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Pengaruh Preeklamsia dan Hipertensi Kronis terhadap Kejadian Bayi Kecil Masa Kehamilan (KMK)

Irmitasari, Irmitasari, Nurdiati, Detty Siti, Hadiati, Diah Rumekti

JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
Publisher : IPAKESPRO

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Abstract

Background: Preeclampsia and chronic hypertension are associated with a large number of cases of small infants during pregnancy (SIP) and perinatal deaths. There are conflicting inconsistencies between research on the effect of preeclampsia and chronic hypertension on KMK. The data showed that preeclampsia had a very significant effect on the occurrence of KMK, but in reality not all infants of preeclampsia mothers gave birth to babies with KMK. This raises the assumption that there are other factors that inhibit the influence of preeclampsia and chronic hypertension on birth weight.Objective: to determine the effect of preeclampsia and chronic hypertension on KMK in Dr. Sardjito Yogyakarta.Method: Retrospective cohort. Data of maternity patients with preeclampsia, maternity patients with chronic hypertension, and weight data of babies born at RSUP Dr. Sardjito were recorded. Also noted parity, maternal age, employment and education. Data were taken from medical records and classified into normotension, preeclampsia, and chronic hypertension using consecutive sampling methods.Result and Discussion: There were 81 samples for each normotension group, preeclampsia, and chronic hypertension. Preeclampsia is significantly at risk of experiencing SIP 7,43 times (95% IK 3,13-17,66). Chronic hypertension is significantly at risk of experiencing 5,15 times SIP% IK 2,15-12,36). Multigravida subjects were at risk of experiencing SIP 1,92 times (IK 95% 1,04-3,55) There was no significant difference in the proportion of SIP in subjects based on age, occupation, and education.Conclusion: Preeclampsia, chronic hypertension, and multigravida parity significantly provide a higher risk of the incidence of SIP. If the three factors work together, they will reinforce the effect on increasing the risk of SIP.Keywords: Small gestational period; preeclampsia; chronic hypertension

Hubungan antara Program Ekspanding Maternal and Neonatal Survival (EMAS) dengan Peningkatan Pengetahuan, Sikap dan Perilaku Bidan dalam Pengelolaan Kasus Kegawatdaruratan Obstetrik Pra Rujukan

Widyaningsih, Wiwik, Siswosudarmo, Risanto, Hadijono, Soerjo

JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
Publisher : IPAKESPRO

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Latar Belakang: Angka kematian ibu di Kabupaten Kebumen tahun 2014 adalah 12 yang sebagian besar disebabkan oleh perdarahan pascasalin dan preeklampsia berat (PEB). Dalam program EMAS salah satu kegiatan adalah peningkatan pengetahuan dan ketrampilan untuk penatalaksanaan perdarahan pascasalin dan preeklampsia berat (PEB).Tujuan: Untuk mengetahui hubungan paparan program EMAS dalam hal pengetahuan, sikap dan perilaku bidan saat mengelola kasus kegawatdaruratan obstetrik pra rujukan.Metode: Penelitian ini menggunakan desain cross sectional, dilaksanakan terhadap bidan yang merujuk kasus perdarahan postpartum dan pre eklampsia berat di IGD RSU PKU Muhammadiyah Gombong dari tahun 2014-2015. Kuesioner yang digunakan dinilai dengan skala Likert, menilai pengetahuan dengan kuesioner benar salah, sedangkan ketrampilan dengan daftar tilik keterampilan nilai dari 10 sampai 100 kalau menjalankan prosedur sesuai harapan.Hasil dan Pembahasan: Sebanyak 104 responden (bidan), yang terdiri dari 52 bidan yang terpapar program EKSPANDING MATERNAl AND NEONATAL SURVIVAL (EMAS) dan 52 lainnya adalah responden tang tidak terkena program EMAS (kontrol). Mereka sebanding dalam usia, tahun pelayanan (pengalaman kerja), dan nilai pelatihan PPGDON. Analisis bivariat menunjukkan bahwa paparan program EMAS berhubungan secara signifikan dengan peningkatan pengetahuan, sikap dan perilaku bidan di bidang kegawatdaruratan kebidanan. Hasil analisis regresi logistik menunjukkan bahwa program EMAS berhubungan dengan hasil peningkatan pengetahuan managemen aktif kala III (OR: 6,41; 95% CI 2,32-17,72); pengetahuan PEB (OR: 11,72; 95% CI 4,19-32,78); sikap managemen aktif kala III (OR: 2,97; 95%CI 1,11-7,91); sikap PEB (OR 25,87; 95% CI 8,17-81,90). Hubungan dengan keterampilan managemen aktif kala III (OR: 7,37; 95% CI 2,10-25,85) dan keterampilan PEB (OR: 26,64; 95% CI 7,98-88,96).Kesimpulan: Terdapat hubungan antara Program Expanding Maternal and Neonatal Survival dengan peningkatan kemampuan, sikap dan perilaku bidan di bidang pengelolaan prarujukan kasus kegawatdaruratan obstetrik.Kata kunci: Expanding Maternal and Neonatal Survival (EMAS); pengetahunan; sikap; perilaku; penanganan prarujukan kegawatdaruratan obstetrik;

Hubungan Pemakaian Alat Kontrasepsi Dalam Rahim (AKDR) Non Hormonal dengan Kejadian Vaginitis

Sari, Eka Mega, Prawitasari, Shinta, Attamimi, Ahsanudin

JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
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Abstract

Background: Colonies of microorganism in reproductive normal women vaginal is influenced by several factors. Changes in the composition of these factors cause of some problems such as infection and inflammation. The use of intrauterine devices could be expected to lead to vaginitis.Objective: To determine whether the use of intrauterine device increase the incidence of vaginitis, either by Bacterial Vaginosis (BV), Vulvovaginal Candidiasis (VVC), and Trichomonas Vaginalis (TV) .Method: Cross Sectional Study on the differences incidence of vaginitis in intrauterine device user and hormonal user.Result and Discussion: At the intrauterine devices and hormonal contraception users, there are significant difference incidence of BV (OR 10,11;95% CI 1,80-56,78) ; p=0,009 (p<0,05) dan VVC (OR 29,78 (1,64-2540,69); p=0,022 (p<0,05), but not TV (OR 3,68;95% CI 0,11-117,63); p=0,460 (p>0,05).Conclusions: The use of an intrauterine device increase the incidence BV and VVC but not  TV.Keywords: Intrauterine Device; Hormonal Contraception; Vaginitis

Hubungan Kepatuhan Tim Bedah dalam Penerapan Surgery Safety Checklist dengan Infeksi Luka Operasi dan Lama Rawat Inap pada Pasien Seksio Sesarea di Rumah Sakit Umum Daerah Kabupaten Barru

Amiruddin, Amiruddin, Emilia, Ova, Prawitasari, Shinta, Prawirodihardjo, Leo

JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
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Background: Surgical Patient Safety is essential to be carried out in operating theatre to prevent mortality and surgical complication. Patient safety is the basic principal in medical care and a major component of medical care management in hospital (WHO, 2009).Objective: To investigate association between SSC implementation among surgical team, surgical site infection and duration of hospital stay.Method: This is an analytical cross sectional study. Population of this study was women who underwent cesarean section with live birth in Barru general hospital during 1 December 2016-30 April 2017. This study was carried out in Barru general hospital, 137 samples met inclusion and exclusion criteria. Data was obtained from medical records. Maternal outcome were duration of hospital stay, surgical site infection, and maternal mortality. Besides, this study also assesed knowledge and compliance of surgical team in implementation of SSC. The result of this study was analysed with computer statisctics analysis program.Result adn Discussion: One-hundred thirty seven patients met study criteria. Compliance of surgery team in SSC was 64%,. SSC was not implemented precisely in 36% patients (49 patients). There is no significant association between surgical team compliance with surgical site infection in cesarean section patients (p=0.078). A significant association was found between surgical team compliance with duration of hospital stay (p=0.006).Conclusion: The surgical team compliance in implementation of SSC was not yet optimal. An intensive socialization is needed to improve compliance of team in order that SSC implementation run promptly. This was part of efforts to reduce post operative complication and shorten hospital stay.Keywords: SSC, cesarean section, compliance, infection, duration of hospital stay

Perbedaan Pola Menyusui Bulan Pertama Ibu Melahirkan Seksio Sesarea Dibandingkan Melahirkan Normal di Rumah Sakit Sayang Bayi

Nurmayani, Winda, Julia, Madarina, Prawitasari, Shinta

JURNAL KESEHATAN REPRODUKSI Vol 5, No 3 (2018)
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Background: exclusive breastfeeding should be provided until 6 months of age, but the fact proves that the pattern of breastfeeding has decreased. The pattern of the first month lactation is a critical period for the survival of the subsequent breastfeeding, so it is necessary to make efforts to maintain the duration of breastfeeding because the success of the first month breastfeeding will increase mothers’ confidence to continue breastfeeding.Objective: To determine differences in the pattern of the first month breastfeeding in mothers who gave birth by cesarean section compared to those by vaginal delivery in Rumah Sakit Sayang Bayi (Baby Friendly Hospital)Method: Type of research is comparative observational  with a prospective cohort design using a quantitative approach. The research was conducted in Baby Friendly Hospital of RSUD (General Hospital) Mataram City. Total sample 120 consisted of 60 mothers giving birth the caesarean section and 60 mothers vaginal delivery. The independent variable of giving birth by Cesarean Section and vaginal delivery, dependent variable pattern the first month of breastfeeding and external variables age, parity, employment, the incidence of antepartum and postpartum. The sampling technique using consecutive sampling. Analysis of the data used is univaribel, bivariate using Chi-square and Fisher's exact test and multivariable logistic regression and stratification testResult and Discussion: There was no significant correlation between the mode of delivery and the patterns of the first month breastfeeding by including a variable of employment with a value of OR (95% CI) = 1.6 (0.63 to 4.17) and there was a decrease in the value of OR (95% CI ) from 2.5 (1.05 to 5.94) to 1.6 (0.63 to 4.17); there was also no  significant correlation when involving the variable of the incidence of ante partum and post partum with the value of OR (95% CI) = 1.7 (0.45 to 6.26) and OR (95% CI) = 2.3 (0.96 to 5.53), respectively.Conclusion: : There is no difference patterns of breastfeeding mothers first month who gave birth cesarean section compared to normal birth. Caesarean section would affect the pattern of the first month breastfeeding if cesarean section deliveries occurred at housewives and mothers who did not experience the incidence of ante partum. Keywords: pattern of breastfeeding; vaginal deliveries; caesarean section; breast milk; 

Pengaruh Konseling Antenatal terhadap Penerimaan AKDR pascasalin sebuah uji klinis non randomisasi

Faris, Abdul, Soetrisno, Soetrisno, Siswosudarmo, Risanto, Malinta, Umar

JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
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Background: During postpartum period women have a high motivation to start using contraception and postpartum IUD is an ideal method to offer. The rate of IUD use is still low, 14.06% of all postpartum contraceptive use. This might be attributed to lack of information and counseling from health providers.Objective: To compare the number of postpartum IUD used among groups of clients who were counseled during ANC and re-counseled during latent phase (exposed group), and group counseled during latent phase only (control group).Method: This study was a prospective quasi-experimental or randomised clinical trial. The first group was those counseled during ANC  and latent phase, and the second was those counseled at latent phase only. Chi square and relative risk were used for statistical test two proportions.Result and Discussion: A total of 342 subjects who met  inclusion and exclusion criteria were recruited. They consisted of the 210 subjects (61,4%) for the first group and 132 subjects (38,6%) for the second.The rate of IUD used in the first group was 82 of 210 (39%) and 30 of 132 (22.7%) in the second, RR 1,72  (95% CI 1.20 – 2.46), p 0,002. The rate of IUD used was also significantly influenced by a history of IUD acceptor RR 2,90 with 95% CI 2.23 – 3.77), a history of contraceptive used (RR 1,79 with95% CI 1,18 – 2,71) and a history of contraceptive counselling (RR 1,50 with 95% CI 1,03 – 2,19).Conclusion: Clients who were counseled twice (during ANC and repeated at latent phase) had higher rate of postpartum IUD used significantly than those who were counseled at latent phase only. Other factors that significantly affected the rate of postpartum IUD used were history of IUD acceptor, history of contraceptive used.Keywords: Postpartum IUD; counseling; rate of postpartum IUD use; antenatal care

Psikoedukasi Dzikr Menurunkan Kadar Kortisol dan Meningkatkan Kadar IGG pada Ibu Primipara

Wahyuni, Sri, Anies, Anies, Soejoenoes, Ariawan, Putra, Suhartono Taat

JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
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Background: Unstable emotions that are common during the perinatal period affect hormonal regulation and affect immunity. Research of psychoeducation dhikr be important was done to reduce perceived stress so that cortisol levels can be controlled hence IgG increases.Purposes: to prove additional psychoeducation of dhikr in routine midwifery care more influential on decreasing cortisol and increasing IgG among primiparous women.Methods: This study was an experimental study. A number of 24 participants as intervention group and a number of 23 participants as control group. Cortisol and IgG levels measured using ELIZA kits in the third trimester of pregnancy, the three days and tenth days after birth. Statistical test using General Linear Model and independent t test to compare ? score.Results: The result showed mean difference between groups on the end of interventions, cortisol 18.95, CI 95% (-13.42 – 51.33) and p value is 0.245. The difference of the IgG between groups 482.72, CI 95% (55,51 - 909,93) and p value is 0.028.Conclusions: Additional psychoeducation of dhikr in routine midwifery care has more decrease Cortisol and increase IgG levels in primiparous women. Keywords: Cortisol, Psychoeducation Dzikr, IgG, Primiparous

Hubungan Asupan Cairan Ibu Hamil terhadap Indeks Cairan Amnion

Fatmawati, Eny, Hadiati, Diah Rumekti, Pradjatmo, Heru

JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
Publisher : IPAKESPRO

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Introduction: Adequate amniotic fluid volume is a requirement for intra uterine fetal development and good pregnancy outputs / neonatal. Adequate intake of fluid in pregnant women can increase both the amniotic fluid index on oligohydramniotic or normoamniotic, but the scientific basis for the adequacy of the recommended daily fluid have not clear yet. Furthermore, the fluid intake counseling in addition to nutrition for pregnant women is neededObjective: To determine the fluid intake in pregnant women and the mean difference of  amniotic fluid index on adequate fluid intake compared to less fluid intake.Methods: This research used prospective observational cohort study, conducted against the third semester pregnant women in Puskesmas Mergangsan and Tegalrejo Yogyakarta during July until September 2014. The subjects who met the inclusion criteria were divided into adequate and less fluid intake groups. The correlation between fluid intake and amniotic fluid index was analyzed using t-test and linear regression.Result and Discussion: The total subjects who met the criteria were 27 people, consist of 12 people in adequate fluid intake group and 15 people in less fluid intake group. The mean of subject’s fluid intake 2078 ml (enough), while the mean of amniotic fluid index (AFI) 12,76 cm (normoamniotic).The result showed that there was a significant difference (3,50 cm (IK 95%; 1,5-5,48); P < 0,05) between the mean of AFI from adequate fluid intake group compared to less fluid intake group . Simple linear regression test showed the effect of fluid intake for AFI namely 31,7%; with the amount of predicted AFI = 10,686 + 3,545 x fluid intake – 1,015 x age – 1,317 x education + 0,314 x occupation (ARS= 44,5%). External variables (age, education, and occupation) had no significant effect for AFI .Conclusion : The mean preview of fluid intake in the third semester pregnant women in Yogyakarta was adequate. Moreover, there was a AFI signifficant difference between adequate fluid intake compared to less fluid intake.  Keywords: fluid intake; amniotic fluid index; AFI

Memeriksa Striae Gravidarum untuk Memperkirakan Laserasi Perineum

Khrisnamurti, Sinta, Nurdiati, Detty Siti, Setiyarini, Wahyu Ikka

JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
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Background: Striae gravidarum is a common phenomenon that occurs in pregnant women and a marker of decrease in skin elasticity. Poor elasticity of the perineum can result perineal laceration in vaginal childbirth. This study was to determine the relationship of striae gravidarum perinenum with the occurrence lacerations in normal labor, and the factors that most influence the occurrence of mild and severe perineal lacerations.Method: Used a cross sectional design, with a sample of 188 respondents. Assessment striae gravidarum using Atwal et al (2006) which has been modified, assessment of perineal lacerations used RCOG (2006). Data collection was done during the months of April to July 2015 in the maternity room Panembahan Senopati Bantul Hospital.Results: Factors that influence the occurrence of mild laceration were striae gravidarum moderate-severe (RP 1,230: CI 95% 1,23053-1,23066), primiparous (RP 1,2675: CI 95% 1,13709-1,41298). Factors that influence the occurrence of severe laceration were striae gravidarum moderate-severe (RP 1,676: CI 95% 1,246-2,255), primiparous (RP 1,117: CI 95% 1,1172-1,1175), the lithotomy position (RP 1,012: CI 95% 1,011-1,0629).Conclusion: Striae gravidarum is factor that influence the occurance of perineal laceration. Checking of striae gravidarum can be to estimate the severity of perineal laceration, the more scores striae gravidarum more severe perineal laceration that may be experienced by childbirth mothers. Keywords: striae gravidarum; perineal laceration; childbirth

Peran Nilai Pribadi, Nilai Budaya dan Nilai Religius terhadap Sikap Remaja Perempuan tentang Seks Pranikah (Suatu Kajian pada Remaja Perempuan di Maumere dan Larantuka, NTT)

Sabarni, Susana, Hidajat, Lidia Laksana

JURNAL KESEHATAN REPRODUKSI Vol 5, No 2 (2018)
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Latar Belakang : Pesatnya perkembangan teknologi informasi, memudahkan remaja mengakses semua hal yang berhubungan dengan informasi seputar seks. Dengan kemudahan yang dimiliki untuk mengakses teknologi informasi ini, remaja seringkali terekspos oleh konten-konten pornografi. Secara langsung maupun tidak langsung akan memengaruhi sikap remaja terhadap perilaku seks pranikah.Tujuan : Mengetahui peran nilai pribadi, nilai budaya dan nilai religius dikaitkan dengan sikap remaja perempuan di Maumere dan Larantuka terhadap perilaku seks pranikah serta mengetahui sikap remaja perempuan terhadap perilaku seks pranikah.Metode : Penelitian menggunakan pendekatan mixed method, pengukuran sikap melalui pengisian kuesioner dan diskusi kelompok terarah (FGD) untuk mengetahui gambaran sikap remaja perempuan terhadap perilaku seks pranikah yang dikaitkan dengan nilai pribadi, nilai budaya dan nilai religius. Kegiatan penelitian dilakukan pada empat SMA di Maumere dan Larantuka. Jumlah partisipan 120 orang, diperoleh dengan teknik accidental sampling. Sebagai informasi tambahan dilakukan wawancara dengan tokoh budaya di Maumere dan tokoh agama di Larantuka. Hasil dan pembahasan : Berdasarkan pengolahan data terhadap pengukuran skala sikap diperoleh gambaran bahwa pada dasarnya remaja perempuan di Maumere dan Larantuka tidak menyetujui hubungan seks pranikah, meskipun telah terjadi pergeseran nilai. Sikap ini berdasarkan pada nilai-nilai pribadi yang diyakini remaja yaitu pertimbangan etika dan moral, dampak kehamilan, aborsi atau penyakit menular seksual. Dalam konteks budaya, pertimbangan remaja adalah sanksi sosial yang akan diperoleh dari kehamilan di luar nikah. Sedang dalam konteks religius, remaja mempertimbangkan tentang dosa. Berdasarkan diskusi kelompok terarah (FGD) disimpulkan bahwa nilai religius dirasakan sangat penting oleh partisipan karena dapat menumbuhkan iman dan memberi dorongan,arah dalam bertingkah laku. Nilai-nilai religius juga berperan dalam memberi motivasi dan membimbing seseorang untuk melakukan perbuatan yang baik. Dalam konteks budaya, para partisipan berpendapat bahwa budaya sangat penting karena dalam budaya diajarkan tentang perilaku yang pantas dan tidak pantas dilakukan. Oleh karena itu dibutuhkan pendampingan orangtua dalam mendidik dan menanamkan nilai-nilai moral dan etika.Kesimpulan : Pernyataan sikap tidak setuju terhadap perilaku seks pranikah merupakan internalisasi nilai-nilai budaya dan religius yang akhirnya membentuk sikap remaja di Maumere dan Larantuka Kata kunci : Peran nilai pribadi, nilai budaya dan nilai religius, sikap remaja perempuan, perilaku seks pranikah, Maumere dan Larantuka, Nusa Tenggara Timur Susana Sabarni, Lidia Laksana HidajatABSTRACT Background: The rapid development of information technology, making it easier for teenagers to access all things related to information about sex. With the ease they have to access this information technology, teenagers are often exposed to pornographic content. Directly or indirectly will influence teen attitudes towards premarital sex behavior.Objective: To acknowlegde the role of personal values, cultural values and religious values associated with the attitudes of adolescent girls in Maumere and Larantuka towards premarital sex behavior and also to acknowlegde  the attitudes of teenage girls to premarital sex behavior.Methods: The study used a mixed method approach, attitude measurement through filling out questionnaires and focus group discussions (FGD) to describe the attitudes of adolescent girls towards premarital sex behavior which is associated with personal values, cultural values and religious values. Research activities were carried out on four high schools in Maumere and Larantuka. The number of participants 120 people, obtained by accidental sampling technique. For additional information, interviews with cultural leaders in Maumere and religious leaders in Larantuka were conducted.Results and discussion: Based on data processing on attitude scale measurement obtained an illustration that basically girls in Maumere and Larantuka do not approve premarital sex, even though there has been a shift in values. This attitude is based on personal values believed by adolescents, namely ethical and moral considerations, the impact of pregnancy, abortion or sexually transmitted diseases. In the context of culture, adolescent considerations are social sanctions that will be obtained from pregnancy outside of marriage. While in a religious context, teenagers consider sin. Based on focus group discussions (FGD) it was concluded that religious values were felt to be very important by participants because they could foster faith and give encouragement, direction in behaving. Religious values also play a role in motivating and guiding someone to do good deeds. In the cultural context, the participants thought that culture was very important because in the culture it was taught about appropriate and inappropriate behavior. Therefore, parents are needed to assist in educating and instilling moral and ethical values.Conclusion: A statement of disagreement with premarital sex behavior is an internalization of cultural and religious values that ultimately shape their attitudes Keywords: The role of personal values, cultural values and religious values, attitudes of adolescent girls, premarital sexual behavior, Maumere and Larantuka, Nusa Tenggara Timur