scholarly journals EFEKTIVITAS POSISI TANGAN PENOLONG DALAM PENCEGAHAN RUPTUR PERINEUM PADA PERSALINAN NORMAL

2017 ◽  
Vol 9 (01) ◽  
pp. 68
Author(s):  
Mulyati Priyantini ◽  
Yuli Trisnawati

ABSTRAKFokus utama asuhan persalinan adalah pencegahan komplikasi untuk mengurangi angka kesakitan dan kematian ibu. Salah satu upaya adalah mencegah terjadinya ruptur perineum. Posisi tangan yang dipakai penolong persalinan kala II untuk mencegah ruptur perineum antara lain posisi tangan APN dan Varney. Penelitian ini bertujuan untuk mengetahui efektivitas antara posisi tangan penolong menurut APN dan menurut Varney dalam mencegah ruptur perineum spontan pada kala II persalinan di RSIA ‘Bunda arif’ Purwokerto. Penelitian ini merupakan penelitian observasional analitik, menggunakan pendekatan cross sectional dengan populasi seluruh persalinan spontan di RSIA ‘Bunda arif’ Purwokerto. Sampel yang digunakan adalah quota sampling  sebanyak 30 sampel yang memenuhi kriteria inklusi. Metode analisis data menggunakan uji U Mann-Whitney. Hasil penelitian ini adalah Kejadian ruptur perineum pada posisi tangan menurut APN sebanyak 93,3%, sedangkan menurut Varney sebanyak 86,7%. Hasil analisa statistik uji U Mann-Whitney didapatkan p value = 0,550 (p>0,005) sedangkan U value  = 33,000 (Uh < U t ), artinya tidak ada perbedaan bermakna, tetapi posisi tangan Varney lebih baik dengan selisih ruptur 6,6%. Posisi tangan penolong menurut Varney lebih efektif daripada posisi tangan menurut APN dalam pencegahan ruptur perineum spontan pada kala II persalinan, tetapi keduanya tidak memberikan perbedaan yang bermakna terhadap kejadian ruptur perineum. Penolong persalinan dapat menemukan metode yang paling tepat dalam meminimalisir kejadian ruptur perineum spontan untuk menurunkan angka kesakitan dan kematian ibu.Keyword : Posisi tangan penolong, ruptur perineumEFFECTIVENESS OF HANDLING POSITION IN PREVENTION OF PERINEUM RUPTURE IN NORMAL LABORABSTRACTMain focus of delivery care is preventing the complication to reduce the maternal morbidity and mortality. One of the efforts to prevent the occurance of perineal rupture. The position hand which is used birth attendant in the second stage of labor to prevent perineal rupture among others APN and Varney hands position. The goal of this reasearch is to know the effectiveness between APN and Varney hands position to prevent spontanoeus perineal rupture in the second stage of labor in RSIA ‘Bunda arif’ Purwokerto. This reasearch was observational analytic by approachment cross sectional with population of this reasearch was all of spontaneous delivery in RSIA ‘Bunda arif’ Purwokerto and the sample used quota sampling, it’s about 30 sample can be a inclusion criteria. The analyze method data used U Mann-Whitney test. The result of this experiment are precentage of spontaneous perineal rupture by  APN hands position is 93,3%, while by Varney is 86,7%. Result of statistic analysis used U Mann-Whitney test is p value = 0,550 (p>0.005) and U value  = 33,000 (Uh < U t). It means, not significant difference, but Varney hands position better by a margin of 6.6%. the conclusion are varney hands position is more effective than APN hands position in  prevention spontaneous perineal rupture in the second stage of labor, but both not significant for perinel rupture. Suggestion : Birth attendants can find the most appopriate method to minimize perineal ruptured to reduce maternal morbidity and mortalityKeyword : APN & Varney hands position, and perineal rupture.

2021 ◽  
Vol 3 (1) ◽  
pp. 70
Author(s):  
Uswatun Hasanah ◽  
Wahyul Anis ◽  
Bambang Purwanto

Abstrak Latar Belakang: Kehamilan dan persalinan merupakan proses alamiah bagi wanita namun peluang terjadinya komplikasi bisa saja terjadi. Komplikasi yg terjadi selama persalinan menjadi penyumbang angka kematian ibu di Indonesia seperti kala II memanjang. Primigravida merupakan faktor risiko terjadinya kala II memanjang, jika lebih dari 2 jam berisiko 1.42 kali menyebabkan trauma jalan lahir dan perdarahan. Upaya pemerintah untuk mencegah komplikasi tersebut dengan menyelenggarakan senam hamil untuk menyeimbangkan emosional, mental, fisik dan spiritual sehingga mengurangi risiko persalinan lama. Penelitian ini bertujuan untuk mengetahui perbedaan pada durasi lama kala II persalinan pada primigravida yg mengikuti senam hamil dan tidak senam hamil. Metode: Penelitian ini adalah anlitik observasional dengan rancangan cross-sectional, jumlah sampel 92 responden dengan teknik total sampling. Variabel independen adalah senam hamil dan variabel dependen yaitu lama kala II persalinan. Instrumen yang digunakan adalah rekam medis dan kuesioner. Analisis data menggunakan uji Mann Whitney Test. Hasil: Hasil penelitian menunjukkan variabel durasi kala II persalinan  p = 0,000 (p<0,05). Kesimpulan: Durasi kala II persalinan pada primigravida yang mengikuti senam hamil lebih cepat dibandingkan dengan ibu yang tidak senam hamil. AbstractBackground: Pregnancy and childbirth are natural processes for women but the chance of complications can occur. Complications that occur during labor contribute to the maternal mortality rate in Indonesia such as elongation in the second period. Primigravida is a risk factor for prolonged stage II, if more than 2 hours the risk is 1.42 times causing trauma to the birth canal and bleeding. Government efforts to prevent these complications by carrying out pregnancy exercises to balance emotional, mental, physical and spiritual thus reducing the risk of prolonged labor. The aim of this study was to determine the differences in the duration of the second stage of labor in primigravidas who followed and did not follow pregnancy exercise. Method: This study was an observational analytic with a cross-sectional design, with a total sample of 92 respondents with a total sampling technique. The independent variable is pregnancy exercise and the dependent variable is the duration of second stage of labor. The instruments used medical records and questionnaires. Data analysis using the Mann Whitney Test. Results: The results showed the variable duration of second stage of labor p = 0,000 (p <0.05). Conclusions: The duration of the second stage of labor in primigravidas who followed pregnancy exercise  was faster than did not follow pregnancy exercise.  


Author(s):  
Christian Homenta ◽  
John J Wantania ◽  
Juneke J Kaeng

Objective: To understand the relationship of heme oxygenase-1 (HO-1) level between normotensive pregnancy and preeclampsia with severe features. Method: The cross sectional study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sam Ratulangi/Prof. Dr. R. D. Kandou General Hospital Manado. The subjects consisted of 26 pregnant women with normal blood pressure and 26 women with severe features of preeclampsia. We took the patients’ history, general physical examination, and laboratory assessment. The blood samples were taken from normotensive women more than 20 weeks of pregnancy and preeclamptic women with severe features more than 20 weeks of pregnancy. The data obtained was processed using SPSS 20.0 software. We did the nonparametric Mann-Whitney test to analyze the relationship between heme oxygenase-1 (HO-1) level in normotensive pregnancy and preeclampsia with severe features. Result: The level of heme oxygenase-1 (HO-1) in normotensive pregnant women was at 3.24 (SD 0.58) ng/ml (95% CI 3.00-3.47), and the level of heme oxygenase-1 (HO-1) of preeclamptic women with severe features was 3.92 (SD 0.73) ng/ml (95% CI 3.62-4.21). The result of Mann-Whitney test showed p value of 0.001 which meant that there was significant difference in the level of heme oxygenase- 1 (HO-1) between normotensive women and pre-eclamptic women with severe features. Conclusion: There was the relationship between the level of heme oxygenase-1 (HO-1) and the incidence of preeclampsia with severe features. Keywords: heme oxygenase-1 (HO-1), normotensive pregnancy, preeclampsia with severe features


2019 ◽  
Vol 5 (3) ◽  
pp. 193-199
Author(s):  
Maria NSW Kause ◽  
Yanita Trisetiyaningsih ◽  
Anastasia Suci Sukmawati

Background: Lactation onset is a term of multiplying breast milk until the release of breast milk for the first time. It is also perceived by mothers as a bit hard breast, inflammed, and full of breast milk or the release of colostrum. Colostrum is the first liquid secreted by breast milk gland since the first day until the fourth day of labour. One of the factors that influences lactation onset is labour methods. Mothers who undergo sectio caesaria surgery will experience pain and prolonged effects of anesthesia compared to mothers with normal labors. Objective: To investigate the difference of colostrum releasing onset in post partum mothers with normal labors and sectio caesaria in Panembahan Senopati General Hospital, Bantul. Method: This study was quantitative with cross sectional design. The number of samples were 80 respondents selected with purposive sampling technique. Study instrument was observational sheets. Data analysis applied Mann-Whitney test. Result: The majority of respondents who had normal labors and sectio caesaria experienced different colostrum onset. In normal labors, the time of colostrum release was 1 day. In sectio caesaria labors, the time of colostrum release was 2 days. The average duration of post partum mothers with normal labors was 13,6 hours and post partum mothers with sectio caesaria was 22,6 hours. The result of Mann-Whitney test was that there was a difference between colostrum release onset of post partum mothers with normal labors and sectio caesaria with p-value of 0,001 (p<0,05). Conclusion: Colostrum onsets were different in normal labors and sectio caesaria labors. Keyword: Colostrum, Normal labors, Sectio Caesaria labors.


2021 ◽  
Vol 6 (4) ◽  
pp. 226-239
Author(s):  
Ali Fatahi ◽  
◽  
Behshad Panjehzadeh ◽  
Zahrah Koreli ◽  
Haniyeh Zehtab Asghari ◽  
...  

Objective: To achieve the excellent levels of athletic performance, professional athletes need to do continuous exercises and strengthen special muscles of the body and have to spend a lot of time training in that sport. As a result, depending on the prevailing condition of each sport, the physical orientation and the degree of abnormalities of the athletes in that sport are affected. Methods: The current study is descriptive and cross-sectional. The statistical population was 12-14 years old boys in middle and high school. The statistical sample of this study included 30 people (13 volleyball players and 17 basketball players) with a targeted training rate of at least three sessions per week. The Chippaux Smirak Index (CSI) method was used to evaluate the arch of the foot and to determine the angles and degrees of kyphosis and lordosis in radiographs. Independent t-test and Mann-Whitney test were used to compare the variables of motor skills and posture by SPSS V. 18 at a significant level of 0.05. Results: The results of independent t-test to compare the variables of motor skills in the two groups of volleyball and basketball show that there is a significant difference between the two groups in the Sargent test and 4mX9m (P=0.000) (P≥0.05). The results were different in strength test (P=0.41) and Sit-up (P=0.75) so that there was no significant difference between the two groups (P≥0.05). The results of Mann-Whitney test to compare posture-related variables showed that there was no significant difference between the two groups in any of the parameters of varus, valgus, pronation, supination, lordosis, kyphosis, foot flat (P≥0.05). Conclusion: The results showed that volleyball players have more impressive and explosive power than basketball players, but in terms of muscle strength and endurance, there is not much difference between these two groups, which is probably due to the nature and specific characteristics of their sports. Therefore, it seems necessary to pay more attention to athletes’ training programs to improve their motor skills and physical condition. In this study, the behavior and common habits of the subjects in interaction with the environment and hereditary characteristics have not been studied, so more research is needed in the etiology of musculoskeletal abnormalities.


Author(s):  
Kurdi Syamsuri

Objective: To assess the effectiveness of vacuum and forceps extraction in prolonged second stage in Dr. Mohammad Hoesin Hospital Palembang. Methods: A retrospective study for 5 years (2005-2009) by doing a prognostic test on prolonged second stage of labor. Results: The subject age most commonly ranges from 20 to 35 years (84.8% in the forceps extraction group and 86% in the vacuum group). The common parity was nulliparity (58.1% in the forceps extraction group and 61.58% in the vacuum extraction). In the forceps extraction group, 76.7% scores >7 in the 1 minute APGAR score with the mean score of 7.14±1.62, whilst in the vacuum extraction group, 79.1% scores >7 in the 1 minute APGAR score, with the mean score of 7.16±1.78. And in the forceps extraction group, 94.2 scores >7 in the 5 minute APGAR score with mean score of 8.62±1.11, whilst in the vacuum extraction group, 93% scores >7 in the 5 minute APGAR score with the mean score of 8.65±1.08. It is concluded that there is no significant differences on both 1 and 5 minute APGAR scores (p value is 0.713 and 0.755, respectively). Maternal complication of extended episiotomy and perineal rupture were found more often in forceps extraction, but with no statistically significant difference (p=0.324). Conclusion: There is no difference of effectiveness between forceps extraction and vacuum extraction in the case of prolonged second stage. Physicians are free whether to use the vacuum or foceps according to their own desirability and skill. [Indones J Obstet Gynecol 2012; 36-1:28-31] Keywords: forceps extraction, prolonged second stage, vacuum extraction


2017 ◽  
Vol 3 (6) ◽  
pp. 697-701
Author(s):  
Fara Imelda Theresia Patty ◽  
Suhartono Suhartono ◽  
Ngadiyono Ngadiyono ◽  
Mardiyono Mardiyono

Background: The prolonged partus is one of the causes of maternal deaths marked by the slow progress of labor. Induction of labor and caesarean section is a common procedure performed on long-term partus events to end pregnancy. The birth acupressure technique is a complementary method to activate the hormone oxytocin at a certain point to use to soften the cervix and increase contraction.Objective: To examine the effect of acupressure point LI4, SP6 and BL60 on the duration of the first stage of labor and APGAR Score of newborn in primigravida.Methods: This research employed a Quasy experimental study with posttest control group design. It was conducted at the Public Health Center of Trauma and Public Health Center of Palaran Samarinda, East Kalimantan. There were 40 respondents selected using purposive sampling, which 20 respondents assigned in the experiment and control group. The duration of the first stage of labor was assessed using partograph and APGAR Score was assessed using APGAR Score assessment sheets. Mann Whitney test was used for data analysisResults: Findings showed that the duration of the first stage of labor in the experiment group was 187 minutes and in the control group was 307 minutes. Mann Whitney test obtained p-value 0.001 (<0.05), which indicated that there was a statistically significant difference of the duration of the first stage of labor between both groups. However, Mann Whitney test for APGAR score showed p-value 0.114 (>0.05), which indicated that there was no significant difference of APGAR score in the experiment and control group.Conclusion: There was a significant effect of acupressure on the duration of the first stage of labor, but no effect of the APGAR score. Therefore, acupressure may be recommended to shorten the duration of the first stage of delivery in primigravida.


2020 ◽  
Vol 3 (2) ◽  
pp. 163-171
Author(s):  
Mohamad Guntur Nangi ◽  
Yulli Fety ◽  
Alianto

Tuberkulosis masih merupakan masalah kesehatan di Indonesia, khususnya di Wilayah Kerja Puskesmas Benu-Benua Kota Kendari (daerah pesisir) dan Wilayah Kerja Puskesmas Anggaberi Kabupaten Konawe (daerah pegunungan). Tujuan penelitian ini untuk mengetahui perbedaan faktor risiko kejadian TB paru BTA Positif di Daerah Pesisir dan Daerah Pegunungan. Jenis penelitian adalah observasional analitik menggunakan studi perbandingan dengan rancangan Cross Sectional Study dari bulan September-Oktober 2019. Populasi penelitian ini adalah 57 kasus, dengan tehnik penarikan sampel secara Random Sampling, jumlah sampel sebanyak 32 kasus di daerah pesisir dan 25 kasus di daerah pegunungan. Metode analisis menggunakan uji Statistik Mann-Whitney Test. Hasil penelitian menunjukkan ada perbedaan faktor risiko kebiasaan tidur kejadian TB paru BTA positif di daerah pesisir dan daerah pegunungan dengan p-value= 0,003 < α = 0,005), tidak ada perbedaan faktor risiko kebiasaan membuang dahak dengan p-value = 0,253 > α = 0,005, dan ada perbedaan faktor risiko kebiasaan membuka jendela kejadian TB paru BTA positif di daerah pesisir dan daerah pegunungan dengan nilai p-value = 0,003 < α = 0,005. Saran dalam penelitian ini menjadi bahan masukan bagi pengelola program pencegahan dan penanggulangan penyakit khususnya penyakit TB.


2019 ◽  
Author(s):  
Dulce Helena Gonçalves Orofino ◽  
Sonia Regina Lambert Passos ◽  
Sheila Moura Pone ◽  
Marcos Silva Pone ◽  
Elisa Barroso de Aguiar ◽  
...  

Abstract Background : Antenatal exposure to the Zika virus (ZIKV) is related to severe neurological, ophthalmological and orthopedic manifestations called congenital Zika syndrome (CZS), but no changes in the electrical activity of the heart have been found. A higher prevalence of structural cardiac changes has been described in CZS patients when compared to the general population of live births. To describe 24-hour Holter findings in infants with confirmed antenatal exposure to ZIKV. Methods : Cross-sectional study of 24-hour Holter findings in infants with antenatal exposure to ZIKV confirmed by positive polymerase chain reaction(PCR) . Patients of the cohort of newborns and infants exposed intrautero to the ZIKV which began in November 2015 and continues to date and were hospitalized for clinical or surgical reasons were included. The 24-hour Holter monitoring was performed the day before discharge. Data analysis was descriptive and included subgroups of patients according to the presence of CZS and severe microcephaly. Heart rate, ST segment, QT interval and arrhythmias were evaluated. To evaluate heart rate variability (HRV) we used time domain analysis. The Mann-Whitney test was performed to verify significant differences between the subgroups of patients. Results : The sample consisted of 15 infants with average age of 16 months and 12 were diagnosed with CZS (8 had severe microcephaly). PCR at birth was positive in 8 newborn and 7 had positive maternal PCR during pregnancy. No arrhythmias or QT interval changes were observed. The Mann-Whitney test showed a significant difference between patients with and without CZS and with and without severe microcephaly, with HRV being lower in the groups with severe microcephaly and CZS. Conclusions : The study suggests that the HRV evaluation can be used as a sentinel event to assess the possibility of progressive neurological impairment in newborns with antenatal exposure to ZIKV, allowing early initiation of stimulation therapies in addition to indicating that cardiovascular complications may arise in the medium and long term.


2018 ◽  
Vol 9 (1) ◽  
Author(s):  
Ni’matul Ulya ◽  
Pedvin Ratna Meikawati ◽  
Putri Andanawarih

Salah satu prinsip dasar PAUD memberikan rangsangan pendidikan mencakup semua aspek perkembangan anak termasuk perkembangan kemandirian anak.Salah satu hal penting dalam perkembangan anak umur 3-5 tahun adalah perkembangan sikap sosialnya.Tujuan penelitian ini untuk mengetahui perbedaan tingkat sosialisasi anak prasekolah (3-5 tahun) yang mengikuti PAUD dan tidak mengikuti PAUD.Penelitian menggunakan desain penelitian deskriptif komparatif dengan pendekatan cross sectional. Populasinya adalah 164 anak usia prasekolah (3-5 tahun) di Kelurahan Medono Kota Pekalongan. Teknik pengambilan sampel dengan simple random sampling untuk 40 anak prasekolah yang mengikuti PAUD dan quota sampling untuk 40 anak prasekolah yang tidak mengikuti PAUD. Analisis univariat menggunakan tabel distribusi frekuensi dari setiap variabel, sedangkan analisis bivariat menggunakan uji statistik kruskal wallis untuk menguji hipotesis komparatif dua sampel independen.Hasil penelitian tingkat kemandirian anak yang mengikuti PAUD sebagian besar dalam kategori sedang (62,5 %) dan tidak mengikuti PAUD sebagian besar dalam kategori sedang (82,5 %) dan kurang (10 %). Melalui uji independent kruskal wallis didapatkan p value = 0,000 < α (0,05), sehingga disimpulkan ada perbedaan yang signifikan tingkat sosialisasi anak prasekolah yang mengikuti PAUD dan tidak mengikuti PAUD.Kata Kunci : Kemandirian, Anak Prasekolah, PAUDOne of the basic principles of early childhood education provides educational stimulation covering all aspects of child development including the development of child self-reliance. One important thing in the development of children aged 3-5 years is the development of social attitudes. The purpose of this study to determine the difference in the level of socialization of preschoolers (3-5 years ) who follow PAUD and do not follow PAUD.The research used descriptive comparative research design with cross sectional approach. The population is 164 preschoolers (3-5 years old) in Medono Urban Pekalongan City. Sampling technique with simple random sampling for 40 preschool children who follow PAUD and quota sampling for 40 preschool children who do not follow PAUD. The univariate analysis used the frequency distribution table of each variable, while the bivariate analysis used a crucial wallist statistic test to test the comparative hypothesis of two independent samples.The results of the research on the independence level of children following the early childhood education were mostly in the medium category (62.5%) and did not follow the PAUD mostly in the medium category (82.5%) and less (10%). Through independent test kruskal wallis obtained p value = 0,000 <α (0,05), so it is concluded there is significant difference of level of socialization of preschool children who follow early childhood and not follow PAUD.Keywords: Independence, preschool children, PAUD


Author(s):  
Juranah Juranah ◽  
Yuyun Widaningsih ◽  
William Hamdani ◽  
Ruland DN Pakasi ◽  
Uleng Bahrun

Metastasis is the major cause of increased morbidity and mortality in breast cancer. Interleukin-8 has a contribution in the spread of the tumour cells. This study was aimed to know IL-8 levels in patients with metastasic and non metasatic breast cancer by analyzing. A cross sectional study was performed at the Dr. Wahidin Sudirohusodo, Ibnu Sina and Labuang Baji hospitals during September to December 2011. Laboratory examinations were done in the Research Centre of the Medical Faculty, University of Hasanuddin. Fiftysix (56) subjects with breast cancer were examined. The results showed that the levels of IL-8 in metastatic and non metastatic breast cancer were 13.73 pg/mL and 10.48 pg/mL respectively. Mann-Whitney test showed no significant difference of IL-8 level between them, (p=0.09). When the subjects were divided into early and advance stages, the mean levels of IL-8 were 8.035 pg/mL and 12.052 pg/mL, respectively, showing a significant difference by Mann-Whitney test (p=0.009). Based on this research, the level of IL-8 can be considered as a marker in predicting the prognosis of breast cancer. A further research in cohort studies which specific metastasis crawl method is advised by the researchers, these are suggested to allow the determination of the risk factors.


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