Angka kematian perinatal merupakan salah satu indikator derajat kesehatan. Angka kematian perinatal Indonesia saat ini masih tinggi yaitu 45 per seribu kelahiran hidup. Diharapkan rumah sakit-rumah sakit di Indonesia terutama rumah sakit tipe C sebagai pusat rujukan di wilayah kerjanya dapat membantu menurunkan angka kematian perinatal yang masih tinggi tersebut. RSU Majalaya sebagai rumah sakit tipe C di Kabupaten DT II Bandung mempunyai angka kematian perinatal yang cukup tinggi yaitu 96,10 % (tahun 1994) menurut Informasi Kesehatan Propinsi Jawa Barat sedangkan menurut catatan medik dan register persalinan di RSU Majalaya sendiri sebesar 151,52% (1993); 146,51% (1994), dan 177,93% (1995) sebelum bayi berat <1000 gram dan bayi umur 4 28 minggu dihilangkan. Tujuan penelitian ini adalah untuk mendapatkan gambaran mengenai faktor-faktor yang berhubungan dengan kematian perinatal di RSU Majalaya, serta untuk mengetahui faktor ekstemal (paritas, usia, kondisi kesehatan ibu, berat badan bayi lahir, rujukan medik eksternal serta status ekonomi ibu) dan faktor internal rumah sakit (kualitas penolong persalinan, lamanya pertolongan persalinan, waktu dan cara persalinan). Metoda penelitian yang digunakan adalah studi deskriptif dengan desain kasus kontrol Sampel yang diambil sebesar 129 ibu bersalin dengan kematian perinatal dan kontrol sebesar 258 ibu bersalin dengan bayi hidup. Data diambil dari bulan Juli 1994 sampai bulan Juni 1996 secara retrospekti£ Analisa data dengan menggunakan program Epi Info versi 6.0 unmatch analysis deskriptif dan Odds Ratio untuk analisis bivariat. Hasil penelitian menemukan bahwa dari 10 variabel ,5 variabel bermalma dengan P c p;OSyaitu berat badan bayi lahir (OR 4.62), kelas perawatan (OR 3,35), rujukan eksternal (OR 0.61), faktor resiko ibu (OR 4,15), dan lama pertolongan persalinan (OR 7,99). Peran RSU Majalaya sebagai Community Hospital belum menunjukkan hasil yang bermakna dalam menurunkan angka kematian perinata1. Demikian pula peran manajemen RSU Majalaya dalam pengelolaan perinatologi masih belum menunjukkan peran yang berarti karena masih tingginya angka kematian perinatal. Disarankan untuk RSU Majalaya untuk meningkatkan manajemen perinatologi terutama dalam segi pendayagunaan tenaga spesialis dan kualitas penolong persalinan terutama persalinan di luar jam kerja dan penataan catatan medik dan register persalinan untuk meningkatkan sistem informasi manajemen rumah sakit. Bagi Dinas kesehatan dan instansi terkait disarankan untuk meningkatkan program penunjang bagi keberhasilan menurunkan angka kematian perinatal khususnya di RSU Majalaya serta mengupayakan perbaikan sarana dan prasarana yang terkait.

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Perinatal mortality rate (PMR) is one of the health status indicators. PMR in Indonesia is still high, estimated around 45 per 1000 life births. It is expected that hospitals in Indonesia. Especially type C hospital, which functioning as a top referral in its catchments area, would help in reducing the perinatal mortality rate.

According to the Health Information of West Java. Majalaya public hospital as a type C hospital at Bandung regency has a high Perinatal Mortality Rate, i.e. about 96,10 % (1994). However according to the hospital medical record the rate were about 151,52 % (1993), 146, 51 % (1994), and 177, 93 % (1995). These rates were based on exclusion of those with weight less than 1000 grams and age less than 28 weeks.

The research explored factors related to PMR in Majalaya public hospital. The spesific objective is to describe the external factors (parity, age of the mother, mother health conditions, weight of the baby born, external medical refferal and the economic status) and internal factors (quality of the personnel assisting the delivery, length, time and method of delivery).

This research utilized a case -control study design. Numbers of cases taken were 129 delivery with perinatal mortality, and the control were 258 delivery with life births. The data were taken during July 1994 until June 1996 retrospectively. The analysis was done by using Epi Info versi 6,0 program, unmatched analysis descriptive program and Odds ratio to bivariate analysis.

The analysis revealed that 5 of the 10 variables have a significant relationship with in PMR with p<0.05. Of the 5 variables, 4 belongs to the external factors they are : weight of the baby born (OR 4,62), economic status (OR 3,35), external medical referral (OR 0,61), mother health condition (OR 4,15) The remaining one variable is belong to the internal factor i.e. length of delivery (OR 7,99). These findings suggest that for the hospital to play an effective role to reduce PMR, it has to adopt the concept of "Community Hospital". It was observed that this role has not been planned and implemented systematically as indicated by the high PMR.

It is suggested for the hospital, to increase its perinatology management including increasing the efficiency of specialist and the quality of personnel when serve delivery during off office time. It is also suggested for the hospital to improve its medical record and management information system. To health department of regency Bandung and another institution it is suggested to increase their support on program to decrease PMR, especially at Majalaya Public Hospital. This can be done for example by improving the hospital facilities.