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Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia)

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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

145 146 147 148 149

Profile of Cesarean Sections Since the BPJS Era: Profil Seksio Sesarea pada Era BPJS Mohd. Andalas; Cut R. Maharani; Raudhatul Jannah; Siti Harisah; Muhammad Haekal; Ichsan
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: to find out the profile of caesarean section in dr. Zainoel Abidin Hospital since the BPJS era. Methods: This study was a descriptive-observational with retrospective design. The data were obtained in March-April 2017. We collected 3656 data from medical record period January 1st, 2014- December 31st, 2016. Results: The finding showed there were 1669 vaginal deliveries (45,65%) and 1987 caesarean sections (54,35%). The most frequent causes to caesarean sections were induction failure (49,77%), cephalopelvic disproportion (14,33%), pregnancy induced hypertension (11,21%), malpresentation (8,91), and antepartum haemorrhage (4,33%). Conclusion: The incidence of caesarean sections in dr. Zainoel Abidin Hospital since the BPJS era was 54,35%, increased by 13,29% than the year of 2011-2013 (41,06%) with the most frequent cause is induction failure (49,77%). Keywords: Antepartum haemorrhage, BPJS, Caesarean section, Induction failure, Pregnancy induced hypertension, Tertiary referral hospital. Abstrak Tujuan: Mengetahui profil persalinan seksio sesarea di RSUD dr. Zainoel Abidin Banda Aceh pada era BPJS. Metode: Penelitian deskriptif-observasional dengan desain studi retrospektif. Pengambilan data dimulai dari bulan Maret-April 2017. Sebanyak 3656 data dikumpulkan dari rekam medik periode 1 Januari 2014- 31 Desember 2016. Hasil: Terdapat 1669 kasus persalinan pervaginam (45,65%) dan 1987 kasus seksio sesarea (54,35%). Indikasi terbanyak yang menyertai seksio sesarea adalah gagal induksi (49,77%), cephalopelvic disproportion (14,33%), hipertensi dalam kehamilan (11,21%), malpresentasi (8,91%), dan perdarahan antepartum (4,33%). Kesimpulan: Angka seksio sesarea di RSUD dr. Zainoel Abidin meningkat 13,29% sejak berlakunya BPJS (1 Januari 2014-31 Desember 2016) mencapai 54,35% dibandingkan tahun 2011-2013 (41,07%) dengan indikasi terbanyak gagal induksi (49,77%). Kata kunci: Perdarahan Antepartum, BPJS, Seksio sesarea, Gagal Induksi, Hipertensi dalam kehamilan, RS Rujukan Tersier.

The Suppression Effect of Kebar Extract on Endometriosis Lesion MDA and TNF -a Independent to VEGF A Study in Endometriosis Mice Mode: Efek Supresi Ekstrak Kebar terhadap Lesi Endometriosis, MDA dan TNF-a, tidak Bergantung pada VEGF: Studi pada Model Tikus Endometriosis Yuli Trisetiyono; Noor Pramono; Syarief T. Hidayat; Widjiati Widjiati
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Background: The pathogenesis of endometriosis remains unclear, and involves multifactorial etiologies. The increase in oxidative stress is known to be associated with this disease. Oxidative stress increases angiogenesis and supports the proliferation of endometriosis tissue in the peritoneal cavity. Kebar grass, a medicinal plant, is expected to increase antioxidant defense resulting in decreased oxidative stress, inflammation, angiogenesis, and reduced endometrial tissue implants. Objective: To investigate the effects of Kebar grass extract administration to MDA serum levels, TNF-a and VEGF expression, and the extension of the endometriotic lesions in mice model. Methods: This study was experimentally designed. It was conducted in the Department of Obstetrics Gynecology, Faculty of Medicine Diponegoro, University and Faculty of Veterinary Medicine, Airlangga University. Twenty-one mice were divided into three groups: the first group is control of 7 untreated endometriosis mice model, the second group consisted of 7 mice injected with leuprolide acetate 1mg/kgBB single dose, and the last group consisted of 7 mice fed with Kebar grass extract 3mg/day for 14 days. MDA serum level was measured by spectrophotometry, TNF-a and VEGF expression by IHC using Rammele Scale Index (ImmunoReactive Score), whereas the extension of the endometriotic lesions was measured using computerize tracing. Results: Both Kebar grass extract and leuprolide acetate administration significantly decrease MDA serum levels in endometriosis mice model, compare with the control group, (0.09Â±0.02 nmol, 0.11Â±0.07 nmol, and 0.30Â±0.06 nmol, respectively; p=0.001). TNF-Î± expression of the group treated with Kebar grass extract was lower than leuprolide acetate and control group (2.43Â±1.521 %, 4.86Â±0.458 %, and 7.26Â±2.898 %, respectively; p=0.002). However, there was no significant difference in VEGF expression among study groups (4.34Â±2.40 %, 5.11Â±1.95 %, and 7.40Â±3.49 % respectively; p=0.116). Finally, the extension of the endometriotic lesions of the mouse models administered with Kebar grass extract and leuprolide acetate was smaller than the control group (0 mm2, 4.54Â±7.75 mm2, and 34.80Â±13.09 mm2 respectively; p=0.005). Conclusion: Kebar grass extract has the effect of decreasing MDA serum levels and reducing TNF-Î± expression, resulted in smaller endometriotic lesions in mice, even though it does not affect VEGF expression. Keywords: malondialdehyde, tumour necrosis factor alpha, vascular endothelial growth factor, endometriotic lesion, kebar grass extract, endometriosis mouse

Lipid Profile, Blood Glucose Level and Body Mass Index (BMI) in Second Trimester of Pregnancy: Screening with Gestational Diabetes: Profil Lipid, Gula Darah dan Indeks Massa Tubuh (IMT) pada Kehamilan Trimester II: Skrining Kejadian Kehamilan dengan Diabetes Melitus Donny S. Winardo; John J. E. Wantania; Suzanna P. Mongan
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To find out lipid profile data, blood sugar and Body Mass Index in trimester II pregnancy to the incidence of pregnancy with diabetes mellitus. Methods: This study is a cross sectional study. The number of samples obtained was 42 samples where all were taken in the second trimester. Samples taken from RSUP Prof. Dr. R. D. Kandou Manado and networking hospitals around Manado that meet the inclusion and exclusion criteria. All patient patients were explained about the research procedure and the signing of consent information. Blood samples were taken for examination of blood sugar (fasting blood sugar and 2 hours post-prandial blood sugar) and lipid profiles (total cholesterol, HDL, LDL, triglycerides). After the data is collected, it is included in the SPSS version 22.0 program for data analysis. Results: Found 2 subjects (4.76%) who had abnormal fasting blood sugar and found 4 subjects (9.53%) who had abnormal 2-prandial 2-hour blood sugar. For lipid profiles, it was found 16 subjects (38.1%) who had abnormal total cholesterol levels, for LDL there were 13 subjects (30.96%) who had abnormal levels, for HDL there were 4 subjects (11.9%) who had abnormal levels and for triglycerides there were 23 subjects (54.76%) who had abnormal levels. There was a significant negative correlation between LDL cholesterol and fasting blood sugar (p = 0.002; r = - 0.455), and so did total cholesterol with fasting blood sugar (p = 0.047; r = - 0.302). There was a significant correlation between BMI and total cholesterol (p = 0.013; r = 0.371). There was 1 subject (2.38%) diagnosed with gestational diabetes melt and fasting blood sugar at 190 mg / dL, for prandial 2 hours post blood sugar at 309 mg / dL and for triglycerides at 617 mg / dL. Conclusions: Based on this study found the incidence of gestational diabetes mellitus 2.38% of all trimester II pregnancies. There is a positive but not significant correlation between blood sugar and triglycerides, whereas there is no significant relationship between blood sugar and other lipid profiles. There is a positive but not significant correlation of BMI in trimester pregnancy with total cholesterol. Keywords: Blood sugar, Body Mass Index (BMI), lipid profile Abstrak Tujuan: Untuk mengetahui data profil lipid, gula darah dan Indeks Massa Tubuh pada kehamilan trimester II terhadap kejadian kehamilan dengan diabetes melitus. Metode: Studi ini merupakan studi potong lintang. Jumlah sampel yang didapatkan sebesar 42 sampel di mana seluruhnya diambil pada trimester II. Sampel diambil dari RSUP Prof. Dr. R. D. Kandou Manado dan rumah sakit jejaring sekitar Manado yang memenuhi kriteria inklusi dan eksklusi. Semua pasien-pasien dijelaskan mengenai prosedur penelitian dan penandatanganan inform consent baru dilakukan pengambilan sampel darah untuk pemeriksaan gula darah (gula darah puasa dan gula darah 2 jam postprandial) dan profil lipid (Kolesterol total, HDL, LDL, Trigliserida). Setelah data dikumpulkan, maka dimasukkan ke dalam program SPSS versi 22.0 untuk data analisis. Hasil: Ditemukan 2 subjek (4,76%) yang memiliki gula darah puasa abnormal dan ditemukan 4 subjek (9.,53%) yang memiliki gula darah 2 jam postprandial yang abnormal. Untuk profil lipid, ditemukan 16 subjek (38,1%) yang memiliki kadar kolesterol total abnormal, untuk LDL ditemukan sebanyak 13 subjek (30,96%) yang memiliki kadar abnormal, untuk HDL ditemukan 4 subjek (11,9%) yang memiliki kadar abnormal dan untuk trigliserida ditemukan 23 subjek (54,76%) yang memiliki kadar abnormal. Terdapat korelasi negatif signifikan antara kolesterol LDL dengan gula darah puasa (p = 0,002 ; r = – 0,455), dan begitu juga dengan kolestrol total terhadap gula darah puasa (p = 0,047 ; r = – 0,302). Terdapat korelasi signifikan antara IMT dengan kolesterol total (p = 0,013 ;r = 0,371). Terdapat 1 subjek (2,38%) yang terdiagnosis diabetes melitus gestasional di mana gula darah puasa sebesar 190 mg/dL, untuk gula darah 2 jam postprandial sebesar 309 mg/dL dan untuk trigliserida sebesar 617 mg/dL. Kesimpulan: Berdasarkan penelitian ini ditemukan kejadian diabetes melitus gestasional 2,38% dari seluruh kehamilan trimester II. Terdapat korelasi positif tetapi tidak bermakna antara gula darah dengan trigliserida, sedangkan tidak terdapat hubungan bermakna antara gula darah dengan profil lipid lainnya. Terdapat korelasi positif tetapi tidak bermakna IMT pada kehamilan trimester dengan kolestrol total. Kata kunci: gula darah, Indeks Massa Tubuh (IMT), profil lipid

Effectiveness, Safety and Obedience of Dienogest and Leuprolide Acetate in Postlaparoscopic Endometriosis Patients: Efektivitas, Keamanan dan Kepatuhan terhadap Dienoges dan Leuprolide Asetat pada Pasien Endometriosis Pascalaparoskopi Joko P. Purwanto; Yusuf Effendi; Heriyadi Manan; Theodorus
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: Comparing therapeutic effectiveness, safety profile, and adherence between Dienogest and postoperative Leuprolide Acetate in women with endometriosis who underwent laparoscopy. Methods: This study was a randomized clinical trial comparing the open label study to compare the effectiveness of therapy, safety profile, and obedience between postoperative dienogest and leuprolide acetate in women with endometriosis who underwent laparoscopy. Result: From the statistical test it was found that there was effectiveness of dienogest after 4 weeks of therapy (p = 0.004), after 8 weeks of therapy (p = 0.004) and after 12 weeks of therapy (p = 0.004). In the leuprolide acetate group it was also found that there was effectiveness of administration after 4 weeks of therapy (p = 0.004), after 8 weeks of therapy (p = 0.004) and after 12 weeks of therapy (p = 0.003). There was no difference in systolic blood pressure (p = 0.481), diastolic blood pressure (p = 1,000) and pulse frequency (p = 0.125) breath frequency (p = 1,000) and temperature (p = 0.236) between patients who received dienogest and leuprolide acetate. From the statistical analysis it was found that there were no differences in side effects in patients who received dienogest and leuprolide acetate (p = 0.238). Conclusion: There was no difference in therapeutic effectiveness, and the safety profile assessed by side effects as well as obedience of postoperative Dienogest and Leuprolide Acetate in endometriosis women undergoing Laparoscopy because in both groups there was a decrease in VAS scores from week to week. Key Word: Dienogest, Leuprolide Acetate, Endometriosis, Post-Laparoscopy, Therapy Abstrak Tujuan: Membandingkan efektivitas terapi, profil keamanan, dan kepatuhan antara Dienogest dengan Leuprolid Asetat pascaoperatif pada wanita endometriosis yang menjalani Lapararoskopi. Metode: Penelitian ini merupakan uji klinik acak berpembanding dengan open label study untuk membandingkan efektivitas terapi, profil keamanan, dan kepatuhan antara dienogest dan leuprolid asetat pascaoperatif pada wanita endometriosis yang menjalani lapararoskopi. Hasil: Dari uji statistik didapatkan hasil terdapat efektivitas pemberian dienogest setelah 4 minggu terapi (p = 0,004), setelah 8 minggu terapi (p = 0,004) dan setelah 12 minggu terapi (p = 0,004). Pada kelompok leuprolid asetat juga didapatkan hasil terdapat efektivitas pemberian setelah 4 minggu terapi (p = 0,004), setelah 8 minggu terapi (p = 0,004) dan setelah 12 minggu terapi (p = 0,003). Tidak terdapat perbedaan tekanan darah sistolik (p = 0,481), tekanan darah diastolik (p = 1,000) dan frekuensi nadi (p = 0,125) frekuensi napas (p = 1,000) dan suhu (p = 0,236) antara pasien yang mendapatkan dienogest dan leuprolid asetat. Dari analisa statistik didapatkan hasil tidak terdapat perbedaan efek samping pada pasien yang mendapatkan dienogest dan leuprolid asetat (p = 0,238). Kesimpulan: Tidak terdapat perbedaan efektivitas terapi, dan profil keamanan yang dinilai dari efek samping serta kepatuhan Dienogest dan Leuprolid Asetat pascaoperatif pada wanita endometriosis yang menjalani Lapararoskopi karena pada kedua kelompok terdapat penurunan VAS skor dari minggu ke minggu.

Agreement Test of Documentation of Visual Inspection with Acetic Acid â€œDoVIAâ€ and Colposcopy findings as a Screening Tool for Cervical Cancer: Kesesuaian Hasil Tes Dokumentasi Inspeksi Visual dengan Asam Asetat (DoVIA) dan Kolposkopi sebagai Alat Skrining untuk Kanker Servik Laila Nuranna; Renny Surya Wardany; Gatot Purwoto; Tofan W. Utami; Lex Peters
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To find out the suitability of Documentation of Visual Inspection with Acetic Acid (DoVIA) result compare to colposcopy result as a method of cervical cancer screening. Method: This is a descriptive study using cross sectional design that took place from April 2017 until March 2019. One hundred eighty two sampels of documentation photographs taken by the researcher were included. The photographs were reviewed by the 3 selected reviewers: oncology and gynecology consultant, obstetry and gynecology resident, and general practitioner that were trained about DoVIA and colposcopy. The review was based on kappa test which assessed the sharpness, squamo-columnar junction and white epitel visualization on the cervix. Results: Kappa score on DoVIA versus colposcopy was 0,717 (good). Inter-rater test was performed to assess consistency and the result was 0,764 (good) between consultant and resident, 0,703 (good) between consultant and general practitioner. Conclusion: Kappa test of IVA documentation â€DoVIAâ€ gives a good kappa value, so that it is expected to be an alternative screening for precancerous lesions. Keyword: cervical cancer screening, VIA, DoVIA, colposcopy, mini colposcopy Abstrak Tujuan: Untuk menemukan kesesuaian antara dokumentasi hasil inspeksi visual dengan asam asetat (DoVIA) dibanding dengan hasil kolposkopi sebagai metode skrining kanker serviks. Metode Penelitian deskripsi ini menggunakan desain cross sectional yang telah dilakukan sejak April 2017 hingga Maret 2019. Seratus delapan puluh dua sampel dokumentasi telah diambil oleh peneliti telah dimasukkan menjadi sampel. Hasil dokumentasi telah dinilai oleh 3 penilai yang terdiri dari konsultan onkologi dan ginekologi, residen obstetri dan ginekologi, dan dokter umum yang telah dilatih untuk DoVIA dan kolposkopi. Hasil penilaian dilakukan berdasarkan kappa untuk menilai ketajaman, sambungan skuamos kolumner dan visualisasi lesi putih di serviks Hasil Skor kappa pada DoVIA dibanding kolposkopi adalah 0,717 (baik). Hasil prbandingan penilaian antar penilai yang ditunjukkan untuk menilai konsistensi dan hasil adalah 0,764 (baik) antara konsultan dan residen, 0,703 (baik) antara konsultan dan dokter umum. Kesimpulan Tes kappa pada dokumentasi IVA (DoVIA) memberikan hasil kappa baik, sehingga DoVIA diharapkan dapat menjadi alternatif skrining untuk lesi prakanker. Kata kunci : skrining kanker serviks, IVA, DoVIA, kolposkopi, minikolposkopi

CuT 380A IUD Inserted by R-Inserter and Ring Forceps during Postpartum Period A Randomized Clinical Trial, Twelve Months Follow Up: IUD CuT380A yang Dipasang dengan R-inserter dan Klem Cincin pada Masa Pascasalin Uji Klinis secara Random, Pengamatan Dua Belas Bulan Risanto Siswosudarmo; Nungky Nugroho; Chandra Kurniawan; Yunita Erlina; Dianisa Ikarumi
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To compare the safety and effectiveness of CuT 380A IUD use inserted by R-inserter compared with those inserted by ring forceps during the postpartum period.Methods: The study was conducted in three puskesmas (community health centre) as affiliated of Sardjito Hospital. Subjects meeting the inclusion and exclusion criteria were recruited to get a 10% proportion expulsion rate difference, type one error 0.05 and type two error 0.20. Insertion using R-inserter was treated while using ring forceps belonged to the control groups. Follow up was carried out one week after the insertion, one month and then monthly for 12months. Rate of the following events i.e.infection, expulsion, pain, bleeding, removal and continuation of use were primary outcomes of interest.Results: A total of 208 eligible subjects were recruited, consisting of 104 subjects using R-inserter and 104 subjects using ring forceps. Cumulative event rates during 12 months follow up were 1%, 4.3%, 3.4%, 10.1% and 4.8% each for infection, expulsion, bleeding, pain, and removal respectively. There was no difference in the rate of infection between the two groups, i.e. 1,0% for each group. There was one pregnancy over 208 subjects giving the overall failure rate of 0.5%. The overall results showed that there were no differences among those events rates (pain, bleeding, removal and continuation) between R-inserter and ring forceps groups. Continuations rate were 93.7%, 93.2%, 90.8%, and 90.8% each for three, six, nine and 12 months follow up respectively.Conclusions: There were no differences in terms of event rates between the use of CuT 380A IUD inserted by R-inserter and ring forceps.Keywords: continuation rate, expulsion, infection, postpartum IUD, R-inserter AbstrakTujuan: Membandingkan keamanan dan keefektifan pemakaian IUD CuT 380A pascasalin yang dipasang dengan R-inserter vs klem cincin.Metode: Penelitian dilakukan di 3 puskesmas di provinsi DIY. Pasien yang memenuhi kriteria kelayakan dimasukkan dalam penelitian ini untuk memenuhi beda proporsi ekspulsi 10%, kesalahan tipe satu 0,05 dan kesalahan tipe dua 0,20. Kelompok uji adalah mereka yang dipasang IUD dengan R-inserter dan kelompok control adalah mereka yang dipasang dengan klem cincin.Follow up dikerjakan setelah satu minggu, satu bulan dan setiap bulan sampai 12 bulan. Infeksi, ekspulsi, nyeri, perdarahan, pelepasan dan kelangsungan pemakaian adalah hasil utama yang diteliti.Hasil: Sebanyak 208 subyek penelitian memenuhi kriteria kelayakan, terdiri atas 104 subyek dipasang dengan R-inserter dan 104 subyek dengan klem cincin. Kejadian kumulatif pada seluruh kasus selama 12 bulan follow up adalah 1%, 4,3%,3,4%, 10,1%, 4,8% masing-masing untuk infeksi, ekspulsi, perdarahan, nyeri, dan pelepasan. Angka infeksi masing-masing sebesar 1% pada kedua kelompok. Terdapat satu kehamilan (0,5%) dari seluruh kasus. Angka kejadian yang lain (nyeri, perdarahan, pelepasan dan kelangsungan pemakaian) tidak menunjukkan perbedaan yang bermakna. Angka kelangsungan pemakaian kumulatif adalah 93,7%, 93,2% 90,8%, dan 90,8% masing-masing pada follow up tiga, enam, Sembilan dan 12 bulan pascapasang.Kesimpulan: Tidak ada perbedaan dalam hal kejadian efek samping antara pemakaian IUD CuT 380A yang dipasang pada masa pascasalin denganR-inserter dan klem cincin.Kata kunci: Angka kelangsungan, ekspulsi, infeksi, IUD pascasalin, pelepasan, R-inserter.

The Role of Stem Cells in Obstetrics and Gynecology Gita Pratama
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 1 January 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Contraceptive Choices for Women with Intellectual Disability: Pemilihan Kontrasepsi untuk Perempuan dengan Disabilitas Intelektual Ida B. Nugraha; Dyana S. Velies
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 2 April 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To describe the case of contraceptive choices for women with intellectual disabilityMetode: A case reportResults: In the case of intellectual disability, we need to perform a holistic approach to the patient.Conclusion: Contraceptive method selection needs much consideration such as medical, ethical, law, and social aspect, therefore it's recommended to start giving an informed choice since antenatal care. The downside of this case is that medical practitioners often overlook the patient's degree of intellectual disability, hence, the patients' judgement, compliance, and self-treatment of complications. The result of counselling with the patient's family, they have chosen LARC method for this patient. Sterilization for eugenic reasons cannot be done because it violates law and ethics of medical practice in Indonesia.Keywords: eugenics, contraceptive, intellectual disability, sterilization. Abstrak Tujuan: Untuk menjelaskan tentang kasus pemilihan alat kontrasepsi untuk perempuan dengan disabilitas intelektualMetode: Laporan kasusKonklusi: Pemilihan alat kontrasepsi memerlukan pertimbangan berberapa aspek seperti factor medis, etika, hukum, dan sosial. Maka itu, edukasi tentang informed choice alat kontrasepsi perlu diberikan sejak mulai antenatal care. Kekurangan pada kasus ini yaitu tenaga medis tidak menilai derajat keparahan disabilitas intelektual pasien. Oleh karena itu, tenaga medis tidak dapat menilai tingkat kemampuan dalam pertimbangan, kepatuhan, dan perawatan diri sendiri terhadap komplikasi penyakit. Hasil dari konseling dengan keluarga pasien, mereka memilih metode LARC untuk pasien. Tindakan sterlisasi untuk alasan eugenik tidak dapat dilakukan, karena tindakan tersebut melanggar etika dan hokum praktik medis yang berlaku di Indonesia.Kata kunci: disabilitas intelektual, eugenik, kontrasepsi, sterilisasi.

Characteristic of Midwife’s who Refer Complex Obstetrics Cases: Karakteristik Bidan yang Merujuk kasus Kebidanan Komplek Arietta R.D. Pusponegoro; Astrid M. P. Iskandar
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 2 April 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Abstract Objective: To identify reasons for referring and characteristics of midwives who practice independently and its relation with complicated cases referred to RSCM.Method: Descriptive analytic case-control. Medical records of patients referred directly to RSCM in January 2016-July 2017 were obtained, then information about midwives and obstetric cases, along with its complications, were collected. Interview and analysis of six characteristics of midwives were conducted. Characteristics analyzed were age, education, training, duration of practice, number of patients ever treated, also distance and travel time of the referral process.Results: All midwives refer due to inadequate facilities. There is a statistically significant correlation between duration of practice and number of patients, with the complicated cases referred directly to RSCM, with OR 7.036 and 6.032, respectively.Conclusion: Midwives refer due to inadequate facilities, and so patients can be treated immediately. Characteristics that affect midwives to refer complicated cases: duration of practice and number of patients. It is necessary to re-evaluate the position of midwives who practiced independently in BPJS, refresher programs, and monitoring by relevant agencies. Further research is needed with more samples and combining midwives' and patients' characteristics in referral cases. Confounding and external factors are identified first in order to do a thorough analysis.Keywords: complicated cases, midwives' characteristics, midwives who practiced independently, referral, referral system. Abstrak Tujuan: Mengetahui alasan rujuk dan karakteristik bidan yang berpraktik mandiri serta hubungannya dengan kasus komplikatif yang dirujuk ke RSCM.Metode: Deskriptif analitik kasus kontrol. Data diambil dari rekam medis pasien yang dirujuk langsung ke RSCM di bulan Januari 2016 hingga Juli 2017, kemudian informasi mengenai data bidan dan kasus obstetri beserta komplikasinya dikumpulkan. Dilakukan wawancara dan analisis enam karakteristik bidan. Karakteristik yang dianalisis yaitu usia, pendidikan, pelatihan, lama waktu berpraktik, jumlah pasien yang pernah ditangani, serta jarak dan waktu tempuh proses merujuk. Hasil: Keseluruhan bidan merujuk karena fasilitas yang tidak memadai. Terdapat hubungan yang bermakna antara waktu praktik dan jumlah pasien yang pernah ditangani, dengan kasus komplikatif yang dirujuk langsung ke RSCM, dengan nilai OR 7.036 dan 6.032.Kesimpulan: Bidan merujuk karena fasilitas tidak memadai dan agar pasien langsung ditangani. Karakteristik bidan yang mempengaruhi dalam merujuk yaitu lama waktu praktik dan jumlah pasien yang ditangani. Perlu dilakukan evaluasi ulang mengenai kedudukan bidan yang berpraktik mandiri di BPJS, program penyegaran bidan, serta monitoring oleh instansi terkait. Perlu penelitian lanjut dengan sampel lebih banyak serta menggabungkan karakteristik bidan dan pasien pada kasus-kasus rujukan. Faktor perancu dan eksternal diidentifikasi terlebih dahulu agar analisis dilakukan menyeluruh.Kata kunci: bidan yang berpraktik mandiri, karakteristik bidan, kasus komplikatif rujukan, sistem rujukan

Side Effects of Misoprostol Per Rectal for Treating Postpartum Hemorrhage in Vaginal Delivery versus Cesarean Section: What Do We Know So Far? Efek Samping Misoprostol Per Rektal untuk Pengobatan Perdarahan Pascasalin Novitasari Nasution; Hesty U. Ramadaniati; Syamsudin Syamsudin; Ajeng Normala
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 2 April 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the incidence and profiles of misoprostol’ side effects given per rectal for treating postpartum haemorrhage in vaginal delivery versus cesarean section.Methods: A prospective observational study involving 40 women delivered by vaginal birth (VD) and 40 by cesarean section (CS) was undertaken in a gynecology ward of a hospital in West Java. The incidence of misoprostol’s side effects was identified through patient observation and medical note review. The side effect probability was rated by the panellists of healthcare providers. Patient characteristics and side effect data were summarized descriptively. The incidence rates of misoprostol’s side effect between the two groups were compared using Z-test.Results: Thirty-four patients (85.0%) in the VD group experienced side effects, whilst all CS patients reported at least one side effect. There was no significant difference in the proportion of patients having side effects in the two groups (p=0.366). There were 135 and 164 side effects in the VD group and CS group, respectively. There was no discernible difference in side effect profile between the two groups. Gastrointestinal side effects accounted for the most frequent side effects. Regarding the side effect probability, the panellists rated all side effects in VD patients as probable. Meanwhile, around70% of side effects in CS patients were regarded as probable leaving the remaining as definite.Conclusion: High incidence of misoprostol’s side effects was documented both in VD and CS patients. The incidence rates and side effect profile between the two delivery modes were quite similar.Keywords: cesarean section, misoprostol, postpartum haemorrhage, side effect, vaginal delivery Abstrak Tujuan:Membandingkan insiden dan profil efek samping misoprostol per rektal untuk pengobatan perdarahan pascasalin pada persalinan pervaginam versus seksio sesarea.Metode: Penelitian observasional prospektif melibatkan 40 perempuan yang melahirkan melalui persalinan pervaginan (VD) versus 40 pasien melalui seksio sesarea (CS) dilakukan di bangsal ginekologi sebuah rumah sakit di Jawa Barat. Insiden efek samping misoprostol diidentifikasi melalui pengamatan pasien dan kajian rekam medis. Probabilitas efek samping dinilai oleh panel tenaga kesehatan. Karakteristik pasien dan profil efek samping dianalisis secara deskriptif. Proporsi insiden efek samping misoprostol antara dua metode persalinan dibandingkan menggunakan uji Z.Hasil :Tiga puluh empat pasien (85,0%) pasien di kelompok VD mengalami efek samping, sementara semua pasien CS melaporkan setidaknya satu efek samping. Tidak ada perbedaan yang signifikan terkait proporsi pasien yang mengalami efek samping di kedua kelompok (p=0,366). Secara keseluruhan terdapat 135 dan 164 efek samping pada kelompok VD dan CS secara berurutan. Tidak ada perbedaan yang nyata dalam profil efek samping kedua kelompok. Efek samping terkait saluran cerna merupakan efek samping yang palings sering ditemukan. Terkait probabilitas kejadian efek samping, panelis menilai semua efek samping pada kelompok VD sebagai “mungkin”. Sementara itu, sekitar 70% efek samping pada pasien CS dikategorikan “mungkin” dan selebihnya “sangat mungkin”.Kesimpulan :Insiden tinggi efek samping misoprostol ditemukan baik pada pasien VD maupun CS. Proporsi insiden dan profil efek samping cukup seragam pada dua kelompok tersebut.Kata kunci: efek samping, misoprostol, perdarahan pascasalin, persalinan pervaginam, persalinan seksio sesarea

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