Prisasanti, Dympna Prameilita
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Improved Understanding of IUD and Implant Family Planning Acceptors in Family Planning Services at Solo Peduli Clinic Budihastuti, Uki Retno; Laqif, Abdurahman; Melinawati, Eriana; Prakosa, Teguh; Udiyanto, Hermawan; Priyanto, Heru; Darto, Darto; Ratnasari, Affi Angelia; Anggraeni, Asih; Prisasanti, Dympna Prameilita
Journal of Maternal and Child Health Vol 5, No 4 (2020)
Publisher : Journal of Maternal and Child Health

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Background: Family planning acceptor's understanding of intra uterine device (IUD) and implant contracep­tion is still low, due to the lack of knowledge and negative percep­tions about IUD and im­plants contraception in the society. Therefore, it needs an effort to increase the understanding of family planning acceptors to reduce fertility rates through increasing the use of contraception. This study aimed to ana­lyze understanding and satisfac­tion of family planning acceptors with the satisfaction aspects of counseling, the comfort­able effect on the insertion of contraceptives, and the satis­faction of family planning services at the Solo Peduli Clinic.Subjects and Method: A cross sectional study was conducted at Solo Peduli Clinic, Surakarta, Central Java, from June to August 2020. A sample of 60 women divided into 2 groups: (1) 30 women who have used IUD and implant contraceptives, and (2) 30 women that will be given counselling and insertions of IUD and implant contraceptives. The study subject was selected by fixed disease sampling. The dependent variable was satisfaction. The independent variables were counselling, com­fortable effect, and family planning service. The data were collected by questionnaire and analyzed by a multiple logistic regression run on SPSS ver. 25.Results: The average level of satisfaction of counseling, the comfortable effect of using contraceptives, and satisfaction with family planning services has an "very satisfied". Good counselling (OR= 1.592; 95% CI= 1.097 to 2.310; p= 0.014), insertion conve­nience (OR= 1.428; 95% CI= 0.976 to 2.090; p= 0.066), and good family planning service (OR= 1.761; 95% CI= 1.191 to 2.603; p= 0.004) increased satisfaction.Conclusion: Good counselling, insertion convenience, and good family planning service increase satisfaction.Keywords: Family planning acceptors, IUD, implants, family planning servicesCorrespondence: Uki Retno Budihastuti. Department of Obste­trics and Gynecology, Dr. Moewardi Hospital/ Faculty of Medicine, Universitas Sebelas Maret, Jl. Kolonel Sutarto 132, Surakarta, Central Java. Email: ukiretno@staff.uns.ac.id. Mobile: 08122656140.Journal of Maternal and Child Health (2020), 05(04): 436-445https://doi.org/10.26911/thejmch.2020.05.04.11 
Massive Adherent Placenta, Placenta Percreta Yuliantara, Eric Edwin; Anggraini, Nutria Widya Purna; Prisasanti, Dympna Prameilita
Journal of Maternal and Child Health Vol 6, No 1 (2021)
Publisher : Journal of Maternal and Child Health

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Abstract

Background: Adherent placentas including placenta accreta, increta and percreta are conditions where there is abnormal implanta­tion of all or part of the placenta on the myo­metrial wall. Massive adherent placenta has high morbidity and mortality rates in both mother and fetus. There is a positive corre­la­tion between the incidence of adherent placenta and the increase in cesarean section rates worldwide. Identification of risk factors, ante­natal diagnosis, accurate preoperative prepara­tion, multidisciplinary management, and appro­priate counseling are the main manage­ment of adherent placenta to reduce maternal morbidity.Case Presentation: A woman, G5P3A1, age 36 years pregnant 37 weeks, complained loudly regularly since 6 hours before admission to hospital. There is a history of CS as much as 3x with indications of 2x Premature rupture of the membranes and uterine rupture, as well as a history of curettage (1x). Physical examination showed that the general condition was good, and composting, vital signs were within normal limits. Abdomen palpable single fetus, intra­uterine, elongated, head presentation, left back, moderate his (+), FHR 150 x/minute. The results of prenatal sonography examination showed that neither placenta previa nor massive adherent placenta was found. The preoperative diagnosis was inparticular stage I latent phase with a history of SC 3 times.Results: An emergency Caesarean section was performed. Durante surgery showed severe adhesions of the placenta, uterine wall and bladder. The diagnosis of placenta percreta was confirmed, uterine resection was performed on the perreta section, hysterography as well as adhesiolysis and MOW sterilization. The results of the PA examination support the diagnosis of placenta percreta.Conclusion: Massive adherent placenta, pla­centa percreta was not diagnosed in this case because there were no clinical features or pre­natal sonography that supported the diagnosis of placenta percreta. A history of trauma to the uterus due to uterine rupture, history of CS and curettage were risk factors for placenta percreta in this case. The incidence rate of placenta per­creta with a history of SC 3 times without placenta previa on the previous sonographic examina­tion was 0.1%. Operative management to manage bleeding and post operative care have been carried out according to the procedure so as to avoid mortality.Keywords: massive adherent placenta, placenta percreta, case reportCorrespondence: Eric Edwin Yuliantara. Department Obstetrics and Gynecology, Faculty of Medicine Univer­sitas Sebelas Maret/ dr. Moewardi General Hospital Surakarta. Jl Kolonel Sutarto 132, Surakarta, Central Java. Email: edwinericog­@staff.uns.ac.id. Mobile: 08122618769.Journal of Maternal and Child Health (2021), 06(01): 108-121https://doi.org/10.26911/thejmch.2021.06.01.11