Eppy Darmadi Achmad
Department of Obstetri&Gynecology Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung

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Perbandingan Sensasi Nyeri 48 Jam dan 42 Hari Pascasalin Menggunakan Benang Chromic Catgut dengan Fast Absorbing Polyglactin 910

Majalah Kedokteran Bandung Vol 43, No 2 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

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Abstract

Nyeri perineum akibat robekan yang terjadi pada saat persalinan dapat dirasakan segera setelah melahirkan atau beberapa bulan kemudian, sehingga menyebabkan dispareunia. Episiotomi sebagai profilaktik untuk melindungi integritas dasar panggul merupakan insisi bedah yang lurus dan rapi akan menggantikan laserasi kasar. Sensasi nyeri akibat penjahitan luka episiotomi dapat dikurangi dengan menggunakan benang yang cepat diabsorbsi. Tujuan penelitian ini untuk membandingkan sensasi nyeri perineum pascapenjahitan luka episiotomi menggunakan benang chromic catgut dengan fast absorbing polyglactin 910 terhadap nyeri perineum 48 jam dan 42 hari pascasalin. Penelitian ini dilakukan di Departemen Obstetri dan Ginekologi FK Universitas Padjadjaran-RS Dr. Hasan Sadikin Bandung periode Desember 2009–Maret 2010. Penilaian nyeri menggunakan visual analog scale (VAS) yang dilakukan 48 jam dan 42 hari pascasalin. Lima puluh dari 100 subjek penelitian dilakukan penjahitan dengan benang chromic catgut dan 50 subjek menggunakan benang fast absorbing polyglactin 910. Analisis uji chi-kuadrat 48 jam pascasalin, didapatkan hasil tidak ada perbedaan bermakna pada penggunaan kedua benang tersebut terhadap nyeri perineum (p=0,645). Analisis 42 hari pascasalin didapatkan perbedaan bermakna (p<0,001), kejadian bebas nyeri perineum lebih baik dengan penjahitan menggunakan benang fast absorbing polyglactin 910 (46 kasus atau 92%) dibandingkan dengan pemakaian benang chromic catgut (29 kasus atau 58%). Simpulan, penjahitan luka perineum menggunakan benang fast absorbing polyglactin 910 memberikan kejadian bebas nyeri perineum yang lebih baik dibandingkan dengan benang chromic catgut pada 42 hari pascasalin. [MKB. 2011;43(2):89–92].Kata kunci: Chromic catgut, fast absorbing polyglactin 910, nyeri perineumComparative Study of Pain Sensation at 48 hours and 42 Days Postpartum Using Chromic Catgut and Polyglactin 910Perineal pain due to tears that occur during delivery can be felt immediately after birth or several months later, causing dyspareunia. Episiotomy as a prophylactic to protect the integrity of the pelvic floor is a straight and neat surgical incision will replace rough lacerations. Pain sensation due to episiotomy wound suturing can be reduced by using thread that quickly absorbed. The purpose of this study was to compare perineal pain sensation after suturing episiotomy wound using chromic catgut with using fast absorbing polyglactin 910. The perineal pain of both groups were evaluated 48 hours and 42 days post episiotomy using visual analog scale (VAS). This study was conducted at the Obstetrics and Gynecology Department, Faculty of Medicine Padjadjaran University/Dr. Hasan Sadikin Hospital period December 2009–March 2010. Fifty out of 100 subjects were sutured using chromic catgut and 50 were using fast-absorbing polyglactin 910. Chi-square test analysis at 48 hours postpartum, showed no significant perineal pain difference (p=0.645) of both groups but at 42 days the analysis showed a significant difference (p<0.001) between both groups, incidence of perineal pain free better with fast absorbing sutures using polyglactin 910 (46 cases or 92%) compared with the use of chromic catgut (29 cases or 58%). In conclusion, suturing perineal wound using fast-absorbing polyglactin 910 provide free events perineal pain better than chromic catgut in 42 days. [MKB. 2011;43(2):89–92].Key words: Chromic catgut, fast-absorbing polyglactin 910, perineal pain

Comparison of Maternal Health Service Satisfaction Level of National Health Coverage and Non National Health Coverage Patients in Bandung Mother and Child Hospital

Althea Medical Journal Vol 3, No 3 (2016)
Publisher : Althea Medical Journal

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Abstract

Background: Healthcare is financially inaccessible to some people. This results in deterioration of patients’ condition or even death, which is proven by the high level of Maternal Death Rate in Indonesia. The government implemented the National Health Coverage (NHC) system to ensure the provision of quality health care for the entire community. This study aimed to examine the NHC and non-NHC patients’ perception to quality maternal healthcare services.Methods: This study was an analytic cross-sectional study conducted from August–October 2014. One hundred and twenty six respondents from Kota Bandung Mother and Child Hospital were included. The tool used in this study was a validity and reliability-tested questionnaire encompassing five dimensions of service quality: tangibles, reliability, responsiveness, assurance, and empathy. The Kolmogorov-Smirnov test was used to test the hypothesis.Results: The study showed that the majority of NHC(75%) and non-NHC patients (89%) ware unsatisfied with the maternal healthcare services. Most patients felt unsatisfied towards the reliability dimension which involved complicated referral procedures and examination time that failed to comply with what was promised.Conclusions: There is no difference between NHC and non-NHC patients’ level of satisfaction of maternal health care service in Bandung Mother and Child Hospital. [AMJ.2016;3(3):425–29]DOI: 10.15850/amj.v3n3.869

Correlation between Folate Intake during Pregnancy and Preterm Labor in Mothers with 0-9 Months Old Babies

Althea Medical Journal Vol 2, No 1 (2015)
Publisher : Althea Medical Journal

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Abstract

 Background: Nutritional factors such as folate intake are important during pregnancy. Satisfying nutritional needs of pregnant mothers is necessary to avoid complications during pregnancy such as preterm labor, High infant mortality rate in Indonesia is still high. This study  aimed to study the relationship between folate intake during pregnancy and preterm labor.  Methods: This study used a cross-sectional analytic approach by using semi-quantitative Food Frequency Questionnaire, as an instrument on mothers with 0−9 months old babies living in the villages of Sayang and Hegarmanah, Jatinangor, Sumedang, Indonesia. Results:  Ninety mothers participated in this study. The result indicated that 25.55% respondents had low folate intake and high incidence of preterm labor (16.67%). Significant association was found between folate intake during pregnancy and preterm labor (p=0.019). Maternal age was not a confounding factor in this study. Conclusions: There is an association between folate intake during pregnancy and preterm labor in mothers living in the villages of Sayang and Hegarmanah, Jatinangor, Sumedang, Indonesia.Keywords: Babies 0−9 months, folate, preterm laborDOI: 10.15850/amj.v2n1.431 

Age at Menarche and Eating Pattern among High School Students in Jatinangor in 2013

Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Althea Medical Journal

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Abstract

Background: Age at menarche has notably declined over the past several decades; the fact is in line with the improvement of nutritional intake. Age at menarche can affect health outcomes in adulthood. This study aimed to describe the age at menarche and eating pattern among students in Jatinangor.Methods: Data were obtained from Survey of Adolescent Reproductive Health in Jatinangor in 2013 with total sampling technique. The sample criteria were data from students who had started their periodwhen the study was conducted. Dietary information was collected by eating pattern recall questionnaire and was taken by trained enumerators. Nutrient intakes and proportion of energy intake were divided into groups according to Recommended Dietary Allowance 2012.Results: In total, 59 data were analyzed. The age at menarche were ranged from 9 (n=1) to 15 (n=1). Most of students had their menarche at 12 (37.3%). Intake of energy (49.2%), protein (64.4%), fat (61%), and carbohydrate (54.2%) were mostly deficient, but the proportion of energy intake from fat (49.2%) and carbohydrate (66.1%) were mostly adequate. The student with youngest age at menarche had adequate energy intake, excess protein intake and excess proportion of energy intake from fat. Student with the oldest age had deficient energy, fat, and protein intake and excess proportion of energy intake from carbohydrate. Conclusions: This study shows that student with youngest age at menarche has different eating pattern compared to the oldest, while the others seem similar. [AMJ.2016;3(1):156–63] DOI: 10.15850/amj.v3n1.714

Perbandingan Kejadian Infeksi Saluran Kemih setelah Pemasangan Kateter antara 24-36 Jam dan 36-48 Jam pada Pasien Pascaoperasi Ginekologi

Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 1 Maret 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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Abstract

AbstrakTujuan: Penggunaan kateter pada saat dilakukan operasi merupakan prosedur rutin termasuk  operasi ginekologi sehingga kandung kemih tetap kosong pada saat operasi serta mencegah jejas. Metode: Penelitian analitik komparatif dibagi menjadi 2 kelompok, pelepasan  24-36 jam dan  36-48 jam. Hasil dipstik leukosit diambil pre-operasi dan 24-36 jam dan 36-48 jam pasca-operasi. Hasil: Total terdapat 48 pasien dengan umur  antara 31-40 tahun  29.2% serta  umur 41-50 tahun 29.2%. Lama operasi  antara 1 sampai 2 jam sebanyak 54.2%. Kelompok 36-48 jam, hasil leukosit urine terbanyak (+) ada 62.5%. Pemasangan Kateter 24-36 jam yang awalnya (-) kelompok 36-48 jam menjadi (+) sebanyak 60.0%. Diskusi:Penelitian ini mengikutsertakan 63 subjek yang memenuhi kriteria inklusi sebanyak 48 orang yang dibagi menjadi dua kelompok. Pasien pascaoperasi dengan peningkatan leukosit urine ditemukan pada 57% subjek di kelompok pelepasan kateter 36-48 jam pasca operasi, sedangkan hanya 15% pada kelompok pelepasan kateter 24-36 jam pasca operasi. Kesimpulan: Pelepasan kateter pascaoperasi 36-48 jam, lebih banyak terjadi insidensi peningkatan leukosit urine dibandingkan kelompok 24-36 jam.Kata kunci: Infeksi saluran kemih, kateter pra-operasi, kateter pasca-operasiComparison of Urinary Tract Infections after the Insertion of Catheter between 24–36 Hours and 36–48 Hours on Post GynecologicSurgery PatientsAbstractObjective: Use of catheter during surgery is a routine procedure in every surgery, also gynecological surgery so the bladder remains empty during surgery. Catheter may prevent iatrogenic injury of the bladder caused by over-distention and atony due to anesthesia. Method: Unpaired categorical comparative analytic study with subjects were categorized into 2 groups, groups of patients in 24-36 hours catheters and patients in 36-48 hours post-surgery catheters. Urine leukocyte dipstick taken pre-surgery, 24-36 hours and 36-48 hours post-surgery. Result: A total of 48 patients were selected for data use for this study. For the longest operation time between 1 to 2 hours as much as 54.2%. For 24-36 hours urine leukocyte with negative results as much as 75%. While in the 36-48 hours catheter insertion there were 62.5%. Increasing of urine leukocyte result at 24-36 hours catheter insertion in 36-48 hours catheter insertion group. Discussion: The study included 63 subjects divided into two groups. Post-surgery patients with elevated urinary leukocytes were found in 57% of subjects in the 36-48 hours post-surgery catheter release group, while only 15% in the 24-36 hours catheter release group.Conclusion: Post-surgery catheters 36-48 hours, there was a greater incidence of urinary leukocyte increment than the group of patients with 24-36 hours post-surgery catheters.Keywords: Urinary tract infection, pre-surgery catheter, post-surgery catheter.

Characteristics of Postpartum Hemorrhage Patients in RSUD Raja Tombolotutu Kabupaten Parigi Moutong Sulawesi Tengah

Indonesian Journal of Obstetrics & Gynecology Science Volume 2 Nomor 1 Maret 2019
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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Abstract

AbstractObjective: This study aimed to identify the characteristics of postpartum hemorrhage patients in Raja Tombolotutu General Hospital, Parigi Moutong Sulawesi Tengah Indonesia.Method: A retrospective-descriptive study was conducted using a cross-sectional method and secondary data with total sampling technique from medical record of obstetric patients with postpartum hemorrhage in Raja Tombolotutu General Hospital, from May 2017 to April 2018.Result: From 72 cases of postpartum hemorrhage, patients’ characteristics were age 20−35 years old (56.95%), multipara (45.84%), gestational age 37−42 weeks (69.45%), underwent vaginal delivery (93.05%), junior high school graduated (41.67%), housewife (59.72%), delivered in Primary Health Care (59.72%) and covered by Universal Health Coverage (58.33%). About 54.17% patients of postpartum hemorrhage have done 1−4 times for antenatal care visits. Majority etiology of the postpartum hemorrhage was retained placenta (61.11%). Conclusion: The major characteristics of postpartum hemorrhage patients are 20−35 years old, multipara, at term pregnancy, underwent vaginal delivery, junior high school graduated, and housewife. Most of them delivered in Primary Health Care and covered by Universal Health Coverage. Retained placenta is the main cause of postpartum hemorrhage. More than half of postpartum hemorrhage patients have done 1−4 times antenatal care visits.  Key words: postpartum hemorrhage, maternal mortality, retained placenta  AbstrakTujuan: Penelitian ini bertujuan untuk menggambarkan karakteristik pasien perdarahan postpartum di RSUD Raja Tombolotutu, Kabupaten Parigi Moutong Sulawesi Tengah Indonesia.Metode: Penelitian ini merupakan penelitian deskriptif retrospektif yang menggunakan metode potong lintang dan data sekunder dengan teknik total sampling dari rekam medis pasien dengan diagnosis perdarahan postpartum di RSUD Raja Tombolotutu, mulai Mei 2017 sampai April 2018.Hasil: Dari 72 kasus perdarahan postpartum, karakteristik pasien antara lain: usia 20-35 tahun (56,95%), multipara (45,84%), usia kehamilan 37-42 minggu (69,45%), persalinan pervaginam (93,05%), lulusan sekolah menengah pertama (41,67%), ibu rumah tangga (59,72%), bersalin di puskesmas (59,72%) dan pembiayaan ditanggung oleh Jaminan Kesehatan Nasional (58,33%). Etiologi perdarahan postpartum terbanyak adalah retensio plasenta (61,11%). Sebanyak 54,17% pasien perdarahan postpartum pernah melakukan 1-4 kali kunjungan antenatal. Kesimpulan: Karakteristik pasien perdarahan postpartum yang tertinggi adalah pasien dengan usia 20-35 tahun, multipara, kehamilan aterm, persalinan pervaginam, lulusan sekolah menengah pertama, dan ibu rumah tangga. Sebagian besar pasien bersalin di puskesmas dan pembiayaan ditanggung oleh Jaminan Kesehatan Nasional. Retensio plasenta merupakan penyebab utama perdarahan postpartum. Sebanyak lebih dari setengah pasien perdarahan postpartum pernah melakukan 1-4 kali kunjungan antenatal.Kata kunci: perdarahan postpartum, kematian ibu, retensio plasenta

Faktor Risiko Penderita Prolapsus Organ Panggul terhadap Hiatus Genitalis, Panjang Total Vagina, dan Perineal Body

Majalah Kedokteran Bandung Vol 46, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Prolapsus organ panggul (POP) merupakan kondisi yang umum pada perempuan usia lanjut. Keluhannya bersifat prolapsus organ panggul (POP) merupakan kondisi umum bersifat progresif pada perempuan usia lanjut. Saat ini belum ada laporan mengenai hubungan antara komponen faktor risiko dan anatomi. Penelitian ini untuk mengetahui faktor risiko klinis POP serta pengaruhnya pada komponen anatomi penentu tahapan klinis kelainan tersebut. Penelitian dilakukan di Departemen Obstetri dan Ginekologi Fakultas Kedokteran Unpad/Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2009–Mei 2010. Limapuluh dua pasien POP dibagi menjadi dua kelompok yaitu 30 subjek POP tingkat III dan 22 POP tingkat I-II. POP berasosiasi signifikan dengan usia, paritas, menopause, serta TSH. Usia ≥50 tahun (OR=0,08; 95% IK=0,018-0,333 versus <50 tahun), paritas ≥3 (OR=5,56; 95% IK=0,02-0,55 versus paritas <3), dan status menopause (OR=5,14; 95% IK=1,18-22,49 versus tidak menopause). Korelasi positif signifikan panjang hiatus genitalis (HG) dengan usia (r=0,656) dan paritas (r=0,539). Ukuran perineal body (PB) korelasi negatif signifikan dengan usia (r= -0,298) dan paritas (r=-0,335). Kelompok menopause menunjukkan peningkatan panjang HG dan penurunan ukuran PB yang signifikan. Panjang PB meningkat signifikan pada kelompok yang menerima TSH. Hubungan yang signifikan antara panjang total vagina (PTV) dan faktor-faktor risiko hanya menemukan pemendekan PTV signifikan pada usia >50 tahun. Simpulan, usia, paritas, dan menopause merupakan faktor risiko kemungkinan POP serta mempunyai korelasi dengan panjang GH dan PB dan progresivitas POP. [MKB. 2014;46(1):57–60]Kata kunci: Hiatus genitalis, panjang total vagina, perineal body, prolapsus organ panggulRisk Factors for Patients with Pelvic Organ Prolapse on Hiatus Genitalis, Total Vaginal Length, and Perineal BodyPelvic organ prolapse (POP) is a common and progressive condition in elderly women. Currently, there are no report regarding the relationship between risk factor and anatomical components. This research was to identify risk factors and its influence on the POP clinical anatomy component determining clinical stages of this disorder. The study was conducted at the Department of Obstetrics and Gynaecology, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung during the period of December 2009–May 2010. Fifty-two POP patients were participated, 30 subjects were in grade III and 22 subjects were in grade I–II. Found a significant association between age, parity, menopause, and hormone replacement therapy (HRT) and the incidence POP. Age >50 years (OR=0.08, 95% CI=0.018 to 0.333 versus <50 years), parity >3 (OR=5.56, 95% C1=0.02 to 0.55 versus parity <3), and menopausal status (OR=5.14, 95% CI=1.18 to 22.59 versus not menopausal). Long hiatus genetalis (HG) had a significant positive correlation to age (r=0.656), while HG had a significant positive correlation to parity (r=0.539). Size of the perineal body (PB) showed a significant negative correlation with age (r=-0.298) and parity (r=-0.335). Menopausal group showed significant increase in HG length and decrease in size of the PB compared to the premenopausal group. The PB length increased significantly in those receiving HRT (p=0.018). Significant relationship between total length of the vagina (PTV) and the risk factors was only found in the form of significant shortening of PTV at aged >50 years. In conclusion, age, parity, and menopause are risk factors for POP probability and has a correlation with HG length, PB and progression of POP. [MKB. 2014;46(1):57–60]Key words: Genital hiatus, pelvic organ prolapse, perinael body, total vaginal length DOI: 10.15395/mkb.v46n1.229