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All Journal Jurnal NERS Indonesian Journal of Cancer JIMKesmas (Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat) Majalah Obstetri dan Ginekologi Pediomaternal Nursing Journal Indonesian Journal of Cancer
PUNGKY MULAWARDHANA, PUNGKY
Departemen Obstetri Ginekologi, Fakultas Kedokteran Universitas Airlangga, RSUD Dr. Soetomo, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Comparison Between HE4, CA-125, and Combination of Both HE4 and CA-125 as Tumor Markers for Epithelial Ovarian Carcinoma Patients MULAWARDHANA, PUNGKY; ASKANDAR, BRAHMANA; -, SOEHATNO
Indonesian Journal of Cancer Vol 6, No 2 (2012): Apr - Jun 2012
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Tujuan: Mengetahui dan membandingkan sensitivitas, spesifisitas, Positive Predictive Value, dan Negative Predictive Value antara  HE4, CA-125, serta kombinasi  HE4 dan CA-125 sebagai  tumor  marker pada pasien  kanker ovarium tipe epitel. Mengetahui adanya korelasi antara kadar HE4 dengan kadar CA-125 serum pada pasien tumor ovarium.Metode penelitian dan tempat:  Penelitian ini merupakan studi observasional analitik dengan  cross-sectional, dilaksanakan di poli, ruang kandungan, dan Laboratorium Patologi  Klinik RSU dr. Soetomo, sert laboratorium Prodia. Sampel dan alur penelitian: Terdapat 53 pasien dengan  tumor  ovarium  yang dioperasi di RSU dr. Soetomo antara Februari sampai  Mei 2011 yang memenuhi kriteria inklusi dan ekslusi. Terhadap masing-masing pasien dilakukan pemeriksaan HE4 dan CA-125 pada  1 hari sebelum operasi.  Setelah  hasil PA selesai,  didapatkan 11 pasien  yang mengalami drop out, 42 pasien  lainnya kami masukkan dalam analisa  penelitian dengan  rincian 17 pasien  kanker ovarium tipe epitel  dan 25 pasien  dengan  tumor  jinak ovarium. Peneliti  berusaha mengetahui dan membandingkan sensitivitas, spesifisitas, Positive Predictive Value, dan Negative Predictive Value antara HE4, CA-125, serta kombinasi HE4 dan CA-125 sebagai tumor marker pasien kanker ovarium tipe epitel.Hasil penelitian: Analisis statistik  Mc Nemar menunjukan kadar CA-125 serum memiliki perbedaan yang bermakna  dengan  hasil PA (p = 0,004), sedangkan kadar HE4 serum (p = 1,000) dan kombinasi kadar HE4 & CA-125 serum (p = 0,344) tidak memiliki perbedaan yang bermakna dengan hasil PA dalam menentukan diagnosis kanker ovarium. Spesifisitas kombinasi HE4 dan CA-125 (88,00%) lebih baik dari HE4 (80,00%) maupun CA-125 (20,00%). Sensitivitas HE4 (76,47%) lebih baik dari CA-125 (70,59%) maupun kombinasi  HE4 dan CA-125 (58,82%). Positive predictive value kombinasi  HE4 dan  CA-125 (76,92%) lebih  baik dari HE4 (72,22%) maupun CA-125 (37,50%). Negative predictive value HE4 (83,33%) lebih baik dari kombinasi HE4 dan CA-125 (75,86%) maupun CA-125 (50,00%). Uji korelasi dari Pearson  menilai semua  pasien  sampel  tumor ovarium mendapatkan adanya korelasi kadar HE4 serum dengan  CA-125 serum, nilai r = 0,453 (p = 0,003).Kesimpulan: Kombinasi HE4 dan CA-125 memiliki nilai diagnostik lebih tinggi dibandingkan dengan  HE4 tunggal  dan CA-125 tunggal  sebagai tumor marker kanker ovarium tipe epitel. Terdapat korelasi antara kadar CA-125 serum  dengan  kadar HE4 serum  pada  pasien  tumor  ovarium, walaupun  tidak ada hubungan patofisiologi antara  kedua tumor marker tersebut.Kata kunci: HE4, CA-125, sensitivitas, spesifisitas, positive  predictive value, negative predictive value, kanker ovarium tipe epitel, tumor jinak ovarium
Ekspresi CD44 (Penanda Sel Punca Kanker) sebagai Faktor Prognostik Kekambuhan pada Kanker Ovarium Tipe Epitel Stadium III MULAWARDHANA, PUNGKY; YULIATI, INDRA; SUDIANA, KETUT
Indonesian Journal of Cancer Vol 11, No 3 (2017): July - September 2017
Publisher : Indonesian Journal of Cancer

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Abstract

Epithelial ovarian cancer is a deadly cancer, cancer recurrence and resistance post surgical staging and chemotherapy are major problems which will eventually occur in most advanced stage ovarian cancer. Recent investigations have unravelled the role of CSC/ Cancer Stem Cell in the cancer recurrence and therapy resistance, CD44 has been reported as a CSC marker in ovarian cancer, investigator wanted to analyse CD44 expression as recurrence prognostic factor in stage III epithelial ovarian cancer. Purpose: to analyse the role of CD44 expression as recurrence prognostic factor in stage III epithelial ovarian cancer. Metode: Hystorical Cohort, ICH CD44 examination was performed on the pathological ovarian cancer sample which diagnosed with platinum resistant recurrence (study sample) and platinum sensitive recurrence (control sample). CD44 expression was measured, the role as recurrence prognostic factor evaluated, influence of CD44 expression increasetowards earlier recurrence analysed, and the CD44 expression differences between 2 groups based on grade; pathological type; and stadium were measured and analysed. Results: 40 research subjects were involved in the research, with 20 among them were platinum resistant and the other 20 were platinum sensitive. Mean CD44 expression in the platinum resistant group was 36,80+29,54; while in the resistant platinum was 7,05+9,58. There was a significant difference of CD44 expression between 2 groups (p=0,000). There was a strong correlation between CD44 expression with the timing of recurrence (p=0,894). With the cut off of12,5; 85% platinum resistant subject had CD44>12,5; 85% platinum sensitive subject had CD44<12,5; with 85% sensitivity and 85% specificity as a good recurrence prognostic factor. Relative Risk (RR) of CD44 Expression is 5,667, RRof tumor residue post surgical staging is 2,513. Through logistic regression analysis, it was concluded that high expression of CD44 and tumor residue are risk factors for recurrences, patient with CD44 expression of ≥ 12,50 has possibility of earlier recurrence (< 6 months) 48,487 times compared with patient with CD44 expression of < 12,50 and patient with tumor residue of < 1cm has possibility of earlier recurrence 13,013 times compared with patient without macroscopic residue.Conclusion: This research found that CD44 expression can be used as recurrence prognostic factor in stage III epithelial ovarian cancer, CD44 expression was significantly higher in the platinum resistant group, there was negative correlationbetween CD44 expression with the timing of recurrence. CD44 expression as recurrence prognostic factor was not influenced with grade and pathologic type, but influenced by stage. Expression of CD44 and tumor residue post surgical staging are good predictors for recurrence timing.ABSTRAKKanker ovarium tipe epitel adalah suatu kanker yang mematikan. Kekambuhan dan resistansi kanker pasca-surgical staging dan kemoterapi merupakan masalah utama yang akan terjadi pada sebagian besar kanker ovarium stadium  lanjut. Penelitian-penelitian terbaru mengemukakan peran CSC (Cancer Stem Cell) dalam proses kekambuhan dan resistansi terapi. CD44 telah dilaporkan sebagai marker CSC pada kanker ovarium. Peneliti ingin meneliti ekspresi CD44 sebagai faktor prognostik kekambuhan kanker ovarium tipe epitel stadium III. Penelitian ini bertujuan menganalisis peran ekspresi CD44 sebagai faktor prognostik kekambuhan pada kanker ovarium tipe epitel stadium III. Metode yang digunakan dalam penelitian ini adalah hystorical cohort, di mana dilakukan pemeriksaan IHC CD44 pada sampel PA pasien kanker ovarium yang mengalami kekambuhan resistan platinum (sampel studi) dan sensitif platinum (sampel pembanding). Ekspresi CD44 diukur, peran sebagai faktor prognostik kekambuhan dievaluasi, pengaruh peningkatan ekspresi CD44 pada kekambuhan yang lebih dini dianalisis, dan perbedaan ekspresi CD44 dinilai pada 2 kelompok berdasarkan grade, tipe PA, dan stadium. Sebanyak 40 subjek penelitian dengan rincian 20 kelompok resistan platinum dan 20 kelompok sensitif platinum diikutkan dalam penelitian ini. Rerata ekspresi CD44 pada kelompok resistan adalah 36,80+29,54 dan kelompok sensitif platinum 7,05+9,58. Didapatkan perbedaan signifikan ekspresi CD44 di antara dua kelompok (p=0,000). Didapatkan pula hubungan yang kuat antara ekspresi CD44 dengan waktu kekambuhan (p=0,894). Dengan cut off 12,5; 85% sampel resistan platinum memiliki CD44>12,5 dan 85% sampel sensitif platinum memiliki CD44<12,5 dengan sensitivitas 85% dan spesifisitas 85% sebagai faktor prognostik kekambuhan yang baik. Didapatkan RR ekspresi CD44 sebesar 5,667, RR residu tumor pasca-surgical staging sebesar 2,513. Melalui analisis regresi logistik, didapatkan bahwa ekspresi CD44 yang tinggi dan adanya residu merupakan faktor risiko kekambuhan. Penderita dengan ekspresi CD44 ≥ 12,50 berisiko kambuh <6 bulan sebesar 48,487 kali penderita dengan ekspresi CD44 < 12,50; dan penderita dengan residu < 1 cm berisiko kambuh <6 bulan sebesar 13,013 kali penderita tanpa residu makroskopik. Penelitian ini menyimpulkan bahwa ekspresi CD44 dapat dipakai sebagai faktor prognostik kekambuhan pada kanker ovarium tipe epitel stadium III, ekspresi CD44 secara signifikan lebih tinggi pada kelompok resistan platinum, serta ada hubungan negatif antara ekspresi CD44 dengan waktu terjadinya kekambuhan. Ekspresi CD44 sebagai faktor prognostik tidak dipengaruhi oleh grade dan tipe PA, tetapi dipengaruhi oleh stadium kanker. Ekspresi CD44 dan residu tumor pasca-surgical staging merupakan indikator prediktif yang baik untuk kecepatan kekambuhan.
HUBUNGAN ANTARA USIA IBU HAMIL BERISIKO DENGAN BERAT BADAN LAHIR BAYI DI PUSKESMAS TANAH KALI KEDINDING SURABAYA Samantha, Ines; Fatmaningrum, Widati; Mulawardhana, Pungky
(Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat) Vol 6, No 1 (2021): JIMKesmas (Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat)
Publisher : Universitas Halu Oleo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37887/jimkesmas.v6i1.16366

Abstract

Abstrak Berat badan lahir bayi merupakan berat bayi yang ditimbang pada waktu satu jam pertama setelah dilahirkanyang menjadi indikator penting dalam kerentanan anak terhadap penyakit dan kemampuan untuk bertahanhidup. Berat badan lahir rendah merupakan masalah kesehatan masyarakat yang menjadi salah satu faktortingginya angka kematian bayi yaitu sekitar 60 – 80% (WHO,2018). Berat badan lahir rendah dapat dipengaruhioleh multifaktor salah satunya usia ibu hamil berisiko yang dapat dikategorikan menjadi dua yaitu usia muda(<20 tahun) dan usia tua (>35 tahun). Penelitian ini bertujuan untuk menganalisis hubungan antara usia ibuhamil berisiko dengan berat badan lahir bayi di Puskesmas Tanah Kali Kedinding Surabaya. Jenis penelitian iniyaitu analitik observasional dengan rancangan cross sectional, menggunakan data sekunder berupa rekammedis dengan simple random sampling. Hasil uji analisis menggunakan independent t-test menunjukkan tidakadanya perbedaan yang signifikan antara rata – rata berat badan lahir bayi yang dilahirkan dari ibu dengan usiaberisiko dan tidak berisiko (p = 0,436) di Puskesmas Tanah Kali Kedinding Surabaya. Responden dengan UsiaBerisiko melahirkan bayi dengan berat badan rata-rata 3034,78 gram dan Usia tidak berisiko melahirkan bayidengan rata-rata berat badan 3125,38 gram. Dapat disimpulkan bahwa tidak terdapat hubungan antara usiaibu hamil berisiko dengan berat badan lahir bayi di Puskesmas Tanah Kali Kedinding Surabaya, namun ibudengan usia berisiko memiliki rata-rata berat lahir bayi yang lebih rendah dibandingkan dengan usia tidakberisikoKata Kunci : Berat badan lahir bayi, BBLR, Usia ibu berisiko (<20 tahun dan >35 tahun)
Demografi, Respon Terapi dan Survival rate Pasien Kanker Serviks Stadium III-IVA yang Mendapat Kemoterapi Dilanjutkan Radioterapi Yuski Amin; Pungky Mulawardhana; Dyah Erawati
Majalah Obstetri dan Ginekologi Vol. 23 No. 3 (2015): September - Desember 2015
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (132.506 KB) | DOI: 10.20473/mog.V23I32015.97-105

Abstract

 Tujuan: Mengetahui demografi pasien kanker serviks III-IVa, respon terapi dan survival rate pasien kanker serviks stadium III-IVA yang mendapat kemoterapi dilanjutkan radioterapi di RSUD Dr. Soetomo Surabaya tahun 2011-2013.Bahan dan Metode: Penelitian ini adalah penelitian deskriptif rektrospektif dengan menggunakan rekam medis Poli Onkologi Kandungan dan SMF/Instalasi Radioterapi RSUD Dr.Soetomo. Subyek penelitian adalah pasien kanker serviks III-IVA yang mendapat kemoterapi dilanjutkan radioterapi mulai Januari 2011 sampai Desember 2013. Analisis statistika pada penelitian ini menggunakan analisis deskriptif dan analisis survival meng-gunakan metode Kaplan Meier.Hasil: Selama tahun 2011-2013 didapatkan kunjungan pasien baru kanker serviks III-IVA sebanyak 648 pasien. Jumlah pasien kanker serviks IIIA sebanyak 48 kasus, stadium IIIB sebanyak 594 kasus dan stadium IVA sebanyak 6 kasus. Jumlah pasien kanker serviks III–IVA yang mendapat kemoterapi dilanjutkan radioterapi selama tahun 2011-2013 sebanyak 77 pasien. Pasien kanker serviks stadium IIIA sebanyak 8 pasien, stadium IIIB sebanyak 69 pasien. Tidak ada pasien kanker serviks stadium IVA yang mendapat kemoterapi dilanjutkan radioterapi. Respon terapi komplet sebesar 88,3% dan respon terapi inkomplet sebesar 11,7%. Analisis survival dengan metode Kaplan-Meier didapatkan 2-YSR dan 3-YSR kanker serviks stadium IIIA sebesar 86% dan 34%. Pada stadium IIIB didapatkan 2-YSR dan 3-YSR sebesar 47% dan 25%.Median survival pada semua kelompok pada penelitian ini adalah 25 bulan.Simpulan: Jumlah pasien kanker serviks III-IVA yang mendapat kemoterapi dilanjutkan radioterapi selama tahun 2011-2013 sebanyak 77 pasien. Respon terapi komplet pasca radioterapi sebesar 88,3% dan respon terapi inkomplet sebesar 11,7%. Hasil analisis survival didapatkan 2-YSR dan 3-YSR kanker serviks stadium IIIA sebesar 86% dan 34%. Pada stadium IIIB didapatkan 2-YSR dan 3-YSR sebesar 47% dan 25%. 
Ovarian cancer with pleural and lung metastasis in Dr. Soetomo Hospital, Surabaya, Indonesia, in 2014-2015 Fitria Khusnul Khotimah; Anna Febriani; Pungky Mulawardhana
Majalah Obstetri dan Ginekologi Vol. 26 No. 1 (2018): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (330.284 KB) | DOI: 10.20473/mog.V26I12018.7-19

Abstract

Objectives: To know the characteristics of ovarian cancer patients with pleural and lung metastasis, and survival rates of ovarian cancer patients with pleural and lung metastasis in Dr. Soetomo Hospital Surabaya in 2014-2015.Materials & Methods: This was a descriptive observational study using secondary data from medical records in dr. Soetomo Hospital, Surabaya, Indonesia, in 2014 and 2015Results: Number of new patients of ovarian cancer in dr. Soe-tomo, Hospital, Surabaya in 2014 was 170 patients (14%) and 122 patients (12%) in 2015. Ovarian cancer patients most often came at the stage IIIC (33.38%) with the most histopathological type was epithelial ovarian cancer. There were 5 patients with ovarian cancer with pleural metastasis and 7 patients with lung metastasis. Pleural metastasis was 80% diagnosed at the time of ovarian cancer’s diagnosis, whereas 57.15% of lung metastasis were diag-nosed >12 months after the ovarian cancer’s diagnosis. Pleural metastasis was established by pleural fluid cytology, while lung metastasis with radiological features and/or biopsies. The most common feature of lung metastasis was nodal (71.42%). Ascites was found in 80% of ovarian cancer with pleural metastasis, but only 42.86% in lung metastasis. In 2 patients receiving NAC chemotherapy and continued by interval debulking, both had negative residues. Median survival rate in ovarian cancer with pleural metastasis was 7 months, whereas in lung metastasis was 12 months.Conclusions: Number of new patients of ovarian cancer in 2014-2015 in dr. Soetomo Hospital was on rising and was the second largest number of visits after cervical cancer. In 2014-2015, there were 5 patients with ovarian cancer and pleural metastasis and 7 patients with ovarian cancer patients and lung metastasis. Median survival rate in ovarian cancer with pleural metastasis was 7 months, whereas in lung metastasis it was 12 months.
Problem diagnostic of Krukenberg tumor Reza Wangsanagara; Pungky Mulawardhana; Vicky Sumarki; Anny Setijo Rahaju; Tri Wulanhandarini
Majalah Obstetri dan Ginekologi Vol. 27 No. 1 (2019): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (639.482 KB) | DOI: 10.20473/mog.V27I12019.34-39

Abstract

Objectives: to report the case of Krukenberg tumor in 57 years old woman, with complaints of abdominal enlargement since the last 10 months.Case Report: a 57 years old woman, multipara, post menopause, came to our hospital with complaints of enlarging abdomen. Abdominal physical examination showed enlarging abdomen, hard palpable mass, measured 17 cm in diameter, and limited mobility. Abdominal CT result showed solid mass of the right adnexal, expanding to upper right abdomen, omental cake, ascites, and left pleural effusion, right lobe hepatic cyst and multiple bilateral renal cysts. Patient was diagnosed as solid ovarian tumor, suspicious of malignancy. Colonoscopy revealed hemorrhoid interna. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was done. Histopathologic findings showed malignant ovarian tumor, signet ring cell carcinoma of the cervics, endometrium, myometrium, nodule in gastrocolica ligament, and prevesica urinaria nodule. IHC examination of the ovarian tumor showed possible source was of colorectal, supporting the diagnosis of Krukenberg tumor with CK20 (+) and CK7 (-)Conclusion: Krukenburg tumor is a rare ovarian malignancy. Clinical symptoms usually consist of abdominal distension, pain caused by large ovarian mass. Diagnosis of Krukenburg tumor is confirmed by characteristic histologic findings of malignant signet ring cells with cellular stroma. Management for ovarian tumor is surgery removal, with very poor prognosis.
Abdominal skin metastasis in endometrial cancer Eccita Rahestyningtyas; Pungky Mulawardhana; Tomy Lesmana
Majalah Obstetri dan Ginekologi Vol. 27 No. 2 (2019): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (542.307 KB) | DOI: 10.20473/mog.V27I22019.84-89

Abstract

Objectives: Surgical wound metastases in stage 1 endometrial cancer are possible, with a variety of different pathophysiological possibilities. Comprehensive management is needed to keep the patient on the possibility of a good prognosis.Cases Report: During January 2015 – January 2018 at dr. Soetomo Hospital, there were 2 cases of metastatic endometrial cancer in the laparotomy wounds by which the condition is very rare. Case 1, The patient was diagnosed with endometrial carcinoma following the results of curettage. Anatomical pathology examination was done and obtained grade 2 endometrioid adenocarcinoma. In Case 2, the patient underwent Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy in 2013 at Mojokerto General Hospital, indicating Uterine Fibroids and Ovarian Cysts. The results of anatomical pathology examination were unknown. On April 2017, the patient complained abdominal swelling since 3 months ago.Conclusion: In January 2015 - January 2018, 2 cases of metastatic endometrial cancer was found in a former laparotomy operation where this condition is very rare in endometrial cancer cases with low grade ,so that follow-up, monitoring and more vigilance are required in patients with low-grade endometrial Ca who have finished undergoing a surgery and chemotherapy. Rapture or mass resection, followed by external radiation, may be performed in patients with recurrence in the laparotomy wound area or in patients with high risk factors for endometrial cancer such as a history of estrogen use, tamoxifen, nullipara, obesity, diabetes mellitus, and family history of endometrial cancer. Currently, there is no fixed procedure (guideline) in RS. Dr. Soetomo to overcome recurrences especially in the scars of cancer surgery.
Association of age at menarche, parity, and hormonal contraceptive use with the histologic type of ovarian cancer Firda Azizah; Pungky Mulawardhana; Willy Sandhika
Majalah Obstetri dan Ginekologi Vol. 29 No. 3 (2021): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V29I32021.118-123

Abstract

HIGHLIGHT1. Relationship between age at menarche, parity, and contraceptive use with histologic type of ovarian cancer was analyzed. 2. A number of patients with ovarian cancer were analytically observed with retrospective cross-sectional approach and the histologic types of the cancer were determined.3. Age of menarche, parity, and hormonal contraceptive use was found not to have significant correlation with histologic type of ovarian cancer. ABSTRACTObjectives: This study analyzed the relationship between age at menarche, parity, and contraceptive use with histologic type of ovarian cancer.Materials and Methods: This study used an observational analytic with a retrospective cross-sectional approach. The research samples were 128 patients with ovarian cancer at Dr. Saiful Anwar Hospital, Malang, Indonesia, in 2017-2019. All patients underwent primary staging laparotomy. The histologic types of the ovarian cancer consisted of serous type as many as 45, mucinous 45, endometrioid 10, clear cell 20, and others 4. Data analysis used chi-square test.Results: The p value for the relationship between age of menarche and histologic type of ovarian cancer was p=0.500 (p> 0.05), parity p=0.313, and contraceptive use p=0.824. The distribution of clear cell was more common in multiparous, 40% of endometrioid found in nulliparous, while serous were more common in women with hormonal contraceptive use >5 years, whereas mucinous were more common in those with history of use of <5 years.Conclusion: There was no significant relationship between age of menarche, parity, and hormonal contraceptive use on  histologic type of ovarian cancer.
KNOWLEDGE, ATTITUDE, AND CULTURE INFLUENCE VISUAL INSPECTION WITH ACETIC ACID SERVICE USE Alifina Izza; Pungky Mulawardhana; Samsriyaningsih Handayani
Jurnal Ners Vol. 15 No. 2 (2020): OCTOBER 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v15i2.21250

Abstract

Background: The service use of visual inspection of cervix with acetic acid (VIA) has been low. This technique designed to detect cervical cancer at its earliest stage to prevent the unnecessary burden of its later stages. This study was aimed at showing the influence of knowledge, attitude and culture on the use of VIA service.Methods: This research was a paired case-control study, conducted in 2019 in in the working area of Kalijudan and Mulyorejo Community Health Centers, Surabaya. Ninety eight female respondents of childbearing age were grouped into control and case groups with 49 respondents respectively. Samples were chosen consecutively. Cases were obtained from the health centres’ records, while controls were chosen from cases’ close neighbours. Interviews were conducted in the respondents’ house using closed questionnaires.Results: The multivariate analysis showed that knowledge (p<0.001), attitudes (p=0.012) and culture (p=0.045) affected the use of VIA early detection services.Conclusion: This study pointed out that knowledge, attitude and cultural factors were influential factors in the use of VIA early detection services. Health workers may improve women’s knowledge and attitude through health promotion, and take into account supportive local cultural factors in the program to enhance the use of VIA.
Faktor Risiko Kejadian Atonia Uteri Mega Lestari; Pungky Mulawardhana; Budi Utomo
Pediomaternal Nursing Journal Vol. 5 No. 2 (2019): VOLUME 5 NO 2 SEPTEMBER 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/pmnj.v5i2.13459

Abstract

Introduction: Postpartum Hemorrhage is one of the main cause of maternal morbidity and mortality worlwide. Every 4 minutes one woman is estimated dead by this case. The cause of postpartum hemorrhage is known as ‘4 T’s’ (tone, tissue, trauma, and thrombin). Common aetiology of hemorrhage postpartum is uterine atony. Uterine atony can be caused by several risk factors . The aim of this study is to determine the correlation between advanced maternal age, grande multiparity, uterine overdistension, labour augmented, and prolonged labour as risk factors with the incidence of uterine atony.Methods: This study was an analysis of observational study with case-control design conducted at a tertiary hospital in Surabaya. The population was all medical record of postpartum women who had hemorrhage in 2016-2018. The case group was postpartum woman who had  hemorrhage due to uterine atony and the control group due to other causes. The sample size of the case group was 37 respondents and the control group was 35 respondents, they were obtained through purposive sampling. The independent variables in this study was maternal age, parity, uterine overdistension, labour augmented, and prolonged labour; the dependent variable was uterine atony. Univariate analysis was used to describe respondent’s characteristic and bivariate analysis was used to determine the correlation between risk factors and the incidence of uterine atony. Fisher Exact was used to analyze the data with α= 0,05.Results: Fisher Exact showed there was correlation between uterine overdistension and uterine atony (p value=0,036; OR= 4,423; 95% CI 1,023-27,267) on the other hand it showed no correlation between maternal age, parity, augmented labour, and prolonged labour with uterine atony (p value >0,05).Conclusion: Increased awareness of pre-conceptual care and early detection of risk factors are needed to reduce the risk factors of the incidence of uterine atony especially in uterine overdistension.
Co-Authors Alifina Izza Anak Agung Istri Sri Wiadnyani Anna Febriani Anny Setijo Rahaju, Anny Setijo Brahmana Askandar Tjokroprawiro Budi Utomo Dyah Erawati Eccita Rahestyningtyas Firda Azizah Fitria Khusnul Khotimah INDRA YULIATI, INDRA Jeremia Alvian Wiranata Mega Lestari Muhammad Hafiz Nila Kurniasari Reza Wangsanagara Samantha, Ines Samsriyaningsih Handayani SOEHATNO - SOEHATNO -, SOEHATNO Tomy Lesmana Tri Wulanhandarini Tsalitsa Fajrina Jauhari Vicky Sumarki Widati Fatmaningrum Willy Sandhika WITA SARASWATI, WITA Yuski Amin