ABSTRAK
Latar belakang : Robekan perineum tingkat III dan IV dapat menimbulkan berbagaimorbiditias seperti disfungsi organ panggul, dispareni, nyeri kronik, dan masalahpsikososial yang mengganggu kualitas hidup perempuan. Audit terhadap tatalaksanarobekan perineum perlu dilakukan sebagai dasar perbaikan panduan pelayanan klinisdan pelayanan di rumah sakit. Tujuan : mengetahui insidensi dan mengaudit tatalaksana robekan perineum tingkatIII dan IV di Rumah Sakit Cipto Mangunkusumo pada tahun 2011-2014 berdasakanpanduan Royal College of Obstetricians and Gynecologist (RCOG) tahun 2015. Metode : Studi deskriptif dengan desain potong lintang dilakukan denganmenggunakan data persalinan di RSUPN Cipto Mangunkusumo dari tahun 2011sampai dengan 2014. Kesesuaian tatalaksana robekan perineum tingkat III dan IVdinilai berdasarkan kehadiran konsulen, tempat memperbaiki, penggunaan anestesi,metode jahitan, bahan jahitan, antibiotik pasca operasi, kateter 1 kali 24 jam,penggunaan analgetik dan laksantia. Subjek yang memenuhi minimal 7 dari 9kriteria, dianggap mendapatkan tatalaksana yang sesuai dengan panduan RCOG. Hasil : Dari tahun 2011 sampai dengan 2014, insidensi robekan perineum berturutturutadalah sebesar 3,54; 4,34; 3,95; dan 1,77%. Tatalaksana robekan perineumtingkat III dan IV pada studi ini didapatkan sesuai pada 57,8% subjek. Ketidaksesuaian ditemukan pada komponen tempat operasi, operator oleh ahli, danpenggunaan kateter urin 1 kali 24 jam pasca tindakanKesimpulan : Insidensi robekan perineum derajat 3 dan 4 didapatkan masih tinggi.Masih terdapat tatalaksana robekan perineum derajat III dan IV yang belum sesuai dengan standar RCOG. ABSTRACT
Background : OASIS may lead to several morbidities i.e pelvic organ dysfunction,dysparenia, chronic pain, and psychosocial problems leading to impaired quality oflife of women. Audit of OASIS management is needed to improve the clinicalguideline and practice of OASIS management in a hospital. Objective : To determine the incidence of OASIS and assess the case management atCipto Mangunkusumo National Hospital during 2011-2014 using the criteria statedin the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015. Methods : A cross-sectional descriptive study was conducted using the deliverydatabase in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal inJakarta, Indonesia during 2011-2014. The OASIS management of each subjectswere assessed based on 9 items listed at RCOG 2015 guideline of OASISmanagement (consultant presence during repair, place of repair, use of anesthesia,methods of suturing, suturing material, use of post-operative antibiotic, use ofurinary catheter 24 hour after surgery, use of laxative agent.Result : During 2011-2014, the incidence of OASIS were respectively 3,54; 4,34;3,95; and. 1,77%. As many as 57,8% subjects with OASIS were approproatelymanaged according to RCOG guideline. Surgery performed at delivery suite, surgeryperformed by resident (not an expert), and not using postoperative foley catheterwere the items that frequently missed in the management. Conclusion : We found a relatively high incidence of OASIS in our hospital. There was several items included in RCOG guideline that should improved in our hospital.;Background : OASIS may lead to several morbidities i.e pelvic organ dysfunction,dysparenia, chronic pain, and psychosocial problems leading to impaired quality oflife of women. Audit of OASIS management is needed to improve the clinicalguideline and practice of OASIS management in a hospital. Objective : To determine the incidence of OASIS and assess the case management atCipto Mangunkusumo National Hospital during 2011-2014 using the criteria statedin the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015. Methods : A cross-sectional descriptive study was conducted using the deliverydatabase in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal inJakarta, Indonesia during 2011-2014. The OASIS management of each subjectswere assessed based on 9 items listed at RCOG 2015 guideline of OASISmanagement (consultant presence during repair, place of repair, use of anesthesia,methods of suturing, suturing material, use of post-operative antibiotic, use ofurinary catheter 24 hour after surgery, use of laxative agent.Result : During 2011-2014, the incidence of OASIS were respectively 3,54; 4,34;3,95; and. 1,77%. As many as 57,8% subjects with OASIS were approproatelymanaged according to RCOG guideline. Surgery performed at delivery suite, surgeryperformed by resident (not an expert), and not using postoperative foley catheterwere the items that frequently missed in the management. Conclusion : We found a relatively high incidence of OASIS in our hospital. There was several items included in RCOG guideline that should improved in our hospital.;Background : OASIS may lead to several morbidities i.e pelvic organ dysfunction,dysparenia, chronic pain, and psychosocial problems leading to impaired quality oflife of women. Audit of OASIS management is needed to improve the clinicalguideline and practice of OASIS management in a hospital. Objective : To determine the incidence of OASIS and assess the case management atCipto Mangunkusumo National Hospital during 2011-2014 using the criteria statedin the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015. Methods : A cross-sectional descriptive study was conducted using the deliverydatabase in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal inJakarta, Indonesia during 2011-2014. The OASIS management of each subjectswere assessed based on 9 items listed at RCOG 2015 guideline of OASISmanagement (consultant presence during repair, place of repair, use of anesthesia,methods of suturing, suturing material, use of post-operative antibiotic, use ofurinary catheter 24 hour after surgery, use of laxative agent.Result : During 2011-2014, the incidence of OASIS were respectively 3,54; 4,34;3,95; and. 1,77%. As many as 57,8% subjects with OASIS were approproatelymanaged according to RCOG guideline. Surgery performed at delivery suite, surgeryperformed by resident (not an expert), and not using postoperative foley catheterwere the items that frequently missed in the management. Conclusion : We found a relatively high incidence of OASIS in our hospital. There was several items included in RCOG guideline that should improved in our hospital.