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"Di Indonesia,kanker serviks merupakan keganasan ginekologi terbanyak yang terjadi pada wanita.Hal ini disebabkan kurangnya program skrining.Di Indonesia program deteksi dini dengan inspeksi visual asam asetat (IVA) telah dimulai,Kementerian Kesehatan memiliki program VIA untuk deteksi dini, dengan target 50% perempuan usia 30-50 tahun pada tahun 2019.Untuk mencapai target tersebut,Kementerian Kesehatan Indonesia telah melakukan pelatihan IVA untuk dokter dan bidan.Penelitian ini akan mengkaji evaluasi pelatihan IVA yang telah dilaksanakan pada bidan dan membandingkan antara bidan di Jakarta Pusat dan bidan di Tangerang Selatan.Dari 39 bidan di Jakarta Pusat dan 24 di Tangerang Selatan yang sudah dilatih IVA hingga tahun 2019,kami mengambil data jumlah pemeriksaan IVA,jumlah kasus positif dan jumlah kasus yang dirujuk bidan selama tahun 2017-2019.Dari penelitian ini didapatkan,bidan di Jakarta Pusat pada tahun 2019 melakukan pemeriksaan IVA 6.622 dari target 83.500 (7,9%) dan ditemukan 105 kasus positif dan seluruh kasus dirujuk untuk dilakukan krioterapi, sedangkan bidan di Tangerang Selatan melakukan 1805 pemeriksaan IVA dari target 113415 (1,59%) dan ditemukan 12 kasus positif dengan 4 kasus dilakukan krioterapi dan 8 kasus dirujuk ke RS.Dari keduanya ditemukan peningkatan kinerja pemeriksaan IVA dari tahun 2017 hingga 2019.Pelaksanaan IVA oleh bidan di Jakarta Pusat dan Tangerang Selatan masih rendah,meskipun meningkat dari tahun 2017 hingga 2019.

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In Indonesia,cervical cancer is the most gynecology malignancy that occurs in women.This is due to lack of a screening program.In Indonesia,an early detection program with visual inspection of acetic acid (VIA) has begun.The Ministry of Health has VIA for early detection program with target 50% women aged 30-50 years on 2019.To achieve this,The ministry of Health Indonesia has conducted VIA training for doctors and midwives.This study would examine the evaluation of the VIA training that has been conducted for midwives.This evaluation would also assess and compare the VIA training evaluation on midwives in Central Jakarta and midwives in South Tangerang.39 midwives in Central Jakarta and 24 in South Tangerang already trained for VIA until 2019.We took data on the number of VIA examinations,the number of positive cases and the number of cases referred by midwives during 2017-2019.From this study,we found that midwives at Central Jakarta on 2019 performed 6.622 VIA examination from 83.500 target (7.9%) and found 105 positive cases and all the cases were referred to performed cryotherapy.Meanwhile midwives at South Tangerang performed 1805 VIA examination from 113415 target population (1.59%) and found 12 positive cases:4 cases was already performed cryotherapy and 8 cases were referred to hospital.From both of them, we found increased of performance of VIA examination from 2017 until 2019. VIA implementation by midwives in Central Jakarta and South Tangerang still low, although increase from 2017 until 2019."

"Latar Belakang: Preeklampsia - eklampsia merupakan penyebab utama morbiditas dan mortalitas ibu dan bayi di dunia khususnya negara-negara sedang berkembang dengan insidensidi Indonesia berkisar 8,6%. Pemberian aspirin diharap dapat menjadi solusi pencegahan preeklampsia bagi ibu hamil dengan risiko tinggi untuk menurunkan terjadi persalinan prematur, berat badan bayi yang rendah, serta turut meningkatkan angka mortalitas dan morbiditas perinatal. Tujuan: Mengetahui keluaran penggunaan aspirin dosis rendah pada ibu hamil dengan risiko tinggi preeklampsia. Metode: Studi ini merupakan kohort retrospektif. Melibatkan 695 subjek ibu hamil dengan risiko tinggi preeklampsia yang dibagi menjadi dua kelompok dengan terapi aspirin dosis rendah dan tanpa terapi. Hasil: Angka kejadian preeklampsia pada kelompok aspirin lebih rendah (8.9%) secara bermakna (odds ratio 0.37; 95% confidence interval, 0.26 hingga 0.54; P = <0.001) dibandingkan kelompok kontrol (14.8%). Pada kelompok aspirin penurunan angka kejadian preeklampsia lebih rendah secara bermakna pada pasien luaran kehamilan kurang dari 34 minggu dibanding luaran kehamilan > 34 minggu (odds ratio 0.117; 95% confidence interval, 0.048 hingga 0.282; P = <0.001). Kesimpulan: Pada studi ini, pemberian aspirin dosis rendah pada ibu dengan risiko tinggi preeklampsia terjadi penurunan insiden preeklampsia secara bermakna dan penurunan luaran kehamilan kurang dari 34 minggu

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Background: Preeclampsia - eclampsia is the main cause of maternal and infant morbidity and mortality in the world, especially developing countries such as Indonesia with incident about 8.6%. We hoped that aspirin can be a solution to prevent preeclampsia for pregnant women with a high risk of preeclampsia to reducing preterm labor, low birth weight, and also increasing perinatal mortality and morbidity. Objective: To determine the output of using low-dose aspirin in pregnant women with a high risk of preeclampsia. Method: This study was a retrospective cohort. Involves 695 pregnant women with a high risk of preeclampsia and divided into two groups with low-dose aspirin therapy and without therapy. Results: The incidence of preeclampsia in the aspirin group was significantly lower (8.9%) (odds ratio 0.37; 95% confidence interval, 0.26 to 0.54; P = <0.001) compared to the control group (14.8%). In the aspirin group the decrease in the incidence of preeclampsia was significantly lower in patients with pregnancy outcomes less than 34 weeks compared with pregnancy outcomes more than 34 weeks (odds ratio 0.117; 95% confidence interval, 0.048 to 0.282; P = <0.001). Conclusion: In this study, administration of low-dose aspirin to women with a high risk of preeclampsia resulted in a significant decrease in the incidence of preeclampsia and a reduction in pregnancy outcomes of less than 34 weeks."

"ABSTRAKLatar Belakang: Sekitar 6-7% kehamilan disertai trauma, yang berkontribusi menyebabkan kematian maternal hingga 46%, namun jarang dibicarakan karena bersifat non-obstetrik. Komplikasi maternal meliputi ketuban pecah, solusio plasenta, cedera organ intraabdomen, perdarahan, terminasi seksio sesarea, bahkan kematian. Morbiditas dan mortalitas janin bahkan dapat terjadi tanpa cedera signifikan pada ibu. Hingga saat ini, belum ada publikasi mengenai trauma pada kehamilan di Indonesia.

 

Tujuan: Penelitian ini bertujuan mengetahui profil trauma pada kehamilan di RSUPN Cipto Mangunkusumo Jakarta dan RSUD Dok II Jayapura.

 

Metode: Penelitian bersifat deskriptif observasional. Semua ibu hamil dengan trauma yang memeriksakan dirinya ke RSUPN Cipto Mangunkusumo dan RSUD Dok II tahun 2016-2018 dimasukkan sebagai subyek penelitian. Data demografis, obstetrik, karakteristik trauma, gejala dan temuan klinis, serta luaran ibu dan janin dianalisa secara deskriptif.

 

Hasil: Didapatkan 100 kasus trauma dari 7130 ibu hamil dalam penelitian ini. Berdasarkan ISS (Injury Severity Score), 76% subyek termasuk trauma derajat ringan, 20% derajat sedang, dan 4% derajat berat. Tiga mekanisme trauma terbanyak adalah jatuh (61%), kecelakaan lalu lintas (24%), dan kekerasan domestik (9%) dengan jenis trauma kontusio (82%) dan trauma superfisial (60%). Gejala klinis meliputi nyeri abdomen (60%), perdarahan pervaginam (13%), dan ketuban pecah (8%). Didapatkan 1 kasus syok, 2 kasus solusio plasenta, dan 2 kasus gawat janin. Luaran ibu baik, dengan 3% abortus, 3% seksio sesarea, 9% induksi pervaginam, dan 85% konservatif (di mana 91,8% kehamilan berhasil dipertahankan, 7,0% lahir prematur dan 1,2% abortus spontan). Luaran janin menunjukkan 1% lahir mati, 4% abortus, 10% lahir prematur, 7% lahir aterm, dan 78% konservatif.

 

Kesimpulan: Insidens trauma pada kehamilan pada penelitian ini sebesar 1.4%. Sebagian besar subyek termasuk kategori trauma derajat ringan (76%), disebabkan mekanisme jatuh (61%), dengan jenis trauma kontusio (82%) dan klinis nyeri abdomen (60%). Didapatkan 1% kasus syok, 2% solusio plasenta, 2% gawat janin, 4% abortus, dan 1% lahir mati, tanpa adanya mortalitas ibu. ISS (Injury Severity Score) dapat diterapkan untuk menilai derajat trauma ibu hamil, namun tidak menggambarkan luaran ibu maupun janin.

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ABSTRACTBackground: Trauma complicates 6-7% pregnancies and causes up to 46% maternal deaths. Yet, it is rarely taken into consideration because of its non-obstetric origin. Maternal complications include membrane rupture, placental abruption, internal organ injury or hemorrhage, caesarean section termination, even maternal death. Fetal morbidity and mortality can even occur without significant maternal injuries. So far, there is no publication regarding trauma in pregnancy in Indonesia.

 

Objectives: This study aimed to determine the profile of trauma in pregnancy at RSUPN Cipto Mangunkusumo Jakarta and RSUD Dok II Jayapura.

 

Methods: This was a descriptive observational study. All pregnant women with trauma went to RSUPN Cipto Mangunkusumo and RSUD Dok II during 2016-2018 were included. Demographic and obstetrics datas, trauma characteristics, clinical findings, and all maternal and fetal outcomes were analysed.

 

Results: Of all 7130 pregnant women included, there were 100 trauma cases. Using ISS (Injury Severity Score), 76% subjects had mild trauma, 20% moderate trauma, and 4% severe trauma. Three main trauma mechanisms were fall (61%), motor vehicle accidents (24%), and domestic assaults (9%), with contusion (82%) and superficial trauma (60%). Clinical symptoms included abdominal pain (60%), vaginal bleeding (13%), and water broke (8%). There were 1 hypovolemic shock and 2 placental abruption cases, with 2 fetuses showing fetal distress. Maternal outcomes were good; with 3% abortion, 3% caesarean-section, 9% vaginal induction, and 85% conservative cases (of which 91.8% managed to continue the pregnancy, 7.0% had preterm labor, and 1,2% had spontaneous abortion). Fetal outcomes showed 1% stillbirth, 4% abortion, 10% preterm birth, 7% term birth, and 78% conservative pregnancy.

 

Conclusions: Incidence of trauma in pregnancy in this study is 1.4%. Most subjects have mild trauma (76%), caused by fall (61%), presented mostly with contusion (82%) and abdominal pain (60%). We reported no maternal mortality, 1% hypovolemic shock, 2% placental abruption, 2% fetal distress, 4% abortion rate, and 1% stillbirth. ISS can be applied to assess maternal trauma degree, but does not represent maternal or fetal outcomes.

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"Defisiensi besi selama kehamilan adalah salah satu defisiensi gizi yang prevalensinya tetap tinggi di dunia yaitu mencapai 70%. Berat badan kurang merupakan salah satu faktor risiko terjadinya defisiensi besi selama kehamilan. Feritin adalah protein cadangan zat besi yang disintesis oleh hati dan dapat meningkat selama peradangan. Penelitian ini bertujuan untuk mengetahui korelasi antara kadar feritin serum dengan indeks massa tubuh pada perempuan hamil trimester 1. Disain penelitian yang digunakan adalah studi potong lintang. Penelitian dilakukan di Pusat Kesehatan Masyarakat Kramat Jati, Jakarta selama bulan Oktober 2013. Pengambilan subyek dilakukan dengan cara consecutive sampling. Empat puluh tujuh perempuan hamil trimester 1 didapatkan memenuhi kriteria penelitian. Didapatkan rerata usia 27,79±4,85 tahun, diantara subyek penelitian 5 orang (10,6%) memiliki berat badan kurang, 25 orang (53,2%) berat badan normal dan 17 berat badan lebih (36,2%). Nilai tengah asupan zat besi 23,21 (8,4 ̶ 36,80) mg/hari. Asupan zat besi menunjukkan 66% subyek memiliki asupan zat besi kurang dari Angka Kecukupan Gizi (AKG) Indonesia. Nilai tengah kadar feritin serum 58,1 (4,9 ̶ 139,8) μg/L dan 6,4% subyek tergolong status feritin rendah. Hasil penelitian ini diperoleh korelasi positif tidak bermakna antara kadar feritin serum dengan indeks massa tubuh pada perempuan hamil trimester 1 (r=0,097, p=0,52).

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Iron deficiency during pregnancy is one of nutritional deficiency with high prevalence in the world, reaching up to 70%. Underweight is one of the main risk factors for iron deficiency during pregnancy. Ferritin is an iron storage protein which synthesized in the liver and can be increased during inflammation. The aim of this study was to find out the correlation between serum ferritin levels and body mass index (BMI) in pregnant woman in their first trimester. The design of the study is cross-sectional. Data collection was conducted at Kramat Jati Primary Health Care, Jakarta during October 2013. Subjects were obtained by consecutive sampling method. A total of 47 pregnant women in their first trimester subjects had met the sudy criteria. The mean of maternal age was 27,79±4,85 years, among them are 5 underweight (10,6%), 25 normal weight (53,2%) and 17 overweight (36,2%). Median of iron intake was 23,21 (8,4 ̶ 36,80) mg/day. Intake of iron showed 66% of the subjects had intake of iron less than Indonesian recomended dietary allowance (RDA). Median of serum ferritin levels was 58,1 (4,9 ̶ 139,8) μg/L, while 6,4% of the subjects were catagorized as low ferritin status. No significant correlation was found between serum ferritin levels and BMI in pregnant women in their first trimester (r=0,097, p=0,52)."

"ABSTRAK Latar Belakang: Persalinan merupakan suatu proses fisiologis, namun berkaitandengan nyeri dan rasa tidak nyaman. Selain itu induksi persalinan merupakan suatuintervensi dari luar terhadap proses alami kehamilan sehingga menginisiasi terjadinyakontraksi uterus dan dilatasi serviks Saat ini belum ada studi yang membandingkannyeri persalinan spontan dan nyeri induksi persalinan.Tujuan: Mengetahui perbedaan nyeri persalinan spontan dan nyeri induksipersalinan pada kala I dengan his 2-3 kali dalam 10 menit dan lama his 20-40 detik,kala I dengan his 4 kali dalam 10 menit dan lama his lebih dari 40 detik, kala IV dansatu hari pasca persalinan.Metode: Penelitian dengan desain kohort prospektif membandingkan 50 ibupersalinan spontan dan 50 ibu yang menjalani induksi persalinan sesuai dengankriteria inklusi dan eksklusi. Sampel didapatkan dari RS Cipto Mangunkusumo danRS jejaring lainnya periode Juli 2013- September 2013. Intensitas nyeri dinilaidengan Visual Analogue Scale. pada persalinan spontan dan induksi persalinan .Perbandingan data antara dua kelompok dianalisis dengan uji Mann-WhitneyHasil : Didapatkan skor nyeri ibu dengan persalinan spontan dibandingkan induksipersalinan pada kala I his 2-3x/10 menit lama his 20-30 detik (5,00 vs 6,00, nilaitengah semu 38,36 vs 62,64, p <0,001), saat kala I his 4x/10 menit lama his lebihdari 40 detik (10,00 vs 10,00, nilai tengah semu 45,50 vs 55,50, p= 0,013), kala IV(1,00 vs 1,00, nilai tengah semu 44,53 vs 56,48, p 0,020). Sedangkan pada skor nyeriibu satu hari pasca persalinan didapatkan nilai median yang lebih tinggi pada skornyeri pasien dengan persalinan spomtan dan induksi persalinan (1,00 vs 0,00, nilaitengah semu 46,00 vs 55,00, p=0,072) nilai p > 0,05 menunjukkan tak ada perbedaanbermakna.Kesimpulan : Persalinan induksi lebih nyeri dibandingkan persalinan spontan padakala I dengan his 2-3 kali dalam 10 menit dan lama his 20-40 detik, kala I his lebihdari 4x /10 menit lama his lebih dari 40 detik dan kala IV. Pada penilaian satu haripasca persalinan, tidak ada perbedaan bermakna secara statistik pada ibu persalinanspontan dengan induksi persalinan

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ABSTRAK Background:Childbirth is a physiological process, but associated with pain anddiscomfort. In addition, the induced labor is an external stimulation for the naturalprocess of pregnancy as to initiate uterine contractions and cervical dilation.Currently no studies comparing the pain between spontaneous labor and inducedlabor .Objectives:Knowing the difference in spontaneous labor pain and induced labor painduring 2-3 times in 10 minutes of contractions within 10 minutes in the first stage was20-40 seconds length of contractions,4 times of contractions in the first stage wichwas more than 40 seconds length of contraction,in the fourth stage of labor and oneday after the birth.Methods: An analytical cohort study, with 50 women undergoing spontaneous laborand compared with 50 women undergoing induced labor, accordance with theinclusion and exclusion criteria. Samples obtained from Cipto Mangunkusumo andothers networking hospital period July 2013 - September 2013. The Pain intensity inspontaneous labor and induced labor was assessed by Visual Analogue Scale.Comparison of data between the two groups were analyzed with the Mann-WhitneytestResults:Obtained pain scores by VAS compared to women with spontaneous laborand induction of labor respectively, in the first stage with contraction 2-3 times in10 minutes with 20-40 seconds length of contraction (5.00 vs 6.00, mean rank 38.36vs. 62.64 , p <0.001) , in the first stage with contractions 4 time in 10 minutes morethan 40 seconds length of contraction (10.00 vs. 10.00,mean rank 45.50 vs 55.50, p =0.013), fourth stage of labor (1.00 vs. 1.00 , mean rank 44.53 vs. 56.48, p 0.020).While the pain score on one day after the birth (1.00 vs 0.00 , mean rank 46.00 vs.55.00 , p 0,072).Conclusion: Induced labor more painful than spontaneous labor in the first stagewith contraction 2-3 times in 10 minutes with 20-40 seconds length of contraction, thefirst stage with contractions 4 time in 10 minutes more than 40 seconds length ofcontraction and at the fourth stage of labor. On one day after the birth assessment,there was no statistically significant difference at spontaneous labor pain comparedwith induced labor pain."

"Peningkatan BB selama kehamilan yang tidak optimal akan meningkatkan risiko komplikasi kehamilan, ibu dan anak melalui mekanisme peningkatan IL-6. Penelitian ini bertujuan untuk mengetahui korelasi kadar IL-6 serum perempuan hamil trimester 3 dengan peningkatan BB selama kehamilan. Penelitian dilakukan pada bulan Januari - Februari 2014 di Puskesmas Jatinegara, Jakarta. Metode penelitian yang digunakan adalah potong lintang, consecutive sampling, pada 64 subyek perempuan hamil trimester 3 ≥37 minggu. Didapatkan hasil penelitian yaitu 42,2% mempunyai IMT trimester 1 BB lebih, 40,6% mempunyai asupan energi total berlebih dan sesuai anjuran serta rerata peningkatan BB 12,1 (±3,8) kg dengan 40,6% mempunyai peningkatan BB selama kehamilan sesuai rekomendasi IOM. Kadar IL-6 serum perempuan hamil trimester 3 pada penelitian ini adalah 3,067 (0,608 ? 18,207) pg/ml dengan kadar IL-6 serum pada peningkatan BB kurang (3,441 (±1,819) pg/ml) dan lebih (3,017 (1,234?14,083) pg/ml) cenderung lebih tinggi dibandingkan dengan kelompok sesuai (2,707 (0,608?18,207) pg/ml). Didapatkan korelasi positif lemah tidak bermakna antara kadar IL-6 serum perempuan hamil trimester 3 dengan peningkatan BB selama kehamilan (r=0,144, p=0,257) dan analisis kadar IL-6 serum berdasarkan kelompok peningkatan BB selama kehamilan didapatkan hasil tidak berbeda bermakna (p=0,708). Kesimpulan hasil penelitian ini adalah kadar IL-6 serum berkorelasi lemah dengan peningkatan BB selama kehamilan.

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Gestational weight gain (GWG) that is not optimal will increase the risk of complications in pregnancy through increasing the IL-6 mechanism. This study aimes to determine the correlation of IL-6 serum levels on third trimester pregnancy with GWG. This is a cross-sectional study with consecutive sampling in 64 pregnant women ≥37 weeks. It was conducted in January-February 2014 at community health centers Jatinegara, Jakarta. The results are most subjects have overweight BMI at 1st trimester (42,2%), most of subjects have either sufficient or excessive total energy intake than the recommendation (40.6%), the majority of the subjects having sufficient GWG based on IOM guidelines (40.6%) with mean GWG is 12.1 (± 3.8) kg. Serum level of IL-6 is 3.067 (0.608-18.207) pg/ml with serum levels of IL-6 in insufficient GWG (3.441 (± 1.819) pg/ml)) and excessive GWG (3.017 (1.234-14.083) pg/ml)) tends to be higher compared with sufficient GWG (2.707 (0.608-18.207) pg/ml)). The correlation of IL-6 serum level on 3rd trimester with GWG is positive, weak and not significant (r = 0.144, p = 0.257). Analysis of IL-6 serum levels within GWG categories show no significant difference between groups (p = 0.708). In conclusion, there is weak correlation between IL-6 serum level on 3rd trimester of pregnancy with GWG."

"Latar Belakang: Kanker serviks masih merupakan penyakit keganasan tersering kedua yang mengenai perempuan di Indonesia dimana setiap tahunnya didapatkan hampir 15.000 kasus baru dan setengahnya meninggal.1-4 Oleh karena itu, skrining kanker serviks penting sebagai usaha pencegahan primer. Metode inspeksi visual dengan asam asetat (IVA) merupakan metode alternaltif yang sesuai dengan kondisi Indonesia. Female Cancer Program (FCP)-Fakultas Kedokteran Universitas Indonesia (FKUI) berkolaborasi dengan Universitas Leiden memiliki program see and treat yaitu skrining lesi prakanker serviks dengan metode IVA dan secara langsung dapat memberikan krioterapi pada kunjungan pertama. Sejak 2007 hingga 2011,FCP Jakarta melakukan skrining lesi prakanker serviks dengan metode IVA melibatkan 25.406 perempuan yang tersebar di beberapa wilayah Jakarta. Dengan menggunakan data tersebut, kita dapat mengetahui prevalensi dan faktor-faktor risiko yang mempengaruhi timbulnya IVA positif di Jakarta yang berguna bagi peningkatan performa kegiatan skrining pencegahan kanker serviks. Tujuan: Untuk mengetahui prevalensi IVA positif di Jakarta dari 2007 - 2011 dan faktor-faktor risiko yang mempengaruhi timbulnya lesi prakanker yang ditandai dengan IVA positif. Metode Penelitian: Penelitian potong lintang menggunakan data program see and treat dari Desember 2007-Desember 2011, dilaksanakan oleh FCP di 6 wilayah di Jakarta menggunakan metode IVA yang dilakukan oleh dokter umum serta bidan yang ada di puskesmas dibawah pengawasan teknik oleh dokter spesialis Obsteri dan Ginekologi. Hasil Penelitian: Sejak Desember 2007 hingga Desember 2011 terdapat sebanyak 25.406 perempuan yang mengikuti program see and treat. Dari 25.406 perempuan terdapat 1192 kasus (4,7%) perempuan dengan hasil IVA positif dimana 1162 kasus (97%) diantaranya memiliki luas lesi acetowhite<75% dan sisanya memiliki luas lesi acetowhite>75%. Sebanyak 4745 kasus (18%) perempuan mengalami servisitis dan 19 kasus (0,07%) perempuan sudah menderita kanker serviks. Faktor-faktor risiko yang menunjukkan hubungan kemaknaan (p<0,05) terhadap timbulnya IVA positif yaitu jumlah pernikahan, paritas, kebiasaan merokok dan penggunaan kontrasepsi hormonal dengan odd ratio 1,51;1,85;1.95 and 0,68 secara berurutan. Diskusi dan Kesimpulan: Prevalensi IVA positif masih cukup tinggi pada populasi Jakarta dan faktor risiko jumlah pernikahan, paritas, kebiasaan merokok dan penggunaan kontrasepsi hormonal dapat mempengaruhi hasil IVA.

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Background: Cervical cancer is still the 2nd most frequent cancer in women especially in developing countries that almost 15,000 women were diagnosed with cervical cancer every year in Indonesia and half of them died from the disease.1-4 Therefore screening program is still important to prevent it.Inspection with acetic acid (VIA) is introduced as an alternative method that more suitable with indonesia?s condition. The female cancer program (FCP)-Faculty of Medicine University of Indonesia (FMUI) organization collaborates with University of Leiden has a program called see and treat program that screen precancerous lesions using VIA method and simultaneously offer the immediate therapy on the first visit setting using cryotherapy. Since 2007 until 2011, the FCP from Jakarta Regional has done cervical cancer screening involving 25.406 correspondents patients spreading across several primary health centers and other agencies in several areas of Jakarta. By using these data, we can find out the prevalence and risk factor of VIA positive in Jakarta as a useful data to improve the performance of cervical cancer screening program.

Objective: The purpose of the study was to report the prevalence and risk factor of VIA Test-Positive in Jakarta from 2007- 2011.

Material and Method: An Observational study using the data from see and treat program that has been conducted at several areas in Jakarta from December 2007 until December 2011. VIA was used as the screening method, and performed by doctors and midwives in community health centers with technical supervision by gynecologists and management supervision by District and Provincial Health Officers.

Results: Starting December 2007 to December 2011, there were 25.406 women screened with VIA (Visual inspection with acetic acid). From 25.406 correspondents that had been screened, there were 1192 cases (4,5%) of VIA test positive. The risk factors that significantly (p<0,05) can influence the result of VIA in this study were number of marriage, parity, smoking habits and the use of hormonal contraception with OR 1,51;1,85;1.95 and 0,68 respectively.

Disscussion and Conclusions: Prevalence of VIA test-positive is still high in Jakarta population and number of marriage, parity, smoking and the use of hormonal contraception can influence the result of VIA. "

"LATAR BELAKANG : Gangguan implantasi pada awal kehamilan menyebabkanIskemia plasenta dan dapat berakibat preeklamsia pada kemudian hari. Pada tahapselanjutnya iskemia plasenta menghasilkan radikal bebas dan berakibat stres oksidatif.Preeklamsia merupakan hasil dari ketidakseimbangan antara produksi radikal bebasdengan antioksidan sehingga terjadi reaksi inflamasi berlebihan pada kehamilan yangberakibat disfungsi endotel. Antioksidan dan inflamasi dalam tubuh ditentukan oleh statusgizi seseorang yang dinilai dari kadar serum ibu seperti seng, selenium, besi dan tembaga.Oleh karena itu perlu penelitian untuk menilai status gizi mikro dengan preeklamsia. TUJUAN : Diketahuinya perbedaan kadar seng, selenium, besi tembaga, danrasio tembaga seng serum maternal pada preeklamsia dibandingkan kehamilan normal. METODE : Penelitian ini merupakan studi potong lintang dengan jumlah sampel30 preeklampia dan 30 normal yang melakukan persalinan di RS Cipto Mangunkusumodan RSUD Tangerang. Pasien diambil darah untuk kemudian diproses menjadi serum danlalu diukur kadarnya. Setelah itu data disajikan dalam tabel dan dianalisis dengan uji ttidakberpasangan. Penelitian ini sudah lolos kaji etik dan mendapat persetujuanpelaksanaan dari Komite Etik Penelitian Kesehatan FKUI-RSCM. HASIL : Kadar serum seng pada preeklamsia dan normal adalah 45,03?10,84dan 41,37?10,59 ?g/dl dengan p=0,868, IK 95 3,66 -1,87-9,21 . Kadar seleniumadalah 84,93?13,67 dan 65,03?15,28 ?g/l dengan p=0,445, IK 95 19,9 12,4-27,39 .Kadar besi 115,77?49,14 dan 75,63?43,79 ?g/dl dengan p=0,409, IK 95 40,13 16,0964,17 .Kadar tembaga 219,85?45,92 dan 207,98?47,66 ?g/dl dengan p=0,73 IK 95 118,63 -123,25-360,52 dan rasio tembaga seng 5,15?1,54 dan 4,96?1,62 dengan p=0,803 1,9 IK 95 -6,25-10,06. KESIMPULAN : Terdapat perbedaan rerata kadar selenium dan besi pada preeklamsiadengan kehamilan normal namun tidak berbeda bermakna secara statistik. Tidak terdapatperbedaan rerata kadar seng, tembaga dan rasio tembaga seng pada preeklamsia dengankehamilan normal.

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BACKGROUND: Poor implantation in early pregnancy lead to placental ischemia wasthe pathogenesis of preeclampsia. On further stage, placenta ischemia generated oxidativestress. Preeclampsia was a manifestation of the free radical and antioxidant imbalanceresulting inflammation and endothelial dysfunction. Antioxidant dan inflammation wasdetermined by nutrition status that measured in maternal serum such zinc, selenium, ironand copper. Therefore, measuring micronutritional status in preeclampsia was needed.

OBJECTIVE: Investigate the mean difference of zinc, selenium, iron, copper, andcopper zinc ratio of maternal serum in preeclampsia comparing healthy pregnancy.

METHOD: This was a cross sectional study enrolled 30 preeclampsia patientsand 30 healthy pregnancy visiting Cipto Mangunkusumo and Tangerang Hospital. Bloodwas withdrawed from vein for further processed. Data was presented in table and wasanalyzed by unpaired t test. This study had been granted ethical clearence and approvedby Ethical Committee for Health Research Faculty of Medicine University of IndonesiaCipto Mangunkusumo Hospital.

RESULTS: The zinc maternal serum level in preeclampsia and healthypregnancy were 45.03 10.84 and 41.37 10.59 g dl, p 0.868, 95 CI 3.66 1.87 9.21 respectively. Selenium level were 84.93 13.67 and 65.03 15.28 g l, p 0.445, 95 CI19.9 12.4 27.39 . Iron level were 115.77 49.14 and 75.63 43.79 g dl, p 0.409, 95 CI40.13 16.09 64.17 . Copper level were 219.85 45.92 dan 207.98 47.66 g dl, p 0.7395 CI 118.63 123.25 360.52 and copper to zinc ratio were 5.15 1.54 and 4.96 1.62dengan p 0.803, 1.9 95 CI 6.25 10.06.

CONCLUSION: Selenium and iron level in preeclampsia and healthy pregnancy weresignificantly difference. However, it was not significance statistically. Zinc, copper andcopper to zinc ratio were not significantly different."

"Latar Belakang: Hipertensi pada kehamilan diketahui menyebabkan morbiditas dan mortalitas ibu dan bayi. Banyak faktor yang memengaruhi, diantaranya asam urat, walau masih banyak perdebatan diantara para ahli. Peneliti ingin mengetahui hubungan luaran ibu dan bayi dengan kadar asam urat darah ibu pada kehamilan dengan gangguan hipertensi. Metode: Studi analitik observasional dengan desain potong lintang. Subjek adalah ibu hamil dengan gangguan hipertensi di Rumah Sakit Umum Pusat Persahabatan, periode Januari 2014 sampai Desember 2018. Luaran ibu adalah tingkat keparahan gangguan hipertensi pada kehamilan dan derajat hipertensi. Luaran bayi adalah usia gestasi saat kelahiran, berat badan lahir bayi berdasarkan kurva Lubchenco dan skor APGAR menit pertama. Hubungan luaran ibu dan bayi dengan kadar asam urat darah ibu diketahui dengan uji Kruskal Willis dan Mann Whitney. Hasil: Sebanyak 704 subjek memenuhi kriteria penelitian dari 880 pasien ibu hamil dengan gangguan hipertensi. Didapatkan perbedaan bermakna kadar asam urat darah ibu (p<0,001) antarkelompok keparahan gangguan hipertensi pada kehamilan (preeklamsia gejala berat 5,7 (2,2–16,0) mg/dL, preeklamsia tanpa gejala berat 5,18 + 1,54 mg/dL, dan hipertensi kronik/hipertensi dalam kehamilan 4,8 (2,2-8,0) mg/dL). Didapatkan perbedaan bermakna kadar asam urat darah ibu antarkelompok derajat hipertensi (hipertensi derajat I 4,8 (2,2–8,0) mg/dL, hipertensi derajat II 5,7 (2,2–16,0) mg/dL, dan krisis hipertensi 5,4 (2,6–9,8) mg/dL). Kelompok usia gestasi aterm saat kelahiran menunjukkan kadar asam urat darah ibu 5,0 (2,2–9,8) mg/dL, lebih rendah bermakna (p<0,001) dibandingkan usia gestasi preterm saat kelahiran 6,3 (2,7–16) mg/dL. Tidak didapatkan perbedaan bermakna antarkelompok berat lahir bayi maupun skor APGAR menit pertama. Simpulan: Didapatkan hubungan bermakna antara luaran ibu yaitu tingkat keparahan gangguan hipertensi dan derajat hipertensi, dan luaran bayi yaitu usia gestasi saat kelahiran, dengan kadar asam urat darah ibu. Tidak didapatkan hubungan bermakna antara berat badan lahir bayi dan skor APGAR menit pertama, dengan kadar asam urat darah ibu.

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Background: Hypertensive disorders in pregnancy is known to cause maternal and perinatal morbidity and mortality. Many factors influence, including uric acid, although there is still a lot of debate among experts. This study aims to find out the relationship between mother and baby outcomes with mother’s uric acid level, in pregnancy with hypertensive disorders.

Method: Observational analytic study with cross sectional design. Subjects were pregnant women with hypertensive disorders at Persahabatan General Hospital, from January 2014 to December 2018. Maternal outcomes were the severity of hypertensive disorders in pregnancy and the degree of hypertension. The perinatal outcomes were the gestational age at birth, the baby's birth weight based on the Lubchenco curve, and the first minute APGAR score. The relationship between maternal and perinatal outcome and maternal blood uric acid levels was questioned by the Kruskal Willis and Mann Whitney test.

Result: A total of 704 subjects met the criteria of the study of 880 pregnant women with hypertensive disorders. There were significant differences of maternal blood uric acid level (p <0.001) between groups of severity of hypertension (preeclampsia with severe features 5.7 (2.2–16.0) mg/dL, preeclampsia without severe features 5.18 + 1.54 mg/dL, and chronic hypertension / gestational hypertension 4.8 (2.2-8.0 mg/dL). There was a significant difference in maternal blood uric acid level between groups of hypertension stage (hypertension stage I 4.8 (2.2–8.0) mg/dL, hypertension stage II 5.7 (2.2–16.0) mg/dL, and a hypertensive crisis 5.4 (2.6–9.8) mg / dL). The group of term gestational age at birth showed maternal blood uric acid level 5.0 (2.2–9.8) mg/dL, significantly lower (p <0.001) than preterm gestational age at birth 6.3 (2.7–7). 16) mg/dL. There were no significant differences between groups of birth weight and first minute APGAR scores.

Conclusion: There is a relationship between maternal outcomes (the severity of hypertensive disorders and the degree of hypertension) and perinatal outcomes (gestational age at birth) with maternal blood uric acid level. There is no relationship between birth weight and first minute APGAR score with maternal blood uric acid level."

"Latar Belakang : Preeklamsia terjadi akibat adanya gangguan pada proses implantasi dan desidualisasi pada awal kehamilan. Vitamin D memainkan peranan penting pada proses desidualisasi, implantasi dan plasentasi. Penelitian terbaru menunjukkan bahwa kadar 25(OH)D yang rendah dalam serum merupakan faktor risiko preeklamsia. Bukti terbaru mendukung peran suplementasi vitamin D yang dimulai pada saat sebelum, awal dan selama kehamilan dalam mengurangi risiko preeklamsia. Tujuan penelitian ini adalah untuk mengetahui peranan suplementasi vitamin D 5000 IU/hari pada implantasi dan plasentasi melalui pemeriksaan PI A. Uterina dan PlGF serum maternal pada wanita hamil trimester pertama.Metode : Uji klinis paralel acak tersamar tunggal. Subjek wanita hamil usia 7-11 minggu yang dibagi 2 kelompok, yaitu normal dan risiko tinggi berdasarkan kriteria risiko tinggi ACOG. Tiap kelompok dibagi lagi menjadi kontrol yang hanya mendapat obat standar dan perlakuan yang mendapat vitamin D 5000 IU/hari. Semua pasien diperiksa kadar 25(OH)D awal, kemudian diberikan intervensi selama 1 bulan dan diperiksa ulang kadar 25(OH)D akhir, PlGF serum maternal dan PI. A. Uterina. Menilai perbandingan kenaikan kadar 25(OH)D, PlGF, dan PI A. Uterina diantara semua kelompokHasil : Subjek awal berjumlah 92 orang, dieksklusi sebanyak 12 orang dan tersisa 80 subjek yang menyelesaikan penelitian. Semua subjek mengalami defisiensi vitamin D. Dibandingkan pasien kontrol kenaikan kadar 25(OH)D pada kelompok perlakuan normal masih lebih tinggi dibandingkan dengan kelompok perlakuan risiko tinggi yaitu 12,33±6,26 ng/mL dan 10,45±5,09 ng/mL dengan nilai p<0,001. Kelompok normal, penurunan PI A. Uterina dibandingkan antara kontrol dan perlakuan bermakna sebesar 0,57±0,36 dan 1,08±0,29 (p<0,001) sedangkan kadar PlGF juga berbeda bermakna antara kontrol (84,27±10,02) dan perlakuan (107,87±31,97) dengan nilai p 0,005. Pada kelompok risiko tinggi, perbadingan rerata kadar PlGF pada kontrol dan perlakuan berbeda bermakna yaitu 37,59±9,67 dan 70,53±18,32) nilai p<0,001. Pada pasien intervensi baik kelompok normal dan risiko tinggi rerata penurunan PI A. Uterina (1,08±0,29 vs 0,43±0,26; nilai p<0,001) dan kadar PlGF (107,87±31,97 vs 70,53±18,32; nilai p<0,001) berbeda bermakna.

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Background : Preeclampsia occurs due to disruption of the implantation and decidualization in early pregnancy. Vitamin D plays an important role in decidualization, implantation, and placentation. Recent evidence supports the role of vitamin D supplementation initiated before, early and during pregnancy in reducing the risk of preeclampsia. The study aim is to determine the effect of vitamin D supplementation of 5000 IU/day on implantation and placentation through examination of Uterine Artery PI (UtA-PI) and maternal serum PlGF in first trimester pregnant women.

Methods: Using a single-blind, randomized parallel clinical trial. Subjects were pregnant women 7-11 weeks gestation and divided into 2 groups, normal and high risk, based on ACOG preeclampsia high risk criteria. Each group was further divided into controls who received the standard drug and interventions who received 5000 IU of vitamin D/day. Subjects were examined for 25(OH)D levels before and after the 1 month intervention, including maternal serum PlGF and UtA-PI levels. Both groups were compared for the difference of 25(OH)D levels, mean PlGF, and UtA-PI.

Results: We have 80 subjects who have vitamin D deficiency. The normal and high-risk intervention group showed the increase of 25(OH)D levels, 12.33±6.26 ng/mL and 10.45±5.09 ng/mL with p<0.001 accordingly. For the normal group, the decrease of UtA-PI compared between control and intervention was significant 0,57±0,36 and 1,08±0,29 (p<0.001) while PlGF levels were also significantly different between control (84,27±10,02) and intervention (107,87±31,97) with p<0.05. While in high-risk group, the PlGF levels of control and intervention were significantly different, 37.59±9.67 and 70.53±18.32 with p<0.001. In intervention patients, both normal and high-risk groups, the decrease of UtA-PI (1.08±0.29 vs 0.43±0.26; p<0.001) and PlGF levels (107.87±31.97 vs 70.53±18.32; p<0.001) were significantly different."