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Abstrak :
ABSTRAK
Latar Belakang : Prevalensi KB menurut alat atau cara KB berdasarkan hasil mini survey peserta aktif tahun 2007 di Indonesia adalah 65,9%. Konseling merupakan aspek yang sangat penting dalam pelayanan KB dan kesehatan reproduksi. Konseling yang baik juga akan membantu klien dalam menggunakan kontrasepsinya lebih lama dan meningkatkan keberhasilan KB Tujuan : Meneliti faktor-faktor yang mempengaruhi pemilihan jenis kontrasepsi dan lama pemakaiannya pada akseptor KB di Klinik Raden Saleh dan Rumah Sakit Umum Pusat Fatmawati Metode : Penelitian observasional dengan desain studi prospektif. Faktor yang diteliti meliputi : faktor perencanaan keluarga (umur istri, jumlah anak yang diinginkan dan infertilitas), faktor subyektf (pengalaman efek samping kontrasepsi, dukungan suami/keluarga dan agama), faktor obyektif (ganguan medis, yang membantu memilih kontrasepsi, tempat layanan kontrasepsi dan ketersediaan alat kontrasepsi) dan tingkat motivasi (tingkat pendidikan). Semua klien yang akan melakukan kontrasepsi dan memenuhi kriteria penelitian, dilakukan wawancara dan pengisian kuesioner hingga mencapai jumlah sampel yang diinginkan. Penelitian dilakukan di Klinik Raden Saleh RSCM dan RSUP Fatmawati. Kemudian dilakukan follow up pada 3 dan 6 bulan pasca melakukan kontrasepsi untuk menilai lama pemakaiannya Hasil : Jumlah total subyek sebanyak 151 orang. Rata-rata usia responden 31 tahun dengan pilihan jenis kontrasepsi AKDR 67.1%, implan 17.8%, kontap 7.2%, suntik 3.9% dan oral 3.9%. Dari seluruh faktor yang diteliti, hanya faktor jumlah anak yang diinginkan yang terbukti secara statistik berpengaruh dalam pemilihan jenis kontrasepsi (p=0.008) di RSUP Fatmawati sedangkan di Klinik Raden Saleh semua faktor tersebut tidak terbukti secara statistik berpengaruh dalam pemilihan jenis kontrasepsi (p>0.05). Didapatkan pula bahwa seluruh faktor tersebut juga tidak memiliki berpengaruh secara statistik (p>0.05) terhadap lamanya pemakaian kontrasepsi baik di Klinik Raden Saleh maupun di RSUP Fatmawati. Dari 6.6 % subyek (n = 10 ) yang mengganti jenis kontrasepsi, terdapat kecenderungan perubahan jenis kontrasepsi dari oral menjadi suntik (33.3%) dan AKDR menjadi suntik (66.7%). Kesimpulan : Faktor jumlah anak yang diinginkan memiliki pengaruh dalam pemilihan jenis kontrasepsi di RSUP Fatmawati sedangkan di Klinik Raden Saleh semua faktor yang diteliti tidak berpengaruh dalam pemilihan jenis kontrasepsi. Faktor perencanaan keluarga, faktor subyektif, faktor obyektif dan tingkat motivasi tidak memiliki pengaruh terhadap lamanya pemakaian kontrasepsi pada klien di Klinik Raden Saleh dan RSUP Fatmawati

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ABSTRAK
Bacground : The prevalence of contraception according to the methods or the way of contraception based on the survey results of active participants in Indonesia in 2007 was 65.9%. Counseling is a very important aspect in the family planning and reproductive health services. Good counseling will also assist clients in using the contraceptive for longer and increase the successful rate of contraception. Objective: To evaluate the factors that related to the selection of the contraception methods and The Length of Its use on acceptors in Raden Saleh Clinic and Fatmawati General Hospital Methods: The study was a prospective observational study designs. The factors that we observe include : the family planning factor (the wife age, number of desired children and infertility), subjective factors (side effects experience of contraception, support from the husband / family and religion), objective factors (medical disorder, person who help to select contraception, family planning service centre and availability of contraceptives) and the level of motivation (level of education). All the clients who will perform and meet the criteria for contraceptive research, conducted interviews and questionnaires to achieve the desired sample size. The study was conducted at the Raden Saleh Clinic and Fatmawati General Hospital. Then we conducted to follow-up at 3 and 6 months after the use of the methods to assess the length of use Results: The total number of subjects as many as 151 people. The average age of respondents was 31 years with the contraception options were IUD (67.1%), implants (17.8%), sterilization (7.2%), injectable contraception (3.9%) and oral contraception (3.9%). From all the factors studied, only the number of desired children affect in the selection of the contraception methods statistically (p=0.008) in Fatmawati General Hospital while in Raden Saleh Clinic all of these factors do not affect in the selection of the contraception methods (p>0.05). We also found that all of these factors does not have a significant relationship to the length of contraceptive use (p> 0.05). There were 6.6% of subjects (n = 10) that change the type of contraception. From all of them, there was a trend of changing the oral contraceptive to injectable method (33.3%) and the IUD into injectable method (66.7%). Conclusion: Only the number of desired children has effect on the selection of the contraception methods in Fatmawati General Hospital while in Raden Saleh xii Universitas Indonesia Clinic all of these factos do not affect in selection of the contraception methods. Family planning factors, subjective factors, objective factors and motivation levels have no effect on the length of contraceptive use by clients at Raden Saleh Clinic and Fatmawati General Hospital

Abstrak :
Latar Belakang : Wabah pneumonia akibat Corona Disesase 2019 (COVID-19) masih menjadi perhatian nasional maupun global. Wanita hamil termasuk dalam kelompok risiko tinggi/rentan terhadap infeksi COVID-19. Adanya badai sitokin akibat infeksi COVID-19 menyebabkan gejala klinis yang semakin berat. Zinc sebagai salah satu mikronutrien penting yang berpengaruh dalam regulasi produksi sitokin oleh sistem imun tubuh. Kondisi defisiensi zinc pada wanita hamil yang terinfeksi COVID-19 dapat menyebabkan disregulasi dari sistem imun dan menghasilkan badai sitokin yang mengakibatkan sindrom ancaman gagal napas akut dan kematian. Tujuan : Meneliti hubungan kadar zinc serum maternal terhadap kadar sitokin pro- inflamasi interleukin-6 (IL-6) dan interferon gamma (IFN-) pada wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Metode : Penelitian observasional dengan desain studi cross-sectional. Subyek penelitian adalah wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Faktor yang diteliti meliputi kadar zinc, IL-6 dan IFN- serum maternal dan hubungannya kadar zinc serum terhadap kadar IL-6 dan IFN- serum maternal. Hasil : Jumlah total subyek sebanyak 48 orang dibagi menjadi 28 subyek untuk kelompok wanita hamil yang terkonfrimasi COVID-19 gejala ringan-sedang dan 20 subyek dengan gejala berat. Rata-rata usia responden 30,61 tahun untuk kelompok gejala ringan-sedang dan 32,9 tahun untuk kelompok gejala berat. Rata-rata usia kehamilan pada kelompok gejala ringan-sedang lebih tua dibanding kelompok gejala berat (38,1 minggu vs 34,5 minggu).Lama perawatan kelompok dengan gejala berat lebih lama dibanding kelompok gejala ringan-sedang. 60% subyek dari kelompok gejala berat berakhir dengan kematian maternal. Semua subyek dalam penelitian ini mengalami defisiensi zinc. Tidak terdapat perbedaan bermakna kadar zinc serum maternal pada kedua kelompok yaitu 54,0 (34-78) μg/dl untuk kelompok gejala ringan-sedang dan 52,0 (38-97) μg/dl untuk kelompok gejala berat. Terdapat perbedaan bermakna antara kelompok gejala ringan-sedang dengan kelompok gejala berat terhadap kadar IL-6 serum (5,8 (1,5-69,6) pg/ml vs 18,6 (3,8-85,3) pg/ml) dan kadar IFN- serum (0,9 (0,1-16,8) pg/ml vs 9,0 (0,9-21,1) pg/ml). Tidak ada korelasi antara kadar zinc serum maternal dengan kadar IL-6 dan IFN- serum maternal. Kesimpulan : Kadar zinc serum maternal tidak berbeda bermakna diantara kedua kelompok penelitan. Kadar IL-6 dan IFN- serum kelompok gejala berat lebih tinggi dibanding kelompok gejala ringan-sedang. Tidak ada korelasi antara kadar zinc serum dengan kadar IL-6 dan IFN- serum maternal. ......Bacground : The outbreak of Corona Disesase 2019 (COVID-19) is still a national and global concern. Pregnant women are included in the highrisk/susceptibility group for COVID-19 infection. The presence of a cytokine storm due to COVID-19 infection causes increasingly severe clinical symptoms. Zinc is one of the important micronutrients that influence the regulation of cytokine production by the immune system. Zinc deficiency in pregnant women with confirmed COVID-19 can cause dysregulation of the immune system and produce a cytokine storm that results in acute respiratory distress syndrome and maternal death. Objective: To evaluate the relationship between maternal serum zinc levels and the pro- inflammatory cytokines interleukin-6 (IL-6) and interferon-gamma (IFN-) in pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. Methods: A cross-sectional was adopted in this study. The subjects of the study were pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. We measure the maternal serum zinc levels, serum IL-6 and IFN- levels, then we evaluate the relation between the maternal serum zinc levels and the maternal serum IL- 6 and IFN- levels. Results: The total number of subjects was 48 patiens, divided into 28 subjects for the pregnant women with confirmed COVID-19 with mild-moderate symptoms and 20 subjects with severe symptoms. The average age of the respondents was 30.61 years for the mild-moderate group and 32.9 years for the severe group. The mean gestational age in the mild-moderate group was older than in the severe one (38.1 weeks vs. 34.5 weeks). The length of stay of subjects with severe symptom was longer than the mild-moderate group. 60% cases from the severe group ended in maternal death. All the participants in this study suffered zinc deficiency. There was no significant difference in maternal serum zinc levels between the two study groups (54.0 (34-78) g/dl in mild-moderate group vs 52.0 (38-97) g/dl in severe group). There was a significant difference between mild- moderate vs severe groups in which the serum IL-6 levels were (5.8 (1.5-69.6) pg/ml vs 18.6 (3.8-85.3) pg/ ml) and the serum IFN- levels were (0.9 (0.1-16.8) pg/ml vs. 9.0 (0.9- 21.1) pg/ml). There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels. Conclusion: The maternal serum zinc levels were not significantly different between the two study groups. The maternal serum IL-6 and IFN- levels in the severe group were higher than in the mild-moderate group. There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels.