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Shofwal Widad
1.Permata Hati Infertility Clinic RSUP DR Sardjito, Yogyakarta 2.Div Reproductive Endocrinology and Fertility OBGYN Medical Faculty Gadjah Mada University, Yogyakarta
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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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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
MICROVOLUME OF 0.1µL 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 Dasuki1,2 ABSTRAK 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 0.1µl 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 0.1µl 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: 0.1µl 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, vitrifikasi 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 0.1µl 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 0.1µl 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: 0.1µl 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, Purwokerto Correspondence address: + 62 274 518684; fax + 62 274 553575; email: itafauzia@yahoo.com
Indications and Complications of Obstetrical Hysterectomy: Sardjito Hospital Experience Eda, Maria Katharina; Siswanti, Edi Patmini Setya; Widad, Shofwal
JURNAL KESEHATAN REPRODUKSI Vol 4, No 3 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.959 KB) | DOI: 10.22146/jkr.36480

Abstract

Latar Belakang: Histerektomi obstetri adalah operasi besar dan tetap merupakan salah satu bencana di bidang obstetri. Tindakan ini jarang dilakukan, namun merupakan operasi penyelamatan hidup dalam kasus perdarahan obstetrik yang sulit ditangani. Hal itu terkait dengan peningkatan morbiditas dan mortalitas ibu.Tujuan: Untuk menentukan indikasi dan komplikasi histerektomi obstetri di RSUP Dr. Sardjito. Metode: Penelitian ini menggunakan metode penelitian retrospektif kasus histerektomi obstetrik di RSUP Dr. Sardjito pada Januari 2012 hingga April 2015.Hasil dan Pembahasan: Selama masa studi, 30 histerektomi obstetri dilakukan. Delapan puluh persen kasus merupakan kasus rujukan. Rata-rata usia 32,47 tahun dengan standar deviasi 5,91. Atonia uteri merupakan indikasi yang paling umum (40%), diikuti oleh dehisensi uterus segmen bawah (33,3%), ruptur uteri (16,7%) dan plasenta akreta (10%). Tipe histerektomi yang dilakukan adalah histerektomi supra servikal sebesar 46,7%, histerektomi abdominal total 33,3%, dan histerektomi sesar 6%. Komorbiditas intraoperatif yang paling umum adalah kehilangan darah masif (93,3%). Disseminated Intravascular Coagulation (DIC) menyebabkan 30% dari komorbiditas pasca operasi. Kematian ibu mencapai 20%.Kesimpulan: Indikasi histerektomi obstetri ialah atonia uteri, dehisensi uterus segmen bawah, ruptur uterus, dan plasenta akreta. Komplikasi intraoperatif yang paling sering terjadi ialah kehilangan darah. DIC merupakan komplikasi paska operatif terbanyak dan penyebab utama kematian.Kata Kunci: Histerektomi obstetrik, atonia uteri, dehisensi uterus segmen bawah, ruptur uteri.
HUBUNGAN KADAR ANTI MULLERIAN HORMONE (AMH) DENGAN KEBERHASILAN STIMULASI OVARIUM PADA FERTILISASI IN VITRO METODE PROTOKOL PANJANG Permana, Ridho; Widad, Shofwal; Lutfi, M.
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 (299.507 KB) | DOI: 10.22146/jkr.12649

Abstract

HUBUNGAN KADAR ANTI MULLERIAN HORMONE (AMH)DENGAN KEBERHASILAN STIMULASI OVARIUM PADAFERTILISASI IN VITRO METODE PROTOKOL PANJANGRidho Permana, Shofwal Widad, M. LutfiABSTRACTBackground: Patient with decline oocyte number and quality assumed has lower Anti Mullerian hormone(AMH). AMH concentration which expressed by the granulosa cells of preantral and small antral folliclesindirectly determine the ovarian reserve. Therefore, AMH may be used as a marker of ovarian ageing andassociated with ovarian response in in vitro fertilization (IVF).Objective: To determine the effect of Anti Mullerian Hormone (AMH) on ovarian response in IVF longprotocol method.Method: This research is a retrospective cohort study in Permata Hati Fertility Clinic, IVF program-Dr.Sardjito Hospital, Yogyakarta, Indonesia. Seventy one cycle enrolled in an IVF program conducted fromJanuary 2011 through December 2013 at the Permata Hati Fertility Clinic.Result and Discussion: ROC curve were used to determine cut-off AMH. With cut-off point 2.59 ng/ml,subject divided into two groups (high AMH level: ≥2.59 ng/ml and low AMH level: <2.59 ng/ml). Totaldose gonadotropin was significantly different in two groups (p=0.02). High AMH and low AMH levelwere significantly associated with ovarian response (RR 2,05; CI 95% 1,32 – 2,20 ; p< 0,01). BesideAMH, multivariate analysis shows basal LH level (p=0,04; OR 7,22; CI 95% 1,09 – 47,87) and peritonealendometriosis (p=0,03; OR 7,80; IK 95% 1,15–52,81) were significantly influenced ovarian response in IVF.Conclusion: high AMH level influence ovarian response in IVF. Total dose gonadotropin on low AMH levelswas greater than high AMH level. In addition to AMH, ovarian response were influenced by basal LH leveland peritoneal endometriosis.Keywords: Anti Mullerian hormone (AMH), ovarian response, long protocol stimulation, in vitro fertilization(IVF).ABSTRAKLatar belakang: Pasien dengan penurunan jumlah dan kualitas oosit diduga mempunyai kadar AntiMullerian Hormone (AMH) lebih rendah. Konsentrasi Anti Mullerian Hormone (AMH) yang dihasilkanfolikel ovarium secara tidak langsung menggambarkan cadangan ovarium yang tersisa. Karenanya kadarAnti Mullerian Hormone (AMH) dapat digunakan sebagai prediktor yang akurat dari cadangan ovarium danrespons stimulasi ovarium pada fertilisasi in vitro.Tujuan: Untuk mengetahui pengaruh kadar Anti Mullerian Hormone (AMH) terhadap keberhasilanstimulasi ovarium pada fertilisasi in vitro pada metode protokol panjang.Metode: Penelitian ini menggunakan rancangan kohort retrospektif observasional.Hasil dan Pembahasan: Sebanyak 71 siklus dari 71 pasangan yang menjalani fertilisasi in vitro disertakandalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Dengan cut off point AMH ditetapkan 2,59 ng/ml, maka subyek ini dibagi menjadi 2 kelompok yaitu ≥2,59 ng/ml sebagai kelompok AMH tinggi dan <2,59 ng/ml sebagai kelompok AMH rendah. Perbedaan bermakna antara dua kelompok ditemukan pada dosistotal gonadotropin (p=0,02).Terdapat perbedaan bermakna respons stimulasi ovarium antara AMH tinggidan AMH rendah (RR 2,05; IK 95% 1,32 – 2,20 ; p< 0,01). Kadar LH basal (p=0,04; OR 7,22; IK 95% 1,09 –47,87) dan endometriosis peritoneal (p=0,03; OR 7,80; IK 95% 1,15–52,81) juga mempengaruhi respons terhadap stimulasi ovarium.Kesimpulan : AMH tinggi mempengaruhi respons terhadap stimulasi ovarium. Dosis total gonadotropinpada AMH rendah dibutuhkan lebih banyak dibandingkan dengan AMH tinggi. Selain AMH, responsterhadap stimulasi ovarium juga dipengaruhi oleh kadar LH basal, dan endometriosis peritoneal.Kata kunci : kadar Anti Mullerian hormone (AMH), stimulasi ovarium protokol panjang, fertilisasi in vitro.Bagian Obstetri Ginekologi, Fakultas Kedokteran, Universitas Gadjah Mada Yogyakarta
PERBANDINGAN PREPARASI KULIT MENGGUNAKAN ALKOHOL-KLORHEKSIDIN DENGAN ALKOHOL-POVIDON IODIN TERHADAP INFEKSI LUKA OPERASI SEKSIO SESAREA Fahmi, Moh. Nailul; Hadiati, Diah Rumekti; Widad, Shofwal
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 (263.825 KB) | DOI: 10.22146/jkr.35416

Abstract

Background: Surgical site infection (SSI) is the second most frequent nosocomial infection and has high morbidity and mortality rate. The use of preoperative skin antiseptics effective in preventing of surgical site infection. There are lack of evidences to evaluate types, concentration and application methods of antiseptic for skin preparation for preventing infection following caesarean sectionObjective: to determine the difference of SSI rate in patients receiving alcohol-chlorhexidine and alcoholpovidone iodine as an agent for skin preparation during caesarean section. Method: The study design was randomized clinical trial. The study was conducted in Dr Sardjito hospital and two affiliated hospital (Saras Husada Hospital and Panembahan Senopati Hospital). Total 174 subjects meeting in inclusion and exclusion criteria were divided into two groups. Experimental group (87 subjects) received alcohol-chlorhexidine as skin preparation antiseptic during caesarean section. Control group (87 subjects) received alcohol-povidone iodine. A computer generated random number was created to assigned subject into experimental and control goups. Outcome assessment was performed on day 3 and day 7 after caesarean section. Surgical site infection was diagnosed based on Center for Disease Control and Prevention (CDC) criteria.Result and Discussion: There were no differences in terms of age, weeks of gestation, body mass index, parity, emergency/elective, duration of operation, duration of membrane rupture, and number of vaginal examination between two groups (P>0.05). SSI rates on day 3 were similar between two groups, alcoholchlorhexidine group was 13.8% (12 subjects) and alcohol-povidone iodine group was 11.5% (10 subjects). Cumulative SSI for 7 days were similar (p=1) between two group, alcohol-chlorhexidine group was 13.8% (12 subjects) and alcohol-povidone iodine group was 12.6% (11 subjects). Conclusions: there were no differences of SSI rates in patients receiving alcohol-chlorhexidine and alcoholpovidone iodine as an agent for skin preparation during caesarean section.Keywords: Surgical site infections, skin preparation, alcohol, povidone iodine, chlorhexidine, caesarean section.
Incidence of Unintended Pregnancy after Laparoscopic Tubal Sterilization at Dr.Sardjito Hospital Widyasari, Anis; Wibowo, Prakoso Adhi; Rahman, M. Nurhadi; LUTFI, MUHAMMAD; Widad, SHOFWAL
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 (179.045 KB) | DOI: 10.22146/jkr.35423

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Background:  Laparoscopic tubal ligation is one of the most commonly performed sterilization procedures and has many advantages such as high success rate and early return to normal activity. In Indonesia, the incidence of unintended pregancy in a study was 0,15 %. This rate is comparable with pregnancy rates for women using another contraceptive method.Objective: To assess the incidence of unintended pregnancy on women who underwent laparoscopic tubal sterilization at Dr. Sardjito Hospital.Method: A descriptive observational study with retrospective cross-sectional design was conducted. The data were acquired from medical record from January 2009 to April 2015. Reports of unintended pregnancy within two years after procedure were recorded.Result and Discussion: 55 women met the inclusion criterion and none were excluded. Method failures resulting on pregnancy occured in 3 cases (5.45 %), so the success rate of the procedure was 94.55 %. All of the reported pregnancies happened within two years after the procedures. There was no major complication occured in the procedure, but minor bleeding (<50 cc) did occur in some cases.Conclusion: The incidence of unintended pregnancy on women who underwent laparoscopic tubal sterilization at Dr. Sardjito Hospital was higher than the average incidence reported on another studies.Keyword: female sterilization, laparoscopic tubal sterilization, unintended pregnancy.
Perbandingan hasil stimulasi ovarium dengan kombinasi klomifen sitrat gonadotropin dan klomifen sitrat pada inseminasi intra uteri Indriani, Farida; Widad, Shofwal; Sofoewan, Sulchan
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 (301.019 KB) | DOI: 10.22146/jkr.35939

Abstract

Background: Infertile couple with the cause of unexplained infertility and male factor can follow intrauterine insemination (IUI) program as a cheap and easy method for infertility therapy. Ovarian stimulation by combination of clomiphene citrate and gonadotropin and also clomiphene citrate alone was done as a superovulation mode to get higher number of mature follicle to gain higher pregnancy rate. Objective : To compare the amount of mature follicles and  endometrial thickness as an outcome of ovarian stimulation between combination drug of clomiphene citrate and gonadotrophin with clomiphene citrate alone.Methods: Observational retrospective cohort. Subject is one cycle intrauterine insemination stimulated either by combination CC gonadotrophin or CC alone, eligible in inclusion criteria and exclusion criteria. Statistic test used was independent t-test, chi-square and logistic regression.Location of study: Infertility Clinic of  Permata Hati, dr. Sardjito Hospital, Yogyakarta.Result: A total of 142 cycle from 98 couples followed IUI and stimulated by combination CC gonadotrophin (n=72) or CC alone (n=70). Multiple mature follicle number was different and statistically significant 77% vs 54%, RR 1,433 (IK95% 1,118-1,836), p=0,005, while endometrial thickness > 7mm was more frequent in combination group but not statistically different with percentage 81,9% vs 74,3%, RR 1,103 (CI95% 0,926-1,315), p=0,367.Conclusion: Ovarian stimulation by combination CC gonadotropin resulting of more multiple mature follicle number while  good endometrial thickness was more in combination group but not statistically significant.Keywords: ovarian stimulation, clomiphene citrate, gonadotrophin, multifollicular, endometrial thickness
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

Abstract

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
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 : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

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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
Co-Authors Agung Kurniawan Arief Boediono Dewanto, Agung Dhestiana, Mega Djaswadi Dasuki Eda, Maria Katharina Fahmi, Moh. Nailul Farida Indriani Fatmawati, Rina Hadiati, Diah Rumekti Hadiati, Diah Rumekti Ita Fauzia Hanoum, Ita Fauzia M. Lutfi Marchira, Carla Mirzanie, Hanifah Muhammad Lutfi MULYOTO PANGESTU Ova Emilia Permana, Ridho R. Sapto Hendri Boedi Soesatyo Rahman, M. Nurhadi Rathi Manjari Fauziah Rukmono Siswishanto Shinta Prawitasari Silitonga, Martha Chaterince Siswanti, Edi Patmini Setya Sulchan Sofoewan, Sulchan Wibowo, Prakoso Adhi Widyasari, Anis Yasmina Ema Yundari, Yundari