FAKTOR RISIKO KEJADIAN PERDARAHAN POSTPARTUM IBU BERSALIN YANG DIRAWAT DI RUMAH SAKIT (Studi Kasus Kontrol Di Kabupaten Temanggung)

Abstract

Latar Belakang : Perdarahan postpartum masih menjadi masalah utama penyebab mortalitas dan morbiditas maternal baik di negara telah berkembang maupun negara sedang berkembang. Sejumlah 27% penyebab kematian maternal di dunia disebabkan karena perdarahan, lebih dari 2/3-nya adalah kematian karena perdarahan postpartum. Dalam upaya pencegahannya maka diperlukan pengetahuan tentang faktor risiko. Tujuan: Mengidentifikasi berbagai faktor risiko kesehatan terhadap kejadian perdarahan postpartum pada ibu bersalin yang dirawat di tiga rumah sakit Kabupaten Temanggung. Metode : Penelitian analitik observasional dengan desain kasus kontrol, yang dilakukan pada bagian rekam medik di tiga rumah sakit di Kabupaten Temanggung. Populasi penelitian adalah ibu bersalin yang dirawat di rumah sakit pada Januari 2015–Juli 2016. Jumlah subyek kasus perdarahan postpartum 55 pasien dan kontrol 55 pasien. Pemilihan subyek kasus secara consecutive dan kontrol secara purposive. Analisis statistik dilakukan dengan penghitungan Odd Ratio dan regresi logistik. Hasil : Beberapa faktor yang terbukti berisiko terhadap kejadian perdarahan postpartum: penolong persalinan bidan (OR=7,10; 95%CI 2,21–22,81; p=0,001), riwayat obstetri buruk (OR=5,37; 95%CI 1,53–18,86; p=0,009), riwayat abortus (OR=4,93; 95%CI 1,20-20,31; p=0,027), interval kehamilan < 2 tahun atau > 5 tahun (OR=4,04; 95%CI 1,48–11,07; p=0,007), dan anemia trimester III (OR= 3,58; 95%CI 1,23-10,43; p= 0,019). Kesimpulan : Faktor risiko kejadian pedarahan postpartum adalah penolong persalinan bidan, riwayat obstetri buruk, riwayat abortus, interval kehamilan <2 tahun atau >5 tahun, dan anemia trimester III. Kata Kunci : Perdarahan, penolong persalinan, anemia. Background; Postpartum hemorrhage remains a common cause of maternal morbidity and mortality in both developed and developing countries. Hemorrhage was contributed to maternal death by 27.1%, while 2/3 among them was caused by postpartum hemorrhage (PPH). To prevent postpartum hemorrhage, knowledge of the risk factors were needed. Objective: To identify the health risk factors for postpartum hemorrhage among hospitalized mothers who delivered in three Temanggung District Hospitals. Methods: A case control study was conducted the medical records of three hospitals in Temanggung District. Study population were hospitalized mothers who delivered on January 2015 – July 2016. The subjects were 55 patients who suffered from PPH (as cases) and 55 patients who were not suffered from PPH (as control). Sampling method for cases was consecutive sampling and purposive sampling for controls. Data were analysed by Odds Ratio calculation and logistic regression. Results : The risks factor for postpartum hemorrhage were midwife as the birth attendant (OR=7.10; 95%CI 2.21–22.81; p=0.001), poor obstetric history (OR=5.37; 95%CI 1.53–18.86; p=0.009), history of abortion (OR=4.93; 95%CI 1.20-20.31; p=0.027), pregnancy interval <2 years or >5 years (OR=4.04; 95%CI 1.48–11.07; p=0.007), and. trimester III anaemia (OR=3,58; 95%CI 1.23-10.43; p=0.019). Conclusion: The risk factors for postpartum hemorrhage were midwife as the birth attendant, poor obstetric history, history of abortion, pregnancy interval <2 years or >5 years, and anaemia trimester III. Keyword : Hemorrhage, birth attendant, anaemia.