Determinan penyebab atonia uteri

DETERMINAN FAKTOR PENYEBAB KEJADIAN PERDARAHAN 

POST PARTUM KARENA ATONIA UTERI

ABSTRAK

Sugi Purwanti, Yuli Trisnawati

Akademi Kebidanan YLPP Purwokerto

Email : sugipurwanti@gmail.com

Penyebab angka kematian ibu terbanyak adalah perdarahan post partum. Penyebab perdarahan post partum adalah atonia uteri dengan prosentase 50 – 60%, dimana faktor resikonya antara lain adalah umur, paritas yang tinggi, pembesaran uterus. Tujuan umum mengetahui hubungan antara umur ibu, paritas ibu, pembesaran uterus terhadap perdarahan post partum karena atonia uteri. Tujuan khusus penelitian adalah mendeskripsikan kejadian perdarahan post partum karena atonia uteri, umur ibu, paritas ibu, pembesaran uterus. Metode penelitian adalah survey kuantitatif dengan pendekatan case control.  Populasi penelitian adalah seluruh ibu nifas di RSUD Margono Soekarjo pada bulan Januari-Desember 2014. Populasi ibu nifas yang mengalami perdarahan karena atonia uteri sebesar 459 kasus. Sampel kasus adalah ibu  dengan perdarahan post partum karena atonia uteri sebesar 80 responden dan sampel kontrol adalah ibu nifas normal sebesar 80 responden. Analisis univariat menggunakan distribusi frekuensi. Analisis bivariate menggunakan chi square. Hasil penelitian umur responden berisiko sebesar 36.2%,  paritas responden berisiko sebesar 29.4%, pembesaran uterus  berisiko sebesar 12.5%. Adanya hubungan antara umur dan paritas terhadap perdarahan posr partum karena atonia dengan p value 0.033 dan 0.037. Tidak adanya hubungan antara pembesaran uterus dengan perdarahan post partum karena atonia uteri dengan p value 0.473. Kesimpulan adanya hubungan antara umur dan paritas terhadap perdarahan posr partum karena atonia. Ibu nifas dengan umur berisiko mempunyai risiko 2.1 lebih besar mengalami perdarahan nifas karena atonia uteri. Ibu nifas dengan paritas berisiko mempunyai risiko 2.2 lebih besar mengalami perdarahan nifas karena atonia uteri Tidak adanya hubungan antara pembesaran uterus dengan perdarahan post partum karena atonia uteri.

ABSTRACT

Most causes of maternal mortality are postpartum hemorrhage. Causes of postpartum hemorrhage is uterine atony with percentage 50-60%, where risk factors include age, high parity, overdistension of uterine . The objective knowing the correlation between maternal age, maternal parity, uterine distension and postpartum hemorrhage due to atonic uterus. The specific objective of this research is to describe the incidence of postpartum hemorrhage due to uterine atony, maternal age, maternal parity, uterine distension. The research method was a quantitative survey with case control approach. The population was all postpartum mothers in hospitals Margono Soekarjo in January-December 2014. The population of puerperal women who experience bleeding due to uterine atony of 459 cases. Sample cases were mothers with postpartum hemorrhage due to atonic uterus by 80 respondents and the control sample was normal postpartum mothers by 80 respondents. Univariate analysis used frequency distribution. Bivariate analysis used chi square. Results of the study respondents age risk by 36.2%, parity amounted to 29.4% of respondents at risk, the risk of uterine overdistension by 12.5%. The correlation between age and parity to hemorrhagic puerpuralis due to atony with p value 0.033 and 0.037. The incorrelation between uterine overdistension to hemorrhagic puerpuralis due to atonic uterus with p value 0.473. Conclusion The rcorrelation between age and parity against hemorrhagic puerpuralis due to uterine atony. Puerperal women with risky age had 2.1 greater risk of experiencing hemorrhagic puerpuralis due to uterine atony. Puerperal women with risk parity had 2.2 greater risk of experiencing hemorrhagic puerpuralis due to uterine atony. The incorrelation between uterine overdistension to hemorrhagic puerpuralis due to atonic uterus

http://ojs.akbidylpp.ac.id/index.php/Prada/article/view/122

Kinerja petugas MTBS

Prosiding Seminar Nasional Kesehatan

ANALISIS   PENGARUH  KARAKTERISTIK   INDIVIDU, FASILITAS, SUPERVISI, DAN MOTIVASI TERHADAP   KINERJA PETUGAS PELAKSANA PELAYANAN ROGRAM MTBS  (MANAJEMEN TERPADU 

 BALITA SAKIT)

ABSTRACT

Integrated Management of Childhood Illness (MTBS) as one as way to reduce infant mortality rate and under-five children mortality rate has been implemented in district of banyumas. However, infant mortality rate and under-five children mortality rate in 2007 was still high, 9.6/1000 live birth. The Objective of this study was to identify the influence of knowledge, work load perception on supervision and motivation towards the performance of MTBS program workers in the district of Banyumas.

            This was an observational-analytical study with a cross sectional approach. Structured questionnaire was used as study instrument. It had been tested for its validity and reliability. The numbers of samples used in this study was 99 respondents. Chi square and logistic regression test were implemented in the data analysis.

            Result  of this study showed that 51.5 % of respondents was in the age of 30-40 years old, 35.4 % of respondents was in the D3 midwifery level of educations, 73.3 % respondent’s job ocupation was civil servant. Among 39 primary health center (puskesmas), 15 of them had MTBS room. Respondents with poor knowledge were 56.7%. respondents with high motivation were 53.5%. Performence of MTBS service workers was sufficient (54.5%).Result of bivariate analysis indicated taht work load perceptions (p:0.0001, Exp B:9.734), motivation (p:0.005,Exp B: 3.9860 towards the performance of workers.

            Health office needs to provide MTBS training, modify workers perceptions on work load, privide  MTBS module and to do continuing research on work load analysis.

ABSTRAK

            MTBS sebagai salah satu upaya dalam menurunkan Angka Kematian Bayi dan Kematian Balita telah dilaksanakan di Kabupaten Banyumas. Tetapi AKABA dan kematian balita pada tahun 2007 masih tinggi yaitu 9,6/1000 kelahiran hidup. Tujuan Penelitian adalah untuk mengetahui pengaruh pengetahuan, persepsi beban kerja, fasilitas, persepsi terhadap supervisi, motivasi terhadap kinerja petugas kesehatan pelaksana program MTBS di Kabupaten Banyumas.

            Penelitian adalah observasional analitik dengan pendekatan cross sectional. Instrumen penelitian menggunakan kuesionar terstruktur yang telah diuji validitas dan reliabilitasnya. Jumlah sampel 99 responden. Analisis yang digunakan adalah uji chi square  dan uji regresi logistik.

Hasil penelitian menunjukkan bahwa responden berusia 30-40 tahun (51,5 %). Tingkat pendidikan responden DIII  Kebidanan (35,4%), status kepegawaian responden PNS (73,7%). Puskesmas yang sudah memiliki ruangan MTBS 15 Puskesmas dari 39 puskesmas. Responden mempunyai pengetahuan yang kurang (56,6%), persepsi beban kerja banyak (59%). Tempat pelayanan memiliki fasilitas lengkap (53,5%). Responden memiliki persepsi supervisi baik (67,7%). Responden memiliki motivasi tinggi (53,5 %). Kinerja petugas pemberi pelayanan MTBS yang cukup (54,5 %). Hasil analisis bivariat menunjukkan bahwa variabel persepsi beban kerja (p value = 0,0001), motivasi (p value = 0,008) berhubungan dengan kinerja petugas. Analisis multivariat menunjukkan adanya pengaruh variabel persepsi beban kerja (p value = 0,0001, Exp B : 9.734), motivasi (p value = 0,005, Exp B : 3.986) terhadap kinerja petugas.

            Dinas Kesehatan perlu mengadakan pelatihan MTBS, merubah persepsi petugas tentang beban kerja, pengadaan ruangan periksa MTBS, pengadaan form pelayanan MTBS, pemberian modul MTBS, penelitian lebih lanjut tentang analisis beban kerja.