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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

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 Baâ€™s pre and post operation. A measurement is required to describe the value of Ba in POPQ to the quality of patientsâ€™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 â‰¤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.

Karakteristik Pasien Prolaps Uteri di RSUP Dr. Sardjito Yogyakarta Tahun 2013 Hamamah, Jefi; Pangastuti, Nuring
JURNAL KESEHATAN REPRODUKSI Vol 4, No 1 (2017)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Uterine prolaps suffer by nearly half population of women. Many factors related to the causes of prolaps. The pattern varies in different country and ages.Objective: To evaluate the characteristic of uterine prolaps patient in Sardjito Hospital in the period January â€“ December 2013.Method: This is an analytic descriptive study that reviewed medical record of Sardjito Hospital within January - December 2013. Data was reported, tabulated dan presented in the form of risk factors, chief complains, grade of uterine prolaps and treatment, finally analysed.Result and Discussion: There were 30 cases of uterine prolaps from Obstetrics and Gynecology Sardjito Hospital within January-December 2013. Most of the patient age were 45-64 year (48.4%), parity more than 2 (73.3%), menopause (73%), vaginal delivery more than 2 (73%). Symptoms that mostly revealed was lump on the delivery passage (73.3%). Patient were mostly suffered from grade 4 uterine prolaps (43%). There were two types of treatment i.e. conservative and operative. Conservative treatment used Kegel exercises and pessarium. Operative treatment used total vaginal hysterectomy, colpocleisis, anterior and posterior colporaphy.Conclusion: The risk factors for uterine prolaps were older age, menopause, multiparity, vaginal delivery. The treatment mostly used total vaginal hysterectomy.Keywords: uterine prolaps, risk factors, vaginal hysterectomy

Robekan Perineum pada Persalinan Vaginal di Bidan Praktik Swasta (BPS) Daerah Istimewa Yogyakarta Indonesia Tahun 2014-2016 Pangastuti, Nuring
JURNAL KESEHATAN REPRODUKSI Vol 3, No 3 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Background: Vaginal delivery is the most preffered mode of delivery by all women, and the birth attendants. The vaginal delivery assistance was conducted by various health professionals such as midwives, physicians, and obstetricians. Various complaints of pelvic floor dysfunction and complaints related to the perineum as a result of vaginal perineal laceration during childbirth can affect the quality of life of a woman.Objective: To identify and conduct an analysis of maternal factors (maternal age, parity, gestational age), fetal factor (birth weight), and the labor factor (duration of 2nd stage of labor), with the occurrence of perineal rupture in vaginal delivery at the 5 Midwifeâ€™s Private Clinic (MPC), Yogyakarta, Indonesia.Method: Retrospective medical record searching, from January 2014 until December 2016.Result and Discussion: There were 1595 obtained samples of data that met the criteria for inclusion and exclusion. Number of perineal laceration reached 1201 (75.3%), with 1.9% of them are grade 3. Perineal rupture occurred in 80.55% of vaginal deliveries at young age, 69.14% in more than 35 years old women, and 85.05% primiparas. There was significant negative correlation (0.186) between parity and perineal rupture (p=0.000). The less the parity, the higher the incidence of perineal rupture (p=0.002). There was significant correlation between babyâ€™s weight less than 2500 gram and perineal rupture but not for the babyâ€™s weight more than 4000grams (p=0.304). The correlation was positive which meant that the heavier the babyâ€™s weight the higher the incidence of perineal rupture. There was significant positive correlation (p=0,018) for the duration of 2nd stage of labor between 30-60 minutes and perineal rupture(0.061). The correlation was positive as well (0.092) for the duration of 2nd stage of labor more than 60 minutes and perineal rupture( p=0.002). The longer the duration of the 2nd stage of labor the higher the incidence of perineal rupture.Conclusion: There was significant relationship between parity, and duration of the 2nd stage of labor and perineal rupture in vaginal delivery.Keywords: perineal rupture, vaginal delivery, parity, duration of the 2nd stage of labor

IIIB-IV Degree Perineal Rupture Repair Using Overlapping and End-to-End Techniques with Pudendal Block Anesthesia Pangastuti, Nuring; Junizaf, Junizaf; Pranoto, Ibnu; Santoso, Budi I; Priyatini, Tyas
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the incidence of persistent sonographic anal sphincter defect, fecal urgency, anal and fecal incontinence after IIIb- IV degree perineal rupture repair using overlapping and end-to-end technique. Method: An open clinical trial with randomization was carried out in July 2010-April 2012. The population consisted of the patients who underwent vaginal delivery in Dr. Sardjito Central General Hospital, Sleman District General Hospital, as well as Tegalrejo, Jetis and Mergangsan Community Health Centers who did no have complaints of fecal urgency, anal incontinence, and/or fecal incontinence, and suffered IIIb-IV degree perineal rupture repaired within less than 24 hours of rupture. The exclusion criteria included conditions in which patients could not undergo repair at the moment (shock, uncooperative patient). Fourty-eight research samples were divided into 2 groups, 24 samples for each of the treatment group (overlapping repair) and the control group (end-to-end repair). Local anesthesia was performed in a pudendal-block manner. Result: Success of the repair was assessed based on the presence of persistent sonographic anal sphincter defects in the 6-week evaluation after repair. Successful repair was higher in the overlapping group than that of the end-to-end group (94.74% vs 81.25%, p=0.31). Clinically and based on the Fecal Continence Scoring Scale (FCSS), evaluation at weeks II and VI indicated successful repair in both groups. Conclusion: There was no difference in the incidence of persistent sonographic anal sphincter defects, fecal urgency, anal incontinence, and fecal incontinence, after IIIb-IV degree perineal rupture repair using overlapping technique in comparison with end-to-end technique. Keywords: end-to-end technique, III-IV degree perineal rupture, obstetric perineal rupture, overlapping technique

Urinary tract infection in premature rupture of membrane (PROM): an academic hospital based study Rahman, Muhammad Nurhadi; Liligoly, Rivaldi D; Pangastuti, Nuring
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 51, No 1 (2019)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Premature rupture of membrane (PROM) and preterm PROM (PPROM) are commonly related with poor maternal and perinatal outcomes. Urinary tract infection (UTI) has been known as one of its risk factors. The aim of study was to ascertain the frequency and pattern of urinary symptoms as well as the risk factors for UTI in PROM and PPROM. A retrospective study was conducted at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. All pregnancy cases with the history of PROM/PPROM from January to December 2015 were included. The research subjects were obtained from medical records, using the format of basic data collection to identify the risk factors of UTI in pregnancy. One hundred cases of complicated pregnancy with either PROM or PPROM were obtained. The mean of maternal age, gestational age, and birth weight were 28 ± 5.99 yr; 34.05 ± 4:28 wk; 2170.79 ± 835.447 g; respectively. Urinalysis was done in 58 patients. The prevalence of bacteriuria was 55.17%. Symptomatic vs. asymptomatic bacteriuria showed statistically significant differences (p

IIIB-IV Degree Perineal Rupture Repair Using Overlapping and End-to-End Techniques with Pudendal Block Anesthesia Pangastuti, Nuring; Junizaf, Junizaf; Pranoto, Ibnu; Santoso, Budi I; Priyatini, Tyas
Indonesian Journal of Obstetrics and Gynecology Volume. 3, No. 3, July 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the incidence of persistent sonographic anal sphincter defect, fecal urgency, anal and fecal incontinence after IIIb- IV degree perineal rupture repair using overlapping and end-to-end technique. Method: An open clinical trial with randomization was carried out in July 2010-April 2012. The population consisted of the patients who underwent vaginal delivery in Dr. Sardjito Central General Hospital, Sleman District General Hospital, as well as Tegalrejo, Jetis and Mergangsan Community Health Centers who did no have complaints of fecal urgency, anal incontinence, and/or fecal incontinence, and suffered IIIb-IV degree perineal rupture repaired within less than 24 hours of rupture. The exclusion criteria included conditions in which patients could not undergo repair at the moment (shock, uncooperative patient). Fourty-eight research samples were divided into 2 groups, 24 samples for each of the treatment group (overlapping repair) and the control group (end-to-end repair). Local anesthesia was performed in a pudendal-block manner. Result: Success of the repair was assessed based on the presence of persistent sonographic anal sphincter defects in the 6-week evaluation after repair. Successful repair was higher in the overlapping group than that of the end-to-end group (94.74% vs 81.25%, p=0.31). Clinically and based on the Fecal Continence Scoring Scale (FCSS), evaluation at weeks II and VI indicated successful repair in both groups. Conclusion: There was no difference in the incidence of persistent sonographic anal sphincter defects, fecal urgency, anal incontinence, and fecal incontinence, after IIIb-IV degree perineal rupture repair using overlapping technique in comparison with end-to-end technique. Keywords: end-to-end technique, III-IV degree perineal rupture, obstetric perineal rupture, overlapping technique

Urinary Tract Infection as a Risk Factor for Preterm Delivery: A Tertiary Hospital-Based Study Pangastuti, Nuring; Indraswari, Lathifa N; Prawitasari, Shinta
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

ABSTRACT   Background: Preterm delivery is the leading cause of perinatal morbidity and mortality in developing countries. Urinary tract infection is one of the infectious diseases that often occur in pregnant women. Despite, the correlation between bacteriuria, either symptomatic or asymptomatic, and preterm delivery is still controversial. Purpose: To investigate the correlation between the incidence of UTI and preterm delivery. Methods: We conducted a cohort retrospective research using patients medical records. We analyzed the incidence of UTI and preterm delivery from January to December 2015, in Dr. Sardjito Hospital, Yogyakarta. Results: The sample of this study covers medical records of 45 patients with preterm delivery. From total sampel, only 25 patients (55.6%) underwent urinalysis. Of these 25 patients, 15  (60%) had UTIs and all of them had preterm delivery. The result showed 13 (86.7%) of 15 patients with bacteriuria were asymptomatic. Bacteriuria that was found in 15 subjects was not statistically significant when compared to preterm delivery indicated with relative ratio of 1,083 (p = 0,581 > 0,05). Multivariate logistic regression analysis showed that preterm delivery were not directly related to UTI (p = 0.704), gestational age (p = 0.274), symptom of UTI (0.699), history of UTI (p=0.999), and history of coitus (p = 0.872). Conclusion: The study revealed that preterm delivery was not related to UTI. Other causes should be considered. However, the discovery of asymptomatic bacteriuria in patients with preterm delivery indicated that this might be one of the risk factors for preterm delivery. Routine urinalysis test for pregnant woman considered for the prevention.   Keywords: UTIs, preterm delivery, bacteriuria  

PENDIDIKAN KESEHATAN DAPAT MEMPENGARUHI PENGETAHUAN, SIKAP PRA REMAJA MENGHADAPI MENARCHE Mualifah, Laily; Pangastuti, Nuring; Purwanta, Purwanta
Journal of Holistic Nursing Science Vol 6 No 2 (2019)
Publisher : Universitas Muhammadiyah Magelang

Menarche and menstruation is a physiological process that can cause physical discomfort, emotional and anxiety. SDN in Cluster 3 and 4 Districts Nanggulan there were 10 grade 5 and 6 are not yet menarche say not know about menarche and menstruation and not knowing what to do when menstruation occurs. This happens because there is no health education about menstruation health in the scope of elementary school. Objective: To determine the effectiveness of health education with group discussion and lecture method to the knowledge, attitudes pre teens to face of menarche. Methods: This study is quasy-experiment with approaches pre test-post test control group design. Subjects were 5th and 6th grade students of elementary school at Cluster 3 and 4 Districts Nanggulan Kulon Progo with as many as 111 (discussion method,n = 55 and lecture method,n = 56) who met the inclusion criteria. The instrument used questionnaire. The sampling technique purposive sampling. Statistical test using Friedman test, Wilcoxon test and Mann-Whitney Test. Results: Scores of knowledge and attitudes before and after treatment there were significant differences in group discussions and lectures with the p=0,00 (p <0.05). Increased knowledge and attitude scores in both groups were significantly different at p=0,00 dan p=0,02 (p <0.05). The increase in effective knowledge and attitude scores on the method of discussion on the first day, the third and fourteenth after health education. Conclusion: Health education with discussion method is more effective than lecture group in increasing knowledge and changing attitudes in the pra-puberty facing menarche. Keywords: health education, group discussion method, menarche

Gambaran Faktor Risiko Prolaps Organ Panggul Pasca Persalinan Vaginal di Daerah Istimewa Yogyakarta Pangastuti, Nuring; Sari, Dwi Cahyani Ratna; Santoso, Budi Iman; Agustiningsih, Denny; Emilia, Ova
Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Prolaps organ panggul merupakan salah satu bentuk disfungsi dasar panggul pada perempuan. Disfungsi dasar panggul adalah keadaan terganggunya fungsi dasar panggul merupakan salah satu kondisi kesehatan yang banyak dikeluhkan perempuan. Lebih dari 46% perempuan dengan riwayat persalinan vaginal mengalami disfungsi dasar panggul,dan peningkatan jumlah paritas berkorelasi dengan peningkatan kejadian prolaps organ panggul. Tujuan penelitian ini adalah untuk mengetahui gambaran karakteristik faktor risiko prolaps organ panggul pasca persalinan vaginal di wilayah Daerah Istimewa Yogyakarta. Penelitian dilakukan pada Januariâ€“Maret 2018. Hasil penelitian didapatkan 51 subjek penelitian dengan persalinan vaginal yang dapat dilakukan pemeriksaan POPQ pada 3 bulan pascapersalinan. Prolaps organ panggul didapatkan pada sebagian besar pasien pascasalin, yaitu sejumlah 46 orang, prolaps uteri 33 orang, sistokel 44 orang, serta rektokel pada 46) orang. Hanya 5 orang yang tidak memiliki gambaran prolaps organ panggul pada 3 bulan pascapersalinan.Dari penelitian ini dapat disimpulkan bahwa faktor risiko prolaps organ panggul pascapersalinan vaginal di Daerah Istimewa Yogyakarta terdiri atas faktor intrinsik (usia ibu, panjang genital hiatus maupun perineal body), dan ekstrinsik (paritas, indeks massa tubuh overweight dan obes, kenaikan berat badan selama hamil >15 kg, serta dilakukan episiotomi dan terjadi robekan perineum). Upaya pencegahan terutama edukasi, perbaikan gaya hidup, pengendalian indeks massa tubuh, pengaturan diet, olahraga penguatan otot dasar panggul, pembatasan jumlah kehamilan dan persalinan, serta pertolongan persalinan sesuai Asuhan persalinan normal.Â Kata kunci: Disfungsi dasar panggul, faktor risiko, persalinan vaginal, prolaps organ panggulÂ Risk Factors for Pelvic Organ Prolapse in Women with History of Vaginal Delivery in YogyakartaPelvic organ prolapse is one form of pelvic floor dysfunctions in women that impairs the pelvic floor function and also one of the most frequently conditions complained by women. More than 46% women with history of vaginal delivery have experienced pelvic floor dysfunction where higher number of parity correllates to increased pelvic organ prolapse incident. The aim of this study was to understand theÂ characteristic risk factors of pelvic organ prolapse incident post vaginal delivery in Special Region of Yogyakarta. The study ws performed during the period of January to March 2018 on 51 subjects with history of vaginal delivery evaluated using POPQ in 3 months postpartum. Pelvic floor dysfunction was present in most postpartum patients, i,e, 46 people while 33 experienced uterine prolapse, 44 experienced cystocele, and 46 experienced rectocele. Only 5 subjects had no pelvic floor dysfunction in any form. Risk factors for pelvic organ prolapse in post vaginal delivery in the Special Region of Yogyakarta consist of intrinsic factors (maternal age, genital length of hiatus, and perineal body), and extrinsic factors (parity, overweight status and obese status based on body mass index, weight gain during pregnancy exceeding 15 kg,Â episiotomy and the occurrence of perineal rupture). Prevention actions includeÂ education followed by lifestyle improvement, control of body mass index, dietary regulation, exercise, restrictions on the number of pregnancies and childbirth, and safe delivery according to normal birth care standard.Key words: Pelvic floor dysfunction, pelvic organ prolapse, risk factors, vaginal delivery

Validation test of Indonesian pelvic floor distress inventory-20 (Indonesian PFDI-20) Pangastuti, Nuring; Iman, Santoso Budi; Denny, Agustiningsih; Emilia, Ova
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The pelvic floor distress inventory-20 (PFDI-20) questionnaire is one of the questionnaires used to help find out complaints of pelvic floor dysfunction. The questionnaire is also frequently used in studies related to pelvic floor dysfunction. The validation test results of the questionnaire have not been obtained from Indonesian population.This study aimed to obtain an Indonesian PFDI-20 questionnaire that is in accordance with the original questionnaire and valid as well as reliable use for the Indonesian population.The validation test series were conducted through several stages: forward translation, back-translation, expert panel, pre-testing, and cognitive interviewing, final version and documentation. Data of 77 female respondents of reproductive age in the Yogyakarta Special Region were collected from January to March 2018.The statistical test result of questionnaire validity from the corrected item-total correlation of each question item has value more than 0.30 (0.385-0.781) indicating that the Indonesian PFDI-20 questionnaire was valid. Test reliability of the questionnaire using Cronbach’s alpha with a high significant result of 0.911 (0.902-0.913)> r table was obtained. In conclusion, the Indonesian PFDI-20 questionnaire is valid and reliable, thereforeit can be used in Indonesian population.

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