[Latar belakang. Ketuban pecah dini (KPD) merupakan komplikasi yang palingsering pada kehamilan, yang dapat berakibat terhadap kejadian sepsis neonatorum.Sepsis neonatorum masih merupakan penyebab utama morbiditas dan mortalitas padabayi, terutama di negara berkembang. Faktor-faktor pada ibu, pemberian antibiotikdan pemeriksaan mikrobiologi dapat mempengaruhi kejadian sepsis neonatorum padabayi yang lahir dari ibu dengan KPD.Metodelogi penelitian. Penelitian ini merupakan studi potong lintang terhadappasien dengan KPD dan bayi yang dilahirkannya di RSCM, Jakarta, Indonesiaperiode September 2012 – Agustus 2013. Dilakukan evaluasi terhadap faktor-faktorpada ibu, pemberian antibiotik dan pemeriksaan mikrobiologi yang dapatmempengaruhi kejadian sepsis neonatorum.Hasil. Diantara 3438 persalinan, terdapat 958 kasus KPD pada periode tersebut.Sebanyak 29 rekam medis ibu yang tidak ditemukan dan 85 dieksklusi. Dari 844rekam medis ibu, hanya ditemukan 677 rekam medis bayi, dengan 12 gemelisehingga total sampel yang dapat dianalisis adalah 689. Insiden KPD di RSCMadalah sebesar 24,55%. Ditemukan 146 kasus sepsis neonatorum. Pemeriksaanmikrobiologi masih belum merupakan prosedur tetap dalam penatalaksanaan pasienKPD. Antibiotik yang paling banyak digunakan untuk pasien KPD adalah ampisilinsulbaktam.Ambang waktu lama ketuban pecah yang berpotensi untuk terjadinyasepsis neonatorum adalah 12 jam. Faktor pada ibu yang berpengaruh terhadapkejadian sepsis neonatorum adalah usia kehamilan <37 minggu, infeksi intra uterin,warna ketuban yang tidak jernih, indeks cairan amnion 2,5-4,9 dan lama ketubanpecah >12 jam.Kesimpulan. Insiden sepsis neonatorum terkait KPD di RSCM masih cukup tinggi.Perlu dibuat panduan penatalaksanaan KPD dengan memperhatikan faktor pada ibu.Pemeriksaan mikrobiologi sebaiknya dijadikan prosedur tetap dalam penatalaksanaanpasien KPD, yang dapat juga menjadi panduan dalam pemilihan antibiotik.
Background. Premature rupture of membranes (PROM) is one of the most commoncomplications of pregnancy that has an impact on neonatal septic. Neonatal septicremains one of the main causes of neonatal mortality and morbidity, particularly indeveloping countries. Maternal factors, antibiotic administration and microbiologydetection can influence on neonatal septic following PROM.Methods. This cross-sectional study was performed at CM hospital, Jakarta,Indonesia from September 2012 to August 2013 to evaluate neonatal septic that wereborn from mother with PROM. Maternal risk, antibiotic administration, microbiologydetection and its influences on neonatal septic were evaluated.Results. Among 3438 deliveries, there were 958 cases of PROM in CM hospitalduring September 2012 – August 2013. Out of 958 PROM cases, 29 medical recordswere not found and 85 were excluded. Of the remaining 844 women, we just found677 medical records of the babies, including 12 twin babies and leaving 689 babieseligible for analysis. The incidence rate of PROM was 24,55%. Overall, there were146 neonatal septic cases. The microbiological examination is still not a remainsprocedure in the management of PROM. Ampicillin-sulbactam is the most widelyused antibiotics for PROM. Prolonged rupture threshold potential for the occurrenceof neonatal sepsis is 12hours. Maternal factors that influence the incidence ofneonatal sepsis are gestational age <37 weeks, intrauterine infection, discoloredamniotic fluid, amniotic fluid index of 2.5 to 4.9 and a long membrane rupture >12hours.Conclusion. The incidence of PROM related neonatal septic in CM hospital is stillhigh. The management of PROM guidelines needs to be made by taking maternalfactors into account. The microbiological examination should be a remains procedurein the management of PROM, which can also provide guidance in the selection ofantibiotics.;Background. Premature rupture of membranes (PROM) is one of the most commoncomplications of pregnancy that has an impact on neonatal septic. Neonatal septicremains one of the main causes of neonatal mortality and morbidity, particularly indeveloping countries. Maternal factors, antibiotic administration and microbiologydetection can influence on neonatal septic following PROM.Methods. This cross-sectional study was performed at CM hospital, Jakarta,Indonesia from September 2012 to August 2013 to evaluate neonatal septic that wereborn from mother with PROM. Maternal risk, antibiotic administration, microbiologydetection and its influences on neonatal septic were evaluated.Results. Among 3438 deliveries, there were 958 cases of PROM in CM hospitalduring September 2012 – August 2013. Out of 958 PROM cases, 29 medical recordswere not found and 85 were excluded. Of the remaining 844 women, we just found677 medical records of the babies, including 12 twin babies and leaving 689 babieseligible for analysis. The incidence rate of PROM was 24,55%. Overall, there were146 neonatal septic cases. The microbiological examination is still not a remainsprocedure in the management of PROM. Ampicillin-sulbactam is the most widelyused antibiotics for PROM. Prolonged rupture threshold potential for the occurrenceof neonatal sepsis is 12hours. Maternal factors that influence the incidence ofneonatal sepsis are gestational age <37 weeks, intrauterine infection, discoloredamniotic fluid, amniotic fluid index of 2.5 to 4.9 and a long membrane rupture >12hours.Conclusion. The incidence of PROM related neonatal septic in CM hospital is stillhigh. The management of PROM guidelines needs to be made by taking maternalfactors into account. The microbiological examination should be a remains procedurein the management of PROM, which can also provide guidance in the selection ofantibiotics.;Background. Premature rupture of membranes (PROM) is one of the most commoncomplications of pregnancy that has an impact on neonatal septic. Neonatal septicremains one of the main causes of neonatal mortality and morbidity, particularly indeveloping countries. Maternal factors, antibiotic administration and microbiologydetection can influence on neonatal septic following PROM.Methods. This cross-sectional study was performed at CM hospital, Jakarta,Indonesia from September 2012 to August 2013 to evaluate neonatal septic that wereborn from mother with PROM. Maternal risk, antibiotic administration, microbiologydetection and its influences on neonatal septic were evaluated.Results. Among 3438 deliveries, there were 958 cases of PROM in CM hospitalduring September 2012 – August 2013. Out of 958 PROM cases, 29 medical recordswere not found and 85 were excluded. Of the remaining 844 women, we just found677 medical records of the babies, including 12 twin babies and leaving 689 babieseligible for analysis. The incidence rate of PROM was 24,55%. Overall, there were146 neonatal septic cases. The microbiological examination is still not a remainsprocedure in the management of PROM. Ampicillin-sulbactam is the most widelyused antibiotics for PROM. Prolonged rupture threshold potential for the occurrenceof neonatal sepsis is 12hours. Maternal factors that influence the incidence ofneonatal sepsis are gestational age <37 weeks, intrauterine infection, discoloredamniotic fluid, amniotic fluid index of 2.5 to 4.9 and a long membrane rupture >12hours.Conclusion. The incidence of PROM related neonatal septic in CM hospital is stillhigh. The management of PROM guidelines needs to be made by taking maternalfactors into account. The microbiological examination should be a remains procedurein the management of PROM, which can also provide guidance in the selection ofantibiotics., Background. Premature rupture of membranes (PROM) is one of the most commoncomplications of pregnancy that has an impact on neonatal septic. Neonatal septicremains one of the main causes of neonatal mortality and morbidity, particularly indeveloping countries. Maternal factors, antibiotic administration and microbiologydetection can influence on neonatal septic following PROM.Methods. This cross-sectional study was performed at CM hospital, Jakarta,Indonesia from September 2012 to August 2013 to evaluate neonatal septic that wereborn from mother with PROM. Maternal risk, antibiotic administration, microbiologydetection and its influences on neonatal septic were evaluated.Results. Among 3438 deliveries, there were 958 cases of PROM in CM hospitalduring September 2012 – August 2013. Out of 958 PROM cases, 29 medical recordswere not found and 85 were excluded. Of the remaining 844 women, we just found677 medical records of the babies, including 12 twin babies and leaving 689 babieseligible for analysis. The incidence rate of PROM was 24,55%. Overall, there were146 neonatal septic cases. The microbiological examination is still not a remainsprocedure in the management of PROM. Ampicillin-sulbactam is the most widelyused antibiotics for PROM. Prolonged rupture threshold potential for the occurrenceof neonatal sepsis is 12hours. Maternal factors that influence the incidence ofneonatal sepsis are gestational age <37 weeks, intrauterine infection, discoloredamniotic fluid, amniotic fluid index of 2.5 to 4.9 and a long membrane rupture >12hours.Conclusion. The incidence of PROM related neonatal septic in CM hospital is stillhigh. The management of PROM guidelines needs to be made by taking maternalfactors into account. The microbiological examination should be a remains procedurein the management of PROM, which can also provide guidance in the selection ofantibiotics.] |
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