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INDONESIA
Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)
ISSN : 23386401     EISSN : 23387335     DOI : -
Core Subject : 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
Preeclampsia after the Seven Quantum Leap Prediction Johanes C Mose
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (39.819 KB) | DOI: 10.32771/inajog.v7i1.986

Abstract

HE4 Levels in Ovarian Cancer-Resistant Menopausal Women: Kadar HE4 pada wanita menopause yang resisten kanker ovarium Wiwi Irawan; Syahrul Rauf; Nasrudin A. Mappaware; St. Maisuri T. Chalid
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 (59.806 KB) | DOI: 10.32771/inajog.v7i3.991

Abstract

Abstract Objective: To analyse the predictive value of HE4 in ovarian cancer patients according to their resistance and menopausal status Methods: Thirteen premenopausal and twenty-five menopausal ovarian cancer patients were measured for HE4 levels measured using automated chemiluminescent microparticle immunoassay ARCHITECT HE4. Patients categorized into resistant and non-resistant after six cycles of chemotherapy in addition to their clinical symptoms and ultrasound image of cancer. Results: The mean HE4 levels were higher in the resistant group compared with a non-resistant group (274.97 pmol/l vs 128.83 pmol/l; p=0.015). Five menopausal resistant women with HE4 levels >140 pmol/l compared with two women in the non-resistant group. In the pre-menopause group, eight resistant women with HE level >70 pmol/l whereas four women in the non-resistant group. HE levels in menopausal and premenopausal for both ovarian cancers resistant and non-resistant were not significantly different (p>0.05). Conclusion: HE4 levels in resistant ovarian cancer patients are higher compared with non-resistant but do not predict ovarian cancer resistance based on patient menopausal status. Keywords: HE4, ovarian cancer, resistance. Abstak Tujuan: Untuk menganalisis nilai prediktif HE4 pada pasien kanker ovarium berdasarkan resistensi dan status menopausenya Metode: Dilakukan pengukuran kadar HE4 menggunakan metode microparticle immunoassay ARCHITECT HE4 terhadap pasien kanker ovarium terdiri dari 13 perempuan premenopausal dan 25 perempuan menopause. Pasien dikategorikan menjadi resisten dan tidak resisten setelah 6 siklus kemoterapi selain gejala klinis dan gambar USG. Hasil: Rerata kadar HE4 rata-rata lebih tinggi pada kelompok yang resisten dibandingkan dengan kelompok yang tidak resisten (274,97 pmol/l vs 128,83 pmol/l; p=0,015). Terdapat 5 perempuan menopause yang resisten kanker ovarium dan 2 perempuan dalam kelompok yang tidak resisten dengan kadar HE4 >140 pmol/l. Pada kelompok premenopause, 8 perempuan yang resisten dengan tingkat HE >70 pmol/l sedangkan 4 perempuan dalam kelompok tidak resisten. Kadar HE dalam menopause dan premenopause untuk kedua kanker ovarium resisten dan tidak resisten tidak berbeda secara signifikan (p>0,05). Kesimpulan: Kadar HE4 pada pasien kanker ovarium lebih tinggi daripada tidak resisten tetapi tidak memprediksi resistensi kanker ovarium berdasarkan status menopause pasien. Kata kunci : HE4, kanker ovarium, resistensi .
Perineal Body Length and Pelvic Organ Prolapse in Menopausal Women: Panjang Perineal Body dan Prolaps Organ Panggul pada Wanita Menopause Chairun Nisa; David Lotisna; Deviana S. Riu; St. Maisuri T. Chalid
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 (61.774 KB) | DOI: 10.32771/inajog.v7i3.992

Abstract

Abstract Objective: To determine the correlation between the perineal body length and the pelvic organ prolapse (POP) in menopausal women. Methods: The total vaginal length (TVL), genital hiatus (GH), and perineal body (PB) length as the POP-Q component were measured at 60 menopausal women enrolled in a cross-sectional study. Results: Menopausal women with POP have the shorter perineal body (63.3%; <3 cm) compared with menopausal women without POP (36.7%; ≥3 cm). The mean length of the perineal body in menopausal women who suffer POP 2.81 ± 0.26 cm while in women without POP is 3.23±0.17 cm. POP risk was 25 times in menopausal women with a perineal body length <3 cm compared with longer perineal body (p = 0.01; OR = 25.4; 95% CI 3.1-209.1).Conclusion: Perineal body length is a risk factor for pelvic organ prolapse in menopausal women.Keywords: perineal body, prolapse, pelvic organ prolapsed Abstrak Tujuan: Menentukan korelasi panjang perineal body dengan kejadian prolaps organ panggul (POP) pada perempuan menopause. Metode: Pengukuran komponen POP-Q meliputi total vaginal length (TVL), genital hiatus (GH), dan panjang perineal body (PB) dilakukan pada 60 perempuan menopause yang dilibatkan dalam penelitian potong lintang. Hasil: Perempuan menopause dengan POP memiliki perineal body yang lebih pendek (63,3%; <3 cm) dibandingkan dengan perempuan menopause tanpa POP (36,7%; ≥3 cm). Panjang rata-rata perineal body pada perempuan menopasue yang menderita POP 2,81 ± 0,26 cm sedangkan pada perempuan tanpa POP adalah 3,23 ± 0,17 cm. Risiko POP 25 kali pada perempuan menopause dengan panjang perineal body <3 cm dibandingkan dengan tubuh perineum yang lebih panjang (p = 0,01; OR = 25,4; 95% CI 3,1-209,1). Kesimpulan: Panjang perineal body merupakan faktor risiko prolaps organ panggul pada perempuan menopause. Kata kunci : perineal body, prolapsed, prolaps organ panggul
Administration Oral Misoprostol after Radical Hysterectomy Due to Cervical Cancer in the Early Stage Decrease Urinary Retention Incident: Pemberian Misoprostol Per Oral Pasca Histerektomi Radikal Pada Karsinoma Serviks Stadium Awal Untuk Menurunkan Insiden Retensio Urine Rajuddin rajuddin; Lutfi N. Nugroho; hasanuddin hasanuddin
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 (75.146 KB) | DOI: 10.32771/inajog.v7i4.997

Abstract

Abstract Objective: to determine the effect of oral Misoprostol after Radical Hysterectomy in the early stage Cervical Cancer to reduce the incidence of urinary retention.Methods: The study was conducted with a prospective cohort method, randomized control trial and double blind to the patients with early stage cervical cancer who performed Radical Hysterectomy in Dr. Zainoel Abidin hospital, Banda Aceh. There are 34 research subjects who had agreed to participate in the study. The research subject divided into 2 groups. The first group who received Misoprostol orally as the intervention group and the other group that received placebo as the control group.Results: The incidence of urinary retention after Radical Hysterectomy in Dr. Zainoel Abidin hospital, Banda Aceh, decreased significantly in the intervention group compared to the control group (P 0,049). In the intervention group Misoprostol reduce residual urine. Ability to void spontaneously and urine volume were increase. The duration of catheterization and length of hospital stay for the patients were shorter.Conclusion: Administration of Misoprostol orally reduce the incidence of urinary retention after Radical Hysterectomy. Oral Misoprostol can be recommended as an additional procedure to reduce urinary retention.Keywords: cervical cancer, misoprostol , radical hysterectomy, urinary retention. Abstrak Tujuan: untuk mengetahui pengaruh pemberian Misoprostol per oral pasca operasi Histerektomi Radikal pada pasien Karsinoma Serviks stadium awal terhadap insidensi retensio urin.Metode: Penelitian dilakukan dengan metode kohort prospektif, randomized control trial dan double blind, pada pasien karsinoma serviks stadium awal yang dilakukan Histerektomi Radikal di RS dr. Zainoel Abidin, Banda Aceh. Terdapat 34 pasien yang telah menyetujui mengikuti penelitian, yang dibagi ke dalam 2 kelompok yaitu kelompok yang mendapat Misoprostol tablet per oral sebagai kelompok perlakuan dan kelompok yang mendapat plasebo sebagai kelompok kontrol. Residu urin pada kedua kelompok diukur dan faktor-faktor lain yang terkait dilakukan pendataan untuk dilakukan analisis. Hasil: Kejadian retensio urin pasca Histerektomi Radikal di RS dr. Zainoel Abidin, Banda Aceh, menurun secara bermakna pada kelompok perlakuan dibandingkan kelompok kontrol (P0,049). Pada kelompok perlakuan Misoprostol menurunkan residu urin.Peningkatan kemampuan berkemih spontan dan volume urin .lama pemakaian kateter transuretra dan lama perawatan menjadi lebih singkat.Kesimpulan: Pemberian Misoprostol per oral mengurangi insiden retensio urin pasca Histerektomi Radikal. Saran : Misoprostol per oral dapat direkomendasikan sebagai prosedur tambahan untuk mengurangi retensio urin.Kata kunci: karsinoma serviks, histerektomi radikal, misoprostol, retensio urin
Differences of Vitamin D Level in Non-pregnant Reproductive Age Women and First Trimester Pregnant Women: Perbedaan Kadar Vitamin D pada Perempuan Usia Reproduksi Tidak Hamil dan Perempuan Hamil Trimester Pertama Rizkar A. Sukarsa; Radiastomo S. Budi; Benny H. Purwara; Hanom H. Syam
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 (85.745 KB) | DOI: 10.32771/inajog.v7i4.998

Abstract

Abstract Objective: To compare vitamin D level in non-pregnantreproductive age women and first-trimester pregnant women. Methods: This was acomparative cross-sectional study. The vitamin D serum level of two groups, the first one wasnon-pregnantreproductive age women (18-35 years), and the second one was first-trimester pregnant women,was collected. Samples were examined by Electro Chemiluminescence Immunoassay (ECLIA) method. The study was conducted in Dr. Hasan Sadikin Hospital in February-April 2018. Results: The mean of vitamin D level in the non-pregnantreproductive age women group was 18.73 (6.93) ng/mL, while the first-trimester pregnant women group was 13.87 (4.04) ng/mL. The difference in mean of vitamin D level in both groups was significant with p-value<0.001. Conclusion: Vitamin D level in the non-pregnantreproductive age women group is higher than the first-trimester pregnant women group. Keywords: first-trimester pregnant women, non-pregnantreproductive-age women, vitamin D Abstrak Tujuan: Membandingkan kadar vitamin D pada perempuan usia reproduksi tidak hamil danperempuan hamil trimester pertama sehingga dapat mencegah berbagai komplikasi kehamilan. Metode: Penelitian analitik komparatif potong lintang terhadap 60 perempuan yang dibagi menjadi 2 kelompok, kelompok perempuan usia reproduksi tidak hamil (18-35 tahun) dan kelompok perempuan hamil trimester pertama. Pada kedua kelompok dilakukan pemeriksaan kadar vitamin D dengan metode Electro-chemiluminescence immunoassay(ECLIA). Penelitian ini dilakukan di RSUP Dr. Hasan Sadikin pada bulan Februari-April 2018.Data diproses menggunakan program SPSS versi 24.0. Hasil: Kadar vitamin D rata-rata pada kelompok perempuan usia reproduksi tidak hamil adalah 18,73 (6,93) ng/mL, sedangkan pada kelompok perempuan hamil trimester pertama adalah 13,87 (4,04) ng/mL. Perbedaan kadar rata-rata vitamin D pada kedua kelompok tersebut bermaka dengan nilai p<0,001. Kesimpulan: Kadar vitamin D pada kelompok perempuan usia reproduksi tidak hamil lebih tinggi dibandingkan dengan kelompok perempuan hamil trimester pertama. Kata kunci: perempuan hamil trimester pertama, perempuan usia reproduksi tidak hamil, vitamin D
Elevated Serum Ferritin and Interleukin-6 Level as the Risk Factor in Preterm Labor: Kadar Feritin dan Interleukin-6 Serum yang Tinggi Merupakan Faktor Risiko Terjadinya Persalinan Preterm Stella Kawilarang; I Ketut Suwiyoga; Tjokorda GA Suwardewa
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 (55.841 KB) | DOI: 10.32771/inajog.v7i2.1002

Abstract

Objective : To investigate the association ofserum ferritin and Interleukin-6 (IL-6) elevation as the risk factors for preterm labor. Method : This study was a case-control study conducted at the Obstetrics and Gynecology Outpatient and Emergency Department at Sanglah General Hospital Denpasar, Bali in November 2014 until June 2015. The sample selection was done by consecutive sampling with total sample as many as 20 case samples (women with preterm labor) and 20 control samples (women with normal preterm pregnancy). Results : Based on the analysis, there was no significant difference of patient demografic such as age, gestational age, and parity among the two groups. Chi-square analysis showed that the increased serum ferritin level had 5 fold increased risk of developing preterm labor (OR = 4.89, 95% CI = 1.20-19.94; p = 0.022), and increased serum IL-6 level had 9 fold increased risk of developing preterm labor (OR = 9.33, 95% CI = 2.18-39.96; p = 0.001) compared to normal preterm pregnancy. Conclusion : It can be concluded that level of IL-6 and serum ferritin was the risk factor for preterm labor. Keywords: Interleukin-6, preterm labor, serum ferritin Abstrak Tujuan :Untuk membuktikan hubungan kadar ferritin dan Interleukin-6 (IL-6) serum yang tinggi sebagai faktor risiko terjadinya persalinan preterm. Metode :Penelitian ini bersifat observasional dengan studi case-control yang dilakukan di Poliklinik dan IRD Kebidanan dan Penyakit Kandungan RSUP Sanglah Denpasar, yang dilakukan mulai bulan November 2014 hingga Juni 2015. Pemilihan sampel dilakukan dengan cara berurutan dengan sampel penelitian sebanyak 20 sampel kasus (ibu dengan persalinan preterm) dan 20 sampel kontrol (ibu hamil preterm normal). Hasil :Tidak didapatkan perbedaan bermakna dari demografik pasien yaitu usia, umur kehamilan, dan paritas pada kedua kelompok. Analisa chi-square menunjukkan peningkatan kadar ferritin serum memiliki peningkatan risiko 5 kali terjadinya persalinan preterm (OR = 4,90, IK 95% = 1,20-19,94; p = 0,022), dan peningkatan kadar IL-6 serum memiliki peningkatan risiko 9 kali terjadinya persalinan preterm (OR = 9,33, IK 95% = 2,18-39,96; p = 0,001) dibandingkan dengan kelompok ibu hamil preterm normal. Kesimpulan : Kadar feritin dan IL-6 serum adalah faktor risiko terjadinya persalinan preterm. Kata kunci: Interleukin-6, persalinan preterm, ferritin serum
Characteristics, Management and Survival Rate of Ovarian Germ Cell Tumor: Karakteristik, Manajmen dan Tingkat Kesintasan Ovarian Germ Cell Tumor Laila Nuranna; Zakiah Tourik
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 (60.298 KB) | DOI: 10.32771/inajog.v7i3.1021

Abstract

Abstract Objective:To determine the prevalence of malignant ovarian germ cell tumour in term of characteristics, management, and 3-year survival rate in Dr. Cipto Mangunkusumo Hospital Jakarta from 2011 to 2013. Methods: This is a cross-sectional study. Secondary data were collected from medical record as well as interviewing patients through phone call or home visit. Results: We collected data from 24 subjects. As many as 54.2% of subjects were between 20 to 40 year old, and 58.3% was single. Around 83.3% of the subjects came with chief complaint of abdominal enlargement. Histopathology finding confirmed dysgerminoma in 50% subjects, mixed ovarian germ cell tumour in 25%, endodermal sinus tumour or yolk sac tumour in 16.7%, and immature teratoma in 8.3%. Half of the cases were found in stage I. The primary therapy was conservative surgical staging and adjuvant chemotherapy.In 2 subjects with dysgerminoma, neoadjuvant chemotherapy (bleomycin, etoposide, cisplatin, and cyclophosphamide-cisplatin regimen) resulted in a good response. The 3-year survival rate was 83.3% in dysgerminoma, 100% in mixed ovarian germ cell tumour, and 50% in immature teratoma. Conclusion: In malignant ovarian germ cell tumour, conservative surgical staging followed by a complete course of chemotherapy is the treatment of choice with 3-year survival rate exceeding 70%. Keywords: dysgerminoma, non-epithelial ovarian tumour,ovarian germ cell tumour, survival Abstrak Tujuan : Mengetahui sebaran meliputi karateristik, penatalaksanaan dan kesintasan 3 tahun pasien tumor ganas sel germinal ovarium di RSCM tahun 2011 – 2013. Metode : Penelitian ini menggunakan studi potong lintang dengan mengambil data sekunder dari rekam medis dan mewawancarai pasien atau keluarga pasien via telepon atau kunjugan rumah. Hasil : Pada penelitian ini, dari 24 subjek penelitian, 54,2% ditemukan pada usia 20-40 tahun dan 58,3% subjek belum menikah. Sebanyak 83,3% datang dengan keluhan perut membesar. Secara histopatologi didapatkan jenis disgeminoma, tumor sel germinal campuran, sinus endodermal (yolk sac) dan teratoma imatur dengan proporsi masing-masing 50%, 25%, 16,7% dan 8,3%, sebagian besar kasus (50%) ditemukan pada stadium I. Conservative surgical staging dan kemoterapi adjuvan tatalaksana pilihan. Terdapat 2 subjek jenis disgerminoma yang diberikan dengan kemoterapi neoadjuvan (regimenbleomycin, etoposide, cisplatin dan cyclophosmide-cisplatin) memberikan respon yang baik. Kesintasan ≥ 3 tahun pada jenis disgerminoma mencapai 83,3%, pada tumor sel germinal campuran 100% dan pada teratoma imatur mencapai 50%. Kesimpulan : Pada tumor ganas sel germinal ovarium conservative surgical staging diikuti kemoterapi lengkap merupakan pilihan terapi dengan kesintasan ≥ 3 tahun mencapai > 70%. Kata kunci : disgerminoma,kesintasan, tumor ovarium non epithelial, tumor sel germinal ovarium.
Oxytocin 10 IU as Prophylactic for Uterine Atony : a Randomized Clinical Trial: Oksitosin 10 IU sebagai Profilaksis Atonia Uteri : suatu Uji Coba Klinis Acak Ridwan A. Putra; Iskandar Zulqarnain; Zaimursyaf Azis; Jusuf S. Effendi; Wiryawan Permadi; Ria Bandiara
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 (110.648 KB) | DOI: 10.32771/inajog.v7i3.1026

Abstract

Abstract Objective : To compare the effectiveness of oxytocin dose of 10 IU and 20 IU for preventing uterine atony in women undergoing cesarean section. Methods : This was a double-blind, randomized clinical trial with good matching selection with randomization block of patients who had risk factors for the occurrence of uterine atony such as preeclampsia, patients were receiving MgSO4, oxytocin intrapartum and chorioamnionitis who performed stratified randomization prospectively with two kinds of oxytocin doses which are 10 IU and 20 IU as a prophylaxis for uterine atony in women who performed emergency cesarean section with transverse incision and were using a general anesthesia. Results : This study found no any significant differences between the use of 10 IU and 20 IU as prophylaxis for uterine atony during cesarean section either in its action at the time or while in recovery room, especially on the cases without chorioamnionitis thus using oxytocin 10 IU regimen can be considered, besides the effectiveness did no differ, it will cost cheaper than oxytocin 20 IU regimen which frequently used. Conclusions : There were no significant differences in the incidence of blood loss during the cesarean section between the treatment of oxytocin 10 IU group and oxytocin 20 IU group. The additional uterotonic was using during the action of the cesarean section between the treatment of oxytocin 10 IU group, and oxytocin 20 IU group gave no significant differences. The side effects in this study at least form of chills and vomiting found no significant differences between both of groups despite the side effects that arise in oxytocin 20 IU group was higher at 23.08% than oxytocin 10 IU group at 15.19%. Chorioamnionitis would be a risk factor for the occurrence of uterine atony during the action of the cesarean section if it associated with the use of additional uterotonic in oxytocin 10 IU group if compared with oxytocin 20 IU group. Keywords : cesarean section, oxytocin, uterine atony. Abstrak Tujuan : Untuk membandingkan efektifitas penggunaan dosis 10 IU dan 20 IU sebagai profilaksis atonia uteri pada saat seksio sesarea. Metode : Penelitian ini menggunakan uji klinis acak ganda dengan seleksi yang sesuai dengan blok acak pada pasien-pasien yang memiliki faktor risiko terjadinya atonia uteri seperti preeklamsia, pasien yang diberikana MgSO4 dan oxytocin intrapartum sebelumnya serta chorioamnionitis yang dilakukan pengacakan secara prosfektif bertingkat yang diberikan dua jenis dosis oksitosin yaitu 10 IU dan 20 IU sebagai profilaksis atonia uteri pada perempuan yang dilakukan seksio sesarea darurat dengan insisi transversal dan menggunakan anestesi umum. Hasil : Penelitian ini menemukan tidak adanya perbedaan yang bermakna antara penggunaan dosis oksitosin 10 IU dan 20 IU sebagai profilaksis atonia uteri pada seksio sesarea baik saat tindakan operasi maupun saat berada di ruang pemulihan, terutama pada kasus-kasus tanpa khorioamnionitis dimana memerlukan oksitosin tambahan pada kelompok 10 IU, selain efektifitasnya tidak berbeda, akan lebih murah dari pada rejimen oksitosin 20 IU yang sering digunakan saat ini. Kesimpulan : Berdasarkan hasil penelitian ini, tidak ada perbedaan yang bermakna dalam kejadian kehilangan darah selama operasi seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU. Penggunaan uterotonik tambahan selama tindakan seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU tidak memberikan perbedaan yang signifikan. Efek samping dalam penelitian ini yakni menggigil dan muntah, tidak ditemukan perbedaan yang bermakna antara kedua kelompok meskipun efek samping yang muncul pada kelompok oksitosin 20 IU lebih tinggi 23,08% dibandingkan kelompok oksitosin 10 IU pada 15,19%. Khorioamnionitis merupakan faktor risiko terjadinya atonia uteri selama tindakan seksio sesarea jika dikaitkan dengan penggunaan uterotonika tambahan pada kelompok oksitosin 10 IU jika dibandingkan dengan kelompok oksitosin 20 IU. Kata kunci : atonia uteri, oksitosin, seksio sesarea.
Evidence Based Patient-Centered Care: Are We Ready? Ali Baziad
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 3, July 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (51.555 KB) | DOI: 10.32771/inajog.v1i3.1036

Abstract

N/A
Evaluation of the Accuracy of Implementation of Obstetric Referral Cases to the Emergency in the JKN Era: Evaluasi Ketepatan Pelaksanaan Rujukan Kasus Gawat Darurat Obstetri ke Instalasi Gawat Darurat dalam Era Jaminan Kesehatan Nasional Omo A. Madjid; Arietta R.D. Pusponegoro; Immanuel S. Margatan
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 (59.739 KB) | DOI: 10.32771/inajog.v7i3.1037

Abstract

Abstract Objective: To investigate the circumstances of the obstetric referral case at the emergency department of the Dr.Cipto Mangunkusumo Hospital as well as the accuracy of the referral implementation. Method: We used cross-sectional study. Medical records of obstetric patients at Emergency department in RSCM in January 2013-July 2014 were obtained, then information about patients and their characteristic were collected. The accuracy of referral cases is based on emergency obstetric criteria by BPJS rules. Results: Primary Health Care became the leading referrer. Inappropriate diagnostic referral cases amounted to 21.2%when JKN first began to be implemented in 2014. Cases with improper diagnoses were more referred when JKN was implemented which amounted to 16.8% and non-emergency referral cases of 6.9% in 2014. Conclusion: Referral implementation has not been efficient and effective, the number of obstetric referral cases to emergency department of RSCM that can actually be handled in the secondary advanced health services after the application of JKN is still high. Monitoring and evaluation is needed by the Local Health Office to improve the quality of the referral system that applied in the newly JKN era. Keywords:accuracy of referrals,BPJS, JKN, obstetric emergencies, referral system. Abstrak Tujuan: Mengetahui gambaran kasus rujukan obstetri di IGD RSCM dan ketepatan pelaksanaan rujukan. Metode: Deskriptif desain studi potong lintang. Data diambil dari rekam medis pasien obstetri di IGD RSCMpada bulan Januari 2013 hingga Desember 2014, kemudian informasi mengenai data dan karakteristik pasien dikumpulkan. Ketepatan pelaksanaan rujukan kasus gaat daraurat obstetri berdasarkan Krietria gawatdarurat bagian kebidanan menurut ketentuan BPJS Kesehatan. Hasil: Perujuk terbanyak adalah Puskesmas (FKTP). Kasus rujukan dengan ketidaksesuaian diagnosa lebih banyakjumlahnya pada saat JKN mulai diterapkan pada tahun 2014 sebesar 21.2%. Kasus dengan diagnosa yang tidak tepat rujuk lebih banyak pada saat JKN di laksanakan yaitu sebesar 16.8% dan kasus rujukan yang bukan gawatdarurat sebesar 6.9% pada tahun 2014. Kesimpulan: Pelaksanaan rujukan belum efisien dan efektif, jumlah rujukan obstetri ke IGD RSCM yangsebenarnya dapat ditangani di fasilitas kesehatan tingkat lanjutan sekunder setelah penerapan JKN masih tinggi. Dibutuhkan monitoring dan evaluasi oleh Dinas Kesehatan setempat untuk meningkatkan kualitas sistem rujukan yang berlaku di era JKN yang baru diterapkan. Kata kunci : BPJS, gawat darurat obstetri, JKN, ketepatan rujukan, sistem rujukan.

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