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PERILAKU BIDAN DALAM PELAKSANAAN INISIASI MENYUSU DINI DI WILAYAH KERJA PUSKESMAS II TAMBAK, PUSKESMAS BANYUMAS DAN PUSKESMAS I KEMRANJEN Sumiyati, Sumiyati; Emilia, Ova; Dasuki, Djaswadi
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
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PERILAKU BIDAN DALAM PELAKSANAAN INISIASI MENYUSU DINI DI WILAYAH KERJA PUSKESMAS II TAMBAK, PUSKESMAS BANYUMAS DAN PUSKESMAS I KEMRANJENÂ Sumiyati1, Ova Emilia2, Djaswadi Dasuki3Â ABSTRACTÂ Background: Early Initiation of Breastfeeding (EIB) is important because it can increase the success of exclusive breastfeeding and infant survival. However, the implementation of the EIB is still not optimal in Banyumas. One of the factors that support the success of EIB is the support of health workers, especially midwives. Central Bureau of Statistics of Banyumas regency in 2012 said that most of deliveries in Banyumas 78.52% in 2011 attended by midwives.Objective: To determine the behavior of midwives in the implementation of Early Initiation of Breastfeeding at Work Area of Tambak Public Health Center Banyumas. Public Health Center and Kemranjen Public Center.Methods: The study was cross sectional complemented with qualitative data. The experiment was conducted at the Working Area of Tambak II, Banyumas and Kemranjen I public healh centers with 38 midwives as subjects. In-depth interviews conducted to 6 midwives and 4 postpartum mothers.Results and Discussion: There were a significant association between knowledge and attitudes of midwives to practice implementation of EIB, knowledgeable midwife tent to practice E.I.B 1.79 times higher than less knowledgeable midwife. Good attitude midwives 1.62 times more likely to support EIB practice.Conclusion: The behavior of midwife in the implementation of the EIB practices is influenced by a good knowledge and attitudes that support the EIB. Factors that inhibit the EIB, included flat nipples exhaustment of postpartum mothers and lack of rest among health professionals when encountered prolong labor.Â Keywords: knowledge, attitude, practice, midwife, early initiation of breastfeedingÂ Â ABSTRAKÂ Latar Belakang: Inisiasi Menyusu Dini (IMD) penting karena dapat meningkatkan keberhasilan ASI eksklusif dan kelangsungan hidup bayi. Namun pelaksanaan IMD masih belum optimal di Kabupaten Banyumas. Salah satu faktor yang mendukung keberhasilan IMD adalah dukungan tenaga kesehatan terutama bidan. Badan Pusat Statistik Daerah Kabupaten Banyumas tahun 2012 menyatakan sebagian besar penduduk Kabupaten Banyumas sekitar 78,52% pada tahun 2011 menggunakan tenaga kesehatan bidan untuk menolong persalinan.Tujuan: Untuk mengetahui perilaku bidan dalam pelaksanaan Inisiasi Menyusu Dini di Wilayah Kerja Puskesmas II Tambak, Puskesmas Banyumas dan Puskesmas I Kemranjen.Metode: Penelitian observasional dengan rancangan cross sectional. Penelitian ini secara kuantitatif dan kualitatif. Penelitian dilaksanakan di Wilayah Kerja Puskesmas II Tambak, Puskesmas Banyumas dan Puskesmas I Kemranjen dengan subjek penelitian 38 bidan dan wawancara mendalam dengan 6 bidan serta 4 ibu postpartum.Hasil dan Pembahasan: Hasil analisis bivariabel terdapat hubungan yang bermakna antara pengetahuan dan sikap bidan dengan pelaksanaan praktik IMD, bidan yang berpengetahuan baik 1,79 kali lebih besar untuk melakukan praktik IMD dengan baik dibandingkan dengan bidan yang berpengetahuan kurang. Sikap bidan yang mendukung IMD 1,62 kali lebih besar untuk melakukan praktik IMD dengan baik dibandingkan dengan sikap bidan yang tidak mendukung IMD.Kesimpulan: Perilaku bidan dalam pelaksanaan praktik IMD dipengaruhi oleh pengetahuan yang baik dan sikap yang mendukung terhadap IMD. Faktor yang menghambat IMD antara lain bentuk puting yang mendatar sehingga bayi kesulitan untuk menghisap, ibu postpartum merasa capai dan lelah karena kurang istirahat serta faktor tenaga kesehatan, apabila menolong persalinan dengan kala II lama sehingga pelaksanaan IMD kurang dari satu jam.Â Kata kunci: pengetahuan, sikap, praktik, bidan, inisiasi menyusu dini1Â Â Â Poltekkes Kemenkes Semarang2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM

DENSITAS MASSA TULANG PADA PENGGUNA KONTRASEPSI IMPLAN LEVONORGESTREL Kumala Dewi, Andriana; Dasuki, Djaswadi; Rumekti Hadiati, Diah
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
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DENSITAS MASSA TULANG PADA PENGGUNA KONTRASEPSI IMPLAN LEVONORGESTRELÂ Andriana Kumala Dewi1 , Djaswadi Dasuki2, Diah Rumekti Hadiati3Â Â ABSTRACTÂ Background: BKKBN reported that implant as a long term method of contraception was the most widely used among new users in 2012. The contraceptive action is mainly by inhibition of ovulation and production of estrogen is supressed. Estrogen is one of the most important factors related to bone remodelling. Thus, it has raised concerns regarding the adverse effect of long term use of this contraceptive method on the bone status of women who use them. So, it is necessary to study the effects of long term use of progestogens on bone mineral density.Objective: Comparing bone mass density in contraceptive implant users and non-hormonal users.Methods: Cross sectional study. This study was conducted in Kontap, outpatient department, Sardjito Hospital in August-December 2013. The participantsâ age were 20-50 years who met the inclusion criteria and regardless of the exclusion criteria. Total of 110 women were divided into 2 groups, contraceptive implant users and non-hormonal contraceptive users. Bone mass density was measured using ultrasound densitometry on the calcaneus bone.Results: Bivariate Chi-square analysis showed that there was no significant association between the use of the contraceptive implant with incidence of abnormal bone density (RP 1.75; 95% CI (0.80-3.83), p = 0.23). BMI as confounding variable provide a significant relationship with bone density with OR 23.24; 95% CI (4.26 to 126.86), p <0.001Conclusion: In this study, there was no significant difference of bone mass density between contraceptive implant group and non hormonal group. BMI were significantly related to bone mass density.Â Keyword: Bone mineral density, contraceptive implant, contraceptive progestin-only, levonorgestrelÂ Â ABSTRAKÂ Latar belakang: Data BKKBN menunjukkan bahwa implan merupakan metode kontrasepsi jangka panjang terbanyak dipakai oleh peserta baru KB tahun 2012. Cara kerja utama implan levonorgestrel dengan inhibisi ovulasi sehingga terjadi supresi produksi estrogen. Estrogen adalah salah satu faktor penting dalam remodelling tulang. Hal inilah yang memunculkan kekhawatiran tentang pengaruh penggunaan implan terhadap status kesehatan tulang pemakainya.Tujuan: Membandingkan densitas massa tulang pada pengguna kontrasepsi implan levonorgetrel dan non hormonal.Metode penelitian: Studi potong lintang. Penelitian dilakukan di Poliklinik Kontap, RSUP Dr. Sardjito. Jumlah peserta penelitian 110 wanita berusia 20-50 tahun yang memenuhi kriteria inklusi dan terlepas dari kriteria eksklusi, terbagi menjadi 2 kelompok, yaitu kelompok pengguna kontrasepsi implan dan pengguna kontrasepsi non hormonal. Densitas massa tulang diukur dengan menggunakan alat densitometri ultrasonografi pada tulang kalkaneus.Hasil: Analisis bivariat Chi-square menunjukkan bahwa tidak ada hubungan bermakna antara penggunaan kontrasepsi implan dengan kejadian densitas tulang yang tidak normal (RP 1,75; IK 95% (0,80-3,83), p=0,23). BMI sebagai variabel luar memberikan hasil analisis yang bermakna terhadap kejadian densitas tulang tidak normal dengan nilai OR 23,24; IK 95% (4,26-126,86), p<0,001.Kesimpulan: Tidak ada perbedaan densitas massa tulang yang bermakna antara kelompok pengguna kontrasepsi implan dan non hormonal. BMI kategori underweight secara signifikan memiliki hubungan dengan kejadian densitas tulang tidak normal.Â Kata kunci: densitas massa tulang, kontrasepsi implan, kontrasepsi progestin-only, levonorgestrelÂ 1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr.Sardjito Yogyakarta

HUBUNGAN MANAJEMEN AKTIF KALA TIGA DENGAN INISIASI MENYUSUI DINI DI KABUPATEN SUMEDANG TAHUN 2010 Ana, Ade; Dasuki, Djaswadi; Taufiqurahman, Irwan
JURNAL KESEHATAN REPRODUKSI Vol 1, No 1 (2014)
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Background: Intervention in activemanagement of the third stage of labor (AMTSL) is aimed to accelerate the deliveryof the placenta, to prevent and reduce blood loss in the third stage of labor. Early initiation of breastfeeding facilitates,a baby to start breastfeeding right away, that aims to stimulate the babyâs suckling reflex for increasingmilk production.This practice can reduce the risk of infant mortality due to hypothermia and infection in infants under 1 month. There are several obstacles in its implementation, due to policy, providers and client. It is important to implement AMTSLand early initiation of breastfeeding to improve the health of mothers and infants accordingly.Objective: To determine the implementation of activemanagement of the third stage and early breastfeeding initiationMethods: This study was an observational study with cross sectional design. The samples were 166 postpartummothers and newborns in public hospitals and health centers at District of Sumedang. Analysis of the data usedunivariate analysis, bivariate analysis using Chi-square and multivariate analysis using logistic regression.Results and Discussion:Â RThe prevalence of active management of the third stage success was 77,1 % and 48,8 %was completed with early initiation of breastfeeding. There was a significant relationship between the success ofearly breastfeeding initiation after active management of the third stage (OR= 3,1, 95 % CI= 1,12-8,49 ). Otherfactors that related were the support of providers, client support and delivery place. Less supportive policy, noten steps to successful breastfeeding and lack of trained personnel led to differences in perception. Lack of staffmotivation and clear information caused the client did not understand the importance of both these proceduresdone.Conclusion: The success of active management of the third stage and early breastfeeding initiation can be achieved ifthere was a comprehensive support from policy makers (policy side), service providers (support side) and servicerecipients (demand side)Â Â

HUBUNGAN ANTARA ENDOMETRIOSIS FERTILITY INDEX (EFI) DAN KEBERHASILAN FERTILISASI IN VITRO (FIV) Amelia, Adelina; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
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Adelina Amelia1, Djaswadi Dasuki2, Heru Pradjatmo3Background: Endometriosis is a gynecological disease that is found in 25-30% of infertile women. The most widely used staging system of endometriosis in IVF is the revised American Fertility Society (r-AFS) which has limited predictive ability for pregnancy after surgery. The Endometriosis Fertility Index (EFI) is used to predict fecundity after endometriosis surgery.Objective: To assess the relationship between EFI and the outcomes of IVF.Methods: The study was retrospective cohort. Subjects of study were endometriosis patients who underwent IVF in Infertility Clinic of Permata Hati, Dr. Sardjito Hospital, Yogyakarta in 2012 that met inclusion and exclusion criteria. Subjects were devided into two groups: high EFI and low EFI. ROC curve was used to obtain the cut-off point.Chi-square and logistic regression statistics analysis were used.Results and Discussion: A total of 54 cycles from 54 couples who underwent IVF were included. Cut off point for EFI is 6. There is no difference in the outcomes of IVF between high and low EFI (OR 15,135; 95% CI 0,830-276,00; p=0,067), but high EFI increased the outcome of IVF 15 times better than low EFI. The outcome of IVF was influenced by type of the embryo transfer (OR 0,126; 95% CI 0,028-0,566).Conclusion: High EFI did not affect the outcomes of IVF both rated at biochemical pregnancy, clinical pregnancy and live birth. The outcomes of IVF was influenced by type of the embryo transfer. The cause of female infertility and stage of the endometriosis increased EFI score but did not affect the outcomes of IVF.Â Keyword: endometriosis, infertility, endometriosis fertility index, in vitro fertilizationÂ ABSTRAKÂ Latar Belakang: Endometriosis adalah salah satu penyakit ginekologi yang ditemukan pada 25-50% wanita infertil. Sistim klasifikasi yang digunakan untuk menentukan derajat atau stadium endometriosis dalam FIV yaitu The revised American Fertility Society (r-AFS) yang memiliki keterbatasan dalam memprediksikan kehamilan setelah pembedahan. Endometriosis Fertility Index ( EFI) adalah sistim klasifikasi endometriosis terbaru yang dapat digunakan untuk memprediksikan kehamilan setelah pembedahan.Tujuan: Menilai hubungan antara Endometriosis Fertility Index (EFI) dan keberhasilan Fertilisasi In Vitro (FIV). Metode: Studi kohor retrospektif. Subyek penelitian adalah pasien endometriosis yang menjalani program FIV di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta pada tahun 2012 yang memenuhi kriteria inklusi dan terlepas dari kriteria ekslusi. Subyek dibagi menjadi 2, kelompok EFI tinggi dan EFI rendah. Nilai titik potong EFI didapat dari kurva ROC. Uji statistik yang digunakan adalah Chi-square dan regresi logistik.Hasil dan Pembahasan: Sebanyak 54 siklus dari 54 pasangan yang menjalani fertilisasi in vitro(FIV) disertakan dalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Nilai titik potongditetapkan EFI=6. Tidak terdapat perbedaan secara statistik terhadap keberhasilan FIV antara EFI tinggi dan rendah (OR 15,135; IK 95% 0,830-276,00; p=0,067) tetapi secara klinis skor EFI tinggi meningkatkan keberhasilan FIV 15 kali dibanding skor EFI rendah. Keberhasilan FIV dipengaruhi oleh jenis embrio yang ditransfer (OR 7,020; IK 95% 1,309-37,660; p=0,023).Kesimpulan: Skor EFI tinggi tidak mempengaruhi keberhasilan dalam program FIV baik dinilai pada kehamilan biokimia, kehamilan klinik, maupun kelahiran bayi hidup. Faktor yang mempengaruhi adalah jenis embrio yang ditransfer. Faktor penyebab infertilitas wanita dan stadium endometriosis meningkatkan skor EFI tetapi tidak mempengaruhi keberhasilan FIV.Kata kunci: endometriosis, infertilitas, endometriosis fertility index,fertilisasi in vitro.Â 1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM

PERBANDINGAN SKOR DISMENOREA PADA PASIEN ENDOMETRIOSIS YANG MENDAPATKAN TERAPI ABLASI LAPAROSKOPI DILANJUTKAN GnRH AGONIST VERSUS ABLASI LAPAROSKOPI SAJA DI RSUP DR. SARDJITO YOGYAKARTA Isyana, Marta; Dasuki, Djaswadi; Rumekti, Diah
JURNAL KESEHATAN REPRODUKSI Vol 1, No 3 (2014)
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PERBANDINGAN SKOR DISMENOREA PADA PASIEN ENDOMETRIOSIS YANG MENDAPATKAN TERAPI ABLASI LAPAROSKOPI DILANJUTKAN GnRH AGONIST VERSUS ABLASI LAPAROSKOPI SAJA DI RSUP DR. SARDJITO YOGYAKARTAMarta Isyana 1 , Djaswadi Dasuki2, Diah Rumekti3ABSTRACTBackground: Dysmenorrhea in endometriosis is a condition that adversely impacts the quality of life of women. The current treatment for dysmenorrhea in endometriosis is essentially palliative, since most of these treatment can only suppress disease progression and relieve its symptoms.Objective: To compare the difference in dysmenorrhea scores pre and post treatment of dysmenorrhea in endometriosis patients who received laparoscopic ablation followed with GnRH agonist versus laparoscopic ablation therapy alone.Method: This is an observational study with a retrospective cohort design. Endometriosis patients were identified through medical records at Dr Sardjito Hospital, Yogyakarta. Patients were categorized into laparoscopic ablation therapy followed by GnRH agonist group and laparoscopic ablation therapy only group. Evaluation of dysmenorrhoea scores were performed in 6 months after therapy.Result and Discussion: A total of 88 subjects (44 subjects in each group) were eligible and gave their consent to participate. Patients who received laparoscopic ablation therapy followed by GnRH agonist showed greater VAS difference pre and post treatment (6,27Â±0,22 vs 4,20Â±1,17,p<0,001) compared with only ablation laparoscopic. This difference was not affected by age, BMI, and endometriosis stage. Eleven of the 44 subjects who received laparoscopic ablation followed by GnRH agonists developed side effects. There were 7 people with hot flushes, 3 people with decreased bone mineral density and 1 people with dry skin, whereas no subject in laparoscopic ablation group alone experienced them.Conclusions: Laparoscopic ablation followed by GnRH agonist therapy was associated with greather difference in dysmenorrhea score pre and post treatment compared with laparoscopic ablation only. Laparoscopic ablation therapy followed with a GnRH agonist was associated with higher side effects.Keywords: endometriosis, laparoscopic ablation, GnRH agonist, visual analog scaleABSTRAKLatar Belakang: Dismenorea pada endometriosis adalah suatu kondisi yang memberikan dampak bermakna pada mutu kehidupan wanita. Penanganan dismenorea pada endometriosis saat ini pada hakikatnya masih belum berhasil menyembuhkannya, karena sebagian besar baru mampu menekan perkembangan penyakit dan menghilangkan gejalanya.Tujuan: Membandingkan selisih skor dismenorea sebelum dan setelah terapi pada pasien endometriosis yang mendapatkan terapi ablasi laparoskopi dilanjutkan GnRH agonist versus ablasi laparoskopi saja.Metode: Penelitian ini adalah penelitian observasional menggunakan rancangan penelitian kohort retrospektif. Pasien endometriosis diidentifikasi melalui rekam medis di RSUP DR Sardjito, Yogyakarta. Pasien dikelompokkan menjadi kelompok terapi ablasi laparoskopi dilanjutkan dengan GnRH agonist dan terapi ablasi laparoskopi saja.Evaluasi untuk skor dismenorea dilakukan pada jangka waktu 6 bulan setelah terapi. Hasil dan Pembahasan: Sebanyak 88 subyek (44 subyek dalam setiap kelompok) memenuhi kriteria penelitian dan memberikan persetujuan untuk diikutsertakan dalam penelitian. Pasien yang mendapatkan terapi ablasi laparoskopi dilanjutkan GnRH agonist menunjukkan selisih VAS sebelum dan setelah terapi yang secara signifikan lebih baik (6,22Â±0,22 vs 4,20Â±1,17;p<0,001) dibandingkan dengan ablasi laparoskopi saja. Perbedaan ini tidak dipengaruhi oleh umur, BMI, maupun derajat endometriosis. Sebelas dari 44 subyek yang mendapatkan ablasi laparoskopi dilanjutkan GnRH agonist mengalami efek samping, yaitu 7 orang mengalami hot flushes, 3 orang mengalami penurunan densitas masa tulang dan 1 orang mengalami kulit kering, sedangkan tidak ada subyek dalam kelompok ablasi laparoskopi saja yang mengalami efek samping.Kesimpulan: Terapi ablasi laparoskopi yang dilanjutkan dengan GnRH agonist berhubungan dengan selisih skor dismenorea sebelum dan setelah terapi yang lebih tinggi dibandingkan dengan terapi ablasi laparoskopi saja. Terapi ablasi laparoskopi yang dilanjutkan dengan GnRH agonist berhubungan dengan tingkat efek samping yang lebih tinggi.Kata kunci: endometriosis, ablasi laparoskopi, GnRH agonist, visual analog scaleÂ 1,2,3 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada

PENGETAHUAN DAN KETERAMPILAN BIDAN UNTUK SKRINING KANKER SERVIKS DENGAN METODE INSPEKSI VISUAL ASAM ASETAT (IVA) DI KALIMANTAN BARAT Mardiana, Mardiana; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
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Mardiana1, Djaswadi Dasuki2, Heru Pradjatmo2Â ABSTRACTÂ Background: Globally it is estimated that every two minutes a woman dies of cervical cancer and 500,000 women are diagnosed to have cervical cancer each year. In Indonesia, the incidence of cervical cancer is by 12.6 per 100,000 women with a mortality rate of 7 per 100,000. Screening method can reduce the incidence of cervical cancer if done cumulatively in 2012, the coverage of screening with a VIA method in Indonesia was 1.57%, whereas screening coverage with IVA in West Kalimantan Province was 1.06 %Objective: To assess midwivesâ knowledge and skills of screening practices with a VIA method in health centers Method: This was an observational study with a cross-sectional study, using quantitative and qualitative approaches. The study was conducted in health centers in the province of West Kalimantan. This study was conducted in September to October 2014. The subjects of research were midwives who served in health centers doing a VIA examination in West Kalimantan who met inclusion and exclusion criteria. The total sample of this study was 42 taken with purposive sampling. The variables of this study were the dependent variable, ie, the practice of screening skills with a VIA method, the independent variable, ie, knowledge, and the extraneous variables, ie, age, education, and years of service. Analysis of the data included univariable, bivariable, multivariable, and qualitative. The quantitative data analysis used the chi-square and logistic regression with a significance level of p <0.05 and an OR value with confidence interval (CI) of 95%.Result & Discussion: The mean value of midwivesâ knowledge was 26.0 from assessment scores of 0-30. A mean score of screening practice skills was 94.4 from 38-114. Of clinical assessment scores skill practice of competent midwives with good knowledge was higher than bad knowledge (OR= 6,98 CI 95% 1,21-40,33). After controlling education and years of service variables, good knowledge influenced screening clinical practice by 33%.Â Conclusion: Most of the midwives in West Kalimantan had good knowledge and skills to perform cervical cancer screening with a VIA method.Keywords: Knowledge, screening practice skills, VIA methodsÂ Â ABSTRAKLatar Belakang: Di seluruh dunia diperkirakan setiap dua menit seorang wanita meninggal karena kanker servik dan sekitar 500.000 wanita di diagnosis kanker seviks setiap tahun. Di Indonesia insiden kanker serviks sebesar 12,6 per 100.000 perempuan dengan angka kematian sebesar 7 per 100.000. Metode skrining dapat menurunkan kejadian kanker serviks jika dilakukan secara kumulatif. Pada tahun 2012 cakupan skrining dengan metode IVA di Indonesia sebesar 1,57%, sedangkan cakupan skrining dengan metode IVA Propinsi Kalimantan Barat sebesar 1,06%.Tujuan: Menilai pengetahuan dan keterampilan praktek skrining bidan dengan metode IVA di puskesmas Metode: Jenis penelitian observasional dengan rancangan cross-sectional study, menggunakan pendekatan kuantitatif dan kualitatif. Penelitian dilakukan di puskesmas di Provinsi Kalimantan Barat. Penelitian ini dilaksanakan bulan September sampai dengan Oktober 2014. Subjek penelitian bidan yang melayani pemeriksaan IVA di puskesmas di Provinsi Kalimantan Barat yang memenuhi kriteria inklusi dan eksklusi. Total sampel penelitian ini 42 sampel dengan pengambilan sampel purposive sampling. Variabel penelitian ini yaitu: variabel terikat adalah keterampilan praktek skrining metode IVA, variabel bebas: pengetahuan, dan variabel luar: usia, pendidikan, dan lama bekerja. Analisis data meliputi: univariabel, bivariabel, multivariabel, dan kualitatif. Untuk analisis data kuantitatif meng-gunakan metode chi square dan logistic regresi dengan tingkat kemaknaan p < 0,05 dan nilai OR dengan Confidence Interval (CI) 95%.Hasil & Pembahasan: Nilai mean pengetahuan bidan sebesar 26,0 dari skor penilaian 0-30. Keterampilan praktik dengan nilai mean 94,4 dari skor 38-114. Keterampilan praktik klinik yang kompeten lebih tinggi pada bidan berpengetahuan baik daripada bidan berpengetahuan kurang (OR= 6,98 CI 95% 1,21-40,33). Pengetahuan baik setelah dikontrol variabel pendidikan dan lama bekerja berpengaruh terhadap keterampilan praktik skrining sebesar 33%.Kesimpulan: Sebagian besar bidan di Kalimantan Barat memiliki pengetahuan baik dan keterampilan yang kompeten untuk skrining kanker serviks dengan metode IVA.Â Kata Kunci: Pengetahuan, keterampilan praktek skrining, metode IVAÂ 1Â Dinas Kesehatan Provinsi Kalimantan Barat2Â Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada Â Â Â Yogyakarta

MICROVOLUME OF 0.1ÂµL GAMA SLEEVED CRYOLOOPS FOR BLASTOCYST VITRIFICATION OF ASSISTED REPRODUCTIVE TECHNOLOGY PATIENTS Hanoum, Ita Fauzia; Boediono, Arief; Pangestu, Mulyoto; Haryadi, Dwi; Widad, Shofwal; Dasuki, Djaswadi
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

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Ita Fauzia Hanoum1,2, Arief Boediono3, Mulyoto Pangestu4,5, Dwi Haryadi1,Shofwal Widad1,2, Djaswadi Dasuki1,2Â ABSTRAKÂ Latar Belakang: Prosedur embrio vitrifikasi menggunakan alat berupa grid, straw atau cryoloop. Gama Sleeved cryoloop dibuat dan dikembangkan di klinik Permata Hati. Untuk itu, dilakukan pengamatan keberhasilan prosedur vitrifikasi menggunakan 0.1Âµl Gama Sleeved cryoloop.Metode: Vitrifikasi dilakukan pada blastokis dengan kualitas baik yang diperoleh pada hari ke 5 setelah fertilisasi. Inform consent telah disampaikan sebelumnya kepada pasien program bayi tabung di Klinik Permata Hati. Prosedur dilakukan dengan menggunakan media handling (GMOPS Plus; Vitrolife) embrio diinkubasi selama 1 menit; (7.5% EG (v/v); 7.5% DMSO (v/v)) selama 2-3 menit, (15% EG (v/v); 15% DMSO v/v; 10 mg/ml Ficoll; 0.65 M Sucrosa) selama 30 detik pada suhu ruang sebelum kemudian diletakkan di dalam cryoloop, setelah itu secara cepat cryoloop yang berisi embrio dibenamkan ke dalam nitrogen cair. Sebelum dilakukan embryo transfer (ET), embrio dihangatkan dengan cara two step technique (sucrose 0.25M) selama 2 menit dan selama 3 menit (sucrose 0.125M).Hasil: Sejumlah 97 blastokis divitrifikasi dan dihangatkan (67 pasien), dimana 91 blastokis berhasil ditransfer ke rahim ibu (93.8%). Blastokis yang tidak berhasil selamat dari prosedur penghangatan adalah blastokis dengan kerusakan lebih dari 50%. Diperoleh kehamilan klinis 43.3% sedangkan angka implantasi adalah 37.4%. Sampai saat ini, dilaporkan 20 kelahiran (23 bayi) dari program vitrifikasi menggunakan 0.1Âµl Gama Sleeved cryoloop, sementara 5 kehamilan masih berlangsung. Satu kehamilan dilaporkan gugur pada usia kehamilan yang masih sangat awal, dua keguguran pada usia kehamilan 12 minggu dan satu bayi lahir meninggal karena kelainan kongenital.Kesimpulan: 0.1Âµl Gama Sleeved cryoloop merupakan pilihan untuk digunakan sebagai alat vitrifikasi blastokis. Data awal yang kami sampaikan dan kelahiran bayi dari program tersebut memberikan harapan untuk kesuksesan program simpan beku embrio di klinik Permata Hati RSUP DR Sardjito Yogyakarta.Kata kunci: kriopreservasi, blastokis, vitrifikasiÂ ABSTRACTBackground: Vitrification has been applied succesfully in human embryo using grid, straw and cryoloop. Gama Sleeved is a home made device develop at Permata Hati. We assessed the survival rate of human blastocyst vitrified in 0.1Âµl Gama Sleeved cryoloop as device.Method: Excess good grade human D5 embryos were vitrified, upon a detailed informed consent. Embryos were hold in handling media (GMOPS Plus; Vitrolife) for 1 minute; (7.5% EG (v/v); 7.5% DMSO (v/v)) for 2-3 minutes, (15% EG (v/v); 15% DMSO v/v; 10 mg/ml Ficoll; 0.65 M Sucrosa) for 30 seconds at room temperature before inserted in to the loops, then directly plunged into the liquid nitrogen. Prior to ET, embryos were warmed by two step technique in sucrose 0.25M for 2 min and 0.125M sucrosa for 3 min. Embryos were then cultured.Results: Total of 97 vitrified warmed human blastocyst (67 patients) were used and 91 (93.8%) were transferred. Non-transferred blastocyst (6.2%) has more than 50% lyse. The clinical pregnancy rate was 43.9%. The implantation rate was 37.4%. Currently, 20 deliveries of 23 babies born from vitrified blastocyst using 0.1Âµl Gama Sleeved cryoloop, and another 5 ongoing pregnancy. So far there was 1 early pregnancy loss, 2 miscarriages at 12 weeks pregnancy, and one infant died due to a congenital anomaly.Conclusion: 0.1Âµl Gama Sleeved cryoloop provides an excellent alternative to existing vitrification devices. These initial data and babies delivered from the program have been promising to a vitrification system in our own ART program.Keywords: cryopreservation, blastocyst, vitrification1Permata Hati Infertility Clinic RSUP DR Sardjito, Yogyakarta2Div Reproductive Endocrinology and Fertility OBGYN Medical Faculty Gadjah Mada University, Yogyakarta3Lab. Anatomi Embriologi FKH, Institut Teknologi Pertanian, Bogor4EPRD- Dept. Obstetrics and Gynecology, Monash University, Monash Medical Center,Victoria, Melbourne5Lab. Reproductive Physiology, Jenderal Soedirman University, PurwokertoÂ Correspondence address: + 62 274 518684; fax + 62 274 553575; email: itafauzia@yahoo.com

A Novel Variant of HOXA10 gene, Ser19Cys, among Patients with Endometriosis and its Relationship with the Severity of the Disease Hutajulu, Pinda; Dasuki, Djaswadi; Sadewa, Ahmad Hamim; Utoro, Totok
Indonesian Journal of Biotechnology Vol 18, No 1 (2013)
Publisher : Universitas Gadjah Mada

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Endometriosis is a gynecological disease associated with inherited genetic traits. HOXA10 gene whichis expressed in uterine plays an important role in the pathogenesis of endometriosis. The protein affects thedevelopment of pinopodes as a biomarker of endometrial receptivity in endometriosis.The aim of this study isto examine if there is a mutation or polymorphism within HOXA10 gene among patients with endometriosis.Thirty twopatients and 32 healthy women were recruited as subjects of this study. The exon 2 of HOXA10which covers most of coding region was amplifi ed using PCR. The presence of a mutation or polymorphismwas detected by direct seguencing. The distribution of genotype and allele was analyzed using Chi square test with p<0.05 is considered as signifi cantly different. A novel heterozygous variant within exon 2 of HOXA10 which substitute an adenine into thymine was detected at base position 55. This missense alteration changed amino acid serine to cystein (Ser19Cys). Interestingly, this variant was detected in 12 endometriosis cases (38%) but none in control. Patients carry HOXA10 Ser19Cys variant were associated with dismenorea and more frequent in stage I endometriosis. The role of this variant in the function of HOXA10 protein and frequency among Indonesians need to be clarifi ed. We found a novel heterozygous HOXA10 gene variant, Ser19Cys.The genotype frequency is 38% among endometriosis patients but none in control. This variant found in patient with dismenore and endometriosis stage 1.Key words: HOXA10 gene, endometriosis, Ser19Cys polymophism

EFEK PIJAT PUNGGUNG TERHADAP PRODUKSI ASI PADA IBU PASCA BEDAH SESAR Dewi, Adinda Putri Sari; Dasuki, Djaswadi; Kartini, Farida
Kesmas Indonesia Vol 9 No 02 (2017): Jurnal Kesmas Indonesia
Publisher : Jurusan Kesehatan Masyarakat dan Fakultas Ilmu-Ilmu Kesehatan Universitas Jenderal Soedirman

The purpose of this research To find out the effect of back massage  as one of the ways in improving the breast milk production of the post secarean section mothers. The study used Randomized Controlled Trial design. The samples were taken using simple random sampling with a total of  27samples for each group (intervention and control). Bivariat analysis used chi square with a significance level of p <0.05. Multivariate analysis used logistic regression to identify confounding variables to milk production after cesarean section. The results indicate that there is a difference in milk production between the intervention and the control groups with an RR of 1.9 (95% CI: 1.097 to 3.291). Parity and frequency of breastfeeding have significant correlation with breast milk production. Motherâs age, obesity, and in patient have no significant correlation with breast milk production.

Pengaruh inisiasi menyusu dini terhadap praktik menyusui 1 bulan pertama Legawati, Legawati; Dasuki, Djaswadi; Julia, Madarina
Jurnal Gizi Klinik Indonesia Vol 8, No 2 (2011): Oktober
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Background: The period of the first month of life is a critical moment for the sustainability of breastfeeding practices. Therefore optimal efforts are needed to maintain the breastfeeding practices. Early initiation of breastfeeding can help increase maternal confidence and support psychological condition of mothers in order to continue breastfeeding practices.Objective: To evaluate the impact of the early initiation of breastfeeding on breastfeeding practices in the first month of infant life.Method: The study was observational with cohort prospective study design using quantitative and qualitative approaches. Samples were 106 pairs of mothers and babies. The group from Pahandut Public Health Center (PHC) consisted of 53 women with early initiation of breastfeeding (exposed group) and the group from Tangkiling PHC consisted of 53 women without early initiation of breastfeeding (non exposed group). In both groups, dissemination on early initiation of complete breastfeeding and exclusive breastfeeding practices followed with one month breastfeeding practices was given. The quantitative data analysis was done in three stages. In addition, qualitative data analysis used exploration of in depth interview.Results: The result of mutivariable analysis with modeling showed that there was a significant relationship between early initiation of breastfeeding and breastfeeding practices in the first month of life (by controlling the variables of the decision to breastfeed, nipple condition, residence and gestational age) that could give contribution as much as 49% for breastfeeding practices in the first month of life. The result of in depth interview showed that breastfeeding practices were highly infuenced by information obtained by the women when checking up their pregnancy so that the decision to breastfeed could be made in advance and the women perceived the beneft of breastfeeding practices for her and her infantâ€™s health. There were some reasons why the mother did not give complete breastfeeding, among others were the abnormal nipple condition and the motherâ€™s fear on her childâ€™s health for preterm baby.Conclusion: Breastfeeding practices in the first month of life occured more in mothers who practiced early initiation of breastfeeding than in those who did not. Mothers with at term delivery, nipple normal condition, breastfeeding decision prior to delivery, and residence in rural areas had greater chance of practicing breastfeeding in the first month of life.

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