The effect of music on pain and anxiety of

women during labour on

first time pregnancy: A study from Turkey
Sule Gokyildiz Surucu*, Melike Ozturk, Burcu Avcibay Vurgec, Sultan Alan, Meltem Akbas

Christian Rivandika
1820221081

Pembimbing
dr. Adi Sukrisno, Sp.OG
Abstract
Objective Method
⬡ This study aims at ⬡ When the pregnant women in
analyzing the the experimental group
effect of music on progressed into the active phase
pain and anxiety of the labor, they were made to
felt by women in listen to music in Acemasiran
labor during their mode with earplugs for 3 h (20
first pregnancy min of listening
⬡ with 10-min breaks)
2
Abstract
Finding Conclusion
⬡ It was observed that after the ⬡ In order to facilitate
first-hour women indicated that
women's coping with labor
their pain was statistically less in
the experimental group. Trait pain and improve their
anxiety scores of the women in wellbeing with the activity
labor were similar for during the labor,
experimental and control groups.
musicotherapy, a non-
Following the practice, state
anxiety average scores became pharmacological method, is
lower in favor of the experimental an effective, simple and
group and the correlation was
⬡ economical method. 3
statistically significant
Introduction
⬡ Labor is one of the most intense pain sources that is
known, especially uterine contractions in primigravidas
and labor. Pain is the primary symptom that motivates
people to seek professional help
⬡ As time progresses, the pain becomes more frequent, and
the resting period between contractions becomes shorter
⬡ Despite the expectation of pain during labor, irregular
pains that exceed women's tolerance may result in
adverse physiological and psychological effects on both
the mother and the fetus 4
Introduction
⬡ Non-pharmacological and pharmacological
methods are used in controlling labor pain
⬡ Essential criteria for the eradication of labor
pain are the provision of good analgesia,
securing the safety of the mother and baby,
continuous and predictable effects, simple
methods and mother's control over the
process
5
Introduction
⬡ Music plays an important role in
people's life. It has been used to
help people's well-being and
provide pain relief since antiquity.
Directly or indirectly, it affects
physiological and clinical symptoms

6
Method
⬡ The research population consisted of pregnant
women who consulted a maternal and children
hospital located in the southern part of Turkey
⬡ The sample consisted of healthy pregnant women
who complied with the research criteria. The
research was conducted with 50 primipara women
(25 for experimental, 25 for the control group)

7
Methode
⬡ Criteria for inclusion in the research:
∙ Voluntary participation
∙ Being in term pregnancy (37 – 41 pregnancy week)
∙ Being primipara
∙ Pregnancy without risk
⬡ Criteria for exclusion:
∙ Having hearing problems
∙ Inducing labor
∙ Using analgesia/anesthesia during labor
∙ Delivery by C-section
∙ Delivering while listening to music

8
Method
⬡ In data collection, “Pregnant Introductory Form” was used for
identifying socio-demographic features of pregnant women,
“Evaluation Form on Labor” for evaluating progression of the
labor, “Visual Comparison Scale” for identifying perceived
level of pain, “STAI I-II State-Trait Anxiety Scale” developed by
Spielberger et al., “Faces Anxiety Scale” for identifying
anxiety levels and “Post-Delivery Evaluation Form” for
evaluating the practise after delivery.

9
Method
⬡ The women in the experimental group were made to
listen to music in Acemasiran mode for 3 h (20 min
listening, 10 min resting) with earphones(dilation 4 cm)
when they progressed into the active phase of labor
⬡ pain perception of the pregnant women was measured
with VAS
⬡ anxiety level was examined by the state anxiety scale
and the faces anxiety scale

10
Result
⬡ When the pain of pregnant women in experimental and
control groups are analyzed according to the visual
analogue scale (VAS)
⬡ It was found that the average score for painwas similar for
both of the groups at the beginning and during the first 30
min
⬡ However, statistically significant difference was observed
between the experimental and control groups' average
scores on VAS after the 1st hour of labor (p < .05).
11
Result
⬡ When the pregnant women in experimental and control
groups are analyzed in terms of their anxiety level, it was
found that their trait anxiety scores were similar, and the
state anxiety average scores changed in favor of
experimental group after the practice (p < 0.05)
⬡ While there was no difference between experimental and
control groups in terms of the faces anxiety scale before
the practice, after the practice the faces anxiety scale
score of the experimental group became lower and the
difference between the groups was statistically significant
12
Result
⬡ The analysis of dilation and effacement findings of the
pregnant women reveal that no statistically significant
differencewas found between experimental and control
groups at the end of the 1st hour of labor, while dilation and
effacement were found to be more for pregnant women in
control group when compared with experimental group in
the 3rd, 5th and 7th hours (p < .05).
⬡ The labor process progressed faster for the women in the
experimental group
13
Result
⬡ When the pregnant women in the experimental
and control groups are analyzed in terms of
contraction periods, no significant difference was
found between the groups in the 1st and 7th hours.
The contraction period was found to be longer for
the participants in the experimental group when
compared with the control group in the 3rd and 5th
hours (p < .05)
14
Result
⬡ The analysis of diastolic blood pressure measurements
reveals that the diastolic blood pressure of the participants
in the experimental group was lower in comparison to the
control group in the 1st, 3rd and 5th hours and the
difference was statistically significant (p < .05).
⬡ No statistically significant difference was found between the
participants in experimental and control groups in terms of
fetal heart rate, pulse, and respiration rate.

15
Result
⬡ The pregnant women in theexperimental group responded
to the question “Can you claim that the music you listened
to had an effect on your pain?” as “partially effective” at
88% and “not effective” at 12%. 88% of the pregnant
women stated that listening to music helped them relax.
88% also stated it helped them adjust to the environment,
while 72% stated it provided tranquility as well as a sense
of trust and 64% stated it helped them reduce their level of
pain

16
Discussion
⬡ In a study which aimed at analyzing the
effects of light music on pain during the
active phase of the labor of primipara Thai
women, Phumdoungand Good (2003) 98% of
the women stated, that the music they
listened to helped them and 92% stated they
liked the music

17
Discussion
⬡ In a thesis study which aimed at analyzing the effect of
training and music on the labor process for primipara
pregnant women who had induction, Ersanli (2007) found
that after the delivery 92.5% of the pregnant women in the
experimental group stated that the music helped their
pain. 30.2% of the women in the experimental group
stated that the music helped them relax, 26.9% stated it
gave them tranquility and assurance, 23.8% said it
reduced the feeling of pain and 14.3% claimed it helped
them adjust to the environment.
18
Discussion
⬡ In line with the other, it was found that
women who participated in our study also
had a fear of pain during labor. In a study
conducted by Phumdoung and Good
(2003), it was found that the pregnant
women's pain perceptionwas lower in the
group that listened to music and that there
was a significant difference between this
group and the control group.

19
Discussion
⬡ No statistically significant difference
was found between fetal heart
sounds. In their study which aimed
at identifying the effects of music
on pain perception and anxiety
levels of primipara women in the
first phase of labor, Nayak et al.
(2014)
20
Terimakasih
22
KONDILOMA
AKUMINATA
Definisi
⬡ Kondiloma akuminata merupakan
salah satu manifestasi klinis yang
disebabkan oleh infeksi Human
Papillomavirus Virus (HPV), paling
sering ditemukan di daerah genital
dan jarang di mukosa

24
Etiologi
⬡ Virus HPV pertama kali diidentifikasikan pada tahun 1907.
Kini, lebih 120 jenis subtipe HPV telah dapat diidentifikasi.
Tapi tidak semua tipe dapat menyebabkan kondiloma
akuminata. Sekitar 90 % kondiloma akuminata diyakini
berhubungan dengan tipe 6 dan tipe 11. Para ahli mencurigai
HPV tipe tertentu memiliki kecenderungan onkogenik
(potensial menjadi kanker), terutama tipe 16 dan tipe 18

25
Epidemiologi
⬡ Saat ini kondiloma akuminata menjadi penyebab paling utama suatu
penyakit menular seksual bahkan melebihi herpes genital. Kondiloma
akuminata terjadi pada 5,5 juta orang Amerika setiap tahun dan
diperkirakan memiliki prevalensi 20 juta. Kondiloma akuminata
adalah infeksi anorektal yang paling umum yang mempengaruhi pria
homoseksual. Namun, juga sering terjadi pada pria biseksual dan
heteroseksual dan wanita

26
Patofisiologi

27
Manifestasi Klinis
⬡ Kebanyakan pasien hanya mengeluhkan adanya lesi, yang
dinyatakan  tanpa gejala. Jarang terdapat gejala seperti gatal,
perdarahan, atau dispaurenia
⬡ Lesi sering ditemukan di daerah yang mengalami trauma selama
hubungan seksual dan mungkin soliter tetapi sering akan ada 5
sampai 15 lesi dari 1-5 mm diameter
⬡ Pada pria yang tidak disunat, rongga prepusium (glans penis, sulkus
koronal, frenulum) yang paling sering terkena, sementara pria yang
telah disunat biasanya terdapat di batang penis
⬡ Pada perempuan, lesi dapat terjadi pada labia minora, labia mayora,
pubis, klitoris, orificium uretra, perineum, daerah perianal, anus,
introitus, vagina, dan ectocervix
28
Manifestasi Klinis

29
Diagnosa
⬡ Periksa dengan cahaya yang baik, sebuah lensa yang
mungkin berguna untuk lesi kecil
⬡ Pada wanita, selalu memeriksa daerah perianal dan
melakukan pemeriksaan spekulum untuk membedakan
serviks atau lesi pada vagina.
⬡ Biopsi tidak diperlukan untuk kutil anogenital yang khas,
biopsi harus selalu dilakukan jika ada kecurigaan pra-
kanker atau kanker, dan dapat berguna untuk diagnosa
banding.

30
Diagnosa Banding
⬡ Moluskum Kontangiusum
⬡ Veruka Vulgaris
⬡ Karsinoma Sel Skuamosa

31
⬡ Moluskum
Kontangiusu
m

32
 Microba usus
⬡ Meskipun komposisi microba antar individu
sangat beragam namun ada beberapa set gen
yang selalu muncul pada individu sehat
⬡ Perubahan komposisi ini sering diimplikasikan
sebagai efek yang negatif atau disebut
DISBIOSIS
⬡ Meskipun belum jelas bagaimana disbiosis bisa
mempengaruhi host khususnya obesitas namun
teori saat ini mengatakan perubahan komposisi
microba dapat mengganggu metabolisme
luminal 33
34
Metodologi Fecal Transplant
⬡ Saat ini hanya infeksi Clostridium dificile yang
di izinkan oleh FDA dilakukan FMT tanpa
investigasi obat baru
⬡ Meskipun FMT mudah dilakukan namun
terdapat bermacam-macam metodologi antar
institusi
⬡ Seperti memberikan doksisiklin atau vankomisin
untuk mengeleminasi bakteri penyebab dibiosis
terlebih dahulu, kemudian dikuti dengan
pemberian polietilen glikol agar microba
transplan dapat berkolonisasi 35
Metodologi Fecal Transplant
⬡ Saat ini tidak ada standardisasi
tentang bagaimana fecal material
diproses untuk transplantasi, dan
perlu eksperimen lebih lanjut agar
FMT bisa mendapatkan hasil yang
optimal
⬡ Meski begitu prinsip umum dalam
memproses fecal material kurang
36
37
Sensitivitas insulin dari
pendonor ke resipien
⬡ Studi terbaru menunjukan resistensi insulin pada tikus
dewasa membaik setelah diberikan antibiotik atau
FMT secara peroral dari tikus kontrol
⬡ Hingga jurnal ini di publikasikan hanya ada 1 jurnal
yang membahas FMT khususnya tentang sindrom
metabolik pada manusia
⬡ Dilakukan FMT pada ± 18 orang dengan 9 orang
dilakukan transplantasi alogenik dan 9 orang lagi
transplantasi autologus dan meskipun tidak ada
perbedaan BMI pasca transplan namun terdapat
peningkatan sensitivitas insulin

38
Donor
⬡ Sejauh ini tidak ada standardisasi dalam
pemilihan donor FMT
⬡ Mulanya donor FMT adalah keluarga namun
penelitian terbaru mengatakan bahwa donor
yang terstandar lebih menguntungkan secara
kepraktisan
⬡ Secara umum pendonor diperiksa kesehatan
ususnya dengan Bristol Stool Chart , penyakit
menular, riwayat berpergian terakhir, dan
penggunaan antibiotik
39
Super Donor
⬡ Vrieze et al. setelah konfrensi dan publikasinya
mengatakan terdapat beberapa pasien yang
memiliki perbaikan insulin yang lebih menonjol
setelah melakukan FMT yang berasal dari
kelompok donor yang sama, sedangkan
beberapa lagi tidak menunjukan perubahan
⬡ Kesuksesan dari terapi tersebut diperkirakan
berasal dari SUPER DONOR
⬡ Studi terbaru saat ini berusaha mengidentifikasi
super donor untuk mendapatkan hasil yang
lebih baik 40
Super Donor
⬡ Penanganan berpotensi lainnya
adalah dengan mendisain dan
memproduksi probiotik yang donor
independent
⬡ Vrieze et al. mengatakan
meningkatnya mikroba pembentuk
butirat ditemukan pada pasien
yang mengalami peningkatan
41
Potensi Risiko
⬡ Salah satu tantangan FMT adalah
mengukur secara akurat efek yang tidak
diinginkan
⬡ Sejauh ini resipient dari FMT menderita
suatu penyakit sehingga sulit
membedakan progresi dari penyakit dan
efek dari FMT
⬡ Meski begitu banyak yang telah menjalani
FMT dan sedikit dampak negatif yang
ditemuka termasuk pada pasien dengan 42
Potensi Risiko
⬡ Mayoritas dari efek negatif yang
nampak adalah diare dan demam
⬡ Terdapat kasus mortalitas pada uji
coba FMT namun dinyatakan bukan
akibat dari FMT

43
Potensi Risiko
⬡ Penyebaran penyakit menular,
meski saat ini belum terdapat
laporan namun hal ini masih
menjadi ancaman yang terlihat
⬡ Sifat obesogenik dari mikroba juga
dapat terdonorkan

44
Kesimpulan
⬡ FMT merupakan terapi yang menarik
dengan potensi yang besar
⬡ Namun saat ini masih kurang penelitian
yang bersifat controlled, randomized untuk
kasus sindrom metabolik
⬡ Dengan jumlah penelitian controlled
clinical yang menguji FMT untuk sindrom
metabolik, beberapa tahun kedepan
mungkin kita dapat menentukan indikasi
FMT dengan jelas 45
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spectrum. of or complete
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Yellow
Is the color of gold, butter
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spectrum of visible light,
yellow is found between
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Blue
Is the colour of the clear
sky and the deep sea. It is
located between violet
and green on the optical
spectrum.
Blue
Is the colour of the clear
sky and the deep sea. It is
located between violet
and green on the optical
spectrum.
Red
Is the color of blood, and
because of this it has
historically been
associated with sacrifice,
danger and courage.
Red
Is the color of blood, and
because of this it has
historically been
associated with sacrifice,
danger and courage.
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