Jusuf S. Effendi
Department of Obstetrics and Gynecology, Padjadjaran University, Bandung

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Role of nuclear factor kappa beta, tumor necrosis factor α, and cyclooxygenase-2 in preterm labor Darwin, Eryati; Nasrul, Ellyza; Effendi, Jusuf S.
Medical Journal of Indonesia Vol 23, No 4 (2014): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (669.766 KB) | DOI: 10.13181/mji.v23i4.1005

Abstract

Background: The pathway of tumor necrosis factor alpha (TNFα), nuclear factor kappa beta (NF-κB), and cyclooxygenase-2 (COX-2) activation in releasing prostaglandins is suggested to be crucial for initiating labor in the pathogenesis of preterm labor. The aim of the study was to know whether there were mean differences of NF-κB, TNFα, and COX-2 expressions between preterm and term labor and also to know the correlation among them in preterm labor.Methods: A case-control study was performed from May 2013 to February 2014 in Arifin Achmad Hospital, Pekanbaru. There were 30 subjects with preterm labor as cases and 30 with normal labor as controls. All subjects had singleton gestation with maximum parity was three, age limit of 35 year-old, and spontaneous labor in both groups. Placental tissue was collected from all subjects and evaluated with hematoxylin eosin staining. The expressions of TNFα, NF-κB, and COX-2 in the tissue were assessed with immunohistochemical staining by counting the percentage of smeared cells by two experts. The expressions of TNFα, NF-κB, and COX-2 between case and control were compared using t-test and the correlation was analyzed with Pearson correlation coefficient.Results: Mean (SD) of expressions of TNFα (93.05% [12.68] vs 49.11% [27.33]), NF-κB (42.46% [27.29] vs 13.66% [17.77]), and COX-2 (88.75% [10.86] vs 46% [30.36]) were significantly higher in the preterm labor compared to term labor (p = 0.001). There was significant correlation between TNFα and NF-κB expression (r = 0.385; p = 0.036) and no correlation was found between NF-κB and COX-2 (p = 0.982) in preterm labor.Conclusion: High expressions of TNFα, NF-κB, and COX-2 in preterm labor showed to contribute in the onset of preterm labor. High TNFα may suggest that infection was a leading cause of preterm labor. This is supported with an increase in NF-κB activation will increase COX-2 and subsequently prostaglandins that result in premature labor.
Hubungan Umur Ibu, Paritas dan Penolong Persalinan dengan Kematian Neonatal di Wilayah Kerja Puskesmas Kabupaten Banjarnegara tahun 2013 Rofiqoch, Isnaeni; Effendi, Jusuf S.; Bratakoesoema, Dinan S.
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.36193

Abstract

Background: The neonatal mortality rate is Banjarnegara district is high compared with a target of IMR in Central Java province. In 2012 the neonatal mortality rate in Banjarnegara reached 316 cases, whereas in 2013 there were 115 cases in all health centers working area. The high neonatal mortality rate in Banjarnegara influenced by the persistence of early marriage in woman, birth attendant by non skilled health worker (dukun bayi) and women’s parity more than 4.Objective: The purpose of this study is to analyze the correlation between maternal age, parity and birth attendants with the incidence of neonatal mortality and examine the most dominant factors influencing the incidence neonatal mortality in the Health Center working area in Banjarnegara.Method: This study is a case control study design with retrospective approach. The data consists of perinatal verbal autopsy and medical records as many as 136 respondents consisting of 68 mothers who gave birth to her child and neonatal death and 68 maternal and child alive. Subjects were mothers who gave birth a baby who died aged 0-28 days.Result and Discussion: Statistical analysis using Chi Square, Mann Whitney, and multiple logistic regression. The results showed maternal age and parity variables were not significantly corerelated with neonatal mortality (p> 0.05), the variables significantly corerelated with neonatal mortality was birth attendants with p = 0.001. The results of logistic regression showed the strength of the corerelation from the most dominant variable to the smallest variable were birth attendants with OR: 5.64 (95% CI: 1.81 to 17.4), maternal age OR 3.97 (CI 95%, from 1.54 to 10.22), and parity OR: 0.32 (CI 95% 0.12 to 0.87).Conclusion: In conclusion, there was no relationship between maternal age and parity with neonatal mortality but there was a relationship between birth attendants with neonatal mortality. Based on the results of the multivariable analysis, birth attendants’ effect on the incidence of neonatal deaths was 5 times greater than mother’s age and parity.Keywords: Neonatal mortality, maternal age, parity, birth attendants
Hubungan Umur Ibu, Paritas dan Penolong Persalinan dengan Kematian Neonatal di Wilayah Kerja Puskesmas Kabupaten Banjarnegara tahun 2013 Rofiqoch, Isnaeni; Effendi, Jusuf S.; Bratakoesoema, Dinan S.
JURNAL KESEHATAN REPRODUKSI Vol 3, No 1 (2016)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.116 KB) | DOI: 10.22146/jkr.36193

Abstract

Background: The neonatal mortality rate is Banjarnegara district is high compared with a target of IMR in Central Java province. In 2012 the neonatal mortality rate in Banjarnegara reached 316 cases, whereas in 2013 there were 115 cases in all health centers working area. The high neonatal mortality rate in Banjarnegara influenced by the persistence of early marriage in woman, birth attendant by non skilled health worker (dukun bayi) and women’s parity more than 4.Objective: The purpose of this study is to analyze the correlation between maternal age, parity and birth attendants with the incidence of neonatal mortality and examine the most dominant factors influencing the incidence neonatal mortality in the Health Center working area in Banjarnegara.Method: This study is a case control study design with retrospective approach. The data consists of perinatal verbal autopsy and medical records as many as 136 respondents consisting of 68 mothers who gave birth to her child and neonatal death and 68 maternal and child alive. Subjects were mothers who gave birth a baby who died aged 0-28 days.Result and Discussion: Statistical analysis using Chi Square, Mann Whitney, and multiple logistic regression. The results showed maternal age and parity variables were not significantly corerelated with neonatal mortality (p> 0.05), the variables significantly corerelated with neonatal mortality was birth attendants with p = 0.001. The results of logistic regression showed the strength of the corerelation from the most dominant variable to the smallest variable were birth attendants with OR: 5.64 (95% CI: 1.81 to 17.4), maternal age OR 3.97 (CI 95%, from 1.54 to 10.22), and parity OR: 0.32 (CI 95% 0.12 to 0.87).Conclusion: In conclusion, there was no relationship between maternal age and parity with neonatal mortality but there was a relationship between birth attendants with neonatal mortality. Based on the results of the multivariable analysis, birth attendants’ effect on the incidence of neonatal deaths was 5 times greater than mother’s age and parity.Keywords: Neonatal mortality, maternal age, parity, birth attendants
HUBUNGAN DUKUNGAN SOSIAL DAN KECEMASAN IBU HAMIL TRIMESTER I PRIMIGRAVIDA DI KOTA TASIKMALAYA Patimah, Meti; Husin, Farid; Effendi, Jusuf S.
JURNAL KESEHATAN BUDI LUHUR Vol 12, No 2 (2019): Juli 2019
Publisher : STIKes Budi Luhur Cimahi

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Pelayanan kesehatan pada ibu hamil tidak hanya tertuju pada pemeliharaan kesehatan fisik saja tetapi juga kesehatan psikologis ibu. Salah satu faktor kesehatan psikologis yang sering terjadi adalah kecemasan dan kurangnya dukungan social. Dukungan sosial digambarkan sebagai bantuan emosional yang diberikan kepada individu oleh orang-orang di sekitarnya seperti suami, teman, atau anggota keluarga. Penelitian ini merupakan penelitian cross sectional yang dilakukan pada 30 orang ibu hamil trimester I primigravida dengan usia kehamilan 8-12 minggu yang diperoleh secara acak dari 21 puskesmas di Kota Tasikmalaya. Pengukuran dukungan sosial dan kecemasan menggunakan kuisioner. Analisis hubungan dukungan social dan kecemasan menggunakan uji Chi Square dengan CI 95%. Hasil penelitian diperoleh data dukungan sosial rendah sebesar 30% dan dukungan sosial sedang sebesar 70%. Kecemasan sedang sebesar 43,3% dan kecemasan berat sebesar 56,7%. Ibu hamil dengan dukungan sosial rendah memiliki kecemasan berat sebanyak 30%, sedangkan ibu hamil dengan dukungan sosial sedang memiliki kecemasan sedang sebanyak 43,3% dan kecemasan berat sebanyak 26,7%.? Hasil analisis hubungan antara dukungan sosial dengan kecemasan pada ibu hamil? trimester 1 primigravida nilai p=0,003, dengan nilai OR 2,625 (CI 95%=1,522-4,528). Terdapat hubungan antara dukungan sosial dengan kecemasan pada ibu hamil? trimester 1 primigravida. Perlu ditingkatkan dukungan suami, keluarga, dan bidan serta peningkatan fungsi kelas ibu hamil pada trimester 1 sehingga ibu hamil dapat saling berkomunikasi dan berbagi informasi dengan sesama ibu hamil.?Kata Kunci : dukungan sosial, ibu hamil, kecemasan, trimester 1.
Oxytocin 10 IU as Prophylactic for Uterine Atony : a Randomized Clinical Trial: Oksitosin 10 IU sebagai Profilaksis Atonia Uteri : suatu Uji Coba Klinis Acak Putra, Ridwan A.; Zulqarnain, Iskandar; Azis, Zaimursyaf; Effendi, Jusuf S.; Permadi, Wiryawan; Bandiara, Ria
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 3 July 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.648 KB) | DOI: 10.32771/inajog.v7i3.1026

Abstract

Abstract Objective : To compare the effectiveness of oxytocin dose of 10 IU and 20 IU for preventing uterine atony in women undergoing cesarean section. Methods : This was a double-blind, randomized clinical trial with good matching selection with randomization block of patients who had risk factors for the occurrence of uterine atony such as preeclampsia, patients were receiving MgSO4, oxytocin intrapartum and chorioamnionitis who performed stratified randomization prospectively with two kinds of oxytocin doses which are 10 IU and 20 IU as a prophylaxis for uterine atony in women who performed emergency cesarean section with transverse incision and were using a general anesthesia. Results : This study found no any significant differences between the use of 10 IU and 20 IU as prophylaxis for uterine atony during cesarean section either in its action at the time or while in recovery room, especially on the cases without chorioamnionitis thus using oxytocin 10 IU regimen can be considered, besides the effectiveness did no differ, it will cost cheaper than oxytocin 20 IU regimen which frequently used. Conclusions : There were no significant differences in the incidence of blood loss during the cesarean section between the treatment of oxytocin 10 IU group and oxytocin 20 IU group. The additional uterotonic was using during the action of the cesarean section between the treatment of oxytocin 10 IU group, and oxytocin 20 IU group gave no significant differences. The side effects in this study at least form of chills and vomiting found no significant differences between both of groups despite the side effects that arise in oxytocin 20 IU group was higher at 23.08% than oxytocin 10 IU group at 15.19%. Chorioamnionitis would be a risk factor for the occurrence of uterine atony during the action of the cesarean section if it associated with the use of additional uterotonic in oxytocin 10 IU group if compared with oxytocin 20 IU group. Keywords : cesarean section, oxytocin, uterine atony.   Abstrak Tujuan : Untuk membandingkan efektifitas penggunaan dosis 10 IU dan 20 IU sebagai profilaksis atonia uteri pada saat seksio sesarea. Metode : Penelitian ini menggunakan uji klinis acak ganda dengan seleksi yang sesuai dengan blok acak pada pasien-pasien yang memiliki faktor risiko terjadinya atonia uteri seperti preeklamsia, pasien yang diberikana MgSO4 dan oxytocin intrapartum sebelumnya serta chorioamnionitis yang dilakukan pengacakan secara prosfektif bertingkat yang diberikan dua jenis dosis oksitosin yaitu 10 IU dan 20 IU sebagai profilaksis atonia uteri pada perempuan yang dilakukan seksio sesarea darurat dengan insisi transversal dan menggunakan anestesi umum. Hasil : Penelitian ini menemukan tidak adanya perbedaan yang bermakna antara penggunaan dosis oksitosin 10 IU dan 20 IU sebagai profilaksis atonia uteri pada seksio sesarea baik saat tindakan operasi maupun saat berada di ruang pemulihan, terutama pada kasus-kasus tanpa khorioamnionitis dimana memerlukan oksitosin tambahan pada kelompok 10 IU, selain efektifitasnya tidak berbeda, akan lebih murah dari pada rejimen oksitosin 20 IU yang sering digunakan saat ini. Kesimpulan : Berdasarkan hasil penelitian ini, tidak ada perbedaan yang bermakna dalam kejadian kehilangan darah selama operasi seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU. Penggunaan uterotonik tambahan selama tindakan seksio sesarea antara perlakuan kelompok oksitosin 10 IU dan kelompok oksitosin 20 IU tidak memberikan perbedaan yang signifikan. Efek samping dalam penelitian ini yakni menggigil dan muntah, tidak ditemukan perbedaan yang bermakna antara kedua kelompok meskipun efek samping yang muncul pada kelompok oksitosin 20 IU lebih tinggi 23,08% dibandingkan kelompok oksitosin 10 IU pada 15,19%. Khorioamnionitis merupakan faktor risiko terjadinya atonia uteri selama tindakan seksio sesarea jika dikaitkan dengan penggunaan uterotonika tambahan pada kelompok oksitosin 10 IU jika dibandingkan dengan kelompok oksitosin 20 IU. Kata kunci : atonia uteri, oksitosin, seksio sesarea.
ANALISIS FAKTOR RISIKO ATONIA UTERI Julizar, Melati; Effendi, jusuf S.; Sukandar, Hadyana
Care : Jurnal Ilmiah Ilmu Kesehatan Vol 7, No 3 (2019)
Publisher : Universitas Tribhuwana Tunggadewi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (275.122 KB) | DOI: 10.33366/jc.v7i3.1399

Abstract

Maternal mortality rate in Indonesia is still relatively high. The biggest cause of maternal mortality in Indonesia is bleeding. Most bleeding in the puerperium (75-80%) is uterine atony. Uterine atony is the most frequent cause of the occurrence of bleeding postpartum. This study aimed to analyze the risk factors for uterine atony in Cut Meutia General Hospital and Health Center PONED in North Aceh district. This study uses a case control design, as a case group, maternal postpartum hemorrhage with uterine atony and control group, maternal postpartum hemorrhage without uterine atony. The sample size for each selected group 69 (the number of cases during the period from 2015 to 2017) while the control selected at random with the same number as many as 69 cases. Data analysis using chi square and multiple logistic regression. The results of the research bivariable indicates a meaningful associated with uterine atony is preeclampsia with OR 10,30 (CI 95%: 2,91-36,41), twin pregnancy with OR 17,31 (CI 95%: 2,21-135,76), induction of labor with an OR 4,39 (CI 95%: 1,0-21,45), grande multipara with OR 4,52 (CI 95%: 1,61-12,73) compared with primipara. Multivariable those associated with uterine atony is the age of the mother with OR 2,98 (CI 95%: 0,56-15,82), preeclampsia with OR 20,27 (CI 95%: 4,66-88,20), induction of labor with an OR 6,69 (CI 95%: 1,12-39,95), twin pregnancy with OR 52,39 (CI 95%: 5,65-486,03), anemia with OR 3,06 (CI 95%: 1,07-8,69). This study concluded that parity, preeclampsia, twin pregnancy and labor induction were risk factors for the incidence of uterine atony with twin pregnancy as the most dominant factor in the incidence of uterine atony. Keywords : Risk factors; Uterine Atony.
HUBUNGAN KADAR ASAM URAT, LAKTAT DEHIDROGENASE, ASPARTAT AMINOTRANSFERASE SERUM PENDERITA PREEKLAMSI BERAT DISERTAI KOMPLIKASI DAN TANPA KOMPLIKASI Apriadi, Galih; Handono, Budi; Pramatirta, Akhmad Yogi; Effendi, Jusuf S.; Madjid, Tita Husnitawati; Pribadi, Adhi
Indonesian Journal of Obstetrics & Gynecology Science Volume 3 Nomor 1 Maret 2020
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (868.094 KB)

Abstract

Latar Belakang: Preeklamsi berat merupakan salah satu penyebab tersering mortalitas dan morbiditas pada ibu dan bayi. Morbiditas dan mortalitas pada ibu akan semakin meningkat karena terjadinya komplikasi. Komplikasi preeklamsi berat yang terjadi dapat berupa komplikasi kardiovaskular, hati, otak dan ginjal. Tujuan penelitian ini untuk mencari perbedaan kadar asam urat, laktat dehidrogenase atau LDH dan aspartat aminotransferase atau AST pada serum penderita preeklamsi berat disertai komplikasi dan tanpa komplikasi dan mengukur kuatnya hubungan peningkatan kadar asam urat, LDH dan AST dengan peningkatan risiko terjadinya komplikasi pada pasien preeklamsi berat.Metode: Rancangan penelitian ini adalah penelitian comparative cross sectional dengan metode consecutive sampling yang membandingkan hasil laboratarium asam urat, LDH, AST dari subjek penelitian yang memenuhi kriteria inklusi. Subjek penelitian adalah penderita preeklamsi berat disertai komplikasi dan preeklamsi berat tanpa komplikasi (n=68). Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung dan rumah sakit jejaring pada bulan November-Desember 2016.Hasil : Hasil penelitian didapatkan perbedaan kadar asam urat, LDH dan AST pada kedua kelompok secara bermakna dengan nilai p ? 0,05. Peningkatan kadar asam urat, LDH dan AST berhubungan dengan peningkatan risiko terjadinya komplikasi pada preeklamsi berat dengan nilai cut off kadar asam urat > 6,5 mg/dL sebesar 33 kali, LDH > 573 U/L sebesar 8,95 kali dan AST > 30 U/L sebesar 5,19 kali. Jika terjadi peningkatan seluruh kadar asam urat, LDH dan AST diatas nilai cut off maka risiko terjadinya komplikasi pada preeklamsi berat sebesar 98,1%.Kesimpulan: Penelitian ini menyimpulkan kadar asam urat, LDH, AST pada preeklamsi berat disertai komplikasi lebih tinggi dibandingkan preeklamsi berat tanpa komplikasi dan peningkatan kadar asam urat, LDH, AST berhubungan dengan peningkatan risiko terjadinya komplikasi pada preeklamsi berat.