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"Angka Kematian Ibu sebagai salah satu indikator kesehatan ibu masih cukup tinggi di Indonesia. Penjaringan ibu hamil risiko tinggi oleh tenaga kesehatan merupakan indikator untuk memperkirakan besarnya masalah yang dihadapi oleh program Pembinaan Kesehatan Keluarga dan diharapkan ibu hamil risiko tinggi mendapat perhatian khusus, meskipun ibu hamil yang tidak termasuk risiko tinggi tidak boleh diabaikan.Dari data laporan yang ada di Dinas Kesehatan Kabupaten Tangerang temyata ada perbedaan antara jumlah bumil risti yang dirujuk oleh Puskesmas ke RSU dengan bumil risti yang sampai di RSU. Untuk ini peneliti tertarik untuk mencari faktor apa yang berhubungan dengan tidak sampainya rujukan bumil risti ke RSU Tangerang.Penelitian dilakukan dengan metode kros seksional. Dari 14 hipotesis yang ditegakkan, ada 6 variabel yang terbukti bermakna secara statistik dengan variabel terikat yaitu variabel pendidikan, sikap, pekerjaan, jarak ke tempat pelayanan, penanggung biaya dan persepsi ibu. Terdapat 8 variabel yang tidak berhubungan secara statistik dengan variabel terikat yaitu variabel umur, paritas, jumlah anak, interval kelahiran, pengetahuan, penghasilan, ketersediaan sarana rujukan medik, riwayat persalinan dengan variabel terikat.Setelah mengetahui hal ini mudah-mudahan dapat dilakukan intervensi melalui peningkatan program Kesehatan Keluarga, dimana program yang sekarang sedang digalakkan adalah Gerakan Sayang Ibu dan Bayi, antara lain dengan melebarkan Gerakan Sayang Thu dan Bayi secara bertahap di semua kecamatan, meluaskan ruang lingkup kegiatan, sehingga ibu hamil risiko tinggi mendapat pertolongan persalinan yang sebaik, secepat dan setepat mungkin, dengan demildan kematian ibu bersalin dapat dicegah.

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Factors Related to Pregnant Woman At Risk Which Do Not Reach Tangerang General Hospital for ReferralsMaternal Mortality rate as one indicator of maternal status is still high in Indonesia. One aspects of antenatal care at the health centers is identifying at risk women and refer them to the district hospital for further treatment. The objective of this study is to find out the profile and reasons of risk pregnant women who were judge to refer themselves to Tangerang General Hospital for obtaining more comprehensive obstetric services, but never made it.

The methodology of the study is cross sectional by finding all at risk pregnant women who were judged to refer thmeselves to Tangerang General Hospital. Fourteen hypothesis were established, mainly to prove the relationship of pregnant women at risk to the use of Tangerang General Hospital : educational level, job, distance to health center, payer and mother's perception, age, parity, number of children, birth space, knowledge, attitude, referral sites, history of delivery. From 14 hypothesis only the first six variables government nationally so far is the ` Mother Friendly Movement `, coordinated by the Minister of Woman's Role. The activities can be found in every subdistrict in Indonesia, covering mobile health care, training of midwives, improve the function of the health center, and improve the referral system. ;Factors Related to Pregnant Woman At Risk Which Do Not Reach Tangerang General Hospital for ReferralsMaternal Mortality rate as one indicator of maternal status is still high in Indonesia. One aspects of antenatal care at the health centers is identifying at risk women and refer them to the district hospital for further treatment. The objective of this study is to find out the profile and reasons of risk pregnant women who were judge to refer themselves to Tangerang General Hospital for obtaining more comprehensive obstetric services, but never made it.

The methodology of the study is cross sectional by finding all at risk pregnant women who were judged to refer thmeselves to Tangerang General Hospital. Fourteen hypothesis were established, mainly to prove the relationship of pregnant women at risk to the use of Tangerang General Hospital : educational level, job, distance to health center, payer and mother's perception, age, parity, number of children, birth space, knowledge, attitude, referral sites, history of delivery. From 14 hypothesis only the first six variables government nationally so far is the ` Mother Friendly Movement `, coordinated by the Minister of Woman's Role. The activities can be found in every subdistrict in Indonesia, covering mobile health care, training of midwives, improve the function of the health center, and improve the referral system."

"Latar belakang. Penyakit ginjal kronik-gangguan mineral tulang (PGK-GMT) adalah komplikasi dari penyakit ginjal kronik (PGK) yang dapat meningkatkan risiko gangguan kardiovaskular pada anak. Salah satu kelainan pada PGK-GMT adalah hiperfosfatemia dan gangguan otot skeletal. Sebuah studipada pasien dewasa didapatkan korelasi negatif antara kadar fosfat yang dengan kekuatan genggaman tangan. Sampai saat ini belum ada penelitian yang menilai kekuatan genggaman tangan pada anak PGK G3-G5 di Indonesia dan faktor lain yang memengaruhi.Tujuan. Mengetahui faktor-faktor yang memengaruhi kekuatan otot melalui pemeriksaan kekuatan genggaman tangan pada anak PGK G3-G5.Metode. Penelitian ini merupakan uji potong lintang terhadap 72 anak PGK G3-G5 usia 6-18 tahun diRSCM dan pemilihan anak dilakukan secara consecutive sampling. Variabel yang dianalisis adalah pemeriksaan massa otot, lingkar lengan atas (LILA), serum fosfat, hemoglobin (Hb), neuropati, dan kekuatan genggaman tangan menggunakan dinamometer hidrolik tangan (JAMAR, Japan).Hasil. Median usia adalah 14 (11-16) tahun dengan lelaki 52/72 (72,2%). Penyebab terbanyak PGKadalah congenital anomalies of the kidney and urinary tract (CAKUT) 30/72 anak (41,7%) yang diikuti dengan glomerulonefritis 18/72 anak (25%). Median massa otot, LILA dan kekuatan genggaman tangan adalah 25,3 (18,7-32,9) kg, 19 (16-22) cm dan 8,65 (7,8-9,3) kg. Rerata kadar Hbdan fosfat adalah 10,45 (±1,72) g/dL dan 5,45 (± 1,92) mg/dL. Prevalens gangguan kekuatan genggaman tangan pada anak PGK G3-G5 adalah 98,6%. Pada penelitian ini tidak didapatkan korelasi antara kekuatan genggaman tangan dan kadar fosfat (r= -0,03; p= 0,42). Namun, didapatkan korelasi antara massa otot, LILA, dan kadar Hb terhadap kekuatan genggaman tangan yaitu (r = 0,70; p<0,01), (r = 0,68; p<0,01),dan (r = 0,44; p<0,01). Simpulan. Kekuatan genggaman tangan memiliki korelasi kuat dengan massa otot dan LILA serta memiliki korelasi cukup dengan kadar Hb.

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Background. Chronic kidney disease-bone mineral disorders (CKD-BMD) is a complication of chronic kidney disease (CKD) which may increase the risk of cardiovascular disease in children.Hyperphosphatemia and skeletal muscle disorder are one of the abnormalities in CKD-MBD. Study in adult population shows there are negative correlation between phosphate levels and hand grip strength.There has been no study for CKD G3-G5 in pediatric population regarding handgrip strength and other factors that correlate to it.

Aim. To determine the factors that affect muscle strength through hand grip strength examination in children with CKD G3-G5

Methods. This is a cross-sectional study of 72 pediatric CKD G3-G5 aged 6-18 years old in RSCM.The subject was selected by consecutive sampling. The variables that we analyzed are muscle mass,mid-upper arm circumference (MUAC), serum phosphate, Hb, neuropathy, and hand grip strength usinghydraulic hand dynamometer (JAMAR, Japan).

Results. The median age of the subjects was 14 (11-16) years old with 52/72 (72.2%) male. The most common causes of CKD are CAKUT with 30/72 subjects (41.7%) followed by glomerulonephritis with 18/72 subjects (25%). The median muscle mass, MUAC, and handgrip strength are 25,3 (18,7-32,9) kg, 19 (16-22) cm, and 8.65 (7.8-9.3) kg. Mean Hb level and phosphate level are 10.45 (±1.72) g/dL and 5.45 (±1.92) mg/dL. The prevalence of handgrip strength disorders in CKD G3-G5 is 98.6%. In this study, we found no correlation between handgrip strength and phosphate levels (r= -0.03; p= 0.42). However, we found positive correlation between muscle mass, MUAC, and Hb levels with handgrip strength (r= 0,70; p<0,01), (r = 0.68; p<0.01), and (r = 0.44; p<0.01).

Conclusion. There is a correlation between muscle mass, MUAC, and Hb level with handgrip strength in pediatric CKD G3-G5."