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"Pendahuluan: Hipoksia plasenta pada bayi prematur menyebabkan stres oksidatif yang merusak protein penaut endotel kapiler plasenta. Kerusakan pada kapiler plasenta diharapkan dapat menggambarkan perubahan permeabiltas kapiler otak yang menyebabkan perdarahan intraventrikel.Metode: Penelitian observasional potong lintang terhadap 58 sampel plasenta bayi prematur. Hipoksia dinilai dari saturasi vena umbilikal, respon jaringan terhadap hipoksia dari kadar HIF-1α, stres oksidatif dari kadar malondialdehid (MDA) dan glutation (GSH). Integritas lapisan endotel dinilai dengan histomorfologi, ekspresi protein N-kaderin dan okludin dengan imunohistokimia, Glial fibrillary acidic protein (GFAP) sebagai petanda kerusakan perivaskular astrosit dan perdarahan intraventrikel dinilai dengan ultrasonografi kepala.Hasil: Kadar HIF-1α lebih tinggi tidak bermakna pada kelompok hipoksia dibandingkan kelompok non hipoksia (uji t tidak berpasangan, p = 0,122); Kadar MDA jaringan plasenta lebih tinggi tidak bermakna sedangkan GSH lebih rendah tidak bermakna (Mann Whitney, p = 0,414 dan p = 0,810). Gambaran histomorfologi lebih tidak utuh tidak bermakna (Chi-square, p = 0,066), sedangkan ekspresi N-kaderin dan okludin lebih rendah bermakna (Chi-square, p = 0,001). Kadar GFAP serum lebih tinggi bermakna (Mann Whitney, p = 0,05). Korelasi tidak bermakna antara ekspresi N-kaderin dan okludin dengan perdarahan intraventrikel (Spearman?s rho, p = 0,869 dan p = 0,341).Kesimpulan: Hipoksia pada plasenta menyebabkan perubahan ekspresi protein penaut endotel kapiler plasenta, secara molekuler sudah menyebabkan perubahan permeabilitas lapisan endotel kapiler plasenta tetapi secara struktural belum. Perubahan ekspresi protein penaut endotel kapiler plasenta tidak berhubungan dengan perdarahan intraventrikel.

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Introduction: Plasental hypoxia in premature infants causes oxidative stress which inflicts damage to endothelial protein junction of placental capillary. It is expected that damaged of placental capillary can demonstate permeability changes in brain capillary that can cause intraventricular hemorrage.

Method:.a cross sectional observational study conducted on 58 placenta of premature infants. Hypoxia is determined by umbilical venous saturation. Tissue response to hypoxia determined by the level of HIF-1α, stress oxidative by the level of malondialdehide (MDA) and glutation (GSH). Endothelial layer integtrity by histomorfologi overview, N-cadherine and occludin by immunohistochemistry. Glial fibrillary acidic protein (GFAP) as perivascular astrocyte disruption marker and intraventricular hemorrhage carried by head ultrasound.

Result: The levels of HIF-1α was not significantly higher in hypoxia group compared to non hypoxia group (unpaired t test, p = 0,122); The level of placental MDA was not significantly hingher while GSH was not significantly lower (Mann Whitney, p = 0,414 and p = 0,810). Histomorpological overview was not significantly not intact (Chi-square, p = 0,066), while the expression of N-cadherine and occludin were significantly lower (Chi-square = 0,001). There was not significant correlation between protein junction expression with intravenrticular hemorrhage (Spearman?s rho, p = 0,869 and p = 0,341).

Conclution: Hypoxia causes lower expression of N-cadherin and occludin, moleculary it cause placental endothelial capillary permeability but structurally it does not. Protein expression changes does not correlate with intraventricular hemorrhage."

"Latar Belakang : Kelahiran prematur saat ini menjadi penyebab utama kematian pada bayi. Bayi yang dapat bertahan hidup memiliki kemungkinan cacat dan keterlambatan perkembangan. Di Indonesia, data dari Maternal Perinatal Death Notification Kementerian Kesehatan tahun 2023 tercatat 29.945 kematian bayi disebabkan bayi berat lahir rendah (BBLR), prematuritas dan asfiksia. Pada bayi prematur sering terjadi gangguan hemodinamik yang memengaruhi aliran darah ke otak. Keadaan ini disertai belum maturnya autoregulasi pada bayi prematur menyebabkan mudah terjadi GM-IVH. Sebagian besar GM-IVH tidak muncul segera setelah lahir. Beberapa penelitian menyebutkan 50% GM-IVH muncul 48 jam pertama setelah lahir dan 90% pada 72 jam pertama setelah lahir. Kesulitan di lapangan adalah 25 - 50 % bayi tidak menunjukkan gejala dan tanda manifestasi GM-IVH pada fase awal. USG kepala Doppler warna diketahui dapat melihat perubahan aliran darah dengan menilai perubahan parameter Doppler warna.Tujuan : Mendapatkan nilai parameter USG kepala Doppler warna sebagai prediktor GM-IVH pada bayi prematur usia gestasi kurang dari sama dengan 34 minggu dalam 24 jam pertama kehidupan.Metode : Penelitian ini merupakan suatu penelitian kohort prospektif untuk mendapatkan prediktor GM-IVH pada 75 bayi prematur usia 24 jam pertama setelah lahir dengan usia gestasi kurang dari sama dengan 34 minggu yang dirawat di RSCM. Satu orang bayi meninggal, sehingga 74 bayi sebagai subjek yang diikutsertakan hingga penelitian selesai. Studi menggunakan Analitik Multivariat Prediktif Kategorik.Hasil : Distribusi karakteristik dalam penelitian ini sebanyak 74 subjek yang diikutsertakan dalam penelitian, diantaranya 60 (81,1%) didiagnosis GM-IVH pada usia antara 2-7 hari. Didapatkan bayi lahir dengan usia gestasi kurang dari sama dengan 34 minggu dalam usia 24 jam pertama menunjukkan parameter RI yang berperan dalam memprediksi GM-IVH dengan titik potong nilai parameter RI >0,69 pada USG kepala Doppler warna. Berdasarkan nilai titik potong RI > 0,69, pada AUC didapatkan sensitivitas 85,0 % dan spesifisitas 71,43%, nilai duga positif sebesar 92% dan nilai duga negatif 52%, kemaknaan p <0.0001.Simpulan: USG kepala Doppler warna dapat digunakan sebagai alat untuk memprediksi GM- IVH pada bayi prematur yang lahir dengan usia gestasi kurang dari sama dengan 34 minggu dalam usia 24 jam pertama kehidupan dengan nilai parameter RI > 0,69 sebagai parameter yang berperan memprediksi GM-IVH.

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Background: Premature delivery nowadays has become the primary cause of death in infants. The survivor infants can have some disabilities and developmental delays. In Indonesia, Maternal Perinatal Death Notification data from Health Ministry in 2023 report 29.945 number of death in infants caused by underweight, prematurities and asphixia. Premature infants often have haemodinamic abnormalities that can influence blood flow to the brain. This condition followed by the immature of the autoregulation in premature infants that can caused GM-IVH easyly. Most of GM-IVH did not appear directly after birth. A number of studies showed that GM-IVH 50% occured at 48 hours and 90% at 72 hours after birth. Difficulties in the field is 25 - 50 % infants do not show symptoms and signs of GM-IVH manifestation at early phase. Color Doppler head ultrasound could detect the early changes in the brain blood flow.

Aim : To have parameters values in color Doppler head ultrasound as predictor GM-IVH in premature infants at gestational ages less than equal 34 weeks and earlier than the first 24 hours of life.

Methods : A cohort prospective study to obtained GM-IVH predictors at 75 premature infants in gestation ages less than equal 34 weeks and age earlier than 24 hours of life, being treated at Cipto Mangunkusumo General Hospital. One baby died. Study was done using Multivarians Predictives Analitics Categories.

Result: There were 74 subject participated. Among the 60 (81,1%) were diagnosed GM-IVH at the age between 2-7 days. We found that premature infants in gestation ages less than equal 34 weeks and earlier than 24 hours of life, showed that the RI parameter played a significant role to predict GM-IVH. The cutoff point for color Doppler head ultrasound value was RI > 0,69, AUC revealed a sensitivity of 85,0 % and a specificity of 71,43 %, positive predictive value of 92% and negative predictive value of 52%, p <0.0001.

Conclusion: Color Doppler head ultrasound could be used as a tool to predict GM-IVH for prematures infants at gestation age less than equal 34 weeks and earlier than 24 hours of life."

"ABSTRAK Latar Belakang. Kemajuan dalam penanganan bayi prematur menyebabkan angka kesintasan meningkat. Akibatnya, angka kesakitan bayi prematur jugameningkat, salah satunya adalah osteopenia of prematurity (OOP). Pemeriksaankadar kalsium, fosfat, dan fosfatase alkali serum saat usia kronologis 4 minggudigunakan sebagai indikator awal sebelum osteopenia tampak secara klinis.Diagnosis sedini mungkin dan pengendalian faktor risiko perlu dilakukansehingga komplikasi dapat dicegah.Tujuan. Mengetahui prevalens dan faktor risiko terjadinya OOP.Desain Penelitian. Penelitian dengan desain potong lintang ini dilaksanakanpada bayi prematur dengan usia gestasi ≤32 minggu di Divisi Perinatalogi RS Dr.Cipto Mangunkusumo. Subyek diperiksa kadar kalsium serum, fosfat inorganikserum, dan fosfatase alkali serum. Pada subyek dilakukan pencatatan faktor risikoOOP untuk menilai hubungan antar variabel dan dilakukan analisis bivariatdengan uji chi square. Hasil Penelitian. Terdapat 80 subyek yang memenuhi kriteria penelitian.Delapan dari 80 subyek (10%) ditemukan menderita OOP. Faktor risiko yangdianalisis dalam penelitian ini ditemukan tidak memiliki hubungan bermaknadengan kejadian OOP, yakni lama penggunaan nutrisi parenteral total (p=0,457),lama penggunaan metilsantin (p=1,000), berat lahir (p=0,459), preeklampsiaberat pada ibu (p=0,344), korioamnionitis pada ibu (p=0,261), dan pemberiannutrisi enteral (p=0,797).Simpulan. Prevalens OOP di RS Dr. Cipto Mangunkusumo adalah 10%. Faktorlama penggunaan nutrisi parenteral total, penggunaan metilsantin, berat lahir,preeklampsia berat pada ibu, korioamnionitis, dan pemberian nutrisi enteral tidak memiliki hubungan bermakna dengan kejadian OOP.ABSTRACT Background. Advances in management of premature infants had increased the survival rate of these infants. However there is also increase of morbidity such as osteopenia of prematurity (OOP). Laboratory examination of serum calcium,phosphate, and alkaline phosphatase at the chronological age of 4 weeks is usedas early indicator before osteopenia become clinically appearant. Early diagnosisand risk control are needed to prevent complication. Objective. To evaluate the prevalence and risk factors of OOP.Methods. A cross sectional study was done in premature infants <32 weeks ofgestational age in Perinatalogy Division of Cipto Mangunkusumo Hospital.Laboratory examination of serum calcium, phosphate, and alkalinephosphatasewere conducted toward these subjects. Risk factors of OOP were alsoevaluated. Bivariat analysis was analysed by chi square test.Results. There are 80 subjects who meet the study criteria. Eight of 80 subjects(10%) was diagnosed as OOP. No risk factors have significant relationship withOOP incidence, which include duration of total parenteral nutrition (p=0,457),duration of methylxanthine usage (p=1,000), birth weight (p=0,459), severepreecalampsia in the mother (p=0,344), chorioamnionitis in the mother(p=0,261), and enteral nutrition (p=0,797).Conclusion. Prevalence of OOP in Cipto Mangunkusumo Hospital is 10%. Thereare no significant relationship between OOP incidence and duration of totalparenteral nutrition, methylxanthine usage, birth weight, severe preeclampsia in the mother, chorioamnionitis, and enteral nutrition.;Background. Advances in management of premature infants had increased the survival rate of these infants. However there is also increase of morbidity such as osteopenia of prematurity (OOP). Laboratory examination of serum calcium,phosphate, and alkaline phosphatase at the chronological age of 4 weeks is usedas early indicator before osteopenia become clinically appearant. Early diagnosisand risk control are needed to prevent complication. Objective. To evaluate the prevalence and risk factors of OOP.Methods. A cross sectional study was done in premature infants <32 weeks ofgestational age in Perinatalogy Division of Cipto Mangunkusumo Hospital.Laboratory examination of serum calcium, phosphate, and alkalinephosphatasewere conducted toward these subjects. Risk factors of OOP were alsoevaluated. Bivariat analysis was analysed by chi square test.Results. There are 80 subjects who meet the study criteria. Eight of 80 subjects(10%) was diagnosed as OOP. No risk factors have significant relationship withOOP incidence, which include duration of total parenteral nutrition (p=0,457),duration of methylxanthine usage (p=1,000), birth weight (p=0,459), severepreecalampsia in the mother (p=0,344), chorioamnionitis in the mother(p=0,261), and enteral nutrition (p=0,797).Conclusion. Prevalence of OOP in Cipto Mangunkusumo Hospital is 10%. Thereare no significant relationship between OOP incidence and duration of totalparenteral nutrition, methylxanthine usage, birth weight, severe preeclampsia in the mother, chorioamnionitis, and enteral nutrition."

"Kelahiran prematur atau bayi yang lahir sebelum usia kehamilan 37 minggu merupakan masalah kesehatan global yang memiliki risiko tinggi terhadap morbiditas dan mortalitas bayi. Bayi prematur yang lahir kurang dari usia kehamilan 34 minggu memiliki pola menghisap-menelan-bernafas yang tidak terkoordinasi dengan sempurna. Koordinasi dan keterampilan menghisap merupakan faktor penting dalam mencapai pemberian oral yang aman dan sukses pada bayi prematur. Intervensi stimulasi oral dapat diterapkan untuk mendukung perkembangan refleks menghisap dan menelan serta mengurangi lama waktu transisi dari pemberian minum melalui enteral ke oral. Karya ilmiah ini memberikan gambaran mengenai proses asuhan keperawatan pada bayi prematur dan efektifitas penerapan Oromotor Stimulation (OMS) selama 8 hari perawatan. Pemberian stimulasi dilakukan 15-30 menit sebelum pemberian minum dengan durasi selama 15 menit. Hasil evaluasi menunjukkan Oromotor Stimulation (OMS) efektif dalam meningkatkan berat badan dan kesiapan minum secara oral. Setelah diberikan intervensi, berat badan bayi meningkat dengan rata-rata kenaikan 24,2 gram/hari. Hasil evaluasi objektif menggunakan instrumen Premature Oral Feeding Readiness Assessment Scale (POFRAS) menunjukkan peningkatan skor dari 23 menjadi 34 yang berarti bayi memiliki kesiapan minum per- oral yang baik.

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Premature birth or infants born before 37 weeks of gestation is a global health problem that has a high risk of infant morbidity and mortality. Premature infants born less than 34 weeks of gestation have a pattern of sucking-swallowing-breathing that is not perfectly coordinated. Coordination and sucking skills are important factors in achieving safe and successful oral administration of preterm infants. Oral stimulation interventions can be used to support the development of sucking and swallowing reflexes and to reduce the transition time from enteral to oral feeding. This scientific work provides an overview of the process of nursing care for premature infants and the effectiveness of Oromotor Stimulation (OMS) for 8 days. Stimulation is given 15-30 minutes before feeding with a duration of 15 minutes. Evaluation results show that Oromotor Stimulation (OMS) is effective in increasing body weight and readiness to oral feeding. After being given the intervention, the baby's weight increased with an average increase of 24.2 grams/day. The results of an objective evaluation using the Premature Oral Feeding Readiness Assessment Scale (POFRAS) instrument showed an increase in score from 23 to 34 which means that the infant has good oral feeding readiness."

"Pendahuluan: Penelitian dilakukan untuk mengetahui peran senyawa flavonoid mangiferin dalam meningkatkan ekspresi mRNA HIF-1α dan sebagai pencekal besi dalam menstabilkan HIF-1α pada lini sel HepG2 dan menganalisis interaksi mangiferin dengan prolil hidroksilase (PHD2) secara simulasi docking.Metode: Sel HepG2 dikultur hingga >80% konfluen dan selanjutnya diberikan mangiferin konsentrasi 25-200μM. Kuersetin digunakan sebagai pembanding flavonoid mangiferin yang bekerja di dalam inti sel, sedangkan DFO dan CuCl2 digunakan sebagai pembanding daya ikat terhadap besi. Ekspresi mRNA HIF-1α ditentukan dengan real time RT- PCR/q-PCR, dan stabilisasi protein HIF-1α ditentukan mengunakan teknik ELISA. Simulasi docking dilakukan terhadap protein PHD2 dengan mangiferin, CuCl2, deferoksamin (DFO), dan campuran mangiferin+ kuersetin.Hasil: Uji viabilitas sel menggunakan metode MTS dengan pemberian mangiferin, kuersetin, campuran mangiferin-kuersetin, DFO dan CuCl2 (25-200μM) memperlihatkan hasil diatas 85%. Ekspresi mRNA HIF-1α dengan mangiferin, kuersetin, mangiferin+kuersetin, dan DFO menunjukkan hasil sedikit lebih tinggi dibanding kontrol. Konsentrasi protein HIF-1α pada pemberian mangiferin, kuersetin, mangiferin-kuersetin, DFO dan CuCl2 lebih tinggi dibanding kontrol. Simulasi docking mangiferin terhadap PHD2 memperlihatkan ΔG= -16,22, dan DFO menunjukkan ΔG= -17,15. Terdapat interaksi antara mangiferin, dan DFO dengan besi dan asam amino pada situs katalitik domain PHD2, sedangkan CuCl2 tidak berinteraksi dengan residu asam amino pada domain PHD2, tetapi langsung menggantikan Fe. Efek penghambatan terhadap PHD2 oleh mangiferin dan kuersetin disebabkan oleh delokalisasi elektron melalui kompleks transfer elektron.Kesimpulan: Mangiferin dapat meningkatkan ekspresi mRNA HIF-1α dan meningkatkan protein HIF-1α, menurun protein PHD2 dan menurunkan protein HO-HIF-1α pada lini sel HepG2 secara in vitro. Analisis docking terdapat interaksi antara mangiferin, dan DFO dengan besi dan asam amino PHD2. Mangiferin memiliki stabilitas pengkikatan dengan besi yang berdekatan dengan DFO.

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Introduction: This research was conducted to determine the role of flavanoid mangiferin to increase expression HIF-1α mRNA, and as an iron chelator to stabilize protein HIF-1α in cell line HepG2 and analyzes the interaction of mangiferin with prolil hidroksilase (PHD2) by docking simulation.

Methods: HepG2 cells were cultured and treated by mangiferin with concentration between 25-200μM. Quercetin is used as a comparison mangiferin flavonoid that works in the nucleus and DFO, CuCl2 is used as a comparison to iron-binding. HIF- 1α mRNA expression was determined by real time RT-PCR/q-PCR, and the stability HIF-1α protein were measured by the increase in HIF-1α protein, decreased PHD2 protein and decreased HO-HIF-1α using ELISA. Docking simulation was conducted between PHD2 protein and mangiferin, CuCl2, desferoxamine (DFO), and quercetin.

Results: Cell viability with MTS assay showed that cell exposure with 25μM-200μM concentrations of mangiferin, quercetin, mangiferin+quercetin mixture, DFO, and CuCl2 is above 85%. HIF-1α mRNA expression was slightly higher than in controls with mangiferin, quercetin, mangiferin quercetin mixture and DFO. HIF-1α protein concentration and ratios vs untreated controls were above 1 with mangiferin, quercetin, mangiferin quercetin mixture, DFO, and CuCl2. Docking simulation mangiferin with PHD2 showed ΔG= -16,22. Docking simulation with DFO showed ΔG= -17,15, and interact mangiferin, and DFO with iron in the catalytic site of PHD2 and with amino acid residues, whereas CuCl2 does not react with amino acid residues in the PHD2 domain, but directly replaces Fe. The inhibitory effect to PHD2 by mangiferin and quercetin is considered by electron delocalisation through an electron transfer complex.

Conclusion: Mangiferin can increase HIF-1α mRNA expression and HIF-1α protein levels in HepG2 cell line by in vitro. Binding interaction with iron and PHD2 amino acids occurs by mangiferin and DFO. Mangiferin has stability iron binding a similar with DFO."

"Latar belakang: Bayi moderate to late preterm menempati 80% populasi kelompok usia bayi prematur. Banyaknya komplikasi dan komorbiditas yang dapat terjadi pada bayi prematur menuntut adanya pemantauan perkembangan yang konsisten, praktis, efisien, dan sedini mungkin. Hal tersebut ditujukan untuk mencegah, mendeteksi, dan memberikan penanganan awal yang optimal. Instrumen uji tapis yang baik harus memiliki validitas, reliabilitas, sensitivitas dan spesifitas yang baik, serta lengkap meliputi semua aspek ranah perkembangan. Tujuan: Membandingkan sensitivitas dan spesifisitas uji tapis ASQ-3 dan Denver II terhadap baku emas Bayley-III dalam deteksi gangguan perkembangan pada bayi prematur usia koreksi 6–12 bulan.Metode: Penelitian potong lintang pada bayi prematur usia koreksi 6-12 bulan di Klinik Tumbuh Kembang RSCM pada bulan Oktober-Desember 2023. Kuesioner ASQ-3 diisi oleh orang tua dengan panduan petugas. Pemeriksaan Denver II dan Bayley III dinilai oleh dokter residen anak dan psikolog klinis anak yang terlatih pemeriksaan Bayley III. Hasil pemeriksaan dianalisis statistik dengan SPSS 25.Hasil: Enam puluh dua subjek penelitian diperiksa dan didapatkan sensitivitas ASQ-3 dan Denver II dibandingkan dengan Bayley-III pada bayi prematur usia koreksi 6-12 bulan masing- masing adalah 89,66% dan 79,31% sedangkan spesifisitasnya sebesar 93,94% dan 87,88%. Selain itu, ASQ-3 memiliki nilai PPV, NPV, PLR, NLR dan akurasi yang lebih tinggi dibandingkan dengan Denver II.Kesimpulan: Uji tapis ASQ-3 memiliki sensitivitas dan spesifisitas yang lebih baik dibandingkan dengan Denver II untuk deteksi gangguan perkembangan pada bayi prematur usia koreksi 6-12 bulan. Kuesioner ASQ-3 dapat digunakan untuk uji tapis gangguan perkembangan bayi prematur yang efektif dan mudah digunakan.

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Background: Moderate to late preterm baby occupies 80% age group of preterm babies. The complications and comorbidities occur in preterm require consistent, practical, and efficient early developmental monitoring to aim optimal initial intervention. The developmental screening test instrument must have good validity, reliability, sensitivity and specificity, and covering all aspect developmental domain.

Objective: This study aims to investigate the sensitivity and specificity of two brief developmental screening, the Ages and Stages Questionnaires, 3rd Edition, Indonesian-version (ASQ-3) with the Denver Developmental Screening test II (Denver II).

Method: A cross-sectional design conducted in corrected aged 6 to 12 months preterm infants from Growth and Developmental Social Paediatric Clinic in Cipto Mangunkusumo Hospital in October to December 2023. The ASQ-3 questionnaires was filled in by parents with guidance from health workers. Denver II and Bayley III was assessed by paediatric resident and trained paediatric clinical psychologist. Results: A total of 62 preterm infant was recruited. Sensitivity of ASQ-3 and Denver II compared to Bayley-III were 89,66% and 79,31%, respectively with specificity 93,94% and 87,88%, respectively. Furthermore, ASQ-3 showed higher PPV, NPV, PLR, NLR, and accuracy compared to Denver II.

Conclusion: The ASQ-3 questionnaires had significantly higher sensitivity and specificity compared to Denver II for developmental delay screening. This tool was appropriate for consistent screening due to its effectiveness and simplicity."

"Kelahiran bayi prematur dan perawatan di ruang rawat intensif neonatus merupakan peristiwa yang menyebabkan sumber stres pada orang tua khususnya ibu. Penelitian ini bertujuan untuk mendapatkan pemahaman yang mendalam mengenai pengalaman ibu selama perawatan masa awal kehidupan bayi prematur di ruang rawat intensif neonatus RSUP Dr. Soeradji Tirtonegoro Klaten. Desain penelitian kualitatif dengan pendekatan fenomenologi ini pada delapan partisipan. Analisis data menggunakan metode Colaizzi dan menghasilkan tujuh tema penelitian, yaitu: reaksi ibu, proses berduka, dampak perawatan bayi prematur, koping diri ibu, upaya ibu untuk meningkatkan hubungan kelekatan (bonding attachment), dukungan terhadap ibu, dan harapan selama perawatan bayi prematur.

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The birth and treatment of premature infants in the neonatal intensive care unit is the event that makes it the source of stress to parents especially the mother. This study aims to gain a deeper understanding of the experience of mother during the early life of premature infants in the neonatal intensive care unit of Dr. Soeradji Tirtonegoro Central Hospital, Klaten. This qualitative research design with phenomenology approach took eight participants. The data analysis uses Colaizzi method and produced seven research themes, namely: the mothers reaction, the grieving process, the impact of premature infant care, mother's self 'coping efforts, the mothers' attempts to improve the close and attached relationship (bonding attachment), the support for the mother, and expectations for the care of premature infants."

"Bayi prematur menghadapi banyak tantangan ketidakseimbangan cairan untuk bertahan di lingkungan ekstrauterin, sehingga membutuhkan pendekatan asuhan keperawatan yang komprehensif. Studi kasus ini menggambarkan proses keperawatan menggunakan model Konservasi Levine untuk merawat lima bayi prematur dengan ancaman keseimbangan cairan. Pengkajian mengidentifikasi triphocognosis meliputi risiko kekurangan volume cairan dan masalah cairan lainnya. Perawat anak merawat sesuai kompetensi, seperti pemantauan kesesuaian cairan masuk dan kebutuhan, pengurangan jumlah insensible water loss, blood management, dan peningkatan kemampuan minum melalui mulut. Intervensi membantu bayi prematur dan keluarga berhasil beradaptasi untuk mencapai wholeness. Penerapan model ini menyediakan pengalaman asuhan keperawatan yang komprehensif sebagai referensi untuk kasus serupa selanjutnya.

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Preterm infants faces many challenges of fluid imbalance for survive in the extrauterine environment. It needs comprehensive nursing care approach. This study describes a nursing process using Levine’s Conservation model to care five preterm infants with threat to fluids imbalance. The assessments identified triphocognosis including risk of deficient fluid volume and other related problems. Pediatric nurse care according to competencies, such as monitoring the suitability of fluid intake and requirement, reducing the amount of insensible water loss, blood management, and increased oral feeding ability. The interventions helped the preterm infant and family adapt successfully to achieve wholeness. This application of model provides a comprehensive nursing care experience as reference for future similar cases."

"Kompleksitas perawatan bayi yang intensif menyebabkan ada perawatan rutin yang terlewatkan sehingga dapat memperpanjang lama perawatan, risiko rawat ulang, meningkatkan komplikasi bayi, dan menurunkan kepuasan orang tua. Penelitian cross-sectional ini bertujuan untuk mengidentifikasi hubungan antara pelaksanaan perawatan bayi prematur dengan kepuasan orang tua. Teknik consecutive sampling dilakukan untuk memilih 59 perawat dan 59 orang tua bayi prematur. Analisis menggunakan uji Pearson. Hasil penelitian menunjukkan bahwa rata-rata pelaksanaan perawatan bayi prematur sebesar 161,93 dan rata-rata kepuasan orang tua sebesar 280,07. Terdapat hubungan antara pelaksanaan perawatan bayi prematur dengan kepuasan orang tua (pvalue<0,001, r= 0,77). Bagi pelayanan keperawatan dapat menjadi evaluasi terhadap kinerja perawat untuk meningkatkan kualitas perawatan bayi prematur dan kepuasan orang tua meningkat.

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Complexity of intensive care of premature babies causes some routine nursing cares are overlooked which may lead to extension of length of stay, risk of rehospitalization, additional disease complications, and decrease of parents satisfaction. This cross-sectional study aimed to identify the relationship between the implementation of a premature babies care with parents satisfaction. Consecutive sampling technique was conducted to select 59 nurses and 59 parents of premature babies as research respondents. The data was analyzed with Pearson test. The results showed that the average of premature babies care score was 161.93 and the average of parents satisfaction score was 280.07. There was a significant relationship between the implementation of premature babies care with parents satisfaction (p value <0.001, r = 0.77). Nursing care should be evaluated to improve the performance of nurses and the quality of care of premature babies and parents satisfaction."

"Latar Belakang :Insidensi terjadinya ketuban pecah dini (KPD) pada kehamilan preterm adalah 3-10,% dari semua persalinan. Lama terjadinya ketuban pecah dini berpengaruh pada kejadian infeksi maternal dan sepsis pada bayi. Sepsis, termasuk sepsis neonatal awitan dini (SNAD), masih menjadi penyebab utama kematian bayi prematur. Vitamin D berperan meningkatkan imunitas tubuh terutama saat menghadapi infeksi. Tujuan penelitian ini ingin mengetahui hubungan antara lama KPD, leukosit maternal, kadar vitamin D maternal dan tali pusat dengan luaran sepsis awitan dini pada bayi prematur.Metode : Desain penelitian kohort retrospektif dengan menggunakan rekam medis dan data penelitian sebelumnya. Mencatat lama ketuban pecah dini, kadar leukosit maternal, kadar vitamin D maternal dan tali pusat dankejadian sepsis pada bayi yang dilahirkan usia 28-34 minggudi Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo dan Rumah Sakit Umum Pusat Persahabatan, Jakarta. Subjek penelitian diambil secaraConsecutivesampling.Hasil : Selama periode penelitian didapatkan 72 subjek bayi yang dilahirkan dari ibu dengan KPD, 22 bayi (31%) diantaranya mengalami SNAD, sedangkan 50 bayi lainnya tidak mengalami SAD. Tidak terdapat hubungan antara lama KPD, jumlah leukosit maternal dengan kejadian SNAD tetapi didapatkan hubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD.

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Background:The incidence of premature rupture of membranes (PROM) in preterm pregnancy is 3-10,% of all deliveries. The duration of premature rupture of the membranes affects the incidence of maternal infection and sepsis in infants. Sepsis, including early onset neonatal sepsis (EONS), is still the main cause of premature infant mortality. Vitamin D acts to increase the body s immunity, especially when facing infection. The purpose of this study was to determine the relationship between the length of the ROM, maternal leukocytes level, maternal and umbilical cord vitamin D levels with early onset sepsis in premature infants.

Method:Design of a retrospective cohort study using medical records and previous research data. Note the duration of premature rupture of the membranes, maternal leukocyte levels, maternal vitamin D levels and umbilical cord and the incidence of sepsis in infants born 28-34 weeks at the National Center General Hospital Dr. Cipto Mangunkusumo and Center General Hospital Pesahabatan, Jakarta. The research subjects were taken by consecutive sampling.

Results: During the study period 72 subjects were born from mothers with ROM, 22 infants (31%) among them experienced EONS, while 50 other infants did not experience EONS. There was no relationship between the duration of ROM, the number of maternal leukocytes with the incidence of EONS, but a significant relationship was found between maternal vitamin D levels and umbilical cord with EONS events."