Academic literature on the topic 'Obsetrics'

Background . The treatment of genital prolapse is exclu­sively surgical, usually approached from the perineal area. If surgery is not recommended, the solution can be conservative palliative. Method . This paper is based on scholarly medical articles and the expertise of Bucur Clinic of Obsetrics and Gynecology, between January 2010 and December 2016, in relation with modern surgical treatments of genital prolapse, using synthetic mesh. Results . Between January 2010 and December 2017, at the Bucur Clinic of Obstetrics and Ginecology, there were 320 patients surgically treated for urogenital affections. There were registered 53 cases of first- and second-degree genital prolaps, and 65 cases of third-degree genital prolaps. A num­ber of 98 patients presented cystorectocele, of which 82 associated with stress urinary incontinence and only 40 with uterine prolaps. There were made 67 direct cystopexies with polypropylene allograft by the transobturator mid­urethral slings procedure (TOT). Also, the Kelly technique was systematically applied for the surgical management of stress urinary incontinence (SUI). The isolated SUI cases have been treated by the aplications of a suburethral sling, again using the TOT technique(61). The surgical treatment for posterior vaginal wall defect usually consisted in posterior colporrhaphy with perineorrhaphy(73). In cases associated with important uterine descensus, the standard technique consisted in hysterosacropexy with or without reinforcement of the rectovaginal fascia with synthetic mesh (3/14). A total of 7 colpocleisis have been recorded exclusively in elderly patients with associated biological conditions, for which extensive surgery was not recommended. Discussion . Petros and Ulmstem’s integral theory, which was developed in the ’90s, states that pelvic-genital static disorders and those of urinary incontinence come from the alteration of fascial and ligamentary structures that are part of the pelvian diaphragm. This theory led to the development of vaginal and endoscopic surgical tehniques using syntetic allograft. After a period of prolonged use because of its superior efficiency on a long term, the indications of synthetic allografts have been reduced and they are reserved now for patients with large defects of pelvine statics, for recurrent cases or for women in perimenopause. An important criterion in the surgical choise is the conservation of sexual function. Conclusions . It is recommended to use the surgical correction of prolapse using synthetic mesh only in case of failure of a first surgery, or if there are known risk factors for the recurrence of prolapse.

Sectio caesarea adalah suatu tindakan pembedahan yaitu dengan cara memberikan sayatan pada dinding depan uterus untuk membantu proses persalinan. Untuk tindakan Sectio Caesarea dengan memutus kontuitas jaringan atau dengan persambungan jaringan pada insisi yang akan mengeluarkan reseptor nyeri terutama setelah efek anastesi habis. Salah satu terapi yang dapat menurunkan nyeri dengan tindakan non farmakologi yaitu dengan terapi relaksasi Benson.Dari penerapan ini yaitu untuk mengetahui penurunan nyeri Pada Klien Post Sectio Caesarea di RSUP DR. Kariadi Semarang dengan menggunakan Tehnik Relaksasi Benson. Studi kasus ini termasuk jenis kasus desain deskriptif. Dengan pendekatan pre-post test. Studi kasus ini adalah semua pasien Post Sectio Caesarea hari ke-2 di ruang Obsetri RSUP DR. Kariadi Semarang. Jumlah responden berjumlah 2 orang. Terapi relaksasi benson dilakukan 10-15 menit selama 3 hari. Alat pengumpulan data menggunkan skala nyeri NRS. Hasil menunjukkan adanya penurunan skala nyeri pada klien Post Sectio Caesarea dengan Tehnik Relaksasi Benson dengan penurunan skala sedang menjadi ringan. Analisis 1 kasus hari pertama skala nyeri 4 hingga hari ke-3 skala nyeri mengalami penurunan menjadi skala 2, sedangkan kasus kedua pertama skala nyeri 5 hingga hari ke-3 mengalami penurunan menjadi skala 3. Hasil studi kasus ini menunjukkan bahwa Tehnik Relaksasi Benson mampu menurunkan skala nyeri. Pada kasus ini peneliti menggunkan 2 responden pasien post section caesarea hari ke 2. Terapi non farmakologi Tehnik Relaksasi Benson dapat menurunkan nyeri pada klien Post Sectio Caesarea.

Hipertensi pada kehamilan sering terjadi (6-10 %) dan meningkatkan risiko morbiditas dan mortalitas pada ibu, janin dan perinatal. Pre-eklampsia/eklampsia dan hipertensi berat pada kehamilan risikonya lebih besar. Hipertensi pada kehamilan dapat digolongkan menjadi pre-eklampsia/ eklampsia, hipertensi kronis pada kehamilan, hipertensi kronis disertai pre-eklampsia, dan hipertensi gestational. Pengobatan hipertensi pada kehamilan dengan menggunakan obat antihipertensi ternyata tidak mengurangi atau meningkatkan risiko kematian ibu, proteinuria, efek samping, operasi caesar, kematian neonatal, kelahiran prematur, atau bayi lahir kecil. Penelitian mengenai obat antihipertensi pada kehamilan masih sedikit. Obat yang direkomendasikan adalah labetalol, nifedipine dan methyldopa sebagai first line terapi. Penatalaksanaan hipertensi pada kehamilan memerlukan pendekatan multidisiplin dari dokter obsetri, internis, nefrologis dan anestesi. Hipertensi pada kehamilan memiliki tingkat kekambuhan yang tinggi pada kehamilan berikutnya. Hypertension complicates 6% to 10% of pregnancies and increases the risk of maternal, fetal and perinatal morbidity and mortality. Preeclampsia / eclampsia and severe hypertension in pregnancy are at greater risk. Four major hypertensive disorders in pregnancy have been described by the American College of Obstetricians and Gynecologists (ACOG): chronic hypertension; preeclampsia-eclampsia; chronic hypertension with superimposed preeclampsia; and gestational hypertension. The current review suggests that antihypertensive drug therapy does not reduce or increase the risk of maternal death, proteinuria, side effects, cesarean section, neonatal and birth death, preterm birth, or small for gestational age infants. The quality of evidence was low. Recommendations for treatment of hypertension in pregnancy are labetalol, nifedipine and methyldopa as first line drugs therapy. Although the obstetrician manages most cases of hypertension during pregnancy, the internist, cardiologist, or nephrologist may be consulted if hypertension precedes conception, if end organ damage is present, or when accelerated hypertension occurs. Women who have had preeclampsia are also at increased risk for hypertension in future pregnancies.

Abstrak Provinsi Papua memiliki prevalensi HIV/AIDS tinggi, dimana terdapat 6957 wanita usia 15-49 tahun menderita HIV/AIDS. Masalah ini dapat menyebabkan penularan HIV/AIDS ke bayi bahkan kematian bayi karena HIV. Penelitian ini bertujuan menganalisa faktor yang mempengaruhi keberlangsungan program PPIA. Penelitian menggunakan metode kualitatif dengan pengumpulan data melalui wawancara mendalam. Penelitian dilakukan di Jayapura, Dinas Kesehatan Kota Jayapura dari Januari 2015 sampai Juni 2015. Populasi penelitian adalah semua tenaga kesehatan di dinas kesehatan kota Jayapura, dan sampel nya adalah 12 orang mencakup kepala UPT AIDS TB, kepala seksi P2PL, kepala puksesmas, kepala KIA, staf KIA dan penanggung jawab HIV puskesmas. Pengambilan sampel adalah purposif sampling dan data dianalisis dengan triangulasi. PPIA tidak berhasil karena rendah nya K1 dan juga K4, dimana ada puskesmas yang memiliki K4 hanya 58%. Di rumah sakit Abepura ditemukan 8 kelahiran bayi dengan HIV, hal ini karena ibu hamil positif yang tidak menkonsumsi ARV secara rutin sampai melahirkan. Rendah nya K1 juga disebabkan oleh beberapa faktor yaitu ibu hamil lebih tertarik ke dokter praktek, suami yang tidak setuju bila istri nya mendapatkan tes VCT, dan rendah nya kesadaran ibu hamil akan pentingnya K1 sampai K4 dan juga VCT. Begitu juga dengan SIHA yang tidak berjalan dengan baik. Kata kunci : Pencegahan HIV, Ibu hamil, bayi, Jayapura Papua province has high prevalence of HIV/AIDS where there was 6957 cases among women age 15-49 years old. Moreover, this increasedthe number of infants with HIV and impact the rise of infant mortality rate.This study aims to analize factors that affected this HIV prevention from mother to child. This study is qualitative using indeep interview, and located in Jayapura City from January 2015 to June 2015. The population is all staffs in Jayapura’s Health Department, and the total sample is 12 including head of this program, staff of local primary care, staf of hospital, and staffs that have responsibily to run this program. This is purposive sampling, and data will analize with triangulation. HIV prevention is not success due to the low rate of pregnant women visit to local primary care. There was a local primary care that only has 58% of pregnant women visit. In Abepura hospital 2015, there was 8 cases of childborn with HIV. This is because many positive mothers did not consum ARV. The low visit in local primary care has several causes such as mother more willing to go to private obsetric, treat from husband where husband didn’t allow VCT to his wive, and the low self efficacy of pregnant mother. The HIV report system is not well implemented. Key words : HIV Prevention, pregnant mother, infant, Jayapura