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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)
Publisher : IPAKESPRO

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Abstract

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)
Publisher : IPAKESPRO

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Abstract

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 Δ 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)
Publisher : IPAKESPRO

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Abstract

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)
Publisher : IPAKESPRO

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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

Client Satisfaction After Family Planning Counseling by Trained Medical Students

Prawitasari, Shinta, Sangun, Diannisa I E, Rahman, Muhammad Nurhadi, Emilia, Ova

JURNAL KESEHATAN REPRODUKSI Vol 4, No 3 (2017)
Publisher : IPAKESPRO

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Abstract

Latar Belakang: Program keluarga berencana mengalami tren penurunan di Indonesia dikarenakan adanya kendala pengetahuan, hambatan budaya, dan ketidakpuasan klien terhadap efek dari penggunaan alat kontrasepsi. Konseling keluarga berencana oleh penyedia layanan kesehatan memainkan peran yang penting dalam memberikan informasi mengenai metode program keluarga berencana.Tujuan: Mengetahui kepuasan klien terhadap konseling keluarga berencana yang dilakukan oleh mahasiswa kedokteran yang telah dilatih.Metode: Penelitian ini merupakan pre-experiment design with posttest only. Dua puluh lima mahasiswa kedokteran yang mengikuti progam ditugaskan untuk memberikan konseling keluarga berencana kepada klien program keluarga berencana di Kabupaten Sleman, Yogyakarta. Modifikasi kuisioner dari William dkk digunakan untuk menilai kepuasan klien. Analisis deskriptif dilakukan dengan program SPSS versi 21.Hasil dan Pembahasan: Dari 69 klien yang mendapatkan pelayanan,secara umum lebih dari 97% klien merasa puas dengan pelayanan yang diberikan kecuali pada poin waktu tunggu dimana ketidakpuasan klien 11,8%. Kepuasan pada poin merasa dihormati, durasi konseling, metode pemberian informasi, kesempatan bertanya, dan kesesuaian antara informasi yang dibutuhkan dengan yang diberikan mencapai 98,5-100%.Kesimpulan: Sebagian besar klien merasa puas dengan konseling yang diberikan oleh mahasiswa kedokteran.Kata kunci: kepuasan, keluarga berencana, konseling, mahasiswa kedokteran

Kadar Hormon LH Basal sebagai Prediktor Kebrhasilan Stimulasi Ovarium pada Program Bayi Tabung

Ariantini, Dyah, Lutfi, Mohammad, Hadiati, Diah Rumekti

JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
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Abstract

Background: Ovarian stimulation is part of assisted reproductive technology (ART) process, which aims to spur the growth of follicles to be developed, so that it will increase the chance of getting pregnant. LH surge cause the final follicular maturation, ovulation and becoming corpus luteum. So that an increase in LH may adversely affect the development of the follicle and eventually affect in-vitro fertilization.Objective To determine the effect of basal LH hormone to follicles on the stimulation of ovarian.Method: Cohort Retrospective. Research Location: Permata Hati Clinic of Sardjito Hospital, YogyakartaResult dan Discussion: The study included 70 cycles of 70 women who underwent ovarian stimulation for in-vitro fertilization and fulfill inclusion and exclusion criterias. The subjects were divided into 2 groups based on basal LH hormone levels i.e. LH ≤ 3 mIU/ml as the test group and LH >3 mIU/ml as the control group. From analysis, response to ovarian stimulation in group with LH ≤3 mIU/ml was significantly different than LH >3 mIU/ml (RR 1,875; 95% CI 1,275–2,757; p=0,00*).Conclusion: Low level of basal LH (≤ 3 mIU/ml) generating fewer number of mature follicles in patients who performed ovarian stimulation in in-vitro fertilization program.Keyword: basal LH, ovarian stimulation, in-vitro fertilization.

Pengaruh Asfiksia terhadap Ukuran Kepala Anak Usia 6 Bulan - 2 Tahun di Rumah Sakit Umum Provinsi Nusa Tenggara Barat

Albayani, Melati Inayati, Ismail, Djauhar, Sitaresmi, Mei Neni

JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : IPAKESPRO

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Background: In developing countries is estimated at about 120 million babies born asphyxiated at birth. Among these who can survive 20% to 30% had mental disorder, cerebral palsy or developmental abnormality due to the small size of head circumference (microcephaly).Objective: To determine the effect of asphyxia on the head circumference size of children age 6 months - 2 years.Method: A matched case-control study design was conducted from May – June 2014. The population of the study was all children age 6 months - 2 years who visited the Growth development clinic of General Hospital of West Nusa Tenggara Province. The cases were children who have microcephaly and the controls were children with normocephaly. From sample size which was calculated by hypothesis testing two populations proportions are obtained a sample of 72 respondents with 36 cases and 36 controls. Bivariate analysis used chi-square (χ2) McNemar and multivariable analysis with logistic regression (conditional logistic regression) with a significance level of p <0.05 and 95% confidence intervals.Result and Discussion: Microcephaly was present in 83 % of the children with asphyxia, compared with 36 % of the controls. The children with asphyxia tent to have microcephaly compared to children without asphyxia (OR = 5,00; 95% CI: 1,36-18,32). Results of multivariable analysis showed that there was a statistically significant effect between asphyxia with head circumference size by controlling the low birth weight variable (OR = 5,00; 95% CI: 1,36-18,32).Conclusion: History of asphyxia increases the risk of microcephaly compared with non-asphyxia in children aged 6 months - 2 years.Keywords: asphyxia, head circumference, children aged 6 months-2 years

Profil Primigravida Muda dan Luaran Persalinan di Rumah Sakit Dr.Oen Surakarta

Raharja, Supanji, Emilia, Ova, Rochjati, Poedji

JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
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Background: Pregnancy at a young age has become an important health problem both in developed and developing countries. Pregnancy at a young age increases the risk of maternal and perinatal morbidity and mortality. This is because adolescent women who are not ready both physically and psychologically to get pregnant.Obsjective: This study aims to identify and analyze labor in young primigravida (<20 years) with pathological labor in hospital Dr.Oen Surakarta.Method: This was an observational analytic study without intervention in the form of comparative cross sectional study conducted in young primigravida group age <20 years and primigravida group age 20 to 34 years old, who underwent labor in hospital delivery room. Dr.Oen Surakarta. This study used secondary data from the medical record of pregnant women who gave birth at RS.Dr.Oen Surakarta from January 1, 2011 to December 31, 201. A comparison between young primigravids (<20 years) in which pathologic pathways were performed with primigravida of reproductive age (20-34 years) experienced pathological labor were conducted.Result and Discussion: The number of deliveries in young primigravida (<20 years) was 61 people (6.65%) whereas in primigravida (21-35 years) there were 856 people (93.34%). Younger primigravids have lower levels of education than the primigravida age of reproductive age (p 0.00, CI 3.557 - 11.227). The younger primigravida has a tendency to give birth outside its residence area compared to primigravida of reproductive age (p 0.00; CI 0.050,178). Unmarried status in the young primigravida is greater than that of primigravida of reproductive age (p 0.00, CI 0.011 - 0,229) .An Antenatal Care on Primigravida reproductive age is more regular than young primigravida (p 0.03; CI 0.255 - 0.97) . Young primigravida tended to have anemia (p = 0.00, OR 8.4 CI 3.22 - 21.93) The risk of prematurity was higher in young primigravids than in the reproductive age primigravida (p 0.01, OR 2.9 CI 1, 16 - 7.25). Younger primigravids have a higher risk for pathologic delivery compared to primigravida of reproductive age (p 0.05 OR 0.56 CI 0.315 - 1.01).Conclusions: There are differences in terms, level of education, marital status, residence, regularity of ANC between young primigravida and prmigravida of reproductive age. The study found that young primigravids have a higher risk of occurrence of anemia, prematurity and pathologic delivery compared with healthy reproductive age primigravids.Keywords: young primigravida, primigravida healthy reproductive age, risk factors

The Accuracy of Risantos Formula and Ultrasound Measurement in Estimating Fetal Weight

Pietersz, Elsina Krisnawati, Rachman, Irwan Taufiqur, Siswosudarmo, Risanto

JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
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Background: Accurate estimated fetal weight (EFW) is crucial in determining delivery management. Several methods to estimate fetal weight were used such as abdominal palpation, measurement of symphisis fundal height (SFH), and ultrasound examination. Risanto’s formula based on Indonesian population had been already proven to be more accurate than Johnson’s formula. The formula was as follows: Y = 125 X - 880 where Y was EFW in grams, X was SFH in cm, and 125 was the constanta.Objective: To compare the accuracy of Risanto’s formula and ultrasound examination in estimating fetal weight.Method: A cross sectional study was carried out in Sardjito hospital, Faculty of Medicine Universitas Gadjah Mada, from March 2013 to March 2014. A total of 400 pregnant women meeting the inclusion criteria at 37 – 42 weeks of gestation were recruited. The estimated fetal weight using Risanto’s formula (R_EFW) was compared to the estimated fetal weight using ultrasound measurement (U_EFW). The U_EFW was done by obstetricians on duty or senior residents using Hadlock’s formula. Actual birth weight (ABW) was measured using the same calibrated baby scale. Accuracy was determined by comparing the mean difference between the R_EFW minus ABW (ΔR_EFW) and the U_EFW minus ABW (ΔU_EFW). Paired t-test was used for statistical analysis.Result and Discussion: The mean ABW was 3025.3 ± 414.6 gram and the mean R_EFW was 2972.7 ± 365.4 grams, while the mean U_EFW was 3058.7 ± 423.2 grams. The mean ΔR_EFW was lower than the mean ΔU_EFW (178.2 ± 147.6 grams vs 197.5 ± 155.4 grams; 95% CI 1.24 – 36.68; p = 0.04).Conclusion: Risanto’s formula was more accurate than ultrasound measurement in estimating fetal weight.Keywords: Estimated fetal weight, Risanto’s formula, Ultrasonography, Fundal height