Karakteristik Perdarahan Antepartum Dan Perdarahan Postpartum

Abstract

The most important cause of hemorrhage in pregnancy and parturition are antepartum hemorrhage and postpartum hemorrhage. The purpose of this research is to investigate the characteristics of antepartum hemorrhage and postpartum hemorrhage at Prof DR. R.D Kandou General Hospital Manado in 2011. This research used a retrospective descriptive through medical records at BLU RSUP Prof dr R.D Kandou Manado in January 2011 to December 2011. From 4155 parturition case in 2011, there were 60 cases (1,44%) of antepartum hemorrhage and 36 case (0,86%) of postpartum hemorrhage. The highest sociodemographic distribution found : in mother’s age between 35-39 years old, in highschool students, and housewives . The highest medico obstetric distribution found: 17 cases (28,3%) of first parity and 17 cases (28,3%) second parity of antepartum hemorrhage and 18 cases (50%) of first parity in postpartum hemorrhage, in gestational age between 37-42 week, 32 cases (53,3%) of antepartum hemorrhage and 30 cases (83,3%) of postpartum hemorrhage. The perabdominal parturition (caesarean section), there were 55 cases (91,7%) of antepartum hemorrhage and 22 case (61,1%) of pervaginam in postpartum hemorrhage. The causes of antepartum hemorrhage were placenta previa in 59 cases (98,3%) and retained placenta in 10 cases (27,8%). The most number of antenatal care check ups were ≥4x check ups on antepartum hemorrhage cases and <4x on postpartum hemorrhage cases. These high incidents needs to be noted by all parties. Pregnant women who are in risk for antepartum hemorrhage and postpartum hemorrhage need to be routinety and checked up and carefulle for their pregnancy. Keywords: Antepartum Hemorrhage, Postpartum Hemorrhage, Patient Characteristic. Abstrak: Penyebab perdarahan pada kehamilan dan persalinan yang penting adalah perdarahan antepartum dan perdarahan postpartum. Tujuan penelitian ini untuk mengetahui karakteristik perdarahan antepartum dan perdarahan postpartum di BLU RSUP Prof DR. R.D Kandou Manado tahun 2011. Penelitian ini menggunakan metode retrospektif deskriptif melalui rekam medik di BLU RSUP Prof dr R.D Kandou Manado tahun 2011. Dari 4155 total persalinan seluruhnya pada tahun 2011, terdapat 60 kasus (1,44%) perdarahan antepartum dan 36 kasus (0,86%) perdarahan postpartum. Distribusi sosiodemografi tertinggi : umur ibu 35-39 tahun, pendidikan terakhir tamat SMA, pekerjaan ibu rumah tangga. Distribusi mediko obstetri tertinggi: 17 kasus (28,3%) paritas pertama dan 17 kasus (28,3%) paritas kedua pada perdarahan antepartum dan 18 kasus (50%) paritas pertama pada perdarahan postpartum, usia kehamilan biasanya 37-42 minggu yaitu 32 kasus (53,3%) perdarahan antepartum dan 30 kasus (83,3%) perdarahan postpartum. Tindakan persalinan perabdominal (seksio sesarea) 55 kasus (91,7%) perdarahan antepartum dan 22 kasus (61,1%) pervaginam perdarahan post partum. Penyebab perdarahan antepartum terbanyak adalah plasenta previa dan perdarahan postpartum disebabkan oleh sisa plasenta. Kebanyakan jumlah pemeriksaan antenatal care ≥4x pemeriksaan pada perdarahan antepartum dan <4x pemriksaan pada perdarahan postpartum. Tingginya angka kejadian ini perlu mendapat perhatian dari semua pihak. Ibu-ibu hamil yang memiliki faktor resiko untuk terjadinya perdarahan antepartum dan perdarahan post partum agar selalu waspada dan selalu memeriksakan kehamilannya kepada tenaga ahli secara berkala dan teratur. Kata kunci: Perdarahan Antepartum, Perdarahan Postpartum, Karakteristik Penderita.

Characteristics of Postpartum Hemorrhage Patients in Raja Tombolotutu General Hospital, Parigi Moutong Sulawesi Tengah, Indonesia

“…This study showed the same result with two previous studies that found most of the women with PPH is in 37-42 weeks pregnancy. 16,17 This study showed that most of patients with PPH were resulted from vaginal delivery (93.05%). The previous study had the same result with this study.…”

“…16 Other study by Londok et al showed that postpartum hemorrhage participants ≥35 years old were the highest percentage. 17 This study discovered that multipara patients were dominant, which was 45.84%. Contrary to this study, the previous studies revealed that primiparity is one of risk factors for PPH.…”

“…The previous study had the same result with this study. 17 Study by Kramer et al, however, showed that cesarean delivery is one of risk factor for PPH. There were 41.67% junior high school graduated of post partum hemorrhage patients and about 15.28% never have formal education.…”

“…7 This study was in line with the study conducted by Londok et al that most of the patients with PPH are housewife (59.72%). 17 More than a half of patients with PPH were covered by Universal Health Coverage (58.33%). In addition, 25% patients were covered by Jampersal.…”

“…21 Study by Londok et al showed the second highest percentage for the cause of PPH was retained placenta, following the placental remnant. 17 Antenatal care (ANC) and delivery care by skilled attendants are recommended to improve maternal health. 22 According to WHO recommendation, the pregnant women at least do 8 times of ANC visits.…”