Salah satu tujuan yang hendak dicapai oleh World Health Organization pada tahun 2000 adalah health for all by year 2000. Beberapa indikator digunakan untuk mengukur pencapaian tersebut, diantaranya angka kematian bayi (AKB) dan angka kematian ibu (AKI). Dinas Kesehatan Sumatera Barat telah berhasil menurunkan AKB dan AKI selama 5 tahun terakhir, akan tetapi angka-angka tersebut tidak menggambarkan angka yang sebenarnya karena hanya diperoleh berdasarkan prediksi perhitungan statistik kependudukan. Angka tersebut juga tidak dapat memperlihatkan disparitas antarwilayah dan kelompok sosial ekonomi di Sumatera Barat. Penelitian ini dilakukan untuk mendapatkan AKB dan AKI yang tepat serta mengetahuifaktor determinan dan permasalahannya di Sumatera Barat pada tahun 2007. Desain penelitian adalah Direct Household Survey Method dengan pendekatan prospektif. Penelitian dilakukan di 19 kabupaten/kota di Provinsi Sumatera Barat dari tanggal 1 Januari sampai 31 Desember 2007. Hasil penelitian menunjukkan AKB dan AKI Sumatera Barat tahun 2007 berkisar 28,4 per 1.000 kelahiran hidup dan 211,9 per 100.000 kelahiran hidup. Asfiksia dan perdarahan postpartum merupakan penyebab kematian utama ibu dan bayi. Dinas Kesehatan Sumatera Barat dan pemerintahannya harus mempunyai komitmen yang kuat untuk membangun jaringan kerja yang efektif untuk menurunkan AKB dan AKI di Sumatera Barat.Kata kunci: Angka kematian bayi, angka kematian ibu, asfiksia, postpartumAbstractOne of the main goals that WHO wants to reach in 2000 is Health for All Year 2000. Some of indicators have been using to measure the goals, such as infant mortality rate (IMR) and maternal mortality rate (MMR). West Sumatera Health Office had been successed reducing IMR and MMR for over 5 years, but the score was not mentioned the exact number becausethis measurement just using national statistic measurement. It also could not describe the disparity between the area and sosial group in West Sumatera. This research aim is to get the exact number of IMR and MMR, determinat factors and its problems in West Sumatera in 2007. The study desain was Direct Household Survey Method with prospective approach. The research was done in 19 different government district in West Sumatera from January 1st until December 31st 2007. Result of this research found IMR and MMR of West Sumatera in 2007 is 28,4 per 1.000 birth life and 211,9 per 100.000 birth life. Asphyxia and postpartum bleeding is the main cause of infant and maternal death. West Sumatera Health Office and its government should have a strong commitment to build effective networking to reduce IMR and MMR in West Sumatera.Key words: Infant mortality rate, maternal mortality rate, asphyxia, postpartum
AbstrakPsoriasis adalah penyakit inflamasi kulit kronik residif, khas ditandai dominasi erupsi pustula yang disertai dengan gejala sistemik seperti demam yang berlangsung beberapa hari. . Psoriasis dalam kehamilan dapat menyebabkan terjadinya abortus spontan, lahir mati (stillbirth), dan kelahiran prematur. Dilaporkan kasus Ny. YS 38 th, dikonsulkan dari bagian kulit kelamin RS M Djamil Padang dengan diagnosa G3P2A0H2 + psoriasis pustularis. Dilakukan USG fetomaternal, didapat biometri : BPD : 80mm, FL : 61 mm, HL : 54 mm, AC 271 mm, AFI 10,7 cm, SDAU 2,79, taksiran berat janin 1700-1800 gram. Kesan : gravid 31-32 minggu, janin hidup tunggal intra uterin. Pasien direncanakan untuk pemberian kortikosteroid dosis tinggi. Informed consent pada pasien dan keluarga tentang tindakan yang akan dilakukan. Dilakukan pemberian kortikosteroid sebanyak 30 mg jangka lama dengan dosis prednison dalam tappering off tiap 2 minggu. Pasien dipulangkan untuk kontrol ke poliklinik kulit dan kebidanan, pasien datang 12 hari kemudian dan dikonsulkan ke bagian kebidanan untuk terminasi kehamilan namun dari bagian kebidanan tidak ada indikasi untuk terminasi kehamilan. Pasien lalu datang 13 hari kemudian dengan keadaan PRM 18 jam. Dilakukan terminasi kehamilan dengan seksio sesarea. lahir bayi perempuan dengan BBL : 3000 gr, PB : 48 cm, A/S : 8/9 , tidak tampak kelainan kongenital seperti gangguan pertumbuhan, bibir sumbing, katarak, dan penyakit ginjal polikistik pada bayi. Penyebab psoriasis pada kasus ini kemungkinan adalah kehamilan. AbstractPsoriasis is a chronic residive skin inflammation disorder, characterized by domination of pustule eruption along with systemic symptoms such as fever that lasts for days. Psoriasis in pregnancy can cause spontaneous abortion, stillbirth, and premature birth. It is reported that YS, A 38 years old woman was consulted by Dermatovenereology Departement of M. Djamil Hospital with G3P2A0H2 with pustularis psoriasis. Fetomaternal Ultrasound was held to gain biometric size : BPD : 80 mm, FL : 61 mm, HL : 54 mm, AC : 271 mm, AFI 10,7 cm, SDAU 2,79, and estimated fetal weight is 1700-1800 grams. Expertised as 31-32 weeks of pregnancy with single living intra uterine fetus, the patient was planed to be given high corticosteroid dose. Informed consent to the patient and the family was held. Long term course of 30 mg of corticosteroid dose with 2 weeks serial tapering off dose of prednison was given. Patient was reffered to the dermatovenereology clinic and then consulted to the obstetric and gynecologic departement the next 12 days to terminate the pregnancy. Since there was no indication of termination, the patient was observed. The next 13 days the patient was admitted to the hospital with 18 hours of PRM. A Caesarean Surgery was held to terminate the pregnancy. A 3000 grams and 48 cm length of female newborn was delivered with Apgar Score 8/9. No congenital defect such as growth restriction, labiopalatum cleft, cataract, and policysctic kidney disease was found. The propable cause of psoriasis in this...
Psoriasis is a residual chronic inflammatory skin disease, characterized by a predominance of pustular eruptions accompanied by systemic symptoms such as fever lasting several days. . Psoriasis in pregnancy can lead to spontaneous abortion, stillbirth and preterm birth. Reported the case of Mrs. YS 38 years old, received from the genital skin section of RS M Djamil Padang with a diagnosis of G3P2A0H2 + pustular psoriasis. Fetomaternal ultrasound was performed, obtained biometrics: BPD: 80mm, FL: 61 mm, HL: 54 mm, AC 271 mm, AFI 10.7 cm, SDAU 2.79, estimated fetal weight 1700-1800 grams. Impression: gravid 31-32 weeks, single live fetus intra uterine. Patients are planned for administration of high doses of corticosteroids. Informed consent to the patient and family about the actions to be performed. Corticosteroid was administered as much as 30 mg long term with a dose of prednisone in tappering off every 2 weeks. The patient was discharged for control to the skin clinic and obstetrics, the patient came 12 days later and was consulted to the obstetrics department for termination of the pregnancy but from the obstetrics department there was no confirmation for termination of the pregnancy. The patient then came 13 days later with 18 hours PRM. Pregnancy termination by cesarean section was performed. a baby girl was born with LBW: 3000 gr, PB: 48 cm, A / S: 8/9, there were no congenital abnormalities such as growth disorders, cleft lip, cataracts, and polycystic kidney disease in infants. The cause of psoriasis in this case is probably pregnancy.Keywords: pustularis psoriais, psoriasis, pregnancy, corticosteroid
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