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"Secara global, sebanyak 15 juta bayi lahir secara prematur setiap tahunnya. Indonesia menempati peringkat kelima negara dengan angka kelahiran prematuritas tertinggi di dunia. Salah satu komplikasi utama pada bayi prematur adalah sepsis neonatorum. Sepsis neonatorum adalah respon inflamasi sistemik yang dapat terjadi pada neonatus diakibatkan oleh transmisi infeksi secara vertikal maupun melalui lingkungan. Dikarenakan oleh temuan klinis sepsis yang variatif, menyebabkan upaya mendiagnosis sepsis menjadi sullit dilakukan. Oleh karena itu, perlu diberlakukan profilaksis sepsis neonatorum pada bayi prematur, sehingga muncul prosedur oral care. Pemahaman mengenai kebermanfaatan dan keamanan prosedur oral care masih diperlukan untuk dapat menggunakan prosedur ini secara optimal. Tujuan. (1) Mengetahui karakteristik subjek penelitian berdasarkan karakteristik jenis kelamin, usia gestasi, berat lahir, usia ibu, dan jenis persalinan. (2) Mengetahui angka kejadian sepsis neonatorum pada bayi prematur yang mendapat dan tidak mendapat oral care. (3) Mengetahui hubungan antara pemberian oral care dengan kejadian sepsis neonatorum pada bayi prematur. Metode penelitian. Sebuah studi cross-sectional dilakukan pada populasi bayi prematur yang lahir di RSCM pada tahun 2015-2017. Sebanyak 42 sampel yang dipilih secara simple random sampling. Pengambilan data dilakukan pada bulan Januari hingga Agustus 2018 dengan melihat rekam medis subjek penelitian yang dilanjutkan dengan analisis bivariat. Hasil penelitian. Jumlah total subjek yang memenuhi kriteria inklusi dan eksklusi pada penelitian ini adalah 42 bayi prematur. Karakteristik penelitian ini adalah jenis kelamin laki-laki sebesar 52,4%, rerata usia gestasi 33 (24-36) minggu, rerata berat lahir 1569,24±493,3 gram, rerata usia ibu 30,5238±6,67 tahun, dan jenis persalinan sectio caesaria sebesar 85,7%. Didapatkan hubungan bermakna antara pemberian oral care dengan kejadian sepsis neonatorum (P=0,030 ; RR=0,533 ; IK 95%=0,290-0,980). Didapatkan hubungan bermakna antara usia gestasi dengan kejadian sepsis neonatorum pada subjek yang mendapat oral care (UG: 32-37 minggu = 91,7% subjek tidak sepsis ; P=0,003), serta hubungan bermakna antara berat lahir dengan kejadian sepsis neonatorum pada subjek yang mendapat oral care (BL: 1500-2499 gram = 100% subjek tidak sepsis ; P=0,002). Kesimpulan. Terdapat hubungan yang signifikan antara pemberian oral care dengan kejadian sepsis neonatorum pada bayi prematur di RSCM, terdapat penurunan kemungkinan terkena sepsis neonatorum sebesar 0,533 kali lipat.

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Introduction. Globally, it is estimated that there are 15 million premature infants born every year. Indonesia ranks fifth in the incidence of prematurity worldwide. One of the major complications of premature infants is neonatal sepsis. Neonatal sepsis is a systemic inflammatory response on infants caused by infections acquired vertically and enviromentally. Sepsis has a wide range of clinical findings, therefore it is hard to diagnose precisely. Therefore, profilactic measures to prevent neonatal sepsis is needed, and oral care rises as one of the solution. The understanding in regards of efficacy and safety of oral care is needed in order to be able to optimally utilize this procedure.

Objectives. (1) To determine the subject characteristic based on gender, gestational age, birth weight, maternal age, and mode of delivery. (2) To determine the incidence of neonatal sepsis in premature infants with or without the administration of oral care. (3) To determine the association between oral care administration and the incidence of neonatal sepsis in premature infants.

Methods. A cross-sectional study is done to premature infants born in RSCM in 2015-2017. 42 samples are chosen by simple random sampling. Data is collected from January to August 2018 by observing the medical records of the subject, and then continued to be analyzed using bivariate analysis.

Results. There are 42 subjects that met the inclusion and exclusion criteria. The characteristics of this study are, 52,4% subject is male, mean gestational age is 33 (24-36) weeks, mean birth weight is 1569,24±493,3 gram, mean maternal age is 30,5238±6,67 years, and 85,7% subject delivered by sectio caesaria mode. There is a significant association between oral care administration and the incidence of neonatal sepsis (P=0,030 ; RR=0,533 ; CI 95%=0,290-0,980). There is a significant association between gestational age and the incidence of neonatal sepsis in subjects receiving oral care (GA: 32-37 weeks = 91,7% subjects without neonatal sepsis ; P = 0,003), and a significant association between birth weight and the incidence of neonatal sepsis in subjects receiving oral care (BW: 1500-2499 gram = 100% subjects without neonatal sepsis ; P = 0,002).

Conclusion. There is a significant association between oral care administration and the incidence of neonatal sepsis in premature infants in RSCM, with the reduction of probability of the incidence of neonatal sepsis as much as 0,533 times higher."

"Latar belakang: Menurut data WHO, sebanyak 15 juta bayi di dunia dilahirkan kurang bulan setiap tahunnya, dan Indonesia menduduki peringkat ke-5 di dunia. Salah satu komplikasi pada bayi kurang bulan yang sering terjadi adalah sepsis. Sepsis Neonatorum Awitan Dini (SNAD) merupakan infeksi sistemik pada bayi pada usia kurang dari 72 jam yang seringkali disebabkan oleh transmisi patogen secara vertikal sebelum atau saat proses kelahiran. Strategi utama dalam penanggulangan kejadian SNAD bergantung pada identifikasi faktor risiko, termasuk ketuban pecah berkepanjangan. Namun, sampai saat ini masih belum ada kesepakatan terkait ambang batas waktu ketuban pecah yang meningkatkan risiko kejadian SNAD secara signifikan pada populasi bayi kurang bulan. Tujuan: (1) Mengetahui sebaran subjek penelitian berdasarkan karakteristik jenis kelamin, usia gestasi, usia ibu, berat lahir dan metode persalinan. (2) Mengetahui sebaran subjek penelitian berdasaran gejala klinis dan hasil pemeriksaan kultur. (3) Mengetahui hubungan antara waktu ketuban pecah dengan kejadian SNAD pada ambang batas waktu 24 jam, 18 jam dan 12 jam di RSCM. Metode penelitian: Sebuah studi kasus-kontrol dilakukan pada populasi bayi kurang bulan yang lahir di RSCM dari tahun 2016-2017. Subjek dibagi menjadi 2 kelompok: (1) kelompok kasus yang mengalami SNAD; dan (2) kelompok kontrol yang tidak mengalami SNAD; dipilih secara simple random sampling. Jumlah total subjek pada penelitian ini adalah 154 bayi kurang bulan (77 kasus dan 77 kontrol). Pengambilan data dilakukan pada Januari-Agustus 2018 dengan melihat rekam medis subjek penelitian, dilanjutkan dengan analisis bivariat menggunakan uji Chi Squared dan analisis multivariat menggunakan regresi logistik. Hasil penelitian: Semua karakteristik tidak memiliki perbedaan yang bermakna, kecuali usia gestasi (p=0,012) dan berat lahir (p=0,02). Gejala klinis yang paling sering ditemukan dan memiliki hubungan yang bermakna adalah sesak napas (63,0%; p<0,001) dan instabilitas suhu (40,9%; p<0,001). Kesimpulan: Terdapat hubungan yang signifikan antara waktu ketuban pecah dengan kejadian SNAD pada bayi kurang bulan di RSCM pada ambang batas waktu 12 jam, 18 jam dan 24 jam. Ketuban pecah lebih dari 12, 18 dan 24 jam meningkatkan risiko SNAD pada bayi kurang bulan 2,3 kali lipat, dan ketuban pecah lebih dari  12 jam meningkatkan risiko 2,9 kali lipat setelah adjustment.

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Introduction: According to WHO, 15 million babies are born premature annually, and  Indonesia ranks 5th worldwide. One of the most frequent complications in preterm infants is sepsis. Early onset neonatal sepsis (EONS) is defined as the systemic infection in infants less than 72 hours old which is often caused by vertical transmission of pathogens before or during labour. With the current lack of consensus in the definition of neonatal sepsis, identification risk factors, including prolonged premature preterm rupture of membranes (ROM), becomes the main strategy. Unfortunately, there is also currently lack of worldwide agreement in the threshold of duration of ROM which significantly increases the risk of EONS in preterm infants.

Objectives: (1) To determine the distribution of subjects based on selected characteristics: gender, gestational age, maternal age, birth weight and mode of delivery. (2) To determine the distribution of subjects based on clinical symptoms and bacterial culture examination. (3) To determine the association between the duration of ROM and the incidence of EONS in preterm infants, at the thresholds of 24 hours, 18 hours and 12 hours, in RSCM.

Methods: A case-control study was done on preterm infants born in RSCM in 2016-2017. The subjects were divided into 2 groups: (1) the case group for preterm infants who had EONS; and (2) the control group for preterm infants who did not have EONS; each selected by simple random sampling. The total number of subjects in the study was 154 preterm infants (77 in the case group and 77 in the control group). Data collection from the medical records of the subjects was performed in January-August 2018, followed by bivariate analysis using Chi Square Test and  multivariate analysis using logistic regression.

Result: Characteristics had insignificant differences, except gestational age (p=0,012) and birth weight (p=0,02). The clinical symptoms which were most frequent and had significant associations with EONS were respiratory instability (63,0%, p<0,001) and temperature instability (40,9%, p<0,001).

Conclusion. There is a significant association between the duration of ROM at 12, 18 and 24 hours, and the incidence of EONS in preterm infants, especially at duration of more than 12 hours. Prolonged PPROM for 12, 18, and 24 hours increases the risk of EONS in preterm infants 2.3 times (unadjusted) and PPROM for 12 hours increases the risk of EONS in preterm infants 2.9 times after adjustment for other factors."

"Latar belakang. Bayi kurang bulan merupakan masalah yang masih sering menghantui dunia kedokteran akibat komplikasi jangka pendek, jangka panjang, maupun kematian secara langsung. Salah satu komplikasi yang dapat muncul adalah enterokolitis nekrotikans, sebuah penyakit kegawatdaruratan gastrointestinal bersifat fatal. Enterokolitis nekrotikans sendiri dapat dicegah dengan pemberian ASI, salah satu metodenya adalah meneteskan ASI secara orofaringeal atau biasa disebut sebagai care. Tujuan. Mengetahui perbandingan antara pemberian oral care dengan kejadian enterokolitis nekrotikans pada bayi kurang bulan, mengetahui sebaran karakteristik subjek penelitian (jenis kelamin, usia gestational, berat lahir, dan usia ibu, mengetahui angka kejadian enterokolitis nekrotikans pada bayi kurang bulan yang mendapat oral care, mengetahui angka kejadian enterokolitis nekrotikans pada bayi kurang bulan yang tidak mendapat oral care, dan mengetahui perbandingan angka kejadian enterokolitis nekrotikans antara bayi kurang bulan yang mendapat oral care dengan bayi yang tidak mendapat oral care. Metode penelitian. Penelitian dilakukan dengan metode crosssectional komparatif pada bayi kurang bulan yang dirawat di NICU RSCM pada tahun 2016-2017 dengan jumlah total subjek sebanyak 144 orang dan dipilih secara random sampling. Sumber data merupakan rekam medis dan pengambilan data dilakukan selama 6 bulan dari Januari hingga Agustus 2018. Hasil penelitian. Dari 144 pasien, didapatkan 72 bayi kurang bulan mendapat oral care dan 72 bayi kurang bulan tidak mendapat oral care. Dari kedua kelompok tersebut, ditemukan adanya perbedaan pada masa gestasi (p=0,006) dan berat lahir bayi (p=0.042). Pada 72 bayi kurang bulan yang mendapat oral care, terdapat 19 bayi kurang bulan yang mengalami enterokolitis nekrotikans dan pada 72 bayi kurang bulan lainnya yang tidak mendapatkan oral care, terdapat 9 bayi kurang bulan yang tidak mendapatkan oral care. Perbandingan kedua kejadian enterokolitis nekrotikans pada kedua kelompok tersebut adalah 26.4% banding 12.5%. Dengan menggunakan analisis kategorik, didapatkan hubungan antara oral care dengan kejadian enterokolitis nekrotikans (p=0.036). Kesimpulan. Terdapat hubungan antara pemberian oral care dengan angka kejadian enterokolitis nekrotikans. Namun penelitian lebih lanjut dengan skala yang lebih besar harus untuk menentukan melihat hasil lebih spesifik dan lebih lanjut mengenai sebab-akibat.

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Introduction. Premature infants still pose a big problem in the medicine due to its association with high morbidity and mortality. Necrotizing enterocolitis, or NEC, a gastrointestinal emergency case, is one of the complications that rises from prematurity. NEC can be prevented with breast milk, especially mothers own milk, through oropharyngeal administration, or in other words, oral care.

Objectives. To determine comparison between oral care administration with necrotizing enterocolitis incidence on preterm infants, to determine the distribution of subjects based on characteristic (gender, gestational age, birth weight, and mothers age), to determine the incidence of necrotizing enterocolitis on preterm infants with oral care administration, to determine the incidence of necrotizing enterocolitis on preterm infants without oral care, and to compare the incidence of necrotizing enterocolitis between preterm infant with and without oral care.

Methods. A cross-sectional study was conducted on preterm infants who were treated in Neonatal Intensive Care Unit of Cipto Mangunkusumo Hospital between 2016 and 2017. There were 144 subjects chosen by simple random sampling. Medical record from Perinatology Division was the source of data and data was taken from January until August 2018.

Result. From 144 Premature infant, there were 72 premature infants with oral care and 72 premature infants without oral care. In those two groups, two characteristics, gestational age (p=-0.006) and birth weight (p=0.042), were significantly different. There were 19 preterm infants with oral care and 9 preterm infants without oral care who suffered from necrotizing enterocolitis. The proportion of necrotizing enterocolitis in these two groups is 26.4%:12.5% The difference is significant (p=0.036).

Conclusion. There is a significant association between oral care and the incidence of necrotizing enterocolitis, though further larger studies must be conducted to obtain more detailed results."

"[ABSTRAKLatar Belakang: Ketrampilan menghisap dan koordinasi antara menghisap, menelan dan bernafas belum adekuat belum adekuat pada neonatur prematur. Neonatal Oral-Motor Assessment Scale (NOMAS) adalah alat ukur yang telah sahih dan andal dalam menilai oromotor skill pada neonatus prematur. Penelitian ini ingin menguji validitas isi dan reliabilitas interrater dan test-retest yang diterjemahkan kedalam bahasa Indonesia yang belum pernah dilakukan sebelumnya.Metode : Desain penelitian ini adalah uji validasi, terdiri dari 16 subjek yang diambil berdasarkan kriteria penerimaan; neonatus prematur, kondisi umum stabil dan diizinkan oleh orang tua dengan mengisi informed consent. Data berupa video saat menyusu diawali dari saat pertama bertemu peneliti hingga usia koreksi 40 minggu. Oromotor skill dinilai dengan NOMAS yang telah diterjemahkan ke bahasa Indonesia. Validitas isi dilakukan dengan proses non-statistik; keandalan intrarater dinilai dengan uji Cohen?s Kappa dan Inter Class Correlation, keandalan interrater dengan uji Cronbach Alpha dan Inter Class Correlation.Hasil : Dari 16 neonatus didapatkan usia gestasi 32-35 minggu dan BBLR 93,75%. Secara isi NOMAS berbahasa Indonesia telah dinyatakan sesuai dengan NOMAS berbahasa Inggris. Keandalan intrarater bernilai baik hingga sempurna (K= 0,6-1,00 dan ICC= 0,4-1,00). Uji keandalan interrater bernilai rendah hingga hampir sempurna (Cronbach?s Alpha = 0,18-0,84 dan ICC= 0,05- 0,80).Kesimpulan : NOMAS berbahasa Indonesia mempunyai validitas isi dan reliabilitas yang baik untuk digunakan sebagai alat ukur oromotor skill pada neonatus prematur. Sebaiknya mengikuti pelatihan NOMAS agar lebih mengusai penggunaan alat ukur ini.

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ABSTRACTBackground : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach?s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure., Background : Sucking skills and the coordination between sucking, swallowing and breathing are inadequate on premature neonates. Neonatal Oral-Motor Assessment Scale (NOMAS) is a measuring instrument that is both valid and reliable in assessing oromotor skills in premature neonates. The study aims to test the content validity and interrater reliability and test-retest reliability of NOMAS translated to Bahasa Indonesia which has never been done before.Methods : This study is a validation test, consisting of 16 subjects who were taken using the inclusion criteria; premature neonates, in stable general condition and allowed by their parents to participate in the study by filling out an informed consent. Data was collected in the form of a video taken during feeding, starting from the first meeting with the researcher until 40 weeks corrected age. Oromotor skills was assessed using NOMAS which has been translated into Bahasa Indonesia. Content validity was performed using non-statistical process; intrarater reliability was assessed using Cohen's Kappa test and Inter Class Correlation, and interrater reliability using Cronbach Alpha test and Inter Class Correlation.Results : Of the 16 neonates, a mean gestation age of 32-35 weeks and low birth weight incidence of 93.75% was found. The content of NOMAS in Bahasa Indonesia has been declared in accordance with NOMAS in English. Intrarater reliability was good to perfect (K= 0,6-1,00 and ICC= 0,4-1,00). Interrater reliability was low to almost perfect (Cronbach’s Alpha = 0,18-0,84 and ICC= 0,05- 0,80)Conclusion : NOMAS in Bahasa Indoensia has good content validity and reliability and can be used as a measuring tool for oromotor skills in premature neonates. NOMAS training is adviced to master the use of this measure.]"

"Latar Belakang: Ketuban Pecah Dini KPD merupakan kejadian yang berhubungan dengan risiko tinggi morbiditas dan mortalitas baik pada maternal maupun perinatal. KPD terjadi pada 5-10 dari seluruh kehamilan dan insiden infeksi selaput ketuban bervariasi dari 6-10 . Berdasarkan data SDKI tahun 2007, AKI di Indonesia sebesar 228/100.000 kelahiran hidup, serta hasil studi epidemiologi oleh WHO dan UNICEF pada tahun 2010 didapatkan bahwa terdapat 7,6 juta kasus kematian anak < 5 tahun, di mana 64 4,879 juta terjadi karena infeksi, dan 40,3 3,072 juta terjadi di neonatus. Belum diketahui hubungan antara lama ketuban pecah, usia kehamilan, dan jumlah periksa dalam pada kasus KPD terhadap kejadian sepsis neonatorum di Indonesia. Tujuan: Studi ini bertujuan untuk mengetahui hubungan antara lama ketuban pecah, usia kehamilan, dan jumlah periksa dalam pada ibu hamil yang mengalami KPD dengan kejadian sepsis neonatorum, sehingga dapat menjadi dasar untuk evaluasi Standar Pelayanan Medik SPM KPD di Rumah Sakit Cipto Mangunkusumo RSCM. Metode: Penelitian ini menggunakan desain studi deskriptif analitik, dilaksanakan di RSCM Jakarta pada bulan Desember 2016 ndash; Juni 2017. Populasi pada penelitian ini adalah semua ibu hamil dengan usia kehamilan >20 minggu yang mengalami KPD dan tidak mempunyai penyulit seperti diabetes melitus ataupun penyakit sistemik serius seperti penyakit jantung atau autoimun, beserta dengan bayinya. Hasil: Terdapat 405 ibu hamil dengan KPD yang diikutsertakan dalam penelitian ini. Didapatkan 21 kasus 5.2 sepsis neonatorum. Hasil analisis menunjukkan bahwa lama ketuban pecah sampai dengan masuk RS ge; 18 jam dengan OR 3,08, lama ketuban pecah selama perawatan di RS ge; 15 jam dengan OR 7,32, dan lama ketuban pecah sampai dengan lahir ge; 48 jam dengan OR 5,77 mempunyai risiko yang lebih tinggi terhadap kejadian sepsis neonatorum. Usia kehamilan preterm < 37 minggu mempunyai risiko yang lebih tinggi terhadap kejadian sepsis neonatorum dengan OR 18,59. Sedangkan jumlah periksa dalam pada penelitian ini tidak dapat dianalisis. Kesimpulan: Lama ketuban pecah yang makin panjang serta usia kehamilan preterm mempunyai risiko yang lebih tinggi terhadap kejadian sepsis neonatorum.

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Background: Premature Rupture of Membrane PROM is associated with high maternal as well as perinatal morbidity and mortality risks. It occurs in 5 to 10 of all pregnancy while incidence of amniotic membrane infection varies from 6 to 10. Based on the 2007 National Demography and Health Survey SDKI, Maternal Mortality Rate MMR in Indonesia is 228 per 100.000 live births. Results of epidemiological studies by the WHO and UNICEF in 2010 found that there were 7.6 million cases of under five mortality, in which 64 4.879 million occurred due to infection and the rest 40.3 3.072 million occurred in neonates. However, there is no known association between prolonged rupture of membrane, gestational age, and number of vaginal examination in PROM cases on neonatal sepsis incidence in Indonesia.

Objectives: This study aims to find out the association between prolonged rupture of membrane, gestational age, and number of vaginal examination in pregnant women with PROM on neonatal sepsis incidence. The result may provide the basis for evaluating Standards of Medical Care SPM in PROM cases at Cipto Mangunkusumo Hospital RSCM.

Methods: A hospital based analytical descriptive study was done in Cipto Mangunkusumo Hospital, Jakarta from December 2016 until June 2017. The study used total sampling method which included all pregnant women with gestational age of more than 20 weeks who experienced PROM and their babies. Samples with existing comorbidities such as diabetes mellitus or other serious systemic illnesses such as heart disease or autoimmune condition were excluded in the analysis.

Results: A total of 405 pregnant women with PROM were incuded in this study. There were 21 cases 5.2 of neonatal sepsis. The analysis showed that risk of neonatal sepsis was higher in pregnant women with prolonged rupture of membrane for 18 hours before hospital admisission OR 3.08, prolonged rupture of membrane for 15 hours during hospitalization OR 7.32 , and prolonged rupture of membrane for 48 hours until birth OR 5.77. The risk of neonatal sepsis was even higher in preterm pregnancy with gestational age of <37 weeks (OR 18.59). However, the number of vaginal examination could not be analyzed.

Conclusion: Risk of neonatal sepsis is higher in longer duration of prolonged rupture of membrane as well as preterm pregnancy."

"Salah satu faktor yang menyebabkan hiperbilirubinemia tak terkonjugasi adalah mutasi pada gen UGT1A1 yang menyandikan enzim UDP-glukuronosiltransferase, berupa single nucleotide polymorphism dari asam amino glisin menjadi asam amino arginin di posisi kodon 71 Gly71Arg , sehingga terjadi penurunan fungsi enzim tersebut sebagai pengatalisis bilirubin tak terkonjugasi menjadi bilirubin terkonjugasi. Penelitian ini bertujuan untuk mengetahui profil polimorfisme Gly71Arg gen UGT1A1 pasien neonatus RSUD M. Yunus-Bengkulu dengan hiperbilirubinemia tak terkonjugasi, khususnya yang berberat badan lahir normal. Sampel berupa darah dari 20 neonatus di RSUD M. Yunus Bengkulu yang telah diperiksa kadar bilirubinnya dengan Bilistick, diekstraksi untuk mendapatkan DNA genomiknya, kemudian dianalisis dengan metode PCR-RFLP menggunakan enzim AvaII. Terdapat 8 sampel DNA yang terdigesti 40 menunjukkan bahwa DNA tersebut normal dan membawa alel glisin, sedangkan tidak terdapat DNA yang tidak terdigesti, yaitu yang mengalami mutasi dengan membawa alel arginin. Namun terdapat 12 sampel DNA heterozigot 60 yang menunjukkan adanya alel glisin dan arginin bersamaan di dalam DNA tersebut. Dengan demikian, mutasi Gly71Arg pada ekson 1 gen UGT1A1 hanya memiliki sedikit pengaruh pada peningkatan kadar hiperbilirubinemia tak terkonjugasi pada neonatus di Bengkulu.

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One of many factors that causes unconjugated hyperbilirubinemia is the existence of mutations in the UGT1A1 gene that encode the UDP glukuronosiltransferase enzyme, where a single nucleotide polymorphism that causes the amino acid glycine to change into amino acid arginine at codon position 71 Gly71Arg , decreases the enzyme from functioning properly as a catalyzer of unconjugated bilirubin into a conjugated bilirubin. This study is aimed to determine the profile of polymorphism Gly71Arg in the UGT1A1 gene of neonatal patients RSUD M. Yunus Bengkulu with unconjugated hyperbilirubinemia, especially with normal birth weight. Samples of blood from 20 newborns in RSUD M. Yunus Bengkulu which had been checked its bilirubin concentration with Bilistick, were extracted to obtain the genomic DNA, then analyzed by PCR RFLP method using the AvaII enzyme. The digested DNA with total of 8 samples 40 indicated that the DNA are normal and carrying the allele glycine, while there is no the undigested DNA which showed the mutation with the allele arginine. But there are 12 heterozygous DNA samples 60 that showed allele glycine and arginine together in the DNA. Therefore, Gly71Arg mutation in exon 1 of UGT1A1 gene has a little effect of the unconjugated hyperbilirubinemia enhancement in neonatal in Bengkulu."

"Bayi prematur berisiko tinggi mengalami sepsis neonatorum awitan lambat pada minggu-minggu pertama pasca kelahiran. Tujuan dari studi ini adalah mengaplikasikan Teori Konservasi Levine dalam menurunkan kejadian sepsis neonatorum awitan lambat pada bayi baru lahir prematur dengan pemberian oral care ASI. Proses asuhan keperawatan menggunakan pendekatan Teori Konservasi Levine berdasarkan empat konservasi yaitu konservasi energi, konservasi integritas struktural, konservasi integritas personal dan konservasi integritas sosial. Lima kasus terpilih menunjukkan masalah keperawatan gangguan pertukaran gas, pola nafas tidak efektif, defisit nutrisi, termoregulasi tidak efektif, risiko infeksi dan risiko gangguan perlekatan. Hasil implementasi pemberian oral care ASI dapat menurunkan kejadian sepsis awitan lambat, mempercepat bayi minum penuh dan mempercepat proses penyapihan alat bantu pernafasan. Intervensi ini dapat menjadi standar prosedur operasional bagi perawat dalam memberikan asuhan keperawatan pada bayi baru lahir.

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Premature infants are at high risk for late onset neonatal sepsis in the first few weeks after birth. The aim of this study was to apply the Levine rsquo s Conservation Theory to decrease the incidence of late onset neonatal sepsis in preterm newborns by oral care of ASI. The nursing care process uses the Levine rsquo s Conservation Theory approach based on four conservation, such as conservation of energy, conservation of structural integrity, conservation of personal integrity and conservation of social integrity. Five selected cases indicate nursing problems of gas exchange disorders, ineffective breathing patterns, nutritional deficits, ineffective thermoregulation, infection risk and risk of attachment disturbance. The results of ASI oral care implementation may decrease the incidence of late onset sepsis, accelerate full feed and accelerate the weaning process of respiratory aids. This intervention can be standard operating procedure for nurses in providing nursing care to newborns."

"Kesulitan menyusu merupakan masalah yang sering terjadi pada bayi prematur. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi pemenuhan kebutuhan nutrisi oral pada bayi prematur melalui edukasi perencanaan pulang pada orang tua dengan pendekatan Teori Konservasi Levine. Lima kasus terpilih menunjukkan terjadi masalah keperawatan defisit nutrisi dan menyusui tida efektif. Pendekatan Teori Konservasi Levine dilakukan dengan menggunakan prinsip konservasi energi, konservasi integritas struktural, konservasi integritas personal, dan konservasi integritas sosial. Hasil pemberian asuhan keperawatan menunjukkan bahwa pengetahuan dan keterampilan ibu menyusui bayi meningkat sehingga pemenuhan kebutuhan nutrisi bayi terpenuhi dan meningkatkan berat badan bayi melalui edukasi perencanaan pulang. Perawat dapat menjadikan intervensi tersebut sebagai standar prosedur operasional pada bayi prematur yang mengalami kesulitan menyusu.

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Having difficulty in breastfeeding is a common problem on premature infants. The purpose of this study is to analyze the optimization of the oral fulfillment of nutritional needs in premature infants through discharge planning education for the parents using Levine rsquo s Conservation Theory. Five chosen cases shows the occurrences of nutritional deficit nursing problems. Levine rsquo s Conversation Theory approach is done using energy conservation principle, structural integrity conservation, personal integrity conservation, and social integrity conservation.

The research result from the intervention of discharge planning education with Levine rsquo s Conservation Theory could improve the mothers rsquo knowledge and skills so that the fulfillment of nutritional needs of the infants fulfilled and also increasing the infants rsquo weight. Nurse could make the intervention as a standard procedure for premature infants who experienced breastfeeding difficulty."

"Kelahiran bayi prematur dan perawatan di ruang rawat intensif neonatusmerupakan peristiwa yang menyebabkan sumber stres pada orang tua khususnyaibu. Penelitian ini bertujuan untuk mendapatkan pemahaman yang mendalammengenai pengalaman ibu selama perawatan masa awal kehidupan bayi prematurdi ruang rawat intensif neonatus RSUP Dr. Soeradji Tirtonegoro Klaten. Desain penelitian kualitatif dengan pendekatan fenomenologi ini pada delapan partisipan. Analisis data menggunakan metode Colaizzi dan menghasilkan tujuh tema penelitian, yaitu: reaksi ibu, proses berduka, dampak perawatan bayi prematur, koping diri ibu, upaya ibu untuk meningkatkan hubungan kelekatan (bonding attachment), dukungan terhadap ibu, dan harapan selama perawatan bayi prematur.

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The birth and treatment of premature infants in the neonatal intensive care unit is the event that makes it the source of stress to parents especially the mother. This study aims to gain a deeper understanding of the experience of mother during the early life of premature infants in the neonatal intensive care unit of Dr. Soeradji

Tirtonegoro Central Hospital, Klaten. This qualitative research design with phenomenology approach took eight participants. The data analysis uses Colaizzi method and produced seven research themes, namely: the mothers? reaction, the grieving process, the impact of premature infant care, mother?s self ?coping efforts, the mothers? attempts to improve the close and attached relationship (bonding attachment), the support for the mother, and expectations for the care of premature infants.

"