Rukmono Siswishanto
Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan (FKKMK) UGM

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PENGARUH CARA PERSALINAN TERHADAP INISIASI LAKTASI Ismiana, Anna; Taufiqurrahman, Irwan; Siswishanto, Rukmono
JURNAL KESEHATAN REPRODUKSI Vol 1, No 3 (2014)
Publisher : IPAKESPRO

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Abstract

PENGARUH CARA PERSALINAN TERHADAP INISIASI LAKTASIAnna Ismiana 1, Irwan Taufiqurrahman2, Rukmono Siswishanto3ABSTRACT Background: Breastfeeding on the first day would prevent 16% of neonatal deaths and if early breastfeeding was given within the first 1 hour would prevent 22% neonatal of mortality per year.Objective: To determine the effect of mode of delivery on the initiation of breastfeeding.Method: The study was prospective cohort. The study was conducted by taking all cases of vaginal delivery and caesarean sections in the obstetric department of Dr. Sardjito, Banjarnegara Hospital, Wates Hospital, Wonosari Hospital and Magelang Hospital that met the criteria from January to May 2014. Maternal data were recorded from the medical records and the data of breast milk secretion within 24 hours after delivery were collected from paramedical personnel who had been trained before. The statistical test that is used was Chi-square.Results and Discussion: Subjects who met the inclusion criteria consisted of 162 women. Based on the mode of delivery, breastfeeding initiation on the first day after vaginal delivery were done in 73 women (90,1%), while in the cesarean delivery group, the initiation were done in only 34 women (42%). There were no significant relationship between age, education level, women occupation, and parity with the initiation of the first day of postnatal breastfeding. Statistically, BMI <25 kg/m2 had a significant association with 24 hours of postnatal breastfeeding initiation, but not clinically significant. There is a significant association between mode of delivery and the first day of postnatal lactation breastfeeding (OR=20,17;95% CI 7,47 to 54,43; p= 0,000).Conclusions: The proportion of the first day of breastfeeding initiation was larger in vaginal delivery group compared with cesarean delivery group.Keywords: mode of delivery, cesarean section, vaginal delivery, lactation initiation. ABSTRAKLatar Belakang: Pemberian Air Susu Ibu (ASI) pada hari pertama akan menyelamatkan 16% kematian neonatal dan jika menyusu dini dalam 1 jam pertama akan menyelamatkan 22% kematian balita pertahun dari kematian. Tujuan: Mengetahui pengaruh cara persalinan terhadap inisiasi laktasi.Metode: Studi kohort prospektif. Penelitian dilakukan dengan mengambil semua kasus persalinan vaginal dan seksio sesarea di RSUP Dr. Sardjito, RSUD Banjarnegara, RSUD Wates, RSUD Wonosari, dan RSUD Magelang yang memenuhi kriteria dari bulan Januari sampai dengan Mei 2014 sampai dengan sampel terpenuhi. Data maternal dicatat dari catatan medis, data penelitian didapat dari melakukan pemeriksaan keluarnya ASI dalam 24 jam pascasalin oleh petugas medis atau paramedis yang telah terlatih. Uji statistik yang digunakan adalah Chi-square. Hasil dan Pembahasan: Subyek penelitian yang memenuhi kriteria inklusi berjumlah 162 orang. Berdasarkan karakteristik cara persalinan, kejadian inisiasi laktasi hari pertama pascasalin pada persalinan vaginal sebanyak 73 orang (90,1%), sedangkan pada persalinan secara seksio sesarea sebanyak 34 orang (42%). Tidak didapatkan hubungan yang bermakna antara usia, tingkat pendidikan, pekerjaan, dan paritas dengan inisiasi laktasi hari pertama pascasalin. Secara statistik IMT <25 kg/m2 memiliki hubungan yang bermakna dengan inisiasi laktasi 24 jam pascasalin, namun tidak bermakna secara klinis. Terdapat hubungan yang bermakna antara cara persalinan dengan inisiasi laktasi hari pertama pascasalin (OR=20,17; 95%CI 7,47-54,43; p=0,000).Kesimpulan: Proporsi inisiasi laktasi hari pertama pascasalin pada kelompok persalinan vaginal lebih besar dibandingkan dengan kelompok persalinan seksio sesarea.Kata kunci: cara persalinan, seksio sesarea, persalinan vaginal, inisiasi laktasi 1,2,3 Bagian Obstetri dan Ginekologi, Facultas Kedokteran, Universitas Gadjah Mada
PENGARUH STATUS RAWATAN BAYI DI NICU TERHADAP RISIKO DEPRESI PASCASALIN Ema, Yasmina; Siswishanto, Rukmono Siswishanto; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 1, No 3 (2014)
Publisher : IPAKESPRO

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Abstract

PENGARUH STATUS RAWATAN BAYI DI NICU TERHADAP RISIKO DEPRESI PASCASALINYasmina Ema1, Rukmono Siswishanto2, Shofwal Widad3ABSTRACT Background: Postnatal depression is a frequent complication after childbirth, approximately occurred 6.5 to 14.5% in postnatal women. Untreated postnatal depression can have adverse long-term effects. Episodes of depression can be chronic so it will affect the quality of life. Depression that occurs in the mother will affect behavioral, emotional, cognitive, and child interpersonal is in the future. Post partum women whose babies are takenb care in the NICU is believed to have the level of depression, level of anxiety, and trauma symptoms that were higher compared with the women who don’t. The occurrence of depression is associated with a variety of factors, including the adaptation with a sick baby, having a baby that isolated in the NICU, and the stress arising from the NICU environment itself.Objective: To observe the influence of the status of infants in the NICU treatment on the incidence of postnatal depression.Method: This study used a cross-sectional design. The subjects were post portum women days 14-21 who met the criteria. Subjects were divided into 2 groups, one group of mothers with babies in the NICU and one group of mothers with babies under wentrooming. This study used edinburgh post natal depression scale (EPDS). Statistical test used was chi-square and logistic in regression.Results and Discussion: The subjects who met the criteria were 144 women. A total of 19 women was suffered from postnatal depression (13.1%). Educational status of husband and infant admision to NICU giving significant differences on postnatal depression (p = 0.027 and p = 0.047). Infant care in the NICU increased postnatal depression 3.34 times compared rooming in group (CI 95% 1.12 to 9.99).Conclusion: The proportion of postnatal depression group of mothers with infants treated in the NICU were larger than the rooming in group. Keyword: postnatal depression, neonatal intensive care admission, EPDS ABSTRAK Latar Belakang: Depresi pascasalin merupakan salah satu komplikasi yang sering muncul setelah persalinan, terjadi pada 6,5-14,5% dari wanita pascasalin. Depresi pascasalin yang tidak diobati dapat memiliki efek jangka panjang yang merugikan. Episode depresi ini bisa menjadi kronis sehingga akan mempengaruhi kualitas hidupnya. Depresi yang terjadi pada ibu akan mempengaruhi perilaku, emosi, kognitif, dan interpersonal anak di kemudian hari. Wanita pascasalin yang bayinya dirawat di NICU dipercaya mempunyai tingkat depresi, tingkat kecemasan, dan gejala trauma yang lebih tinggi dibandingkan dengan wanita pascasalin yang bayinya menjalani rawat gabung. Terjadinya depresi ini berhubungan dengan berbagai macam faktor, meliputi adaptasi dengan bayi yang sakit, memiliki bayi yang terisolasi di ruangan NICU, dan stress yang timbul karena lingkungan NICU itu sendiri.Tujuan: Mengetahui pengaruh status rawatan bayi di NICU terhadap kejadian depresi pascasalin.Metode: Penelitian ini menggunakan rancangan potong lintang. Subyek penelitian adalah pasien pascasalin hari ke 14-21 yang memenuhi kriteria inklusi. Subyek dibagi menjadi 2, kelompok ibu dengan bayi yang dirawat di NICU dan kelompok ibu dengan bayi rawat gabung. Penelitian ini menggunakan Edinburgh Post Natal Depression Scale (EPDS).Hasil dan Pembahasan: Subyek penelitian yang memenuhi kriteria berjumlah 144 orang. Sebanyak 19 ibu menderita depresi pascasalin (13,1%). Pendidikan suami dan status rawat bayi memberikan perbedaan secara bermakna terhadap depresi pascasalin (p= 0,027 dan p=0,047). Perawatan bayi di NICU meningkatkan risiko depresi pascasalin sebesar 3,34 kali dibanding perawatan bayi secara rawat gabung (CI 95% 1,12-9,99). Kesimpulan: Proporsi depresi pascasalin kelompok ibu dengan bayi dirawat di NICU lebih besar dibanding kelompok ibu dengan bayi rawat gabung.Kata kunci: depresi pascasalin, status rawat bayi NICU, skor EPDS. 1,2,3 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada
Relationship between perimenopause symptoms and bone mineral density Siswishanto Rukmono, Aida Djaswadi Dasuki
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (334.833 KB) | DOI: 10.19106/JMedScie004601201404

Abstract

The menopausal transition or perimenopause is associated with numerous symptoms. Womenentering perimonopause normally have menstrual irregular periods due to an imbalance of serumestradiol. Since the status of estrogen is known as an important determinant of bone massdensity, menopausal symptoms can be an effective indicator of bone status in women. Thisstudy aimed to evaluate the relationship between perimenopause symptoms and bone mineraldensity (BMD). This was an observational study using cross-sectional design conducted duringthree months periode from June to August 2010 in Kalangan Village, Banguntapan, BantulDistrict. Subjects were women between the aged 46-55 years who fulfilled the inclusion andexclusion criteria. After underwent history taking, subjects underwent physical examinationaccording to International Physical Activity Questionnaires (IPAQ). The BMD of subjects wasthan measured using dual-energy X-ray absorptiometry (DEXA). The relationship betweenperimenopause symptoms and BMD was then evaluated using multivariate analysis. The resultsshowed that perimenopause symptoms increase abnormal BMD of subjects 1.38 times higherthan those without perimenopause symptoms (RR=1.38; 95%CI 1.39-13.78; p=0.01). Inconclusion, the perimenopause symptoms is associated with the high proportion of abnormalBMD in women.
HUBUNGAN ANEMIA DALAM KEHAMILBAayi NKeci luTntuRk MIaMsa KeEhaSmilTan E(KMRK) dTi RIS GDr. ASard jito TERHADAP KEJADIAN BAYI KECIL UNTUK MASA KEHAMILAN (KMK) DI RS DR SARDJITO Ratnawati, Lili; Siswishanto, Rukmono; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (483.469 KB) | DOI: 10.22146/jkr.12652

Abstract

HUBUNGAN ANEMIA DALAM KEHAMILBAayi NKeci luTntuRk MIaMsa KeEhaSmilTan E(KMRK) dTi RIS GDr. ASard jitoTERHADAP KEJADIAN BAYI KECIL UNTUK MASA KEHAMILAN(KMK) DI RS DR SARDJITOLili Ratnawati*, Rukmono Siswishanto*, Ova Emilia*ABSTRACTBackground: The high prevalence of anemia during pregnancy at Yogyakarta could be associated with theadverse pregnancy outcome as SGA. Previous study reported inconsitent result about association betweenanemia during third trimester and babies with SGA. Research is needed to determine the contribution ofanemia during third pregnancy to the adverse pregnancy outcome at RS Dr Sarjito.Objective: To compare the prevalance of SGA between pregnancy with and without anemia during thirdtrimester at RS Dr Sarjito.Method: Cross sectional study based on RS Dr Sardjito’s medical record. The subjects of study werepregnant women who took delivery at RS Dr Sarjito during third trimester from 2010 to 2011. Anemiadefine as haemoglobin level < 11g/dl which performed before delivery. Babies with brith weigth < 10percentile Lubchenco curve group into SGA. Association between anemia during third trimester and SGAanalyzed with Chi square test and Fisher’s exact test.Resul and Discussion: A total of 239 subjects were recruited and devided into 146 subjects with anemiaand 93 subjects without anemia. The anemia groups consist of 97,95% mild anemia, 2,05% moderateanemia, and none severe anemia. The prevalence of SGA in total population, group with anemia, andgroup without anemia was 14%, 15,8%, and 10% irrespectively. The prevalance of SGA between groupwith and without anemia was not different (p=0,27; RR 1,46; 95%CI 0,73-2,93). Maternal age, BMIpregestational, education, and parity did not influence the prevalence of anemia and SGA. Consideringmultivariat analysis, neither anemia, maternal age, BMI pregestational, education, nor parity did not affectthe prevalance of SGA.Conclusion: In this study, the prevalence of SGA in pregnancy with and without anemia during thirdtrimester did not different at RS Dr Sarjito.Kata kunci: Anemia in pregnancy, third trimester, SGA.ABSTRAKLatar Belakang: Prevalensi anemia dalam kehamilan di Yogyakarta masih cukup tinggi sehingga dapatmenyebabkan peningkatan dampak buruk anemia terhadap janin, salah satunya KMK. Penelitiansebelumnya menunjukkan perbedaan hasil tentang hubungan anemia trimester tiga terhadap kejadianKMK. Penelitian tentang hubungan anemia dalam kehamilan trimester tiga terhadap kejadian KMK di RSSarjito penting dilakukan untuk mengetahui besarnya dampak negatif yang timbul akibat anemia dalamkehamilan.Tujuan: Mengetahui perbedaan kejadian bayi KMK pada ibu hamil dengan anemia pada trimester tigadibandingkan ibu hamil tanpa anemia di RS Dr Sarjito.Metode: Penelitian ini menggunakan rancangan cross sectional bersumber data rekam medis pasien ibuhamil trimester tiga yang bersalin di RS Dr Sardjito pada tahun 2010 s.d. 2011. Subyek penelitian yangmemenuhi kriteria inklusi dibagi dalam kelompok anemia dan normal. Hubungan antara anemia dengankejadian bayi KMK dianalisis dengan Chi square test dan Fisher’s exact test.Hasil dan Pembahasan: Subyek penelitian yang memenuhi kriteria sebanyak 239 orang terdiri atas 146orang kelompok anemia dan 93 orang kelompok tanpa anemia. Kelompok anemia terbagi atas 97,95%anemia ringan, 2,05% anemia sedang, dan tidak didapatkan anemia berat. Kejadian bayi KMK sebesar14% pada total populasi, 15,8% pada kelompok anemia dan 10% pada kelompok tanpa anemia. KejadianKMK kelompok anemia tidak berbeda bermakna secara statistik dibandingkan kelompok tanpa anemia(p=0,27; RR 1,46; 95%CI 0,73-2,93). Usia ibu, IMT sebelum hamil, pendidikan, dan paritas sebagai variabelluar yang diteliti tidak berpengaruh terhadap kejadian anemia maupun bayi KMK. Hasil analisis multivariatmenunjukkan bahwa anemia, usia ibu, Indeks Masa Tubuh (IMT) sebelum hamil, pendidikan, dan paritastidak berpengaruh terhadap kejadian bayi KMK.Kesimpulan: Pada penelitian ini, kejadian bayi KMK di RS Dr Sardjito tidak berbeda pada ibu hamil trimestertiga dengan anemia dibandingkan ibu hamil trimester tiga tanpa anemia.Kata kunci: Anemia dalam kehamilan, trimester tiga, KMK* Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada/RS Dr Sardjito Yogyakarta
Perubahan Nilai BA pada Pelvic Organ Prolaps Quantification (POPQ) terhadap Kualitas Berkemih Pre dan Pasca Opreasi Kolporafi Anterior paa Pasien Sistokel Ramadona, Izwin; Siswishanto, Rukmono; Pangastuti, Nuring
JURNAL KESEHATAN REPRODUKSI Vol 4, No 2 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.641 KB) | DOI: 10.22146/jkr.35427

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Background: Anterior colporrhaphy is used to correct anatomical abnormalities of POP, especially cystocele. In the cystocele, POPQ is focused on Ba point. However, no reference value has been established during evaluation on the changes of Ba’s pre and post operation. A measurement is required to describe the value of Ba in POPQ to the quality of patients’s micturition who have undergone anterior colporrhaphy on cystocele indication.Objective: To determine whether a change of Ba value more than 4 cm post anterior colporrhapy can improve voiding quality.Method: This study used a pretest-posttest design by measuring the value of Ba and voiding quality (UDI6 score) in cystocele patients before and after anterior colporrhapy. Ba value changes compared with changes in postoperative voiding quality.Result and Discussion: There were 20 subjects recruited from January until July 2016 who met the inclusion criteria. There were significant differences between the voiding quality and changes of Ba value before and after surgery for 2nd and 6th week (p<0.001). From the bivariate analysis there were no differences in changes of voiding quality for Ba> 4 cm compared ≤4 cm (p = 0.34; RR 1.43; 95% CI 0.61-3.37). Age, BMI and parity had no significant affects the voiding quality before and after surgery (p= 0.12, p= 0.62, p=0.27). From a logistic regression analysis of variables change in value of Ba and external variables of age, BMI and parity were not statistically significant influence the voiding quality.Conclusion: Changes in the value of Ba more than 4 cm from baseline in patients who undergo anterior colporrhapy does not improve the voiding quality.Keywords: Ba value, voiding quality, anterior colporrhapy.
PERBANDINGAN ANTARA PEMBERIAN ANTIBIOTIKA PROFILAKSIS PADA SEKSIO SESAR SESUAI ALUR KLINIS RSUP DR SARDJITO DENGAN ANTIBIOTIKA DOSIS MULTIPEL TERHADAP KEJADIAN INFEKSI LUKA OPERASI Rahmansyah, Ardian; Hakimi, Mohammad; Siswishanto, Rukmono
JURNAL KESEHATAN REPRODUKSI Vol 3, No 2 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.342 KB) | DOI: 10.22146/jkr.35444

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Background: Clinical pathway recommend the use of short-term prophylaxis antibiotics for cesarean section. Long-term antibiotics or multiple doses was found in clinical practice. There are differences in the mode of administration and the number of doses administered at sardjito hospital.Objective: To determine the effectiveness of short-term antibiotic prophylaxis in cesarean section appropriate to clinical pathway in the prevention of surgical site infection (ssi), the incidence of fever, dysuria events, length of stay.Method: The study used randomized clinical trial. The study subjects who underwent cesarean section and meet the inclusion and exclusion criteria in the period July 2013 to January 2014 divided into an intervention group (n = 52) who received ampicillin 2 gram pre and post-cesarean section, and a control group (n = 54) who received ampicillin 2 gram pre cesarean section and 1 gram every 8 hours for 6 times. Observed on days 3 and 10 post-cesarean section. The primary outcomes assessed were the incidence of surgical wound infection based on the criteria of surgical site infection from Centers for Disease Controland Prevention. Secondary outcomes assessed were the incidence of fever, dysuria events, length of stay. Homogeneity analysis were conducted on subject. Outcome analysis performed bivariate with t test and chi squared test.Results and Discussion : A total of 106 subjects can be analyzed. SSI events in the intervention group at day 3 was 3.8% (n = 52) and control group was 1.84% (n = 54) with p>0.05 RR 2.077 (95% CI 0.194 to 22.219). SSI on day 10 of 7.7% (n = 52) in the intervention group versus 9.3% (n = 54) in controls with p<0.05 RR 0.831 (CI 95%, 0.236 to 2.924). Fever events on day 3 by 5.8% in the intervention group versus 3.7% incontrols with p>0.05 RR 1.558 (95% CI 0.271 to 8.948) and on day 10 was 3.8% versus 3.7 % with p>0.05 RR 1.038 (95% CI 0.152 to 7.102). Dysuria not found on day 3 and but on 10 found 5.8% in the intervention group versus 11.1% with p>0.05 RR 0.519 (IK95% 0.137 to 1.968). Length of stay after cesarean section for 3.21 ± 0.412 days in the intervention group and 3.26 ± 0.442 days in the control group with p>0.05 (95% CI -0.213 - 0.117).Conclusion: There is no significant difference in the incidence of surgical wound infections, the incidence of fever, dysuria, length of stay between short-term prophylaxis antibiotics ampicillin appropriate to clinical pathway and long-term or multiple doses prophylaxis antibiotics. Short term antibiotics prophylaxis are more efficiently with the same effectiveness in preventing outcomes research.Keywords: prophylaxis antibiotics, ampicillin, short term regimen, long term regimen, cesarean section, surgical site infection. 
Peran Intervensi Grup Psikoterapi Suportif untuk Memperbaiki Keadaan Depresi pada Wanita Infertil di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta Dhestiana, Mega; Marchira, Carla; Siswishanto, Rukmono; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.005 KB) | DOI: 10.22146/jkr.36037

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Background: Infertility is a worldwide problem, relates to a devastating condition that can destroy couples striving to have children. It can affect both men and women, and cause psychological related distress, depression, and low self- -esteem. Most interventions using directional, complete, and integrated approach have been focused on improving the quality of life of infertile men or women. Supportive psychotherapy is an example of such interventions.Objective: The study aimed to measure the effectiveness of supportive psychotherapy intervention in treating depression among infertile women.Method: A quasi experiment design using a pre and post- -test with a control group was employed in this study. Subjects were women (n=80) with infertility cases who sought for treatment at PermataHati Clinic Dr. Sardjito hospital. during the period from April to September 2014. A modified short supportive psychotherapywas to groups of patients over the course of four sessions. The sessions were managed by trained facilitatorscomprising psychiatrist and psychologist. Personal data and Beck Depression Inventory (BDI)were then used to assess the patients depression state.Result and Discussion: Findings indicated that 59.37% of the study subjects were found to have mild depression, whereas the other 40.63% had moderate depression. A significant change in BDI scores within the treatment group was found after intervention.Conclusion:Modified short supportive psychotherapy intervention can effectivelly reduce depression on infertile women.Keywords: modified short supportive psychotherapy, depression, infertile women
Evaluasi Clinical Pathway Seksio Sesarea: Keefektifan Penggunaan Antibiotika Injeksi Cefotaxime 2 Gram dalam 24 Jam untuk Mencegah Terjadinya Infeksi Luka Operasi Fauziah, Rathi Manjari; Siswishanto, Rukmono; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (357.203 KB) | DOI: 10.22146/jkr.36039

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Background: The usage of prophylactic antibiotics in Dr. Sardjito Hospital, Yogyakarta, is still diverse. Previously, prophylactic antibiotics that were given would be in a form of multidose and or multidrug regimen. Recently, a clinical pathway for c-section had been set up to uniform the antibiotics given. Cefotaime 2g, given intravenously, in 24 hours is the antibiotic of choice. Unfortunately, there was no data about the effetiveness of cefotaime that can be used as a basis of clinical pathway. Objective: Comparing the incidence of surgical site infection (SSI) between cefotaime 2g,/24 hours (clinical pathway or CP) with previous regimen of prophylactic antibiotics (non-clinical pathway or nonCP) and also identify the risk factors.Method: This is a retrospective cohort study with 129 subjects, divided into two groups. The CP group consists of 63 subjects, while non-CP group consists of 66 subjects. The surgical site infection was observed in the day 3 and day 10 aer C-section. Multivariat analysis was used to determine the risk factors of SSI.Result and Discussion: SSI incidence in the CP group at day 3 was higher compared to non-CP group, but it was not statistically significant (OR 4,73 95% CI 0,52 43,04), eukocytosis (>17000/mcl) was the independent risk factor for SSI (OR 7,54 95% CI 1,25 45,39).Conclusion: SSI incidence between two groups was not statistically significant but was clinically significant. The presence of leukocytosis is becoming the risk factor for SSI.Keywords: prophylactic antibiotic, c-section, cesarean section, surgical site infectio
Analisis Angka Seksio Caesarea di RSUP Dr. Sardjito Yogyakarta Tahun 2009-2013 Dameria, Netty Katrina; Dasuki, Djaswadi; Siswishanto, Rukmono
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (670.632 KB) | DOI: 10.22146/jkr.36192

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Background: Caesarean section is a procedure to reduce maternal and perinatal mortality and morbidity. The caesarean section rate is continuously uprising in the last 3 decades. However, the increasing rate, especially in low risk women, may compromise maternal and perinatal outcome. In 1985, WHO recommended that optimal national caesarean rates should be in the range of 5% to 10% and the rate above 15% might be less benefits. Previous study conducted in DR Sardjito hospital reported caesarean section rate in 1996 was 13.38%, while in 2001 was 18.39%. In national level, based on Indonesia Basic Health Survey 2010, caesarean section rate was 10.8%. Therefore, in this study we analyzed the rate of Caesarean section performed in DR Sardjito hospital, and studied whether the operations occurred in high-risk group or low-risk group.Objective: To compare the rate of caesarean section between high-risk group and low-risk group in DR Sardjito hospitalMethod: Retrospective cohortResult and Discussion: Participants of this study were 7821 patients undergoing labor at RSUP DR Sardjito in 2009-2013. Among them, 3152 patients underwent caesarean section and 4669 patients underwent vaginal delivery. There was an increasing in the overall caesarean section rate of 38,7% in 2009 to 43% in 2013. T-test found the presence of significant differences between the caesarean section rate of high-risk group and low-risk group in 2009-2013 (p<0.05) with a mean difference was 28.5 (20.2-36.8). Caesarean section rate of high-risk group was significantly higher than the low-risk group (p<0.05).Conclusion: There was a difference in caesarean section rate of high-risk group compared to low-risk group. Caesarean section rate in high-risk group was significantly higher than in the low-risk group.Keywords: caesarean section rate, caesarean section, low-risk group, high- risk group
Hubungan Kadar CA-125 Praoperatif terhadap Prognosis Survival Penderita Kanker Ovarium Epitelial di RSUP Dr.Sardjito Pradjatmo, Herlina; Siswishanto, Rukmono; Prawitasari, Shinta
JURNAL KESEHATAN REPRODUKSI Vol 5, No 1 (2018)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (376.131 KB) | DOI: 10.22146/jkr.37949

Abstract

Background: CA-125 level increases in 50% of patients with stage I, 90% of patients with stage II, 92% of patients with stage III and 94% of patients with stage IV ovarian cancer. CA-125 level were not a diagnostic tool to detect ovarian cancer, however it was useful to monitor the progressive of disease and as a prognostic marker.Objectives: The aim of this study is to prove whether CA-125 level before surgery in ovarian cancer patients at Dr. Sardjito Hospital as well as a factor that correlates to the survival prognosis of those patients.Method: This research used cohort retrospective study at Dr. Sardjito Hospital Yogyakarta.Result and Discussion: As much as 71 ovarian cancer patients which had been included in this research with inclusion and exclusion criteria. Subjects were divided into two groups. One group was for patients with low CA-125 level (≤35 U/ml) as much as 18 subjects and another group was for patients with high CA-125 level (>35 U/ml) as much as 53 subjects. The result of a bivariate analysis with an independent survival analysis (Cox’s Regression) was the stage of disease (p=0.005, HR 4.827, CI 95% 1.623 – 14.355) and residual tumour (p=0.029, HR 2.605, CI 95% 1.101 – 6.161) were a survival prognosis factor. Multivariate analysis with a survival analysis (Cox’s Regression) shows CA-125 level (p=0.031, HR 4.131, CI 95% 1.143 – 14.933) and menarche (p=0.003, HR 4.989, CI 95% 1.736 – 14.342) were significantly related with survival prognosis in EOC (Epithelial Ovarian Cancer) patients at Dr. Sardjito Hospital.Conclusion: CA-125 level affects the survival rate of epithelial ovarian cancer patients in Dr. Sardjito Hospital. Besides the level of CA-125, there are other factors that affect the survival rate of epithelial ovarian cancer patients which is the stage of cancer, residual operation and age of menarche.Keywords: CA-125 level, EOC, prognosis, survival.