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"Pemakaian antibiotik profilaksis pada sebagian kasus bedah caesar telah terbukti dapat mengurangi kejadian infeksi daerah operasi. Tujuan penelitian ini adalah untuk mengetahui gambaran penggunaan antibiotik profilaksis serta kesesuaian penggunaan antibiotik profilaksis yang digunakan pada pasien bedah caesar di Rumah Sakit Anak dan Bunda Harapan Kita Tahun 2016. Penelitian dilakukan secara observasional dengan menggunakan metode deskriptif analitik dan data diperoleh dari rekam medis pasien secara retrospektif. Data yang di analisis meliputi kesesuaian jenis antibiotik, dosis, dan waktu pemberian dibandingkan degan pedoman. Pasien yang memenuhi kriteria inklusi sebanyak 267 pasien.Hasil analisis data menunjukkan antibiotik profilaksis yang banyak digunakan adalah seftriakson injeksi. Ditinjau dari jenis antibiotik yang digunakan, dosis, dan waktu pemberiaan kesesuaiannya masing-masing sebesar 59,18 , 74,91 , 76,40 . Secara keseluruhan, penggunaan antibiotik profilaksis pada pasien bedah caesar 28,46 mendapatkan penggunaan antibiotik profilaksis yang sesuai dan 71,54 tidak sesuai terhadap Clinical Pathway Sectio Caesarea di RSAB Harapan Kita, American Society of Health-System Pharmacists ASHP 2013, dan Drug Information Handbook 17th Edition.

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The use of antibiotics prophylaxis in some cases of caesarean has been shown to reduce the incidence of surgical site infections. The purpose of this study was to know the description of the use of antibiotics prophylaxis and the suitability of antibiotics prophylaxis used in cesarean section patients at Mother and Children 39 s Hospital Harapan Kita in 2016. The study was conducted in observation using descriptive analytics method and data aquired from the patient 39 s medical records investigation retrospectively. The data analyzed included suitability of antibiotic type, dosage, and delivery time compared with guidelines. Patients who met the inclusion criteria were 267 patients.The results of the data analysis show that the widely used prophylactic antibiotics are ceftriaxone injection. Judging from the type of antibiotics used, dose of confirmity, and time of conformity, suitability was 59.18 , 74.91 , and 76.40 , respectively. Overall, the use of prophylactic antibiotics in cesarean section 28.46 of the use of appropriate prophylactic antibiotics and 71.54 were incompatible with the clinical pathway of Sectio Caesarea at Mother and Children 39 s Hospital Harapan Kita, American Society of Health System Pharmacists ASHP 2013, and Drug Information Handbook 17th Edition."

"Angka kejadian bedah caesar di seluruh dunia terus meningkat setiap tahun. Namun, angka risiko kematian pasca bedah caesar sangat tinggi akibat infeksi. Pemakaian suatu jenis antibiotik profilaksis pada sebagian kasus bedah caesar telah terbukti dapat mengurangi kejadian infeksi luka operasi. Tujuan penelitian ini untuk mengetahui pola penggunaan antibiotik profilaksis serta kerasionalan antibiotik profilaksis yang digunakan pada pasien bedah caesar di RSUPN Dr. Cipto Mangunkusumo tahun 2015. Penelitian dilakukan secara observasional dengan menggunakan metode deskriptif dan data diperoleh dari rekam medis pasien secara retrospektif. Pengambilan data dilakukan dengan teknik purposive sampling. Evaluasi kerasionalan penggunaan antibiotik profilaksis dinilai dari ketepatan pasien, tepat indikasi, tepat obat, tepat dosis, tepat waktu pemberian dan tanpa infeksi luka operasi. Pasien yang memenuhi kriteria sebagai subjek penelitian sebanyak 245 pasien. Data yang diperoleh menunjukkan bahwa jenis antibiotik profilaksis yang paling banyak digunakan adalah sefazolin (72,66%). Pada penelitian terdapat pasien bedah caesar yang menerima antibiotik profilaksis 100% tepat pasien, 100% tepat indikasi, 98,78% tepat obat, 98,37% tepat dosis dan 72,24% tepat waktu pemberian, serta 98,37% tanpa infeksi luka operasi. Penggunaan antibiotik profilaksis pada pasien bedah sesar terbukti 72,24% pasien menunjukkan kerasionalan. The number of caesarean section in all over the world continue to increase each year. But the rate of post caesarean section risk of death is very high due to infection. The use of a type of antibiotics prophylaxis in some cases of caesarean section has been proven to reduce the occurrence of surgical site infection. The purpose of this study was to know the image of antibiotic prophylaxis and the rationality of antibiotic prophylaxis on caesarean section patients in RSUPN Dr. Cipto Mangunkusumo in 2015. This study was conducted in observation using descriptive method and the data is acquired from medical record investigation retrospectively. Data were collected using purposive sampling technique. Rational use of antibiotics assessed evaluation of the appropriate patient, appropriate indication, appropriate drug, appropriate dose, appropriate time and without the provision of surgical site infection. Eligible patients as subjects of research were 245 patients. Data obtained showed that the most common kind of antibiotic prophylaxis that being used is cefazoline (72.66%). In this study were caesarean patients who received antibiotic prophylaxis showed 100% appropriate patient, 100% appropriate indication, 98.78% appropriate drug, 98.37% appropriate dose, 72.24% appropriate time and 98.37% no surgical site infection. The usage of antibiotic prophylaxis in patients with proven 72.24% caesarean section patients showed rationality."

"ABSTRAKNama : Echa AisyahProgram Studi : Ilmu Kesehatan MasyarakatJudul : Evaluasi Ekonomi Penggunaan Antibiotika Profilaksis CefotaximeDan Ceftriaxone Pada Pasien Operasi Seksio Sesarea Di RumahSakit X Tahun 2017Pemberian antibiotik profilaksis pada operasi seksio sesarea sangat dianjurkan.Menurut pedoman umum penggunaan antibiotik obat dipilih atas dasar keamanan danefektivitas biaya. Evaluasi ekonomi ini menggunakan metode alongside observationalstudy, data dikumpulkan selama bulan April ndash;Mei 2017 secara prospektif mencakup 60pasien dengan operasi seksio sesarea yang mendapatkan antibiotik profilaksis,membandingkan efektivitas biaya antara Cefotaxime dan Ceftriaxone. Hasil ujistatistik menunjukkan bahwa tidak ada perbedaan karakteristik pada 60 pasien tersebut.Analisis menggunakan perspektif rumah sakit, dilaksanakan di rumah sakit milikPemerintah di Jawa Barat. Hasil Systematic Review menunjukkan bahwa tidak adaperbedaan efikasi pada penggunaan kedua obat tersebut. Hasil penelitian inimenkonfirmasi bahwa tidak ada perbedaan outcome klinis berupa infeksi luka operasibaik pada pasien yang mendapatkan antibiotik profilaksis Ceftriaxone maupunCefotaxime. Komponen biaya terbesar adalah biaya operasional 84,79 , diikutibiaya alokasi dari unit penunjang 13,68 , lalu biaya investasi 1,2 dan biayapemeliharaan 0,32 . Analisis memberikan hasil biaya inkremental sebesar Rp.342.535,00 pada satu episode rawat inap. Rumah sakit memiliki potensi untukmenghemat sebesar Rp. 317.529.945,00 setahun dengan memilih antibiotik profilaksisCefotaxime pada pasien operasi seksio sesarea.Kata Kunci : Antibiotik Profilaksis; Operasi Seksio Sesarea; Efektivitas Biaya.

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ABSTRACTName Echa AisyahProgram of Study Public HealthTitle Economic Evaluation on The Use of Prophylaxis AntibioticCefotaxime and Ceftriaxone in Caesarean Section SurgeryPatients at X Hospital in The Year 2017.Prophylactic antibiotic for patients with caesarean section surgery is highlyrecommended in the clinical guideline. The use of antibiotics is selected by usingcriteria safety and cost effectiveness. This economic evaluation was using alongsideobservational study method, prospective data was collected from April to May 2017covering 60 patients with cesarean section surgery who received prophylaxisantibiotics, comparing cost effectiveness between Cefotaxime and Ceftriaxone. Thestatistical test showed that there was no differences of characteristics in the 60 patients.The analysis based on hospital perspective, carried out in a public hospital in WestJava. The Systematic Review showed that there were no difference in the efficacy ofthe drugs. This study confirmed that there was no difference in clinical outcome onsurgical wound infections either in patient who received Ceftriaxone prophylaxis orCefotaxime. The greatest component of the cost was the operational cost 84,79 ,followed by the indirect cost 13,68 , investment cost 1,2 , and maintenance cost 0,32 . The analysis suggested the incremental cost was IDR 342.535 in one episodeof treatment. Hospital would save cost of IDR 317.529.945 a year by choosingCefotaxime prophylactic antibiotics for patients with cesarean section surgery.Keywords Prophylaxis Antibiotic Cesarean Section Surgery Cost Effectiveness"

"ABSTRAKLatar belakang: Nyeri pasca bedah yang tidak terkontrol dapat menyebabkan perubahan klinis dan fisiologis yang terkait dengan peningkatan mortalitas, morbiditas dan biaya rawat serta menurunnya kualitas hidup pasien. Sebaliknya, penggunaan analgetik yang berlebihan dapat meningkatkan risiko terjadinya efek samping obat. Studi prospektif ini bertujuan untuk mengetahui pola penggunaan analgetik (jenis, dosis, frekuensi dan cara pemberian analgetik) dan menilai keadekuatan tatalaksana nyeri, tingkat kepuasan pasien terhadap penatalaksanaan nyeri, efek samping dan interaksi obat analgetik pada pasien pasca bedah sesar emergency.Metode: Penelitian ini merupakan studi observasional prospektif pada pasien pasca bedah sesar emergency yang dirawat di ruang perawatan Departemen Kebidanan dan Kandungan Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN-CM) dalam periode Juli 2015 - Januari 2016. Keadekuatan tatalaksana nyeri dinilai berdasarkan pain management index (PMI). Tingkat kepuasan pasien terhadap tatalaksana nyeri dinilai menggunakan American Pain Society Patient Outcome Questionnaire (APSPOQ). Hubungan keadekuatan tatalaksana nyeri dengan tingkat kepuasan pasien dievaluasi dengan uji Fisher's exact. Analisis statistik dilakukan menggunakan SPSS versi 20.Hasil penelitian: Dari 92 pasien bedah sesar emergency yang dirawat di ruang inap RSUPN-CM, 80 pasien memenuhi kriteria inklusi dan menjadi subjek penelitian. Terdapat 19 pasien (8.7%) yang selama perawatan diberikan 2 jenis AINS secara bersamaan dan 28 analgetik (41.8%) yang pada hari pertama perawatan frekuensi pemberiannya kurang. Sebagian besar pasien masih merasakan nyeri dengan numeric rating scale (NRS)>3 dalam 24 jam pasca bedah:59 pasien (73.75%) merasakannya saat aktivitas dan 7 pasien (8.75%) saat istirahat. Median tingkat kepuasan pasien terhadap penatalaksanaan nyeri selama di ruang perawatan berdasarkan skor APSPOQ adalah 7.50 (range 0-10). Tidak terdapat hubungan antara tingkat kepuasan pasien dengan kontrol intensitas nyeri, baik saat beraktivitas (Fisher's exact test, p=0.537) maupun saat istirahat (Fisher's exact test, p=0.1616). Pada penelitian ini terdapat 2 potensi terjadinya interaksi obat yaitu ketoprofen dan natrium diklonefak dengan bisoprolol.Kesimpulan:Penatalaksanaan nyeri pasca bedah sesar emergency di RSUPN-CM masih optimal; sebagian besar (73.75% pasien) belum mendapatkan penatalaksanaan nyeri yang adekuat pada 24 jam pasca bedah, meskipun demikian, tingkat kepuasan pasien mencapai skor APSPOQ 7,50.

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ABSTRACT

Backgroud

Uncontrolled post-operative pain can cause clinical and physiological changes leading to increased mortality and morbidity and treatment cost and decreased quality of life. On the other hand, excessive analgetic use can increase the side effects of the drug. The objective of this study was to understand the using pattern of analgetic (type, doses, interval and analgetic used) and to evaluate the pain management of post-operative caesarean section emergency patients (pain intensity, the level of patients satisfaction to pain management, analgetic drug side effects, the appropriateness of pain management).

Methods

This was a prospective observational study conducted on patients after an emergency caesarean section and treated at The Department of Obstetry and Gynecology, National Center Hospital Cipto Mangunkusumo (RSUPN-CM) during July 2015 - January 2016. The adequacy of pain management were assessed with pain management index (PMI). Level of patient satisfaction to pain management were esesssed with American Pain Society Patient Outcome Questionnaire (APSPOQ). Relationship between level of patient satisfaction and pain intensity were assessed with Fisher's exact test. Statistical analysis was performed by SPSS version 20.

Results

Out of 92 patients which have undergone emergency caesarean section and treated in RSUPN-CM, 80 patients fulfilled inclusion criteria. There were 19 patients (8.7%) that received 2 type of NSAIDs simultaneously with the total of 28 analgetics (41.8%) were given with interval of administration less than advised by the references during the first 24 hour of the treatment. Most of patients still experienced the pain during treatment with numeric rating scale (NRS) > 3 in first 24 hour post-operative: 59 patients (73.75%) had pain during movement and 8.75% (7 patients) during rest. The study median value of patient satisfaction with pain management was 7.50 (range 0-10). There is no relationship between level of patient satisfaction and pain intensity during movement (p=0.537) and during rest (p=0.161). There were 2 potential drug interaction, namely ketoprofen and sodium diclofenac with bisoprolol.

Conclusion

About 73.75% patients still experience post-operative pain which indicate that pain management of post-operative emergency caesarean section emergency in CM hospital was not yet adequate, However, level of patient's satisfaction with pain management reach the value of 7,5."

"Penelitian ini merupakan studi kasus di salah satu rumah sakit swasta tipe C di Kabupaten Bogor yang bertujuan untuk melakukan evaluasi efektivitas alur pelayanan sectio caesarea (SC) emergency pada tahun 2021 (masa pandemi COVID-19) dari sisi input, proses, dan outcome. Alur pelayanan sectio caesarea (SC) emergency yang ada disesuaikan dengan referensi Pemerintah dan Profesi (POGI), yakni adanya skrining COVID-19 dengan melakukan pemeriksaan swab-RDT Antigen dan rontgen thorax, serta konsultasi kepada Spesialis Paru atau Penyakit Dalam. Penelitian ini dilakukan dengan mix-method, secara kuantitatif dengan metode potong lintang dari berkas rekam medis dan dilanjutkan dengan kualitatif dari para informan kunci dan informan tambahan. Penelitian dilakukan pada 379 sampel pasien yang melakukan persalinan secara sectio caesarea (SC) emergency periode Januari-Desember 2021. Karakteristik pasien didapatkan 75,5% adalah usia 20-35 tahun dengan rata-rata 29,32 tahun; 58,8% adalah multipara dengan rata-rata paritas 1,96; dan 92,3% usia kehamilan 37-42 minggu dengan rata-rata 38,50 minggu. Diagnosis pasien didapatkan 77% kategori 2 dan 95,5% status non COVID-19. Diagnosis kategori 1 sebanyak 11,8% adalah fetal distress dan diagnosis kategori 2 sebanyak 27,7% adalah ketuban pecah dini (KPD), dengan response time kategori 1 <30 menit hanya 1,1% dan response time kategori 2 dalam 30-75 menit sebanyak 33,2%. Kemudian rata-rata waktu informed consent didapatkan 3,71 menit; waktu konsul Spesialis Paru/Penyakit Dalam didapatkan 4,06 menit; waktu konsul Spesialis Anestesi didapatkan 3,77 menit; proses transfer pasien didapatkan 6,01 menit; waktu spinal anestesi didapatkan 5,08 menit; waktu mulai operasi sampai bayi lahir didapatkan 20, 37 menit, dengan rata-rata pasien per-bulan adalah 31,58 dan waktu tanggap sectio caesarea (SC) emergency selama 111,87 menit. Pada analisis bivariat didapatkan adanya korelasi yang bermakna antara rerata jumlah pasien terhadap waktu tanggap sectio caesarea (SC) emergency (p-value=0,019), dan tidak ada hubungan bermakna antara diagnosis kategori 1 dan kategori 2 (p-value=0,767) serta status COVID-19 dan Non COVID-19 (p-value=0,071) terhadap waktu tanggap sectio caesarea (SC) emergency; namun status COVID-19 terhadap waktu tanggap SC emergency memiliki hubungan bermakna dari sisi substansi. Pada kualitatif, didapatkan bahwa seluruh informan sudah mengetahui dan memahami alur pelayanan SC emergency selama pandemi ini, faktor pendukung yang ada adalah kekompakan dan kerjasama tim, dukungan manajemen rumah sakit untuk mengutamakan safety tenaga kesehatan ditunjang oleh sarana prasarana dan sumber daya manusia (SDM) yang sesuai, serta faktor penghambat yang ada adalah proses skrining/penapisan COVID-19 (hasil pemeriksaan penunjang), letak kamar operasi di lantai 2 dan tidak ada lift khusus transfer pasien, serta kekosongan alat pelindung diri (APD) dan linen operasi. Kesimpulannya, penilaian efektivitas alur pelayanan SC emergency tahun 2021 dengan pendekatan goal approach belum efektif, dilihat dari outcome yaitu rata-rata waktu tanggap SC emergency yang belum mencapai target indikator mutu (≤30 menit).

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This research is a case study in a type C private hospital in Bogor Regency which aims to evaluate the effectiveness of the emergency sectio caesarea (SC) service flow in 2021 (the COVID-19 pandemic) in terms of input, process, and outcome. The existing emergency sectio caesarea (SC) service flow is adjusted to the Government and Profession (POGI) reference, namely the presence of COVID-19 screening by carrying out an antigenic swab-RDT examination and chest X-ray, as well as consultation with Lung Specialists or Internal Medicine. This research was conducted using a mix-method, quantitatively with a cross-sectional method from medical record files and followed by qualitative research from key informants and additional informants. The study was conducted on 379 samples of patients who delivered emergency caesarean section (SC) for the period January-December 2021. Characteristics of patients obtained were 75.5%, aged 20-35 years with an average of 29.32 years; 58.8% were multiparous with a mean parity of 1.96; and 92.3% gestational age 37-42 weeks with a mean of 38.50 weeks. The patient's diagnosis obtained 77% category 2 and 95.5% non-COVID-19 status. Category 1 diagnosis of 11.8% was fetal distress and diagnosis of category 2 of 27.7% was premature rupture of membranes (PROM), with category 1 response time <30 minutes only 1.1% and category 2 response time within 30-75 minutes as much as 33.2%. Then the average time for informed consent was 3.71 minutes; the time for the Lung Specialist/Internal Medicine consul was 4.06 minutes; Anesthesia specialist consul time was 3.77 minutes; patient transfer process obtained 6.01 minutes; spinal anesthesia time was found to be 5.08 minutes; the time from the operation to the birth of the baby was 20.37 minutes, with the average patient per month was 31.58 and the emergency sectio caesarea (SC) response time was 111.87 minutes. In bivariate analysis, it was found that there was a significant correlation between the mean number of patients and the response time for emergency sectio caesarea (SC) (p-value=0.019), and there was no significant relationship between category 1 and category 2 diagnoses (p-value=0.767) and status COVID-19 and Non COVID-19 (p-value=0.071) for emergency sectio caesarea (SC) response time; however, the status of COVID-19 on the emergency SC response time has a significant relationship in terms of substance. In qualitative terms, it was found that all informants already knew and understood the flow of emergency SC services during this pandemic, the supporting factors were cohesiveness and teamwork, hospital management support to prioritize the safety of health workers supported by adequate infrastructure and human resources (HR). appropriate, and the existing inhibiting factors are the COVID-19 screening process (results of supporting examinations), the location of the operating room on the 2nd floor and no special elevator for patient transfers, as well as the vacancy of personal protective equipment (PPE) and operating linen. In conclusion, the assessment of the effectiveness of the SC emergency service flow in 2021 with the goal approach approach has not been effective, seen from the outcome, namely the average emergency SC response time that has not reached the target quality indicator (≤30 minutes)."

"Diare akut adalah proses defekasi yang lebih sering dari biasanya (>3x sehari) dengan durasi < 14 hari. Salah satu penyebab diare akut adalah infeksi bakteri. Adanya infeksi bakteri ini harus ditangani dengan penggunaan antibiotik spesifik terhadap bakteri penyebab secara rasional. Penelitian ini dilakukan untuk mengevaluasi penggunaan antibiotik pada pasien diare akut di ruang rawat inap anak RSAB Harapan Kita tahun 2016. Evaluasi penggunaan antibiotik dilakukan secara kuantitatif dan kualitatif. Penelitian ini merupakan penelitian deskriptif dengan desain studi cross-sectional. Pengambilan data dilakukan secara retrospektif menggunakan data rekam medis pasien dengan teknik total sampling. Sampel dalam penelitian ini adalah seluruh data pasien anak (usia >1 bulan-12 tahun) yang menderita diare akut di ruang rawat inap anak RSAB Harapan Kita tahun 2016 dengan terapi antibiotik. Penelitian dilakukan terhadap 88 data rekam medis yang memenuhi kriteria inklusi. Kuantitas penggunaan antibiotik terbesar yang dinyatakan dalam satuan PDD adalah seftriakson (152,75) dan DDD/100 pasien/hari terbesar adalah seftriakson (34,56). Antibiotik yang menyusun segmen DU90% adalah seftriakson, sefotaksim, seftizoksim, dan ampisilin sulbaktam. Penggunaan antibiotik untuk terapi diare akut di ruang rawat inap anak RSAB Harapan Kita tahun 2016 90,87% sesuai dengan Formularium Nasional.

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Acute diarrhea is a defecation process which happens more often than usual (3x daily) with duration < 14 days. One of its cause is bacterial infections. This bacterial infection needs to be treated by specific antibiotic against the bacteria and used rationally. This research is done to evaluate the uses of the antibiotic for acute diarrhea patient in child inpatiens room Mother and Child Harapan Kita Hospital of year 2016. The uses of antibiotic evaluation are done quantitatively and qualitatively. This research is a descriptive research with cross-sectional study design. Data collection is done retrospectively using patients medical records and total sampling technique. Sample of this research is all children patients in age interval of >1 month until 12 years old in child inpatiens room in Mother and Child Harapan Kita Hospital of year 2016 which suffer from acute diarrhea and need antibiotic therapy. The research is done for all 88 medical records which fulfill the inclusion criteria. The largest quantity of used antibiotics is expressed in PDD unit is ceftriaxone (152.75) and the largest of DDD/100 patient/day is ceftriaxone (34.56). Antibiotics that composed in DU90% segment are ceftriaxone, cefotaxime, ceftizoxime, and ampicillin sulbactam. The uses of antibiotic against diarrhea in child inpatiens room in Mother and Child Harapan Kita Hospital of Year 2016 is 90.87% corresponds with Formularium Nasional."

"Caesarean figure in Indonesia has passed a maximum limit WHO has set. An overview of Caesarean mothers show that 64,52% of whom reside in urban areas with 50,25$ received junior high school education and below, and 47,5% are of poor families (quintiles 1 and 2). Approximately 72% of family heads works in informal sector. About 38% of Caesaeran surgery were primiparous, where 75% is done where the mothers are not in the high risk age for normal vaginal deliveries. 80% of mothers also do not have history of fetal death and signs of complications during pregnancy only give result of 15,4%. "

"Disfungsi seksual perempuan merupakan gangguan yang terjadi pada fungsi seksual perempuan sehingga dapat mengganggu kegiatan seksual dan menyebabkan tekanan intrapersonal. Disfungsi seksual perempuan secara umum memiliki prevalensi sebesar 40,9% pada perempuan pre-menopause di dunia. Disfungsi seksual pasca persalinan dapat terjadi setelah proses persalinan dan mengganggu fungsi seksual perempuan serta berdampak pada psikologis dan hubungan dengan pasangan. Disfungsi seksual pasca persalinan dipengaruhi oleh banyak faktor, salah satunya adalah operasi Caesar. Penelitian ini bertujuan untuk mengidentifikasi hubungan disfungsi seksual dengan pasca operasi Caesar. Penelitian ini menggunakan desain studi potong lintang. Pengambilan sampel dilakukan secara consecutive sampling menggunakan Female Sexual Function Index (FSFI-6) dan pengolahan data dilakukan menggunakan SPSS versi 20. Uji analisis menggunakan uji Chi Square dan Fisher’s exact test. Secara statistik, hubungan disfungsi seksual dengan metode persalinan secara Caesar tidak signifikan (OR=2,750; IK 95%=0,771-9,808; P=0,111). Faktor lain yang diteliti (usia, status pendidikan, dan status pekerjaan) juga secara statistik tidak signifikan (p>0,05). Hubungan disfungsi seksual dengan metode persalinan secara operasi Caesar secara statistik tidak signifikan. Namun, berdasarkan nilai OR operasi Ceasar memiliki risiko 2,750 kali lipat meningkatkan kejadian disfungsi seksual.

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Female sexual dysfunction is a disorder that occurs in a woman's sexual function that can interfere with sexual activity and cause intrapersonal distress. Female Sexual dysfunction has a prevalence of 40.9% in pre-menopausal women in the world. Postpartum sexual dysfunction can occur after childbirth and have an impact on psychological and relationships with partners. Postpartum sexual dysfunction is influenced by many factors, one of which is the Caesarean section.

This study aims to identify the relationship between sexual dysfunction and post- Caesarean section.

This study uses cross-sectional study design. Sample is obtained by consecutive sampling using Female Sexual Function Index (FSFI-6) questionnaire and the data is processes through SPSS version 20. Statistical analysis test used in this study are Chi Square test and Fisher’s exact test.

Statistically the relationship between sexual dysfunction and delivery method by Caesarean isnot significant (OR = 2.750; 95% CI = 0.771-9.808; P = 0.111). Other factors studied (age, educational status, and employment status) are also statistically insignificant (p> 0.05).

The relationship between sexual dysfunction and delivery method by caesarean section is not statistically significant. However, based on the OR value, Caesarean surgery has a 2,750-fold risk to increased the accident of female sexual dysfunction."

"Provinsi Sumatera Barat merupakan 5 provinsi dengan proporsi SC tertinggi yaitu 23,6%. Proporsi SC di Kota Pariaman dan RSUD Pariaman termasuk kategori sangat tinggi lebih dari 40%. Sejumlah penelitian menunjukkan usia maternal dan paritas sebagai faktor yang konsisten dan berkontribusi besar terhadap tingginya proporsi persalinan SC. Tujuan penelitian ini adalah untuk mengetahui hubungan usia maternal dan paritas dengan persalinan SC. Desain penelitian ini adalah kohort retrospektif dengan populasi sumber ibu bersalin di RSUD Pariaman tahun 2023. Pengambilan sampel dilakukan dengan teknik acak sederhana. Analisis data mencakup analisis deskriptif, bivariat, stratifikasi, dan multivariat. Hasil penelitian menunjukkan terdapat hubungan signifikan antara usia maternal dengan persalinan SC setelah dikontrol faktor paritas, dan riwayat SC (RR=1,27; 95%CI=1,020 –1,597) dan terdapat hubungan paritas dengan persalinan SC setelah dikontrol faktor usia maternal, riwayat SC dan komplikasi kehamilan (RR=1,85; 95%CI=1,37 – 2,50). Dapat disimpulkan, ibu dengan usia maternal lanjut dan ibu nullipara berisiko lebih besar melahirkan secara SC. Oleh karena itu perlu diprioritaskan intervensi menurunkan SC yang fokus pada kelompok ibu usia maternal lanjut dan nullipara.

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West Sumatra province includes 5 provinces with the highest proportion of SC, which is 23.6%. The proportion of SC in Pariaman City and Pariaman Public Hospital is in the very high category of more than 40%. Numerous studies point to maternal age and parity as consistent factors that contribute greatly to the high proportion of SC deliveries. The purpose of this study was to determine the relationship between maternal age and parity with SC delivery. The design of this study is a retrospective cohort, with the source population being maternity mothers at RSUD Pariaman in 2023. Sampling is done using a simple random technique. Data analysis includes descriptive, bivariate, stratified, and multivariate analyses. The results showed a significant relationship between maternal age and SC delivery after controlling for parity and SC history (RR = 1,27; 95% CI = 1,020–1,597), and there was a significant association between parity and SC delivery after controlling for maternal age, SC history, and pregnancy complications (RR = 1,85; 95% CI = 1,37–2,50). It can be concluded that mothers with advanced maternal age and nulliparity are at greater risk of giving birth to SC. Therefore, it is necessary to prioritize interventions to reduce SC that focus on advanced maternal age, and nullipara groups."

"Pendahuluan : Komplikasi kehamilan dan atau adanya penyulit persalinan umumnya merupakan indikasi dilakukannya seksio sesarea (SS). Namun dari 15,3% angka SS hasil Riskesdas 2010, 13% diantaranya terjadi pada ibu melahirkan yang tidak mengalami komplikasi kehamilan. Oleh sebab itu, penelitian ini dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan persalinan SS pada ibu tanpa komplikasi kehamilan dan atau penyulit persalinan di Indonesia. Metode : Menggunakan disain cross sectional dengan menganalisis jawaban dari 9.485 responden, menggunakan program SPSS versi 18, melalui uji regresi logistik. Hasil dan Kesimpulan: Proporsi SS pada ibu tanpa riwayat komplikasi kehamilan dan atau penyulit persalinan di Indonesia adalah 12,3%. Faktor yang berhubungan adalah : umur saat melahirkan, pendidikan, pengeluaran bulanan RT, wilayah tempat tinggal, umur kehamilan, jumlah ANC, paritas dan ukuran lahir anak. Sedangkan faktor yang tidak berhubungan adalah : pekerjaan dan jarak persalinan. Adapun faktor yang paling besar pengaruhnya adalah pengeluaran bulanan RT kuintil 5 dibanding kuintil 2 & 1 (OR=2,32 {95%CI : 1,89?2,83}).

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Introduction : Pregnancy and labor of complications is generally an indication of doing caesarean section (CS). But the figure of 15,3% CS outcome Riskesdas 2010, 13% of them occurred in mothers without experience of pregnancy and labor complications. Therefore, the study was conducted to determine the factors associated with childbirth by CS in mothers without experience of pregnancy and labor complications in Indonesia.

Methods : Using a cross sectional design to analyze the respons of the 9.485 respondents, using SPSS version 18, through logistic regression test.

Results and Conclusions : The proportion of CS in mothers without experience of pregnancy and labor complications in Indonesia is 12,3%. Related factors were : age at delivery, educations, monthly household expenses, area of residence, gestational age, number of ANC, parity and size of the child was born. Unrelated factors are : occupational and distance delivery. The factors that most impact is the monthly household expenditure quintile 5 compared with quintile 2 & 1 (OR=2,32 {95%CI : 1,89 to 2,83})."