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Abstrak :
Angaka kematian ibu di Indonesia saat ini masih tinggi, pada tahun 1997 sebesar 373 per 100.000 kelahiran hidup, padahal pemerintah dalam hal ini Depkes ingin menurunkan angka kematian ibu. Untuk menurunkan angka kematian ibu (AKI) pemerintah telah menempatkan petugas kesehatan (Bidan di desa) dan fasilitas pelayanan kesehatan sampai kedaerah terpencil untuk ikut menjaga kesehatan ibu dan bayi selama masa kehamilan, persalinana, dan masa sesudah persalinan. Tujuan penelitian ini ingin mengetahui gambaran tingkat kepatuhan. bidan di desa terhadap standar pelayanan antenatal care (ANC) di Kabupaten Karawang, serta faktor-faktor apa saja yang berhubungan dengan kepatuhan bidan di desa terhadap standar pelayanan antenatal. Rancangan penelitian adalah cross sectional (potong lintang), populasi penelitian ini bidan di desa yang ada di Kabupaten Karawang, sebanyak 277 orang dengan jumlah sampel sebanyak 162 orang. Data di analisis secara univariat. bivariat, dan multivariat dengan menggunakan regresi logistik ganda. Perangkat lunak yang dipakai ialah program komputer di laboratorium Program Studi llmu Kesehatan Masyarakat Universitas Indonesia (PS-IKM). Hasil penelitian yang didapat adalah dari 162 responden, yang patuh terhadap standar pelayanan antenatal care (ANC) sebanyak 115 responden (71,0%), dan yang tidak patuh sebanyak 47 responden (29,0%). Faktor yang memiliki hubungan dengan kepatuhan bidan di desa terhadap standar pelayanan antenatal care (ANC) adalah.umur, pengalaman kerja, pengetahuan, sedangkan perkawinan, pelatihan, supervisi dan sarana tidak memiliki hubungan bermakna. Sedangkan hasil multivariat faktor yang paling dominan berhubungan dengan kepatuhan bidan di desa pada standar pelayanan antenatal adalah status perkawinan. Mempertimbangkan hasil penelitian ini, maka disarankan kepada semua pihak yang terkait (Dinas Kesehatan, Puskesmas) perlu pembinaan khusus terhadap bidan di desa terutama bidan di desa yang memiliki tingkat pengetahuan yang kurang, sedangkan untuk bidan perlu meningkatkan pengetahuannya melalui pelatihan dan banyak membaca. ......The Factors that Related to Village Midwife Compliance on Antenatal Service Standard at Karawang District, 2002The Maternal Mortality Rate (MMR) in Indonesia is still high, it was 373 per 1000 live births, 1997, even the government, and MOH would like to reduce it. To reduce the MMR, the government has been placed Village Midwife and facility of health service up to Remote Areas to participate maintain the maternal health and infant during pregnancy, delivery, and post-natal. The objective this study is to determine the description of Village Midwife compliance rate to ANC standard at Karawang District, and also on what factors that influence to Village Midwife compliance to ANC standard. The study design used cross-sectional, the population of this study is Village-Midwife that available at Karawang District, and the number is 277 people, with the sample as 162 people. The data was analyzed by univariate, bivariate, and multivariate used logistic regression. The software is computer program at the Laboratory of the Faculty of Public Health, University of Indonesia (PS-IKM-UT). The result of this study obtained that out of 162 respondents who's having compliance to ANC standard as 115 respondents (71.0%), and was not compliance 47 respondents (29.0%). Result of bivariate prove have significant relationship to Village Midwife compliance to ANC standard are age, work experience, knowledge, while marital, training, supervision and facility is not having significant relationship. The specially vector to related wich compliance to ANC standard as married status. Considering to the result of this study, it is recommended to all related parties (Local Health Service, Health Center) need special guidance to Village Midwife, especially Village Midwife that having lower compliance, while for Midwife should increase her knowledge through training and a lot of reading.

Abstrak :
Latar Belakang. Oleh karena tingginya angka kecacatan dan kematian pada penderita stroke hemoragik, beberapa peneliti mendapatkan adanya hiperglikemia pada perdarahan intraserebral menyebabkan kerusakan otak yang luas kerusakan otak. Untuk mencegah kerusakan tersebut, sangat penting untuk mengetahui dan mengantisipasi peningkatan kadar gula darah sewaktu pada perdarahan intraserebral fase akut. Metod e. Penelitian ini merupakan analitik observasional secara potong lintang pada 50 penderita stroke hemoragik dengan riwayat hipertensi yang dirawat di rurnah sakit Cipto Mangunkusumo dipilih secara consecutive sampling berdasarkan kriteria inklusi yaitu onset stroke kurang dari 72 jam, riwayat diabetes melitus, usia 45 - 65 tahun. Kriteria eksklusi yaitu stroke iskemik dan berulang. Dilakukan diagnosis dengan pemeriksaan fisik, pemeriksaan neurologis dan Cf Scan, volume perdarahan dihitung dengan menggunakan rumus elipsoid 4/3 X n X Y2 p X Y2 1 X Y2 t. Defisit neurologis diukur dengan menggunakan skala NIHSS. Pemeriksaan gula darah sewaktu, HbA1c diukur setelah dihitung volume perdarahan, kemudian dianalisis dengan uji statistik korelasi regresi, analisis multi regresi (p < 0,05). Hasil. Usia rata-rata penderita perdarahan intraserebral hemoragik adalah 55,5 ± 6,2 tahun. Peningkatari tekanan darah sistolik (rerata 190,0 ± 21,0 mmHg) berhubungan bermakna dengan peningkatan kadar gula darah sewaktu (p = 0,032, p < 0,05). Rerata kadar gula darah sewaktu 155 ± 56,7 mg/dl. Besamya volume perdarahan (rerata 32,0 ± 31,4 cm3) berhubungan berrnakna dengan peningkatan kadar gula darah sewaktu (p = 0,032, p < 0,05). Peningkatan HbA1c berhubungan bermakna dengan volume perdarahan (p = 0,000, p < 0,05). Kesimpulan. M~ tinggi tekanan darah sistolik akan makin besar volume perdarahan intraserebral. Makin besar volume perdarahan intraserebral akan makin tinggi kadar gula darah. Adanya riwayat diabetes melitus akan menambah besarnya volume perdarahan. ......Background Regarding of the hight disability and mortality rates on hemorrhage stroke patients, many authors found that hyperglicemia in intracerebral hemorrhage leading to severe brain damage. To prevent such effect, the anticipation of increasing random blood glucose consentration in acute phase intracerebral hemorrhage is crucial. Method This is a cross sectional analytic observational study on 50 consecutive sampling of stroke hemorrhage patients with history of hypertension at Cipto Mangunkusumo Hospital, with onset of stroke before 72 hours, history of diabetes mellitus, age range of 45 - 65 years as primary inclusion criteria. Patients with multiple stroke were excluded. Diagnostic on admission were screened by clinical examinations, clinical neurologic computed tomographic scans (CT Scans). Volume of intracerebral hemorrhage was then estimated using the formula for an ellipsoid 4/3 x 1t x ~ p x ~ 1 x ~ t. Neurological deficit was measured by NIHSS (National Institutes of Health Stroke Scale). Blood glucose level, HbA1c were measured after estimated the hemorrhage volume at the time of admission. Data were taken statistical method with univariate logistic regression analysis values of p < 0,05. Results The mean age of acute stroke hemorrhage patients is 55,5 ± 6,2 years old. Elevation of systolic blood pressure (mean 190,0 ± 21,0 mmHg) was significantly correlated with the height of blood glucose level (p = 0,020, p < 0,05). Mean blood glucose level155 ± 56,7 mg/dl. Elevation of intracerebral hemorrhage volume was significantly correlated with the height of blood glucose level (p = 0,032, p < 0,05). Elevation of the HbA1c was significantly correlated with the height volume of intracranial hemorrhage (p = 0,000, p < 0,05). Conclusion The higher the systolic blood pressure larger the intracerebral hemorrhage volume. Elevation of systolic blood pressure will raising the volume of intracerebral hemorrhage. The larger the intracerebral hemorrhage the higher the blood glucose consentration. History of diabetes mellitus will increase the hemorrhage volume.