; p value 0.000).Conclusion: The new Risanto’s formula was more accurate to estmate infant birth weight than Johnson’s in overweight mothers.Keywords: Risanto’s and Johnson’s Formulas, Estimated Fetal Weight, Overweight Mothers.
PERBANDINGAN PREPARASI KULIT MENGGUNAKAN ALKOHOL-KLORHEKSIDIN DENGAN ALKOHOL-POVIDON IODIN TERHADAP INFEKSI LUKA OPERASI SEKSIO SESAREA Moh. Nailul Fahmi; Diah Rumekti Hadiati; Shofwal Widad
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 | DOI: 10.22146/jkr.35416

Abstract

Background: Surgical site infection (SSI) is the second most frequent nosocomial infection and has high morbidity and mortality rate. The use of preoperative skin antiseptics effective in preventing of surgical site infection. There are lack of evidences to evaluate types, concentration and application methods of antiseptic for skin preparation for preventing infection following caesarean sectionObjective: to determine the difference of SSI rate in patients receiving alcohol-chlorhexidine and alcoholpovidone iodine as an agent for skin preparation during caesarean section. Method: The study design was randomized clinical trial. The study was conducted in Dr Sardjito hospital and two affiliated hospital (Saras Husada Hospital and Panembahan Senopati Hospital). Total 174 subjects meeting in inclusion and exclusion criteria were divided into two groups. Experimental group (87 subjects) received alcohol-chlorhexidine as skin preparation antiseptic during caesarean section. Control group (87 subjects) received alcohol-povidone iodine. A computer generated random number was created to assigned subject into experimental and control goups. Outcome assessment was performed on day 3 and day 7 after caesarean section. Surgical site infection was diagnosed based on Center for Disease Control and Prevention (CDC) criteria.Result and Discussion: There were no differences in terms of age, weeks of gestation, body mass index, parity, emergency/elective, duration of operation, duration of membrane rupture, and number of vaginal examination between two groups (P>0.05). SSI rates on day 3 were similar between two groups, alcoholchlorhexidine group was 13.8% (12 subjects) and alcohol-povidone iodine group was 11.5% (10 subjects). Cumulative SSI for 7 days were similar (p=1) between two group, alcohol-chlorhexidine group was 13.8% (12 subjects) and alcohol-povidone iodine group was 12.6% (11 subjects). Conclusions: there were no differences of SSI rates in patients receiving alcohol-chlorhexidine and alcoholpovidone iodine as an agent for skin preparation during caesarean section.Keywords: Surgical site infections, skin preparation, alcohol, povidone iodine, chlorhexidine, caesarean section.
Kadar Hormon LH Basal sebagai Prediktor Kebrhasilan Stimulasi Ovarium pada Program Bayi Tabung Dyah Ariantini; Mohammad Lutfi; Diah Rumekti Hadiati
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.37988

Abstract

Background: Ovarian stimulation is part of assisted reproductive technology (ART) process, which aims to spur the growth of follicles to be developed, so that it will increase the chance of getting pregnant. LH surge cause the final follicular maturation, ovulation and becoming corpus luteum. So that an increase in LH may adversely affect the development of the follicle and eventually affect in-vitro fertilization.Objective To determine the effect of basal LH hormone to follicles on the stimulation of ovarian.Method: Cohort Retrospective. Research Location: Permata Hati Clinic of Sardjito Hospital, YogyakartaResult dan Discussion: The study included 70 cycles of 70 women who underwent ovarian stimulation for in-vitro fertilization and fulfill inclusion and exclusion criterias. The subjects were divided into 2 groups based on basal LH hormone levels i.e. LH ≤ 3 mIU/ml as the test group and LH >3 mIU/ml as the control group. From analysis, response to ovarian stimulation in group with LH ≤3 mIU/ml was significantly different than LH >3 mIU/ml (RR 1,875; 95% CI 1,275–2,757; p=0,00*).Conclusion: Low level of basal LH (≤ 3 mIU/ml) generating fewer number of mature follicles in patients who performed ovarian stimulation in in-vitro fertilization program.Keyword: basal LH, ovarian stimulation, in-vitro fertilization.
Hubungan Asupan Cairan Ibu Hamil terhadap Indeks Cairan Amnion Eny Fatmawati; Diah Rumekti Hadiati; Heru Pradjatmo
JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.38549

Abstract

Introduction: Adequate amniotic fluid volume is a requirement for intra uterine fetal development and good pregnancy outputs / neonatal. Adequate intake of fluid in pregnant women can increase both the amniotic fluid index on oligohydramniotic or normoamniotic, but the scientific basis for the adequacy of the recommended daily fluid have not clear yet. Furthermore, the fluid intake counseling in addition to nutrition for pregnant women is neededObjective: To determine the fluid intake in pregnant women and the mean difference of  amniotic fluid index on adequate fluid intake compared to less fluid intake.Methods: This research used prospective observational cohort study, conducted against the third semester pregnant women in Puskesmas Mergangsan and Tegalrejo Yogyakarta during July until September 2014. The subjects who met the inclusion criteria were divided into adequate and less fluid intake groups. The correlation between fluid intake and amniotic fluid index was analyzed using t-test and linear regression.Result and Discussion: The total subjects who met the criteria were 27 people, consist of 12 people in adequate fluid intake group and 15 people in less fluid intake group. The mean of subject’s fluid intake 2078 ml (enough), while the mean of amniotic fluid index (AFI) 12,76 cm (normoamniotic).The result showed that there was a significant difference (3,50 cm (IK 95%; 1,5-5,48); P < 0,05) between the mean of AFI from adequate fluid intake group compared to less fluid intake group . Simple linear regression test showed the effect of fluid intake for AFI namely 31,7%; with the amount of predicted AFI = 10,686 + 3,545 x fluid intake – 1,015 x age – 1,317 x education + 0,314 x occupation (ARS= 44,5%). External variables (age, education, and occupation) had no significant effect for AFI .Conclusion : The mean preview of fluid intake in the third semester pregnant women in Yogyakarta was adequate. Moreover, there was a AFI signifficant difference between adequate fluid intake compared to less fluid intake.  Keywords: fluid intake; amniotic fluid index; AFI
Pengaruh Preeklamsia dan Hipertensi Kronis terhadap Kejadian Bayi Kecil Masa Kehamilan (KMK) Irmitasari Irmitasari; Detty Siti Nurdiati; Diah Rumekti Hadiati
JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.73 KB) | DOI: 10.22146/jkr.39137

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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
Faktor yang Mempengaruhi Skor Apgar Menit Pertama pada Seksio Sesarea dengan Anestesi Spinal Ide Pustaka Setiawan; Diah Rumekti Hadiati; Ahsanudin Attamimi
JURNAL KESEHATAN REPRODUKSI Vol 6, No 3 (2019)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (521.06 KB) | DOI: 10.22146/jkr.49332

Abstract

Latar Belakang: Seksio sesarea membawa konsekuensi morbiditas dan mortalitas pada ibu dan bayi. Morbiditas ibu pada seksio sesarea seyogyanya tidak diikuti dengan kejadian morbiditas pada bayi khususnya rendahnya nilai skor APGAR sehingga berpotensi menjadi asfiksia pada bayi baru lahir. Faktor risiko terjadinya asfiksia yang dinilai dari rendahnya skor APGAR pada bayi baru lahir saat dilakukan secara seksio sesarea dengan anestesi spinal perlu diketahui agar ada usaha untuk meminimalisasi kejadian asfiksia tersebut.Tujuan: Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi rendahnya skor APGAR menit pertama pada seksio sesarea dengan anestesi spinal.Metode:  Penelitian ini adalah studi observasional dengan rancangan penelitian crossectional study dengan cara observasi langsung proses seksio sesarea elektif yang menggunakan anestesi spinal dan dilihat luaran skor APGAR bayi baru lahir pada menit pertama. Uji statistik yang digunakan untuk analisis bivariat adalah uji Chi Square, Fisher Exact serta Mann-Whitney. Sedangkan analisis multivariat dilakukan dengan uji regresi logistik. Pengolahan data untuk pengujian statistik menggunakan SPSS 21.Hasil dan Pembahasan: Terdapat 93 subjek memenuhi kriteria inklusi dan eksklusi dalam penelitian ini. Terjadinya penurunan tekanan darah sistolik (RR 1,05; CI 0,40–2,75; p=1,00), terjadinya penurunan tekanan darah diastolik (RR 0,93; CI 0,33–2,59; p=0,56), terjadinya penurunan MAP (RR 0,72; CI 0,28–1,86; p=0,35) pasca induksi anestesi, pemanjangan waktu insisi kulit hingga bayi lahir ≥5,5 menit (RR 1,63; CI 0,65–4,12; p=0,44) dan rendahnya kadar Hb sebelum operasi (RR 1,22; CI 0,44–3,37; p=0,47) berhubungan tidak signifikan dengan rendahnya skor APGAR menit pertama pada seksio sesarea dengan anestesi spinal. Sedangkan interval waktu induksi anestesi hingga bayi lahir ≥12,5 menit (RR 2,91; CI 1,10–7,72; p=0,04) dan interval waktu insisi uterus hingga bayi lahir ≥3 menit (RR 3,48; CI 1,51–8,02; p=0,01) berhubungan kuat serta bermakna secara signifikan baik secara statistik maupun klinis menyebabkan skor APGAR menit pertama <7 pada bayi baru lahir secara seksio sesarea dengan anestesi spinal.Kesimpulan: Faktor-faktor yang mempengaruhi rendahnya skor APGAR menit pertama pada seksio sesarea dengan anestesi spinal adalah interval waktu induksi anestesi hingga bayi lahir ≥12,5 menit dan interval waktu insisi uterus hingga bayi lahir ≥3 menit.Kata kunci: seksio sesarea; asfiksia; anestesi spinal; skor APGAR
Co-Authors Agung Kurniawan Agung Kurniawan Ahsanudin Attamimi Andriana Kumala Dewi Andriana Kumala Dewi Aprivinta, Sherlyana Mega Ariantini, Dyah Arsi Palupi Budi Arianto Budi Arianto, Budi Detty Siti Nurdiati Dewajani Purnomosari Didik Setyo Heriyanto Djaswadi Dasuki Djaswadi Dasuki Dyah Ariantini Efriyan Imantika Eny Fatmawati Fatmawati, Eny Fifi Noviana Herman Sumawan Heru Pradjatmo Ide Pustaka Setiawan Ifrinda Giantari Irmitasari Irmitasari Irmitasari, Irmitasari Irwan Taufiqqurachman Moh Nailul Fahmi Mohammad Hakimi Mohammad Lutfi Mohammad Lutfi Muhammad Javedh Iqbal Noviana, Fifi Risanto Siswosudarmo Risanto Siswosudarmo Shinta Prawitasari Shofwal Widad Sofia Mubarika Haryana Sumawan, Herman