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ABSTRAK Latar belakang : Robekan perineum tingkat III dan IV dapat menimbulkan berbagai
morbiditias seperti disfungsi organ panggul, dispareni, nyeri kronik, dan masalah
psikososial yang mengganggu kualitas hidup perempuan. Audit terhadap tatalaksana
robekan perineum perlu dilakukan sebagai dasar perbaikan panduan pelayanan klinis
dan pelayanan di rumah sakit.
Tujuan : mengetahui insidensi dan mengaudit tatalaksana robekan perineum tingkat
III dan IV di Rumah Sakit Cipto Mangunkusumo pada tahun 2011-2014 berdasakan
panduan Royal College of Obstetricians and Gynecologist (RCOG) tahun 2015.
Metode : Studi deskriptif dengan desain potong lintang dilakukan dengan
menggunakan data persalinan di RSUPN Cipto Mangunkusumo dari tahun 2011
sampai dengan 2014. Kesesuaian tatalaksana robekan perineum tingkat III dan IV
dinilai 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 9
kriteria, dianggap mendapatkan tatalaksana yang sesuai dengan panduan RCOG.
Hasil : Dari tahun 2011 sampai dengan 2014, insidensi robekan perineum berturutturut
adalah sebesar 3,54; 4,34; 3,95; dan 1,77%. Tatalaksana robekan perineum
tingkat III dan IV pada studi ini didapatkan sesuai pada 57,8% subjek.
Ketidaksesuaian ditemukan pada komponen tempat operasi, operator oleh ahli, dan
penggunaan kateter urin 1 kali 24 jam pasca tindakan
Kesimpulan : 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 of
life of women. Audit of OASIS management is needed to improve the clinical
guideline and practice of OASIS management in a hospital.
Objective : To determine the incidence of OASIS and assess the case management at
Cipto Mangunkusumo National Hospital during 2011-2014 using the criteria stated
in the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015.
Methods : A cross-sectional descriptive study was conducted using the delivery
database in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal in
Jakarta, Indonesia during 2011-2014. The OASIS management of each subjects
were assessed based on 9 items listed at RCOG 2015 guideline of OASIS
management (consultant presence during repair, place of repair, use of anesthesia,
methods of suturing, suturing material, use of post-operative antibiotic, use of
urinary 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 approproately
managed according to RCOG guideline. Surgery performed at delivery suite, surgery
performed by resident (not an expert), and not using postoperative foley catheter
were 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 of
life of women. Audit of OASIS management is needed to improve the clinical
guideline and practice of OASIS management in a hospital.
Objective : To determine the incidence of OASIS and assess the case management at
Cipto Mangunkusumo National Hospital during 2011-2014 using the criteria stated
in the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015.
Methods : A cross-sectional descriptive study was conducted using the delivery
database in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal in
Jakarta, Indonesia during 2011-2014. The OASIS management of each subjects
were assessed based on 9 items listed at RCOG 2015 guideline of OASIS
management (consultant presence during repair, place of repair, use of anesthesia,
methods of suturing, suturing material, use of post-operative antibiotic, use of
urinary 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 approproately
managed according to RCOG guideline. Surgery performed at delivery suite, surgery
performed by resident (not an expert), and not using postoperative foley catheter
were 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 of
life of women. Audit of OASIS management is needed to improve the clinical
guideline and practice of OASIS management in a hospital.
Objective : To determine the incidence of OASIS and assess the case management at
Cipto Mangunkusumo National Hospital during 2011-2014 using the criteria stated
in the Royal College of Obstetricians and Gynecologist (RCOG) guideline 2015.
Methods : A cross-sectional descriptive study was conducted using the delivery
database in Cipto Mangunkusumo Hospital, a tertiary referral university hosptal in
Jakarta, Indonesia during 2011-2014. The OASIS management of each subjects
were assessed based on 9 items listed at RCOG 2015 guideline of OASIS
management (consultant presence during repair, place of repair, use of anesthesia,
methods of suturing, suturing material, use of post-operative antibiotic, use of
urinary 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 approproately
managed according to RCOG guideline. Surgery performed at delivery suite, surgery
performed by resident (not an expert), and not using postoperative foley catheter
were 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."
