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Neurodevelopment and Fetal Growth in Fetuses with Congenital Heart Disease 先天性心脏病胎儿的神经发育和胎儿生长
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1751
Adhi Pribadi
Objective: To determine mechanisms underlying fetal growth abnormalities, particularly intrauterine neurodevelopment, in congenital heart defects. Method: Literature Review Results: Since intrauterine, smart mechanisms have ensured that blood flow to the central nervous system remains smooth to maintain Neurodevelopment. The mechanism fluctuates to keep oxygen flowing to the brain. Blood with the highest oxygen content should always be pumped to upper body and the head via the heart and the aorta. Aortic arch region contains three major blood vessels, a.Brachiocephalic, a.Carotid communis, and a.Subclavia that bleed the upper body and head, including the brain. So, blood flow from the left heart through the aortic arch is critical for fetal brain growth. If the heart cannot drain blood to the head, brain growth will be jeopardized because hypoxia will interfere with brain growth so will be influence to Neurodevelopment. Impaired blood flow can occur as early as intrauterine, particularly if the fetus has congenital heart disease. Blood flow in the Middle Cerebral Artery (MCA) can be used to measure blood flow in the fetus head. The pulsatility index value can be used to measure blood flow in the MCA, and another parameter is the cardioplacental ratio. There is a decrease in flow to the head in congenital heart disease, which results in a decrease in the Pulsatily index of the MCA and a decrease in the cardioplacental ratio. Conclusions: Prolonged reduction in cardiac-derived blood flow leads to compromised neurodevelopment. Consequently, timely correction of postpartum heart defects becomes paramount to prevent protracted impairments in brain growth. Failing to address this promptly could also diminish the overall quality of life for children afflicted by congenital heart disease. Keyword: cardioplacental ratio, middle cerebral artery, congenital heart disease, fetal neurodevelopment. Keyword: cardioplacental ratio, cerebral media artery, congenital heart disease, fetal neurodevelopment.   Abstrak Tujuan: Untuk menentukan mekanisme kelainan pertumbuhan janin terutama perkembangan saraf intrauterin pada cacat jantung bawaan. Metode: Kajian Pustaka Hasil: Pada kehidupan intrauterin, mekanisme yang baik telah memastikan bahwa aliran darah ke sistem saraf pusat tetap lancar untuk mempertahankan perkembangan saraf. Mekanisme ini berfluktuasi untuk menjaga oksigen tetap mengalir ke otak. Darah dengan kandungan oksigen tertinggi harus selalu dipompa ke otak melalui jantung dan arteri utama ke kepala melalui a.Brachiocephalic, a.Carotid communis, dan a.Subclavia. Pada daerah arkus aorta terdapat tiga pembuluh darah utama yang memperdarahi tubuh bagian atas dan kepala, termasuk otak. Aliran darah ini dipompa melalui jantung kiri melalui arkus aorta. Bila jantung tidak dapat mengalirkan darah ke kepala, maka akan menyebabkan pertumbuhan otak terancam karena hipoksia akan mengganggu pertumbuhan otak, sehingga secara jangka panjang akan berpengaruh
研究目的确定先天性心脏缺陷胎儿发育异常,尤其是宫内神经发育异常的机制。 方法: 文献综述文献综述 结果:从宫内开始,智能机制就确保了中枢神经系统的血流保持顺畅,以维持神经发育。该机制不断波动,以保持氧气流向大脑。含氧量最高的血液应始终通过心脏和主动脉输送到上半身和头部。主动脉弓区域包含三条主要血管,即肱动脉、颈总动脉和锁骨下动脉,它们流向包括大脑在内的上半身和头部。因此,从左心流经主动脉弓的血液对胎儿大脑的生长至关重要。如果心脏不能将血液排到头部,大脑的生长就会受到影响,因为缺氧会干扰大脑的生长,从而影响神经发育。血流受损最早可发生在宫内,尤其是在胎儿患有先天性心脏病的情况下。大脑中动脉(MCA)的血流量可用于测量胎儿头部的血流量。搏动指数值可用于测量大脑中动脉的血流量,另一个参数是心胸比。先天性心脏病患者流向头部的血流量会减少,从而导致 MCA 的搏动指数和心胸比值下降。 结论心源性血流的长期减少会导致神经发育受损。因此,及时纠正产后心脏缺陷对防止大脑发育长期受损至关重要。如果不能及时解决这一问题,也会降低先天性心脏病患儿的整体生活质量。 关键词:心胸比例、大脑中动脉、先天性心脏病、胎儿神经发育。 关键词:心胸比、大脑中动脉、先天性心脏病、胎儿神经发育。 Abstrak Tujuan:了解先天性心脏病胎儿宫内发育状况。 方法:Kajian Pustaka Hasil:在宫内避孕方面,宫内避孕系统中的所有细胞都会被激活,以提高宫内避孕的成功率。该系统可帮助人们了解自己的兴趣爱好,并将这些兴趣爱好传递给他人。在脑动脉、颈总动脉和锁骨下动脉的周围,会有大量的动脉瘤形成。在主动脉的周围,有大量的主动脉,这些主动脉会在周围和颈部形成 "小动脉"。主动脉瘤的治疗需要在主动脉上进行手术。在这种情况下,胎儿的髋关节可能会对胎儿的髋关节造成损伤,从而导致胎儿畸形。在怀孕期间,胎儿的生长发育会受到影响。Arteri Serebri Media (MCA) 公司的 "烛光晚餐"(Aliran Darah)可在家庭食谱中添加 "烛光晚餐"。MCA的搏动指数只有一个,其参数为心血管瓣膜。在心肌梗塞的关键部位测量心律失常,可以测量心肌梗塞的脉搏指数,也可以测量心肌病变。 研究结果:如果在长期工作中出现心肌梗塞的情况,那么就需要对心肌梗塞患者进行治疗。在这期间,我们将继续通过 "膳食计划 "来帮助那些需要帮助的人。 相关信息:中枢动脉、心肌梗塞、心肌炎、心肌病。
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引用次数: 0
The Role of Social Obstetrics and Gynecology in the Coverage of Cervical Cancer Screening in the Era of Health Transformation in Indonesia 印度尼西亚卫生改革时代社会妇产科在宫颈癌筛查覆盖率中的作用
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.2181
J. Indarti
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引用次数: 0
Infertile Couple and Pregnancy Outcomes for Patients Undergoing a Pregnancy Program in the Rural Area of Nagekeo District, Flores, East Nusa Tenggara 东努沙登加拉弗洛勒斯岛纳吉科区农村地区不育夫妇和接受怀孕计划患者的怀孕结果
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1921
Chatarina L. S. D. Dando, Angga Dominius, Jacob T. Salean
Objective: To elucidate the characteristics of infertile couples residing in the rural area of Nagekeo Regency and assess the outcomes of their participation in the local pregnancy program. Methods: We conducted a descriptive study at Aeramo Regional General Hospital (RGH) in Nagekeo Regency, Flores, East Nusa Tenggara (ENT), utilizing a total sampling technique from January 2020 to April 2022. A total of 56 couples participated in this study. Results: The analysis revealed that infertile couples at Aeramo RGH were typically aged between 23 and 35 years, with an average infertility duration exceeding 4 years. Primary infertility was the predominant condition (89.3%), with 55.4% of male partners exhibiting obesity. A significant number of male participants reported alcohol and cigarette consumption. Data were insufficient to determine the prevalence of infertility in men versus women. Notably, the outcomes of the pregnancy program in this region did not demonstrate significant improvements. Conclusions: This study identified potential risk factors such as smoking, alcohol consumption, and obesity that may contribute to infertility; however, it did not establish a strong correlation between these factors and infertility. Moreover, the pregnancy program's outcomes were inconclusive, likely due to limited diagnostic and treatment resources in the area. Keyword: infertility characteristics, pregnancy program,  pregnancy outcomes.       Abstrak Tujuan : Mendeskripsikan karakteristik pasangan infertil di Kabupaten Nagekeo serta mengetahui hasil luaran kehamilan bagi pasangan yang mengikuti program kehamilan di daerah tersebut. Metode : Penelitian ini merupakan penelitian deskriptif yang dilakukan di Rumah Sakit Umum Daerah (RSUD) Aeramo, Kabupaten Nagekeo, Flores, Nusa Tenggara Timur. Dengan menggunakan teknik total sampling pada periode Januari 2020 - April 2022, terdapat 56 pasangan yang bergabung dalam penelitian ini. Hasil : Hasil penelitian kemudian dianalisis secara univariat dan didapatkan usia pasangan infertil di Aeramo RGH adalah antara 23 - 35 tahun dengan durasi infertilitas lebih dari 4 tahun. Infertilitas primer dan obesitas pada pria mendominasi masing-masing kelompok yaitu 89,3% dan 55,4%. Mayoritas pria mengonsumsi alkohol dan rokok. Tidak ditemukan data yang cukup untuk menentukan apakah infertilitas terjadi pada pria atau wanita. Hasil dari program kehamilan yang dilakukan di daerah ini belum menunjukkan hasil yang signifikan. Kesimpulan : Karakteristik yang memicu faktor risiko seperti merokok, mengkonsumsi alkohol dan obesitas. Meskipun pada penelitian ini belum didapatkan korelasi yang kuat dari faktor risiko tersebut pada infertilitas. Hasil dari program kehamilan belum menunjukkan hasil yang signifikan karena modalitas diagnostik dan pengobatan yang sangat terbatas. Kata kunci : karakteristik infertilitas, luaran kehamilan,  program hamil.
目的:阐明居住在纳吉科地区农村的不孕夫妇的特征,并评估他们参与当地怀孕计划的结果。 研究方法2020年1月至2022年4月,我们在东努沙登加拉(ENT)弗洛里斯(Flores)Nagekeo地区的Aeramo地区综合医院(RGH)采用总体抽样技术进行了一项描述性研究。共有56对夫妇参与了此次研究。 研究结果分析结果显示,爱拉莫区域医院的不孕夫妇年龄一般在23至35岁之间,平均不孕时间超过4年。原发性不孕是主要病症(89.3%),55.4%的男性伴侣有肥胖症。相当多的男性参与者表示酗酒和吸烟。由于数据不足,无法确定男性与女性不孕症的发病率。值得注意的是,该地区怀孕计划的结果并未显示出明显改善。 结论:这项研究发现了吸烟、饮酒和肥胖等可能导致不孕不育的潜在风险因素,但并没有确定这些因素与不孕不育之间存在密切联系。此外,由于该地区的诊断和治疗资源有限,妊娠计划的结果也不确定。 关键词:不孕不育特征;妊娠计划;妊娠结果。 摘要 目的描述纳吉科地区不孕夫妇的特征,并确定参加该地区怀孕计划的夫妇的怀孕结果。 研究方法本研究是一项描述性研究,在东努沙登加拉省弗洛勒斯市纳格克奥县的爱拉莫地区综合医院(RSUD)进行。在 2020 年 1 月至 2022 年 4 月期间,采用总体抽样技术,共有 56 对夫妇参加了本研究。 研究结果对研究结果进行单变量分析后发现,在爱拉莫生殖健康中心就诊的不孕不育夫妇年龄在23-35岁之间,不孕不育时间超过4年。男性原发性不育和肥胖在各组中占多数,分别为 89.3%和 55.4%。大多数男性饮酒和吸烟。没有足够的数据来确定不孕症是发生在男性还是女性身上。在这一领域开展的怀孕计划并未取得显著效果。 结论引发吸烟、饮酒和肥胖等风险因素的特征。尽管在这项研究中,这些风险因素与不孕症之间并没有很强的相关性。由于诊断和治疗方式非常有限,怀孕计划的结果并未显示出显著的效果。 关键词:不孕不育特征、妊娠结果、妊娠计划。
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引用次数: 0
Partum Mothers' Experience Regarding Support during the COVID-19 Pandemic 产妇在 COVID-19 大流行期间获得支持的经验
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1876
Ria H. Sari, Farida Kartini, Menik S. Daryanti
Objective: This study aims to investigate the experiences of mothers giving birth with regard to family support and the assistance of health workers during the COVID-19 pandemic. Methods: A descriptive phenomenological approach was employed for this research, following the framework standards for reporting qualitative research (SRQR). Thirteen individuals participated in the study, comprising seven mothers giving birth, three husbands, two midwives, and one parent. The research was conducted at the Mlati II Health Center in Sleman Regency, specifically in Cabakan Hamlet, Sumberadi, Kec. Mlati, Kab. Sleman, Special Region of Yogyakarta, during January-February 2022. The choice of location was based on specific criteria set by the researchers. Data collection took place online due to practical reasons, with informants being contacted to choose between online or offline interviews. Purposive sampling was used for informant selection, and in-depth interviews lasting approximately one hour each were conducted via WhatsApp, Zoom, or phone calls, with prior agreement from the informants. The interviews followed a semi-structured format. Results: Two main themes emerged from the data analysis: the emotional experiences of mothers during labor and their various needs. The COVID-19 pandemic had a significant impact, leading to feelings of anxiety, fear, tension, and the need for comfort and confidence. These psychological needs were categorized into verbal support, including encouragement, communication, and reassurance, as well as tactile support, involving gestures such as stroking, holding, and back rubs. Mothers also expressed spiritual needs, such as prayer and maintaining positive thoughts for a smooth delivery and the health of the baby. Nutritional needs, encompassing healthy and balanced eating, were identified as essential during childbirth. Support from husbands, family members, and health workers played a crucial role in reassuring mothers and educating them about COVID-19 prevention, contributing to a positive birthing experience. Conclusion: The provision of positive support during childbirth can facilitate a normal delivery and instill confidence in mothers. Keywords: childbirth, covid-19 pandemic, experience, maternity, support.                                                                     Abstrak Tujuan: Untuk mengetahui pengalaman ibu bersalin mengenai dukungan keluarga dan tenaga kesehatan selama pandemi covid-19. Metode: Desain penelitian ini menggunakan pendekatan fenomenologi deskriptif sehingga untuk melengkapi pelaporan menggunakan framework standards for reporting qualitative research a synthesis of recommendations (SRQR). Jumlah informan yang digunakan dalam penelitian ini yaitu 13 orang, yang terdiri dari 7 ibu bersalin, 3 suami, 2 bidan dan 1 orang tua. Penelitian ini dilakukan di Puskesmas Mlati II di Kabupaten Sleman, di Dusun Cabakan, Sumberadi, Kec. Mlati, Kab. Sleman Daerah Istimewa Yogyakarta. Penelitian ini
研究目的本研究旨在调查在 COVID-19 大流行期间,产妇在家庭支持和医护人员协助方面的经历。 研究方法本研究采用描述性现象学方法,遵循定性研究报告框架标准(SRQR)。13 人参与了研究,其中包括 7 名产妇、3 名丈夫、2 名助产士和 1 名家长。Mlati, Kab.调查于 2022 年 1 月至 2 月期间在日惹特区 Sleman 的 Mlati II 卫生中心进行。地点的选择基于研究人员设定的特定标准。由于实际原因,数据收集工作在网上进行,并联系信息提供者选择在线或离线访谈。在选择信息提供者时采用了有目的的抽样,在事先征得信息提供者同意的情况下,通过 WhatsApp、Zoom 或电话进行了深入访谈,每次访谈持续约一小时。访谈采用半结构化形式。 结果数据分析得出两大主题:母亲在分娩过程中的情感体验和她们的各种需求。COVID-19 大流行产生了重大影响,导致了焦虑、恐惧、紧张的情绪,以及对安慰和信心的需求。这些心理需求分为语言支持(包括鼓励、沟通和安慰)和触觉支持(包括抚摸、拥抱和擦背等动作)。母亲们还表达了精神上的需求,如祈祷和保持积极的想法,以确保顺利分娩和婴儿健康。营养需求,包括健康和均衡的饮食,被认为是分娩期间必不可少的。丈夫、家庭成员和卫生工作者的支持在安抚母亲和教育她们预防 COVID-19 方面发挥了重要作用,有助于她们获得积极的分娩体验。 结论在分娩过程中提供积极的支持可促进正常分娩,并为产妇注入信心。 关键词:分娩、COVID-19 大流行、体验、产妇、支持。 Abstrak Tujuan:在科维德-19 大流行病期间对产妇的支持和帮助。 方法:本报告旨在介绍定性研究报告标准框架(SRQR)和建议综述(SRQR)。在本报告中收集到的信息有 13 个,其中 7 个是儿童,3 个是成人,2 个是儿童,1 个是成人。该项目在斯勒曼省的姆拉蒂二区(Puskesmas Mlati II di Kabupaten Sleman, di Dusun Cabakan, Sumberadi, Kec.Mlati, Kab.Sleman Daerah Istimewa Yogyakarta。项目的实施时间为 2022 年 1 月至 2 月,项目的实施标准为项目的实施。在线培训模式。在线数据管理是一种在线数据管理方法。您可以通过在线或离线的方式获取相关信息,以帮助您更好地管理您的数据。在笔者的工作中收集信息,并进行有目的的抽样调查。通过whatsapp、zoom和电话等媒体在网上进行深入访谈,以获取信息。 目标:设计了两个主题,分别是 "持续发展 "和 "社会责任"。通过 "Covid-19 "项目的实施,使人们认识到了 "as-was"、"kekhawatiran"、"takut "和 "cemas"、"tegang"、"berusaha nyaman"、"berusaha tenang "和 "rasa percaya diri"。科学心理学的主要内容是语言和感官方面的知识。言语治疗包括唤醒、治疗、修复、康复、治疗、心理治疗、心理治疗、康复治疗和心理治疗。精神方面的知识可以帮助人们提高生活质量,例如,保持乐观、积极向上的生活态度,以及保持良好的生活习惯。营养物质的种类包括:健康制造、安全制造、最低空气消耗量。通过对其进行监测、分析和评估,可帮助用户了解自己的身体状况,并在感染 Covid-19 病毒后对其进行教育,从而提高用户的积极性。 结果阳性结果可使正常人和罹患疾病的人的寿命延长。 Kata kunci: dukungan, ibu bersalin, pandemi covid-19, pengalaman, persalinan.
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引用次数: 0
COVID-19 Infection and the Preeclampsia in Pregnant Women COVID-19 感染与孕妇先兆子痫
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1796
Cindy M. Pradana, D. D. Parti, Elly N. Sakinah
Objective:  To determine the relationship between COVID-19 infection and preeclampsia in pregnant women at RSD dr. Soebandi Jember. Methods: This study used cross-sctional study with simple random sampling. The data is secondary data from medical records of 118 pregnant women who checked their pregnancies from March 2020 to December 2021 at RSD dr. Soebandi Jember and analyzed with chi-square test and logistic regression test. Results: Multivariate analysis showed that there were a relationship between COVID-19 infection with preeclampsia. COVID-19 is the most risky variable with an OR of 4.045 (95% CI 1.595 – 10.259). This condition happens because COVID-19 infection triggers down-regulation of RAS which make the failure of spiral artery remodelling and preeclampsia. Conclusion: There is a relationship between COVID-19 infection and the incidence of preeclampsia in RSD dr. Soebandi Jember. Keywords: COVID-19, preeclampsia, renin-angiotensin system (RAS), SARS-CoV-2   Abstrak Tujuan:  Untuk mengetahui hubungan antara infeksi COVID-19 dengan kejadian preeklamsia pada ibu hamil di RSD dr. Soebandi Jember. Metode: Penelitian ini merupakan studi potong lintang dengan pengambilan sampel menggunakan simple random sampling. Penelitian ini menggunakan data sekunder rekam medis 118 ibu hamil yang memeriksakan kehamilannya mulai Maret 2020 hingga Desember 2021 di RSD dr. Soebandi Jember dan dianalisa dengan uji statistik Chi-square dan uji regresi logistik. Hasil: Analisis statistik menunjukkan terdapat hubungan antara infeksi COVID-19, usia, dan obesitas dengan kejadian preeklamsia di RSD dr. Soebandi Jember. Variabel COVID-19 merupakan variabel yang paling berisiko terhadap terjadinya preeklampsia dengan OR 4,045 (95% CI 1,595 – 10,259). Hal ini terjadi karena infeksi COVID-19 memicu down-regulasi pada RAS yang mengakibatkan kegagalan remodelling arteri spiralis dan preeklamsia Kesimpulan: Terdapat hubungan antara infeksi COVID-19 dengan kejadian preeklamsia di RSD dr. Soebandi Jember. Kata kunci: COVID-19, preeklamsia, renin-angiotensin system (RAS), SARS-CoV-2
目的 确定 Soebandi Jember RSD 医生处孕妇 COVID-19 感染与先兆子痫之间的关系。 研究方法本研究采用简单随机抽样的交叉性研究。数据来自于苏班迪-詹伯医生中心(RSD dr. Soebandi Jember)2020 年 3 月至 2021 年 12 月期间 118 名孕妇的医疗记录,并通过卡方检验(chi-square test)和逻辑回归检验(logistic regression test)进行分析。 结果显示多变量分析表明,COVID-19感染与子痫前期之间存在关系。COVID-19是最危险的变量,OR值为4.045(95% CI 1.595 - 10.259)。出现这种情况的原因是 COVID-19 感染引发了 RAS 下调,导致螺旋动脉重塑失败和子痫前期。 结论COVID-19 感染与 RSD Soebandi Jember 医生的子痫前期发病率之间存在关系。 关键词COVID-19、子痫前期、肾素-血管紧张素系统(RAS)、SARS-CoV-2 Abstrak Tujuan: 在Soebandi Jember的RSD医生那里收集关于COVID-19基因对先兆子痫的影响的信息。 方法:通过简单随机抽样的方式,对该地区进行研究。该项目收集了从 2020 年 5 月至 2021 年 9 月期间在苏班迪金巴拉省的 118 名学生的数据,并利用卡氏方差统计和逻辑回归统计进行分析。 目的统计分析表明,在苏班迪金巴拉姆乡村发展中心,COVID-19、usia 和肥胖症的相关数据均有所减少。COVID-19变量是一个与子痫前期相关的变量,其OR值为4,045(95% CI为1,595 - 10,259)。这表明 COVID-19 基因对 RAS 的下调作用有助于重塑螺旋动脉和子痫前期:在Soebandi Jember博士的RSD研究中,发现了COVID-19的作用。 关键词: COVID-19、疱疹、肾素-血管紧张素系统(RAS)、SARS-CoV-2
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引用次数: 0
The Use of Maternal Early Obstetric Warning Score (MEOWS) as a Tool to Predict Treatment Needs in the Intensive Care Unit in Severe Preeclampsia Patients 使用产妇产科早期预警评分(MEOWS)作为重症子痫前期患者在重症监护室的治疗需求预测工具
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1920
Astuti D. P. Ratu, Imelda E.B Hutagaol
Objective: To determine the cut-off point of the Modified Early Obstetric Warning System (MEOWS) scores for severe preeclampsia patients to enhance clinical surveillance and responsiveness for determining the appropriate level of care. Methods: A retrospective cross-sectional study design was employed, involving 282 samples selected from medical record data of research subjects at Arifin Achmad Hospital in Pekanbaru. The research variables included preeclampsia (PEB), MEOWS score, and the place of care. The research sample was categorized into two groups: those with high MEOWS scores (MEOWS ≥ 8) and those with low MEOWS scores (MEOWS < 8). Data were processed and statistically analyzed using SPSS, with sensitivity and specificity measurements conducted using the Receiver Operating Characteristic (ROC) curve. Results: Statistically significant differences were found in the MEOWS score thresholds between the two groups. The calculated cut-off point for the MEOWS score was determined to be 7.57 (rounded to 8). There was a significant association between MEOWS scores ≥ 8 and the need for Intensive Care Unit (ICU) care (Relative Risk [RR] 0.35; 95% Confidence Interval [CI]: 0.157–0.788; p = 0.009) as well as the risk of Intrauterine Fetal Demise (IUFD) (RR 1.04; 95% CI 1.02–1.06). Conclusion: The MEOWS score can serve as a valuable parameter for early detection of ICU care requirements in severe preeclampsia patients, thereby enhancing clinical surveillance and responsiveness.
目的确定重度子痫前期患者的改良产科早期预警系统(MEOWS)评分的临界点,以加强临床监测和反应能力,从而确定适当的护理级别。研究方法采用回顾性横断面研究设计,从北干巴鲁市阿里芬-阿奇玛德医院研究对象的医疗记录数据中选取282个样本。研究变量包括子痫前期(PEB)、MEOWS评分和护理地点。研究样本分为两组:MEOWS 得分高(MEOWS ≥ 8)和 MEOWS 得分低(MEOWS < 8)。使用 SPSS 对数据进行处理和统计分析,并使用接收者工作特征曲线(ROC)对灵敏度和特异性进行测量。结果两组患者的 MEOWS 评分临界值在统计学上存在明显差异。计算得出的 MEOWS 临界值为 7.57(四舍五入为 8)。MEOWS评分≥8分与重症监护室(ICU)护理需求之间存在明显关联(相对风险 [RR] 0.35;95% 置信区间 [CI]:0.157-0.788):0.157-0.788; p = 0.009)以及宫内胎儿夭折(IUFD)的风险(RR 1.04; 95% CI 1.02-1.06)。结论MEOWS评分可作为早期检测重度子痫前期患者是否需要重症监护室护理的重要参数,从而提高临床监测和响应能力。
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引用次数: 0
The Low Level of Serum 1,25-Dihydroxyvitamin D3 and Calcium in Preeclampsia Women and Its Impact on Maternal Outcomes 先兆子痫妇女血清中 1,25-二羟维生素 D3 和钙的低水平及其对产妇预后的影响
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1931
H. R. Karmia, Tara Fadhillah, Yusrawati Karmia
Objective: To investigate the association of serum 1,25-dihydroxyvitamin D3 (1,25[OH]2D3) and calcium levels in pregnancy with the risk of preeclampsia and its impact on maternal outcomes. Methods: This cross-sectional observational study was conducted in the Obstetrics and Gynecology Department at Dr. M. Djamil Padang General Hospital from May 2021 to April 2022. Patients with normal pregnancy, diagnosed with preeclampsia, and willing to sign the informed consent were included in this study. Blood serum samples from patients were collected and examined with an ELISA kit. The collected data were then statistically analyzed with univariate and bivariate analysis. Results: The serum 1,25(OH)2D3 levels strongly correlate with maternal outcomes (systolic and diastolic blood pressure) among preeclampsia patients, with p-value = <0.0001. The serum 1,25(OH)2D3 levels in preeclampsia were significantly lower than in normal pregnancy (88,73 ± 42,22 vs. 111,11 ± 52,49 pg/ml), with p-value = 0,033. The serum calcium levels in preeclampsia patients were significantly lower compared to normal pregnant women's (8,67 ± 0,49 vs. 9,55 ± 0,93 mg/dL), with p-value = <0.0001. However, there was no association between serum 1,25(OH)2D3 and serum calcium levels in pregnancy. Conclusion: Serum levels of 1,25-dihydroxyvitamin D3 and calcium in preeclampsia were significantly lower than in normal pregnancy. Serum 1,25-dihydroxyvitamin D3 levels were also found to have a significant correlation with systolic and diastolic blood pressure in preeclamptic patients. These findings reinforce the suggestion of the importance of vitamin D and calcium supplementation during pregnancy to reduce the risk of preeclampsia and to achieve better maternal outcomes. Keywords: 1,25-Dihydroxyvitamin D3, calcium, hypertension, pregnancy, preeclampsia   Abstrak Tujuan: Mengetahui hubungan antara kadar serum 1,25-dihidroksivitamin D3 (1,25[OH]2D3) dan kalsium pada kehamilan dengan risiko preeklamsia dan pengaruhnya terhadap luaran maternal Metode: Studi observasional potong lintang ini dilakukan di Departemen Obstetri dan Ginekologi RSUP Dr. M. Djamil Padang dari Mei 2021 hingga April 2022. Pasien dengan kehamilan normal, terdiagnosis preeklampsia, dan bersedia menandatangani informed consent diinklusi dalam penelitian ini. Sampel serum darah dari pasien dikumpulkan dan diperiksa dengan ELISA-kit. Data yang terkumpul kemudian dianalisis secara statistik dengan analisis univariat dan bivariat. Hasil: Kadar serum 1,25(OH)2D3 memiliki hubungan yang kuat dengan luaran maternal (tekanan darah sistolik dan diastolik) pada pasien preeklamsia, dengan nilai p = <0,0001. Kadar serum 1,25(OH)2D3 pada preeklampsia lebih rendah secara signifikan dibandingkan kehamilan normal (88,73 ± 42,22 vs 111,11 ± 52,49 pg/ml), dengan p-value = 0,033. Kadar kalsium serum pada pasien preeklampsia juga secara signifikan lebih rendah dibandingkan ibu hamil normal (8,67 ± 0,49 vs 9,55 ± 0,93 mg/dL), dengan p-valu
目的:研究妊娠期血清 1,25- 二羟维生素 D3(1,25[OH]2D3)和钙水平与子痫前期风险的关系及其对产妇预后的影响。 研究方法这项横断面观察研究于 2021 年 5 月至 2022 年 4 月在 M. Djamil Padang 医生综合医院妇产科进行。研究对象包括正常妊娠、确诊为子痫前期并愿意签署知情同意书的患者。研究人员收集了患者的血清样本,并使用 ELISA 试剂盒进行检测。然后对收集到的数据进行单变量和双变量统计分析。 结果子痫前期患者血清中 1,25(OH)2D3 水平与产妇预后(收缩压和舒张压)密切相关,P 值 = <0.0001。子痫前期患者的血清 1,25(OH)2D3 水平明显低于正常妊娠(88.73 ± 42.22 vs. 111.11 ± 52.49 pg/ml),p 值 = 0.033。与正常孕妇相比,子痫前期患者的血清钙水平明显较低(8.67 ± 0.49 vs. 9.55 ± 0.93 mg/dL),p 值 = <0.0001。然而,妊娠期血清1,25(OH)2D3与血清钙水平之间没有关联。 结论子痫前期患者血清中的1,25-二羟维生素D3和钙水平明显低于正常妊娠。研究还发现,子痫前期患者血清中的 1,25-二羟维生素 D3 水平与收缩压和舒张压有明显的相关性。这些研究结果加强了孕期补充维生素 D 和钙对降低子痫前期风险和改善产妇预后的重要性。 关键词1,25-二羟维生素 D3;钙;高血压;妊娠;子痫前期 摘要 目的研究妊娠期血清中 1,25-二羟维生素 D3(1,25[OH]2D3)和钙水平与子痫前期风险之间的关系及其对产妇预后的影响 方法:这项横断面观察研究于 2021 年 5 月至 2022 年 4 月在巴东 Dr. M. Djamil 医院妇产科进行。研究对象包括正常妊娠、确诊为子痫前期并愿意签署知情同意书的患者。研究人员收集了患者的血清样本,并使用 ELISA 检测试剂盒进行检测。然后通过单变量和双变量分析对所收集的数据进行统计分析。 结果血清 1,25(OH)2D3 水平与子痫前期患者的产妇预后(收缩压和舒张压)密切相关,P 值 = <0.0001。子痫前期患者的血清 1,25(OH)2D3 水平明显低于正常妊娠(88.73 ± 42.22 vs 111.11 ± 52.49 pg/ml),p 值 = 0.033。子痫前期患者的血清钙水平也明显低于正常孕妇(8.67 ± 0.49 vs 9.55 ± 0.93 mg/dL),p 值 = <0.0001。然而,妊娠期血清 1,25(OH)2D3 水平与血清钙水平之间没有关联。 结论子痫前期患者的血清1,25-二羟维生素D3和血钙水平明显低于正常妊娠。研究还发现,子痫前期患者血清中的 1,25-二羟维生素 D3 水平与收缩压和舒张压有明显的相关性。这些研究结果进一步说明了在孕期补充维生素 D 和钙对降低子痫前期风险和改善产妇预后的重要性。 关键词1,25-二羟维生素 D3、钙、高血压、妊娠、子痫前期
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引用次数: 0
Optimal Omega-3 Intake: A Natural Way to Ease Primary Dysmenorrhea Severity 最佳欧米茄-3 摄入量:缓解原发性痛经严重程度的自然方法
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1900
Benedicta A. Widyatmoko, Edihan Mardjuki
Objective: To examine the link between adequate omega-3 intake and degree of primary dysmenorrhea in Atma Jaya preclinical medical students Methods: This cross-sectional study of 126 female students who experienced primary dysmenorrhea started from August to October 2022. Data was collected through the distribution of google forms containing the Working ability, Location, Intensity, Days of pain, Dysmenorrhea (WaLLID) score and Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). According to Recommended Dietary Allowance (RDA), daily intake of omega-3 fatty acids is sufficient if it is ≥ 1.1 g/day. Data were processed using Microsoft Excel and SPSS and analyzed by a 2x3 Chi-square test. Results: The findings showed that the majority of the respondents who consumed optimal omega-3 fatty acids, 17.5% (22 people), had primary dysmenorrhea with mild pain and also had a low percentage of severe primary dysmenorrhea, 3.2% (4 people). The link between adequate intake of omega-3 fatty acids with the degree of primary dysmenorrhea in female medical students showed significant test results (p=0.046). Conclusion: There is a significant link between optimal intake of omega-3 and degree of primary dysmenorrhea in Atma Jaya preclinical medical students (p<0.005).
目的研究阿特玛查亚(Atma Jaya)临床前医科学生摄入足量欧米伽-3与原发性痛经程度之间的联系 方法:这是一项横断面研究:这项横断面研究从 2022 年 8 月至 10 月开始,对 126 名经历过原发性痛经的女学生进行了调查。通过分发谷歌表格收集数据,其中包含工作能力、位置、强度、疼痛天数、痛经(WaLLID)评分和半定量食物频率问卷(SQ-FFQ)。根据膳食营养素推荐摄入量(RDA),每天摄入ω-3脂肪酸≥1.1克即可。数据使用Microsoft Excel和SPSS进行处理,并通过2x3卡方检验进行分析。结果显示调查结果显示,摄入最佳欧米伽-3 脂肪酸的受访者中,17.5%(22 人)的原发性痛经症状为轻微疼痛,严重原发性痛经的比例也较低,仅为 3.2%(4 人)。测试结果显示,摄入充足的欧米伽-3 脂肪酸与医科女学生原发性痛经程度之间存在显著联系(P=0.046)。结论是在阿特玛查亚(Atma Jaya)临床前医科学生中,欧米伽-3的最佳摄入量与原发性痛经程度之间存在明显联系(p<0.005)。
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引用次数: 0
The prevalence of lower urinary tract symptoms in Caesarean section patients’ first and seventh day of postpartum 剖腹产患者产后第一天和第七天的下尿路症状发生率
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.1905
Austin Julian, Johannes C. Prihadi, Yuma S. S. Indrajaya
Objective: To compare the prevalence of Lower Urinary Tract Symptoms (LUTS) on the first day and the seventh day postpartum in Caesarian section patient Method: This cross-sectional study utilized the ICIQ-FLUTS LF (ICIQ-Female Lower Urinary Tract Symptoms-Long Form) and a questionnaire to screen for risk factors among postpartum patients who underwent C-section delivery at Santo Antonius Hospital, Pontianak, West Kalimantan. Data were collected twice, 12 hours after urinary catheter removal and on the seventh day of the postpartum period. The study sample consisted of 95 respondents. Results: Among the 111 total respondents, the majority were under 35 years old, multiparous, classified as obese, had no family history of Lower Urinary Tract Symptoms (LUTS), and had not used diuretics or traditional medicine. Significant differences were observed in the prevalence of LUTS between the first and seventh days of the postpartum period. Most symptoms showed a decrease on the seventh day, except for six symptoms: insensible urinary incontinence, hesitancy, urinary retention, feeling of incomplete emptying, bladder pain, and dysuria, which increased. Conclusion: In conclusion, our study suggests that the duration of the postpartum period affects the prevalence of LUTS following C-section delivery. However, it's important to acknowledge the limitations of this study, which may impact the understanding of LUTS progression during the postpartum period. Conclusion: In conclusion, we concluded that the duration of the postpartum period affects the LUTS after delivery with the method of C-section, but this study has many limitations which may affect the progressivity of LUTS in the Postpartum period. Keywords:  Caesarean Section, ICIQ FLUTS Long From, Lower Urinary Tract Symptoms, Postpartum period   Abstrak Tujuan: Untuk membandingkan prevalensi Gejala Saluran Kemih Bawah di hari pertama dan hari ketujuh postpartum pada pasien Sectio Caesarea. Metode: Desain penelitian berupa studi potong li.ntang dengan pengumpulan data menggunakan kuesioner terstruktur ICIQ FLUTS-LF dan kuesioner skrining dasar penelitian yang dilakukan 2 kali yaitu 12 jam setelah pelepasan kateter dan postpartum hari ke 7. Subjek penelitian ini adalah semua ibu postpartum dengan metode SC yang memenuhi kriteria inklusi dan eksklusi penelitian di RS Santo Antonius Pontianak, Kalimantan Barat. Jumlah sampel pada penelitian ini adalah 95 responden Hasil: Pada penelitian ini didapatkan subjek sebesar 111 responden yang mayoritasnya berusia kurang dari sama dengan 35 tahun, multipara, status gizinya obesitas, tidak memiliki riwayat keluarga yang mengalami LUTS, tidak mengkonsumsi obat-obatan tradisional dan obat-obatan diuretik. Terdapat perbedaan signifikan di prevalensi LUTS hari 1 dan 7 postpartum SC dengan mayoritas dari 16 gejala LUTS yang didata mengalami penurunan di hari ketujuh dibanding hari pertama, terkecuali 6 gejala LUTS yang mengalami peningkatan di hari ketujuh yaitu I
目的:比较剖腹产患者在产后第一天和第七天出现下尿路症状(LUTS)的比例比较剖腹产患者产后第一天和第七天下尿路症状(LUTS)的发生率:本横断面研究采用 ICIQ-FLUTS LF(ICIQ-女性下尿路症状长表)和调查问卷,对在西加里曼丹省坤甸市圣安东尼奥斯医院接受剖腹产的产后患者进行风险因素筛查。研究人员分别在拔除导尿管 12 小时后和产后第七天收集了两次数据。研究样本包括 95 名受访者。 研究结果在总共 111 名受访者中,大多数人的年龄在 35 岁以下,多产,属于肥胖,没有下尿路症状(LUTS)家族史,没有使用过利尿剂或传统药物。产后第一天和第七天的下尿路症状发生率有显著差异。大多数症状在第七天都有所减轻,只有六种症状有所加重:无感觉尿失禁、排尿迟缓、尿潴留、排空不尽感、膀胱疼痛和排尿困难。 结论总之,我们的研究表明,产后时间的长短会影响剖腹产后尿失禁的发生率。但是,必须承认本研究的局限性,这可能会影响对产后 LUTS 进展的理解。 结论总之,我们得出的结论是,产后时间的长短会影响剖腹产分娩后的 LUTS,但这项研究存在很多局限性,可能会影响产后 LUTS 的进展。 关键词 剖腹产 ICIQ FLUTS Long From 下尿路症状 产后 Abstrak Tujuan:在剖腹产产妇产前和产后提高下尿路症状的流行率。 方法:该研究通过对数据的收集和分析,得出了ICIQ FLUTS-LF测试数据和2个月到12个月的产前和产后数据。在加里曼丹岛坤甸的圣安东尼奥斯医院(RS Santo Antonius Pontianak)开展的产后护理子项目采用了SC方法,以了解产后护理的标准和方法。目前,共有 95 份 Hasil 答复:在该项目中,111 名受访者的年龄在 35 岁以下,多产妇,肥胖状态,可能患有严重的尿崩症,可能患有传统肥胖症和利尿肥胖症。产后第 1 和第 7 个月的 LUTS 患病率明显增加,其中有 16 例 LUTS 患者在产后第 1 和第 7 个月和产后第 8 个月都有明显改善、有 6 例 LUTS 患者可在产后出现无知觉性尿失禁、排尿困难、尿潴留、尿频、尿急、尿痛等症状。 说明通过本手册,您可以了解产后 LUTS 的持续时间是多久、在这一领域中,我们的研究表明,在 LUTS Kata kunci 的进展过程中,存在着大量的风险因素:剖腹产, ICIQ FLUTS 长表, 腹部疼痛, 持续疼痛, 产后疼痛
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引用次数: 0
Hospital Cost vs INA-CBGs Claim for Obstetrics Procedure In Soe Rural General Hospital, East Nusa Tenggara 东努沙登加拉省 Soe 农村综合医院产科手术的医院成本与 INA-CBGs 索赔对比
Q4 Medicine Pub Date : 2023-10-26 DOI: 10.32771/inajog.v11i4.2010
Raymond Surya, Ascobat Gani, Y. B. Saroyo
Objective:  To depict the discrepancy and analyze the difference between hospital cost and INA-CBGs claim in obstetrics’ cases in SoE Rural General Hospital, Timor Tengah Selatan regent, East Nusa Tenggara. Methods: This is an observational descriptive study using medical record documents of spontaneous vaginal, assisted vaginal, and cesarean delivery cases from the period of October to December 2022. We included all completed billing documents on that period. Cases paid by fee-for-service and local government were excluded. Data analysis was conducted using IBM SPSS Statistic 23.0 Results: From the total of 323 delivery cases recorded in SoE Rural General Hospital, only 245 cases were included. Most subjects were patients aged around 30 years old, referred from primary healthcare facility in the district, were in term pregnancy, and in 3rd class inpatient rooms. The median of length of stay (LOS) in vaginal delivery (spontaneous and assisted) and cesarean delivery were 2 days and 3 days, respectively. Mean difference between hospital cost to INA-CBGs claim was 67% to 158% for either vaginal or cesarean delivery based on class inpatient room. We found that hospital cost was always higher than claim cost based on INA-CBGs claim. Conclusion: There is a significant discrepancy between hospital cost and INA-CBGs claim (from 67% to 158%) for obstetric services in SoE Rural General Hospital. Keywords: hospital cost, INA-CBGs claim, obstetric.   Abstrak Tujuan: Untuk memberikan gambaran perbedaan dan menganalisis perbedaan antara tarif RS dengan klaim INA-CBGs pada kasus obstetrik di RSUD SoE, Timor Tengah Selatan, Nusa Tenggara Timur. Metode: Studi deskriptif observasional menggunakan dokumen rekam medis dari kasus persalinan pervaginam spontan, persalinan pervaginam dengan alat, dan seksio sesarea dari Oktober hinga Desember 2022. Kami memasukkan seluruh dokumen billing yang lengkap. Dokumen biling yang dibayarkan mandiri dan oleh pemerintah lokal dieskslusi. Analisis data dengan menggunakan IBM SPSS Statistik 23.0. Hasil: Dari 323 persalinan yang terekam di RSUD SoE, hanya 245 kasus diinklusikan. Kebanyakan subjek berusia 30 tahun, dirujuk dari puskesmas, kehamilan cukup bulan, dan ruang perawatan kelas 3. Angka median dari lama rawat pervaginam (baik spontan maupun dengan alat) adalah 2 hari dan seksio sesarea 3 hari. Rerata perbedaan tarif RS dengan klaim INA-CBGs ialah 67% hingga 158% baik persalinan pervaginam maupun seksio sesarea berdasarkan ruang kelas perawatan. Kami menemukan angka tarif RS selalu lebih tinggi cukup jauh dari klaim INA-CBGs. Kesimpulan: Terdapat perbedaan antara tarif RS dan klaim INA-CBGs (antara 67 hingga 158%) untuk prosedur obstetrik di RSUD SoE. Kata kunci: tarif RS, klaim INA-CBGs, obstetrik.
目的:描述并分析东努沙登加拉省东帝汶摄政王中南部 SoE 农村综合医院产科病例中医院费用与 INA-CBGs 索赔之间的差异。 方法:这是一项观察性描述研究,使用的是 2022 年 10 月至 12 月期间自然阴道分娩、辅助阴道分娩和剖腹产病例的医疗记录文件。我们纳入了该期间所有完整的账单文件。由收费服务和地方政府支付费用的病例除外。数据分析采用 IBM SPSS Statistic 23.0 进行:在苏州市乡镇综合医院记录的 323 个分娩病例中,只有 245 个病例被包括在内。大部分受试者年龄在 30 岁左右,由区内基层医疗机构转诊,为足月妊娠,住在三等病房。阴道分娩(自然分娩和助产)和剖宫产的住院时间中位数分别为 2 天和 3 天。根据住院病房等级,阴道分娩或剖宫产的住院费用与 INA-CBGs 索赔的平均差异为 67% 至 158%。我们发现,住院费用总是高于根据 INA-CBGs 索赔的费用。 结论:SoE 农村综合医院产科服务的住院费用与 INA-CBGs 索赔费用之间存在明显差异(从 67% 到 158%)。 关键词:医院成本、INA-CBGs 索赔、产科。 摘要 目的描述并分析东努沙登加拉省东帝汶中南部SoE乡村综合医院产科病例的住院费用与INA-CBGs索赔之间的差异。 研究方法利用 2022 年 10 月至 12 月期间自然阴道分娩、使用器械的阴道分娩和剖腹产病例的医疗记录文件进行描述性观察研究。我们纳入了所有完整的账单文件。不包括自费和地方政府的账单记录。数据使用 IBM SPSS Statistics 23.0 进行分析。 结果在 SoE 综合医院记录的 323 例分娩中,只有 245 例被纳入。阴道分娩(自然分娩和使用器械分娩)的住院时间中位数为 2 天,剖腹产的住院时间中位数为 3 天。各病房阴道分娩和剖宫产的住院率与 INA-CBGs 索赔的平均差异为 67% 至 158%。我们发现,住院率总是明显高于 INA-CBGs 的报销率。 结论:RSUD SoE产科手术的医院收费与INA-CBGs报销之间存在差异(67%至158%)。 关键词:医院收费、INA-CBGs报销、产科。
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引用次数: 0
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Indonesian Journal of Obstetrics and Gynecology
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