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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 1,731 Documents
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Microscopic Examination of Urine Samples as the Early Detection of Asymptomatic Urinary Tract Infection in Pregnant Women: A Cross-Sectional Study: Uji Mikroskopik Spesimen Urin sebagai Deteksi Dini Infeksi Saluran Kemih tidak Bergejala pada Perempuan Hamil: Sebuah Studi Potong Lintang Yeva Rosana; Dwiana Ocviyanti; Rahmah Amran
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (71.937 KB) | DOI: 10.32771/inajog.v7i3.899

Abstract

Abstract Objectives:To investigate the role of microscopic examination of urine sample in supporting early diagnosis of asymptomatic urinary tract infection (UTI) in pregnant women. To compare correspondence between microscopic examination and urine culture result as a gold standard diagnostic modality to support the diagnosis of UTIs and as an evidence-based to start empirical therapy. Methods: Microscopic analysis was conducted in 74 centrifuged and non-centrifuged urine samples from 317 pregnant who came to six healthcare centres in Jakarta, which showed a positive result of nitrite examination. The results of the microscopic examination of bacteriuria and leukocyturia were compared with a urine culture. Results: Sensitivity of centrifuged bacteriuria was the highest among the other microscopic parameters, which was 74% with the p-value of 0.009. Combination of bacteriuria and leukocyturia≥3/HPF dan≥5/HPF have increased the specificity with the value of 91.5% and 93.6% in non-centrifuged urine. Conclusion: This result showed that the best method of microscopic examination for early diagnosis of asymptomatic urinary tract infection in pregnant women is the detection of bacteriuria in centrifuged urine. Combination of bacteriuriaandleukocyturiatest, as well as leukocyturia≥3/HPF and≥5/HPF, can be used to rule out the diagnosis of UTI at an early stage. Keywords: asymptomatic urinary tract infection, bacteriuria, leukocyturia,microscopic examination, urine culture. Abstrak Tujuan: Mengetahui peran pemeriksaan mikroskopis sampel urin dalam mendukung diagnosis dini infeksi saluran kemih asimptomatik (ISK) pada perempuan hamil. Membandingkan kesesuaian antara pemeriksaan mikroskopis dan hasil kultur urin sebagai modalitas diagnostik standar emas untuk mendukung diagnosis ISK dan sebagai dasar bukti untuk memulai terapi empiris. Metode: Penelitian uji mikroskopik dilakukan pada 74 sampel urin disentrifugasi dan tidak sentrifugasi, dari 317 sampel urin perempuan hamil yang berobat ke-enam puskesmas di Jakarta dengan uji nitritpositif. Hasil uji mikroskopik bakteri uria dan leukosit uria dibandingkan dengan hasil kultururin. Hasil: Sensitivitas bakteriuria yang disentrifugasi menunjukan hasil yang paling baik dibandingkan dengan parameter uji mikroskopik lain, yaitu 74% dengan nilai p yang bermakna sebesar 0,009. Kombinasi bakteri uria dan leukosituria ≥3/LPB dan ≥5/LPB dapat meningkatkan spesifisitas uji dengan nilai 91,5% dan 93,6% pada urin yang tidak disentrifugasi. Kesimpulan: Hasil menunjukkan bahwa bakteri uria pada urin yang disentrifugasi, merupakan metode yang paling baik untuk membantu diagnosis dini ISK tidak bergejala pada perempuan hamil. Uji kombinasi bakteri uria dan leukosituria, serta uji leukosituria ≥3/LPB dan ≥5/LPB dapat dimanfaatkan untuk membantu secara dini menyingkirkan orang yang tidak mengalami ISK. Kata kunci: bakteriuria, infeksi saluran kemih tidak bergejala, kultur urin,leukosituria, uji mikroskopik
The Accuracy of Modified Risk Malignancy Index (RMI) in Predicting Malignancy of Epithelial Type Ovarian Cancer: Akurasi Modifikasi Risk of Malignancy Index dalam Memprediksi Keganasan Tumor Ovarium Tipe Epitel Esfi Triana; Defrin Defrin; Joserizal Serudji; Adriswan Adriswan
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.75 KB) | DOI: 10.32771/inajog.v7i3.900

Abstract

Abstract Objective:To investigate the accuracy of modified Risk of Malignancy Index (RMI) in predicting malignancy of epithelial type ovarian tumour. Method: This research was comparative research using cross-sectional study design, which compared RMI modification and RMI method in predicting malignancy of epithelial type ovarian tumour. The sampling technique was consecutive sampling. This research was conducted on October 2017 until samples were fulfilled in Obstetrics and Gynecology Division of RSUP Dr. M. Djamil and Laboratory of RSUP Dr. M Djamil in Padang. Chi-square test was used to compare specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR, and accuracy of RMI modification and RMI with 95% CI (p≤0,05). Results: A total of 61 subjects were recruited in this study. Sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy RMI modification scoring was 90.5%, 82.5%, 73.1%, 94.3%, 5.1, 0.1, dan 85.2%. Sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy RMI scoring was 66.7%, 70%, 53.8%, 80%, 2.2, 0.4, and 70% Conclusions:Modified RMI scoring method was more accurate in predicting the malignancy of ovarian type epithelial tumours than RMI. Keywords: CA125, malignancy, ovarian tumor,pelvic mass, RMI, Abstrak Tujuan: Mengetahui akurasi Risk of Malignancy Index (RMI) dalam prediksi keganasan tumor ovarium tipe epitel. Metode: Penelitian ini merupakan penelitian komparatif dengan desain penelitian potong lintang yang membandingkan metode RMI modifikasi dan RMI dalam prediksi keganasan tumor ovarium tipe epitel. Jumlah sampel sebanyak 61 orang. Teknik pengambilan sampel berurutan. Penelitian di mulai pada bulan Oktober 2017 hingga jumlah sampel terpenuhi di Departemen Obstetri dan Ginekologi RSUP Dr. M Djamil dan Laboratorium RSUP Dr. M Djamil Padang. Untuk membandingkan spesifisitas, sensitivitas, nilai duga positif (NDP), nilai duga negatif (NDN), rasio kemungkinan positif (RKP), rasio kemungkinan negatif (RKN), dan akurasi RMI modifikasi dan RMI digunakan uji chi-square dengan 99% CI (p≤0,01). Hasil: Sensitivitas, spesifisitas, NDP, NDN, RKP, RKN, dan akurasi skoring RMI modifikasi adalah 90,5%, 82,5%, 73,1%, 94,3%, 5,1, 0,1, dan 85,2%. Sensitivitas, spesifisitas, NDP, NDN, RKP, RKN, dan akurasi skoring RMI adalah 66,7%, 70%, 53,8%, 80%, 2,2, 0,4, dan 70%. Kesimpulan: Metode skoring RMI modifikasi lebih akurat dalam memprediksi keganasan tumor ovarium tipe epitel dibandingkan RMI. Kata kunci: CA125, keganasan, massapelvik, RMI, tumor ovarium
Born too Early, Where are We Now? T. Joewono, Hermanto
Indonesian Journal of Obstetrics and Gynecology Volume 6 No. 4 October 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (63.024 KB) | DOI: 10.32771/inajog.v6i4.936

Abstract

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Neurofibrillary Pathology in the Infundibular Nucleus in Relation to Age and Abnormal Hormone Levels: Patologi Neurofibrilar pada Nukleus Infundibularis Terkait Usia dan Kadar Hormon Abnormal Andon Hestiantoro; Dick F. Swaab
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (214.826 KB) | DOI: 10.32771/inajog.v7i3.962

Abstract

Abstract Objective: to determine whether the decline of testosterone during ageing would make this nucleus more vulnerable for NF changes (i.e. hyperphosphorylated-tau) in men, or that the decline of estrogens in the postmenopausal period would protect the infundibular nucleus in women. Methods: We investigated the infundibular nucleus in postmortem subjects. Brain materials obtained from 29 subjects in the Netherlands Brain Bank were further classified as control subjects and subjects with abnormal hormone conditions. Procedures consisted of tissue collection, immunochemical staining, and analysis of the staining intensity. Results then were collected and concluded using observational methods. Results: Elderly male subjects with low testosterone conditions showed more severe NF changes in the infundibular nucleus than postmenopausal women. The occurrence of NF changes in elderly subjects was generally accompanied by the presence of basket-like nerve terminals staining for ERβ. Conclusion: The sex difference in NF changes in the infundibular nucleus in the elderly is due to hyperphosphorylated-tau induction in low testosterone and ageing condition in men, while in postmenopausal women the declining estrogen levels seem to protect against NF changes in this brain area. Keywords: ageing, estrogen, hyperphosphorylated-tau, infundibular nucleus, testosterone Abstrak Tujuan: untuk menentukan apakah penurunan level testosteron selama proses penuaan menyebabkan nukleus infundibularis menjadi lebih rentan terhadap perubahan neurofibrilar (NF) (misalnya hyperphosphorylated-tau) pada laki-laki atau apakah penurunan level estrogen selama masa pasca-menopause memiliki efek protektif terhadap nukleus infundibular pada perempuan. Metode: Peneliti memeriksa nukleus infundibular pada subjekpost-mortem. Materi berupa jaringan otak dari 29 subjek dari Netherlands Brain Bank lebih lanjut diklasifikasikan sebagai subjek kontrol dan subjek dengan kondisi hormon abnormal. Prosedur terdiri dari pengumpulan jaringan, pewarnaan dengan teknik imunohistokimia, dan analisis dari intensitas pewarnaan. Hasil yang didapat kemudian dikumpulkan dan disimpulkan sesuai dengan metode observasional. Hasil: Subjek laki-laki lanjut usia dengan testosteron rendah menunjukkan perubahan NF yang lebih buruk pada nukleus infundibular dibandingkan dengan wanita postmenopause. Kejadian perubahan NF pada subjek lanjut usia secara umum diikuti oleh munculnya pewarnaan pada ujung saraf berbentuk basket-like yang positif untuk Erβ. Kesimpulan:Perbedaan jenis kelamin terkait perubahan NF pada nukleus infundibular pada subjek lanjut usia terjadi akibat induksi hiperfosforilasi taupada kondisi testosteron yang rendah yang dikombinasi oleh proses penuaan pada pria. Sedangkan pada perempuan pascamenopause, penurunan level estrogen menunjukkan efek protektif terhadap perubahan NF pada area otak ini. Kata kunci: estrogen, hiperfosforilasi protein tau, nukleus infundibularis, penuaan, testosteron
Improvement Knowledge and Attitude about Adolescent’s Reproductive Health through Education Intervention in Junior and Senior High: Peningkatan Pengetahuan dan Sikap tentang Kesehatan Reproduksi Remaja melalui Intervensi Penyuluhan pada Siswa Sekolah Menengah Pertama dan Sekolah Menengah Atas Negeri Amiruddin Amiruddin; Sriyana Herman; Hermanto T. Joewono; Asrul Sani; Junaid Junaid; Ali Imran; Jafriati Jafriati
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (46.908 KB) | DOI: 10.32771/inajog.v7i4.972

Abstract

Abstract Objective:To determine the changesin point of view and positive attitudes towards adolescent reproductive health in junior and senior high school students in Southeast Sulawesi after counseling interventions. Methods: Experimental Research with The One Group Pretest-Posttest Design. The population in the study were all adolescents aged between 12-19 years as students in Southeast Sulawesi. The sampling was performed by Simple stratified random sampling technique with a sample of 300 people for middle and high school students. The instrument used was a questionnaire with data analysis by using the t-test. Results:Showed that the level of knowledge and attitudes of students about adolescent reproductive health was differed between pretest & posttest in junior and senior high school students (ρ<0.05),because the students who were given counseling interventions with lecture methods, powerpoint, and discussion, will add to the broader understanding and insight and tend to generate positive responses from studentsm so that they have good basic knowledge and attitudes about adolescent reproductive health. Conclusion:The study was the increase in knowledge and positive attitudes about adolescent reproductive health after counseling interventions. Keywords:adelescent, counseling, knowledge and attitude, reproductive health Abstrak Tujuan:Untuk mengetahui perubahan pengetahuan dan sikap yang positif tentang kesehatan reproduksi remaja pada siswa SMP dan SMA Negeri di Sulawesi Tenggara setelah dilakukan intervensi penyuluhan. Metode: Penelitian Eksperimen (pre-experiment) dengan rancanganThe One Group Pretest-Posttest Design. Populasi dalam penelitian adalah keseluruhan remaja yang berusia antara 12-19 tahun yang sementara berstatus sebagai siswa SMP dan SMA Negeri di Sulawesi Tenggara. Pengambilan sampel dilakukan dengan teknikSimple stratified random sampling dengan jumlah sampel 300 orang untuk siswa SMP dan SMA.Instrumen yang dipakai adalah angket dengan analisis data menggunakan uji-t. Hasil:Menunjukkan tingkat pengetahuan dan sikap siswa tentang kesehatan reproduksi remaja berbeda antara pretest dan posttest pada siswa SMP dan SMA Negeri di Provinsi Sulawesi Tenggara (ρ value< 0,05).Hal ini disebabkan karena pada siswa SMP dan SMA Negeri di Provinsi Sulawesi Tenggara yang diberikan intervensi penyuluhan dengan metode ceramah, visualisasi (power point), dan tanya jawab, akan menambah pemahaman dan wawasan yang lebih luas dan cenderung menimbulkan respon yang positif dari siswa sehingga memiliki pengetahuan dan sikap yang baik tentang kesehatan reproduksi remaja. Kesimpulan:Terjadi peningkatan pengetahuan dan sikap yang positif tentang kesehatan reproduksi remaja setelah intervensi penyuluhan. Kata Kunci:remaja,penyuluhan, pengetahuan dan sikap, kesehatan reproduksi
Maternal Death Risk Factors in Wahidin Sudirohusodo Hospital and Its Affiliates: Faktor Risiko Kematian Maternal di Rumah Sakit Umum Pusat Wahidin Sudirohusodo dan Jejaringnya Elizabet C. Jusuf; Witono Gunawan; Nurbani Bangsawan
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (67.034 KB) | DOI: 10.32771/inajog.v7i4.976

Abstract

Abstract Objectives : To identify maternal death risk factors in Wahidin Sudirohusodo Hospitals and its affiliates between 01 January - 31 December 2017 Methods: This study is an observational case control study that includes all cases of maternal death and considerable numbers of pregnancy without complications that occured in Wahidin Sudirohusodo Hospital and its affiliates between 01 January 2016 and 31 December 2017. Data were then be analysed using chi square and logistic regression test to know the correlations between risk factors and maternal death. Results :There are 28 cases of maternal death in Wahidin Sudirohusodo Hospital and its affiliates which mostly occured at age 20-35 years old (60.7%) and antenatal care in in primary health care (71,4%). Hypertension (39,3%) and hemorrhage (35,7%) were the most frequent complicaitons of maternal death. Age under 20 years old and older than 35 years old (odds ratio 3.882; 95% CI, 1.056-14.276; P<0.05), education level less than 9 years (odds ratio 3.178; 95% CI, 0.987-10.228; P<0.05), Age and education level did not seem to affect incidence of maternal death when analysed simultaneously (odds ratio 1.842; 95% CI, P> 0.05). Conclusions: Hypertension and hemorrhage were the most frequent causes of maternal death. Age under 20 years old and older than 35 years old as well as education level less than 9 yearsincreased the risk of maternal deaths independently. Parity, frequency of antenatal care, and location of antenatal care did not show any significant role in maternal death occurence. Keywords : Maternal death, risk factors, hypertension, hemorrhage, age Abstrak Tujuan: Untuk mengetahui faktor-faktor risiko kematian maternal di Rumah Sakit Umum Pusat Wahidin Sudirohusodo dan jejaringnya dalam periode 01 Januari – 31 Desember 2016. Metode : Penelitian ini penelitian studi observasional case control dengan mengambil seluruh data kematian maternal yang terjadi di Rumah Sakit Umum Pusat Wahidin Sudirohusodo dan jejaringnya dalam periode 01 Januari – 31 Desember 2016. Data dianalisis dengan Uji chi square dan regresi logistik untuk melihat faktor risiko yang diteliti dengan terjadinya kematian maternal. Hasil : Ada 28 kasus kematian maternal di Rumah Sakit Umum Wahidin Sudirohusodo dan jejarignya yang sebagian besar terjadi pada kelompok umur 20-35 tahun (60,7%) dan lokasi asuhan antenatal di Puskesmas (71,4%). Komplikasi kehamilan terbanyak ialah hipertensi (39,3%) dan perdarahan (35,7%). Kelompok umur kurang dari 20 tahun dan lebih dari 35 tahun (odds ratio 3.882; 95% CI, 1.056-14.276; P <0.05) dan pendidikan kurang dari 9 tahun (odds ratio 3.178; 95% CI, 0.987-10.228; P<0.05) memiliki pengaruh signifikan terhadap terjadinya kematian maternal . Umur dan tingkat pendidikan secara simultan tidak mempengaruhi terjadinya angka kematian maternal (odds ratio 1.842; 95% CI; P > 0.05). Kesimpulan : Hipertensi dan perdarahan merupakan penyebab utama terjadinya kematian maternal. Kelompok umur kurang dari 20 dan lebih dari 35 tahun serta tingkat pendidikan < 9 tahun secara independen berisiko meningkatkan jumlah kematian maternal. Paritas, frekuensi asuhan antenatal, dan lokasi asuhan antenatal tidak memiliki peran signifikan dalam terjadinya kematian maternal. Kata kunci : Kematian maternal, faktor risiko, hipertensi, perdarahan, umur
Nasal Congestion and Its Management in Pregnancy Rhinitis Niken L. Poerbonegoro
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (116.381 KB) | DOI: 10.32771/inajog.v7i4.977

Abstract

Background: Pregnancy rhinitis occurs approximately in one-fifth of pregnancies, at almost any gestational week. The incidence rate of pregnancy rhinitis reaches up to 40%, with prevalence as high as 17%. Pathomechanism is still unclear, but it is suspected that estrogen and placental growth hormone (PGH) play roles in the development of disease. Objective: To elaborate the pathomechanism of pregnancy rhinitis and the proper management of rhinitis symptoms, particularly nasal obstruction. Methods: Literature review. Conclusion: Pregnancy rhinitis, manifested as nasal congestion, is considered a phenomenon and may become a serious condition. Persistent nasal congestion acts as a potential risk factor in affecting fetal growth and development through gradual hypoxia process. This condition can lead to various complications such as maternal hypertension, preeclampsia, impaired fetal growth, and low APGAR scores. Indepth knowledge of pathomechanism is essential as guidance to accurate treatment including conservative and pharmaca therapies, which will lead to optimal outcome for both mother and baby.
The Influence of Education Level and Occupation of Pregnant Women to the use of Maternal and Child Health (MCH) Handbook: Pengaruh Tingkat Pendidikan dan Pekerjaan Ibu Hamil dengan Pemanfaatan Buku Kesehatan Ibu dan Anak (KIA) Renny Aditya; Samuel Tobing; Mitfahul Jannah
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 4 October 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (56.173 KB) | DOI: 10.32771/inajog.v7i4.978

Abstract

Abstract Objective: to investigate the relationship between education level and occupation of pregnant women with MCH handbook utilization at the Pekauman Public Health Center of Banjarmasin in July–August 2018. Methods: the method that was used is analytical observational research with cross-sectional design. The number of research sample is 50 people with systematic random sampling techniques, and data were analyzed by chi-square statistical tests. Results: the majority of respondents were34 pregnant women (68%) with low education level, and36 pregnant women (72%) were unemployed. There were 36 pregnant women (72%) with ineffective MCH handbook utilization. The statistical result between education level of pregnant women with MCH handbook utilization is p-value = 0.005 (p < 0.05) and between occupation of pregnant woman with MCHhandbook utilization is p-value = 0.001 (p <0.05). Conclusion: there a significant relationship of education leveland occupation of pregnant women with MCH handbook utilization at the Pekauman Public Health Center of Banjarmasin in July-August 2018. Keywords: level ofeducation, occupation, MCH handbook Abstrak Tujuan: untuk mengetahui hubungan tingkat pendidikan dan pekerjaan Ibu hamil dengan pemanfaatan buku KIA di Puskesmas Pekauman Banjarmasin Periode Juli–Agustus 2018 Metode: metode yang digunakan adalah observasional analitik dengan desain cross sectional. Besar sampel penelitian adalah 50 orang dengan teknik pengambilan systematic random sampling dan datadianalisis dengan uji statistik chi square Hasil: sebagian besar responden adalah 34 ibu hamil (68%) dengan tingkat pendidikan rendah dan 36 ibu hamil (72%) yang tidak bekerja. Terdapat 36 ibu hamil (72%) dengan pemanfaatan buku KIA yang tidak efektif. Hasil uji statistik antara tingkat pendidikan ibu hamil dengan penggunaan buku KIA adalah p value = 0.005 (p < 0.05) dan antara pekerjaan ibu hamil dengan pemanfaatan buku KIA adalah p value = 0.001 (p < 0.05). Kesimpulan: terdapat hubungan yang bermakana tingkat pendidikan dan pekerjaan ibu hamil dengan pemanfaatan buku KIA di Puskesmas Pekauman Banjarmasin periode Juli–Agustus 2018 Kata kunci: tingkatpendidikan, pekerjaan, buku KIA
Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome: Angka Kematian Ibu di RSUD Ogan Komering Ulu Timur (OKU Timur) dalam Periode Empat Tahun: Pola, Faktor yang Berkaitan dan Luaran Neonatus Cindy Kesty; Hendra S Saputra
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (52.885 KB) | DOI: 10.32771/inajog.v7i2.980

Abstract

Objective: To determine the MMR trends, its associated factors, and neonatal outcome at East OKU Regional Public Hospital from 2013 until 2016. Methods: This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East OKU Regional Public Hospital, South Sumatera. Data was collected from medical records. There were 17 maternal deaths, but 1 data was excluded due to lack of data. Results: We recorded 2,191 pregnancies and 17 maternal deaths. Over 4 years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major etiology of maternal deaths were hypertensive disorder (37.5%), followed by hypertensive disorder + hemorrhage and hypertensive disorder + infection in the same proportion. MMR were higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%). Conclusion: MMR trends in our hospital were fluctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays significant role in maternal deaths. In addition, most of neonates were born alive. We hope that this study can be a feedback for hospital to do maternal and perinatal audit. Keywords: Factors, Maternal mortality rate, Neonatal outcome, Regional public hospital, Trends Tujuan: Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD OKU Timur dari 2013 hingga 2016. Metode: Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD OKU Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap. Hasil: Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui sectio caesaria (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%). Kesimpulan: Pola AKI di RSUD berfluktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifikan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal. Kata kunci: Angka kematian ibu, Faktor, Luaran neonatus, Pola, Rumah sakit umum daerah
Effect of Delay in Postpartum Hemorrhage Management on the Rate of Near-Miss and Maternal Death Cases: Pengaruh Keterlambatan Penanganan Perdarahan Pascapersalinan terhadap Kejadian Hampir Mati dan Kematian Ibu Risanto Siswosudarmo
Indonesian Journal of Obstetrics and Gynecology Volume. 2, No. 4, October 2014
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.294 KB) | DOI: 10.32771/inajog.v2i4.984

Abstract

Objective: To recognize the effect of delay in the management of postpartum bleeding to the occurrence of near-miss and maternal death cases. Method: Prospective cohort. The study population was patients with postpartum hemorrhage. All PPH cases from thirteen hospitals (Sardjito and 12 affiliated hospitals) were recorded. The study was carried out from January 1st to June 30th 2009. The study group was those who experienced delay and the control group was those without delay. The outcome was measured as the number of near-miss and death cases. Near-miss was defined as those who experienced severe shock, demonstrated by systolic blood pressure 90 mmHg or less. Chi square test, t-test and logistic regressions were used to analyze our data.Result: From January 1st to June 30th 2009 we identified 139 cases of PPH from 8,924 deliveries (1.6%). From the 80 referred cases, as much as 22 cases (27.5%) were delayed, and 12 from 139 (8.6%) experienced delay in the hospital. A total of 30 cases among 139 (21.6%) experienced delay both outside and in the hospital. There were 74 near-miss cases, 9 of which ended in death of the patient. This means the real occurrence of near-miss cases is 65 from 139 cases or 46.8% while the occurrence of maternal death was 9 out of 139, or 6.47%. Case fatality rate was 9 from 139 or 6.47%; maternal near-miss ratio was 6.22; mortality index was 13.84% and maternal mortality ratio is estimated as 103/100.000 live births. Multivariate analysis showed delay in referral increased the risk of near-miss cases as much as 8.37 folds, while bleeding >1500 ml increased risk of near-miss by 12.12 folds. Delay in both referral and management in the hospital increased the risk of maternal death rate as much as 25.34 folds, hemoglobin <6 g/dl and unavailability of blood increase maternal death by 31.58 folds and 13.39 folds, respectively.Conclusion: Delay in referral and delay of in-hospital management ncreased the occurrence of near-miss and maternal mortality cases significantly. Multivariate analysis showed that the amount of bleeding, hemoglobin level and lack of blood availability influenced the occurrence of near-miss and maternal death more than the delay itself.Keywords: delay, maternal death, maternal near-miss, PPH

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