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The Role of Tumor Necrosis Factor  (TNF ) and Matrix Metalloproteinase9 (MMP9) Serum in Preterm Premature Rupture of Membranes Ardiles, Ardiles; Desmiwarti, Desmiwarti; Bachtiar, Hafni
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the role of TNF- and MMP-9 serum in preterm premature rupture of membranes (PPROM). Methods: We used cross-sectional study design. Subjects were all pregnant women with and without PPROM who underwent checkup at Obstetrics and Gynecology Functional Medical Staff General Hospital Dr. M. Djamil and networking hospital. Results: A total of 48 subjects were enrolled in this study. The mean serum levels of TNF- in patients with PPROM 17.43 ng/ml  12.4 ng/ml and without PPROM 8.45 ng/ml  6.86 ng/ml. The mean serum levels of MMP-9 in patients with PPROM 8.77 ng/ml  4.41 ng/ml, and without PPROM 4.46 ng/ml  3.04 ng/ml. Statistical test result p value <0.05, it can be conclude there are differences in the levels of TNF- and MMP-9 serum in premature rupture of membranes and without premature rupture of membranes pregnancy of preterm. Conclusion: There are differences in the levels of TNF- and MMP-9 serum in PPROM and without PPROM.Keywords: MMP-9, premature rupture of membranes, TNF-

The Role of Tumor Necrosis Factor  (TNF ) and Matrix Metalloproteinase9 (MMP9) Serum in Preterm Premature Rupture of Membranes Ardiles, Ardiles; Desmiwarti, Desmiwarti; Bachtiar, Hafni
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the role of TNF- and MMP-9 serum in preterm premature rupture of membranes (PPROM). Methods: We used cross-sectional study design. Subjects were all pregnant women with and without PPROM who underwent checkup at Obstetrics and Gynecology Functional Medical Staff General Hospital Dr. M. Djamil and networking hospital. Results: A total of 48 subjects were enrolled in this study. The mean serum levels of TNF- in patients with PPROM 17.43 ng/ml  12.4 ng/ml and without PPROM 8.45 ng/ml  6.86 ng/ml. The mean serum levels of MMP-9 in patients with PPROM 8.77 ng/ml  4.41 ng/ml, and without PPROM 4.46 ng/ml  3.04 ng/ml. Statistical test result p value <0.05, it can be conclude there are differences in the levels of TNF- and MMP-9 serum in premature rupture of membranes and without premature rupture of membranes pregnancy of preterm. Conclusion: There are differences in the levels of TNF- and MMP-9 serum in PPROM and without PPROM.Keywords: MMP-9, premature rupture of membranes, TNF-

Faktor-Faktor yang Berhubungan dengan Pelaksanaan Penerapan Standar Asuhan Persalinan Normal Oleh Bidan Puskesmas Rawat Inap di Kabupaten Bungo Provinsi Jambi Evrina Solvia Soleh; Masrul Masrul; Desmiwarti Desmiwarti
Jurnal Ilmiah Universitas Batanghari Jambi Vol 18, No 3 (2018): Oktober
Publisher : Universitas Batanghari Jambi

Implementation of Standard Normal Birth Assembly is an integrated effort in reducing MMR and IMR. This activity is very important to be carried out considering that Bungo Regency has the highest maternal and infant mortality rates in Jambi Province. Several factors related to Standard Application of Normal Birth care in Bungo Regency are: Education, Training, Motivation, Perceptions of Rewards, Experience and Facilities. The objective of this research is to know factors related to the implementation of Normal Birth Standard by Inpatient Health Center Midwife in Bungo Regency. This study is an analytic observational study with a cross-sectional design of 47 midwives who served in Bungo Regency inpatient Health Center from July to September 2017. Respondents were interviewed and observed in implementing normal labor standards. Data processing was done by computerization and analyzed statistically using univariate, bivariate, and multivariate analysis with product moment correlation. There is a relationship between training with the implementation of normal labor standards (p = 0.001), there is a relationship between experience with the implementation of normal labor standards (p = 0.010). There is no correlation between perceptions of rewards and the implementation of normal labor (p = 0.539), there is no educational relationship with the implementation of normal labor standards (p = 0.404) and motivation with the implementation of normal labor standards (p = 1,000). The conclusion of this study is that training is the dominant factor that relates to the implementation of normal labor standards by midwives at the health center in Bungo regency..

Perbedaan Profil Lipid pada Akseptor Depo Medroksi Progesteron Asetat dengan Implant Levonorgestrel di Wilayah Kerja Puskesmas Air Tawar Padang Tahun 2014 Rafika Oktova; Desmiwarti Desmiwarti; Arni Amir
Jurnal Kesehatan Andalas Vol 4, No 1 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i1.186

AbstrakDepo Medroksiprogesteron Asetat dan Implant Levonorgestrel merupakan kontrasepsi hormonal progestin sintetik yang memiliki efek samping yaitu peningkatan berat badan dan mempengaruhi metabolisme lipid. Tujuan penelitian ini adalah untuk mengetahui perbedaan profil lipid pada akseptor Depo Medroksiprogesteron Asetat dengan Implant Levonorgestrel. Ini adalah studi observasional dengan desain cross sectional comparative. Penelitian dilakukan di laboratorium Bagian Biokimia Fakultas Universitas Andalas dari Maret sampai Mei 2014. Subjek penelitian terdiri dari dua kelompok, masing-masing 20 subjek. Pemeriksaan dengan metode enzimatis kolorimetri yaitu GPO-PAP untuk trigliserida, dan CHOD-PAP untuk kolesterol total, HDL dan LDL. Data dianalisis menggunakan uji t dengan nilai p<0.05 dianggap bermakna secara statistik. Rerata kadar LDL pada Depo Medroksiprogesteron Asetat lebih tinggi (95,51 ± 20,47) mg/dl daripada Implant Levonorgestrel (79,35 ± 12,55) mg/dl dengan nilai p<0,05 artinya terdapat perbedaan yang bermakna sedangkan kadar trigliserida, kolesterol total dan HDL tidak bermakna. Kesimpulan penelitian in adalah terdapat perbedaan yang bermakna rerata kadar LDL pada Depo MedroksiprogesteronAsetat dan Implant Levonorgestrel, sedangkan kadar trigliserida, kolesterol total dan HDL tidak bermakna. Secara klinis profil lipid pada kedua kelompok dalam keadaan normal.Kata kunci: profil lipid, depo medroksiprogesteron asetat, implant levonorgestrelAbstractDepo Medroxyprogesterone Acetate and Levonorgestrel Implants are synthetic progestine hormonal contraceptives that have side effect in body weight and lipid metabolism. The objective of this study was to determine the differences of lipid profile between acceptors Depo Medroxyprogesterone Acetate and Levonorgestrel Implants. This was a comparative cross sectional study. The study was done at laboratory of Biochemistry Departement in Medical Faculty of Andalas University from March until May 2014. The subjects were consisted of two groups, each group had 20 subjects. The examination used an enzymatic colorimetric method GPO-PAP for trygliserides and CHOD-PAP for total cholesterol, HDL and LDL. Data was analyzed using analysis of t-test with p<0.05 was considered to be significantly different. LDL levels average in Depo Medroxyprogesterone Acetate was (95,51 ± 20,47) mg/dl and Levonorgestrel Implants was (79,35 ± 12,55) mg/dl with p-value, it means there is a significantly difference, but levels of trygliserides, total cholesterol and HDL means there is no significantly difference. This research concluded that there is a significant difference on average levels of LDL in the Depo Medroxyprogesterone Acetate and Levonorgestrel Implants but levels of trygliserides, total cholesterol and HDL there is no significantly difference. The clinically lipid profile in the two groups is in normal range.Keywords: lipid profile, depo medroxyprogesterone acetate and levonorgestrel implants

Pengaruh Media Promosi Kesehatan tentang ASI Eksklusif terhadap Peningkatan Pengetahuan Ibu di Wilayah Kerja Puskesmas Lubuk Begalung Padang Tahun 2014 Binarni Suhertusi; Desmiwarti Desmiwarti; Emi Nurjasmi
Jurnal Kesehatan Andalas Vol 4, No 1 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i1.177

AbstrakUpaya meningkatkan cakupan pemberian ASI eksklusif sudah banyak dilakukan, diantaranya dalam bentuk promosi kesehatan. Namun demikian hingga saat ini kegiatan tersebut belum menunjukkan hasil yang optimal terutama dalam hal penggunaan media. Tujuan penelitian ini adalah untuk mengetahui pengaruh media promosi kesehatan terhadap peningkatan pengetahuan menggunakan media leaflet dan media film. Ini merupakan penelitian eksperimen semu (quasi-experimental) dengan rancangan pretest-posttest group design. Dilaksanakan di wilayah kerja puskesmas Lubuk Begalung Padang tahun 2014. Subjek penelitian adalah ibu hamil sebanyak 42 orang yang dipilih dengan cara simple random sampling. Subjek dibagi menjadi dua kelompok, kelompok pertama menggunakan media leaflet dan kelompok kedua dengan media film. Data dianalisis dengan uji Wilcoxon Signed Rank Test untuk mengetahui perbedaan pengetahuan sebelum dan sesudah promosi kesehatan dan uji Mann-Whitney membandingkan kedua media promosi kesehatan. Rata-rata pengetahuan responden sebelum diberikan promosi kesehatan dengan media leaflet 8,71 dan setelahnya 11,52. Pada media film sebelum diberikan promosi kesehatan 7,90 dan setelahnya 13,19. Selisih nilai pengetahuan responden dengan media leaflet 2,81 dan media film 5,29. Ada peningkatan pengetahuan ibu sebelum dan sesudah diberi promosi kesehatan dengan media leaflet dan media film. Media film lebih efektif meningkatkan pengetahuan dibanding dengan media leaflet.Kata kunci: ASI eksklusif, leaflet, filmAbstractVarious attempts have been taken to improve the granting of exclusive breastfeeding, one of them is health promotion. Nonetheless, the health promotion has not shown the optimal result especially on the use of media. The objective of this study was to determine the effect of health promotion regarding exclusive breastfeeding on the knowledge improvement of pregnant mothers either by using leaflet or film media. This was a quasi-experimental study with pretest-posttest group design. This study was conducted in the area of Lubuk Begalung health center Padang in 2014. The subjects were 42 pregnant women, choosen by using simple random sampling. The subject were divided into two categories. The first category was given a health promotion by using leaflet as the media and the second category was given by using film as the media. The data analyzed by using Wilcoxon Signed Rank Test to compare the knowledge of respondent before and after being given promotion and Mann-Whitney test to compare both of media. The average of respondent knowledge before being given health promotion by using leaflet was 8.71 and after being given health promotion was 11.52. In media film, the average of knowledge before was 7.90 and after was 13.19. The deviation of knowledge value of leaflet was 2.81 and film was 5.29. There is a significant knowledge improvement before and after being given the health promotion either by leaflet or film. Film is more effective in improving the knowledge of pregnant mothers compare than leaflet.Keywords:Exclusive Breastfeeding, leaflet, film

Kasus Persalinan Dengan Bekas Seksio Sesarea Menurut Keadaan Waktu Masuk di Bagian Obstetri dan Ginekologi RSUP Dr. M. Djamil Padang Anggy Afriani; Desmiwarti Desmiwarti; Husnil Kadri
Jurnal Kesehatan Andalas Vol 2, No 3 (2013)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v2i3.141

AbstrakKehamilan dengan bekas seksio sesarea merupakan kehamilan dengan risiko tinggi sehingga persalinannya harus dilakukan di rumah sakit dengan fasilitas yang memadai. Ibu hamil dengan bekas seksio sesarea yang akan melakukan persalinan seharusnya datang ke rumah sakit dalam keadaan belum in partu, belum ada komplikasi persalinan. Namun, masih banyak ibu hamil dengan bekas seksio sesarea datang ke rumah sakit dalam keadaaan in partu. Penelitian ini bertujuan untuk mengetahui kasus-kasus persalinan dengan bekas seksio sesarea saat masuk ke bagian Obstetri dan Ginekologi RSUP.dr.M.Djamil Padang. Penelitian ini dilakukan pada ibu hamil dengan bekas seksio sesarea yang datang ke RSUP.dr.M.Djamil untuk melakukan persalinan. Penelitian dilakukan pada tanggal 22 Desember 2012-21 Maret 2013 di bagian Obstetri dan Ginekologi RSUP. dr. M. Djamil Padang. Penelitian ini merupakan studi deskriptif. Kasus-kasus persalinan dengan bekas seksio sesarea didapat dari observasi rekam medik dan mewawancarai subjek penelitian dengan menggunakan kuesioner. Hasil penelitian didapatkan 52 kasus persalinan dengan bekas seksio sesarea. Premature rupture of membrane (PRM) merupakan kasus persalinan dengan bekas seksio sesarea terbanyak yaitu 13 kasus (25%) dan ibu hamil dengan bekas seksio sesarea yang melakukan rujukan dini berencana sebanyak 5,7%. Simpulan dari penelitian adalah masih kurangnya kesadaran ibu hamil dengan bekas seksio sesarea yang akan melakukan persalinan untuk datang ke rumah sakit beberapa hari sebelum tanggal taksiran persalinan.Kata kunci: bekas seksio sesarea, rujukan dini berencanaAbstractPregnancy with previous caesarean section is a high risk pregnancy. The delivery must be performed in hospital. The women who has previous caesarean section in their pregnancy must come to the hospital before the date of planned birth, no labor, and no complications for the woman and her infants. However, there are many woman with caesarean section come to the hospital in partu. The objective of this study to describe labor case of previous section birth when come to the Obstetric and Gynecology of dr.M.Djamil Padang Hospital. This study is descriptive .The subject of this study is a pregnant women with previous caesarean section who come to the dr.M.Djamil Padang hospital to the delivery. This study was performed from on 22rd December 2012 until 21rdMarch 2013 in Obstetric and Gynecology of dr.M.Djamil Padang. The labor case of previous caesarean section are gotten from medical record and interview with use questionnaire. The result of this study is gotten fifty two labor cases of previous caesarean section. Premature rupture of membrane (PRM) is the mayority labor case, thirteen case(25%) and account for 5,7% of woman with previous caesarean section who early referral plan come to the hospital. The conclusion is the woman who have previous caesarean section are not awarness to come to the hospital a few days before the plan birth.Keywords: previous caesarean section, early referral plan

Analisis Sistem Pelaksanaan Kelas Ibu Hamil di Puskesmas Malalak dan Biaro Kabupaten Agam Ayu Nurdiyan; Desmiwarti Desmiwarti; Rizanda Machmud
Jurnal Kesehatan Andalas Vol 4, No 1 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i1.173

AbstrakKelas ibu hamil merupakan sarana belajar bersama bagi ibu hamil agar memperoleh pengetahuan yang cukup untuk mencegah komplikasi, meningkatkan cakupan kunjungan ibu hamil dan melakukan persalinan pada tenaga kesehatan. Tujuan penelitian ini adalah untuk menganalisis sistem pelaksanaan kelas ibu hamil di Puskesmas Malalak dan Biaro Kabupaten Agam. Ini adalah suatu penelitian deskriptif kualitatif dengan melakukan wawancara terhadapa informan penelitian yang terdiri dari kepala dan kasie KIA (Kesehatan ibu dan Anak) dinas kesehatan kabupaten, kepala, fasilitator dan kader puskesmas, serta ibu hamil peserta kelas ibu hamil. Analisis input pelaksanaan kelas ibu hamil yaitu masih kurangnya pemahaman dari kebijakan yang sudah ada, tenaga yang belum cukup dan belum dilatih, sarana dan prasarana yang belum memadai. Analisis proses menunjukkan belum ada sosialisasi dengan stakeholder terkait, tahapan persiapan yang kurang matang karena kurangnya pertimbangan latar belakang budaya di Malalak, sehingga ditemukan berbagai kendala dalam hal pelaksanaan. Analisis output yaitu belum ada monitoring dan evaluasi khusus yang dilakukan oleh dinas kesehatan Kabupaten Agam dan kepala puskesmas Malalak. Secara keseluruhan kurangnya peran bidan dalam menjalankan tugas dan fungsinya sebagai pelaksana pelayanan kebidanan di komunitas dan belum adanya kolaborasi antar profesi dalam menjalankan program KIH. Sistem pelaksanaan kelas ibu hamil belum sesuai dengan pedoman pelaksanaan kelas ibu hamil. Perlu berbagai upaya yang dilakukan untuk mengoptimalkan dan mengembangkan pelaksanaan kelas ibu hamil.Kata kunci: puskesmas, analisis sistem, kelas ibu hamilAbstractAntenatal class is a learning tool for pregnant women to obtain sufficient knowledge to prevent complication, increase coverage of antenatal visits and having child delivery at the health care practitioner. The objective of this study was to analyze the system of antenatal class in Malalak and Biaro in Agam District. This is a descriptive qualitative study conducted interviews Informants as chief and section chief of maternal and child health department, head clinics, facilitator, cadre clinics and pregnant women who attend antenatal class. Analysis of input were lack of understanding of policy about antenatal class, lack of human resources and have not been trained for antenatal class, and inadequate infrastructure. Analysis of process showed the absence of socialization with relevant stakeholders, poor preparation which cause by lack of concern in culture in Malalak that make many barriers in implementation. Analysis of output showed the absence of specific monitoring and evaluation by ministry of health department and head of Malalak HC. In the whole system there is a lack of active role of midwife as a midwivery care practitioner in community in performing her duties and functions and there is none of interprofessional collaboration in implementation of this program. System of antenatal classes is not accordance with the guideline of antenatal class. Necessary effort to optimize and expand antenatal class implementation.Keywords: health care, system analysis, antenatal class

Hubungan Anxietas dengan Kejadian Amenore Sekunder pada Mahasiswi Fakultas Kedokteran Universitas Andalas Flora Oktavia; Desmiwarti Desmiwarti; Yaslinda Yaunin
Jurnal Kesehatan Andalas Vol 4, No 1 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i1.211

AbstrakAmenore sekunder merupakan salah satu gangguan siklus menstruasi yang berkaitan dengan penurunan fertilitas dan gangguan kesehatan organ reproduksi. Anxietas merupakan faktor yang dapat menyebabkan amenore sekunder. Tujuan penelitian ini adalah untuk mengetahui hubungan anxietas dengan kejadian amenore sekunder pada mahasiswi pendidikan dokter Fakultas Kedokteran Universitas Andalas angkatan 2009 dan 2010 yang dipilih sebagai subjek. Penelitian ini menggunakan cross sectional study dengan jumlah subjek 193 orang. Pengumpulan data dari responden dilakukan dengan wawancara terpimpin (pengisian kuesioner). Analisis statistik yang digunakan adalah uji chi square. Hasil penelitian menemukan bahwa kejadian amenore sekunder lebih banyak terjadi pada responden yang mengalami anxietas (36,3%), jika dibandingkan dengan responden yang tidak mengalami anxietas (2,1%). Uji statistik chi square menunjukkan ada hubungan yang bermakna antara anxietas dengan kejadian amenore sekunder (p<0,05) dan ada hubungan yang bermakna antara tingkat anxietas dengan kejadian amenore sekunder berdasarkan uji statistik chi square (p<0,05).Kata kunci: anxietas, amenore sekunder, mahasiswiAbstractSecondary amenorrhea is one a menstrual cycle disturbances have been associated with decreased fertility and various health disorderson reproductive systems. Anxiety have been found at risk of disturbances of the secondary amenorrhea.The objective of this study was to determine the association of anxiety with secondary amenorrhea in female medical faculty of Andalas University.This study used cross sectional study design with 193 samples. Data was collected by guided interview. Statistic analysis used chi square test. Result of this study found that incidence of secondary amenorrhea is more common in women who experience anxiety (36,3%), when compared with who did not has anxiety (2,1%). Chi square test statistic showthere was significant relationship between anxiety and secondary amenorrhea (p<0,05) and also there is significant relationship between anxiety levels and secondary amenorrhea base on statistic square test (p<0,05).Keywords:anxiety,secondary amenorrhea,female medical faculty

Hubungan Stresor Psikososial pada Kehamilan dengan Partus Prematurus Yuli Nenti Herlina; Desmiwarti Desmiwarti; Edison Desmiwarti
Jurnal Kesehatan Andalas Vol 5, No 1 (2016)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v5i1.456

Abstrak Partus prematurus merupakan suatu keadaan patologis dengan beragam penyebab, lebih kurang 50% disebabkan prematur spontan yang merupakan akselerasi sumbu HPA ibu-janin yang disebabkan stres fisik dan psikologis dalam kehamilan. Stres psikologis dapat disebabkan peristiwa kehidupan sehari-hari (stres psikososial) yang disebabkan stresor psikososial. Tujuan penelitian ini adalah menentukan hubungan beberapa stresor psikososial dengan partus prematurus. Penelitian ini merupakan studi analitik observasional dengan rancangan case control. Kasus adalah ibu bersalin dengan usia gestasi < 37 minggu sedangkan kontrol ≥ 37 minggu di rumah sakit, klinik bersalin dan praktik bidan di Kota Sawahlunto, Kota Payakumbuh dan Kota Pariaman pada tahun 2014. Sampel terdiri 36 kasus dan 36 kontol yang memenuhi kriteria inklusi. Analisis menggunakan uji chi-square dengan derajat kepercayaan 95% (α=0,05). Stresor masalah internal keluarga (p=0,009; OR=0,245; 95%CI=0,091–0,659) dan perubahan hidup lingkungan tempat tinggal (p=0,032; OR=0,253; 95%CI=0,080–0,807) ada hubungan dengan partus prematurus. Stresor kesulitan ekonomi, kehamilan sekarang serta beban pekerjaan tidak terbukti ada hubungan dengan partus prematurus. Stresor masalah internal keluarga dan perubahan hidup lingkungan tempat tinggal adalah beberapa stresor psikososial yang terbukti berhubungan dengan partus prematurusKata kunci: partus prematurus, stres, stresor psikososial AbstractPreterm labor is a pathologic state with various cases, less than 50% caused by spontaneous preterm labor which is an accelaration process of fetal–maternal hypothalamic pituitary adrenal axis that caused by physical and psychological stress during pregnancy. Psychological stresses caused by daily events (psychosocial stress) as a result from psychological stressor. The objective of this study was to determine the relationship between psychological stressor and preterm labor.This was an observational analytic study with case control design. Case group of samples were women who delivered in < 37 weeks of gestation, and control group of samples were women who delivered in > 37 weeks of gestation in hospital, maternity clinic, and private practice of midwives in Sawahlunto, Payakumbuh and Pariaman in 2014. Samples consist of 36 people for controls which met inclusion criteria. Data were analyzed by using chi-square test with 95% confidence interval (α=0.05). Internal family problems stressor (p=0.009; OR=0.245; 95%CI=0.091–0.659), and changes in life of environment (p=0.032; OR=0.253; 95% CI=0.080–0.807), that means there is relationship with preterm labor. Difficulty economic stressor, current pregnancy problem and workload were not proven relationship with preterm labor.Internal family problem and changes in life of environment are some of psychosogical stressor that had been proven has relationship with preterm labor.Keywords: preterm labor, stress, psychosocial stressor

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