Introduction:The incidence of placenta accreta spectrum (PAS) has increased, but the optimal management and the optimal way to achieve vascular control are still controversial. This study aims to compare maternal outcomes between different methods of vascular control in surgical PAS management. Material and methods: A retrospective cohort study on consecutive cases diagnosed with PAS between 2013 and 2020 in single tertiary hospital. The final diagnosis of PAS was made following preoperative ultrasound and confirmation during surgery. Management of PAS using cesarean hysterectomy with internal iliac artery ligation (IIAL) was compared with two types of vascular control in uterine conservativeresective surgery (IIAL vs identification-ligation of the upper vesical, upper vaginal, and uterine arteries).Results: Over an 8-year period, 234 pregnant women were diagnosed with PAS meeting the inclusion criteria. Uterine conservative-resective surgery (200 cases) was associated with lower mean blood loss compared with cesarean hysterectomy with IIAL (34 cases) in all PAS cases (1379 ± 769 mL vs 3168 ± 1916 mL; p < 0.001). In subanalysis of the two uterine conservative-resective surgery subgroups, the group with identification-ligation of the upper vesical, upper vaginal, and uterine arteries had a significantly lower blood loss compared with uterine conservative-resective surgery with IIAL (1307 ± 743 mL vs 1701 ± 813 mL; p = 0.005). Women in the hysterectomy with IIAL group had more massive transfusion (35.3% vs 2.5%; p < 0.001; odds ratio[OR] 21.3, 95% confidence interval [CI] 6.9-66), major blood loss (>1500 mL) (70.6% vs 34%, p < 0.001; OR 4.7; 95% CI 2.1-10.3), catastrophic blood loss (>2500 mL)

No abstract

Pandemi Covid-19 membuat masyarakat indonesia semakin sadar untuk menjaga kesehatan dan daya tahan tubuh, dan kemudian melakukan PHBS (Pola Hidup Bersih dan Sehat) yang dapat menjadikan perubahan pola hidup di masyarakat untuk mengonsumsi produk yang banyak dicari oleh masyarakat adalah jamu. Jamu sendiri memang dipercaya berkhasiat untuk menguatkan sistem kekebalan tubuh hingga mengurangi peradangan dan kadar lemak tubuh. Menjaga imunitas tubuh sudah menjadi kewajiban bagi diri kita sendiri. Hal tersebut didukung dengan adanya pemanfaatan TOGA yang telah dibudidayakan oleh warga BTN Batara Graha. Meskipun mereka mempunyai lahan yang kurang luas tetapi mereka tetap bisa membudidayakan tanaman TOGA ini. Manfaat TOGA sangatlah banyak, salah satunya adalah bisa dijadikan jamu dan rimpang-rimpang yang terdiri dari kunyit, jahe, sereh dan temulawak. Dalam memasuki masa new normal sangat baik jika kita meminum jamu karena dapat meningkatkan imunitas tubuh dan menjadi salah satu cara untuk terhindar dari virus corona.

Background: Preeclampsia is one of the risk factors for complications and also contributes to the high rate of morbidity and mortality in mothers and babies. The Maternal Mortality Rate (MMR) at the Mgr. Gabriel Manek Hospital, SVD Atambua has continued to increase in the last three years, from 2017 to 2019. It was recorded that in 2019 there were 126 cases of severe preeclampsia and eclampsia with 5 cases of maternal death and 2 maternal causes of death. is eclampsia. In addition to the factors that cause maternal death, one of the contributing causes of maternal and infant mortality is caused by the speed at which decisions are made in the family. Pregnant women are at risk of experiencing maternal death if during the referral process they experience at least one of the three delays, namely being late in making the decision to be referred. This study aims to determine the factors that influence the delay in decision making in preeclampsia pregnant women. Methods: The type of research is observational analytic with a cross sectional design. Collecting data using primary data with a questionnaire instrument by interview and secondary data obtained from the register of maternity mothers and medical records. The number of samples is 30 respondents. The sampling technique used was total sampling. The data were processed and calculated using frequency tables and cross tabulations and then analyzed using Multiple Logistics Regression Analysis with a significance level of 5% (p = 0.05). Bivariate data analysis used fisher's exact test andtest cramer's v. Results: The results showed that the factors that caused delays in decision making were knowledge having a p-value of 0.006 (OR 2.293, 95% Cl: 0.481-10.918), confidence having a p-value of 95%: 0.002-0.513, health insurance having p-value 0.010 (OR 0.000, 95% Cl: 0.000). Multivariate analysis shows that work is the most dominant factor in delaying decision making compared to other factors, and it can be concluded that the more working mothers, the smaller the delay, and the more mothers who do not work, the greater the delay in making decisions to get health services. . Conclusion: There is a relationship between knowledge, belief, occupation, and health insurance on the delay in decision making.

Objective: To analyze the relationship between body mass index (BMI) before pregnancy and gestational weight gain throughout pregnancy with the incidence of preeclampsia. Methods: This was a systematic review-meta analysis of literature collected from three e-databases: Scopus, PubMed, and Science Direct. Quality assessment was measured with the Effective Public Health Practice Project methods. Meta-analysis was done by calculating the fixed and random-effects of odds ratio (OR) for each BMI category and gestational weight gain as compared with the incidence of preeclampsia. Results: Overweight was associated with a significantly increased risk of preeclampsia (OR=2.152, 95% CI 1.363-3.400; P=0.001). Obesity was also associated with a noticeably increased risk of preeclampsia (OR=2.856, 95% CI 1.755-4.649; P<0.001). Meanwhile, underweight was associated with a significantly reduced risk of preeclampsia (OR=0.639, 95% CI 0.500-0.817; P<0.001) when compared with normal BMI. Pregnant women who gained weight below the standard throughout pregnancy was a protective factor from preeclampsia (OR=0.813, 95% CI 0.610-1.083; P=0.157) whereas pregnant women who gained weight above the standard had almost doubled risk of preeclampsia (OR=1.850, 95% CI 1.377-2.485; P<0.001). Conclusions: The result of this study affirms the role of overweight-obesity pre-pregnancy, and gestational weight gain above the standard during pregnancy as significant risk factors for developing preeclampsia.