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Abstrak :
An intervention program on the impact of iron preparation with intensive nutrition education among pregnant women was undertaken in Kecamatan Curug, Kabupaten Tanggerang. Twwo kinds of iron tablets, both containing 200 mg ferrous sulphate and 0,25 mg folic acid were distributed in four villages, namely village A: Kadu Jaya, village B: Kadu, village C: Curug Wetan and village D: Cukang Galih. The new iron tablet was prepared in a coated membrane form, with red coloring and was distributed in sachets containing 14 or 28 tablets. The existing (currently used) tablet was prepared in coated film form, with grey coloring and was loosely packaged. Intensive nutrition educaation was delivered to twwo villages, which were given the different iron tablet forms as described above. A number of 162 pregnant women as subjects in four villages were divided into four different intervention groups, 41 of them in village A received new iron with intensive nutition education, 41 in village B received new iron, 40 in village C received existing iron with intensive nutrition education and 40 in village D received exixting iron alone was as the control group, for 12 weeks of intervention period, however only 127 of them could be monitored and evaluated. Analysisi of nutrition knowledge, attitude and behavior of the subjects, recording of iron tablet consumption, dietary habits, nutrient intake and nutritional status was conducted in the four villages, for each of the four groups before and after intervention. In addition serum ferritin and hemoglobin concentration were determined to evaluate the change in the prevalence of anemia. Distribution of new iron or existing iron tablets without intensive nutrition knowledge, attitude, behavior of the subjects towards anemia problem. he results show that subjects which received new iron could improve their dietary habits, calories and protein intakes, but not in iron and vitamin C intakes. Although, a significantly higher (p<0.0500) consumption of iron was observed in the group which received new iron, neither in the subsequent improvement in hemoglobin and serum ferritin values. Intensive nutrition education was positively associated with the improvement of nutritional knowledge, attitude and behavior of the pregnant women as well as significant increase in iron tablet consumption (p<0.0500). Dietary habits were improved, as seen in the increase in calorie and protein intake and the resulting improvement in the nutritional status of the mothers. The results indicated that the new iron supplementation with intensive nutrition education had a greater effect on invreasing the iron tablet consumption of pregnant women compared to those who only received existing iron supplementation without intensive nutrition education. Since the iron intake was not different in the two villages, their effect on hrmoglobin and serum ferritin concetration was not different. Witihin the time period of observation, there was no different reduction in the prevalence of anemia between each village of the population studied.

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ABSTRAK
Nama : Priska Asrana BaidahProgram Studi : : Pendidikan Dokter Spesialis Obstetri dan GinekologiJudul : Prevalensi dan Faktor-Faktor Risiko Konstipasi pada Wanita Hamil di Poliklinik Rawat Jalan Obstetri dan Ginekologi RSCM. LATAR BELAKANG: Konstipasi merupakan masalah saluran gastrointestinal yang sering dialami oleh wanita hamil. Adanya konstipasi dapat menghabiskan biaya dan waktu untuk berobat, menurunkan produktivitas dan kualitas hidup serta dapat pula menimbulkan kelainan permanen seperti rusaknya fungsi penyokong otot-otot dasar panggul. Penelitian untuk melihat prevalensi konstipasi pada ibu hamil dan faktor-faktor yang mempengaruhinya di Indonesia belum ada. Padahal dengan mengetahui faktor-faktor risiko konstipasi dalam kehamilan, kualitas perawatan antenatal pada ibu hamil akan lebih baik. TUJUAN: Diketahuinya prevalensi dan hubungan antara usia kehamilan, asupan serat, konsumsi air, dan tingkat aktivitas fisik dengan konstipasi pada ibu hamil di poliklinik rawat jalan obstetric dan ginekologi RSCM. METODE: Penelitian ini merupakan penelitian potong lintang dengan jumlah sampel 174 wanita hamil yang sehat yang berkunjung untuk melakukan pemeriksaan antenatal di poliklinik rawat jalan RSCM. Data dikumpulkan melalui pengisian kuesioner. Diagnosis konstipasi berdasarkan kriteria ROME III, pengukuran asupan serat dengan kuesioner FFQ, pengukuran tingkat aktivitas fisik dengan kuesioner IPAQ. Uji chi square dan Fisher dilakukan untuk menilai hubungan antar variabel. HASIL:Prevalensi konstipasi pada wanita hamil pada penelitian ini 13,2 IK95 8,3-18,1 dengan prevalensi tiap trimester yaitu 5,9 pada trimester 1, 21,4 pada trimester 2, dan 11,3 pada trimester 3. Keluhan tersering yaitu mengedan keras, BAB tidak lampias, dan sensasi tidak dapat mengeluarkan tinja saat BAB. Sebanyak 81,03 subjek asupan serat per harinya kurang dengan rata-rata asupan serat 18,97 gram/hari.Tidak terdapat hubungan yang bermakna antara asupan serat dengan konstipasi p=0,776 , konsumsi air dengan konstipasi p=0,485 , dan tingkat aktivitas fisik dengan konstipasi p=0,553 . Namun, terdapat nilai OR yang cukup tinggi antara usia kehamilan dengan konstipasi yaitu OR 4.364 untuk trimester 2 dan OR 2,039 untuk trimester 3 yang menunjukkan kemungkinan ada kebermaknaan secara klinis walaupun tidak bermakna secara statistik p=0,254 KESIMPULAN: Prevalensi konstipasi pada wanita hamil sebanyak 13,2 . Tidak terdapat hubungan yang bermakna antara usia kehamilan, asupan serat, konsumsi air, dan tingkat aktivitas fisik.KATA KUNCI : konstipasi, ROME III, wanita hamil

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ABSTRACT
Name Prika Asrana BaidahStudy Program Obstetric and GynecologyTitle Prevalence and Risk Factors Constipation in Pregnancy at Obstetric and gynecology Outpatient Clinic RSCM AIM To estimate constipation prevalence and it rsquo s relation with age of gestation, diet fiber, water consumption, and physical activityBACKGROUND Constipation is a common symptom in pregnancy. The presence of constipation can be costly, reducing the productivity and quality of life and can also cause permanent abnormalities of the pelvic floor muscles. There was no research that looking for prevalence of constipation in pregnant women and it rsquo s risk factors in Indonesia yet. Yet by knowing the risk factors for constipation in pregnancy, the quality of antenatal care for pregnant women would be betterDESIGN AND METHODOLOGY This study is a cross sectional study with a sample of 174 healthy pregnant women who visit to antenatal care at outpatient clinic RSCM. Data were collected through questionnaires. The diagnosis of constipation based ROME III criteria, measurement of fiber intake by FFQ questionnaire, measuring the level of physical activity by questionnaire IPAQ. Chi square test and Fisher conducted to assess the relationship between variables.RESULTS The prevalence of constipation in pregnant women in this study 13.2 CI95 8.3 to 18.1 with each trimester prevalence is 5.9 in the first trimester, 21.4 in the second trimester, and 11.3 in third trimester. The most common complaint are straining, incomplete evacuation, and anorectal obstruction. A total of 81.03 of the subjects was poor on fiber intake with an average fiber intake was 18.97 g day. There were no significant association between fiber intake with constipation p 0.776 , water consumption with constipation p 0.485 , and physical activity levels with constipation p 0.553 . However, there is a clinically significant association between gestational age with constipation with OR 4,364 for second trimester to trimester and 2,039 OR 3. This clinical significancy unfortunately not statistically significant p 0.254 CONCLUSION The prevalence of constipation in pregnant women as much as 13.2 . There were no significant association between gestational age, fiber intake, water consumption, and physical activity levels.Keywords Constipation, pregnancy, ROME III

Abstrak :
Latarbelakang:Sebagian besar wanita hamil mengalami kolonisasi Streptococcus haemolyticus grup B (SGB) di saluran urogenital yang mempengaruhi kesehatan ibu hamil dan bayi. Deteksi SGBintrapartum perlu pemeriksaan yang cepat dan sensitif. Pemeriksaan mikrobiologi untuk mendeteksi SGB menggunakan metode kultur dan real time polymerase chain reaction(RT-PCR) telah digunakan untuk mendukung diagnosis, namun penggunaannya untuk skrining pada ibu hamil belum pernah diuji keakuratannya di Indonesia. Penelitian ini bertujuan untuk mencari metode terbaik untuk mendeteksi kolonisasi SGB pada ibu hamil sekaligus menilai akurasi uji RT-PCR. Metode: Penelitian dengan metode potong lintang padawanita hamil kurang dari 37 minggu dengan ketuban pecah diRumah Sakit Umum Pusat Nasional Cipto Mangunkusumo(RSCM), Rumah Sakit Umum Daerah Pasar Rebo, dan Rumah Sakit Budi Kemuliaan. serta bayi baru lahir dengan tersangka sepsis neonatorum awitan dini yang lahir dari ibu tersebut di RSCM. Swab rektovaginal pada ibu dan darah pada bayi untuk pemeriksaan tes RT-PCRdan kultur pada 3 media: agar darah (AD), agar darah Columbia (ADC), dan CHROMagar (CA). Hasil: Ada 50 ibu dan 25 bayi direkrut dalam penelitian ini.Prevalensi SGB pada ibu hamil 24%, 2 bayi meninggal. Dibandingkan dengan kultur dengan media ADC, tes RT-PCR mempunyai sensitivitas 83,33%, spesifisitas 86,84 %, NPP 66,67 %, NPN 94,29 %, dan akurasi 86,00 %.Media CAmenunjukkan hasil yang lebih tinggi dalam hal sensitivitas 100%, spesifisitas 100%, NPP 100%, NPN 100%, dan akurasi 100 %, dengan hasil lebih singkat, lebih praktis, dan lebih murah. Simpulan: Pemeriksaan RT-PCR menjadi pilihan dalam skrining SGB intrapartum, dengan alternatif media CA. ......Background: Most pregnant women were colonized of group B Streptococcus haemolyticus (GBS) in urogenital tract which affects the health of pregnant women and babies. Detection of intrapartum GBS requires rapid and sensitive examination. Microbiological examination to detect GBS using culture and real time polymerase chain reaction (RT-PCR) has been used to support the diagnosis, but its use for screening in pregnant women has never been tested for accuracy in Indonesia. This study aims to find the best method for detecting GBS colonization in pregnant women as well as assessing the accuracy of the RT-PCR test. Methods: This was a cross-sectional study in pregnant women less than 37 weeks with ruptured membranes at the Cipto Mangunkusumo National Central General Hospital (RSCM), Pasar Rebo Regional General Hospital, and Budi Kemuliaan Hospital, And newborns with suspected early-onset neonatal sepsis born to these mothers at RSCM. Rectovaginal swab in mother and blood in infant for RT-PCR assay and culture on 3 media: blood agar (BA), Columbia blood agar (CBA), and CHROMagar (CA). Results: There were 50 mothers and 25 infants recruited in this study. The prevalence of GBS in pregnant women was 24%, 2 neonates died. Compared with culture with CBA media, the RT-PCR test had a sensitivity of 83,33%, specificity 86,84%, PPN 66,67%, NPN 94,29%, and accuracy 86,00%. CA media showed higher results in terms of 100% sensitivity, 100% specificity, 100% NPP, 100% NPN, and 100% accuracy, with shorter results, more practical, and cheaper. Conclusions: RT-PCR examination is an option in intrapartum GBS screening, with CA media as an alternative.

Abstrak :
Anemia selama kehamilan merupakan masalah yang umum terjadi pada ibu hamil. Penyebab utama anemia pada ibu hamil disebabkan oleh defisiensi zat besi yang dapat berpengaruh terhadap rendahnya nilai hemoglobin (Hb) dan disebabkan karena rendahnya tingkat konsumsi zat besi dan faktor penghambat serapan zat besi. Tujuan penelitian untuk menilai pengaruh konseling apoteker dengan media leaflet terhadap kejadian anemia pada ibu hamil. Desain penelitian yang digunakan eksperimental dengan randomized pre post control design. Responden penelitian sebanyak 146 responden terdiri dari 87 responden kelompok tidak konseling dan 59 responden kelompok konseling dengan media leaflet. Penelitian dilakukan di Puskesmas Pagedangan, Kabupaten Tangerang pada bulan Januari 2017 hingga April 2017. Seluruh responden baik pretest atau posttest dilakukan wawancara dan pemeriksaan nilai Hb dengan alat Hemocue Hb 301 Analyzer. Analisis data dengan uji Chi-Square, uji Mann Whitney, uji Wilcoxon, dan analisa regresi logistik biner. Hasil penelitian menunjukkan kelompok yang diberikan konseling berpotensi 8,1 kali (OR=8,1, 95%, CI=1,49-44,36) tidak anemia dibandingkan kelompok yang tidak diberikan konseling setelah dikontrol variabel usia ibu hamil, usia kehamilan, pendidikan, kepatuhan, pola konsumsi TTD dengan tablet kalsium, pola konsumsi TTD dengan makanan/minuman yang dapat menghambat absorpsi zat besi. Dengan demikian konseling apoteker dengan media leaflet berpengaruh meminimalkan kejadian anemia pada ibu hamil di Puskesmas Pagedangan, Kabupaten Tangerang.

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Anemia during pregnancy is a common problem in pregnant women. The main cause of anemia in pregnant women is due to iron deficiency which can affect the low hemoglobin (Hb) value and is due to low levels of iron intake and iron absorption inhibitors. The objective of the study was to assess the effect of pharmacist counseling using leaflet media on the occurrence of anemia in pregnant women. The research design used experimental with randomized pre-post control design. Research respondents were 146 respondents consisted of 87 respondents group without counseling and 59 respondents counseling group with media leaflet. The study was conducted at Pagedangan Public Health Center, Tangerang District in January 2017 until April 2017. All respondents both of pretest or posttest were interviewed and examined the Hb values with Hemocue Hb 301 Analyzer. Data analysis with Chi-Square test, Mann Whitney test, Wilcoxon test, and binary logistic regression analysis. The results showed that the group given counseling potentially has 8.1 times (OR = 8.1, 95%, CI = 1.49-44.36) not anemic compared to the group that was not given counseling after controlled by variable age of pregnant mother, education, adherence, consumption patterns of iron tablet with calcium tablets, consumption patterns of iron tablet with foods/beverages that can inhibit iron absorption. Therefore, pharmacist counseling with leaflet media influences minimizing the incidence of anemia in pregnant women at Pagedangan Public Health Center, Tangerang District.

Abstrak :
ABSTRAK
Kehamilan tidak diinginkan memiliki akibat risiko tinggi bagi ibu dan berkontribusi 11% terhadap angka kematian ibu. Berdasarkan data Survei Demografi dan Kesehatan Indonesia (SDKI) 2007, kehamilan tidak diinginkan meningkat menjadi 19,7% dari 16,8% di tahun 2002-2003. Diperlukan pengetahuan alat kontrasepsi modern yang lengkap untuk meningkatkan pemakaian kontrasepsi sehingga dapat menurunkan kehamilan tidak diinginkan. Penelitian ini bertujuan mengetahui hubungan pengetahuan alat kontrasepsi modern dengan kehamilan tidak diinginkan. Penelitian dilakukan pada 1920 wanita hamil dan 484 pasangan usia subur (PUS) sebagai sampel. Sampel PUS merupakan bagian dari sampel wanita, yang pada saat survei, suaminya turut diwawancari. Odds Ratio (OR) diperoleh dengan analisis regresi logistik setelah dilakukan kontrol terhadap umur, umur pertama menikah, pendidikan, tempat tinggal, jumlah anak, paparan informasi alat kontrasepsi dari media massa, petugas KB atau tenaga kesehatan, riwayat pemakaian alat kontrasepsi, dan riwayat aborsi. Diperoleh hasil bahwa pengetahuan alat kontrasepsi modern pada wanita saja tidak berhubungan dengan kehamilan tidak diinginkan. Sedangkan pengetahuan alat kontrasepsi modern berhubungan dengan kehamilan tidak diinginkan pada istri dengan OR 0,37 (95%CI 0,266-0,523), suami dengan OR 0,7 (95%CI 0,430-1,184) dan pasangan dengan OR 0,29 (95%CI 0,151-0,572). Artinya alat kontrasepsi yang diketahui bersama oleh kedua pasangan, istri bersama suami, akan semakin menurunkan risiko terjadinya kehamilan tidak diinginkan.

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ABSTRACT
Unwanted pregnancy has high-risk consequences for mother and contributed 11% to maternal mortality. Based on Indonesia Demographic and Health Survey data in 2007, unwanted pregnancy has increased to 19,7% from 16,8% in 2002-2003. Required knowledge of various modern contraceptives method to increase usage, so unwanted pregnancy can be prevented. This study aims to determine the relationship between contraceptives knowledge with unwanted pregnancy in Indonesia. Samples of this study are 1920 pregnant women and 484 reproductive age couples. Reproductive age couples is a part of pregnant women sample, who at the time of survey, her husband also interviewed. Odds Ratio (OR) obtained by multivariate logistic regression analysis after the adjustment in age, age at first marriage, education, region, number of children, exposed of contraceptives information through mass media, family planning fieldworkers or health workers, ever use contraception, and abortion history. The result indicates that contraceptives knowledge did not significantly associated with unwanted pregnancy in women. While contraceptives knowledge associated with unwanted pregnancy in wives with OR 0,37 (95%CI 0,266-0,523), husband with OR 0,7 (95%CI 0,430-1,184), and couples with OR 0,29 (95%CI 0,151-0,572). The result means contraceptives which known by couples will further reduce the risk of unwanted pregnancy.

Abstrak :
Toksoplasmosis adalah suatu penyakit pada manusia dan hewan yang disebabkan oleh Toxoplasma Gondii. Pada wanita hamil, infeksi akut primer dapat menyebabkan kelainan bawaan; kerusakan jaringan otak janin, kematian fetus dan abortus. Penentuan terjadinya infeksi akut sangat penting karena pengobatan yang dilakukan terutama pada ibu hamil, neonatus dengan toksoplasmosis kongenital dan pasien imunosupresi sangat bermanfaat dan akan mengurangi akibat infeksi. Metoda standar penentuan infeksi akut biasanya dengan pemeriksaan antibodi spesifik IgG dan Igm. IgM merupakan petanda infeksi baru sedangkan lgG petanda infeksi lampau. Tetapi deteksi ini tidak adekuat pada pasien yang imunosupresi karena respon imun terhambat. Peneiitian ini bertujuan untuk mendapatkan metoda diagnosis toksoplasmosis yang lebih sensitif dan dapat menentukan fase akut. Detensi antigen toksoplasma adalah suatu cara yang lebih sensitif dan dapat mendeteksi fase akut.

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LATAR BELAKANG: Infeksi Saluran Reproduksi (ISR) merupakan masalah yang berdampak penting pada wanita hamil. Banyak faktor yang mempengaruhi terjadinya ISR, namun jarang sekali dilakukan penelitian mengenai hal ini. METODE: Dilakukan studi potong lintang dengan analisis kasus kontrol. Subyek ialah wanita hamil, yang tidak mengalami inkompetensia serviks, plasenta praevia, perdarahan per vaginam, ketuban pecah dini, atau karsinoma serviks, yang datang ke Poliklinik Antenatal Bagian Kebidanan dan Kandungan RSUPN Dr. Cipto Mangunkusumo Jakarta Juni-September 1998. Dari duh tubuh vagina dan serviks dibuat sediaan apus dengan pewarnaan Gram, sediaan basah dengan larutan NaCl fisiologis, biakan untuk gonokokus, dan pemeriksaan enzyme immuno assay untuk deteksi infeksi Chlamydia trachomatis. Dari darah vena dilakukan tes serologi sifilis. Analisis data menu unakan cara regresi logistik multinomial. HASIL: Dari 300 wanita hamil yang diperiksa, terdapat 28,4% menderita ISR dengan jenis terbanyak ialah kandidosis vaginalis (15%) , diikuti oleh vaginosis bakterial (9,3%), serta infeksi menular seksual (4%). Duh tubuh vagina bergumpal, dan duh tubuh vagina melekat di dinding berhubungan kuat dengan kandidosis vaginalis dengan berturut-turut odds ratio suaian (OR) 10,4 dengan 95% confidence interval (CI) 2,73 ; 39,59 dan OR suaian 4,05 (95% CI 1,16 ; 14,11) . Umur 17-24 tahun berisiko lebih tinggi mendapat PMS dengan OR suaian 9,91 (95% Cl 1,08 ; 90,68). KESIMPULAN: Pada wanita hamil, lebih dari seperempatnya dapat ditemukan ISR, sehingga perlu dipertimbangkan untuk menjadikan skrining ISR sebagai bagian dari pemeriksaan rutin antenatal. Faktor yang paling berhubungan dengan kejadian kandidosis vaginalis pada wanita hamil ialah duh tubuh bergumpal atau melekat di dinding. Risiko penyakit menular seksual paling tinggi pada kelompok umur 17-24 tahun.

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Risk factors of reproductive tract infection among pregnant women in Antenatal Clinic Dr. Cipto Mangankusumo General HospitalBACKGROUND: Reproductive tract infection (RTI) is an important problem especially for pregnant women. However, factors that can affect the occurrence of this infection are not well known. METHODS: We analyzed data derived from cross-sectional study. Study's subjects were pregnant women, who didn't experience cervix incompetence, placenta praevia, vaginal bleeding, premature rupture of the membrane, or carcinoma of the cervix, visited Antenatal Clinic of Obstetric and Gynecology Department dr. Cipto Mangunkusumo Hospital Jakarta July-September 1998, and the vaginal and cervical discharge were examined with Gram staining and wet mount, gonococcal culture, and for Chlamydia detection with enzyme immuno assay technique. Serology test of syphilis was also done. Data were then analyzed using the polytomous logistic regression. RESULTS: From 300 pregnant women examined, RTI was found in 28,4% with vaginal candidosis being the most prevalent (15%) followed by bacterial vaginosis (9,3%), sexually transmitted infection (4%). The thick and curdy vaginal discharge, and vaginal discharge adhered to vaginal wall were strongly associated with vaginal candidosis with adjusted odds ratio (OR) 10,40 with 95% confidence interval (95% CI) 2,73 ; 39,59 and adjusted OR 4,05 (95% Cl 1,16 ; 14,11) respectively. Pregnant women aged 17-24 years has a higher risk for sexually transmitted diseases with adjusted OR 9,91 (95% Cl 1,08 ; 90,68). CONCLUSION: RTI can be found in more than one-fourth pregnant women visiting antenatal clinic, so it was recommended to screen every pregnant women for RTI. The associated factor of candidosis vaginalis was thick and curdy vaginal discharge or discharge adhered to the vaginal wall The risk of sexually transmitted infection was more prominent among young aged pregnant women.