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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
Published by Perkumpulan Obstetri dan Ginekologi Indonesia
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
The Indonesian Journal of Obstetrics and Gynecology is an official publication of the Indonesian Society of Obstetrics and Gynekology. INAJOG is published quarterly.
Arjuna Subject : -
Articles 12 Documents
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Search results for , issue "Volume 11 No. 4 October 2023" : 12 Documents clear
Resolution of ethical conflicts between medical indications and patient preferences in case of unmarried woman with ovarian cancer: Penyelesaian Konflik Etika antara Indikasi Medik dan Preferensi Pasien pada Kasus Perempuan yang belum Menikah dengan Kanker Ovarium Taufik S. Ismail; Putri Irmayani; Kulsum Kulsum
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i1.1652

Abstract

Objectives: To resolve ethical conflicts in medical decision making in unmarried patients with a diagnosis of ovarian cancer. The ethical issue in this case is the main operative management in cases of ovarian cancer, namely removal of the uterus and both ovaries even though the patient is not married and has never been pregnant. The opportunity for patients to get pregnant no longer exists, so there is an ethical conflict between medical indications and patient preferences.Methods: This case report is about an unmarried woman 38- year with a diagnosis of ovarian cancer. This patient initially underwent right salfingooophorectomy surgery. Anatomical pathology results found adenocarcinoma serosum ovarii. The patient underwent chemotherapy for 3 cycles. Then the patient was re-operated with a planned debulking interval laparotomy.Discussion: From the aspect of patient indications, the results of combination treatment between surgery and chemotherapy have shown a marked increase in the survival rate of patients in five years. The choice of performing a debulking interval laparotomy is a difficult choice. The patient's preference to get pregnant will be difficult to accept, but it can be accommodated by improving the quality of life and paying attention to humanism, social and cultural aspects of its contextual features.Conclusion: Clinical ethical considerations related to uterine removal in unmarried patients is a matter of debate. Clinical ethical theory namely quality of life, patient preferences, medical indications, and contextual features are beneficial in medical decision making.Keywords: debulking intervals, ethical conflicts, medical indications, ovarian cancer, patient preferences.Tujuan: Untuk menyelesaikan konflik etik dalam pengambilan keputusan medik pada pasien yang belum menikah dengan diagnosis kanker ovarium. Isu etik pada kasus ini yaitu manajemen operatif utama pada kasuskanker ovarium yaitu pengangkatan uterus dan kedua ovarium padahal pasien belum menikah dan belum pernah hamil. Kesempatan untuk pasien untuk hamil tidak ada lagi sehingga terjadi pertentangan etik antara indikasi medik dengan preferensi pasien.Metode: Laporan kasus ini tentang seorang pasien perempuan yang belum menikah, berusia 38 tahun dengandiagnose kanker ovarium. Pasien ini awalnya dilakukan operasi salfingoooforektomi kanan. Hasil patologi anatomi ditemukan adenokarsinoma serosum ovari. Pasien menjalani kemoterapi sebanyak 3 siklus. Kemudian pasien dilakukan operasi kembali yang direncanakan tindakan laparotomi interval debulking.Diskusi: Dari aspek indikasi pasien, hasil pengobatan kombinasi antara pembedahan dan kemoterapi telahmenunjukkan peningkatan survival rate yang nyata pada pasien dalam lima tahun. Pilihan melakukan tindakanlaparotomi interval debulking merupakan pilihan sulit. Preferensi pasien untuk dapat hamil akan sulit dikabulkan, namun dapat diakomodir dengan peningkatan kualitas hidup dan memperhatikan aspek humanism, sosial dan kultural pada fitur kontekstualnya.Kesimpulan: Pertimbangan etik klinik yang berhubungan dengan pengangkatan rahim pada pasien yang belum menikah merupakan masalah yang diperdebatkan. Teori etika klinis yaitu indikasi medis, preferensi, kualitas hidup dan fitur kontektual sangat membantu dalam pengambilan keputusan medis yang etis.Kata kunci: indikasi medis, interval debulking, kanker ovarium, konflik etik, preferensi pasien
Neurodevelopment and Fetal Growth in Fetuses with Congenital Heart Disease: Perkembangan Saraf dan Pertumbuhan Janin dengan Penyakit Jantung Bawaan Adhi Pribadi
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1751

Abstract

Objective: To determine mechanisms underlying fetal growth abnormalities, particularly intrauterine neurodevelopment, in congenital heart defects. Method: Literature Review Results: Since intrauterine, smart mechanisms have ensured that blood flow to the central nervous system remains smooth to maintain Neurodevelopment. The mechanism fluctuates to keep oxygen flowing to the brain. Blood with the highest oxygen content should always be pumped to upper body and the head via the heart and the aorta. Aortic arch region contains three major blood vessels, a.Brachiocephalic, a.Carotid communis, and a.Subclavia that bleed the upper body and head, including the brain. So, blood flow from the left heart through the aortic arch is critical for fetal brain growth. If the heart cannot drain blood to the head, brain growth will be jeopardized because hypoxia will interfere with brain growth so will be influence to Neurodevelopment. Impaired blood flow can occur as early as intrauterine, particularly if the fetus has congenital heart disease. Blood flow in the Middle Cerebral Artery (MCA) can be used to measure blood flow in the fetus head. The pulsatility index value can be used to measure blood flow in the MCA, and another parameter is the cardioplacental ratio. There is a decrease in flow to the head in congenital heart disease, which results in a decrease in the Pulsatily index of the MCA and a decrease in the cardioplacental ratio. Conclusions: Prolonged reduction in cardiac-derived blood flow leads to compromised neurodevelopment. Consequently, timely correction of postpartum heart defects becomes paramount to prevent protracted impairments in brain growth. Failing to address this promptly could also diminish the overall quality of life for children afflicted by congenital heart disease. Keyword: cardioplacental ratio, middle cerebral artery, congenital heart disease, fetal neurodevelopment. Keyword: cardioplacental ratio, cerebral media artery, congenital heart disease, fetal neurodevelopment. Abstrak Tujuan: Untuk menentukan mekanisme kelainan pertumbuhan janin terutama perkembangan saraf intrauterin pada cacat jantung bawaan. Metode: Kajian Pustaka Hasil: Pada kehidupan intrauterin, mekanisme yang baik telah memastikan bahwa aliran darah ke sistem saraf pusat tetap lancar untuk mempertahankan perkembangan saraf. Mekanisme ini berfluktuasi untuk menjaga oksigen tetap mengalir ke otak. Darah dengan kandungan oksigen tertinggi harus selalu dipompa ke otak melalui jantung dan arteri utama ke kepala melalui a.Brachiocephalic, a.Carotid communis, dan a.Subclavia. Pada daerah arkus aorta terdapat tiga pembuluh darah utama yang memperdarahi tubuh bagian atas dan kepala, termasuk otak. Aliran darah ini dipompa melalui jantung kiri melalui arkus aorta. Bila jantung tidak dapat mengalirkan darah ke kepala, maka akan menyebabkan pertumbuhan otak terancam karena hipoksia akan mengganggu pertumbuhan otak, sehingga secara jangka panjang akan berpengaruh terhadap perkembangan saraf fetus. Gangguan aliran darah dapat terjadi sejak dini terutama jika janin memiliki penyakit jantung bawaan. Aliran darah di Arteri Serebri Media (MCA) dapat digunakan untuk mengukur aliran darah pada bagian kepala. Nilai indeks pulsatilitas dapat digunakan untuk mengukur aliran darah di MCA, dan parameter lain adalah rasio kardioplasental. Terdapat penurunan aliran ke kepala pada penyakit jantung bawaan, yang mengakibatkan penurunan indeks Pulsatily pada MCA serta terdapat penurunan rasio kardioplasental. Kesimpulan: Penurunan perkembangan saraf terjadi ketika aliran darah dari jantung berkurang secara kronis ke daerah kepala janin, sehingga bila terdapat kelainan jantung bawaan pasca persalinan harus diperbaiki segera agar penurunan pertumbuhan otak pada periode pascasalin tidak berlangsung terlalu lama. Bila hal ini terjadi akan menurunkan pula kualitas hidup anak dengan penyakit jantung bawaan. Kata kunci: arteri serebri media, penyakit jantung bawaan, perkembangan saraf janin, rasio kardioplasenta.
COVID-19 Infection and the Preeclampsia in Pregnant Women : Infeksi COVID-19 dengan Preeklamsia pada Ibu Hamil Cindy M. Pradana; Dita D. Parti; Elly N. Sakinah
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1796

Abstract

Objective: To determine the relationship between COVID-19 infection and preeclampsia in pregnant women at RSD dr. Soebandi Jember. Methods: This study used cross-sctional study with simple random sampling. The data is secondary data from medical records of 118 pregnant women who checked their pregnancies from March 2020 to December 2021 at RSD dr. Soebandi Jember and analyzed with chi-square test and logistic regression test. Results: Multivariate analysis showed that there were a relationship between COVID-19 infection with preeclampsia. COVID-19 is the most risky variable with an OR of 4.045 (95% CI 1.595 – 10.259). This condition happens because COVID-19 infection triggers down-regulation of RAS which make the failure of spiral artery remodelling and preeclampsia. Conclusion: There is a relationship between COVID-19 infection and the incidence of preeclampsia in RSD dr. Soebandi Jember. Keywords: COVID-19, preeclampsia, renin-angiotensin system (RAS), SARS-CoV-2 Abstrak Tujuan: Untuk mengetahui hubungan antara infeksi COVID-19 dengan kejadian preeklamsia pada ibu hamil di RSD dr. Soebandi Jember. Metode: Penelitian ini merupakan studi potong lintang dengan pengambilan sampel menggunakan simple random sampling. Penelitian ini menggunakan data sekunder rekam medis 118 ibu hamil yang memeriksakan kehamilannya mulai Maret 2020 hingga Desember 2021 di RSD dr. Soebandi Jember dan dianalisa dengan uji statistik Chi-square dan uji regresi logistik. Hasil: Analisis statistik menunjukkan terdapat hubungan antara infeksi COVID-19, usia, dan obesitas dengan kejadian preeklamsia di RSD dr. Soebandi Jember. Variabel COVID-19 merupakan variabel yang paling berisiko terhadap terjadinya preeklampsia dengan OR 4,045 (95% CI 1,595 – 10,259). Hal ini terjadi karena infeksi COVID-19 memicu down-regulasi pada RAS yang mengakibatkan kegagalan remodelling arteri spiralis dan preeklamsia Kesimpulan: Terdapat hubungan antara infeksi COVID-19 dengan kejadian preeklamsia di RSD dr. Soebandi Jember. Kata kunci: COVID-19, preeklamsia, renin-angiotensin system (RAS), SARS-CoV-2
Partum Mothers' Experience Regarding Support during the COVID-19 Pandemic: Pengalaman Ibu Bersalin Mengenai Dukungan selama Pandemi COVID-19 Ria H. Sari; Farida Kartini; Menik S. Daryanti
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1876

Abstract

Objective: This study aims to investigate the experiences of mothers giving birth with regard to family support and the assistance of health workers during the COVID-19 pandemic. Methods: A descriptive phenomenological approach was employed for this research, following the framework standards for reporting qualitative research (SRQR). Thirteen individuals participated in the study, comprising seven mothers giving birth, three husbands, two midwives, and one parent. The research was conducted at the Mlati II Health Center in Sleman Regency, specifically in Cabakan Hamlet, Sumberadi, Kec. Mlati, Kab. Sleman, Special Region of Yogyakarta, during January-February 2022. The choice of location was based on specific criteria set by the researchers. Data collection took place online due to practical reasons, with informants being contacted to choose between online or offline interviews. Purposive sampling was used for informant selection, and in-depth interviews lasting approximately one hour each were conducted via WhatsApp, Zoom, or phone calls, with prior agreement from the informants. The interviews followed a semi-structured format. Results: Two main themes emerged from the data analysis: the emotional experiences of mothers during labor and their various needs. The COVID-19 pandemic had a significant impact, leading to feelings of anxiety, fear, tension, and the need for comfort and confidence. These psychological needs were categorized into verbal support, including encouragement, communication, and reassurance, as well as tactile support, involving gestures such as stroking, holding, and back rubs. Mothers also expressed spiritual needs, such as prayer and maintaining positive thoughts for a smooth delivery and the health of the baby. Nutritional needs, encompassing healthy and balanced eating, were identified as essential during childbirth. Support from husbands, family members, and health workers played a crucial role in reassuring mothers and educating them about COVID-19 prevention, contributing to a positive birthing experience. Conclusion: The provision of positive support during childbirth can facilitate a normal delivery and instill confidence in mothers. Keywords: childbirth, covid-19 pandemic, experience, maternity, support. Abstrak Tujuan: Untuk mengetahui pengalaman ibu bersalin mengenai dukungan keluarga dan tenaga kesehatan selama pandemi covid-19. Metode: Desain penelitian ini menggunakan pendekatan fenomenologi deskriptif sehingga untuk melengkapi pelaporan menggunakan framework standards for reporting qualitative research a synthesis of recommendations (SRQR). Jumlah informan yang digunakan dalam penelitian ini yaitu 13 orang, yang terdiri dari 7 ibu bersalin, 3 suami, 2 bidan dan 1 orang tua. Penelitian ini dilakukan di Puskesmas Mlati II di Kabupaten Sleman, di Dusun Cabakan, Sumberadi, Kec. Mlati, Kab. Sleman Daerah Istimewa Yogyakarta. Penelitian ini dilakukan pada bulan Januari-Februari 2022, alasan pemilihan tempat ini adalah berdasarkan kriteria peneliti. Metode dalam penelitian dilakukan secara online. Peneliti memiliki beberapa alasan praktis untuk mengumpulkan data secara online. Peneliti menghubungi informan untuk menanyakan apakah bersedia di wawanacara secara online atau offline. Rekruitmen informan pada penelitian ini menggunakan purposive sampling. Peneliti melakukan indepth interview dengan informan secara online melalui media whatsapp, zoom dan telepon seluler kurang lebih satu jam tiap individu dengan perjanjian terlebih dahulu dengan informan.Wawancara yang digunakan dalam penelitian ini semi structure. Hasil: Didapatkan 2 tema yaitu tanda-tanda persalinan dan kebutuhan ibu bersalin. Dampak pandemi covid-19 membuat ibu merasa was-was atau kekhawatiran, takut dan cemas, tegang, berusaha nyaman, berusaha tenang dan rasa percaya diri. Kebutuhan psikologis ini terbagi menjadi dua bagian yaitu dukungan secara verbal dan dukungan secara sentuhan. Dukungan secara verbal seperti menyemangati, di ajak ngobrol, memberikan dukungan, mendampingi, ramah, komunasi, percaya diri, siaga, pelayanan bagus, harus kuat, menyayangi dan perhatian. Dukungan secara sentuhan seperti di elus-elus, mengusap keringat, pegang kepala, menggosok-gosok punggung dan menggosok perut.Kebutuhan spiritual yang didapatkan ibu selama proses persalinan yaitu zikir, berdoa, dan selali berpikir positif agar persalinan lancar dan bayi sehat. Kebutuhan nutrisi ibu bersalin seperti makan-makanan yang sehat, makanan bergizi seimbang, minum air putih untuk tenaga mengejan. Dukungan yang diberikan oleh suami, keluarga dan tenaga kesehatan membuat ibu merasa tenang dan mendapatkan edukasi terhadap penyebaran covid-19 agar mendapatkan persalinan yang positif. Kesimpulan: Dukungan yang positif akan memberikan persalinan normal dan ibu percaya diri. Kata kunci: dukungan, ibu bersalin, pandemi covid-19, pengalaman, persalinan.
Optimal Omega-3 Intake: A Natural Way to Ease Primary Dysmenorrhea Severity: Asupan Omega-3 yang Optimal: Cara Alami untuk Mengurangi Derajat Dismenore Primer Benedicta A. Widyatmoko; Edihan Mardjuki
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1900

Abstract

The prevalence of lower urinary tract symptoms in Caesarean section patients’ first and seventh day of postpartum : Perbandingan Prevalensi Gejala Saluran Kemih Bawah pada Ibu Postpartum Hari pertama dan Hari Ketujuh secara Sectio Caesarea Austin Julian; Johannes C. Prihadi; Yuma S. S. Indrajaya
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1905

Abstract

Objective: To compare the prevalence of Lower Urinary Tract Symptoms (LUTS) on the first day and the seventh day postpartum in Caesarian section patient Method: This cross-sectional study utilized the ICIQ-FLUTS LF (ICIQ-Female Lower Urinary Tract Symptoms-Long Form) and a questionnaire to screen for risk factors among postpartum patients who underwent C-section delivery at Santo Antonius Hospital, Pontianak, West Kalimantan. Data were collected twice, 12 hours after urinary catheter removal and on the seventh day of the postpartum period. The study sample consisted of 95 respondents. Results: Among the 111 total respondents, the majority were under 35 years old, multiparous, classified as obese, had no family history of Lower Urinary Tract Symptoms (LUTS), and had not used diuretics or traditional medicine. Significant differences were observed in the prevalence of LUTS between the first and seventh days of the postpartum period. Most symptoms showed a decrease on the seventh day, except for six symptoms: insensible urinary incontinence, hesitancy, urinary retention, feeling of incomplete emptying, bladder pain, and dysuria, which increased. Conclusion: In conclusion, our study suggests that the duration of the postpartum period affects the prevalence of LUTS following C-section delivery. However, it's important to acknowledge the limitations of this study, which may impact the understanding of LUTS progression during the postpartum period. Conclusion: In conclusion, we concluded that the duration of the postpartum period affects the LUTS after delivery with the method of C-section, but this study has many limitations which may affect the progressivity of LUTS in the Postpartum period. Keywords: Caesarean Section, ICIQ FLUTS Long From, Lower Urinary Tract Symptoms, Postpartum period Abstrak Tujuan: Untuk membandingkan prevalensi Gejala Saluran Kemih Bawah di hari pertama dan hari ketujuh postpartum pada pasien Sectio Caesarea. Metode: Desain penelitian berupa studi potong li.ntang dengan pengumpulan data menggunakan kuesioner terstruktur ICIQ FLUTS-LF dan kuesioner skrining dasar penelitian yang dilakukan 2 kali yaitu 12 jam setelah pelepasan kateter dan postpartum hari ke 7. Subjek penelitian ini adalah semua ibu postpartum dengan metode SC yang memenuhi kriteria inklusi dan eksklusi penelitian di RS Santo Antonius Pontianak, Kalimantan Barat. Jumlah sampel pada penelitian ini adalah 95 responden Hasil: Pada penelitian ini didapatkan subjek sebesar 111 responden yang mayoritasnya berusia kurang dari sama dengan 35 tahun, multipara, status gizinya obesitas, tidak memiliki riwayat keluarga yang mengalami LUTS, tidak mengkonsumsi obat-obatan tradisional dan obat-obatan diuretik. Terdapat perbedaan signifikan di prevalensi LUTS hari 1 dan 7 postpartum SC dengan mayoritas dari 16 gejala LUTS yang didata mengalami penurunan di hari ketujuh dibanding hari pertama, terkecuali 6 gejala LUTS yang mengalami peningkatan di hari ketujuh yaitu Insensible Urinary Incontinence, Hesitansi, retensio urin, perasaan tidak lampias setelah berkemih, nyeri kandung kemih, serta disuria. Kesimpulan: Dalam penelitian ini, peneliti menyimpulkan bahwa durasi masa postpartum berpengaruh pada keluhan LUTS yang dialami pasca persalinan secara Sectio Caesarea, akan tetapi, penelitian ini memiliki keterbatasan yang dimana terdapat banyak oleh faktor-faktor risiko tertentu yang dapat berpengaruh terhadap progresivitas LUTS Kata kunci: Sectio Caesarea, ICIQ FLUTS Long Form, Gejala Saluran Kemih Bawah, Masa Pasca Persalinan, Masa nifas, Postpartum
The Use of Maternal Early Obstetric Warning Score (MEOWS) as a Tool to Predict Treatment Needs in the Intensive Care Unit in Severe Preeclampsia Patients : Penggunaan Maternal Early Obstetric Warning Score (MEOWS) sebagai Parameter Prediksi Kebutuhan Perawatan Intensive Care Unit (ICU) Pasien Preeklamsia Berat Astuti D. P. Ratu; Imelda E.B Hutagaol
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1920

Abstract

Infertile Couple and Pregnancy Outcomes for Patients Undergoing a Pregnancy Program in the Rural Area of Nagekeo District, Flores, East Nusa Tenggara : Pasangan Infertil dan Luaran Kehamilan pada Pasien yang Menjalani Program Kehamilan di Kabupaten Nagekeo, Flores, Nusa Tenggara Timur Chatarina L. S. D. Dando; Angga Dominius; Jacob T. Salean
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1921

Abstract

Objective: To elucidate the characteristics of infertile couples residing in the rural area of Nagekeo Regency and assess the outcomes of their participation in the local pregnancy program. Methods: We conducted a descriptive study at Aeramo Regional General Hospital (RGH) in Nagekeo Regency, Flores, East Nusa Tenggara (ENT), utilizing a total sampling technique from January 2020 to April 2022. A total of 56 couples participated in this study. Results: The analysis revealed that infertile couples at Aeramo RGH were typically aged between 23 and 35 years, with an average infertility duration exceeding 4 years. Primary infertility was the predominant condition (89.3%), with 55.4% of male partners exhibiting obesity. A significant number of male participants reported alcohol and cigarette consumption. Data were insufficient to determine the prevalence of infertility in men versus women. Notably, the outcomes of the pregnancy program in this region did not demonstrate significant improvements. Conclusions: This study identified potential risk factors such as smoking, alcohol consumption, and obesity that may contribute to infertility; however, it did not establish a strong correlation between these factors and infertility. Moreover, the pregnancy program's outcomes were inconclusive, likely due to limited diagnostic and treatment resources in the area. Keyword: infertility characteristics, pregnancy program, pregnancy outcomes. Abstrak Tujuan : Mendeskripsikan karakteristik pasangan infertil di Kabupaten Nagekeo serta mengetahui hasil luaran kehamilan bagi pasangan yang mengikuti program kehamilan di daerah tersebut. Metode : Penelitian ini merupakan penelitian deskriptif yang dilakukan di Rumah Sakit Umum Daerah (RSUD) Aeramo, Kabupaten Nagekeo, Flores, Nusa Tenggara Timur. Dengan menggunakan teknik total sampling pada periode Januari 2020 - April 2022, terdapat 56 pasangan yang bergabung dalam penelitian ini. Hasil : Hasil penelitian kemudian dianalisis secara univariat dan didapatkan usia pasangan infertil di Aeramo RGH adalah antara 23 - 35 tahun dengan durasi infertilitas lebih dari 4 tahun. Infertilitas primer dan obesitas pada pria mendominasi masing-masing kelompok yaitu 89,3% dan 55,4%. Mayoritas pria mengonsumsi alkohol dan rokok. Tidak ditemukan data yang cukup untuk menentukan apakah infertilitas terjadi pada pria atau wanita. Hasil dari program kehamilan yang dilakukan di daerah ini belum menunjukkan hasil yang signifikan. Kesimpulan : Karakteristik yang memicu faktor risiko seperti merokok, mengkonsumsi alkohol dan obesitas. Meskipun pada penelitian ini belum didapatkan korelasi yang kuat dari faktor risiko tersebut pada infertilitas. Hasil dari program kehamilan belum menunjukkan hasil yang signifikan karena modalitas diagnostik dan pengobatan yang sangat terbatas. Kata kunci : karakteristik infertilitas, luaran kehamilan, program hamil.
The Low Level of Serum 1,25-Dihydroxyvitamin D3 and Calcium in Preeclampsia Women and Its Impact on Maternal Outcomes: Kadar Serum 1,25-Dihidroksivitamin D3 dan Kalsium yang Rendah pada Perempuan Preeklamsia dan Dampaknya terhadap Luaran Maternal Hudila Rifa Karmia; Yusrawati; Tara Fadhillah
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.1931

Abstract

Objective: To investigate the association of serum 1,25-dihydroxyvitamin D3 (1,25[OH]2D3) and calcium levels in pregnancy with the risk of preeclampsia and its impact on maternal outcomes. Methods: This cross-sectional observational study was conducted in the Obstetrics and Gynecology Department at Dr. M. Djamil Padang General Hospital from May 2021 to April 2022. Patients with normal pregnancy, diagnosed with preeclampsia, and willing to sign the informed consent were included in this study. Blood serum samples from patients were collected and examined with an ELISA kit. The collected data were then statistically analyzed with univariate and bivariate analysis. Results: The serum 1,25(OH)2D3 levels strongly correlate with maternal outcomes (systolic and diastolic blood pressure) among preeclampsia patients, with p-value = <0.0001. The serum 1,25(OH)2D3 levels in preeclampsia were significantly lower than in normal pregnancy (88,73 ± 42,22 vs. 111,11 ± 52,49 pg/ml), with p-value = 0,033. The serum calcium levels in preeclampsia patients were significantly lower compared to normal pregnant women's (8,67 ± 0,49 vs. 9,55 ± 0,93 mg/dL), with p-value = <0.0001. However, there was no association between serum 1,25(OH)2D3 and serum calcium levels in pregnancy. Conclusion: Serum levels of 1,25-dihydroxyvitamin D3 and calcium in preeclampsia were significantly lower than in normal pregnancy. Serum 1,25-dihydroxyvitamin D3 levels were also found to have a significant correlation with systolic and diastolic blood pressure in preeclamptic patients. These findings reinforce the suggestion of the importance of vitamin D and calcium supplementation during pregnancy to reduce the risk of preeclampsia and to achieve better maternal outcomes. Keywords: 1,25-Dihydroxyvitamin D3, calcium, hypertension, pregnancy, preeclampsia Abstrak Tujuan: Mengetahui hubungan antara kadar serum 1,25-dihidroksivitamin D3 (1,25[OH]2D3) dan kalsium pada kehamilan dengan risiko preeklamsia dan pengaruhnya terhadap luaran maternal Metode: Studi observasional potong lintang ini dilakukan di Departemen Obstetri dan Ginekologi RSUP Dr. M. Djamil Padang dari Mei 2021 hingga April 2022. Pasien dengan kehamilan normal, terdiagnosis preeklampsia, dan bersedia menandatangani informed consent diinklusi dalam penelitian ini. Sampel serum darah dari pasien dikumpulkan dan diperiksa dengan ELISA-kit. Data yang terkumpul kemudian dianalisis secara statistik dengan analisis univariat dan bivariat. Hasil: Kadar serum 1,25(OH)2D3 memiliki hubungan yang kuat dengan luaran maternal (tekanan darah sistolik dan diastolik) pada pasien preeklamsia, dengan nilai p = <0,0001. Kadar serum 1,25(OH)2D3 pada preeklampsia lebih rendah secara signifikan dibandingkan kehamilan normal (88,73 ± 42,22 vs 111,11 ± 52,49 pg/ml), dengan p-value = 0,033. Kadar kalsium serum pada pasien preeklampsia juga secara signifikan lebih rendah dibandingkan ibu hamil normal (8,67 ± 0,49 vs 9,55 ± 0,93 mg/dL), dengan p-value = <0,0001. Namun, tidak ada hubungan antara kadar serum 1,25(OH)2D3 serum dengan kadar serum kalsium pada kehamilan. Kesimpulan: Kadar serum 1,25-dihidroksivitamin D3 dan kalsium pada preeklamsia lebih rendah secara signifikan dibandingkan kehamilan normal. Kadar serum 1,25-dihidroksivitamin D3 juga ditemukan memiliki korelasi yang signifikan dengan tekanan darah sistolik dan diastolik pada pasien preeklamsia. Temuan ini memperkuat saran akan pentingnya suplementasi vitamin D dan kalsium selama kehamilan untuk menurunkan risiko preeklampsia dan untuk mendapatkan luaran maternal yang lebih baik. Kata kunci: 1,25-Dihydroxyvitamin D3, kalsium, hipertensi, kehamilan, preeklamsia
Hospital Cost vs INA-CBGs Claim for Obstetrics Procedure In Soe Rural General Hospital, East Nusa Tenggara: Tarif Rumah Sakit vs Klaim INA-CBGs untuk Prosedur Obstetrik di Rumah Sakit Umum Daerah SoE, Nusa Tenggara Timur Raymond Surya; Ascobat Gani; Yudianto B. Saroyo
Indonesian Journal of Obstetrics and Gynecology Volume 11 No. 4 October 2023
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v11i4.2010

Abstract

Objective: To depict the discrepancy and analyze the difference between hospital cost and INA-CBGs claim in obstetrics’ cases in SoE Rural General Hospital, Timor Tengah Selatan regent, East Nusa Tenggara. Methods: This is an observational descriptive study using medical record documents of spontaneous vaginal, assisted vaginal, and cesarean delivery cases from the period of October to December 2022. We included all completed billing documents on that period. Cases paid by fee-for-service and local government were excluded. Data analysis was conducted using IBM SPSS Statistic 23.0 Results: From the total of 323 delivery cases recorded in SoE Rural General Hospital, only 245 cases were included. Most subjects were patients aged around 30 years old, referred from primary healthcare facility in the district, were in term pregnancy, and in 3rd class inpatient rooms. The median of length of stay (LOS) in vaginal delivery (spontaneous and assisted) and cesarean delivery were 2 days and 3 days, respectively. Mean difference between hospital cost to INA-CBGs claim was 67% to 158% for either vaginal or cesarean delivery based on class inpatient room. We found that hospital cost was always higher than claim cost based on INA-CBGs claim. Conclusion: There is a significant discrepancy between hospital cost and INA-CBGs claim (from 67% to 158%) for obstetric services in SoE Rural General Hospital. Keywords: hospital cost, INA-CBGs claim, obstetric. Abstrak Tujuan: Untuk memberikan gambaran perbedaan dan menganalisis perbedaan antara tarif RS dengan klaim INA-CBGs pada kasus obstetrik di RSUD SoE, Timor Tengah Selatan, Nusa Tenggara Timur. Metode: Studi deskriptif observasional menggunakan dokumen rekam medis dari kasus persalinan pervaginam spontan, persalinan pervaginam dengan alat, dan seksio sesarea dari Oktober hinga Desember 2022. Kami memasukkan seluruh dokumen billing yang lengkap. Dokumen biling yang dibayarkan mandiri dan oleh pemerintah lokal dieskslusi. Analisis data dengan menggunakan IBM SPSS Statistik 23.0. Hasil: Dari 323 persalinan yang terekam di RSUD SoE, hanya 245 kasus diinklusikan. Kebanyakan subjek berusia 30 tahun, dirujuk dari puskesmas, kehamilan cukup bulan, dan ruang perawatan kelas 3. Angka median dari lama rawat pervaginam (baik spontan maupun dengan alat) adalah 2 hari dan seksio sesarea 3 hari. Rerata perbedaan tarif RS dengan klaim INA-CBGs ialah 67% hingga 158% baik persalinan pervaginam maupun seksio sesarea berdasarkan ruang kelas perawatan. Kami menemukan angka tarif RS selalu lebih tinggi cukup jauh dari klaim INA-CBGs. Kesimpulan: Terdapat perbedaan antara tarif RS dan klaim INA-CBGs (antara 67 hingga 158%) untuk prosedur obstetrik di RSUD SoE. Kata kunci: tarif RS, klaim INA-CBGs, obstetrik.

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