Rekaman contraction stress test denyut jantung janin sebagai prediktor kebutuhan resusitasi pada bayi baru lahir di RSUP Dr. Sardjito Yogyakarta

KARTINI, Farida, Prof. dr. Djaswadi Dasuki, MPH, Ph.D, Sp.OG(K)

2010 | Tesis | S2 MSPPDS-Maternal Perinatal

Latar Belakang: Asfiksia merupakan salah satu penyebab utama kematian bayi. Prevalensi kematian bayi akibat asfiksia di Indonesia sebanyak 27%. Di Yogyakarta pada tahun 2003 kematian bayi sebanyak 52 kasus (18,5%) disebabkan karena asfiksia. Asfiksia merupakan kelanjutan dari hipoksia janin. Hipoksia dapat diketahui melalui pemantauan kesejahteraan janin. Salah satu pemantauan kesejahteraan janin pada masa intrapartum dengan contraction stress test (CST). Hasil CST positif menunjukkan bahwa telah terjadi gawat janin. Keadaan tersebut menyebabkan bayi baru lahir membutuhkan resusitasi. Tujuan Penelitian: Diketahuinya sensitifitas dan spesifisitas rekaman contraction stress test (CST) denyut jantung janin sebagai prediktor kebutuhan resusitasi pada bayi baru lahir di RSUP DR. Sardjito Yogyakarta. Metode Penelitian: Jenis penelitian observasional dengan desain penelitian potong lintang. Populasi penelitian ini adalah semua bayi yang lahir di RSUP DR. Sardjito Yogyakarta yang pemantauan kesejahteraan janinnya dengan CST. Cara pemilihan sampel menggunakan metode consecutive sampling dengan jumlah 168 sampel. Analisis data: Uji Fisher’s Exact test didapatkan p = 0,268 yang berarti tidak ada hubungan rekaman contraction stress test (CST) denyut jantung janin sebagai prediktor kebutuhan resusitasi pada bayi baru lahir. Nilai sensitifitas sebesar 12,5%, nilai spesifisitas sebesar 92,2%. Nilai prediksi positif sebesar 33,3% dan nilai prediksi negatif sebesar 77,1%. Untuk nilai rasio kecendrungan sebesar 1,6. Hasil uji number needed to treat sebesar 10. Kesimpulan: Rekaman CST tidak sensitif namun spesifik untuk menilai adanya kebutuhan resusitasi pada bayi baru lahir. Setiap 10 bayi dengan rekaman CST positif, ada 1 bayi yang tidak dilakukan resusitasi

Background: Asphyxia is a major cause of infant mortality. The prevalence of infant mortality caused by asphyxia in Indonesia is 27%. In Yogyakarta 2003 there were 52 cases (18.5%) of infant mortality caused by asphyxia. Asphyxia is a continuation of fetal hypoxia. Hypoxia can be identified through monitoring of fetal condition. A method to monitor fetal condition during intrapartum period is contraction stress test (CST). Positive result of CST shows the fetal is in emergency. The condition causes newborn baby to have resuscitation. Objective: To identify sensitivity and specificity of CST record of fetal heart rate as predictor of the need of resuscitation in newborn baby at DR. Sardjito Hospital, Yogyakarta. Method: The study was observational with cross sectional design. Population of the study were all neonates at DR. Sardjito Hospital Yogyakarta monitored using CST. There were 168 samples determined using consecutive sampling technique. Result: The result of Fisher's Exact test showed p=0.268 which meant that there was no association of CST record of fetal heart rate as predictor of the need for resuscitation in newborn baby. Score of sensitivity was 12.5% and specificity was 92.2%. Score of positive prediction was 33.3% and negative prediction was 77.1%. Score of likelihood ratio was 1.6. The result of number needed to treat test was 10. Conclusion: CST record was not sensitive but specific to assess the need for resuscitation in newborn baby. There was 1 infant out of ten with positive CST record that did not have resuscitation.

Kata Kunci : Contraction stress test,Denyut jantung janin,Indikator,Kebutuhan resusitasi,Bayi baru lahir,contraction stress test, fetal heart rate,resuscitation,newborn baby