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1/172Doddi Suhariadi : Strategi penurunan kejadian preeklamsia (PE) melalui pendekatan studi kasus..., 2005 .

USU e-Repository 2008

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Doddi Suhariadi : Strategi penurunan kejadian preeklamsia (PE) melalui pendekatan studi kasus..., 2005 .


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RINGKASAN

STRATF:Gl PENliRliNAN KKJADlAN PREEKIAMPSIA (PF:) MELAUJI

PENDEKATAN STlJDI KASUS KELOLA DAN METODE MULTIPLE

CRITERL4 UTILITYSS SM NT MCUA

KOTA MEDAN

PE merupakan salah satu penyulit dalam kehamilan dan persalinan yang

dapat menyebabkan kematian ibu dan janin. Berbagai faktor dinyatakan

berhubungan dengan kejadian ini dan disebut juga sebagai ' 'Dissease

of

many

Theories

Untuk mengetahui

determinan

PE, berupa faktor internal (usia

ibu

;

20

dan

> 35

tahun, usia menarche ;

12 dan 16 tahun, usia menikah ;

20 dan 35 tahun, usia

saat kehamilan pertama ;

20 dan> 35 tahun, usia kehamilan ;

20 dan> 35 tahun,

penyakit lain yang ihu derita selama hamil ; jantung, ginjal dan OM, dan riwayat PE

; tidak ada riwayat PE dan faktor eksternal (ANC ; 4 kali, pendidikan ; SLTA

kebawah, pekerjaan ; tidak bekerja) tclah dilakukan penelitian studi kasus kelola

terhadap

ibu

hamil dan bersalin di RSUP H Adam MalikMedan,

RSUD

Dr. Pirngadi

Medan, RS Sundari Medan dan klinik bersalin di kota Medan periode 1 Oktober - 28

Februari 2005 sebanyak 98 kasus yaitu ibu yang menderita PE dan 98 kontrol, ibu

yang melahirkan di tempat yang sama dengan kasus dengan tanpa preeklampsia

disetaraxan dcngan kasus tcrhadap paritas dan riwayat hipertensi sebelum hamil.

Sample dipilih tidak secan, random, pengumpulan data dengan wawancara langsung

menggunakan kuesioner.

Analisis data dengan analisis univariat, bivariat, dan multivariat multiple logistic

regression analysis menggunakan perangkat lunak komputer.

Ditemukan

proporsi

kasus dengan PE berat 69.4 dan PE ringan 30.6 .

Ada

hubungan yang bermakna antara faktor risiko internal dan internal dengan kejadian

PE, kecuali usia kehamilan dan penyakit lain selama hamil. Bahwa terdapat

hubungan yang signifikan antara beberapa faktor risiko terhadap kejadian PE yaitu

faktor usia ibu (OR

3.3; 95 CI 1.551-7.126; nilai p 0.001), usia menarche

OR

3.3; 95

Cl

1.698-6.358; nilai p

0.000), usia menikah (OR

4.6; 95 CI 2.042

10.254; nilai p

0.000), usia pada kehamilan pertama (OR 4.7; 95 CI 1.928

11.432 nilai p= 0.000), riwayat PE (OR 3.4; 95 Cl1.306-9.113; nilai p 0.009),

ANC (OR = 13.5; 95 C16.725-27.009; nilai p =0.000), pekerjaan (OR 2.5; 95

CI 1.298-4.937; nilai p 0.006), dan pendidikan OR 3.1; 95 CI 1.680-5.659;

nilai p 0.000).



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Dati delapan faktor risiko yang dianalisis dengan

mult v r t

temyata hanya tiga

variabel yang berhubungan secara bermakna dengan kcjadian PE yaitu usia

menarche tidak normal adjusted OR

=

3.2 95 CI

=

1.455-7.229; nilai p

=

0.004),

usia menikah adjusted OR=3.7 95 CI 1.419-9.766; nilai p 0.008), dan ANC

adjustedOR = 10.795 CI= 5.202-22.093; nilai P = 0.000)

Untuk menentukan masalah mana yang harus diintervensi terlebih dahulu digunakan

metode MCUA dengan mempertimbangkan besamya masalah, keseriusan masalah,

kemampuan sumber daya manusia untuk mengatasi masalah, tehnologi yang

tersedia, dan kerawanan politik untuk mengatasi masalah tersebut, dan diperoleh

s or tertinggi pada variabel NC Maka strategi penurunan kejadian PE dilakukan

melalui peningkatan kualitas NC

Kata Kunci : PE, Faktor Risiko, Strategi

11



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ABSTRACT

THE STR TEGI ofMINIMIZING PREECL MPSI (PE)

INCIDENCE

by CASE

CONTROL

STUDY PPRO CHAND MULTIPLE

CRITERI

I UTILITY ASSESMENT (MCUA)

METHOD in

MEDAN

PE is worsening of pregnancy and giving birth that can cause maternal and fetal

mortality. Various factor have been stated to have relationship with this incident

which is called deseases

of

many theories .

This study

w s

aimed to learn the influence

of

the risk factors

of

internal factor

(including mother's age; < 20 and 35

th

,

age of menarche; < 12 and 35

th

,

age

of

marriage;

20 and > 35

th

mother's age during first pregnancy;

20

and

35

th

age

of

pregnancy; 20 and > 35

th

other diseases suffered by mother's during

pregnancy; hearth disease, kidney, Diabetes Mellitus and the history of PE; without

PE history) and external factor (ANC;

4 times, education; un employment, and

occupation; high school) toward PE in Medan City. This was matohed case control

study using 98 PE cases and 98 comparisons matching in parity and hypertension

history before pregnancy from H. Adam Malik General Hospital, Dr. Pirngadi

Hospital, Sundari Hospital, maternity clinics in Medan visitors during October 1,

2004 to February 28, 2005.

Samples were drawn not rondomly and data were collected through direct interviews

by using questionnaires and analyzed applaying univariate, bivariate, and multivariate

(multiple logistic regressions analysis) using computer software.

The result shows that 69.4

of

the cases was malignant PE and the rest (30.6 )

benign. There is a significant association between interval risk factors and PE with

the exception of both the age of pregnancy and the other diseases suffered during

pregnancy namely including mother's age (OR = 3.3; 95 Cl 1.551-7.126; P value

= 0.001), age

of

menarche (OR

=

3.3; 95 Cl 1.698-6.358; P value = 0.000), age

of

marriage (OR

=

4.6; 95 CI 2.042-10.254; p value

=

0.000), mother's age during

first pregnancy (OR

=

4.7; 95 CI 1.928-11.432 P value

=

0.000), the history of Pli

(OR = 3.4; 95 CI 1.306-9.113; p value = 0.009), ANC (OR = 13.5; 95 CI 6.725

27.009; p value = 0.000), education (OR = 3.1; 95 CI 1.680-5.659; p value

=

0.000), occupation (OR

=

2.5; 95 CI 1.298-4.937; P value

=

0.006).

Multiple logistic regressions analysis shows only there out of eight variables

are significant association with PE namely, age

of

menarche (Adjusted OR = 3.2;

95 CI 1.455-7.229; p value = 0.004), mother's age when getting married



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djusted OR

=

3.7; 95 CI 1.419-9.766; P value

=

0.008), and ANC Adjusted OR

=

10.7; 95 CI 5.202-22.093; P value

=

0.000).

To determine the problem to be first intervened, the MCUA method was used by

considering the size problem, the seriousnes problem, the capability available

human resources, available technologi, and existing political instability solve the

problem, and the highest score ANC variable. Therefore, the strategy

minimizing the incident PE is carried out through the improvement ANC.

Key words: PE, risk factor, strategy

IV


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