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"Maternal deaths in Timor Island, East Nusa Tenggara Province, are one of the contributors to the overall maternal mortality rate (MMR) of Indonesia. The MMR of Western Timor Island was 150/100,000 live births in 2015. The aim of this qualitative study was to explore the perceived causes of maternal death due to postpartum hemorrhage. Data were obtained from family members, traditional birth attendants, and Posyandu cadres, as well as health providers. Using the retrospective method, this study traced six out of nine postpartum hemorrhage cases in the four sub-districts with the highest maternal death rate in 2010. The research findings showed that most childbirth processes were done at home without any help from health workers. Postpartum hemorrhage happened among women ranging from 24-42 years old; five among them had been pregnant more than four times. Medically, five cases were caused by a prolonged third stage of labor due to a retained placenta. Non-medical factors causing postpartum hemorrhage were poor accessibility, lack of communication devices, and lack of infrastructure.

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Kematian maternal di Pulau Timor, Provinsi Nusa Tenggara Timur, merupakan salah satu penyumbang Angka Kematian Ibu (AKI) di Indonesia. Tahun 2015, AKI di Pulau Timor bagian barat adalah sebesar 150/100.000 kelahiran hidup. Tujuan dari studi kualitatif ini adalah untuk mengeksplorasi persepsi para pihak yang paling mengetahui mengenai penyebab kematian maternal karena perdarahan postpartum. Data diberikan oleh anggota keluarga, dukun bersalin, dan kader Posyandu, serta penyedia layanan. Menggunakan metode retrospektif, penelitian ini menyusur enam dari sembilan kasus perdarahan postpartum yang terjadi di empat kecamatan yang memiliki angka kematian maternal tertinggi pada tahun 2010. Hasil penelitian menunjukkan bahwa sebagian besar prosedur persalinan dilakukan di rumah tanpa bantuan dari tenaga kesehatan. Perdarahan postpartum terjadi di antara wanita dengan rentang umur 24–42 tahun; empat di antara mereka sudah pernah hamil sebanyak lebih dari empat kali. Secara medis, lima kasus disebabkan oleh perpanjangan kala tiga persalinan berhubungan dengan retensi plasenta. Faktor-faktor non medis yang menyebabkan perdarahan posrpartum adalah aksesibilitas yang buruk, ketiadaan piranti komunikasi, dan kurangnya infrastruktur."

"ABSTRAK Latar BelakangPerdarahan pascasalin adalah penyebab 25% kematian ibu diseluruh dunia,bahkan mencapai 60% pada beberapa negara. Sekitar 60-90% disebabkan olehatonia uteri. Berbagai alat ditemukan dan digunakan seperti tamponade balonuterus, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloon dan TheGlenveigh Medical Complete Tamponade System namun memiliki efektifitassekitar 65-87,5% dan potensi komplikasi. Oleh sebab itu diperkenalkanlah suatumetode baru untuk mengontrol perdarahan pascasalin. MetodeTujuan dari penelitian ini adalah untuk melihat keamanan, kemudahan danefektifitas alat InPress mengatasi perdarahan pascasalin karena atonia uteri. AlatInPress menggunakan mesin vakum bertekanan rendah untuk menurunkantekanan atmosfer dalam kavum uteri sehingga uterus menjadi kolaps danmembuat tamponade sehingga perdarahan berhenti. Selain itu secara fisiologis,dapat merangsang kontraksi uterus pascasalin yang normal dan retraksi uterus kebentuk dan ukuran semula. HasilDari sepuluh subyek penelitian menunjukkan bahwa mesin vakum dengan cepatmenciptakan tamponade yang efektif melalui balon pengunci yang berada diostium uteri eksterna. Jumlah perdarahan yang dievakuasi dari kavum uteri sekitar100-250 cc, tertampung dalam kanister. Uterus kolaps dan terjadi tamponadedalam waktu 1-2 menit sehingga perdarahan berhenti. Alat InPress dipasangselama minimal 1 jam dan maksimal 6,5 jam. Repair luka robekan perineum danvagina dapat dilakukan dengan mudah saat alat InPress terpasang di dalam uterus.Pada sepuluh subyek tidak ada tindakan lanjutan untuk mengatasi perdarahansetelah alat InPress dipasang. Tidak ditemukan adanya kelainan pada uterus,serviks dan vagina pada saat dan sesudah pemasangan alat InPress. KesimpulanTamponade uterus yang berasal dari tekanan negatif mesin vakum terbukti aman dan efektif untuk mengatasi perdarahan pascasalin karena atonia uteri.ABSTRACT Background the Treatment of Postpartum Hemorrhage Due To UterineAtonia Postpartum Hemorrhage (PPH) is responsible for +/- 25% of maternal mortalityworldwide, reaching as high as 60% in some countries. Approximately 60-90%caused by uterine atonia. Many devices were invented and applied such as uterineballoon tamponade, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloondan The Glenveigh Medical Complete Tamponade System but the effectivenessonly about 65-87,5% control hemorrhage and have potential complications.Therefor a new method to control PPH has been introduced. MethodThe purpose of this study was to demonstrate patient safety, device efficiency, andease of use, as an overall Proof of Concept with a new device, the InPress Device,for the treatment of primary postpartum hemorrhage (PPH) due to atony.The InPress device uses gentle vacuum force to lower the atmospheric pressurewithin the uterine cavity to collapse the uterus into and onto itself to stophemorrhage through tamponade. It also stimulates normal postpartum uterinecontractions, to effect hemostasis. In this hemostatic state the atonic uterusrecovers, physiologically, and retracts down to its? normal hemostatic postpartumsize. Results Results from our ten trial patients showed that: the vacuum created an immediateeffective tamponade confined to the uterus by our seal situated at the externalcervical ostium, 100-250 milliliters of residual blood were evacuated from theuterine cavity into the vacuum canister. The uterus collapsed and regained tonewithin 1-2 minutes, and hemorrhaging stopped, in all cases. The device stayed inplace while vaginal and perineal lacerations, which occurred during delivery, wereeasily repaired. The device was left in for one-hour minimum up to 6,5 hours. There were no further operative procedures required to stop hemorrhaging in anyof these cases. There was no abnormality of uterus, cervix and vagina while andafter InPress procedur performed. Conclusion Vacuum induced uterine tamponade using physiologic force, is a safe andeffective way to achieve rapid control of PPH due to atony.;Background the Treatment of Postpartum Hemorrhage Due To UterineAtonia Postpartum Hemorrhage (PPH) is responsible for +/- 25% of maternal mortalityworldwide, reaching as high as 60% in some countries. Approximately 60-90%caused by uterine atonia. Many devices were invented and applied such as uterineballoon tamponade, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloondan The Glenveigh Medical Complete Tamponade System but the effectivenessonly about 65-87,5% control hemorrhage and have potential complications.Therefor a new method to control PPH has been introduced. MethodThe purpose of this study was to demonstrate patient safety, device efficiency, andease of use, as an overall Proof of Concept with a new device, the InPress Device,for the treatment of primary postpartum hemorrhage (PPH) due to atony.The InPress device uses gentle vacuum force to lower the atmospheric pressurewithin the uterine cavity to collapse the uterus into and onto itself to stophemorrhage through tamponade. It also stimulates normal postpartum uterinecontractions, to effect hemostasis. In this hemostatic state the atonic uterusrecovers, physiologically, and retracts down to its? normal hemostatic postpartumsize. Results Results from our ten trial patients showed that: the vacuum created an immediateeffective tamponade confined to the uterus by our seal situated at the externalcervical ostium, 100-250 milliliters of residual blood were evacuated from theuterine cavity into the vacuum canister. The uterus collapsed and regained tonewithin 1-2 minutes, and hemorrhaging stopped, in all cases. The device stayed inplace while vaginal and perineal lacerations, which occurred during delivery, wereeasily repaired. The device was left in for one-hour minimum up to 6,5 hours. There were no further operative procedures required to stop hemorrhaging in anyof these cases. There was no abnormality of uterus, cervix and vagina while andafter InPress procedur performed. Conclusion Vacuum induced uterine tamponade using physiologic force, is a safe andeffective way to achieve rapid control of PPH due to atony.;Background the Treatment of Postpartum Hemorrhage Due To UterineAtonia Postpartum Hemorrhage (PPH) is responsible for +/- 25% of maternal mortalityworldwide, reaching as high as 60% in some countries. Approximately 60-90%caused by uterine atonia. Many devices were invented and applied such as uterineballoon tamponade, NASG (Nonpneumatic Anti Shock Garment), Bakri Balloondan The Glenveigh Medical Complete Tamponade System but the effectivenessonly about 65-87,5% control hemorrhage and have potential complications.Therefor a new method to control PPH has been introduced. MethodThe purpose of this study was to demonstrate patient safety, device efficiency, andease of use, as an overall Proof of Concept with a new device, the InPress Device,for the treatment of primary postpartum hemorrhage (PPH) due to atony.The InPress device uses gentle vacuum force to lower the atmospheric pressurewithin the uterine cavity to collapse the uterus into and onto itself to stophemorrhage through tamponade. It also stimulates normal postpartum uterinecontractions, to effect hemostasis. In this hemostatic state the atonic uterusrecovers, physiologically, and retracts down to its? normal hemostatic postpartumsize. Results Results from our ten trial patients showed that: the vacuum created an immediateeffective tamponade confined to the uterus by our seal situated at the externalcervical ostium, 100-250 milliliters of residual blood were evacuated from theuterine cavity into the vacuum canister. The uterus collapsed and regained tonewithin 1-2 minutes, and hemorrhaging stopped, in all cases. The device stayed inplace while vaginal and perineal lacerations, which occurred during delivery, wereeasily repaired. The device was left in for one-hour minimum up to 6,5 hours. There were no further operative procedures required to stop hemorrhaging in anyof these cases. There was no abnormality of uterus, cervix and vagina while andafter InPress procedur performed. Conclusion Vacuum induced uterine tamponade using physiologic force, is a safe andeffective way to achieve rapid control of PPH due to atony."

"Perdarahan postpartum merupakan salah satu situasi kegawatan maternal yangmembutuhkan penanganan segera. Penanganan kegawatan diprioritaskan untukmencegah syok hipovolemia yang mengancam jiwa. Setelah stabil, klien akan mendapatperawatan lanjutan untuk pemulihan. Di masa pemulihan, klien masih membutuhkanbantuan untuk mengatasi gangguan yang masih muncul, merawat diri, danmempersiapkan diri untuk memulai peran barunya. Penerapan integrasi modelkeperawatan Need For Help Wiedenbach dan Konsep Adaptasi Roy merupakan formatpengkajian yang sesuai untuk kondisi pada lima kasus yang dikelola Residen. Residenmengaplikasikan Evidence-Based Practice Nursing (EBPN) dalam perawatan klienperdarahan postpartum fase pemulihan. EBPN yang digunakan bertujuan untukmengatasi kecemasan klien akibat trauma dan hospitalisasi. EBPN yang digunakansebagai intervensi keperawatan adalah teknik afirmasi positif. Teknik Afirmasi positifdalam pengelolaan lima kasus kelolaan berpengaruh signifikan dalam menurunkan nilaikecemasan klien. Teknik afirmasi efektif untuk membantu klien menghadapi masalahpsikologis pasca perdarahan postpartum yang menimbulkan stres dan trauma. Perawatyang bertugas mengelola klien-klien dengan perdarahan postpartum fase pemulihandapat menggunakan integrasi model keperawatan sebagai acuan bagi perawatankliennya. Perawat maternitas juga dapat menggunakan teknik afirmasi positif untukmenurunkan tingkat kecemasan pada klien-klien dengan gangguan perdarahanpostpartum.

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Postpartum hemorrhage is one of the maternal emergencies which need immediate

treatment. The emergency management is prioritized to avoid hypovolemic shock which

can be life threatening. Once stable, clients will receive further treatment for recovery.

During the recovery period, clients still need help to overcome problems that still occur,

to take care of themselves, and to prepare to start their new roles. The application of

Needs Help Wiedenbach nursing model integration and Roy's Adaptation Concept is an

assessment format that is suitable for the conditions of the five cases managed by the

Resident. Resident applies EvidenceBased Practice Nursing (EBPN) in the treatment of

postpartum hemorrhage clients in the recovery phase. EBPN is used to treat clients’

anxiety caused by trauma and hospitalization. The use of EBPN as a nursing

intervention is a positive affirmation technique. Positive affirmation technique in the

five managed cases management significantly affects in reducing clients’ anxiety. The

affirmation technique is effective to help clients to face psychological issues after

postpartum hemorrhage which causes stress and trauma. Nurses who are in charge of

supporting clients with postpartum hemorrhage in the recovery phase can use the

nursing model integration as a reference for treatment for their patients. Maternity

nurses can use positive affirmation techniques as well to reduce anxiety levels of clients

with postpartum hemorrhage disorders."

"Obstetric Hemorrhage is one of leading causes for maternal death in developing country and cause for 50% of estimated 500.000 maternal death globally per year. It is known that 7,6% of complications during labor and delivery that happen in Indonesia is postpartum hemorrhage (PPH). The purpose of this study is to examine factors that associated with PPH complication in Indonesia. Research method which is used in this study is cross sectional that analyze Indonesia Demographic and Health Survey (SDKI) 2012?s data source. Population in this study is all woman in age range 15-49 year old that ever gave birth in Indonesia from January 2007 until SDKI 2012 started. This study find that mother with low education (PR=1,248; 95% CI: 1,108 ? 1,405), maternal age <20 and >35 years (PR= 1,157; 95% CI: 1,007 ? 1,329), smoking behavior (PR= 1,991; 95% CI: 1,047 ? 1,425), parity >3 children (PR= 1,221; 95% CI: 1,047 ? 1,425), pregnancy complications (PR= 2,805; 95% CI: 2,477 ? 3,175), past labor complications (PR= 1,765; 95% CI: 1,468 ? 2,123), and completeness of antenatal care (PR= 0,79; 95% CI: 0,664 ? 0,94) are associated with PPH complication. Government commitment is needed to improve health facility?s coverage, train health assistance, and educate people to increase awareness of rights and needs of maternal and newborn health.

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Perdarahan obstetri adalah salah satu penyebab utama kematian maternal di negara berkembang dan penyebab 50% dari 500.000 kematian maternal yang diperkirakan terjadi per tahun di dunia. Sebesar 7,6% dari komplikasi persalinan yang terjadi di Indonesia adalah komplikasi perdarahan pascapersalinan. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian komplikasi perdarahan pascapersalinan di Indonesia. Penelitian ini menggunakan desain studi cross sectional dengan analisis data sekunder SDKI 2012. Populasi penelitian adalah seluruh wanita usia 15-49 tahun yang pernah melahirkan di Indonesia dalam kurun waktu Januari 2007 sampai pelaksanaan SDKI 2012. Hasil penelitian menunjukkan bahwa ibu dengan pendidikan rendah (PR=1,248; 95% CI: 1,108 ? 1,405), umur ibu <20 dan >35 tahun (PR= 1,157; 95% CI: 1,007 ? 1,329), perilaku merokok ibu (PR= 1,991; 95% CI: 1,047 ? 1,425), paritas >3 anak (PR= 1,221; 95% CI: 1,047 ? 1,425), komplikasi kehamilan (PR= 2,805; 95% CI: 2,477 ? 3,175), riwayat komplikasi persalinan (PR= 1,765; 95% CI: 1,468 ? 2,123), dan kelengkapan pelayanan antenatal (PR= 0,79; 95% CI: 0,664 ? 0,94) berhubungan dengan kejadian komplikasi perdarahan pascapersalinan. Perlunya komitmen pemerintah untuk memperbaiki cakupan fasilitas kesehatan, pelatihan lebih lanjut pada tenaga kesehatan, dan pemberian edukasi pada masyarakat sehingga menumbuhkan kesadaran hak dan kebutuhan tentang kesehatan ibu dan anak."

"Angka Kematian Ibu (AKI) harus diturunkan untuk mencapai kesejahteraan masyarakat di suatu negara. Perdarahan postpartum menjadi penyebab kematian ibu paling besar di dunia dan Indonesia. Upaya penurunan angka kematian ibu perlu dilakukan dengan mencegah kejadian perdarahan postpartum. Pelayanan kesehatan ibu berperan dalam upaya menurunkan kematian ibu serta dengan adanya temuan bahwa tingginya kematian ibu di Kawasan Timur Indonesia diikuti dengan akses dan kualitas pelayanan kesehatan ibu yang lebih rendah dari Kawasan Barat Indonesia. Penelitian ini bertujuan untuk mengetahui hubungan antara pelayanan kesehatan ibu dengan kejadian perdarahan postpartum di Kawasan Timur dan Barat Indonesia. Penelitian adalah penelitian kuantitatif dengan desain studi cross sectional dan memanfaatkan data Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2017. Analisis dilakukan dengan uji Chi Square dan Uji Regresi Logistik Berganda. Hasil penelitian menunjukkan bahwa proporsi perdarahan postpartum di Indonesia adalah 7,1% (95% CI (6,6% 7,7%)) dan lebih tinggi di Kawasan Barat Indonesia 7,4% (95% CI (6,8% - 8%)) dibandingkan di Kawasan Timur Indonesia 5,6% (95% CI (4,8%-6,5%)). Tidak ditemukan hubungan yang bermakna antara variabel-variabel pelayanan kesehatan ibu dengan kejadian perdarahan postpartum, kecuali pada variabel penggunaan KB di Kawasan Timur Indonesia yang memiliki hubungan signifikan dengan kejadian perdarahan postpartum, namun hubungan tersebut bersifat negatif (p-value = 0,045; COR = 0,664 (95% CI (0,444-0,993)). Kunjungan ANC memiliki hubungan sebagai faktor risiko perdarahan postpartum, meskipun hubungan tersebut tidak signifikan secara statistik. Variabel yang berhubungan terhadap kejadian perdarahan postpartum adalah riwayat komplikasi kehamilan dan jarak ke fasilitas kesehatan di Kawasan Timur Indonesia serta riwayat komplikasi kehamilan dan pendidikan di Kawasan Barat Indonesia. Oleh karena itu, pelayanan kesehatan perlu penguatan terkait dengan variabel-variabel tersebut.

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The Maternal Mortality Rate (MMR) must be reduced in order to achieve public welfare in a country. Postpartum hemorrhage is the main cause of maternal death in the world and Indonesia. Efforts to reduce maternal mortality need to be done by preventing the incidence of postpartum hemorrhage. Maternal health services have a role to reduce maternal mortality as the finding shows that high maternal mortality in East Indonesia is followed by lower access and quality of maternal healthcare than West Indonesia. This study aims to determine the relationship between maternal health services and the incidence of postpartum hemorrhage in East and West Indonesia. This study is a quantitative study with a cross sectional study design and utilizes data from the 2017 Indonesian Demographic and Health Survey (IDHS). The analysis was performed using Chi Square Test and Multiple Logistics Regression Test. The results showed that the proportion of postpartum hemorrhage in Indonesia was 7.1% (95% CI (6.6% 7.7%)) and was higher in West Indonesia 7.4% (95% CI (6.8% - 8%)) compared to East Indonesia 5,6% (95% CI (4.8%-6.5%).) No significant relationship was found between the variables of maternal healthcare and the incidence of postpartum hemorrhage, except for the use of family planning in East Indonesia which had a significant relationship with the incidence of postpartum hemorrhage, but the relationship was negative (p-value = 0.045; COR = 0.664 (95% CI (0.444-0.993). ANC visits have an association as a risk factor of postpartum hemorrhage, although the relationship is not statistically significant. Variable that associated with the incidence of postpartum hemorrhage are history of pregnancy complications and distance to health facilities problems in East Indonesia and then history of pregnancy complications and education level in West Indonesia. Therefore, healthcare services needs to strengthen the aspect related to those variables."

"[Perempuan pasca melahirkan adalah kelompok yang berisiko mengalami perubahan pada fungsi seksual. Penelitian ini untuk mengetahui perbedaan fungsi seksual ibu postpartum pervaginam dengan atau tanpa episiotomi dan pasca bedah sesar. Penelitian ini merupakan studi deskriptif dengan desain cross sectional. Sampel berjumlah 225 ibu postpartum yang diambil secara consecutive sampling dari bulan April-Mei 2015. Fungsi seksual dinilai dengan Sexual Function Questionnaire (SFQ). Hasil penelitian menunjukkan tidak ada perbedaan yang bermakna antara fungsi seksual pada semua jenis persalinan (p=0,977), begitupun hasrat seksual, gairah seksual, dan orgasme. Penelitian ini dapat digunakan untuk meningkatkan kesehatan seksual ibu pada perawatan postpartum yang berkualitas.;The postpartum women is one of group who experience sexual function changes. The aims of the study is to know the comparation sexual function woman after vaginal delivery without episiotomi and post caesarean section. The study was a descriptive study of cross-sectional design. The sample was 225 womanpostpartum was taken by consecutive sampling from April-May 2015. Sexual function was assessed by the Sexual Function Questionnaire (SFQ) score. The results of this study showed there were no significant differences between sexual function and types of delivery (p=0.977), including sexual desire, sexual arousal and orgasm. The results of the study can be used to increase nurses’s service sexual postpartum women for reach quality postpartum care., The postpartum women is one of group who experience sexual function changes.The aims of the study is to know the comparation sexual function woman aftervaginal delivery without episiotomi and post caesarean section. The study was adescriptive study of cross-sectional design. The sample was 225 womanpostpartum was taken by consecutive sampling from April-May 2015. Sexualfunction was assessed by the Sexual Function Questionnaire (SFQ) score. Theresults of this study showed there were no significant differences between sexualfunction and types of delivery (p=0.977), including sexual desire, sexual arousaland orgasm. The results of the study can be used to increase nurses’s servicesexual postpartum women for reach quality postpartum care.]"

"Pelayanan nifas sangat bermanfaat untuk mengetahui kondisi ibu, sehingga bila tejadi morbiditas postpartum segera dapat ditangani dan kematian ibu dapat dicegah. Namun pemanfaatan pelayanan nifas di Indonesia masih sangat rendah dan dibawah target, kunjungan nifas lengkap sekitar 32 persen, angka ini masih jauh dari yang ditargetkan yaitu sebesar 90 persen pada tahun 2015. Penelitian ini menggunakan metode cross sectional dengan data sekunder Riskesdas 2013. Populasi dalam penelitian ini adalah 497 kabupaten/kota, dan sampel penelitian ini sebanyak 192 kabupaten/kota. Analisis dilakukan dengan uji regresi logistic ganda. Hasil penelitian didapatkan faktor yang paling dominan menentukan status Kunjungan Nifas lengkap adalah persentase K4 antenatalcare (B=-0,056). Penelitian ini menyarankan untuk pengkajian ulang standar pelayanan minimal di kabupaten/kota, peningkatan kualitas antenatalcare, peningkatan program home visit dan Komunikasi, Informasi dan Edukasi.

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Postpartum care is very useful to know the condition of the mother, so that when the immediate postpartum morbidity occurred can be handled and maternal deaths can be prevented. However, postnatal care utilization in Indonesia is still very low and below target, postpartum visits about 32 percent, this figure is still far from the target is equal to 90 per cent in 2015. This study used cross sectional method with secondary of Riskesdas 2013. The population 497 districts / cities, and the sample as much as 192 districts / cities. The analysis was performed by multiple logistic regression.

The result showed that the most dominant factor determining the status of postpartumcare Visits is the percentage K4 antenatalcare (B = -0.056). This study suggests for the review of minimum service standards in the district / city, antenatalcare quality improvement, increase in home visit program and Communication, Information, and Education."

"Makrosomia merupakan salah satu faktor risiko terjadinya pendarahan postpartum. Peneliti ini bertujuan untuk mengetahui hubungan antara makrosomia dengan perdarahan postpartum di Indonesia tahun 2012. Penelitian ini menggunakan desain studi kasus kontrol dengan bersumber dari data survey demografi dan kesehatan Indonesia (SDKI) tahun 2012. Semua kasus yaitu sebanyak 497 dianalisis dalam penelitian ini sedangkan kontrol dirandom dari seluruh eligible kontrol sehingga didapatkan besar sampel yaitu 994 dengan perbandingan kasus dan kontrol adalah 1:1. Hasil penelitian menunjukkan bahwa makromia merupakan faktor risiko kejadian perdarahan postpartum dengan nilai ORadjusted=1.525 (95%CI 1.031- 2.255) setelah dikontrol oleh variabel kunjungan anc dan penolong persalinan. Penelitian ini menyarankan. Penelitian ini menyarankan kepada wanita hamil untuk meningkatan kesadaran akan pentingnya pemeriksaan antenatal care dan penolong persalinan oleh tenaga kesehatan.

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Macrosomia is a risk factor for postpartum hemorrhage. This study aim to determine the relationship between macrosomia with postpartum hemorrhage in Indonesia in 2012. This study used a case-control study design using Demographic and Health Survey Indonesia (IDHS) 2012. All of 497 cases were analyzed in this study, while controls were randomized from eligible controls in order to obtain a sample of 994 with a ratio of cases and controls were 1:1.

The results showed that macrosomia as a risk factor for postpartum hemorrhage with OR adjusted = 1.525 (95% CI 1.031-2.255) (controlled by antenatal care visits and birth attendants). This study suggests to pregnant woman to increase awareness of the importance of checking of antenatal care and birth attendant by health workers."

"Untuk mengetahui effektivitas dan keamanan injeksi intravitreal gas Sulfur Heksaflorida (SF6) tanpa tissue Plasminogen Activator (tPA) pada perdarahan subhialoid di premakula, 5 mata dari 5 pasen dimasukkan dalam penelitian ini. Setelah parasentesis cairan akuos, 0.3 ml gas sulfur hexafluoride murni disuntikkan intravitreal dan penderita diharuskan mempertahankan posisi muka kebawah selama 5 hari.. Foto fundus dibuat pre injeksi,pada 1 hari dan 7 hari pasca injeksi. Perdarahan subhialoid bergeser pada 4/5 (80%) mata dengan lama perdarahan subhialoid kurang dari 2 minggu. Tajam penglihatan pre-operatif pada ke-lima mata adalah hitung jari, dan mengalami perbaikan pasca-operatif pada 4/5 (80%) mata dalam 3 hari sampai 7 hari.. Tajam penglihatan berkisar antara 6/20 hingga 6/6. Penyakit sistemik yang mendasari, terdiri dari hiperkoagulasi pada 1 pasien, diabetes mellitus pada 2 pasien, hipertensi pada 1 pasien dan tidak ditemukan pada 1 pasien. Komplikasi akibat tindakan tidak ditemukan pada semua mata yang diinjeksi. Sebagai kesimpulan, injeksi gas SF6 tanpa penggunaan tPA ke dalam vitreus mampu menggeser perdarahan subhialoid, bila dilakukan dalam 14 hari, dan dapat menghasilkan perbaikan tajam penglihatan yang cepat. Tindakan ini terbukti aman. (Med J Indones 2007; 16:104-7).

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To assess the efficacy and safety of intravitreal injection of Sulfur Hexafluoride (SF6) gas without the use of tissue Plasminogen Activator (tPA) in premacular Subhyaloid Hemorrhage ( SHH ), 5 eyes of 5 patients with premacular SHH were enrolled. After performing paracentesis of the anterior chamber, 0.3 ml pure SF6 gas was injected through pars plana with a 30 gauge needle. Facedown position was maintained for 5 days. Subhyaloid Hemorrhage was displaced in 4/5 ( 80% ) eyes with a duration of SHH less than 2 weeks. The pre-injection visual acuity of all 5 eyes was finger counting and improved in 4/5 ( 80% ) eyes within 3 days to 7 days post-injection to 6/20 - 6/6. The underlying disease was hypercoagulation in 1 patient , diabetes mellitus in 2 patients , hypertension in 1 patient and unknown in 1 patient. No complications were encountered. In conclusion, SF6 gas injected into the vitreous without the use of tPA, can displace SHH if performed within 14 days of duration, and results in rapid visual recovery. This procedure is proven to be safe. (Med J Indones 2007; 16:104-7)."

"Postpartum Hemorrhage (PPH) merupakan suatu keadaan dimana kehilangan darah 500 ml atau lebih dalam 24 jam setelah persalinan ibu. PPH menduduki posisi pertama pada penyebab langsung pada kematian ibu dengan menyumbang 19,7% kematian ibu pada tingkat global. Berbagai kebijakan telah dikeluarkan untuk mengatasi masalah tingginya angka PPH, namun sampai saat ini angka kejadian PPH masih dapat dikatakan tinggi. Untuk dapat mengetahui penyebab yang mempengaruhi proses implementasi kebijakan pencegahan PPH dapat dilakukan melalui studi implementasi kebijakan publik. Penelitian ini membahas mengenai implementasi kebijakan pencegahan PPH diberbagai negara di dunia tahun 2022. Analisis implementasi kebijakan dilakukan menggunakan gabungan teori implementasi kebijakan publik yang dikemukakan oleh Van Meter and Van Horn, Grindle, Sabatier and Mazmanian, Edward III dan Peters. Tujuan penelitian ini adalah mengetahui analisis implementasi kebijakan pencegahan Postpartum Hemorrhage pada ibu dari berbagai negara di dunia. Penelitian ini menggunakan studi literature review melalui delapan database, yaitu Ebsco, Emerald, Sage, Science Direct, Scopus, Pubmed, BMC dan PMC. Terdapat 13 artikel terinklusi dari 7.153 artikel yang diidentifikasi dari kedelapan database. Hasil studi menunjukkan terdapat hubungan faktor komunikasi, sumber daya, disposisi, struktur birokrasi, standar dan sasaran kebijakan dan lingkungan terdapat pelaksanaan implementasi kebijakan PPH di berbagai negara.

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Postpartum Hemorrhage (PPH) is a condition in which blood loss of 500 ml or more within 24 hours after delivery of the mother. PPH occupies the first position in the direct cause of maternal death by contributing 19.7% of maternal deaths at the global level. Various policies have been issued to address the problem of the high rate of PPH, but until now the incidence of PPH is still high. To be able to find out the causes that affect the process of implementing PPH prevention policies, it can be done through a study of the implementation of public policies. This study discusses the implementation of PPH prevention policies in various countries in the world in 2022. Analysis of policy implementation is carried out using a combination of public policy implementation theories proposed by Van Meter and Van Horn, Grindle, Sabatier and Mazmanian, Edward III and Peters. The aim of this study was to determine the analysis of the implementation of Postpartum Hemorrhage prevention policies in mothers from various countries in the world. This study uses a literature review study through eight databases, namely Ebsco, Emerald, Sage, Science Direct, Scopus, Pubmed, BMC and PMC. There were 13 included articles out of 7,153 articles identified from the eight databases. The results of the study show that there is a relationship between communication factors, resources, disposition, bureaucratic structure, policy standards and objectives and the environment on the implementation of PPH policies in various countries."