Pengaruh Waktu Penjepitan Tali Pusat Terhadap Kadar Hemoglobin dan Hematokrit Bayi Baru Lahir

Abstract

Latar belakang. Masa setelah bayi lahir, sebelum plasenta dilahirkan, terjadi peralihan peran oksigenasi dariplasenta ke paru bayi. Selama masa tersebut, oksigenasi bayi melalui plasenta masih berlanjut, darah masihditransfusikan ke bayi (disebut transfusi plasenta). Jika peran oksigenasi plasenta dihentikan mendadakdengan penjepitan tali pusat dini, sementara paru belum berfungsi optimal, maka cerebral blood flowmenjadi tidak adekuat. Kapan penjepitan tali pusat seharusnya dilakukan, masih menjadi kontroversi danperdebatan lebih dari satu abad, namun mana yang lebih baik bagi bayi, belum mendapatkan jawabanyang memuaskan.Tujuan. Membuktikan pengaruh waktu penjepitan tali pusat setelah bayi lahir terhadap kadar hemoglobin(Hb) dan hematokrit (Ht) bayi baru lahir.Metode. Penelitian dengan posttest-only control group design, menganalisis pengaruh waktu penjepitan talipusat 45 detik (penjepitan lanjut) setelah bayi lahir terhadap kadar Hb dan Ht bayi baru lahir dibandingkandengan 15 detik (penjepitan dini). Subjek adalah 36 bayi baru lahir (19 subjek dilakukan penjepitan dini),lahir spontan di RSUP Dr. Kariadi Semarang dan rumah Bidan praktek swasta, antara Agustus 2007 -Februari 2008. Uji beda rerata kedua kelompok menggunakan independent t-test. Uji multivariat digunakanuji regresi logistik.Hasil. Kadar Hb subjek kelompok penjepitan dini (13,4-18,4)g% dan lanjut (14,5-20,1)g%. Kadar Ht bayipenjepitan 15 detik (37,6-54,7)% dan penjepitan 45 detik antara (41,6-60,6)%. Pada kelompok penjepitan15 dan 45 detik terdapat perbedaan bermakna rerata Hb subjek (16,30g±1,36) dan (17,34±1,67)g% dan Ht(47,08±4.54)g% dan (51,34±6,07)g% dengan angka signifikansi berturut-turut p=0,048 dan p=0,022.Kesimpulan. Rerata kadar Hb dan Ht kelompok penjepitan tali pusat 45 detik lebih tinggi (secara statistikbermakna) dibandingkan kelompok penjepitan 15 detik.

Apgar Score and the Amount of Blood of Mother in Labour in Delayed Cord Clamping Period

“…According to researchers, 116 out of 120 infants which is in mild asphyxia categoryno asphyxia with Apgar Score 7-10 and 4 (3.3%) respondents which is in moderate asphyxia category with Apgar Score 4-6, and no infants in severe asphyxia category with Apgar Score values 0-3 is in line with the theory that reveals that the delay of doing umbilical cord cutting could elevate the erythrocyte which was being transfered to the infants and it also led to the increase of hematocrit of newborn infants (Sundari, 2016). The method of cutting directly after the baby is born can remove the blood needed by the baby and cause the baby to lack blood which eventually causes anemia in the baby.…”

“…According to Andersson, et al, (2013), by waiting until the umbilical cord stops pulsating naturally can reduce the risk of bleeding. Stated that delayed cord clamping can reduce the risk of bleeding after giving birth (Sundari, 2016). Even though there is still little evidence to suggest that delayed cord clamping can reduce the risk of heavy bleeding after giving birth.…”

Optimal Timing for Delayed Umbilical Cord Clamping to Improve Hemoglobin Level after Birth

“…This is possible because the status of hemoglobin level of infants aged 2-4 months influenced by many factors such as anemia during pregnancy, baby growth, low intake of iron from food (breast milk). Delayed umbilical cord clamping increases iron and decreases the incidence of anemia in infants (Kosim et al, 2009). The incidence of anemia in infants who require blood transfusion decreased 61% after applying Delayed umbilical cord clamping (WHO, 2013).…”

“…The process of the fetus to be baby is an important part of the process of child development that can be affected by the quality of human resources. During the pregnancy period, the oxygenation of the baby is got through the placenta, the mother' blood is transfused to the baby so that it can affect hemoglobin, hematocrit, blood volume, and the brain gets enough oxygen supply (Astrianti, Pangemanan, Bernolian, & Yakub, 2012;Kosim, S, & Sudarmanto, 2009;Rabe, Reynolds, & Diaz-Rossello, 2007). The blood transfusion from mother to the infant may contribute between one-quarter and one-third of the total blood volume in newborns (80-85 ml/kg) and also delayed umbilical clamping cord might reduce the risk of hypovolemic complications, complications, and disability.…”

Empowerment of Posyandu Cadres in Early Detection of Child Growth Problems: Optimization of KIA Books

“…Children are the future generation who determine a nation's future. The good quality of children is a step in creating a bright future for a nation (Depkes, 2008;Kosim, Santosa, & Sudarmanto, 2009;Santosa et al, 2019). Experts on child development agree that the first two years of a child's is the golden period or critical period (Iswarawanti, 2010).…”