Articles

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.875 KB) | DOI: 10.22146/jkr.7127

Abstract

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
PENGETAHUAN DAN KETERAMPILAN BIDAN UNTUK SKRINING KANKER SERVIKS DENGAN METODE INSPEKSI VISUAL ASAM ASETAT (IVA) DI KALIMANTAN BARAT Mardiana, Mardiana; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.687 KB) | DOI: 10.22146/jkr.6898

Abstract

Mardiana1, Djaswadi Dasuki2, Heru Pradjatmo2 ABSTRACT Background: Globally it is estimated that every two minutes a woman dies of cervical cancer and 500,000 women are diagnosed to have cervical cancer each year. In Indonesia, the incidence of cervical cancer is by 12.6 per 100,000 women with a mortality rate of 7 per 100,000. Screening method can reduce the incidence of cervical cancer if done cumulatively in 2012, the coverage of screening with a VIA method in Indonesia was 1.57%, whereas screening coverage with IVA in West Kalimantan Province was 1.06 %Objective: To assess midwives? knowledge and skills of screening practices with a VIA method in health centers Method: This was an observational study with a cross-sectional study, using quantitative and qualitative approaches. The study was conducted in health centers in the province of West Kalimantan. This study was conducted in September to October 2014. The subjects of research were midwives who served in health centers doing a VIA examination in West Kalimantan who met inclusion and exclusion criteria. The total sample of this study was 42 taken with purposive sampling. The variables of this study were the dependent variable, ie, the practice of screening skills with a VIA method, the independent variable, ie, knowledge, and the extraneous variables, ie, age, education, and years of service. Analysis of the data included univariable, bivariable, multivariable, and qualitative. The quantitative data analysis used the chi-square and logistic regression with a significance level of p <0.05 and an OR value with confidence interval (CI) of 95%.Result & Discussion: The mean value of midwives? knowledge was 26.0 from assessment scores of 0-30. A mean score of screening practice skills was 94.4 from 38-114. Of clinical assessment scores skill practice of competent midwives with good knowledge was higher than bad knowledge (OR= 6,98 CI 95% 1,21-40,33). After controlling education and years of service variables, good knowledge influenced screening clinical practice by 33%. Conclusion: Most of the midwives in West Kalimantan had good knowledge and skills to perform cervical cancer screening with a VIA method.Keywords: Knowledge, screening practice skills, VIA methods  ABSTRAKLatar Belakang: Di seluruh dunia diperkirakan setiap dua menit seorang wanita meninggal karena kanker servik dan sekitar 500.000 wanita di diagnosis kanker seviks setiap tahun. Di Indonesia insiden kanker serviks sebesar 12,6 per 100.000 perempuan dengan angka kematian sebesar 7 per 100.000. Metode skrining dapat menurunkan kejadian kanker serviks jika dilakukan secara kumulatif. Pada tahun 2012 cakupan skrining dengan metode IVA di Indonesia sebesar 1,57%, sedangkan cakupan skrining dengan metode IVA Propinsi Kalimantan Barat sebesar 1,06%.Tujuan: Menilai pengetahuan dan keterampilan praktek skrining bidan dengan metode IVA di puskesmas Metode: Jenis penelitian observasional dengan rancangan cross-sectional study, menggunakan pendekatan kuantitatif dan kualitatif. Penelitian dilakukan di puskesmas di Provinsi Kalimantan Barat. Penelitian ini dilaksanakan bulan September sampai dengan Oktober 2014. Subjek penelitian bidan yang melayani pemeriksaan IVA di puskesmas di Provinsi Kalimantan Barat yang memenuhi kriteria inklusi dan eksklusi. Total sampel penelitian ini 42 sampel dengan pengambilan sampel purposive sampling. Variabel penelitian ini yaitu: variabel terikat adalah keterampilan praktek skrining metode IVA, variabel bebas: pengetahuan, dan variabel luar: usia, pendidikan, dan lama bekerja. Analisis data meliputi: univariabel, bivariabel, multivariabel, dan kualitatif. Untuk analisis data kuantitatif meng-gunakan metode chi square dan logistic regresi dengan tingkat kemaknaan p < 0,05 dan nilai OR dengan Confidence Interval (CI) 95%.Hasil & Pembahasan: Nilai mean pengetahuan bidan sebesar 26,0 dari skor penilaian 0-30. Keterampilan praktik dengan nilai mean 94,4 dari skor 38-114. Keterampilan praktik klinik yang kompeten lebih tinggi pada bidan berpengetahuan baik daripada bidan berpengetahuan kurang (OR= 6,98 CI 95% 1,21-40,33). Pengetahuan baik setelah dikontrol variabel pendidikan dan lama bekerja berpengaruh terhadap keterampilan praktik skrining sebesar 33%.Kesimpulan: Sebagian besar bidan di Kalimantan Barat memiliki pengetahuan baik dan keterampilan yang kompeten untuk skrining kanker serviks dengan metode IVA. Kata Kunci: Pengetahuan, keterampilan praktek skrining, metode IVA 1 Dinas Kesehatan Provinsi Kalimantan Barat2 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada      Yogyakarta
PERBANDINGAN SKOR DISMENOREA PADA PASIEN ENDOMETRIOSIS YANG MENDAPATKAN TERAPI ABLASI LAPAROSKOPI DILANJUTKAN GNRH AGONIST VERSUS ABLASI LAPAROSKOPI SAJA DI RSUP DR. SARDJITO YOGYAKARTA Isyana, Marta; Dasuki, Djaswadi; Rumekti, Diah
JURNAL KESEHATAN REPRODUKSI Vol 1, No 3 (2014)
Publisher : IPAKESPRO

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PERBANDINGAN SKOR DISMENOREA PADA PASIEN ENDOMETRIOSIS YANG MENDAPATKAN TERAPI ABLASI LAPAROSKOPI DILANJUTKAN GnRH AGONIST VERSUS ABLASI LAPAROSKOPI SAJA DI RSUP DR. SARDJITO YOGYAKARTAMarta Isyana 1 , Djaswadi Dasuki2, Diah Rumekti3ABSTRACTBackground: Dysmenorrhea in endometriosis is a condition that adversely impacts the quality of life of women. The current treatment for dysmenorrhea in endometriosis is essentially palliative, since most of these treatment can only suppress disease progression and relieve its symptoms.Objective: To compare the difference in dysmenorrhea scores pre and post treatment of dysmenorrhea in endometriosis patients who received laparoscopic ablation followed with GnRH agonist versus laparoscopic ablation therapy alone.Method: This is an observational study with a retrospective cohort design. Endometriosis patients were identified through medical records at Dr Sardjito Hospital, Yogyakarta. Patients were categorized into laparoscopic ablation therapy followed by GnRH agonist group and laparoscopic ablation therapy only group. Evaluation of dysmenorrhoea scores were performed in 6 months after therapy.Result and Discussion: A total of 88 subjects (44 subjects in each group) were eligible and gave their consent to participate. Patients who received laparoscopic ablation therapy followed by GnRH agonist showed greater VAS difference pre and post treatment (6,27±0,22 vs 4,20±1,17,p<0,001) compared with only ablation laparoscopic. This difference was not affected by age, BMI, and endometriosis stage. Eleven of the 44 subjects who received laparoscopic ablation followed by GnRH agonists developed side effects. There were 7 people with hot flushes, 3 people with decreased bone mineral density and 1 people with dry skin, whereas no subject in laparoscopic ablation group alone experienced them.Conclusions: Laparoscopic ablation followed by GnRH agonist therapy was associated with greather difference in dysmenorrhea score pre and post treatment compared with laparoscopic ablation only. Laparoscopic ablation therapy followed with a GnRH agonist was associated with higher side effects.Keywords: endometriosis, laparoscopic ablation, GnRH agonist, visual analog scaleABSTRAKLatar Belakang: Dismenorea pada endometriosis adalah suatu kondisi yang memberikan dampak bermakna pada mutu kehidupan wanita. Penanganan dismenorea pada endometriosis saat ini pada hakikatnya masih belum berhasil menyembuhkannya, karena sebagian besar baru mampu menekan perkembangan penyakit dan menghilangkan gejalanya.Tujuan: Membandingkan selisih skor dismenorea sebelum dan setelah terapi pada pasien endometriosis yang mendapatkan terapi ablasi laparoskopi dilanjutkan GnRH agonist versus ablasi laparoskopi saja.Metode: Penelitian ini adalah penelitian observasional menggunakan rancangan penelitian kohort retrospektif. Pasien endometriosis diidentifikasi melalui rekam medis di RSUP DR Sardjito, Yogyakarta. Pasien dikelompokkan menjadi kelompok terapi ablasi laparoskopi dilanjutkan dengan GnRH agonist dan terapi ablasi laparoskopi saja.Evaluasi untuk skor dismenorea dilakukan pada jangka waktu 6 bulan setelah terapi. Hasil dan Pembahasan: Sebanyak 88 subyek (44 subyek dalam setiap kelompok) memenuhi kriteria penelitian dan memberikan persetujuan untuk diikutsertakan dalam penelitian. Pasien yang mendapatkan terapi ablasi laparoskopi dilanjutkan GnRH agonist menunjukkan selisih VAS sebelum dan setelah terapi yang secara signifikan lebih baik (6,22±0,22 vs 4,20±1,17;p<0,001) dibandingkan dengan ablasi laparoskopi saja. Perbedaan ini tidak dipengaruhi oleh umur, BMI, maupun derajat endometriosis. Sebelas dari 44 subyek yang mendapatkan ablasi laparoskopi dilanjutkan GnRH agonist mengalami efek samping, yaitu 7 orang mengalami hot flushes, 3 orang mengalami penurunan densitas masa tulang dan 1 orang mengalami kulit kering, sedangkan tidak ada subyek dalam kelompok ablasi laparoskopi saja yang mengalami efek samping.Kesimpulan: Terapi ablasi laparoskopi yang dilanjutkan dengan GnRH agonist berhubungan dengan selisih skor dismenorea sebelum dan setelah terapi yang lebih tinggi dibandingkan dengan terapi ablasi laparoskopi saja. Terapi ablasi laparoskopi yang dilanjutkan dengan GnRH agonist berhubungan dengan tingkat efek samping yang lebih tinggi.Kata kunci: endometriosis, ablasi laparoskopi, GnRH agonist, visual analog scale 1,2,3 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada
The Correlation Of Age, BMI, FBS And Akt Protein Expression In Granulosa Cells Of Polycystic Ovarium Anovulatory Imantika, Efriyan; Dasuki, Djaswadi; Hanoum, Ita Fauziah
JUKE Unila Vol 4, No 07 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

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HUBUNGAN MANAJEMEN AKTIF KALA TIGA DENGAN INISIASI MENYUSUI DINI DI KABUPATEN SUMEDANG TAHUN 2010 Ana, Ade; Dasuki, Djaswadi; Taufiqurahman, Irwan
JURNAL KESEHATAN REPRODUKSI Vol 1, No 1 (2014)
Publisher : IPAKESPRO

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Background: Intervention in activemanagement of the third stage of labor (AMTSL) is aimed to accelerate the deliveryof the placenta, to prevent and reduce blood loss in the third stage of labor. Early initiation of breastfeeding facilitates,a baby to start breastfeeding right away, that aims to stimulate the baby’s suckling reflex for increasingmilk production.This practice can reduce the risk of infant mortality due to hypothermia and infection in infants under 1 month. There are several obstacles in its implementation, due to policy, providers and client. It is important to implement AMTSLand early initiation of breastfeeding to improve the health of mothers and infants accordingly.Objective: To determine the implementation of activemanagement of the third stage and early breastfeeding initiationMethods: This study was an observational study with cross sectional design. The samples were 166 postpartummothers and newborns in public hospitals and health centers at District of Sumedang. Analysis of the data usedunivariate analysis, bivariate analysis using Chi-square and multivariate analysis using logistic regression.Results and Discussion: RThe prevalence of active management of the third stage success was 77,1 % and 48,8 %was completed with early initiation of breastfeeding. There was a significant relationship between the success ofearly breastfeeding initiation after active management of the third stage (OR= 3,1, 95 % CI= 1,12-8,49 ). Otherfactors that related were the support of providers, client support and delivery place. Less supportive policy, noten steps to successful breastfeeding and lack of trained personnel led to differences in perception. Lack of staffmotivation and clear information caused the client did not understand the importance of both these proceduresdone.Conclusion: The success of active management of the third stage and early breastfeeding initiation can be achieved ifthere was a comprehensive support from policy makers (policy side), service providers (support side) and servicerecipients (demand side)  
Placental Trophoblast Responses to Porphyromonas gingivalis Mediated by Toll-like Receptor-2 and -4 Kusumawardani, Banun; Soesatyo, Marsetyawan HNE; Dasuki, Djaswadi; Asmara, Widya
Journal of Dentistry Indonesia Vol 20, No 2 (2013): August
Publisher : Faculty of Dentistry, University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (935.461 KB) | DOI: 10.14693/jdi.v20i2.150

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Trophoblast participates in preventing allorecognition and controlling pathogens that compromise fetal wellbeing. Toll-like receptors recognize conserved sequences on the pathogens surface and trigger effector cell functions. Porphyromonas gingivalis is thought to spread to the umbilical cord and cause fetal growth restriction. Objective: To characterize expression and function of TLR-2 and TLR-4 in trophoblast cells from Porphyromonas gingivalisinfected pregnant rats. Methods: Live Porphyromonas gingivalis were challenged into the maxillary first molar subgingival sulcus of female rats before and/or during pregnancy and sacrified on gestational day (GD) 14 and 20. Porphyromonas gingivalis was detected by API-ZYM system in the maternal blood of the retro-orbital venous plexus and the umbilical cord. TLR-2 and TLR-4 expressions in trophoblast cells was detected by immunohistochemistry. Results: Porphyromonas gingivalis was first detected in the maternal blood and finally spread to the umbilical cord. Syncytiotrophoblast, spongitrophoblast and trophoblastic giant cell in treated groups had significantly higher expression of TLR-2 and TLR-4 than control group (p&lt;0.05). Conclusion: Syncytiotrophoblast, spongitrophoblast and trophoblastic giant cell are able to recognize Porphyromonas gingivalis through TLR-2 and TLR-4 expression. The ligation of TLR-2 and TLR-4 promoted cytokine production and induced trophoblast cell death. These findings strengthen links between periodontal disease and fetal growth restriction.DOI: 10.14693/jdi.v20i2.150
Gestational Day-Dependent Expression of Interleukin-10 and Tumor Necrosis Factor-alpha in Porphyromonas gingivalis-infected Pregnant Rats Kusumawardani, Banun; Soesatyo, Marsetyawan HNE; Dasuki, Djaswadi; Asmara, Widya
Journal of Dentistry Indonesia Vol 20, No 3 (2013): December
Publisher : Faculty of Dentistry, University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (926.193 KB) | DOI: 10.14693/jdi.v20i3.199

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Fetal growth restriction remains a major cause of neonatal morbidity and mortality. Porphyromonas gingivaliscan induce placental inflammatory response resulting in fetal growth restriction. Objective: This study aimed to evaluate the potential utility of the pro-inflammatory cytokine TNF-α and anti-inflammatory cytokine IL-10 in rat placental tissues to understand whether these events were causally related. Methods: Female rats were infected with live-Porphyromonas gingivalis at concentration of 2x109 cells/ml into subgingival sulcus area of the maxillary first molar before and/or during pregnancy. They were sacrificed on gestational day (GD)-14 and GD20. The expression of TNF-α and IL-10 in macrophages and trophoblast cells were detected by immunohistochemistry. Results: A higher expression of TNF-α was found in spongiotrophoblast of the Pg-BD group on GD14 (6.30±1.16), and in trophoblastic giant cells of Pg-D group on GD20 (5.50±1.35). Furthermore, a higher expression of IL-10 was found in trophoblastic giant cells of the Pg-BD group on GD14 (4.50±1.51) and in syncytiotrophoblasts of Pg-BD group on GD20 (8.70±2.67). Conclusion: The expression of TNF-α on GD14 and GD20 were accompanied by increased expression of IL-10. The placental pathologic conditions induced by Porphyromonas gingivalis can be inhibited by elevated expression of IL-10 in macrophages and trophoblast cells.DOI: 10.14693/jdi.v20i3.199
PERILAKU BIDAN DALAM PELAKSANAAN INISIASI MENYUSU DINI DI WILAYAH KERJA PUSKESMAS II TAMBAK, PUSKESMAS BANYUMAS DAN PUSKESMAS I KEMRANJEN Sumiyati, Sumiyati; Emilia, Ova; Dasuki, Djaswadi
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

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PERILAKU BIDAN DALAM PELAKSANAAN INISIASI MENYUSU DINI DI WILAYAH KERJA PUSKESMAS II TAMBAK, PUSKESMAS BANYUMAS DAN PUSKESMAS I KEMRANJEN Sumiyati1, Ova Emilia2, Djaswadi Dasuki3 ABSTRACT Background: Early Initiation of Breastfeeding (EIB) is important because it can increase the success of exclusive breastfeeding and infant survival. However, the implementation of the EIB is still not optimal in Banyumas. One of the factors that support the success of EIB is the support of health workers, especially midwives. Central Bureau of Statistics of Banyumas regency in 2012 said that most of deliveries in Banyumas 78.52% in 2011 attended by midwives.Objective: To determine the behavior of midwives in the implementation of Early Initiation of Breastfeeding at Work Area of Tambak Public Health Center Banyumas. Public Health Center and Kemranjen Public Center.Methods: The study was cross sectional complemented with qualitative data. The experiment was conducted at the Working Area of Tambak II, Banyumas and Kemranjen I public healh centers with 38 midwives as subjects. In-depth interviews conducted to 6 midwives and 4 postpartum mothers.Results and Discussion: There were a significant association between knowledge and attitudes of midwives to practice implementation of EIB, knowledgeable midwife tent to practice E.I.B 1.79 times higher than less knowledgeable midwife. Good attitude midwives 1.62 times more likely to support EIB practice.Conclusion: The behavior of midwife in the implementation of the EIB practices is influenced by a good knowledge and attitudes that support the EIB. Factors that inhibit the EIB, included flat nipples exhaustment of postpartum mothers and lack of rest among health professionals when encountered prolong labor. Keywords: knowledge, attitude, practice, midwife, early initiation of breastfeeding  ABSTRAK Latar Belakang: Inisiasi Menyusu Dini (IMD) penting karena dapat meningkatkan keberhasilan ASI eksklusif dan kelangsungan hidup bayi. Namun pelaksanaan IMD masih belum optimal di Kabupaten Banyumas. Salah satu faktor yang mendukung keberhasilan IMD adalah dukungan tenaga kesehatan terutama bidan. Badan Pusat Statistik Daerah Kabupaten Banyumas tahun 2012 menyatakan sebagian besar penduduk Kabupaten Banyumas sekitar 78,52% pada tahun 2011 menggunakan tenaga kesehatan bidan untuk menolong persalinan.Tujuan: Untuk mengetahui perilaku bidan dalam pelaksanaan Inisiasi Menyusu Dini di Wilayah Kerja Puskesmas II Tambak, Puskesmas Banyumas dan Puskesmas I Kemranjen.Metode: Penelitian observasional dengan rancangan cross sectional. Penelitian ini secara kuantitatif dan kualitatif. Penelitian dilaksanakan di Wilayah Kerja Puskesmas II Tambak, Puskesmas Banyumas dan Puskesmas I Kemranjen dengan subjek penelitian 38 bidan dan wawancara mendalam dengan 6 bidan serta 4 ibu postpartum.Hasil dan Pembahasan: Hasil analisis bivariabel terdapat hubungan yang bermakna antara pengetahuan dan sikap bidan dengan pelaksanaan praktik IMD, bidan yang berpengetahuan baik 1,79 kali lebih besar untuk melakukan praktik IMD dengan baik dibandingkan dengan bidan yang berpengetahuan kurang. Sikap bidan yang mendukung IMD 1,62 kali lebih besar untuk melakukan praktik IMD dengan baik dibandingkan dengan sikap bidan yang tidak mendukung IMD.Kesimpulan: Perilaku bidan dalam pelaksanaan praktik IMD dipengaruhi oleh pengetahuan yang baik dan sikap yang mendukung terhadap IMD. Faktor yang menghambat IMD antara lain bentuk puting yang mendatar sehingga bayi kesulitan untuk menghisap, ibu postpartum merasa capai dan lelah karena kurang istirahat serta faktor tenaga kesehatan, apabila menolong persalinan dengan kala II lama sehingga pelaksanaan IMD kurang dari satu jam. Kata kunci: pengetahuan, sikap, praktik, bidan, inisiasi menyusu dini1    Poltekkes Kemenkes Semarang2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM
HUBUNGAN ANTARA ENDOMETRIOSIS FERTILITY INDEX (EFI) DAN KEBERHASILAN FERTILISASI IN VITRO (FIV) Amelia, Adelina; Dasuki, Djaswadi; Pradjatmo, Heru
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

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Abstract

Adelina Amelia1, Djaswadi Dasuki2, Heru Pradjatmo3Background: Endometriosis is a gynecological disease that is found in 25-30% of infertile women. The most widely used staging system of endometriosis in IVF is the revised American Fertility Society (r-AFS) which has limited predictive ability for pregnancy after surgery. The Endometriosis Fertility Index (EFI) is used to predict fecundity after endometriosis surgery.Objective: To assess the relationship between EFI and the outcomes of IVF.Methods: The study was retrospective cohort. Subjects of study were endometriosis patients who underwent IVF in Infertility Clinic of Permata Hati, Dr. Sardjito Hospital, Yogyakarta in 2012 that met inclusion and exclusion criteria. Subjects were devided into two groups: high EFI and low EFI. ROC curve was used to obtain the cut-off point.Chi-square and logistic regression statistics analysis were used.Results and Discussion: A total of 54 cycles from 54 couples who underwent IVF were included. Cut off point for EFI is 6. There is no difference in the outcomes of IVF between high and low EFI (OR 15,135; 95% CI 0,830-276,00; p=0,067), but high EFI increased the outcome of IVF 15 times better than low EFI. The outcome of IVF was influenced by type of the embryo transfer (OR 0,126; 95% CI 0,028-0,566).Conclusion: High EFI did not affect the outcomes of IVF both rated at biochemical pregnancy, clinical pregnancy and live birth. The outcomes of IVF was influenced by type of the embryo transfer. The cause of female infertility and stage of the endometriosis increased EFI score but did not affect the outcomes of IVF. Keyword: endometriosis, infertility, endometriosis fertility index, in vitro fertilization ABSTRAK Latar Belakang: Endometriosis adalah salah satu penyakit ginekologi yang ditemukan pada 25-50% wanita infertil. Sistim klasifikasi yang digunakan untuk menentukan derajat atau stadium endometriosis dalam FIV yaitu The revised American Fertility Society (r-AFS) yang memiliki keterbatasan dalam memprediksikan kehamilan setelah pembedahan. Endometriosis Fertility Index ( EFI) adalah sistim klasifikasi endometriosis terbaru yang dapat digunakan untuk memprediksikan kehamilan setelah pembedahan.Tujuan: Menilai hubungan antara Endometriosis Fertility Index (EFI) dan keberhasilan Fertilisasi In Vitro (FIV). Metode: Studi kohor retrospektif. Subyek penelitian adalah pasien endometriosis yang menjalani program FIV di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta pada tahun 2012 yang memenuhi kriteria inklusi dan terlepas dari kriteria ekslusi. Subyek dibagi menjadi 2, kelompok EFI tinggi dan EFI rendah. Nilai titik potong EFI didapat dari kurva ROC. Uji statistik yang digunakan adalah Chi-square dan regresi logistik.Hasil dan Pembahasan: Sebanyak 54 siklus dari 54 pasangan yang menjalani fertilisasi in vitro(FIV) disertakan dalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Nilai titik potongditetapkan EFI=6. Tidak terdapat perbedaan secara statistik terhadap keberhasilan FIV antara EFI tinggi dan rendah (OR 15,135; IK 95% 0,830-276,00; p=0,067) tetapi secara klinis skor EFI tinggi meningkatkan keberhasilan FIV 15 kali dibanding skor EFI rendah. Keberhasilan FIV dipengaruhi oleh jenis embrio yang ditransfer (OR 7,020; IK 95% 1,309-37,660; p=0,023).Kesimpulan: Skor EFI tinggi tidak mempengaruhi keberhasilan dalam program FIV baik dinilai pada kehamilan biokimia, kehamilan klinik, maupun kelahiran bayi hidup. Faktor yang mempengaruhi adalah jenis embrio yang ditransfer. Faktor penyebab infertilitas wanita dan stadium endometriosis meningkatkan skor EFI tetapi tidak mempengaruhi keberhasilan FIV.Kata kunci: endometriosis, infertilitas, endometriosis fertility index,fertilisasi in vitro. 1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM
DENSITAS MASSA TULANG PADA PENGGUNA KONTRASEPSI IMPLAN LEVONORGESTREL Kumala Dewi, Andriana; Dasuki, Djaswadi; Rumekti Hadiati, Diah
JURNAL KESEHATAN REPRODUKSI Vol 1, No 2 (2014)
Publisher : IPAKESPRO

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Abstract

DENSITAS MASSA TULANG PADA PENGGUNA KONTRASEPSI IMPLAN LEVONORGESTREL Andriana Kumala Dewi1 , Djaswadi Dasuki2, Diah Rumekti Hadiati3  ABSTRACT Background: BKKBN reported that implant as a long term method of contraception was the most widely used among new users in 2012. The contraceptive action is mainly by inhibition of ovulation and production of estrogen is supressed. Estrogen is one of the most important factors related to bone remodelling. Thus, it has raised concerns regarding the adverse effect of long term use of this contraceptive method on the bone status of women who use them. So, it is necessary to study the effects of long term use of progestogens on bone mineral density.Objective: Comparing bone mass density in contraceptive implant users and non-hormonal users.Methods: Cross sectional study. This study was conducted in Kontap, outpatient department, Sardjito Hospital in August-December 2013. The participants’ age were 20-50 years who met the inclusion criteria and regardless of the exclusion criteria. Total of 110 women were divided into 2 groups, contraceptive implant users and non-hormonal contraceptive users. Bone mass density was measured using ultrasound densitometry on the calcaneus bone.Results: Bivariate Chi-square analysis showed that there was no significant association between the use of the contraceptive implant with incidence of abnormal bone density (RP 1.75; 95% CI (0.80-3.83), p = 0.23). BMI as confounding variable provide a significant relationship with bone density with OR 23.24; 95% CI (4.26 to 126.86), p &lt;0.001Conclusion: In this study, there was no significant difference of bone mass density between contraceptive implant group and non hormonal group. BMI were significantly related to bone mass density. Keyword: Bone mineral density, contraceptive implant, contraceptive progestin-only, levonorgestrel  ABSTRAK Latar belakang: Data BKKBN menunjukkan bahwa implan merupakan metode kontrasepsi jangka panjang terbanyak dipakai oleh peserta baru KB tahun 2012. Cara kerja utama implan levonorgestrel dengan inhibisi ovulasi sehingga terjadi supresi produksi estrogen. Estrogen adalah salah satu faktor penting dalam remodelling tulang. Hal inilah yang memunculkan kekhawatiran tentang pengaruh penggunaan implan terhadap status kesehatan tulang pemakainya.Tujuan: Membandingkan densitas massa tulang pada pengguna kontrasepsi implan levonorgetrel dan non hormonal.Metode penelitian: Studi potong lintang. Penelitian dilakukan di Poliklinik Kontap, RSUP Dr. Sardjito. Jumlah peserta penelitian 110 wanita berusia 20-50 tahun yang memenuhi kriteria inklusi dan terlepas dari kriteria eksklusi, terbagi menjadi 2 kelompok, yaitu kelompok pengguna kontrasepsi implan dan pengguna kontrasepsi non hormonal. Densitas massa tulang diukur dengan menggunakan alat densitometri ultrasonografi pada tulang kalkaneus.Hasil: Analisis bivariat Chi-square menunjukkan bahwa tidak ada hubungan bermakna antara penggunaan kontrasepsi implan dengan kejadian densitas tulang yang tidak normal (RP 1,75; IK 95% (0,80-3,83), p=0,23). BMI sebagai variabel luar memberikan hasil analisis yang bermakna terhadap kejadian densitas tulang tidak normal dengan nilai OR 23,24; IK 95% (4,26-126,86), p&lt;0,001.Kesimpulan: Tidak ada perbedaan densitas massa tulang yang bermakna antara kelompok pengguna kontrasepsi implan dan non hormonal. BMI kategori underweight secara signifikan memiliki hubungan dengan kejadian densitas tulang tidak normal. Kata kunci: densitas massa tulang, kontrasepsi implan, kontrasepsi progestin-only, levonorgestrel 1,2,3 Bagian Obstetri dan Ginekologi FK UGM/RSUP Dr.Sardjito Yogyakarta
Co-Authors Abdul Wahab Ade Ana Adelina Amelia Agustin Endriyani, Agustin Ahmad Hamim Sadewa Aida, . Andriana Kumala Dewi Anifah, Fulatul ARIEF BOEDIONO Ariyanti, Lilik Asmar Yetty Zein, Asmar Yetty Astutik, Widya Atik Triratnawati Awal Prasetyo Banun Kusumawardani Batubara, Irwan Dameria, Netty Katrina Dewi, Adinda Putri Sari Dewi, Adinda Putri Sari Dewi, Fovilia Dewi, Suryani Puspa Dewi, Suryani Puspa Dhesi Ari Astuti, Dhesi Ari Diah Rumekti Diah Rumekti Hadiati Dita Maria Virginia, Dita Maria Djauhar Ismail Dwi Haryadi Edy Meiyanto Efriyan Imantika Elisabeth S Herini, Elisabeth S Endang Purwaningsih Ery purwanti Evi Nurhidayati, Evi Hadi, Cahyono Herlin Fitriani Kurniawati, Herlin Fitriani Heru Pradjatmo Husnawati Husnawati Indria Laksmi Gamayanti Indwiani Astuti Irwan Taufiqurahman Ita Fauzia Hanoum, Ita Fauzia Ita Fauziah Hanoum K, Herlin Fitriana Kadarsih Soejono, Sri Kadarsih Soejono, Sri kartini, farida Kartini, Farida Kora, Firmina Th Kurniaty, Kurniaty Lamana, Aspia Legawati Legawati, Legawati Madarina Julia Mardiana Mardiana Marga, Anik Dwi Marsetyawan HNE Soesatyo Marsetyawan HNE. Soesatyo, Marsetyawan HNE. Marsetyawan Soesatyo Marta Isyana Mubasysyir Hasanbasri MULYOTO PANGESTU Novianto, Asep Nurdiati Z, R. Detty Siti Ova Emilia Patui, Nurhaya S Pinandari, Anggriyani W. Pinda Hutajulu, Pinda Primadani, Astrid Kizy Putri, Intan Mutiara Putri, Isnaini Putri, Nita Tri Restu, Sri Retno Mawarti, Retno Rosdarni Rosdarni, Rosdarni Rukmono Siswishanto Rukmono, Siswishanto Setianingsih, . Shofwal Widad Siswanto Agus Wilopo Sri Handayani Sri Kadarsih S, Sri Sri Kadarsih Soejono Sulchan Sofoewan, Sulchan Sumarni Djoko Waluyo, Sumarni Djoko Sumarni DW, Sumarni SUMIYATI SUMIYATI Totok Utoro Tri Hastuti Tunjung Wibowo Tuti Nuraini Virarisca, Sheilla Wahyuni, Budi Widya Asmara Yayi Suryo Prabandari