FAKTOR-FAKTOR RISIKO YANG BERPENGARUH TERHADAP PERSALINAN DENGAN TINDAKAN (Studi Kasus di RS dr. Moewardi Surakarta) ! "#

KUSUMAWATI, YULI (2006) FAKTOR-FAKTOR RISIKO YANG BERPENGARUH TERHADAP PERSALINAN DENGAN TINDAKAN (Studi Kasus di RS dr. Moewardi Surakarta) ! "#. Masters thesis, Program Pascasarjana Universitas Diponegoro.

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Abstract

Background : operative delivery indicates the presence of complicating factors of delivery. Data at Dr. Moewardi Hospital, Surakarta in 2005 shows that deliveries with complications which need necessary to operative procedures were as many as 738 cases (50,2%), with proportion of sectio cesarean was as many as 26% and vacuum extraction was as many as 3%. Objective : this study aim to prove maternal risc factors, nutritions factor, health factor and delivery aid which are influential to the occurrence operative delivery. Method : this was an observational research using case control study. The number of samples are 85 cases and using 85 cases as controls. Cases are mothers who deliveried with vacuum extraction, forceps or sectio cesarean diagnosed by doctors, or midwife who help the delivery suited the indication and are hospital collected medical record. Control group are normal delivery which are achieved from medical record in the same hospital and from the mothers were closen who are close with care of cases. Data analyzing was performed using univariate, bivariate and multivariate logistic regression method by program of SPSS version 13.0. Result : factors that constitute risk factor occurrence to operative delivery are antenatal frecuency were less than 4 times during pregnancy (OR adjusted : 14,48 ; 95% CI :1,55 — 135,00), condition of high risk pregnancy (OR adjusted: 11,01 ; 95% CI : 2,21 — 55,03), interpregnancy interval 0 years (OR adjusted : 5,45 ; 95% CI : 1,27 — 23,32), anemia (OR adjusted : 4,44 ; 95% CI : 1,13 —17,50) and patient come from outside of city (OR adjusted : 4,48; 95% CI : 1,05 — 19,09). Suggestions : for mothers who doesn't want to be pregnant again, it is suggested to use contraception with hight effectiveness (steady contraception), to avoid the occurrence of serious anemia during pregnancy mothers should consume foods which high iron, protein and take iron tablet that are provided by health care professional provider regularly, with increase to antenatal care at least 4 times during pregnancy to profesionel health services. For health services: it is nessesary to increase early detection for mothers with high risk pregnancy and to join active monitoring pregnancy course to increase promotion efforts by increasing knowledge, attitude and practices pregnancy to antenatal care, especially about the necessity of nutrition for pregnant mother, the necessity of iron and blood pressure of pregnancy, reforceful antenatal care through activity revitalization of integrated service center (ISC) in level of orchard by activating the forth table in integrated service center (ISC) for antenatal care. Latar Belakang : Persalinan dengan tindakan menunjukkan adanya faktor penyulit ataupun komplikasi persalinan. Data RS dr. Moewardi tahun 2005 menunjukkan persalinan dengan komplikasi yang memerlukan tindakan sebanyak 738 (50,2%), dimana proporsi persalinan seksio sesarea sebanyak 26% dan tindakan ekstraksi vakum sebanyak 3%. Tujuan : Penelitian ini bertujuan untuk membuktikan faktor risiko ibu, faktor gizi, faktor kesehatan dan pertolongan persalinan merupakan faktor risiko terjadinya persalinan dengan tindakan. Metode : Jenis penelitian ini merupakan penelitian observasional dengan rancangan kasus kontrol. Jumlah responden sebanyak 85 kasus dan 85 kontrol. Kasus adalah ibu yang melahirkan dengan tindakan ekstraksi vakum, forsep atau seksio sesarea yang didiagnosis oleh dokter atau bidan penolong persalinan sesuai indikasi dan diperoleh berdasarkan catatan medik RS dr. Moewardi Surakarta. Kontrol adalah ibu yang melahirkan secara normal yang diambil melalui catatan medik yang ada di RS dan dipilih ibu yang dekat dengan perawatan kasus. Analisis data dilakukan secara univariat, bivariat dan multivariat dengan metode regresi logistik dengan program SPSS versi 13.0. Hasil : Faktor-faktor yang merupakan faktor risiko terjadinya persalinan dengan tindakan adalah frekuensi ANC < 4 kali (OR adjusted : 14,48 ; 95% CI :1,55 —135,00), Kondisi kehamilan risiko tinggi (OR adjusted: 11,01 ; 95% CI : 2,21 —55,03), Jarak kehamilan jauh (10 tahun) (OR adjusted : 5,45 ; 95% CI : 1,27 —23,32), Kadar Hb rendah (anemia) (OR adjusted : 4,44 ; 95% CI : 1,13 — 17,50) dan Tempat tinggal luar kota (OR adjusted : 4,48; 95% CI : 1,05 — 19,09). Saran : Bagi Ibu-ibu yang sudah tidak menginginkan hamil lagi, disarankan untuk menggunakan alat kontrasepsi yang efektifitasnya tinggi (alat kontrasepsi mantap), Untuk menjaga agar tidak terjadi anemia gizi berat pada masa hamil, sebaiknya mengkonsumsi makanan yang mengandung Fe tinggi, protein dan minum tablet tambah darah yang diberikan oleh petugas kesehatan secara teratur, meningkatkan kunjungan pemeriksaan kehamilan secara teratur, minimal 4 kali selama hamil ke pelayanan kesehatan professional. Bagi Petugas Pelayanan Kesehatan :Perlu meningkatkan upaya deteksi dini ibu hamil risiko tinggi dan melakukan pemantauan secara aktif perjalanan kehamilan. Meningkatkan upaya promotif dengan meningkatkan pengetahuan, sikap dan praktek ibu hamil dalam perawatan antanatal, terutama mengenai kebutuhan gizi ibu hamil, kebutuhan zat besi dan tekanan darah ibu hamil, memberdayakan kembali pelayanan antenatal melalui kegiatan revitalisasi posyandu di tingkat dusun (rukun warga) dengan mengaktifkan meja IV posyandu untuk pemeriksaan kehamilan.

Item Type:Thesis (Masters)
Subjects:H Social Sciences > HV Social pathology. Social and public welfare
Divisions:Postgraduate Program > Master Program in Epidemiology
ID Code:15334
Deposited By:Mr UPT Perpus 2
Deposited On:29 Jun 2010 14:13
Last Modified:29 Jun 2010 14:13

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