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"Masalah psikososial seringkali terabaikan dan tidak terkaji dalam kunjungan perawatan antenatal, sehingga berdampak pada meningkatnya jumlah ibu hamil yang mengalami prenatal distress. Literasi kesehatan maternal, yaitu kemampuan wanita hamil untuk memperoleh dan menggunakan informasi kesehatan untuk mengambil tindakan yang mempengaruhi status kesehatan dirinya dan janin yang dikandung, berperan penting dalam meminimalkan masalah kesehatan yang timbul selama kehamilan. Penelitian ini bertujuan untuk menganalisa hubungan antara literasi kesehatan maternal dengan prenatal distress pada ibu hamil. Penelitian ini merupakan penelitian kuantitatif dengan design penelitian cross-sectional, yang melibatkan 107 ibu hamil di Puskesmas Pancoran Mas, Puskesmas Rangkapan Jaya Baru, dan Puskesmas Depok Jaya yang dipilih secara consecutive sampling. Instrument penelitian yang digunakan yaitu Socio-demographic Questionnaire, Maternal Health Literacy Inventory in Pregnancy (MHELIP) versi Bahasa Indonesia, dan Revised Prenatal Distress Questionnaire (NuPDQ) versi Bahasa Indonesia. Hasil penelitian menunjukkan bahwa karakteristik responden didominasi oleh ibu hamil dengan rata-rata usia 29,084 tahun (95% CI), tingkat pendidikan menengah (44,860%), tingkat pendapatan keluarga rendah (59%), multigravida (64,486%), dan berada di usia kandungan trimester kedua (35,514%) dan ketiga (35,514%). Literasi kesehatan maternal mayoritas ibu hamil berada pada tingkat problematic (51,336%) dan prenatal distress yang tinggi (56,075%). Hasil uji bivariat Spearman didapatkan nilai p= <0,001 yang menunjukkan bahwa literasi kesehatan maternal berhubungan dengan prenatal distress pada ibu hamil. Hasil penelitian ini dapat dimanfaatkan bagi pelayanan kesehatan untuk melakukan pemberian konseling kehamilan, upaya deteksi dini masalah psikologis, serta perawatan antenatal yang sesuai pada ibu hamil. Penelitian selanjutnya dapat dilakukan dengan menambahkan variabel lain yang berkaitan dengan literasi kesehatan maternal dan prenatal distress.

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Psychosocial issues are often overlooked and not adequately addressed during antenatal care visits, leading to an increase in the number of pregnant women experiencing prenatal distress. Maternal health literacy, which refers to the ability of pregnant women to obtain and use health information to take actions that affect their health status and that of their unborn child, plays a crucial role in minimizing health issues during pregnancy. This study aims to analyze the relationship between maternal health literacy and prenatal distress in pregnant women. This quantitative study employs a cross-sectional design, involving 107 pregnant women from Pancoran Mas Health Center, Rangkapan Jaya Baru Health Center, and Depok Jaya Health Center, selected through consecutive sampling. The research instruments used include the Socio-demographic Questionnaire, the Maternal Health Literacy Inventory in Pregnancy (MHELIP) in the Indonesian version, and the Revised Prenatal Distress Questionnaire (NuPDQ) in the Indonesian version. The study results indicate that the respondents' characteristics are predominantly pregnant women with an average age of 29.084 years (95% CI), a medium education level (44.860%), low family income (59%), multigravida (64.486%), and in the second (35.514%) and third (35.514%) trimesters of pregnancy. The majority of pregnant women have problematic maternal health literacy (51.336%) and high prenatal distress (56.075%). The bivariate Spearman test results show a p-value of <0.001, indicating a relationship between maternal health literacy and prenatal distress in pregnant women. These findings can be utilized by health services to provide pregnancy counseling, early detection of psychological problems, and appropriate antenatal care for pregnant women. Future research can explore additional variables related to maternal health literacy and prenatal distress."

"Penelitian ini adalah tentang pengaruh praktik kesehatan ibu dari pesan persuasif dalam promosi kesehatan. Hipotesis adakah bahwa pesan-pesan persuasif dalam promosi kesehatan meningkatkan promosi kesehatan ibu. Penelitian ini bereksperimen dengan rancangan pra-postes kelompok. Populasi adalah semua ibu hamil trimester ketiga di Kecamatan Momunu dan Lipunoto. Sampel dipilih oleh cluster samping dari 28 perempuan,"

"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"

"[ABSTRAKIbu hamil risiko tinggi rentan mengalami kecemasan dan depresi yang berdampak pada kelekatannya dengan janin. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara dukungan sosial dengan kelekatan ibu dan janin pada ibu hamil risiko tinggi. Penelitian cross sectional ini melibatkan 108 ibu hamil risiko tinggi yang dipilih menggunakan consecutive sampling. Hasil penelitian menunjukkan bahwa terdapat hubungan antara dukungan sosial dengan kelekatan ibu dan janin pada ibu hamil risiko tinggi (p=0.003). Ibu dengan dukungan sosial tinggi berpeluang 3,9 kali mempunyai kelekatan tinggi dengan janinnya dibandingkan ibu yang dukungan sosialnya rendah setelah dikontrol depresi (OR=3.9; 95% CI=1.66-8.99). Hasil penelitian ini menegaskan bahwa aspek psikososial perlu lebih diperhatikan dalam perawatan ibu hamil sehingga status sejahtera bagi ibu dan bayi dapat dicapai.

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ABSTRACTHigh risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby.;High risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby.;High risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby., High risk pregnant women tend to experience anxiety and depression that occur prenatal attachment dismissed. This study aimed to identify the relationship between social support and prenatal attachment among high risk pregnant women. This cross sectional study involved 108 high risk pregnant women which selected by consecutive sampling. The result showed that there is relationship between social support and prenatal attachment among high risk pregnant women (p= 0,003). Pregnant women with high social support had prenatal attachment 3,9 times higher than women with low social support after controlled by depression (OR= 3,9; 95% CI=1.66-8.99). This finding confirms that the psychosocial aspects need to be considered in the antenatal care in order to achieve the wellness status for both mother and the baby.]"

"Latar belakang: Menurunkan angka kematian ibu menjadi prioritas program kesehatan global, dan merupakan salah satu target dalam United Nation Millennium Development Goals (MDGs), yaitu menurunkan angka kematian ibu hingga 75% pada tahun 2015. Angka kematian ibu di Indonesia tahun 2012 adalah 359/100.000 kelahiran hidup, dan merupakan salah satu negara dengan angka tertinggi di Asia Tenggara dengan Jakarta memiliki jumlah kematian ibu sebanyak 97 jiwa. Tujuan : Mengidentifikasi karakteristik kematian ibu di RSCM, meliputi karakteristik sosio-demografi, riwayat obstetri dan medis, serta kondisi klinis pasien saat tiba di rumah sakit. Metode : Penelitian ini merupakan survey untuk mengetahui data deskriptif kematian maternal menggunakan rekam medis selama rentang waktu penelitian. Dilakukan telaah rekam medis 51 kasus kematian ibu yang terjadi selama 2 tahun dari Januari 2013 hingga Desember 2014 di bagian Obstetri dan Ginekologi, RSCM. Hasil: Dari 51 kasus kematian maternal, diketahui kelompok usia yang dominan adalah 25-34 tahun (58,8%) dengan mayoritas berpendidikan setingkat SMA (70,6%). Tiga puluh dua (62,8%) subjek dengan paritas lebih dari 2 dan tidak ada subjek yang menggunakan metode kontrasepsi IUD atau implan. Sembilan puluh dua persen subjek melakukan ANC, dengan sebagian besar ≥ 4 kali (33 subjek, 64,7%) dan umumnya dilakukan di bidan (41 subjek, 80,4%). Preeklampsia berat merupakan kelainan dalam kehamilan yang paling banyak dijumpai (26 subjek, 65%). Empat puluh tujuh subjek (92,2%) merupakan pasien rujukan, dengan 10 subjek mengalami eklampsia (19,6%) dan 12 subjek dengan perdarahan (23,5%). Preeklampsia adalah penyebab kematian utama. Kesimpulan: Karakteristik dominan pada kematian maternal di RSCM adalah Ibu dengan preeklampsia, kelompok umur 25-34 tahun, pendidikan setaraf SMA, ANC di bidan, dan jumlah ANC lebih dari 4 kali.

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Background: Reducing maternal mortality is a priority in global health programs, and is one of the targets in the United Nations Millennium Development Goals (MDGs), which is to reduce maternal mortality by 75% by 2015. The maternal mortality rate in Indonesia in 2012 was 359 / 100,000 live births , and is one of the countries with the highest rates in Southeast Asia with 97 maternal death in Jakarta as its capital city.

Objective: Identify characteristics of maternal mortality in tertiary hospitals in Jakarta, including socio-demographic characteristics, previous medical and obstetric history, and patient?s clinical condition on arival to the hospital.

Method: This was a survey to identify descriptive data of maternal mortality using medical records during study period. Manual review of 51 medical records was conducted for 2 years from January 2013 to December 2014 in Department of Obstetric & Gynecology, Cipto Mangunkusumo Hospital.

Results: From 51 maternal mortality, 58,8% was 25-34 years old, with most of them had education at a level of senior high school (70,6%). Thirty two subjects (62,8%) with parity more than 2, there was no history of using IUD or implant as contraception methods. Ninety two percents subjects had antenatal care visits, and mostly ≥ 4 times (33 subjects, 64,7%) and visit midwives (41 subjects, 80,4%). Severe preeclamsia was the dominant comorbid during pregnancy (26 subjects, 65%). Forty seven subjects (92,2%) are referral patients, ten subjects (19,6%) had eclampsia and 12 subjects (23,5%) had hemorrhage. Most of death occured as a result of severe preeclampsia (26 subjects, 50,98%).

Conclusion: Maternal mortality characteristics were identified. Severe preeclamsia was the dominant comorbid during pregnancy, with 25-34 years old group, high school education background, had at least 4 times antenatal care and visit midwife for antenatal care."

"Latar Belakang : Indonesia merupakan salah satu negara di Asia dengan angka kematian ibu yang tinggi yaitu berkisar 126 per100,000 kelahiran hidup, dan 14% dari angka ini adalah karena hipertensi dan preeklampsia. Hal ini menjadi dasar perlunya upaya pencegahan preeklampsia yang dapat dilakukan melalui program skrining kehamilan berisiko tinggi yang efektif pada saat kunjungan antenatal, antara lain dengan penilaian karakteristik ibu dan faktor biofisik.Tujuan : Memperoleh kalkulasi faktor risiko dari karakteristik dan biofisik ibu hamil sebagai prediktor preeklampsia dan aplikasi penggunaannya dalam suatu program berbasis android yang dapat digunakan oleh tenaga medis.Metode : Studi ini kohort prospektif, dengan consecutive sampling mengumpulkan 1150 subyek terdiri dari ibu hamil dengan janin tunggal hidup dan tak terdapat kelainan kongenital. Setiap faktor maternal dan biofisik akan dianalisis bivariat, kemudian hasil yang bermakna dilanjutkan dengan analisis multivariat. Variabel yang bermakna hingga analisis multivariat akan menghasilkan persamaan regresi logistik yang digunakan untuk menghitung a priori risk seorang perempuan mengalami preeklampsia.Hasil : Berdasarkan hasil analisis, faktor risiko yang bermakna untuk prediktor preeklampsia meliputi hipertensi kronis, nilai indeks massa tubuh lebih besar sama dengan 25 kg/m2, nilai tekanan arteri rerata lebih besar sama dengan 95 mmHg, dan indeks pulsatilitas arteri uterina tinggi. Model prediksi risiko preeklampsia yang didapatkan yaitu logit (preeklampsia=1) adalah -3,63 + 2,11 (hipertensi kronik) + 0,50 (IMT lebih besar sama dengan 25 kg/m2) + 1,61 (MAP lebih besar sama dengan 95 mmHg) + 1,74 (IP arteri uterina tinggi). Cut-off 0,08 dengan sensitivitas 81,06% dan spesifisitas 73,07%. Kemampuan diskriminasi memprediksi preeklampsia sebesar 84% (instrumen yang baik untuk skrining).Kesimpulan : Faktor maternal dan biofisik dapat digunakan untuk skrining preeklampsia. Akurasi skoring dan sensitivitas pada penelitian ini mempunyai nilai yang tinggi sehingga digunakan sebagai acuan pembuatan program aplikasi prediktor preeklampsia berbasis android sebagai alat skrining preeklampsia yang efektif.

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Background : Indonesia is one of the Asia countries with high maternal mortality rate range 126/100,000 live births, and 14% of them is due to preeclampsia. This is the reason for the need to perform preeclampsia prevention. An effective high-risk pregnancy screening during antenatal visits, by assessing maternal characteristics and biophysical factors.

Aim : To obtain risk calculations from maternal and biophysical characteristics as preeclampsia predictors and their use in an android-based program for medical daily practice.

Methods : This is a prospective cohort design studies. Around 1150 subjects was collected by consecutive sampling for every pregnant woman with a single live fetus with out any congenital anomalies. Each maternal and biophysical factor will be analyzed bivariately, then significant results are followed by multivariate analysis. Variables that are significant until multivariate analysis will produce a logistic regression equation that can be used to calculate a priori risk of a woman experiencing preeclampsia.

Results : Based on the analysis, there are some risk factors that significant for predicting preeclampsia, included chronic hypertension, body mass index ​​the same as or more than 25kg/m2, mean arterial pressure ​​the same as or more than 95mmHg, and high uterine artery pulsatility index. The risk prediction model of preeclampsia obtained was logit (preeclampsia = 1) was -3.63 + 2.11 (chronic hypertension) + 0.50 (BMI the same as or more than 25 kg/m2) + 1.61 (MAP the same as or more than 95 mmHg) + 1 , 74 (high PI uterine artery). Cut-off was 0.08 with sensitivity of 81.06% and specificity of 73.07%. Discrimination ability to predict preeclampsia by 84% (a good instrument for screening).

Conclusion : A combination of maternal and biophysical factors can be used for preeclampsia screening. This study shows a high accuracy scoring and sensitivity that can be use as a reference for making an Android-based preeclampsia predictor application program as an effective preeclampsia screening tool."

"Ibu hamil merupakan kelompok berisiko mengalami gangguan tidur karena ketidaknyamanan fisik dan emosional, terutama ibu hamil trimester ketiga. Penelitian ini bertujuan untuk memberikan gambaran kualitas tidur ibu hamil yang mengikuti dan tidak mengikuti latihan yoga kehamilan. Penelitian ini menggunakan desain deskripitif dengan jumlah sampel 86 responden, terdiri dari 43 ibu hamil yang mengikuti dan tidak mengikuti latihan yoga kehamilan. Instrumen yang digunakan tidur adalah The Pittsburgh Sleep Quality Index. Hasil penelitian menunjukkan jumlah responden yang memiliki kualitas tidur baik lebih banyak terdapat pada kelompok responden yang mengikuti latihan yoga kehamilan dengan perbandingan 4:1. Bedasarkan penelitian ini, diharapkan pelayanan keperawatan dapat memperluas akses pelayanan terapi komplementer, khususnya yoga kehamilan di pelayanan kesehatan maupun komunitas.

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Pregnant women, especially those in the third trimester of pregnancy, are in a risk group that experience sleep disturbances as a result of physical and emotional discomfort. This study was descriptive study aimed to depict the quality of sleep in pregnant women who did and did not partake in prenatal yoga. There were 86 respondents and they were divided into two equal groups of 43. The instrument used for this study was 'The Pittsburgh Sleep Quality Index'. The result of this study showed the number of respondents who had good quality of sleep was greater on the group that participated in prenatal yoga, with a resultant comparison rate of 4:1. Based on this study, nursing institution could be expected to broaden complementary therapy service, especially prenatal yoga in both healthcare and community."

"Tidur merupakan salah satu kebutuhan dasar manusia yang seharusnya dipenuhi secara kuantitas dan kualitas. Kehamilan menjadi salah satu faktor predisposisi individu mengalami masalah tidur karena adanya perubahan fisik dan fisiologis. Faktor tempat tinggal seperti di wilayah perkotaan juga dapat menjadi pemicu munculnya masalah tidur. Salah satu masalah keperawatan yang dapat muncul yaitu insomnia. Penatalaksanaan masalah tidur dapat dilakukan secara farmakologi dan nonfarmakologi. Adanya efek samping obat yang ditimbulkan bagi kehamilan menyebabkan penatalaksanaan nonfarmakologi lebih diutamakan pada ibu hamil. Karya tulis ilmiah ini bertujuan untuk menganalisis intervensi sleep hygiene dan relaksasi otot progresif untuk meningkatkan kualitas tidur pasien ibu A. Karya tulis ilmiah ini menggunakan metode studi kasus dengan melakukan intervensi selama satu minggu. Intervensi diberikan dengan melakukan edukasi, demonstrasi, serta evaluasi dari pelaksanaan intervensi oleh pasien. Hasil intervensi menunjukan terjadi peningkatan kualitas tidur yang ditunjukan dengan penurunan nilai PSQI 10 menjadi 7 dari total nilai 21. Sleep hygiene dan relaksasi otot progresif yang dilakukan secara teratur dapat menciptakan kebiasaan jam tidur, meningkatkan kenyamanan, dan menginduksi tidur sehingga pola tidur menjadi lebih teratur.

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Sleep is one of the basic human need that should be meet in quantity and quality. Pregnancy become one of the predisposing factors of individuals experiencing sleep problems due to physical and physiological changes. Another factor such as residence in urban area also can be a trigger of sleep problems. One of the nursing diagnoses that can arise is insomnia. Sleep problems can be done with pharmacological and nonpharmacological management. Nonpharmacological management is preffered for pregnant women because of the side effects of drug in pregnancy.

This scientific paper aims to analyze the intervention of sleep hygiene and progressive muscular relaxation PMR to improve sleep quality in Mrs. A. This scientific paper use case study method with one week intervention. Implementation in done by providing education, demonstration, and evaluation of the intervention that performed by the patient during one week.

The result of intervention showed an increase in sleep quality that indicated by a decrease in PSQI value from 10 become 7 with total value is 21. Sleep hygiene and PMR that performed regularly can create sleep habits, improve comfort, and induce sleep so that sleep patterns become more regular."

"ABSTRAKWorld Health Organization (WHO) memperkirakan 800 perempuan meninggalsetiap harinya akibat komplikasi kehamilan dan proses kelahiran. Sekitar 80%kematian maternal merupakan akibat komplikasi selama kehamilan, persalinan danpostpartum. Oleh sebab itu diperlukan pendidikan kesehatan yang komprehensifuntuk mempersiapkan ibu hamil beresiko dan suami dalam menghadapi persalinan.Penelitian ini bertujuan mengidentifikasi perbedaan pengaruh pendidikan kesehatanpaket ?Riski? dan pendidikan kesehatan dengan leaflet terhadap kesiapan ibu hamilberesiko dan suami dalam menghadapi persalinan. Desain penelitian adalah kuasieksperimen dengan sampel 43 orang di kelompok satu dan 43 sample di kelompokdua dipilih dengan quota sampling. Instrumen yang digunakan adalah BirthPreparedness and Complication Readiness (BPCR). Hasil penelitian inimenunjukkan ada perbedaan pengaruh pendidika nkesehatan paket ?Riski?terhadap kesiapan ibu hamil beresiko dan suami dibandingkan dengan pendidikankesehatan menggunakan leaflet, p=0,001. Penelitian ini merekomendasikan untukmenggunakan paket ?Riski? dalam pemberian pendidikan kesehatan pada ibu hamilresiko tinggi dan suaminya.

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ABSTRACTWHO estimates that 800 women has died because of pregnancy complication anddelivery process everyday. Approximately 80% maternal mortality in the world iscaused by the complication during pregnancy, delivery and postpartum.Thosesituation needs a comprehensive health education to prepare the high risk pregnantwomen and their husband. The aim of this study is to identify the differentinfluence between package health education ?Riski?and leaflet to prepare the highrisk pregnant women and their husband in delivery. This research used a quasyexperiment to compare two group pre and post intervention. First group with?Riski‟ package involved 43 sample and second group with leaflet for 43 sample.The birth preparedness and complication readiness (BPCR) is used in this study.The result showed that there were a significant diferrent between group one andgroup two (p=0,001). This study recommend that it is important to used thispackage in the health education for high risk pregnant women and their husband"

"Latar Belakang : Wabah pneumonia akibat Corona Disesase 2019 (COVID-19) masih menjadi perhatian nasional maupun global. Wanita hamil termasuk dalam kelompok risiko tinggi/rentan terhadap infeksi COVID-19. Adanya badai sitokin akibat infeksi COVID-19 menyebabkan gejala klinis yang semakin berat. Zinc sebagai salah satu mikronutrien penting yang berpengaruh dalam regulasi produksi sitokin oleh sistem imun tubuh. Kondisi defisiensi zinc pada wanita hamil yang terinfeksi COVID-19 dapat menyebabkan disregulasi dari sistem imun dan menghasilkan badai sitokin yang mengakibatkan sindrom ancaman gagal napas akut dan kematian. Tujuan : Meneliti hubungan kadar zinc serum maternal terhadap kadar sitokin pro- inflamasi interleukin-6 (IL-6) dan interferon gamma (IFN-) pada wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Metode : Penelitian observasional dengan desain studi cross-sectional. Subyek penelitian adalah wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Faktor yang diteliti meliputi kadar zinc, IL-6 dan IFN- serum maternal dan hubungannya kadar zinc serum terhadap kadar IL-6 dan IFN- serum maternal.Hasil : Jumlah total subyek sebanyak 48 orang dibagi menjadi 28 subyek untuk kelompok wanita hamil yang terkonfrimasi COVID-19 gejala ringan-sedang dan 20 subyek dengan gejala berat. Rata-rata usia responden 30,61 tahun untuk kelompok gejala ringan-sedang dan 32,9 tahun untuk kelompok gejala berat. Rata-rata usia kehamilan pada kelompok gejala ringan-sedang lebih tua dibanding kelompok gejala berat (38,1 minggu vs 34,5 minggu).Lama perawatan kelompok dengan gejala berat lebih lama dibanding kelompok gejala ringan-sedang. 60% subyek dari kelompok gejala berat berakhir dengan kematian maternal. Semua subyek dalam penelitian ini mengalami defisiensi zinc. Tidak terdapat perbedaan bermakna kadar zinc serum maternal pada kedua kelompok yaitu 54,0 (34-78) μg/dl untuk kelompok gejala ringan-sedang dan 52,0 (38-97) μg/dl untuk kelompok gejala berat. Terdapat perbedaan bermakna antara kelompok gejala ringan-sedang dengan kelompok gejala berat terhadap kadar IL-6 serum (5,8 (1,5-69,6) pg/ml vs 18,6 (3,8-85,3) pg/ml) dan kadar IFN- serum (0,9 (0,1-16,8) pg/ml vs 9,0 (0,9-21,1) pg/ml). Tidak ada korelasi antara kadar zinc serum maternal dengan kadar IL-6 dan IFN- serum maternal. Kesimpulan : Kadar zinc serum maternal tidak berbeda bermakna diantara kedua kelompok penelitan. Kadar IL-6 dan IFN- serum kelompok gejala berat lebih tinggi dibanding kelompok gejala ringan-sedang. Tidak ada korelasi antara kadar zinc serum dengan kadar IL-6 dan IFN- serum maternal.

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Bacground : The outbreak of Corona Disesase 2019 (COVID-19) is still a national and global concern. Pregnant women are included in the highrisk/susceptibility group for COVID-19 infection. The presence of a cytokine storm due to COVID-19 infection causes increasingly severe clinical symptoms. Zinc is one of the important micronutrients that influence the regulation of cytokine production by the immune system. Zinc deficiency in pregnant women with confirmed COVID-19 can cause dysregulation of the immune system and produce a cytokine storm that results in acute respiratory distress syndrome and maternal death. Objective: To evaluate the relationship between maternal serum zinc levels and the pro- inflammatory cytokines interleukin-6 (IL-6) and interferon-gamma (IFN-) in pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. Methods: A cross-sectional was adopted in this study. The subjects of the study were pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. We measure the maternal serum zinc levels, serum IL-6 and IFN- levels, then we evaluate the relation between the maternal serum zinc levels and the maternal serum IL- 6 and IFN- levels.

Results: The total number of subjects was 48 patiens, divided into 28 subjects for the pregnant women with confirmed COVID-19 with mild-moderate symptoms and 20 subjects with severe symptoms. The average age of the respondents was 30.61 years for the mild-moderate group and 32.9 years for the severe group. The mean gestational age in the mild-moderate group was older than in the severe one (38.1 weeks vs. 34.5 weeks). The length of stay of subjects with severe symptom was longer than the mild-moderate group. 60% cases from the severe group ended in maternal death. All the participants in this study suffered zinc deficiency. There was no significant difference in maternal serum zinc levels between the two study groups (54.0 (34-78) g/dl in mild-moderate group vs 52.0 (38-97) g/dl in severe group). There was a significant difference between mild- moderate vs severe groups in which the serum IL-6 levels were (5.8 (1.5-69.6) pg/ml vs 18.6 (3.8-85.3) pg/ ml) and the serum IFN- levels were (0.9 (0.1-16.8) pg/ml vs. 9.0 (0.9- 21.1) pg/ml). There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels. Conclusion: The maternal serum zinc levels were not significantly different between the two study groups. The maternal serum IL-6 and IFN- levels in the severe group were higher than in the mild-moderate group. There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels."