Faktor–Faktor yang Mempengaruhi Kunjungan Nifas Lengkap di Indonesia: Analisis Lanjut Data Riskesdas 2018

Abstrak Latar Belakang: Perawatan nifas dibutuhkan pada periode setelah persalinan untuk mendeteksi dini masalah atau mengobati penyakit pascapersalinan. Lebih dari 65% kematian ibu terjadi selama 42 hari pertama pascapersalinan. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang mempengaruhi kunjungan nifas lengkap di Indonesia. Metode: Penelitian menggunakan data Riset Kesehatan Dasar (Riskesdas) 2018. Unit analisis penelitian ini adalah ibu yang melahirkan anak terakhir dalam kurun 2013 sampai wawancara Riskesdas 2018. Hasil: Berdasarkan hasil regresi logistik, faktor predisposisi yang memiliki peluang untuk mempengaruhi kunjungan nifas lengkap adalah umur ibu 20-35 tahun (OR 0,885), pendidikan tinggi (OR 1,167), paritas ≤ 2(OR 1,090), persalinan secara sesar/vacuum/forceps, dll (OR 1,491), persalinan di fasilitas kesehatan (OR 1,489), pemeriksaan kehamilan lengkap (OR 1,613), dan regional Sumatera (OR 0,510). Faktor pemungkin yang memiliki peluang untuk mempengaruhi kunjungan nifas lengkap adalah status tidak bekerja (OR 0,954) dan memiliki jaminan kesehatan (OR 1,141). Faktor kebutuhan yang memiliki peluang untuk mempengaruhi kunjungan nifas lengkap adalah memiliki riwayat komplikasi kehamilan (OR 0,948). Kesimpulan: Faktor-faktor yang mempengaruhi kunjungan nifas lengkap adalah umur ibu, pendidikan, paritas, metode persalinan, tempat persalinan, pemeriksaan kehamilan, regional tempat tinggal, status pekerjaan, kepemilikan jaminan kesehatan, dan riwayat komplikasi kehamilan. The Determinants of Fully Postpartum Visit in Indonesia: Further Analysis of Riskesdas 2018 Abstract Background: Post-natal care is needed during postpartum for early detection or to cure disease or any problem of postpartum. More than 60% of maternal mortality happens during 42 days of postpartum. This research is intended to analyse the determinant factors of fully postpartum visit in Indonesia. Method: This research uses the data from Riskesdas 2018. The unit of analytic research is mothers having last birth happened from 2013 until Riskesdas interview on 2018. Result: Based on the result of logistic regression, predisposition factors that have chance to affect the fully postpartum visit are mothers on age 20-35 years old (OR 0,885), advance education (OR 1,167), parity ≤2 (OR 1,090), laboring through caesar, vacuum, forceps et all (OR 1,491), labor using medical facility (OR 1,489), fully pregnancy checkup (OR 1,613) and region Sumatera (OR 0,510). Enabling factors that have chance to affect the fully postpartum visit are unemployment (OR 0,954) and owning health insurance (OR 1,141). Need factor that has chance to affect fully postpartum visit is having history of pregnancy complications (OR 0,948). Conclusion: The factors affecting fully postpartum visit are age, education, parity, labor method, place of labor, pregnancy checkup and region of province, job status, health insurance ownership and history of pregnancy complication.

Hubungan Antara Perubahan TitiK B Anterior (BA) dengan Berat Badan Lahir Bayi pada Persalinan Normal

Background : Pelvic organ prolapse (POP), also known as urogenital prolapse, is a decrease in pelvic organs which causes protrusion of the vagina, uterus or both. Determination of POP is seen from anterior vaginal wall prolapse (cystocele), uteri (urethrocele) and posterior vaginal wall (rectocele). In identifying the incidence of POP can be seen by knowing anatomic abnormalities, especially cytoceles, based on the degree measured by the Prevalence Organ Prolapse Quantification (POPQ) system. In the cystocele the POPQ assessment is focused on the anterior B point (Ba), which is the point that is in the anterior vaginal wall, between the Aa point and the anterior fornix.Objectives : determine the relationship between changes in anterior point B with the birth weight of infants in normal labor. Method: This study was conducted with a cross sectional comparative study method in the obgin polyclinic Prof. dr. Hanafiah Batusangkar from September to December 2017. The number of samples was 74 people with 37 people in the group with an anterior point B change> 3 cm and 37 people in the group with an anterior point B change <3 cm. Data analysis using SPSS version 22, theresults of statistical tests were significant if p <0.05.Results: There was a relationship between age (p = 0.041) and parity (p = 0.047) with changes in anterior B point (BA) in normal labor and women who gave birth to birth weight. 3500 gram babies had 2.7 times the chance to experience changes in anterior B points (BA) of> 3 cm.Conclusion: this study is that there is a relationship between birth weight of babies with anterior point B changes. Keywords: Pelvic Organ Prolap, Prevalence Organ Prolapse Quantification (POPQ), Anterior Point B

Applying best practices to pregnant women in the obstetric center

ABSTRACT Objective: To identify the meaning attributed by nursing technicians to good care practices based on scientific evidence used with the pregnant women during the dilation stage of labor. Method: A qualitative study, based on Grounded Theory principles. Twelve interviews with nursing technicians attending labor in the obstetric center of two public hospitals, in Florianópolis/SC, were performed, from August of 2016 to March of 2017. Data were analyzed using open, axial coding. Results: The implementation of good practices, for nursing technicians, means adequately performing their activities, providing humanized care to the pregnant woman, respecting her autonomy, promoting pain relief, and a peaceful labor. Final Considerations: An adequate number of technicians must be determined to maintain quality of care, and to complete nursing records in a more detailed and systematized manner.

Aromaterapia para alívio da dor durante o trabalho de parto

RESUMOObjetivo: analisar a utilização da aromaterapia no alívio da dor durante o trabalho de parto. Método: trata-se de um estudo bibliográfico, descritivo, do tipo revisão integrativa no período de 2000 a 2017, nas bases de dados MEDLINE, LILACS e BDENF. Analisaram-se os estudos a partir de uma leitura exploratória dos artigos e apresentaram-se os resultados de forma descritiva em figuras. Consideraram-se as categorias temáticas que emergiram da Técnica de Análise de Conteúdo após a análise dos artigos. Resultados: observou-se nos estudos selecionados que a aromaterapia possui um leque de variedades com properiedades específicas e que é um método excelente para o alívio da dor e/ou diminuição da ansiedade e medo, como também no auxílio da contração e redução do tempo de trabalho de parto. Conclusão: recomenda-se a ampliação de conhecimento referente aos benefícios da aromaterapia por parte dos profissionais que estão ligados a assistência obstétrica, principalmente o profissional de enfermagem por está no acompanhamento contínuo da mulher em trabalho de parto. Destaca-se também, a necessidade de novos estudos que reconheçam outros tipos de métodos não farmacológicos. Descritores: Enfermagem Obstétrica; Atenção Integral à Saúde da Mulher; Aromaterapia; Medicina Tradicional; Dor do Parto; Trabalho de Parto.ABSTRACT Objective: to analyze the use of aromatherapy in pain relief during labor. Method: this is a bibliographic, descriptive, integrative review study in the period from 2000 to 2017, in databases MEDLINE, LILACS, and BDENF. The studies were analyzed from an exploratory reading of articles and the results were descriptively presented in figures. Thematic categories emerged from the Content Analysis Technique after analyzing the articles. Results: the studies selected showed that aromatherapy has a range of varieties with specific properiedades and is an excellent method for the pain relief and/or decreasing anxiety and fear, as well as aids in the contraction and reduction of labor time. Conclusion: there should be expansion of the knowledge concerning the benefits of aromatherapy by professionals related to obstetric care, especially the nursing professional, who is part of the continuous monitoring of the woman in labor. There is also need for further studies that recognize other types of non-pharmacological methods. Descritores: Obstetric Nursing; Comprehensive Women’s Health Care; Aromatherapy; Traditional Medicine; Labor Pain; Labor.RESUMEN Objetivo: analizar el uso de la aromaterapia en el alivio del dolor durante el trabajo de parto. Método: este es un estudio bibliográfico, descriptivo, del tipo revisión integradora en el período de 2000 a 2017, en las bases de datos MEDLINE, LILACS y BDENF. Se analizaron los estudios desde una lectura exploratoria de los artículos y se presentaron los resultados de forma descriptiva en figuras. Se consideraron las categorías temáticas que surgieron a partir de la técnica de análisis de contenido, después del análisis de los artículos. Resultados: se observó en los estudios seleccionados que la aromaterapia tiene una amplia gama de variedades con properiedades específicos y que es un excelente método para el alivio del dolor y/o la disminución de la ansiedad y el temor, así como ayuda en la contracción y la reducción del tiempo de trabajo de parto. Conclusión: se recomienda la ampliación de los conocimientos acerca de los beneficios de la aromaterapia por los profesionales que están relacionados con la atención obstétrica, especialmente al profesional de enfermería por la continua vigilancia de la mujer en el trabajo. También se destaca la necesidad de más estudios que reconocen otros tipos de métodos no farmacológicos. Descritores: Enfermería Obstétrica; Atención Integral de Salud; Aromaterapia; Medicina Tradicional; Dolor de Parto; Trabajo de Parto.

EFFECTIVENESS OF AURICULAR THERAPY ON LABOR PAIN: A RANDOMIZED CLINICAL TRIAL

ABSTRACT Objective: to evaluate the effectiveness of auricular therapy on pain in the active phase of labor. Method: a randomized, parallel and triple-blind clinical trial, conducted from April 2015 to June 2016. A total of 102 pregnant women with a gestational age ≥37 weeks, cervical dilatation ≥4 cm and two or more contractions within 10 minutes, randomly divided into three groups: intervention (auricular therapy), placebo (sham points) and control (without intervention). Auricular therapy was applied with crystal microspheres in four strategic points and pain intensity evaluated by a Visual and Analog Scale. For the analyses, the following tests were used: Kruskal-Wallis and Generalized estimating equations. Results: pain intensity averages were similar at admission (intervention: 7.2±1.6 vs placebo: 6.9±2.4 vs control: 7.5±1.8; p-value=0.4475), but with 60 minutes (intervention: 6.8±1.9 vs placebo: 7.5±2.4 vs control: 8.3±1.8; p=0.0060) and 120 minutes (intervention: 7.1±1.9 vs placebo: 8.0±2.4 vs control: 8.8±1.9; p-value=0.039), there was a significant increase in pain scores between parturients of the placebo and control groups. Conclusion: parturients who received auricular therapy during labor showed a reduction in pain intensity, which may characterize the effectiveness of the therapy in this phase. Registration: No. RBR-47hhbj.

Effectiveness of auriculotherapy on anxiety during labor: a randomized clinical trial

ABSTRACT Objective: to evaluate the effectiveness of auriculotherapy on the anxiety of women during labor. Method: this is a randomized, parallel, triple-blind clinical trial. 102 parturients with gestational age ≥ 37 weeks, cervical dilatation ≥ 4 cm and two or more contractions in 10 min were selected and randomly assigned into three groups to receive auriculotherapy, placebo or control (routine care). Auriculotherapy was applied with crystal microspheres to the shenmen, uterus, neurasthenia area and endocrine points, and anxiety was assessed by the Hamilton Anxiety Rating Scale (HAM-A). Analyzes were performed using the Kruskal-Wallis, Generalized estimating equations, Chi-square and Fisher’s exact tests. Results: the groups showed no significant difference at baseline according to the HAM-A. After the intervention there was a significant increase in HAM-A scores at 120 min in the placebo versus auriculotherapy group (mean difference (MD) 3.62, confidence interval (CI) 0.42-6.81, p=0.0265) and control versus auriculotherapy group (MD 4.88, CI 1.87-7.88, p=0.0015). Conclusion: the parturients with auriculotherapy presented lower levels of anxiety according to the HAM-A score after the treatment when compared to the women from the other groups; this can represent alternative care in obstetric practice. Registration: n. RBR-47hhbj.

PAINLESS DELIVERY

One of the most severe pain that a woman experiences in her lifetime is laborpain which leads to increase their desire to perform caesarean section. In the present study weassessed the attitudes and awareness of obstetricians and midwives by raising their knowledgeand skills, to increase the rate of vaginal delivery and reduce the cesarean. Methods: StudyDesign: Qualitative study. Setting: Obstetricians and Midwives from throughout the ShirazCity, South of Iran, were participated by completing the questionnaire. Period: 6 months in2015. Statistical analysis was performed using the SPSS software, version 20.0. The resultswere presented as frequency (percentage). Results: 118 individuals including 25 (21%)Obstetricians and 93 (79%) Midwives were participated in the current study. Both obstetriciansand midwives preferred normal vaginal delivery (NVD) (83.9%). 91% of subjects believed thatthe reason of preference of NVD is the safety of mother and child. 34.7% of individuals wasfully aware of painless labor. 21.2% had average information. Most of the subjects was agreedwith the painless labor method (92.4%) and 4.2% was disagreed. Lack of pain and calmnessduring labor (62.2%) and reduction of fear of natural childbirth (50.5%) were the main reasonsof agreements. 85.2% of obstetrics and midwives believed that the number of painless labor inIran in comparison to international standards is less than desired. Conclusions: Although themajority of obstetricians and midwives were agreed with the painless labor in hospitals, almosthalf of them were aware of the painless delivery. Raising the knowledge of health care providersabout painless delivery can influence on awareness and attitude of them and parturient towardnormal vaginal delivery.

The Effectiveness of Dhikr Toward Decreasing Anxiety and Labor Pain During Active Phase of First Stage among Primigravida

Introduction: Childbirth is an event that causes stress to the mother. Anxiety and pain during labor, if not handled properly will disrupt the process of birth. Interventions to do is dhikr to God. The purpose of this study was to determine the effectiveness of dhikr to reduce anxiety and pain during the active phase of labor. Method: The study used a quasiexperimental design involving control groups were measured pretest and posttest. The samples were 40 moeslem primigravida with 37–42 weeks gestation and cervical dilation > 3 cm were taken by purposive sampling. Data was collected using a questionnaire (Taylor Manifest Anxiety Scale) and observation of labor pain (Visual Analog Scale) per hour. Multivariate data analysis using ANOVA test at α = 0.05. Results: This study showed that dhikr was effective to reduce the level of anxiety during labor in primigravida (59.8%). The average score of maternal anxiety and pain felt by mothers during childbirth have decreased, with a value of p = 0.001. Analysis and discussion: Primigravida who did dhikr tend to experience mild anxiety during delivery process, while primigravida who did not perform dhikr is likely to experience more severe anxiety. Dhikr is also effective in reducing labor pain during the active phase of labor.Keywords: birth, nursing, dhikr, anxiety, pain

Comparison of intramyometrial and intramuscular 15 methyl PGF2? against traditional prophylactic intramuscular methergin for the active management of third stage of labor

Objective: To compare intramyometrial, intramuscular (I M) 15 methyl PGF2α with IM Methergin on the duration and blood loss of 3rd and 4th stage of labor. Method: Prospective randomized control study, done from May 2004 to June 2005. Three hundred parturient women were randomly assigned to receive either an intramyometrial or IM 15 methyl PGF2α or IM methergin immediately after delivery of baby. Duration of 3rd stage and blood loss during 3rd and 4th stage of labor was measured. Other parameters measured were – presence of atonic postpartum hemorrhage (PPH), need for MRP, and blood transfusion, any side effects of drugs. Results: Women who received prophylactic intramyometrial PGF2α had significantly shorter duration of 3rd stage of labor (2.3 + 0.66 mins: p= 0.0000) compared to both IM group ( 3.04+1.03 mins) and IM methergin group ( 4.22+ 1.58 mins) and also significantly less blood loss ( median- 110ml; P= 0.0002) compare to both IM group (median-145ml) and IM methergin group( medin-197ml). Conclusion: Intramyometrial PGF2α is better than IM PGF2α and methergin in terms of reducing duration of 3rd stage and blood loss. Thus can be prophylactically used especially in those patients where even minimal blood loss will adversely affect the health of mother. DOI: http://dx.doi.org/10.3126/njog.v3i2.10829 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 35-39

The Study of Cassava Root Conveying Equipment Attached to a Truck

The objective of this study was for development of cassava transporting equipment installed on a truck. The study process was divided into 2 steps: 1) The study of cassava harvesting and transporting to the truck pattern by farmers practice today and 2) preliminary study of transporting cassava by using additional conveying device in order to reduce time and labor for the overall harvest system. Results in step 1 indicated that the pattern of cassava harvesting consisted of four main steps : tillage, heap compiling, stem cutting and cassava transporting to the truck. The most time consuming step was the transporting of cassava to the truck. The cassavas transporting to the plant normally had to be completed within one day. The consequently, cassava transporting was considered to be the bottle-neck problem of cassava harvest system. Result from the study in step 2, which was preliminary study of using a conveying device attached to the truck to reduce time and labor indicated that a working capacity of 1.44 rai/hour was obtained, being 3.13 time higher than the usual manual labor method.