PERDARAHAN POST PARTUM DAN KEMATIAN MATERNAL DI RSUP DR. SARDJITO

STEPHEN VALENTINO, dr. R Detty Siti Nurdiati, MPH, PhD, Sp.OG(K); dr. Irwan Taufiqur Rachman, Sp.OG(K)

2018 | Skripsi | S1 PENDIDIKAN DOKTER

Latar Belakang : Kejadian kematian maternal di dunia masih tinggi hingga saat ini, mencapai 216 kematian per 100.000 kelahiran hidup pada tahun 2015. Hampir seluruh kejadian kematian maternal ini terjadi di negara berkembang, yaitu sebesar 99% kasus. Perbedaan ini sangat signifikan bila dilihat dari Angka Kematian Ibu (AKI) negara maju, yaitu sebesar 16 per 100.000 kelahiran hidup, dibandingkan dengan negara berkembang, yaitu 240 per 100.000 kelahiran hidup. Pernyataan tersebut sesuai dengan data dari Kementerian Kesehatan Republik Indonesia, yaitu AKI Indonesia yang terhitung masih cukup tinggi, yaitu sebesar 305 per 100.000 kelahiran hidup pada tahun 2015. Di sisi lain, penyebab utama kematian maternal di dunia maupun Indonesia adalah perdarahan post partum. Tujuan Penelitian : Penelitian ini ditujukan untuk mengkaji praktik manajemen perdarahan post partum di RSUP Dr. Sardjito, Sleman, Yogyakarta. Metode Penelitian : Penelitian ini dirancang secara deskriptif dan analitik menggunakan metode studi case series. Data penelitian diambil dari rekam medis kematian maternal RSUP Dr. Sardjito dari tahun 2012 hingga September 2017. Data yang diambil adalah kasus kematian maternal akibat perdarahan post partum. Kasus-kasus tersebut kemudian ditelaah praktiknya dan dibandingkan dengan guideline yang berlaku baik secara nasional maupun internasional. Hasil Penelitian : Terdapat beberapa aspek praktik manajemen perdarahan post partum yang dapat ditingkatkan untuk meminimalisir kematian maternal akibat perdarahan post partum Kesimpulan : Praktik manajemen perdarahan post partum di RSUP Dr. Sardjito telah terlaksana dengan cukup baik, namun demikian diperlukan pengembangan format skrining faktor resiko perdarahan post partum, checklist pencatatan penanganan perdarahan post partum yang akurat, serta mengutamakan penanganan pembedahan konservatif terlebih dahulu.

Background: Maternal mortality is considered high as yet, reaching 216 cases per 100.000 live births in 2015. As total as 99% of these cases took place in developing countries, accounting to 240 cases per 100.000 live births as opposed to 16 cases per 100.000 live births in developed countries. This is parallel to the data provided by the Ministry of Health of the Republic of Indonesia, citing the significant number of maternal mortality occurring in Indonesia in 2015 up to a total of 305 cases per 100.000 live births. On the other hand, the main cause of maternal mortality in the world as well as Indonesia is postpartum hemorrhage (PPH). Objective: The intention of this research was to review and analyze the practice of postpartum hemorrhage management in RSUP Dr. Sardjito, Sleman, Yogyakarta. Method: This research was designed in a descriptive manner using case series study method. Research data was obtained from medical records of maternal mortality cases in RSUP Dr. Sardjito from the period of 2012 to September 2017. The data collected was further selected to choose cases whose mortality was caused by postpartum hemorrhage. Those cases were then reviewed and analyzed based on the management of postpartum hemorrhage conducted and compared them with the latest and valid guidelines available. Result: There were aspects of practice that can be improved to reduce maternal mortality by postpartum hemorrhage in RSUP Dr. Sardjito. Conclusion: The management of postpartum hemorrhage in RSUP Dr. Sardjito was appreciable. However, development of risk factors screening form, itemized management checklist form, and Prioritization of more conservative procedure in surgical management of PPH were strongly recommended.

Kata Kunci : Perdarahan post partum, PPH, kematian maternal