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Evaluasi Clinical Pathway Seksio Sesarea: Keefektifan Penggunaan Antibiotika Injeksi Cefotaxime 2 Gram dalam 24 Jam untuk Mencegah Terjadinya Infeksi Luka Operasi Fauziah, Rathi Manjari; Siswishanto, Rukmono; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: The usage of prophylactic antibiotics in Dr. Sardjito Hospital, Yogyakarta, is still diverse. Previously, prophylactic antibiotics that were given would be in a form of multidose and or multidrug regimen. Recently, a clinical pathway for c-section had been set up to uniform the antibiotics given. Cefotaime 2g, given intravenously, in 24 hours is the antibiotic of choice. Unfortunately, there was no data about the effetiveness of cefotaime that can be used as a basis of clinical pathway.Â Objective: Comparing the incidence of surgical site infection (SSI) between cefotaime 2g,/24 hours (clinical pathway or CP) with previous regimen of prophylactic antibiotics (non-clinical pathway or nonCP) and also identify the risk factors.Method: This is a retrospective cohort study with 129 subjects, divided into two groups. The CP group consists of 63 subjects, while non-CP group consists of 66 subjects. The surgical site infection was observed in the day 3 and day 10 aer C-section. Multivariat analysis was used to determine the risk factors of SSI.Result and Discussion: SSI incidence in the CP group at day 3 was higher compared to non-CP group, but it was not statistically significant (OR 4,73 95% CI 0,52 43,04), eukocytosis (>17000/mcl) was the independent risk factor for SSI (OR 7,54 95% CI 1,25 45,39).Conclusion: SSI incidence between two groups was not statistically significant but was clinically significant. The presence of leukocytosis is becoming the risk factor for SSI.Keywords: prophylactic antibiotic, c-section, cesarean section, surgical site infectio

Robekan Perineum pada Persalinan Vaginal di Bidan Praktik Swasta (BPS) Daerah Istimewa Yogyakarta Indonesia Tahun 2014-2016 Pangastuti, Nuring
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Vaginal delivery is the most preffered mode of delivery by all women, and the birth attendants. The vaginal delivery assistance was conducted by various health professionals such as midwives, physicians, and obstetricians. Various complaints of pelvic floor dysfunction and complaints related to the perineum as a result of vaginal perineal laceration during childbirth can affect the quality of life of a woman.Objective: To identify and conduct an analysis of maternal factors (maternal age, parity, gestational age), fetal factor (birth weight), and the labor factor (duration of 2nd stage of labor), with the occurrence of perineal rupture in vaginal delivery at the 5 Midwifeâ€™s Private Clinic (MPC), Yogyakarta, Indonesia.Method: Retrospective medical record searching, from January 2014 until December 2016.Result and Discussion: There were 1595 obtained samples of data that met the criteria for inclusion and exclusion. Number of perineal laceration reached 1201 (75.3%), with 1.9% of them are grade 3. Perineal rupture occurred in 80.55% of vaginal deliveries at young age, 69.14% in more than 35 years old women, and 85.05% primiparas. There was significant negative correlation (0.186) between parity and perineal rupture (p=0.000). The less the parity, the higher the incidence of perineal rupture (p=0.002). There was significant correlation between babyâ€™s weight less than 2500 gram and perineal rupture but not for the babyâ€™s weight more than 4000grams (p=0.304). The correlation was positive which meant that the heavier the babyâ€™s weight the higher the incidence of perineal rupture. There was significant positive correlation (p=0,018) for the duration of 2nd stage of labor between 30-60 minutes and perineal rupture(0.061). The correlation was positive as well (0.092) for the duration of 2nd stage of labor more than 60 minutes and perineal rupture( p=0.002). The longer the duration of the 2nd stage of labor the higher the incidence of perineal rupture.Conclusion: There was significant relationship between parity, and duration of the 2nd stage of labor and perineal rupture in vaginal delivery.Keywords: perineal rupture, vaginal delivery, parity, duration of the 2nd stage of labor

Impact of Obstetrician/Gynecologist Hospitalists on Response Time of Obstetric Emergency Operation in Sardjito Hospital Yogyakarta Indonesia: A Retrospective Cohort Study Ganap, Eugenius Phyowai; Hakimi, Mohammad; Hadijono, Soerjo; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: The hospitalist model in obstetric care which was introduced over the last decades now has an important role in care delivery management with the potential positive impact on maternal and neonatal outcomes.Objective: The aim of this study was to evaluate the effect of hospitalist model towards surgical emergency response time.Method: This research design was cohort a retrospective study. Participants included wereÂ the patient in the time before and after implementation of obstetrician/gynecologist full-hospitalist policy during October 2013 until September 2014. The outcome measured were mean response time and possible hospital factors which contribute to response time.Result and Discussion: We included a total of 71 patients (30 on-call obstetrician group andÂ 41 full-time hospitalist group).Â Univariate analysis indicatedÂ mean response time was significantly differ in full-time hospitalist group when compared to the on-call obstetrician group (65.3 + 25.89 vs. 84 + 22.29 mins; p = 0.002). Multivariable analysis determined that hospital factors which contribute to response time are readiness of operating theatre.Conclusion: Implementation of full-time hospitalist model is associated with a significant improvement of response time in emergency obstetric care.Keywords: Maternal mortality, Obstetrician/Gynecology Hospitalist, C-section, Response Time

Perbandingan Kejadian Retensi Urin antara Persalinan dengan Vakum Ekstraksi dan Persalinan Normal Petrana, Nurul Hikmah; Emilia, Ova; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Urinary retention after vaginal delivery is a common problem with incidence 1.7% - 17.9%. Assissted vaginal delivery is one risk factor for the occurence of urinary retention.Objective: to compare urinary retention between normal vaginal delivery and assissted vaginal delivery using extraction vacum, and evaluate factors related to urinary retention.Method: The study was prospective cohort design, conducted in 3 hospitals and 2 primary health centres during 6 month period since September 2013- February 2014. Subjects were divided into two groups i.e. normal delivery and assissted delivery using extraction vacum, each 118 subjects. Events of urinary retention was assessed and also related factors were identified. Analysis used Chi-Square test, Fisher test and also logistic regression analysis.Result and Discussion: In total 236 subjects were involved, there was no difference in age and parity among the subjects. Incidence of urinary retention among extraction vacum delivery group was higher (32.2%) compare to normal delivery (11.9%). Multivariate analysis using logistic regression showed that extraction vacum (p=0.074; OR 2.71; 95% CI 1.55-4.73), baby weight (p= 0.230; OR 1.95; 95% CI 0.655.84) and perineal injury (p= 0.614; OR 1.35; 95% CI 0.41-4.36) were not significant risk factors for urinary retention. Length of labour (p=0.003; OR 3.71; 95% CI 1.55-8.86) and parity (p= 0.023; OR 2.29; 95% CI 1.2-4.66) were significant risk factors for urinary retention.Conclusion: Urinary retention is higher among vaginal delivery with extraction vacum compare to normal delivery. Length of labour and parity are external factors related to urinary retention.Keywords: Assissted vaginal delivery, extraction vacum, normal delivery, urinary retention, postpartum

Perilaku Ibu dalam Memilih Tenaga Penolong Persalinan di Wilayah Kerja Puskesmas Tembilahan Hulu Tahun 2016 Alhidayati, Alhidayati; Asmuliyanti, Asmuliyanti
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Maternal Mortality Rate (MMR) is an indicator of health development in Indonesia. Some effort have been done to decrease maternal mortality ie to increase range labor by health personnel. The target coverage of labor by health personnel in Tembilahan Hulu Public health center has yet to reach the target of 80%. its coverage was only 45%. The number of maternal mortality in Tembilahan Hulu Health center in 2016 was 1 cases and the number of infant maternal mortality was 5 cases.Objective: The purpose of this study was to determine the motherâ€™s behavior in selecting birth attendants in health center in the region of the upstream Tembilahan Hulu.Method: This research used qualitative method to gain the in depth information on how to Motherâ€™s Behavior In Selecting Birth Attendants In Health Centers Working Area Tembilahan Hulu 2016. The data are analysed by using content analysis, which is comparing the result from the research with the theories in the literature.Result and Discussion: There were 13 informants in this research. This studyâ€™s result showed that the decision for birth attendants were closely related to knowledge, attitude, socio-cultural, access to health center, and support from family. Advise to relevant agencies, namely health centers Tembilahan Hulu order to further increase coverage deliveries by health care and in personels villages to which access is far from health facilities to build Birth Waiting Homes (BWH).Conclusion: The Decision for birth attendants were closely related to knowledge, attitude, socio cultural, acces to health center and support from family.Keywords: birth attendant, community health center, pregnant women behavior

Pemaknaan Menopause pada Perempuan Bangsawan Keraton Jawa Sulistiyani, Lisy; Suci, Eunike Sri Tyas
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: In most cases, women experience menopause with various kind of physical and psychological symptoms. Womenâ€™s understanding on menopause is influenced by their cultural background. Royal Javanese women are not sepatared from various Javanese traditions, such as â€œpitutur-pituturâ€, â€œlaku Jawaâ€, et cetera. Such traditions are the foundation they construct menopause experience.Objective: The purpose of this research is to obtain the meaning of menopause as experienced by Royal Javanese Women.Method: A qualitative method with in-depth interview is used in this research. Informants are seven Royal Javanese Women from three Javanese palaces: Solo, Yogyakarta and Cirebon; who were selected with purposive sampling technique.Result and Discussion: Based on this research, the meaning of menopause as experienced by Royal Javanese Women is significantly influenced by their construction of Javanese culture. Menopause is understood as an important event occurred to womanâ€™s body. As an important event, Royal Javanese Women carry out several preparations and anticipative efforts prior to Menopause. Preparations are outer and inner treatment and applied in day-to-day activities such as taking Javanese traditional herbs (jamu) and carry out Javanese traditions or rituals (fasting, meditation, et cetera).Conclusion: The Acceptance of manapausal symptoms are the result of cultural exposure and aaptation in royal live enviroments.Keywords: Menopause, Javanese Culture, Royal Javanese Women, Meaning

Interaksi Sosial dalam Kejadian Abortus Provokatus Kriminalis di Kabupaten Bulukumba Provinsi Sulawesi Selatan Ridwan, Rizal; Prawitasari, Shinta; Prawirodihardjo, Leo
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Many factors influence the decision to commit abortions, among all are marital status and educational status which most are still in school, economic pressure, multiparity or contaception failure. The social interaction is a connection between t the people who perform abortion and their suggestive environment.Objective: to observe the social interaction that happend among the person who perform abortion and the surrounding society.Method: This research makes use of qualitative method to understand the motives behind abortion practice, through an indepth interview. The sample collection is performed on H. A. Sulthan Dg Radja Hospital and Daffiku Hospital Bulukumba.Result and Discussion: Subject who performed abortion was influenced by internal and external factors. The internal factors include anxiousness, financial worrisome to support the child and fear of embarrassing the family in an unmaried women. As for the external factor includes pressure from families and friends who insist on performing abortion and the help from traditional healer on performing abortion. These two factors are not independent, and between them there are interactions to materialize abortion practice.Conclussion: Social interaction between individuals and between individual and the environment are an important role against abortion in decision making to have an provocative abortion.Keywords: Social interaction, abortion, factors for abortion

Peran Intervensi Grup Psikoterapi Suportif untuk Memperbaiki Keadaan Depresi pada Wanita Infertil di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta Dhestiana, Mega; Marchira, Carla; Siswishanto, Rukmono; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Infertility is a worldwide problem, relates to a devastating condition that can destroy couples striving to have children. It can affect both men and women, and cause psychological related distress, depression, and low self- -esteem. Most interventions using directional, complete, and integrated approach have been focused on improving the quality of life of infertile men or women. Supportive psychotherapy is an example of such interventions.Objective: The study aimed to measure the effectiveness of supportive psychotherapy intervention in treating depression among infertile women.Method: A quasi experiment design using a pre and post- -test with a control group was employed in this study. Subjects were women (n=80) with infertility cases who sought for treatment at PermataHati Clinic Dr. Sardjito hospital. during the period from April to September 2014. A modified short supportive psychotherapywas to groups of patients over the course of four sessions. The sessions were managed by trained facilitatorscomprising psychiatrist and psychologist. Personal data and Beck Depression Inventory (BDI)were then used to assess the patients depression state.Result and Discussion: Findings indicated that 59.37% of the study subjects were found to have mild depression, whereas the other 40.63% had moderate depression. A significant change in BDI scores within the treatment group was found after intervention.Conclusion:Modified short supportive psychotherapy intervention can effectivelly reduce depression on infertile women.Keywords: modified short supportive psychotherapy, depression, infertile women

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Journal Mail Official
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Kab. sleman,

Daerah istimewa yogyakarta

INDONESIA