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"Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) merupakan indikator penting dalam menilai kualitas pelayanan kesehatan. Di Indonesia, kedua angka ini masih jauh dari target SDGs. Salah satu cara menurunkan angka kematian maternal dan neonatal adalah melalui sistem rujukan yang efektif. Penelitian ini bertujuan untuk menggambarkan profil rujukan kasus obstetri serta luaran maternal-neonatal di RSCM selama pandemi COVID-19 pada tahun 2021. Penelitian deskriptif observasional ini menggunakan data rekam medis RSCM tahun 2021. Variabel yang dianalisis meliputi usia, pekerjaan, usia kehamilan, gravida, paritas, asal rujukan, indikasi rujukan, COVID-19, metode persalinan, kontrasepsi, kondisi maternal, neonatal, berat bayi, dan skor APGAR. Mayoritas pasien dirujuk ke RSCM berusia 19–35 tahun, ibu rumah tangga, usia kehamilan 29–36 minggu, multigravida, melahirkan ≤1 anak, dan dirujuk dari FKRTL karena keterbatasan NICU. Sebagian besar melahirkan melalui operasi sesar, menggunakan IUD sebagai metode kontrasepsi, dan berada di ruang rawat inap pasca persalinan. Kondisi neonatal menunjukkan berat lahir 1.500–2.500 gram dan skor APGAR 7–10. Penelitian ini menggambarkan karakteristik ibu yang dirujuk beserta luaran maternal-neonatal dan dapat menjadi referensi untuk penelitian serta perbaikan sistem rujukan di masa depan.

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Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) are key indicators of healthcare quality. In Indonesia, these rates remain far from Sustainable Development Goal (SDG) targets. An effective referral system is essential to reducing maternal and neonatal mortality. During the COVID-19 pandemic, referral cases to higher-level healthcare facilities increased, posing a greater risk of mortality if prompt treatment was not provided. This study aimed to describe the profile of obstetric referral cases and maternal-neonatal outcomes at RSCM during 2021. A descriptive observational method was used to analyze medical records from RSCM, focusing on variables such as age, occupation, gestational age, gravida, parity, referral origin, referral indication, COVID-19 status, maternal condition, delivery method, contraception, neonatal condition, birth weight, and APGAR scores. Most referred patients were aged 19–35, housewives, with a gestational age of 29–36 weeks, multigravida, and having ≤1 child. Referrals predominantly came from secondary or tertiary facilities due to NICU unavailability, and most patients did not have COVID-19. Cesarean section was the common delivery method, and IUD was the preferred contraception. Newborns mostly weighed 1,500–2,500 g, had APGAR scores of 7–10, and required inpatient care. This study highlights the characteristics and outcomes of referred cases, providing insights for improving referral systems and future research."

"Latar belakang:. Data tahun 2007 menunjukkan prevalensi perempuan dewasa dengan obesitas di Indonesia 13,9% dan terus mengalami peningkatan, yaitu 15,5% pada 2010 dan 32,9% pada 2013. The Royal College of Obstetricians and Gynaecologists (RCOG) mendefinisikan obesitas dalam kehamilan sebagai indeks massa tubuh (IMT) >30 kg/m2 pada kunjungan antenatal pertama. Risiko kehamilan terkait berat badan berlebih dan obesitas diantaranya adalah peningkatan risiko hipertensi dalam kehamilan (termasuk preeklampsia), tromboemboli, dan diabetes melitus gestasional. Peningkatan lama persalinan dan peningkatan risiko seksio sesaria juga diketahui terkait dengan berat badan berlebih dan obesitas. Obesitas dalam kehamilan juga meningkatan risiko janin makrosomi, kematian dalam kandungan, dan malformasi kongenital. Tujuan: a. Diketahuinya luaran maternal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. b. Diketahuinya luaran perinatal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. c. Diketahuinya kualitas Asuhan Antenatal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. c. Diketahuinya pandangan tenaga kesehatan terhadap ibu hamil dengan berat badan berlebih dan obesitas, d. Diketahuinya pandangan ibu hamil , serta keluarga terhadap kehamilan dengan berat badan berlebih dan obesitas Metode: Dilakukan studi kuantitatif dan kualitatif pada kasus ibu hamil dengan berat badan berlebih dan obesitas yang bersalin RSCM tahun 2015-2019. Pengambilan data kuantitatif dilakukan dengan telaah rekam medis dan kelengkapan pengisian buku KIA secara umum, dimana akan dilihat untuk luaran maternal, perinatal serta edukasi ANC yang berhubungan dengan kehamilan dengan berat badan berlebih dan obesitas. Pengambilan data kualitatif dilakukan dengan wawancara mengenai pemahaman ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM dan tenaga kesehatan pemberi pelayanan asuhan antenatal di fasyankes asal asuhan antenatal serta keluarga Hasil: Terdapat 509 kasus ibu hamil dengan obesitas dan berat badan berlebih yang bersalin di RSCM selama tahun 2015-2019, Dari 509 subjek, diketahui 189 subjek (37,1%) mengalami obesitas dan 320 subjek (62,9%) mengalami berat badan berlebih. Berdasarkan data tersebut, didapatkan insidensi obesitas dan berat badan berlebih persalinan di RSCM periode tahun 2015-2019 masing-masing sebesar 4,28% dan 2,53%.Luaran maternal ibu dengan obesitas dan berat badan berlebih yang bersalin di RSCM, ditemukan morbiditas persalinan prematur, ketuban pecah dini, dan preeklampsia, dengan jumlah masing-masing 249 (48.9%), 133 (26.1%), dan 121 (23.8%). Luaran Perinatal luaran perinatal patologis yang paling sering dijumpai adalah asfiksia, IUGR, dan IUFD, dengan jumlah masing-masing sebanyak 113 (22.2%), 46 (9.0%), 31 (6.1%). Luaran cara persalinan Mayoritas subjek melahirkan dengan cara seksio sesarea dan pervaginam, dengan jumlah masing-masing 345 (67.8%) dan 154 (30.2%) orang. Secara kualitatif, didapatkan pandangan ibu hamil dengan obesitas dan berat badan berlebih yang bersalin di RSCM dan tenaga kesehatan pemberi asuhan antenatal serta keluraga masih kurang tepat Kesimpulan: Secara kuantitatif dan kualitatif Terjadi kegagalan Identifikasi Kehamilan dengan berat badan berlebih dan obesitas pada kasus-kasus yang dirujuk ke RSCM pada saat dilakukan ANC di faskes primer
. Kata kunci: Luaran maternal dan perinatal. Pandangan Ibu hamil dengan berat badan berlebih dan obesitas, tenaga kesehatan, keluarga, Asuhan antenatal

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Background: Data shows in 2007 the prevalence of obese adult women in Indonesia is 13.9% and continues to increase, namely 15.5% in 2010 and 32.9% in 2013. The Royal College of Obstetricians and Gynecologists (RCOG) defines obesity in pregnancy as body mass index (BMI) >30 kg/m2 at the first antenatal visit. Obesity-related pregnancy risks include an increased risk of hypertension in pregnancy (including preeclampsia), thromboembolism, and gestational diabetes mellitus. Increased length of labor and increased risk of cesarean section are also known to be associated with obesity. Obesity in pregnancy also increases the risk of fetal macrosomy, stillbirth, and congenital malformations Aim: (1) To determine the maternal outcomes in overweight and obese pregnant women who give birth in RSCM. b. To determine perinatal outcomes in overweight and obese pregnant women who give birth in RSCM. c. To know the quality of Antenatal Care in pregnant women with overweight and obesity who gave birth in RSCM. c. To determine the views of health workers on pregnant women with excess weight and obesity, d. To determine the views of pregnant women, as well as their families towards overweight and obesity pregnancies Method: A set of Quantitative and qualitative studies were conducted on cases of overweight and obese pregnant women who gave birth to RSCM in 2015-2019. Quantitative data retrieval was carried out by reviewing medical records and the completeness of filling out the ANC book in general which to see for maternal, perinatal and ANC education related to pregnancy with overweight and obesity. Qualitative data was collected by deep interviewing about the understanding of pregnant women with excess weight and obesity who gave birth at the RSCM and health workers who provide antenatal care services in health facilities from antenatal care and families. Result: There were 509 cases of pregnant women with obesity and overweight who gave birth at the RSCM during 2015-2019. From 509 subjects, 189 subjects (37.1%) were obese and 320 subjects (62.9%) were overweight. Based on these data, the incidence of overweight and obesity in labor at the RSCM for the 2015-2019 period was 4.28% and 2.53%, respectively. preterm, premature rupture of membranes, and preeclampsia, with a total of 249 (48.9%), 133 (26.1%), and 121 (23.8%). Perinatal Outcomes The most common pathological perinatal outcomes were asphyxia, IUGR, and IUFD, with a total of 113 (22.2%), 46 (9.0%), 31 (6.1%). Outcomes of mode of delivery The majority of subjects gave birth by caesarean section and vaginally, with a total of 345 (67.8%) and 154 (30.2%) people, respectively. Qualitatively, it was found that the views of pregnant women with obesity and overweight who gave birth at the RSCM and health workers who provided antenatal care and their families were still inaccurate. Conclusion : Quantitatively and qualitatively there was a failure to identify pregnancies with excess weight and obesity in cases referred to the RSCM at the time of ANC at primary health facilities. Keyword: Maternal and perinatal outcomes. Views of pregnant women with excess weight and obesity, health workers, families, antenatal care"