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Articles 195 Documents
Perubahan Nilai BA pada Pelvic Organ Prolaps Quantification (POPQ) terhadap Kualitas Berkemih Pre dan Pasca Opreasi Kolporafi Anterior paa Pasien Sistokel Ramadona, Izwin; Siswishanto, Rukmono; Pangastuti, Nuring
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.641 KB) | DOI: 10.22146/jkr.35427

Abstract

Background: Anterior colporrhaphy is used to correct anatomical abnormalities of POP, especially cystocele. In the cystocele, POPQ is focused on Ba point. However, no reference value has been established during evaluation on the changes of Ba’s pre and post operation. A measurement is required to describe the value of Ba in POPQ to the quality of patients’s micturition who have undergone anterior colporrhaphy on cystocele indication.Objective: To determine whether a change of Ba value more than 4 cm post anterior colporrhapy can improve voiding quality.Method: This study used a pretest-posttest design by measuring the value of Ba and voiding quality (UDI6 score) in cystocele patients before and after anterior colporrhapy. Ba value changes compared with changes in postoperative voiding quality.Result and Discussion: There were 20 subjects recruited from January until July 2016 who met the inclusion criteria. There were significant differences between the voiding quality and changes of Ba value before and after surgery for 2nd and 6th week (p<0.001). From the bivariate analysis there were no differences in changes of voiding quality for Ba> 4 cm compared ≤4 cm (p = 0.34; RR 1.43; 95% CI 0.61-3.37). Age, BMI and parity had no significant affects the voiding quality before and after surgery (p= 0.12, p= 0.62, p=0.27). From a logistic regression analysis of variables change in value of Ba and external variables of age, BMI and parity were not statistically significant influence the voiding quality.Conclusion: Changes in the value of Ba more than 4 cm from baseline in patients who undergo anterior colporrhapy does not improve the voiding quality.Keywords: Ba value, voiding quality, anterior colporrhapy.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.005 KB) | DOI: 10.22146/jkr.36037

Abstract

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
Pengetahuan tentang Infeksi Menular Seksual dengan Perilaku Seksual Tidak Aman pada Remaja Putri Maluku Tenggara Barat di Daerah Istimewa Yogyakarta Kora, Firmina Th; Dasuki, Djaswadi; Ismail, Djauhar
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.499 KB) | DOI: 10.22146/jkr.13880

Abstract

Background: Based on the Indonesian Demographic and Health Survey (IDHS, 2012), adolescents’ knowledge (females aged 15-24 years) about STI (Sexually Transmitted Disease) is still low under 50%. A total of 16.46% Indonesian adolescents have had sex, 46.26% of them have been doing it actively, first sex occurred in below 20 years of age.Objective: To determine the relationship between knowledge about sexually transmitted infections with unsafe sexual behavior.Method: This study is a quantitative and qualitative with cross-sectional study design. Subjects in this study were all female adolescents of West Southeast Moluccas who are continuing education in Yogyakarta. Univariable and bivariable data analysis was conducted using chi-square test statistic. Multivariable analysis was conducted using logistic regression to estimate the effective model.Result and Discussion: Low knowledge STI is practically and statistically related to unsafe sexual behavior with a p-value <0.05, RP 1.71 and CI 1.07 to 2.70. Low knowledge about STIs in adolescents increase the risk by 1.7 times for unsafe sexual behavior. Conclusion: 67,1% female adolescent who have unsafe sexual behavior. Female adolescents who have knowledge about STIs low 65.7%. Low knowledge STI significantly increases unsafe sexual behavior in adolescent girls. Unsafe sexual behavior conducted by adolescent female are sexual intercourse before the age of 20 not using condoms during sexual intercourse, and multiple sexual partner.Keywords: Knowledge of Sexually Transmitted Infections, Unsafe Sexual Behavior, Female Adolescent
Perbandingan Skala Nyeri pada Kuretase antara Pemberian Lidokain Paraservikal dan Intraservikal Ksyatria, Yudhistya Ngudi Insan; Pradjatmo, Heru; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.139 KB) | DOI: 10.22146/jkr.13872

Abstract

Background: Curettage is a gynecological diagnostic and therapeutic procedures. Curettage actions causing sensation of pain although the pain threshold is different for each person. Local anesthesia is an effective choice for various minor gynecological procedures. One of them is paracervical block. Paracervical block reduces pain by blocking nerve impulses across the uterovaginal plexus. Another method is the injection of local anesthetic trough intracervical who works as an anesthetic infiltrating agent, distending the tissue, causing mechanical disruption of nerve impulses. Theoritically, intracervical lidocaine injection will require a lower level of precision than the blockade of peripheral nerves directly, more reliable and reproducible. We measured patient’s pain during curettage usingthe Visual Analogue Scale (VAS). Method: RCT Location of study: Bantul District Hospital, Wonosari District Hospital, and Banjarnegara Distric Hospital. Result and Discussion: The study included 60 patients who got curettage within inclusion criteria. Every time patients came, we performed randomization and divided the patients into two groups, the control group (paracervical) and intervention group (intracervical), 30 subjects each. VAS was measured 5 minute after curettage was started. Characteristics of subjects in curettage frequency, curettage indication, parity and educational level for both groups are equal, did not differ statistically. The results of the mean pain scale (VAS). In the control group was 42,33±16,583 and 34,33±18,880 on the treatment group. Mean difference was 8 mm, with 95% CI -1.124 to 17.124 and p=0.408. The difference was not significant statistically. The intracervical group has mild pain scale (VAS<44 mm) in 27 of 30 patient, compared to 15 of 30 patients in paracervical group. It result in Relative Risk (RR) of 1,532. Conclusion: Intracervical lidocaine injection can be considered as an alternative local anesthetic on curettage. The average pain scale did not differ significantly with paracervical block. And both of it located in VAS < 44mm (mild pain). Intracervical lidocaine injection even have RR= 1,532 compared with paracervical block to produce mild pain scale (VAS < 44 mm). Keywords: curettage; paracervical;intracervical ;VAS 
The Impact of Obstetrician/Gynecologist Hospitalists on Maternal Quality of Care in Yogyakarta Indonsia: A Cohort Study Ganap, Eugenius Phyowai; Hakimi, Mohammad; Hadijono, Soerjo; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (261.484 KB) | DOI: 10.22146/jkr.35421

Abstract

Background: The hospitalist is defined by 24-hour a day/7 day a week physician who assists or is employed by the hospital to manage patients, triage and emergencies.  The hospitalist model in obstetric care that was introduced over the last decades now has an important role in care delivery management with the potential positive impact on maternal outcomes. Unfortunately, in Indonesia there were limited data available related to the implementation of hospitalist model and the impact on maternal quality of care.Objective: To determine the impact of obstetrician/gynecologist hospitalist on maternal quality care. Method: This research design was a retrospective cohort. Participants included were the patients in the time before and after implementation of obstetrician/gynecologist hospitalist policy during October 2013 until September 2014. Univariate and multivariate analysis were conducted to evaluate and determine the factors, which significantly contribute to maternal outcomes.Result and Discussion: We included a total of 71 patients (30 in the on-call group and 41 in the full time hospitalist group). Univariate analysis indicated mean response time was significantly different in the hospitalist group compared to the on-call group (65.3 ± 25.89 vs 84 ± 22.29 mins; p = 0.002). Implementation of full-time hospitalists did not impact the ICU admission and transfusion incidence.Conclusions: Implementation of the full-time hospitalist model was associated with a significant improvement of response time in emergency obstetric care without affecting maternal outcomes.Keywords: Maternal mortality, obstetrician/gynecologist hospitalist, labor and delivery, maternal care, ICU response time
HUBUNGAN ANTARA VAGINOSIS BAKTERIAL DAN PERSALINAN PRETERM Lidia, Hepta; Emilia, Ova; Anwar, Moch.
JURNAL KESEHATAN REPRODUKSI Vol 2, No 2 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1252.183 KB) | DOI: 10.22146/jkr.12637

Abstract

HUBUNGAN ANTARA VAGINOSIS BAKTERIAL DANPERSALINAN PRETERMHepta Lidia1, Ova Emilia2, Moch. Anwar3ABSTRACTBackground: Preterm birth remain becomes global issue due to its contribution on high neonatal mortalityrate. WHO (2012) estimated 15 million babies are born premature and Indonesia as one of 10 countries withhighest rates of preterm birth (15,5/100 live births). In the poorest countries, on average, 12% of babiesare born too soon compared with 9% in higher-income countries. Approximately 50% of spontaneouspreterm birth is associated with genital infection. Plenty of efforts had been done to detect risk factorearly, however if has not successfully decreased preterm birth rate. Because of that, it is a needed to doearly screening of lower genital tract in pregnant woman to prevent preterm birth.Method: Cross sectionalLocation of study: Senopati Bantul hospital and Sewon community health centerResult and Discussion: This study involved 134 pregnant woman. Bivariate and multivariate analysis resultshowed that bacterial vaginosis, increased preterm birth significantly (OR 4,26; IK 95% 1,16-15,62). Otherrisk factor that increased preterm birth are history of preterm birth (OR 11,16; IK 95% 1,32-94,45).Conclusion: Proportion of bacterial vaginosis in preterm birth significantly higher, compare to fulltermbirth. History of preterm birth in last pregnancy significantly increased the number of preterm birth.Keywords: Preterm Birth - bacterial vaginosis – early screeningABSTRAKLatar Belakang: Persalinan preterm masih menjadi masalah global oleh karena memberikan kontribusipada kematian bayi yang cukup tinggi, WHO (2012) memperkirakan 15 juta bayi lahir preterm dan Indonesiatermasuk salah satu dari 10 negara dengan angka persalinan preterm tertinggi (15,5/100 kelahiran hidup).Di negara-negara miskin, rata-rata 12% bayi lahir preterm dibandingkan 9% di negara berpendapatan lebihtinggi. Diperkirakan 50% dari kelahiran prematur spontan terkait dengan infeksi saluran genital. Banyakupaya yang telah dilakukan untuk mendeteksi risiko secara dini selain juga intervensi medis, namun belumbanyak menurunkan kejadian persalinan preterm. Oleh karena itu perlu dilakukan suatu skrining awaluntuk infeksi saluran genital bawah pada wanita hamil untuk mencegah persalinan pretermMetode: cross sectionalTempat penelitian: RSUD Senopati Bantul dan Puskesmas SewonHasil dan Pembahasan: Penelitian melibatkan 134 ibu hamil. Hasil analisis bivariat dan multivariatmenunjukkan bahwa vaginosis bakterial meningkatkan kejadian persalinan preterm secara signifikan (OR2,70; IK 95% 1,29-5,67). Faktor risiko lainnya yang meningkatkan persalinan preterm secara signifikanadalah riwayat persalinan preterm pada kehamilan sebelumnya (OR 11,16; IK 95% 1,32-94,45).Kesimpulan: Kejadian vaginosis bakterial pada persalinan preterm secara signifikan lebih tinggi dibandingkanpada persalinan aterm. Demikian juga riwayat persalinan preterm pada kehamilan sebelumnya secarasignifikan meningkatkan risiko kejadian persalinan preterm.Kata kunci: Persalinan preterm - vaginosis bakterial - skrining awal1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr. Sardjito Yogyakarta
Hubungan Pengetahuan, Sikap dan Perilaku Bidan Desa terhadap Kanker Leher Rahim dan Pencegahannya di Kabupaten Sragen Sutresno, Ismail Joko; Emilia, Ova; Prawitasari, Shinta
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (231.463 KB) | DOI: 10.22146/jkr.35429

Abstract

Background: Cervical cancer (cervix) is the second most common type of cancer in women, with an estimated of 530,000 new cases and more than 270,000 deaths each year. In 2012, cervical cancer cases in Central Java was 2,259 cases. Cervical cancer is easily recognizable and can be prevented with screening. A village midwife as the closest healthcare provider to the community is expected to function better in encouraging the prevention of cervical cancer.if they receive appropriate knowledge and attitude toward screening.Objective: to understand the correlation of knowledge, attitude and behavior of village midwife against cervical cancer and its prevention in Sragen district.Method: This analytic study is using quantitative and qualitative approach. Quantitative studies was done with cross-sectional study. The population of this research were 208 village midwifes from 20 sub-districts in Sragen and the subjects were 118 midwives whom randomly sampled. Data were analyzed using univariate and bivariate analysis.The qualitative study was done using depth interview.Result and Discussion: There is no correlation between age, level of education as well as work duration with their knowledge about cervical cancer prevention (P = 0.787; 0.344; 0.822); there is no correlation between village midwives’ knowledge with their behavior towards cervical cancer prevention (P = 0.664); there is no correlation between the village midwives’ attitudes and behavior towards prevention of cervical cancer (P = 0.460). Qualitative results support the quantitative results.Conclusion: There is no correlation between village midwives’ knowledge, attitudes and behavior towards cervical cancer prevention.Keywords: Cervical cancer, knowledge, attitude, behavior
PERBANDINGAN RERATA EKSPRESI PROTEIN Bax DAN Bak PADA PREEKLAMPSIA BERAT DAN KEHAMILAN NORMOTENSI Sujatmiko, Tejo; H, Diah Rumekti; Nurdiati, Detty S
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1505.81 KB) | DOI: 10.22146/jkr.12650

Abstract

PERBANDINGAN RERATA EKSPRESI PROTEIN Bax DANBak PADA PREEKLAMPSIA BERAT DAN KEHAMILANNORMOTENSITejo Sujatmiko*, Diah Rumekti H*, Detty S Nurdiati*ABSTRACTBackground: Preeclampsia is still become major cause of maternal and perinatal mortality. The placentais an important and central focus on the pathogenesis of preeclampsia. Failure of trophoblast cells toperform remodeling on spiral arteries due to excessive apoptosis may cause uteroplacental ischemiaand endothelial cells damage, this induce clinical manifestations of preeclampsia especially through theintrinsic pathway. Intracellular Bax and Bak are genes that play a role as a cells apoptosis regulator (as proapoptosis).They are located in the mitochondria and endoplasmic reticulum and would in turn activatecaspase the intrinsic apoptotic pathway that cascade resulting in cell death processes.Objective: Comparing the mean of Bax and Bak protein expression between normotensive pregnancies andsevere preeclampsia.Method: This research is a cross-sectional study design. The subjects were severe preeclampsia andnormotensive patients treated at RSUP dr. Sardjito Jogjakarta between October 2011 to March 2012,with total patients of 81. Bak and Bax protein expression were measured with immunohistochemistrytechniques.Result and Discussion: The mean expression of Bax and Bak proteins in severe preeclampsia group weresignificantly higher compared to normotensive group. The mean value of Bax expression was 0,23 (CI 95% 0,12 - 0,34) and the mean expression of Bak was 0,44 (95 % CI 0,10 - 0,78).Conclusion: Expression of Bax and Bak proteins in severe preeclampsia is higher than normotensivepregnancies and Bax protein gave more effect statistically in preeclampsia compared to Bak protein.Keywords: trophoblast, immunohistochemistry, severe preeclampsia, Bak protein, Bax protein, apoptosis.ABSTRAKLatar belakang: Preeklampsia masih merupakan penyebab kematian maternal dan perinatal yang utama.Plasenta merupakan fokus sentral dan penting pada patogenesis terjadinya preeklampsia. Kegagalan seltrofoblas melakukan remodeling arteri spiralis akibat proses apoptosis yang berlebihan menyebabkanterjadinya iskemia uteroplasenter dan kerusakan sel endotel yang menimbulkan manifestasi klinispreklampsia terutama terjadi melalui jalur intrinsik intraseluler dimana Bax dan Bak adalah gen-genyang berperan sebagai regulator apoptosis pada sel (sebagai pro-apoptosis). Mereka terletak di dalammitokondria dan reticulum endoplasma dan bekerja mengaktifkan caspase cascade sehingga terjadiproses kematian sel.Tujuan: Membandingkan rerata ekspresi protein Bax dan Bak antara preeklampsia berat dengan kehamilannormotensi.Metode: Penelitian ini merupakan rancangan penelitian potong lintang dengan sampel penderitapreeklampsia berat dan normotensi yang dirawat di RSUP dr. Sardjito Jogjakarta antara bulan Oktober2011 hingga Maret 2012, sebanyak 81 pasien. Pengamatan ekspresi protein Bak dan Bax dilakukan denganteknik imunohistokimia.Hasil dan Pembahasan: Rerata ekspresi protein Bax dan Bak pada kelompok preeklampsia berat lebihtinggi secara bermakna di bandingkan kelompok normotensi Dengan nilai rerata ekpresi Bax 0.23 (CI 95%0.12 – 0.34) dan rerata ekspresi Bak 0.44 (CI 95% 0.10 – 0.78).Kesimpulan: Ekspresi protein Bax dan Bak pada preeklampsia berat lebih tinggi dibanding dengankehamilan normotensi dan protein Bax lebih berpengaruh pada preeklampsia dibanding dengan proteinBak.Kata kunci: trofoblas, imunohistokimia, preeklampsia berat, protein Bak, protein Bax, apoptosis.* Departement of obstetrics and gynecology* Medical Faculty of Gadjah Mada University* Sardjito Hospital
Does Misoprostol for Induction of Labor Increase the Risk of Uterine Rupture? Anggreany, Kiswa; Luthfi, Mohammmad; Siswosudarmo, Risanto
JURNAL KESEHATAN REPRODUKSI Vol 3, No 2 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.016 KB) | DOI: 10.22146/jkr.35445

Abstract

Background: Misoprostol is a synthetic prostaglandin E1 analogue which is now commonly used for induction of labor. Hyperstimulation is a complication of misoprostol that may lead to uterine rupture.Objective: To find the association between misoprostol exposure for induction of labor with uterine rupture.Methods: Case were all women who delivered in Sardjito and affiliate Hospitals from January 2007 to November 2012 with the diagnosis of uterine rupture. Controls were taken randomly from the same hospital. Chi square test and logistic regression model were used for statistical analysis.Result and Discussion: There were 53 cases of uterine rupture and 199 controls. The incidence of uterine rupture was 53 over 64,244 deliveries or 0,08%. Risk of of uterine rupture associated with misoprostol exposure was 1, 09 (CI 95% 0,52-2,2), while that of oxytocin exposure was 0,80 (CI 95% 0,35-1,85). Logistic regression analysis showed that the highest risk factor associated with uterine rupture was fetal weight > 3500 (OR 3,46; 95% CI 1,48-8,56) followed by parity (OR 2,56;95% CI 1,019-6,465) and vacuum extraction(OR 2,45;95% CI 0,94-6,39).Conclusion: There was no association between misoprostol exposure with uterine rupture. Fetal weight> 3500 gram, Parity more than 3, and vacuum extraction increased the risk of uterine rupture associated with misoprostol use.Keywords: Misoprostol, induction of labor, uterine rupture, fetal weight, parity.
Faktor Risiko Individu dan Masyarakat serta Gambaran Pelayanan Kesehatan terhadap Kasus Preeklampsia Berat di RSUD Manokwari Kabupaten Manokwari Provinsi Papua Barat (Periode September 2015-Februari 2016) Sugiarti, Endang Sri; Soejoenoes, Ariawan; Cahyanti, Ratnasari Dwi; Hartono, Eddy
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (248.871 KB) | DOI: 10.22146/jkr.35420

Abstract

Background: The high rate of maternal mortality is still a health problem in Indonesia and also reects the uality of health care during pregnancy and childbirth. The main causes of maternal mortality in Indonesia is hypertension (32.4) and postpartum bleeding (28.3). Recently in Manowari eneral Hospital there is an increase trend cases of severe preeclampsia include 12 cases (September 2015), 14 cases (October 2015) and 14 cases (November 2015).Objective: To identify ris factors of the community and health care to cases of severe preeclampsia in the eneral Hospital of Manowari, Papua Barat Province period September 2015 - ebruary 2016. Method: The study was an observational descriptive study, cross sectional design with a retrospective approach. A total of 148 medical records of pregnant women who meet the eligibility criteria for inclusion in this study. Chi-suare test and isher eact was used for statistical analysis. Multivariate analysis using logistic regression with signicance p 0.05.Result and Discussion: A total of 148 medical records of pregnant women from September 2015 - ebruary 2016 met eligibility criteria which consisted of 74 pregnant women with severe preeclampsia and 74 pregnant women without preeclampsia. Chi-suare analysis showed a signicant association between gestational age 20-36 wees with severe preeclampsia cases (p 0.016; RR 1.8; CI 1.2 to 26.6) and a history of hypertension (p 0.000; RR 2.2; CI 3.1 to 21.2). Community ris factors had no signicant relationship with severe preeclampsia. The health care services regarding severe preeclampsia was well implemented and the second phase delay mainly due to geographic factors.Conclusion: There is a signicant association between gestational age 20-36 wees and a history of hypertension in cases of severe preeclampsia.Keywords: severe preeclampsia, gestational age, history of hypertension, ris factor of the community, second phase delay

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