Pengaruh Spektrum Plasenta Akreta terhadap Luaran Maternal di RSUP Dr. Hasan Sadikin Bandung

Wati Puspitasari, Hadi Susiarno, Akhmad Yogi Pramatirta


Abstract


Tujuan: Penelitian bertujuan untuk menganalisis pengaruh spektrum plasenta akreta terhadap volume perdarahan, infeksi daerah operasi, dan lama hari rawat.
Metode: Metode yang digunakan adalah analitik observasional dengan desain kohor retrospektif. Data diambil dengan meninjau rekam medis. Pengambilan sampel untuk kedua kelompok diambil dengan menggunakan teknik purposive sampling melalui penetapan kriteria inklusi dan ekslusi. Kelompok pertama subjek dengan spektrum plasenta akreta yang tercatat di dalam rekam medik dalam kurun waktu dari tahun 2016 – 2021, dan kelompok kedua subjek dengan non spektrum plasenta akreta diambil dengan perbandingan 1:2 terhadap kelompok pertama. Data dianalisis menggunakan uji Fisher Exact dan Regresi Logistik Ganda dengan nilai p<0,05 dianggap bermakna secara statistik.
Hasil: Hasil penelitian menunjukkan bahwa terdapat pengaruh yang signifikan (p<α) terhadap volume perdarahan (p=0,025), infeksi daerah operasi (p=0,025), dan lama hari rawat (p<0,001). Peluang spektrum plasenta akreta terhadap terjadinya volume perdarahan sebesar 3,58 kali, infeksi daerah operasi 4,03 kali, dan lama hari rawat 50,09 kali. Meskipun pengaruh spektrum plasenta akreta secara multivariat tidak dominan terhadap volume perdarahan dan infeksi daerah operasi namun berpengaruh secara bermakna terhadap lama hari rawat.
Kesimpulan: Terdapat pengaruh spektrum plasenta akreta terhadap volume perdarahan, infeksi daerah operasi, dan lama hari rawat.

The Effect of Placenta Accreta Spectrum on Maternal Outcomes at Hasan Sadikin Bandung General Hospital

Abstract
Objective: The aim of this study was to analyze the effect of placenta accreta spectrum on bleeding volume, surgical site infection, and length of stay.
Methods: This was an observational analytic study with a retrospective cohort design. Data were taken by reviewing medical records with samples divided into two groups. Sampling for both groups was taken using a purposive sampling technique, the samples were selected by establishing inclusion and exclusion criteria. The first group of subjects with the placenta accreta spectrum recorded in the medical record in the period from 2016 – 2021, and the second group of subjects with non-spectrum placenta accreta was taken in a ratio of 1:2 to the first group. Data were analyzed using the Fisher Exact test and Multiple Logistic Regression with a value of p <0.05 which was considered statistically significant.
Result: The results showed there was a significant effect (p<α) on bleeding volume (p=0.025), surgical site infection (p=0.025), and length of stay (p<0.001). The probability of placenta accreta spectrum for the occurrence of bleeding volume is 3.58 times, 4.03 times for surgical site infection, and 50.09 times for length of stay. Even though the placenta accreta spectrum multivariate test did not show a significant effect on bleeding volume and surgical site infection, but has a significant effect on length of stay.
Conclusion: There was an effect of placenta accreta spectrum on bleeding volume, surgical site infection, and length of stay.

Key words: bleeding, length of stay, maternal outcome, surgical site infection, placenta accreta spectrum.


Keywords


infeksi daerah operasi, lama hari rawat, perdarahan, spektrum plasenta akreta

Full Text:

PDF

References


Dewi TP, Rusly DK, Adelina M. Keterlambatan Deteksi Plasenta Akreta pada Trimester Pertama. Jurnal Kedokteran Banda Aceh. 2021;21(1):54–9.

Ardhana Iswari W, Uli Pardede T, Darus F, Puspitasari B, Santana S, Abidin F, et al. USG untuk Deteksi Plasenta Akreta. Cdk [Internet]. 2017;44(8):586–90. Available from: http://www.kalbemed.com/Portals/6/25_255Teknik-USG untuk Deteksi Plasenta Akreta.pdf

Bartels HC, Postle JD, Downey P, Brennan DJ. Review Article Placenta Accreta Spectrum : A Review of Pathology , Molecular Biology , and Biomarkers. 2018;2018.

C S. Perioperative management of undiagnosed placenta percreta: case report and management strategies. International Journal fo Women’s Health. 2012;4(451).

Departemen Kesehatan Republik Indonesia. Survei Demografi Kesehatan Indonesia. Jakarta; 2012.

Fonseca A, Ayres de Campos D. Maternal morbidity and mortality due to placenta accreta spectrum disorders. Best Pract Res Clin Obstet Gynaecol [Internet]. 2021;72:84–91. Available from: https://doi.org/10.1016/j.bpobgyn.2020.07.011

Kasraeian M, Hashemi A, Hessami K, Alamdarloo SM, Vahdani R, Vafaei H, et al. A 5-year experience on perinatal outcome of placenta accreta spectrum disorder managed by cesarean hysterectomy in southern Iranian women. BMC Womens Health. 2021 Dec 1;21(1).

Aditiawarman, Saroyo YB, Dachlan EG, Sulistyono A, Akbar MIA, Hadijono RS, et al. Kelainan spektrum plasenta akreta. 1st ed. Jakarta: Satuan Tugas Plasenta Akreta Indonesia Himpunan Kedokteran Fetomaternal POGI; 2019.

Allen L, Jauniaux E, Hobson S, Papillon-Smith J, Belfort MA, Duncombe G, et al. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management. International Journal of Gynecology and Obstetrics. 2018 Mar 1;140(3):281–90.

Kawakita T, Landy HJ. Surgical site infections after cesarean delivery: epidemiology, prevention and treatment. Matern Health Neonatol Perinatol. 2017 Dec;3(1).

Maulina F, Dilmy MAF, Saroyo YB, Purwosunu Y. Maternal outcome in accreta cases. Conservative surgery and hysterectomy in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from January 2017 to January 2018. Majalah Obstetri & Ginekologi. 2021;29(3):129.

Qatrunnada A, Antonius PA, Yusrawati. Faktor Risiko dan Luaran Maternal Plasenta Akreta in Dr. M. Djamil Padang General Hospital. Obgynia. 2018;1(2):97–102.

Thurn L, Wikman A, Westgren M, Lindqvist PG. Massive blood transfusion in relation to delivery: incidence, trends, and risk factors: a population-based cohort study. International Journal of Obstetrics and Gynaecology [Internet]. 2019; Available from: https://doi.org/10.1111/1471-

Cheng H, Chen BPH, Soleas IM, Ferko NC, Cameron CG, Hinoul P. Prolonged Operative Duration Increases Risk of Surgical Site Infections: A Systematic Review. Vol. 18, Surgical Infections. Mary Ann Liebert Inc.; 2017. p. 722–35.

Son Tran T, Jamulitrat S, Chongsuvivatwong V, Geater A. Risk Factors for Postcesarean Surgical Site Infection. 2000.




DOI: http://dx.doi.org/10.24198/obgynia.v6i1.468

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.


     
     

Creative Commons License
Indonesian Journal of Obstetrics & Gynecology Science is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
  Web Analytics
  View My Stat