Supriyadi Hari Respati
Bagian Obgin FK UNS/ RSUD Dr. Moewardi, Jl. Kol. Sutarto 132 Surakarta

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The Effect of Neoadjuvant Chemotherapy on HIF-1α Expression in Cervical Uterine Cancer Wiraswesty, Ika; Respati, Supriyadi Hari; Sulistyowati, Sri; Priyanto, Heru
Indonesian Journal of Medicine Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Uterine cervical cancer is one of the main causes of female death related to cancer. Neoadjuvant chemotherapy aims to reduce tumor mass to allow radical surgery. HIF-1α is thought to have a key role in the development of cancer and the main target for chemoprevention.Objective: This study aims to prove the effect of neoadjuvant chemotherapy on HIF-1α expression in uterine cervical cancer as an assessment parameter for chemotherapy response. Subjects and methods: The study was carried out in the Department of Obstetrics and Gynecology and the Pathology Department of Anatomy Dr. Moewardi - Faculty of Medicine, Sebelas Maret University, Surakarta. Thirty (30) cervical cancer samples that met the inclusion and exclusion criteria were examined for HIF-1α expression before and after giving 3 times neoadjuvant chemotherapy. Examination using immunohistochemical methods. Data analysis using t-test.Results: Mean HIF-1α expression before administration of neoadjuvant chemotherapy 5.10± 1.174 cell/field, after administration of neoadjuvant chemotherapy 4.00±1.174 cell/field with p=0.001.Conclusion: Neoadjuvant chemotherapy has an effect on reducing HIF-1α expression in uterine cervical cancer.Keywords: neoadjuvant chemotherapy, HIF-1α, uterine cervical cancerCorrespondence: Sri Sulistyowati. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret. Mobile: 08122968215. email: elis_spog@yahoo.co.id Indonesian Journal of Medicine (2018), 3(2): 119-124https://doi.org/10.26911/theijmed.2018.03.02.08
Korioamnionitis Sebagai Faktor Risiko Terjadinya Persalinan Preterm Rahmi, Elita; Respati, Supriyadi Hari; Melinawati, Eriana
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Background: Premature Rupture of Membranes (PROM) is one causes of fetal mortality and morbidity. Suspected chorioamnionitis is a major cause of preterm labor. Methods: This study was observational analytic cross-sectional approach. Sample of 694 study subjects that satisfy with inclusion and exclusion criteria were taken from the medical records of patients who gave birth in RSUD Dr. Moewardi. The data was analyzed using bivariate analysis and processed with Statistical Product and Service Solutions (SPSS) for Windows 20:00. Results: Chorioamnionitis is a risk factor 1.045 times to preterm delivery occur (OR = 1045; CI = 95%, 0737, 1483, p = 0804). Chorioamnionitis caused  death of neonatal mortality 1.554 times compared with norma pregnancy (OR = 1554; CI = 95%, 0790, 3057, p = 0.194). Chorioamnionitis 1.747 times risk factors for occur asphyxia in preterm labor and statistically significant (OR = 1747; CI = 95%, 1114, 2741, p = 0.014). Conclusions: There was no significant relationship between chorioamnionitis with preterm labor and chorioamnionitis with neonatal mortality. There is a significant relationship between chorioamnionitis with asphyxia. Keywords: PROM, Chorioamnionitis, preterm labor
Maternal, Obstetric, and Infant Factors and Their Associatio with the Risk of HIV Infection in Infants at Dr. Moewardi Hospital, Surakarta Rahmawati, Deni Nur Fauzia; Respati, Supriyadi Hari; Hanim, Diffah
Journal of Maternal and Child Health Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Incidence of HIV infection by mother to child transmission has been increasing for the past few years. This study aimed to determine the association between maternal, obstetric, infant factors, and the risk of HIV infection in infant.Subjects and Method: This was an analytic observational study using case control design. This study was conducted at Dr. Moewardi Hospital, Surakarta. A total of 68 study subjects, consisting of 34 HIV infected infants, and 34 non HIV infected infants, were selected for this study by fixed disease sampling. The dependent variable was HIV infection. The independent variable included maternal nutrirional status, opportunistic infection, antenatal care, type of labor, birth weight, and prematurity. The data were collected by a set of questionnaire and analyzed using logistic regression model.Results: Maternal HIV opportunistic infection (OR= 10.09; 95% CI= 1.99 to 51.20; p=0.005) and pervaginam labor (OR=5.21; 95% CI=0.92 to 29.58; p=0.063) increase the risk of HIV infection in infant, and they were statistically significant. Maternal body weight (BMI<18.5)(OR=2.71; 95% CI=0.44 to 16.53; p=0.280), antenatal care <4 times (OR=1.94; 95% CI= 0.42 to 9.00; p=0.395), birth weight <2.500 gram (OR=1.09; 95%CI=0.19 to 6.05;p=0.924) and prematurity (OR= 1.65; 95% CI=0.36 to 7.61; p=0.523), each increased the risk of HIV infection but statistically non-significant.Conclusion: Maternal HIV opportunistic infection and pervaginam labor are strong and significant predictors for the risk of infant HIV infection. Health personnel should pay special attention on these significant risk factors when assisting birth delivery, in order to prevent HIV infection in infants.Keywords: maternal, obstetric, infant risk factors, HIV infection.Correspondences: Deni Nur Fauzia Rahmawati. Masters of Public  Health Program, Sebelas Maret University. Email: denierahmawati@gmail.comJournal Maternal  and Child Health (2016), 1(2): 73-82https://doi.org/10.26911/thejmch.2016.01.02.02
Kadar Heat Shock Protein 70 pada Persalinan Prematur Wiharjo, Soetrisno Kasan; Respati, Supriyadi Hari; Bawono, Antonius Budi Giri
Jurnal Kedokteran Brawijaya Vol 28, No 4 (2015)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (600.067 KB) | DOI: 10.21776/ub.jkb.2015.028.04.9

Abstract

Persalinan preterm merupakan masalah kesehatan bagi negara maju maupun berkembang, berperan besar peningkatan morbiditas dan mortalitas neonatus, serta sering berdampak kesehatan jangka panjang seperti celebral palsy, kebutaan, dan perkembangan psikomotorik. Menganalisis apakah terdapat perbedaan serta hubungan antara kadar HSP70 persalinan preterm dibandingkan kehamilan normal. Observasional analitik dengan rancangan potong lintang. Jumlah subyek penelitian 60 ibu hamil dibagi dua kelompok, persalinan preterm 30 ibu hamil dan kelompok kehamilan normal 30 ibu hamil. Pemeriksaan HSP70 dilakukan di laboratorium klinik Prodia. Analisa statistik dengan uji Chi-kuadrat. Berdasarkan karakteristik ibu pada kedua kelompok penelitian, pendidikan dan LILA (Lingkar Lengan Atas) berpengaruh terhadap kejadian persalinan preterm (Probability (p)=0,008 dan p=0,002). Ibu berpendidikan SD mengalami persalinan preterm sebanyak 6,6 kali lebih besar (Prevalence Ratio (PR)=6,682 dan p=0,029), sedangkan berpendidikan SMP berisiko mengalami persalinan preterm sebanyak 3 kali lebih besar (PR=3,27 dan p=0,054) dibanding SMA. Ibu berLILA kurang memiliki risiko persalinan preterm sebanyak 5,5 kali lebih besar dibanding ibu berLILA normal (PR=5,5). Ibu berkadar HSP70 yang tinggi berisiko mengalami persalinan preterm sebanyak 5,2 kali lebih besar dibanding kehamilan normal (PR=5,26 dan p=0,122). Ada perbedaan dan hubungan ?antara kadar Heat Shock Protein 70 persalinan preterm dibandingkan kehamilan normal, namun didapatkan kesimpulan statistik yang tidak bermakna. LILA dan pendidikan berpengaruh bermakna terhadap kejadian persalinan preterm.Kata Kunci: Distres maternal, heat shock protein 70, persalinan preterm, lingkar lengan atas, pendidikanABSTRACT
EXPRESSION OF HUMAN LEUKOCYTE ANTIGEN-E AND NATURAL KILLER CELLS IN INTRA UTERINE FETAL DEATH Sulistyowati, Sri; Nugroho, Muhammad Anggit; Respati, Supriyadi Hari; Soetrisno, Soetrisno
Folia Medica Indonesiana Vol 53, No 4 (2017): December 2017
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (91.127 KB) | DOI: 10.20473/fmi.v53i4.7156

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Intra Uterine Fetal Death (IUFD) is one contributor to infant mortality. Human Leukocyte Antigen-E (HLA-E) and Natural Killer Cells (NK cells) are believed to play an important role towards IUFD associated with immune maladaptation. This study aimed to determine the expression of HLA-E and NK cells on trophoblast on IUFD and normal pregnancy. The study used cross sectional approach undertaken at Department of Obstetrics and Gynecology, Dr. Moewardi Hospital, Surakarta, networking hospitals, and Anatomic Pathology Laboratory of Faculty of Medicine, Sebelas Maret University. The number of samples were 32 subjects consisting of 16 subjects with normal pregnancy and 16 subjects with IUFD. The expression of HLA-E and NK cells on trophoblast of subjects who met the inclusion and exclusion criteria were examined using immunohistochemistry method and t-test statistical analysis. The mean value of HLA-E expression in the trophoblast of IUFD group was 17.30±6.69, in normal pregnancy was 57.06±32.04, with p=0.00 (p<0.05). The mean value of NK cell expression in trophoblast in IUFD group was 78.62±36.43, in normal pregnancy was 19.87±6.43, with p=0.00 (p<0.05). This study concluded that the expression of HLA-E was lower and NK cells wass higher in IUFD compared to those in normal pregnancy.
Association Between Pregnant Woman Class and Pregnancy Complication in Tegal District, Central Java Maryani, Siti; Respati, Supriyadi Hari; Astirin, Okid Parama
Journal of Maternal and Child Health Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Maternal mortality amounted to 33 cases in Tegal, Central Java, in 2015. The leading cause of maternal mortality rate in Indonesia was obstetric complication, i.e 46.8%. Pregnancy complication may be affected by maternal age, parity, education, and maternal employment status. Various efforts have been implemented by the government to reduce maternal mortality rate, including pregnant woman class. The objective of the pregnant mother class is to increase maternal knowledge in risk factor detection and to increase their willingness to use antenatal care. This study aimed to estimate the association between pregnant woman class and pregnancy complication, while controlling for confounding factors.Subjects and Method: This was an analytical observational with case control design. This study was conducted at Pagerbarang, Pangkah and Dukuhwaru Health Centers, Tegal, Central Java. A total of 90 study subjects, consisting of 30 laboring women with complication and 60 without complication. The dependent variable was pregnancy complication. The independent variables were maternal age, parity, education, employment status, and participation in pregnant woman class. The data were collected by a set of questionnaire. The data on pregnancy complication was obtained from the obstetric record at the health center. The data were analyzed by multiple logistic regresion.Results: Parity ≥3 (OR = 3.47; CI 95% = 0.95 to 12.69; p=0.060) and maternal education <senior high school (OR= 8.58; CI 95% = 1.7 to 43.33; p= 0.009) increased the risk of pregnancy complication. Maternal age 20 to 35 years (OR= 0.26; CI 95% = 0.08 to 0.81; p=0.020), employed  mother (OR= 0.21; CI 95% = 0.06 to 0.71; p = 0.012), and participation in pregnant woman class (OR =0.35; CI 95% = 0.12 to 1.05; p = 0.061), decreased the risk of pregnancy complication.Conclusion: Participation in pregnant woman class is associated with decreased risk of pregnancy complication. Parity ≥3 and maternal education <senior high school are associated with increased risk of pregnancy complication. Maternal age 20 to 35 years and employed  mother are associated with decreased risk of pregnancy complication. It is suggested that pregnant women plan their pregnancy in order to prevent pregnancy complication.Keywords: pregnant woman class, pregnancy complication.Correspondence: Siti Maryani. Academy of Midwifery Siti Fatimah, Slawi, Central Java. Mobile: 085741950488.Journal of Maternal and Child Health (2016), 1(4): 214-219https://doi.org/10.26911/thejmch.2016.01.04.02
Maternal, Obstetric, and Infant Factors and Their Associatio with the Risk of HIV Infection in Infants at Dr. Moewardi Hospital, Surakarta Rahmawati, Deni Nur Fauzia; Respati, Supriyadi Hari; Hanim, Diffah
Journal of Maternal and Child Health Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Incidence of HIV infection by mother to child transmission has been increasing for the past few years. This study aimed to determine the association between maternal, obstetric, infant factors, and the risk of HIV infection in infant.Subjects and Method: This was an analytic observational study using case control design. This study was conducted at Dr. Moewardi Hospital, Surakarta. A total of 68 study subjects, consisting of 34 HIV infected infants, and 34 non HIV infected infants, were selected for this study by fixed disease sampling. The dependent variable was HIV infection. The independent variable included maternal nutrirional status, opportunistic infection, antenatal care, type of labor, birth weight, and prematurity. The data were collected by a set of questionnaire and analyzed using logistic regression model.Results: Maternal HIV opportunistic infection (OR= 10.09; 95% CI= 1.99 to 51.20; p=0.005) and pervaginam labor (OR=5.21; 95% CI=0.92 to 29.58; p=0.063) increase the risk of HIV infection in infant, and they were statistically significant. Maternal body weight (BMI<18.5)(OR=2.71; 95% CI=0.44 to 16.53; p=0.280), antenatal care <4 times (OR=1.94; 95% CI= 0.42 to 9.00; p=0.395), birth weight <2.500 gram (OR=1.09; 95%CI=0.19 to 6.05;p=0.924) and prematurity (OR= 1.65; 95% CI=0.36 to 7.61; p=0.523), each increased the risk of HIV infection but statistically non-significant.Conclusion: Maternal HIV opportunistic infection and pervaginam labor are strong and significant predictors for the risk of infant HIV infection. Health personnel should pay special attention on these significant risk factors when assisting birth delivery, in order to prevent HIV infection in infants.Keywords: maternal, obstetric, infant risk factors, HIV infection.Correspondences: Deni Nur Fauzia Rahmawati. Masters of Public  Health Program, Sebelas Maret University. Email: denierahmawati@gmail.comJournal Maternal  and Child Health (2016), 1(2): 73-82https://doi.org/10.26911/thejmch.2016.01.02.02
Effectiveness of Pregnant Woman Class in The Prevention of Pregnancy Anemia in Banyuwangi, East Java Andriani, Yeni; Respati, Supriyadi Hari; Astirin, Okid Parama
Journal of Maternal and Child Health Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: In developing countries 40% of maternal mortality is associated with pregnancy anemia. Pregnancy anemia has negative effect to mothers, before, during, and after delivery. The purpose of this study was determined effectiveness of pregnant woman class in the prevention of pregnancy anemia in Banyuwangi, East Java.Subjects and Method: This was an analytical observational study with retrospective cohort design. This study was conducted at Benculuk health center, Banyuwangi, East Java. A total of 100 subjects were selected for this study by fixed exposure sampling, consisting of 50 pregnant mothers who participated pregnant woman class and 50  who did not participate pregnant woman class. The dependent variable was pregnancy anemia. The independent variables were  participation in the pregnant woman class, maternal education, family income, food myth, and visit to obstetric gynecology specialist. Anemia was measured by spectrophotometer. Other variables were measured by a set of questionnaire. The data were analyze by multiple logistic regression.Results: Participation in pregnant woman class (OR=0.18; CI 95%= 0.03 to 1.21; p=0.078), maternal education ≥ senior high school (OR=0.07; CI 95%= 0.01 to 0.92; p=0.043), and high family income (≥ Rp 1,599,000) (OR=0.18; CI 95%= 0.31 to 1.03; p=0.054) decreased the risk of pregnancy anemia. Myth in food restriction (OR=4.47; CI 95%=0.73 to 27.51; p=0.106) increased the risk of pregnancy anemia. There was no relationship between visit to obstetric and gynecology specialist and the risk of pregnancy anemia (OR=0.93; CI 95%=0.09 to 9.17; p=0.952).Conclusion: Participation in pregnant mother class, maternal education ≥ senior high school, and high family income (≥ Rp 1,599,000) decrease the risk of pregnancy anemia. Myth in food restriction increase the risk of pregnancy anemia. There is no relationship between visit to obstetric and gynecology specialist and the risk of pregnancy anemia.Keywords: pregnant woman class, pregnancy anemiaCorrespondence: Yeni Andriani. Masters Program in Public Health, Sebelas Maret University, Surakarta.Journal of Maternal and Child Health 2016, 1(4): 230-241https://doi.org/10.26911/thejmch.2016.01.04.04
Multilevel Analysis on the Risk Factors of Post Partum Hemorrhage in Bondowoso, Central Java Saadah, Miftahus; Respati, Supriyadi Hari; Aristin, Okid Parama
Journal of Maternal and Child Health Vol 1, No 4 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: The primary causes of maternal mortality in Indonesia are hemorrhage (32%), pre-eclampsia/ eclampsia (25%), infection (5%), prolonged labor (5%), abortus (1%), and other causal factors not related to pregnancy and birth delivery (32%). This study aimed to investigate risk factors of post partum hemorrhage in Bondowoso, East Java.Subjects and Method: This was an analytic observational study with case control design. This study was conducted in Bondowoso, East Java, from  May, 15 to June, 15, 2016. A total of 90 study subjects was selected by fixed disease sampling, consisting of 30 women with post-partum bleeding and 60 control women without post-partum bleeding. The dependent variable was post-partum hemorrhage. The independent variables were age, parity, hemoglobin, obstetric history, use of ANC, and type of birth attendant. The data were collected by questionnaire and medical record. The data were analyzed by mix-effect model.Results: Anemia (Hb <11 g%) (b=2.22; 95%CI=1.05 to 3.39; p=0.001) and obstetric history of bleeding (b=1.31; 95%CI= 0.15 to 2.47; p= 0.027) increased the risk logodd of postpartum hemorrhage, and it was statistically significant. ANC ≥ 4 times (b= -1.46; 95%CI=-2.95 to 0.02; p=0.052) decreased the risk logodd of postpartum hemorrhage, and it was marginally significant. Age <20 year or ≥ 35 year (b= 0.12; 95%CI= -1.01 to 1.26; p= 0.827) and parity = 1 or ≥4 (b= 0.18; 95%CI= -0.95 to 1.32; p=0.754) increased the risk logodd of postpartum hemorrhage, but it was not statistically significant. Multilevel analysis was not needed in this model because ICC <1%.Conclusion: Anemia and history of postpartum bleeding are important risk factors of postpartum hemorrhage. Use of ANC ≥4 times decreases the risk of postpartum bleeding.Keywords: Postpartum bleeding, risk factor.Journal of Maternal and Child Health (2016), 1(4): 205-213https://doi.org/10.26911/thejmch.2016.01.04.01
Analysis of Maternal Mortality Determinants in Bondowoso District, East Java Fransiska, Ratna Diana; Respati, Supriyadi Hari; Mudigdo, Ambar
Journal of Maternal and Child Health Vol 2, No 1 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Data from Population Inter-Census Survey (Survei Penduduk Antar Sensus,  SUPAS) 2015 showed that maternal mortality ratio was 305 per 100,000 live-births in Indonesia. Sustainable Development Goals (SDGs) set 70 per 100,000 live-births as the target for maternal mortality ratio to be achived by 2030. This study aimed to analyze the determinants of maternal mortality in Bondowoso district, East Java.Subjects and Method:This was an analytic observational study with cross-sectional design. This study was carried out at 17 Community Health Centers, in Bondowoso, East Java from February to March 2017. A sample of 117 study subjects, consisting of 39 cases of maternal death and  78 control, was selected for this study by fixed disease sampling. The dependent variable was incidence of maternal death. The independent variables were maternal education, maternal employment status, antenatal care  visit, complication, late model, and other pregnancy risk factors. The data were collected from the obstetric and medical record, as well as a set of questionnaire. The data were analyzed by path analysisResults: Determinants of maternal death included late decision making (b=2.37; 95% CI=0.81 to3.93; p=0.003), late transfer to the hospital (b=2.35; 95%CI =-0.21to4.91; to p=0.072), late handling at the hospital (b=2.36; 95%CI=-0.19to 4.91; p=0.069), and  complication (b=2.5; 95%CI=1.41to3.62; p<0.001). Complication was determined by completeness of antenatal visits (b=-1.01; 95%CI=-1.94to-0.09; p=0.032), and existence of pregnancy risk factor (b=1.90; 95%CI=1.01to 2.78; p=<0.001). Pregnancy risk factors was determined by completeness of antenatal visit (b=-1.09; 95%CI =-1.99to-0.19; p=0.018), maternal education (b=-0.47; 95%CI=-0.85to-0.07; p=0.020), and maternal employment status (b=0.14; 95%CI=-0.17to0.45; p=0.369). Antenatal visit was determined by maternal education (b=0.54; 95%CI=0.098to0.99; p=0.017) and maternal employment status (b=0.08; 95%CI=-0.29to0.45; p=0.683).Conclusion: The direct determinants of maternal death include late decision making, late transfer to the hospital, late handling at the hospital, and complication. The indirect determinants of maternal death include completeness of antenatal visits, existence of pregnancy risk factor, maternal education, and maternal employment status.Keywords: determinant, delay, complication, antenatal care, maternal death Correspondence: Ratna Diana Fransiska. Masters Program in Public Health, Sebelas Maret University. Email: ratnadiana00@gmail.com. Mobile: 085778822668Journal of Maternal and Child Health (2017), 2(1): 76-88https://doi.org/10.26911/thejmch.2017.02.01.08