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"Menurut WHO, tingkatan unmet need terhadap kontrasepsi pada wanita sangatlah tinggi, terutama pada daerah kelompok pendatang, wanita muda, daerah kumuh perkotaan, daerah pengungsian, dan wanita pasca kehamilan. Untuk itu, sebuah studi cross-sectional dilakukan pada Rumah Susun Jatinegara Barat untuk membuktikan keabsahan pernyataan tersebut. Sejumlah 100 wanita yang baru pindah ke tempat tersebut setelah relokasi yang dilakukan oleh pemerintah, telah diteliti untuk mengetahui nilai prevalansi dari unmet need terhadap kontrasepsi. Beberapa faktor yang mempengaruhi ketidak inginan perempuan terhadap pemakaian kontrasepsi juga diteliti dalam studi ini. Dalam studi ini, dapat diketahui nilai ketidak-pemakaian kontrasepsi di Rumah Susun Jatinegara Barat sebesar 49%. Sedangkan dalam kelurahan dimana Rumah Susun itu berada (Kampung Melayu), tingkatan unmet need pada wanita menikah di usia subur sebesar 30%. Beberapa faktor seperti sosioekonomi, sosiobudaya, lingkungan, dan lainnya telah diteliti, namun tidak menunjukkan asosiasi yang bermakna secara statistik (tidak mencapai p < 0.05). Kesimpulan: prevalansi unmet need pada Rumah Susun Jatinegara Barat tidak menemui angka pencapaian yang ditetapkan oleh BKKBN. Status sosioekonomi, faktor sosiobudaya, faktor lingkungan, dan faktor terkait host lainnya tidak menunjukan asosiasi statistik yang bermakna dengan tingkatan unmet need pada kontrasepsi oleh wanita menikah usia subur di Rumah Susun Jatinegara Barat, Jakarta.

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According to WHO, the unmet need for contraception among the women are considerably high especially among the groups such as migrants, adolescents, urban slum dwellers, refugees, and the women in postpartum period. Therefore, a cross-sectional  study was conducted in the Rumah Susun Jatinegara Barat to prove the statement.

A number of women (100 people) who newly resided the area after the mass relocation by the government, were studied in order to identify the prevalence of the unmet need for contraception. The specific investigation regarding the factors associating with the prevalence of  the unmet need for the contraception among married women, was also conducted.

From this study, the number of the prevalence of the unmet need for the contraception in Rumah Susun Jatinegara Barat reached 49%, while in Kelurahan Kampung Melayu, the proportion was about 30%. Socioeconomical, sociocultural, envirornental, and other factors were observed in this study but resulting in weak association to the unmet need for contraception (p value was not < 0.05).

In conclusion, the prevalence of the unmet need for contraception was considerably high and did not meet the goal set by the National population and family planning board. Socioeconomical status, sociocultural, environmental, and other host-related factor did not show a statistically significant association with the unmet need for contraception among married women in Rumah Susun Jatinegara Barat, Jakarta."

"Latar belakang: Kesalahan dalam pelayanan medis merupakan ancaman serius karena dapat menyebabkan pasien cedera, meninggal, dan meningkatkan biaya perawatan kesehatan yang tinggi. 1 Berdasar laporan Institute of Medicine (IOM) tahun 2000, terdapat 3-16% Kejadian Tidak Diharapkan (KTD) pada pelayanan pasien rawat inap di Amerika Serikat, Denmark, Inggris, dan Australia. Laporan JOGC tahun 2015 didapatkan 10% KTD terjadi di bidang obstetri. Data tentang KTD di Indonesia masih sulit didapatkan. Tahun 2007, Jakarta menduduki posisi teratas tentang laporan insiden keselamatan pasien yaitu 37,9%. Dari data Komite Mutu, Keselamatan Pasien, dan Kinerja (KMKK) RSUPN dr Cipto Mangunkusumo tahun 2015 dilaporkan 198 kasus KTD. Tujuan: Mengetahui distribusi kasus KTD di Departemen Obstetri dan Ginekologi RSCM tahun 2015 berdasarkan (1) tempat kejadian, (2) penyebab terjadinya, (3) jenis kegagalan, dan (4) penambahan masa rawat. Metode: Penelitian ini merupakan penelitian deskriptif analisis terhadap kasus KTD yang terjadi di Departemen Obstetri dan Gineklogi RSCM dari Januari hingga Desember 2015. Data didapatkan dari Koodinator Pelayanan Masyarakat (Koyanmas) yang telah dilakukan audit klinik dengan metode Root Cause Analysis (RCA). Hasil: Sepanjang tahun 2015 dilaporkan 36 kasus KTD dan dilakukan audit klinik oleh Tim Manajemen Risiko Klinis. Dari 36 kasus, yang memenuhi kriteria inklusi adalah 24 kasus. Berdasar tempat kejadiannya, terdapat 13 kasus (54%) terjadi di IGD, 4 kasus (17%) di ICU, 4 kasus (17%) di Ruang Operasi, dan 3 kasus (12%) di Ruang Rawat Inap. Berdasar penyebab terjadinya, terdapat 18 kasus (75%) disebabkan kurangnya pengetahuan dan kemampuan tenaga medis, 4 kasus (17%) karena penyebab lain, dan 2 kasus (8%) karena kesalahan teknis. Berdasar jenis kegagalannya, didapatkan 8 kasus (33%) terjadi penundaan perawatan atau tindakan medis, 6 kasus (25%) terjadi kegagalan tindakan medis, 5 kasus (21%) terjadi misdiagnosis, 3 kasus (13%) terjadi ketidaktepatan tata laksana, dan 2 kasus (8%) terjadi kegagalan memberikan peringatan untuk mencegah cedera. Berdasar penambahan masa rawat, data menunjukkan distribusi data yang tidak normal dengan nilai Shapiro-Wilk <0,05. Maka digunakan nilai median yaitu 2 hari. (0-34 hari; 95% IK). Kesimpulan: Sebagian besar KTD di Departemen Obstetri dan Ginekologi RSCM tahun 2015 terjadi di IGD (54%), penyebab terbesar adalah kurangnya pengetahuan dan kemampuan tenaga medis (75%), dan sebagian besar kegagalan terjadi penundaan perawatan atau terapi (33%).

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Background: Medical errors are a serious threat because they can cause injury, death and increase the cost of high health care.1 According to Institute of Medicine (IOM) report in 2000, there are 3-16% of adverse events (AEs) in the care of nursing patients stay in the United States, Denmark, United Kingdom and Australia. In 2015, JOGC report 10% of the AEs occurred in obstetrics. Data on AEs in Indonesia is still difficult to obtain. In 2007, Jakarta occupied the top position regarding patient safety incident reports which is 37.9%. In 2015, from Quality, patient Safety and Performance Committee RSUPN dr. Cipto Mangunkusumo reports 198 cases of AEs. Aim: To obtain the distribution of AEs in the Department of Obstetrics and Gynecology RSCM in 2015 based on (1) place where AEs occured, (2) factor contributing to the AEs (3) failure to prevent the occurrence of the AEs, and (4) the additional length of the stay. Method: This research is a descriptive analysis of the AEs case that occurred in the Department of Obstetrics and Gynecology RSCM from January to December 2015. Data were obtained from the Koordinator Pelayanan Masyarakat (Koyanmas) which had been carried out by a clinical audit using the Root Cause Analysis (RCA) method. Result: In 2015, 36 cases of AEs were reported and a clinical audit was carried out by the Clinical Risk Management Team. From 36 cases, which met the inclusion criteria were 24 cases. Based on the place where AEs occurred, there were 13 cases (54%) in the ER, 4 cases (17%) in the ICU, 4 cases (17%) in the OR, and 3 cases (12%) in the Ward. Based on the factor contributing to the AEs, there were 18 cases (75%) due to lack of knowledge and ability of medical personnel, 4 cases (17%) due to other causes, and 2 cases (8%) due to technical errors. Based on the failure to prevent the occurrence of the AEs, there were 8 cases (33%) delayed treatment or medical treatment, 6 cases (25%) malpractice, 5 cases (21%) misdiagnosis, 3 cases (13%) failure to act based on test results, and 2 cases (8%) failure to take precautions in order to avoid injuries. Based on the additional length of stay, the data showed an abnormal distribution of data with a Shapiro-Wilk value <0.05. We use the median value which is 2 days. (0-34 days; 95% CI). Conclusion: Most of the AEs in the Department of Obstetrics and Gynecology RSCM in 2015 occurred in the ER (54%), the biggest cause was the lack of knowledge and ability of medical personnel (75%), and most of failure due to delay in treatment or therapy (33%)."

"Latar belakang: Perubahan fungsi seksual perempuan pascapersalinan berkisar 23% - 86% dan mempunyai dampak yang signifikan dalam keharmonisan keluarga. Berbagai studi dan penelitian tentang fungsi seksual perempuan pascapersalinan banyak dilakukan dengan hasil yang berbeda karena adanya perbedaan alat ukur, waktu pengukuran serta pengontrolan variabel perancu. Penelitian ini sebagai konfirmasi dari penelitian sebelumnya serta belum adanya data yang pasti terutama di Jakarta dan Indonesia umumnya. Tujuan: mengetahui perbandingan dorongan, bangkitan, orgasme, nyeri dan kepuasan fungsi seksual perempuan 3 bulan pascapersalinan spontan dengan seksio sesaria di Rumah Sakit Cipto Mangunkusumo Jakarta. Metode: Penelitian observasional, subyek kelompok persalinan spontan dan seksio sesaria, pengukuran fungsi seksualnya 3 bulan pascapersalinan menggunakan kuisioner Female Sexual Function Index (FSFI) desain penelitian cross sectional (potong lintang), pengambilan sampel consecutive sampling. Analisis komparatif katagorik tidak berpasangan dengan chi square atau uji fisher. Analisis variabel perancu dilakukan analisis multivariat regresi logistik. Hasil: Dari 150 responden 3 bulan pascapersalinan spontan dan seksio sesaria didapatkan 43,3% disfungsi seksual dengan 52 % spontan dan 34 % seksio sesaria. Analisa bivariat terjadinya disfungsi seksual 3 bulan pascapersalinan spontan 1,5 kali lebih besar (IK 95% 1,02-3,19) dibandingkan seksio sesaria. Gangguan hasrat/dorongan seksual 2 kali lebih besar (IK 95% 1,17-3,40) dibandingkan seksio sesaria, sedangkan gangguan orgasme 8 kali lebih besar (IK 95% 1,90-3,58) dengan variable perancu adanya robekan perineum. Gangguan bangkitan seksual, lubrikasi, kepuasan seksual dan nyeri tidak berbeda secara bermakna pada persalinan spontan dengan seksio sesaria. Analisa multivariat variabel persalinan spontan bermakna secara statistik untuk disfungsi seksual pasien 3 bulan pascapersalinan pada variabel disfungsi dorongan seksual dan pencapaian orgasme, dengan nilai p=0,008, RR 2,716 dan p=0,031 RR 6,952, sedangkan variabel usia lebih dari 30 tahun bermakna secara statistik pada disfungsi seksual pada variabel bangkitan seksual dengan p=0,021 dan RR 2,601. Kesimpulan: persalinan spontan bermakna secara statistik untuk terjadinya disfungsi seksual 3 bulan pascapersalinan, terutama variabel dorongan seksual dan tercapainya orgasme. Sedangkan variabel usia lebih dari 30 tahun merupakan variabel yang berpengaruh pada disfungsi seksual terutama pada variabel bangkitan seksual.

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Background: The alteration of postpartum sexual function on female is about 23%-86% and has a significant impact in a family?s tranquility. Many studies and research regarding postpartum sexual function on female were performed by various comparison variables such as Glasner, Barret, Thomson and Rochelle with different results because of the difference of measuring instruments, time of measurement and the control of confounding variables.

Objective: To know the comparison of encouragement, stimuli, orgasm, pain and satisfaction of female sexual function at 3 months post partum between spontaneous and cesarean section in Cipto Mangunkusumo National General Hospital in Jakarta.

Methods: This was an observational research involving subjects starting from identification of spontaneous and cesarean section group, and then their sexual function was measured at three months postpartum with Female Sexual Function Index (FSFI) questionnaire. The study design used was cross sectional with consecutive sampling. Analysis for non-paired of category comparative were chi square or fisher analysis. Analysis for confounding variables with multivariate logistic regression.

Results: From 75 respondents of spontaneous and Cesarean Section 43,3% have sexual dysfunction with 52% of spontaneous and 34% of cesarean section. Bivariate analysis of happening of sexual dysfunction at three months spontaneous was 1.5 times higher (IPK 95% 1,02-3,19) compared with cesarean section. Sexual encouragement shows a twice higher value (IPK 95% 1,17-3,40) compared to cesarean section. However, orgasm disturbance was 8 times higher (IPK 95% 1,90-3,58) with confounding variable of perineum rupture. Disturbance of sexual stimuli, satisfaction and pain were not significantly different between spontaneous and cesarean section. Multivariate analysis of vaginal labor was statistically significant for sexual dysfunction at three months postpartum in patient with sexual encouragement dysfunction and orgasm accession, with value of p=0,008, RR 2,716 and p=0,031 RR 6,952. However, more than 30 years old of age variable was statistically significant in sexual dysfunction variable with value of p=0,021 and RR=2,60.

Conclusion: Spontaneous labor is statistically significant for sexual dysfunction at three months postpartum, especially for sexual encouragement variable and orgasm accession. Meanwhile, the variables with the age of 30 years old or older."

"[ABSTRAKTujuan : Mengetahui gambaranpemilihan gender dokter obgin di RSUDZA Banda Aceh secara umum dan berdasarkan tindakan medis (pemeriksaan pelvik, kontrol kehamilan, bedah sesar, dan bedah ginekologi). Mengetahui apakah terdapat hubungan antara pemilihan gender dokter obgin dengan prosedur tindakan medis. Mengetahui adakah pengaruh umur, agama, status perkawinan, jumlah paritas, tingkat pendidikan, dan pekerjaan terhadap pemilihan gender dokter obgin.Metode : Penelitian observasionaldengan desain potong lintang. Penelitian berlangsung dari Juli sampai Desember 2013 di Poli Obgin RSUDZA Banda Aceh. Sebanyak 186 sampel diwawancara menggunakan kuesioner. Dilakukan deskriptif kategorikuntuk mengetahui gambaranpemilihan gender dokter obgin sehingga didapatkan jumlah dan persentase dari tiap-tiap variabel. Untuk mengetahui adakah hubungan antara pemilihan gender dokter obgin berdasarkan tindakan medisdilakukan penelitian analitik komparatif kategorik tidak berpasangan menggunakan uji Chi Square (p < 0,05 hipotesis terbukti benar). Analisis multivariat dengan regresi logistik untuk mencari pengaruh variabel independen (umur, agama, status perkawinan, jumlah paritas, tingkat pendidikan, pekerjaan) secara bersama-sama terhadap tindakan medis.Hasil : Pasien yang memilih dokter obgin perempuan 72%, laki-laki 5,4%, tidak memilih gender dokter 22,6%. Pada tindakan pemeriksaan pelvik, sebanyak 86,6% memilih dokter perempuan, 10,8% tidak memilih gender dokter, dan 2,7% memilih dokter laki-laki. Pada tindakan kontrol kehamilan, sebanyak 67,2% memilih dokter perempuan, 24,2% tidak memilih gender dokter, dan 8,6% memilih dokter laki-laki. Pada tindakan bedah sesar, sebanyak 59,7% memilih dokter perempuan, 25,8% tidak memilih gender dokter, dan 14,5% memilih dokter laki-laki. Pada tindakan bedah ginekologi, sebanyak 59,1% memilih dokter perempuan, 26,3% tidak memilih gender dokter, dan 14,5% memilih dokter laki-laki. Jumlah paritas mempengaruhi pemilihan gender dokter obgin untuk pemeriksaan pelvik, dengan nilai p 0,046 (< 0,05), namun tidak berpengaruh terhadap tindakan medis lainnya.Kesimpulan : Faktor umur, status perkawinan, jumlah paritas, tingkat pendidikan, dan pekerjaan, tidak berpengaruh terhadap pemilihan gender dokter obgin di RSUDZA Banda Aceh. Terdapat pengaruh jumlah paritas terhadap pemilihan gender dokter obgin khusus untuk tindakan pemeriksaan pelvik. Diharapkan dapat dilakukan pengembangan penelitian dengan metode berbeda di daerah lain agar dapat meningkatkan pelayanan dokter obgin di Indonesia.

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ABSTRACTAim : To know the description of women's preferences in selecting their obstetrician and gynecologist in Zainoel Abidin Hospital Banda Aceh in general and based on medical treatments (pelvic examination, control of pregnancy, cesarean section, and surgical gynecology). To know is there any influence of gender selection towards medical treatments. To know is there any influence of age, religion, marital status, parity, educational level, and work towards women's preferences in selecting their obstetrician and gynecologist.Methods : This study was an observational cross-sectional design starting from July to December 2013 at Obstetrics and Gynecology Policlinic ofZainoel Abidin Hospital Banda Aceh. A total of 186 samples were interviewed using a questionnaire. To find a description of the gender preferences for obstetrician and gynecologist, we performed a descriptive categorical to get the number and percentage of each variable. To determine whether there's a relationship between women's preferences in selecting their obstetrician and gynecologist with medical treatment procedures (pelvic examination, ANC, cesarean section, and gynecology surgical), we used an unpaired categorical comparative analytic study using Chi Square (p < 0,05 hypothesis proved correct). Multivariate analyze using logistic regression to find the influence of the independent variables (age, religion, marital status, parity, education level, occupation) jointly based on medical treatments.Results : The most gender preferences for obstetrician and gynecologist was female (72%), 5.4% choosing male, and 22.6% did not choose gender. Based on pelvic examination, 86.6% choosing female physician, 10.8% did not choose gender, and 2.7% choosing male physician. In the act of ANC, 67.2% choosing female physician, 24.2% did not choose gender, and 8.6% choosing male physician. Based on cesarean section, as many as 59.7% choosing female physician, 25.8% did not choose gender, and 14.5% choosing male physician. At gynecological surgery, as much as 59.1% choosing female physician, 26.3% did not choose gender, and 14.5% choosing male physician. There is the effect of parity on gender preferences of obstetrician and gynecologist for pelvic examination, with p value 0.046 (<0.05), but no effect on other treatments.Conclusion : Age, marital status, parity, education level, and employment did not influence the gender preferences of obstetrician and gynecologist in Zainoel Abidin Hospital Banda Aceh. There is the effect of parity on gender preferences specifically for pelvic examination.It is hoped that further research by using difference methods can be developed at other regions in order to improve obstetrician and gynecologist services in Indonesia.;Aim :To know the description of women?s preferences in selecting their obstetrician and gynecologist in Zainoel Abidin Hospital Banda Aceh in general and based on medical treatments (pelvic examination, control of pregnancy, cesarean section, and surgical gynecology). To know is there any influence of gender selection towards medical treatments. To know is there any influence of age, religion, marital status, parity, educational level, and work towards women?s preferences in selecting their obstetrician and gynecologist.Methods : This study was an observational cross-sectional design starting from July to December 2013 at Obstetrics and Gynecology Policlinic ofZainoel Abidin Hospital Banda Aceh. A total of 186 samples were interviewed using a questionnaire. To find a description of the gender preferences for obstetrician and gynecologist, we performed a descriptive categorical to get the number and percentage of each variable. To determine whether there?s a relationship between women?s preferences in selecting their obstetrician and gynecologist with medical treatment procedures (pelvic examination, ANC, cesarean section, and gynecology surgical), we used an unpaired categorical comparative analytic study using Chi Square (p < 0,05 hypothesis proved correct). Multivariate analyze using logistic regression to find the influence of the independent variables (age, religion, marital status, parity, education level, occupation) jointly based on medical treatments.Results : The most gender preferences for obstetrician and gynecologist was female (72%), 5.4% choosing male, and 22.6% did not choose gender. Based on pelvic examination, 86.6% choosing female physician, 10.8% did not choose gender, and 2.7% choosing male physician. In the act of ANC, 67.2% choosing female physician, 24.2% did not choose gender, and 8.6% choosing male physician. Based on cesarean section, as many as 59.7% choosing female physician, 25.8% did not choose gender, and 14.5% choosing male physician. At gynecological surgery, as much as 59.1% choosing female physician, 26.3% did not choose gender, and 14.5% choosing male physician. There is the effect of parity on gender preferences of obstetrician and gynecologist for pelvic examination, with p value 0.046 (<0.05), but no effect on other treatments.Conclusion : Age, marital status, parity, education level, and employment did not influence the gender preferences of obstetrician and gynecologist in Zainoel Abidin Hospital Banda Aceh. There is the effect of parity on gender preferences specifically for pelvic examination.It is hoped that further research by using difference methods can be developed at other regions in order to improve obstetrician and gynecologist services in Indonesia., Aim :To know the description of women’s preferences in selecting their obstetrician and gynecologist in Zainoel Abidin Hospital Banda Aceh in general and based on medical treatments (pelvic examination, control of pregnancy, cesarean section, and surgical gynecology). To know is there any influence of gender selection towards medical treatments. To know is there any influence of age, religion, marital status, parity, educational level, and work towards women’s preferences in selecting their obstetrician and gynecologist.Methods : This study was an observational cross-sectional design starting from July to December 2013 at Obstetrics and Gynecology Policlinic ofZainoel Abidin Hospital Banda Aceh. A total of 186 samples were interviewed using a questionnaire. To find a description of the gender preferences for obstetrician and gynecologist, we performed a descriptive categorical to get the number and percentage of each variable. To determine whether there’s a relationship between women’s preferences in selecting their obstetrician and gynecologist with medical treatment procedures (pelvic examination, ANC, cesarean section, and gynecology surgical), we used an unpaired categorical comparative analytic study using Chi Square (p < 0,05 hypothesis proved correct). Multivariate analyze using logistic regression to find the influence of the independent variables (age, religion, marital status, parity, education level, occupation) jointly based on medical treatments.Results : The most gender preferences for obstetrician and gynecologist was female (72%), 5.4% choosing male, and 22.6% did not choose gender. Based on pelvic examination, 86.6% choosing female physician, 10.8% did not choose gender, and 2.7% choosing male physician. In the act of ANC, 67.2% choosing female physician, 24.2% did not choose gender, and 8.6% choosing male physician. Based on cesarean section, as many as 59.7% choosing female physician, 25.8% did not choose gender, and 14.5% choosing male physician. At gynecological surgery, as much as 59.1% choosing female physician, 26.3% did not choose gender, and 14.5% choosing male physician. There is the effect of parity on gender preferences of obstetrician and gynecologist for pelvic examination, with p value 0.046 (<0.05), but no effect on other treatments.Conclusion : Age, marital status, parity, education level, and employment did not influence the gender preferences of obstetrician and gynecologist in Zainoel Abidin Hospital Banda Aceh. There is the effect of parity on gender preferences specifically for pelvic examination.It is hoped that further research by using difference methods can be developed at other regions in order to improve obstetrician and gynecologist services in Indonesia.]"

"Profil Kehamilan Remaja dan Faktor Yang Berhubungan Dengan Cara Persalinannya di Rumah Sakit Umum dr.Zainoel Abidin Banda Aceh Latar belakang : Kehamilan remaja merupakan kehamilan risiko tinggi yang dapat menyebabkan masalah psikologis, luaran neonatal, dan obstetrik yang buruk. Beberapa studi menunjukkan luaran obstetri dan neonatologi yang kurang baik pada kehamilan remaja bila dibandingkan dengan kehamilan dewasa. Salah satunya angka seksio yang sesaria tinggi dibandingkan dengan perempuan dewasa. Tujuan : Untuk mengetahui luaran Obstetrik buruk pada kehamilan remaja serta mengetahui apakah terdapat hubungan antara faktor sosiodemografik dan kunjungan antenatal dengan metode persalinan pada kehamilan remaja. Metode : Analisa potong-lintang dilakukan pada persalinan dengan kehamilan remaja di RSUD Zainal Abidin, Banda Aceh, yang diambil dari rekam medis pasien pada bulan Januari 2010 sampai dengan Desember 2015. Profil kehamilan remaja, luaran buruk obstetrik, dan indikasi seksio sesaria pada subjek penelitian disajikan secara deskriptif. Analisis bivariat dilakukan untuk menilai hubungan antara metode persalinan dengan jumlah kunjungan ANC, provider ANC, klasifikasi usia Ibu, tingkat pendidikan dan jenis asuransi. Hasil : Dari 186 persalinan remaja, sebanyak 75 subjek atau 40.3 menjalani seksio sesaria. Preeklamsia, kelahiran kurang bulan, dan malpresentasi adalah 3 luaran obstetri terbanyak yang terjadi pada subjek yaitu masing-masing sebesar 14 7.5, 10 5.4, 10 5.4. Indikasi seksio sesaria terbanyak pada subjek penelitian adalah gagal induksi, ketuban pecah dini, dan persalinan sungsang, yaitu masing-masing sebesar 19 25.3, 11 14.7, dan 10 subjek 13.3. Jumlah ANC berhubungan secara bermakna dengan jenis persalinan pada kehamilan remaja OR 4.14, IK 95 1.86-9.21. Sedangkan usia ibu, penyedia jasa kunjungan antenatal, jenis asuransi, dan pendidikan terakhir tidak berhubungan dengan jenis persalinan. Kesimpulan : Angka seksio sesaria pada kehamilan remaja pada populasi di Banda Aceh tinggi. Frekuensi kunjungan antenatal yang adekuat berhubungan dengan jenis persalinan pada kehamilan remaja di Banda Aceh.

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Profile of Teenage Pregnancy and Associated Factor of the Delivery Management in dr.Zainoel Abidin General Hospital Banda Aceh Background Teenage pregnancy is one of the high risk pregnancy which can cause psychologic problems and adverse outcome to mother and neonate. Some studies show that adverse obstetrical and neonatal outcomes occur more likely in teenage pregnancy than adult pregnancy. One of the bad outcome is the high rate of caesarian section in teenage pregnancy than adult pregnancy.

Objective : To evaluate adverse obstetrical outcome in teenage pregnancy and to investigate whether the social factor, demographic factor, and antenatal care associate with management of delivery in teenage pregnancy.

Methods : Cross sectional analysis is conducted to all medical records of teenage pregnancy from January 2010 to December 2015 in Zainal Abidin General Hospital, Banda Aceh. Descriptive analysis was conducted to teenage pregnancy profile, obstetrical adverse outcome, and caesarian section rsquo s indication. Bivariate analysis was conducted to evaluate the association between management of delivery with the amount of antenatal care, the provider of antenatal care, maternal age classification, education, and insurance.

Results : From 186 teenage pregnancies, 75 pregnancies was terminated by caesarian section procedures 40,3 . Preclampsia, preterm labour, and malpresentation are the three most common obstetrical outcomes with each percentage is 14 7.5 , 10 5.4 , and 10 5.4. Indication of caesarian section procedures is 25.3 failure of induction N 19, 14.7 premature rupture of membrans N 11, and 13,3 breech presentation N 10. The amount of antenatal care visit significantly associates with teenage pregnancy OR 4.14, CI95 1.86 9.21. with The provider of antenatal care, maternal age classification, education, and insurance do not associate with management of labour.

Conclusion : There is high rates of sectio cessaria procedures in teenage pregnancy in Banda Aceh. The frequency of adequate antenatal care associates with management of labour in Banda Aceh. "

"Latar Belakang: Kehamilan remaja adalah beban kesehatan utama. Kehamilan remaja dapat menyebabkan berbagai komplikasi, termasuk anemia, prematuritas, dan bayi berat lahir rendah BBLR . Sampai saat ini, penelitian mengenai kehamilan remaja di Indonesia masih jarang. Penelitian ini bertujuan untuk mengetahui prevalensi kehamilan remaja serta luarannya. Metode: Untuk menganalisis prevalensi ibu remaja, kami menggunakan desain studi potong lintang dengan mengeavaluasi rekam medis dari seluruh ibu hamil yang berobat ke klinik obstetri RSUPN Cipto Mangunkusumo pada periode Januari 2014 sampai Desember 2016. Pada luaran ibu hamil, kami menggunakan desain studi retrospektif dengan menganalisis rekam medis ibu remaja yang bersalin di RSUPN Cipto Mangunkusumo pada periode yang sama. Luaran ibu remaja dibandingkan dengan ibu yang bersalin yang berusia 20-30 tahun. Luaran ibu yang kami ukur meliputi preeklampsia, metode persalinan, anemia, perdarahan pasca persalinan, sedangkan luaran perinatal yang kami ukur meliputi kelahiran prematur dan BBLR. Hasil: Dari seluruh 3.578 pasien di Poliklinik Obstetri RSUPN Dr. Cipto Mangunkusumo, diperoleh 503 subjek yang hamil, sebanyak 16 3.2 subjek adalah remaja. Dari seluruh 520 subjek yang bersalin, 78 15 subjek adalah remaja. Kehamilan remaja berhubungan signifikan dengan anemia p < 0.05, adjusted OR = 2.08 dam BBLR p < 0.05, adjusted OR = 1.83 . Kehamilan remaja tidak berhubungan signifikan dengan preeklampsia, metode persalinan, perdarahan pasca persalinan, dan kelahiran prematur. Kesimpulan: Prevalensi kehamilan remaja di RSUPN Dr. Cipto Mangunkusumo adalah 3.2 dan persalinan remaja di RSUPN Dr. Cipto Mangunkusumo adalah 15 . Ibu remaja berada pada peningkatan risiko anemia dan melahirkan bayi BBLR.

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Background Teenage pregnancy is a major health burden, leading to many complications, including anemia, preterm birth, and low birthweight. To date, studies regarding teenage pregnancies in Indonesia are scarce. We aimed to evaluate the prevalence as well as maternal and perinatal outcome of teenage pregnancies. Methods For analyzing the prevalence of the teenage mothers, we used crosssectional study design by evaluating the medical records of all pregnant mothers who went to the obstetric clinic of Cipto Mangunkusumo Hospital, Jakarta, Indonesia, during January 2014 until December 2016. For the outcome of the teenage mothers, we used retrospective study design by analyzing medical records of teenage mothers who had delivery at the delivery ward of Cipto Mangunkusumo Hospital during January 2014 until December 2016. We compared their outcomes to outcomes of pregnant women aged 20 to 30 years old delivered at the same hospital in the same period. Maternal outcomes that were measured include preeclampsia, methods of delivery, anemia, and postpartum hemorrhage, as well as perinatal outcomes including preterm delivery, and low birthweight. Results Among 3.578 outpatients at Obstetric Clinic, RSUPN Cipto Mangunkusumo, we got 503 pregnant subjects, 16 3.2 were teenagers. Among 520 subjects who had delivery, 78 15 subjects were le 19 years old. Teenage pregnancy was significantly associated with anemia p 0.05, adjusted OR 2,08 and low birthweight p 0.05, adjusted OR 1.83 . Teenage pregnancy was not significantly associated with preeclampsia, methods of delivery, postpartum hemorrhage, and preterm delivery. Conclusion The prevalence of teenage pregnancy at Cipto Mangunkusumo Hospital is 3.2 and teenage mothers who had delivery is 15 . Teenage mothers are at increased risk of anemia and delivering low birth weight babies."

"ABSTRAKTujuan Penelitian: Untuk melihat keakuratan koding diagnosis dan prosedur medis serta faktor-faktor yang mempengaruhi terjadinya perbedaan klaim INA CBGs RSUPN Dr. Cipto Mangunkusumo.Metode: Deskriptif observasional, simple random sampling, perhitungan kuantitatif menggunakan data retrospektif, data resume medis elektronik pasien.Hasil: Didapatkan 43% coding diagnosis utama oleh dokter tidak sesuai. 62% koding diagnosis sekunder DPJP tidak sesuai, namun mengalami perbaikan setelah dilakukan reseleksi dan entry data oleh coder sebesar 97%. Kesesuaian coding prosedur medis sebesar 98% dan 100% grouper yang sesuai, tapi masih ditemukan kesalahan coding dan severity level sebesar 27,7%. Akibat ketidaksesuaian coding dan grouping severity level menimbulkan kerugian Rp 584.099 per kasus pada tahun 2016, dan bila dihitung berdasarkan biaya riil terhadap klaim INA CBGs maka didapatkan selisih negatif yang jauh lebih besar yaitu Rp 17.263.241 per kasus.Kesimpulan: Penyebab kerugian klaim RSUPN Dr. Cipto Mangunkusumo diakibatkan ketidakcermatan dokter dalam penulisan resume medis elektronik dan coding, serta diperburuk oleh ketidaktelitian coder dalam melakukan reseleksi dan prosedur entry coding.

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ABSTRACTObjective : To know the accuracy of diagnostic coding, medical procedures and factors affecting the difference in claims of hospital INA CBGs and BPJS HealthMethods: observational descriptive, simple random sampling methode,retrospective data sourced from patient's electronic medical resume .Results: 43% of the principal diagnosis codes were not appropriate. 62% of secondary diagnosis codes by Doctor are not appropriate, but improved to 97% after the reselection and data entry by the coder.The suitability of medical procedures coding reaches 98% and 100% accuracy of diagnosis grouping. However, there is still 27.7% cases of difference in severity level due to mismatch of coding and causing potential loss of Rp 584.099 IDR each case during period of 2016, If calculated based on the ratio of hospital real cost tariff to the INA CBGs claims, there will be a much larger negative difference of 17.263.241 IDR each case.Conclusion: Causes of negative claims (loss) of RSUPN Dr. Cipto Mangunkusumo with BPJS payments due to incompleteness in electronic medical resume input and bad coding standard, and continued with the coder s inaccuracy in reselection diagnosis and data entry that causes potential losses."

"Latar Belakang : Disfungsi seksual dialami oleh 22-86% perempuan pada periode pascapersalinan. Alasan yang dikemukakan untuk menunda hubungan seksual adalah kekhawatiran mengenai nyeri perineum, perdarahan, dan kelelahan. Disfungsi seksual seringkali tidak disadari, baik oleh pasien maupun oleh klinisi. Penelitian ini dilakukan untuk menilai fungsi seksual perempuan dalam waktu enam bulan setelah melahirkan spontan. Metode : Penelitian ini merupakan studi potong lintang menggunakan kuesioner female sexual function index (FSFI) yang didistribusikan di antara 47 responden dalam periode September-Desember 2012. Tiap hasil individu digunakan untuk menilai fungsi seksual secara umum dan disfungsi seksual per domain. Karakteristik responden kemudian dianalisis bivariat dengan disfungsi seksual. Hasil : Dalam enam bulan setelah persalinan spontan, 44 responden (93,6%) telah memulai kembali aktivitas seksual. Dari 47 responden, 27 (57,5%) menderita disfungsi seksual. Nilai p untuk analisis bivariat antara kelompok usia, tingkat pendidikan, paritas, derajat robekan perineum, status menyusui dan disfungsi seksual secara berturut-turut, yaitu: 0,064; 0,437; 0,836; 0,761; 0,723. Kesimpulan : Tidak ada perbedaan bermakna antara berbagai variabel yang dianalisis dengan disfungsi seksual, baik secara umum maupun per domain, dalam periode enam bulan pascapersalinan spontan.

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Background : Sexual dysfunction is experienced by 22-86% women after giving birth. The reasons to delay resuming sexual intercourse is due to anxiety about perineal pain, bleeding, and fatigue. Sexual dysfunction is usually unnoticed either by patients or clinicians. This study was conducted to assess sexual function in women during six months period after spontaneous delivery.

Methods : This was a cross-sectional study using female sexual function index (FSFI) questionnaires which were distributed among 47 subjects during period of September-December 2012. Each individual results was assessed for general sexual function and per domain sexual dysfunction. Subjects characteristics were analyzed bivariately with sexual dysfunction prevalence.

Results : During six months after spontaneous delivery, 44 subjects (93.6%) had resumed sexual activity. Out of 47 subjects, 27 (57.5%) suffered from sexual dysfunction. P value for bivariate analysis between patients? age group, education level, parity, perineal rupture, breastfeeding and sexual dysfunction status were respectively 0.064; 0.437; 0.836; 0.761; 0.723.

Conclusion : There was no significant difference between various variables analyzed and sexual dysfunction, either general or per domain, in six months period after spontaneous delivery."

"Gangguan seksualitas merupakan masalah yang sering dialami oleh perempuan yang dipengaruhi oleh banyak faktor. Di Indonesia membicarakan masalah seksualitas masih dianggap tabu, sehingga tidak banyak informasi yang didapatkan terkait gangguan fungsi seksual perempuan. Penelitian ini dilakukan di Klinik Yasmin RSCM Kencana. Dengan tujuan untuk mengetahui gambaran gangguan fungsi seksual pada perempuan subfertil yang datang pada kunjungan pertama untuk memiliki anak. Rancangan penelitian dengan studi potong lintang menggunakan kuisioner pada perempuan dengan keluhan ingin memiliki anak. Besar sampel 108 orang. Pengambilan sampel dengan consecutive sampling. Dilakukan wawancara dan pengisian kuisioner Female Sexual Function Index (FSFI), Kuisioner Hamilton Rating Scale For Anxiety (HARS), Kuisioner Hamilton Derpression Rating Scale (HDRS), Kuisioner International Index of Erectile Function (IIEF). Analisa data dengan metode Chi Square dan dilanjutkan dengan analisa multivariat Backward Conditional dilanjutkan dengan Regresi Logistik. Didapatkan hasil mayoritas  subjek perempuan berusia 30 tahun sebanyak 11 orang, belum pernah menikah sebanyak 93 (86,10 %), riwayat menggunakan alat kontrasepsi (16.67%), lama menikah kurang dari atau sama dengan 10 tahun (83.30%), Subjek yang bersekolah hingga pendidikan tinggi (93,50 %) dan memiliki pekerjaan (82,40%). Jenis disfungsi seksual pada pasien perempuan subfertil di Klinik Yasmin RSCM Kencana yaitu gangguan dorongan seksual (79,60%), bangkitan seksual (66.7%), orgasme (50,9%), nyeri (48.1%), lubrikasi  (18,50%) dan kepuasan (34.3%). mengalami depresi sebanyak 46,20% dan mengalami kecemasan 38.00%.

Subjek pria dibawah umur 40 tahun (77,80%), semua bekerja (100,00 %), dan berpendidikan tinggi (88,90 %), Pria yang mengalami depresi 21.30% dan kecemasan 19,49%.

Pada analisa bivariat Frekuensi hubungan seksual memiliki hubungan yang signifikan dengan  disfungsi seksual perempuan pasien subfertil di Klinik Yasmin RSCM Kencana p = 0.09.

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Sexuality disorders are problems often experienced by women which can be influenced by many factors. Talking about sexuality in Indonesia is still considered taboo, and not much information I available regarding women's sexual dysfunction. This research was conducted at the Yasmin Clinic, RSCM KencaTo know the description of sexual function disorders in subfertile on the first visit wanting to have children. The research design was a cross-sectional study using a questionnaire on women with chief complaints of wanting to have children. The sample size is 108 people. Sampling with consecutive sampling. Interviews and questionnaires were filled in. Female Sexual Function Index (FSFI) Questionnaire, Hamilton Rating Scale For Anxiety (HARS) Questionnaire, Hamilton Depression Rating Scale (HDRS) Questionnaire, and International Index of Erectile Function (IIEF) Questionnaire. Data analysis using the Chi-Square method and followed by Backward Conditional multivariate analysis followed by Logistic Regression. The results obtained were that the majority of female subjects were 30 years old as many as 11 people, 93 (86.10%) had never been married, history of using contraception (16.67%), length of marriage less than or equal to 10 years (83.30%), subjects who attended school to higher education (93.50%) and have a job (82.40%). Types of sexual dysfunction in subfertile female patients at the Yasmin Clinic RSCM Kencana are sexual drive disorders (79.60%), sexual arousal (66.7%), orgasm (50.9%), pain (48.1%), lubrication (18.50%) ) and satisfaction (34.3%). experiencing depression at as much as 46.20% and experiencing anxiety at 38.00%. Male subjects under the age of 40 years (77.80%), all working (100.00%), and highly educated (88.90%). Men who experience depression 21.30% and anxiety 19.49%. In bivariate analysis, the frequency of sexual intercourse had a significant relationship with female sexual dysfunction in subfertile patients at the Yasmin Clinic, RSCM Kencana, p = 0.09."

"Latar Belakang : Pandemi COVID-19 merupakan sebuah kejadian dengan dampak luar biasa terutama pada populasi berisiko seperti ibu hamil. Indonesia sebagai salah satu negara dengan jumlah pasien COVID-19 tertinggi di dunia memiliki banyak kasus kehamilan dengan luaran maternal dan perinatal yang buruk akibat infeksi COVID-19. Namun, hingga saat ini belum terdapat studi yang secara komprehensif menilai faktor klinis dan non-klinis yang berpengaruh terhadap luaran buruk pada pasien hamil dengan COVID-19. Tujuan : Mengetahui faktor klinis dan non-klinis yang berhubungan dengan luaran buruk maternal dan perinatal pada ibu hamil dengan COVID-19. Metode : Penelitian kohort retrospektif dilakukan pada perempuan hamil yang terinfeksi COVID-19 yang dirawat Rumah Sakit Pusat Angkatan Darat (RSPAD) Gatot Soebroto selama periode Januari 2021 - April 2022. Pasien dengan data tidak lengkap dieksklusi dari penelitian. Faktor klinis yang dinilai adalah usia maternal, usia gestasi, beratnya gejala COVID-19 saat admisi, status obstetrik, status vaksinasi COVID-19, lama rawat instalasi gawat darurat, lama rawat inap biasa, lama rawat inap intensif, dan komorbiditas. Fakotr non-klinis yang dinilai adalah lama waktu sejak gejala hingga datang ke fasilitas pelayanan kesehatan, keengganan datang ke fasilitas pelayanan kesehatan, tingkat pendapatan, dan tingkat pendidikan. Hasil : Didapatkan sebanyak 79 subjek penelitian yang diikutsertakan dalam penelitian. Sebanyak 9 subjek mengalami luaran buruk berupa kematian ibu (n = 1), janin meninggal (n = 5), dan gejala COVID-19 berat (n = 6). Faktor klinis yang berpengaruh terhadap luaran yang buruk adalah usia maternal yang lebih tua, usia gestasi yang lebih muda, gejala COVID-19 yang lebih berat, serta durasi perawatan di instalasi perawatan intensif yang lebih lama (p < 0,05). Faktor non-klinis yang berpengaruh terhadap luaran yang buruk adalah lama gejala awal yang lebih lama, keberadaan kendala mencari pertolongan, dan pendapatan yang lebih rendah (p < 0,05). Kesimpulan : Luaran maternal dan perinatal yang lebih buruk pada kehamilan dengan COVID-19 terjadi akibat interaksi dari faktor klinis dan non-klinis. Diperlukan edukasi terhadap klinisi maupun masyarakat guna meningkatkan luaran pada kehamilan dengan COVID-19. Kata Kunci : COVID-19, infeksi, kehamilan, maternal, perinatal.

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Background: The COVID-19 pandemic is an event with a tremendous impact, especially on higher risk populations such as pregnant women. Indonesia as one of the countries with the highest number of COVID-19 patients in the world has many cases of pregnancy with adverse maternal and perinatal outcomes due to COVID-19 infection. However, there have been no studies that have comprehensively assessed clinical and non-clinical factors that influence adverse outcomes in pregnant patients with COVID-19.

Objective: To determine clinical and non-clinical factors associated with adverse maternal and perinatal outcomes in pregnant women with COVID-19.

Methods: A retrospective cohort study was conducted on pregnant women infected with COVID-19 who were treated at the Gatot Soebroto Army Central Hospital (RSPAD) during the period January 2021 - April 2022. Patients with incomplete data were excluded from the study. The clinical factors assessed were maternal age, gestational age, severity of COVID-19 symptoms upon admission, obstetric status, COVID-19 vaccination status, length of stay in the emergency department, length of regular hospitalization, length of intensive hospitalization, and comorbidity. The non- clinical factors assessed were the length of time from symptoms to arrival to health care facilities, reluctance to come to health care facilities, income level, and education level.

Results: There were 79 research subjects who were included in the study. A total of 9 subjects experienced adverse outcomes in the form of maternal death (n = 1), fetal death (n = 5), and severe COVID-19 symptoms (n = 6). Clinical factors that influenced poor outcomes were older maternal age, younger gestational age, more severe COVID-19 symptoms, and longer duration of treatment in intensive care (p < 0.05). The non- clinical factors that influenced the poor outcome were a longer duration of initial symptoms, the presence of obstacles in seeking help, and lower income (p < 0.05).

Conclusion: The worse maternal and perinatal outcomes in pregnancies with COVID-19 occur due to the interaction of clinical and non-clinical factors. Education for clinicians and the public is needed to improve outcomes in pregnancies with COVID- 19. Keywords: COVID-19, infection, maternal, perinatal, pregnancy"