Spiritual Endorphine Stimulation as Methods to Increase Fetal Well
Being on Pregnant Woman with Early Premature Rupture of
Membranes
Sri Wahyuni, Tutik Rahayu
and Apriliani Yulianti Wuriningsih
Maternity Department, Nursing Faculty, Sultan Agung Islamic University, Kaligawe Street Km.4 Semarang, Central Java
Keywords: Spiritual Endorphin Stimulation, Fetal Well Being. Pregnant Woman, Early Rupture of Membrane, Health
Problem.
Abstract: The membrane rupture before the process of giving a birth starts can cause health problems. The possible
health problems to the fetus can be in the form of a well being disorder. This study is aimed to investigate the
effect of Sipiritual Endorphine Stimulation on the increasing of the fetus well being to the mother with the
early membrane rupture at Islamic Sultan Agung hospital Semarang. The method The population in this study
is the overall pregnant women who experienced premature rupture of membranes. This research used
quantitative with pra experimental pre post test design with one group on 19 respondents taken by accidental
sampling. The intervention was in the form of reciting holy Qur’an, given through auditoric stimulation for
30 minutes.. Data analysis was performed by using wilcoxon test. The result shows that the p value was 0.003.
Discussion: auditoric stimulation was accepted by the brain in the Midbrain section, then it stimulated the
Midbrain to release Gama Amino Butyric Acid, enkepalin and beta endorphin which function as electrical
conductivity inhibitors, have analgesic effect and act as relaxation making the heart rate more regular and the
blood circulation run more smoothly. In conclusion there is a significant effect of Spiritual Endorphin
Stimulation on the fetus well being to the mother with the early membrane rupture.
1 BACKGROUND
Early premature rupture of membranes is a condition
of rupture of the membranes before delivery begins
and may also occur late in pregnancy or well before
delivery time (Mackeen, Seamon, Muhammad,
Baxter, Berghella, 2014). A rupture of membranes is
called preterm premature membranes if rupture
membranes are before age 37 weeks of pregnancy,
while prolonged rupture of membranes is the rupture
of the membranes that occur more than 12 hours
before delivery (Lowdermilk (2011).
Premature rupture of either preterm or prolonged
fetus is very dangerous for both mother and fetus
because it is one of the factors causing asphyxia
neonatorum and infection (Endale, Fentahun,
Gemada and Hussen, 2016). Feffixia neonaturum
occurs due to the interruption of oxygen transported
from mother to fetus so that there is disturbance in the
supply of 02 and in removing CO2 (Hofmeyr, GJ, et
al. (2008). The response that occurs in the fetus to an
amniotic mother is premature tachycardia (Ken
Mizaki, 2012).
The condition experienced by the fetus in mothers
who experience premature rupture of membranes is
very dangerous and can cause pain and death during
the perinatal period (Fatemeh Tavassoli, 2010). This
condition requires prompt and appropriate treatment
to prevent fetal harm. Research conducted by Arisa
Fujiwara in 2013 at Kyushu University Hospital,
Kyushu Kouseinenkin Hospital, Kitakyushu
Municipal Medical Center and Oita Prefectural
Hospital stated that a fast and appropriate
management strategy could minimize the risk of
complications in neonatal (Arisa Fujiwara, 2013).
Meanwhile, in a study conducted by Janae M.
Davis in 2008 mentioned that the fetus in pregnant
women with premature rupture of membrane
experience prolong bradycardia, decreased
variability, not reactive and distres, the researchers
stated that it needs action to reduce the stressor
experienced by the fetus and monitoring regular to the
condition of fetal can be well-being.
Wahyuni, S., Rahayu, T. and Wuriningsih, A.
Spiritual Endorphine Stimulation as Methods to Increase Fetal Well Being on Pregnant Woman with Early Premature Rupture of Membranes.
DOI: 10.5220/0008331306990702
In Proceedings of the 9th International Nursing Conference (INC 2018), pages 699-702
ISBN: 978-989-758-336-0
Copyright
c
2018 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
699
Efforts that can be done by the nurse to reduce the
stressor one of which is by doing Spiritual
Endorphine Stimullation (SES). This method is a way
to stimulate the endorphine contained in the body that
is done by way of Auditory stimulation using the
recitation of the Qur'an (murotal). Endorphine
improves feelings of relaxation, and diverts attention
from fear, anxiety and tension, improves the body's
chemical system so as to reduce tension, pressure,
heart rate, pulse, and brainwave activity (Stopler,
2013).
Preliminary survey conducted at Sultan Agung
Islamic Hospital in January 2016 got data of pregnant
mother with early rupture membarenes counted 19
people. Of the 19 patients, 10 fetuses have tachicardi,
4 people have bradicardi fetus and 5 fetuses
experience variability disorder.
2 METHODS
This research used pra experimental pre post test
design with a one group (Notoatmojo, 2005). In this
study, researcher provides Spiritual Endorphine
Stimullation (SES) to determine whether there is
influence on the well being of the fetus in pregnant
women with premature rupture of membranes. The
population in this study is the overall pregnant
women who experienced premature rupture of
membranes in January 2016 at Sultan Agung Islamic
Hospital Semarang with a total of 19 people. The
number of samples were taken the whole and
conducted by using accidental sampling.
Respondents in the study were given spiritual
treatment of endorphine stimulation by listening to
Quran recitation for 30 minutes. Assessment of fetal
well being including heart rate and fetal movement is
done pre and post intervention. Measurement of fetal
heart rate using dopler while calculating fetal
movement is done by counting the number of fetal
movement for one hour. Data were analyzed by using
Wilcoxon test
This research has passed the ethical clearent by
the team of ethics nursing faculty of Sultan Agung
Islamic University.
3 RESULTS
Table 1. shows that most of the fetus in the
respondents before to the Spiritual Endorphine
Stimulative (SES) intervention experienced an not
prosperous condition of 13 (68.4%.).
Table 2. shows that most of the fetus in the
respondents after the Spiritual Endorphine
Stimulative (SES) intervention experienced a
prosperous condition of 15 respondents (78.9%).
Normality test using Shapiro-wilk shows the
result p value 0,00 which means the distribution of
data is not normal.
Table 4. shows that by using the wilcoxon test the
value of p value is 0.003 or less than 0.05 which
means that there is a significant influence between
Spiritual Endorphine Stimulation (SES) on fetal well-
being in pregnant women who experience premature
rupture of membranes at the Sultan Agung Islamic
Hospital at Semarang.
Table 1: Results of fetal well being frequency
distribution before Spiritual Endorphine Stimulatory
(SES) intervention in early membrane rupture of
mothers at Sultan Agung Islamic Hospital 2016 (n = 19).
Variable
Well being
Test Result
Frequency
Percent
(%)
Not Prosperous
13
68.4
Prosperous
6
31.6
Table 2: Results of fetal well being frequency
distribution after Spiritual Endorphine Stimulatory
(SES) intervention in premature rupture of membranes
of mothers at Sultan Agung Islamic Hospital 2016 (n =
19).
Variable
Well being
Test Result
Frequency
Not Prosperous
4
Prosperous
15
Table 3: Result of fetal well being normality test at early
membrane rupture of mother at Sultan Agung Islamic
Hospital of 2016 (n = 19).
Kolmogorov-
Smirnov
a
Shapiro-Wilk
Statistic
df
Sig.
Statistic
df
Sig.
Fetal well-being
before Intv
.430
19
.000
.591
19
.000
Fetal well-being
before Intv
.482
19
.000
.507
19
.000
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
700
4 DISCUSSION
The results showed that there was a significant
influence between Spiritual Endorphine Stimullation
(SES) on the well being of the fetus in pregnant
women who experience early membrane rupture at
Sultan Agung Islamic Hospital Semarang. Spiritual
Endorphine Stimullation (SES) is a stimulation in the
form of recitation of the holy Qur'an, given by
auditoric stimulation. According Cantekin, 2013
mentioned that auditor stimulation is able to stimulate
the release of edorphine in the body so as to reduce
stress and individuals become more comfortable.
Research conducted by Adriano et.al in 2013 also
mentioned that with the giving of music therapy can
make the heart rate becomes more organized and the
blood circulation becomes more smoothly. Similar
research was also conducted by Carolyn J. Murrock
& Patricia in the year 2013 which states that the
provision of music therapy can increase physical
activity and health.
The Spiritual Endorphine Stimulation (SES)
which is part of the auditoric therapy works in a way,
the sound of the recitation of the Qur'an / murotal is
received by hearing, transmitted to the brain and
affecting the limbic system (Eka, Erwin 2009).
Auditory stimulation in which the murotal readings
are received by the brain in the Midbrain section,
further stimulates the midbrain to secrete Gama
Amino Butyric Acid (GABA), enkepalin and beta
endorphin, which act as electrical conductive
inhibitors, have analgesic effects and serve as
relaxants (Guyton & Hall, 2008). Correlations can be
seen significantly in the respondents who conducted
the study by providing SES intervention. The results
obtained the condition of the fetus in early membrane
rupture patients showed significant improvement in
well being.
5 CONCLUSIOS
The result shows that the auditoric stimulation was
accepted by the brain in the Midbrain section, then it
stimulated the Midbrain to release Gama Amino
Butyric Acid, enkepalin and beta endorphin which
function as electrical conductivity inhibitors, have
analgesic effect and act as relaxation making the heart
rate more regular and the blood circulation run more
smoothly. In conclusion there is a significant effect of
Spiritual Endorphin Stimulation on the fetus well
being to the mother with the early membrane rupture.
REFERENCE
Adriano ett.al. (2013). The effect of auditory stimulation
with on heart rate variability in healthy women. Journal
List Clinics Sao Paulo. 2013.Jul; 68 (7): 960-967. Doi:
10.6061/clinics/2013(07)12.
Arisa Fujiwara et all. (2013). Perinatal management of
preterm premature ruptured membranes affects
neonatal prognosis. DOI 10.1515/jpm-2013-0192 J.
Perinat. Med. 2014; 42(4): 499505
Cantekin et all. (2013). The Influence of Music Therapy on
Perceived Stressors and Anxiety
Levels of Hemodialysis Patients. Renal Failure, 2013;
35(1): 105109. Copyright © Informa Healthcare USA,
Inc.ISSN 0886-022X print/1525-6049
Carolyn & Patricia. (2013). The theoryof musi, mood and
movement to improve health outcome. J. Adv Nurs.
Author manuscript; available in PMC 2013 Feb 15
Published in final edited form as: J Adv Nurs.2009 Oct;
65(10):2249 2257.
DeCherney, Nathan, Murpy Goodwin, Laufer, 2003,
Diagnosis & Treament Obstetrics & Gynecology, Tenth
Edition, United States, The McGraw-Hill Companies.
Eka, Erwin. (2009). Pusat riset terapi musik dan gelombang
otak, Indonesia.
Endale, Fentahun, Gemada and Hussen. (2016). Maternal
and fetal outcomes in term premature rupture of
membrane. World J Emerg Med. 2016; 7(2): 147152.
doi: 10.5847/wjem.j.1920-8642.2016.02.011
Fatemeh Tavassoli et all. (2010).Survey of Pregnancy
Outcome in Preterm Premature Rupture of Membranes
Table 4: Influence of Spiritual Endorphine Stimullation
(SES) on fetal well-being in pregnant women who
experience early membrane rupture at Sultan Agung
Islamic Hospital 2016 (n = 19).
N
Mean
Rank
Sum
of
Ranks
Fetal well-being
before Intv - Fetal
well-being after Intv
Negative
Ranks
0
a
.00
.00
Positive
Ranks
9
b
5.00
45.00
Ties
10
c
Total
19
Test Statistics
b
Fetal well-being
before Intv - Fetal
well-being before
Intv
Z
-3.000
a
Asymp. Sig.
(2-tailed)
.003
Spiritual Endorphine Stimulation as Methods to Increase Fetal Well Being on Pregnant Woman with Early Premature Rupture of Membranes
701
with Amniotic Fluid Index <5 and ≥5. Oman Medical
Journal 2010, Volume 25, Issue 2, April 2010
Guyton & Hall. (2017). Buku Ajar Fisiologi Kedokteran.
12th Edition. Copyright © 2017 Elsevier, except certain
content provided by third party
Hofmeyr,G.J, et all. (2008). A Cochrane Pocketbook
Pregnancy and Childbirth. John Wiley & Son Ltd.
Kementrian Kesehatan RI (2016). Profil Kesehatan
Indonesia tahun 2015. Health Statistic. . ISBN 978-
602-416-065-4
Ken Miyazaki et all (2012). Aggressive intervention of
previable preterm premature rupture of membranes.
Acta Obstetricia et Gynecologica Scandinavica C _
2012 Nordic Federation of Societies of Obstetrics and
Gynecology 91 (2012) 923929 Department of
Obstetrics and Gynecology, Japanese Red Cross
Nagoya Daiichi Hospital, Nagoya, Japan
Lowdermilk (2011). Maternity and women’s health care, 8
Ed. St Louis, Missouri: Mosby.
Mackeen, Seamon, Muhammad, Baxter, Berghella. (2014).
Tocolytics for preterm premature rupture of
membranes. Cochrane Database of Systematic Reviews
2014, Issue 2. Art. No.: CD007062. DOI:
10.1002/14651858.CD007062.pub3.
www.cochranelibrary.com
Prawirahardjo, S., 2014. Pelayanan Kesehatan Maternal
dan Neonatal. Jakarta Penerbit Yayasan Bina Pustaka
Pusat Data dan Informasi Kementrian Kesehatan RI (2014).
Mothers Day.
Stoppler (2013).Endorphin Natural pain & Stress Fighter.
Diambil dari
http://www.medicinenet.com/script/main/art.asp?articl
ekey=55001
WHO.(2010) Millenium Development Gold
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