Risk factors of post partum haemorrhage in Indonesia

Abstract

Latar belakang: Perdarahan post-partum (PPH) merupakan salah satu trias klasik penyebab kematian ibu. Studi ini mengevaluasi beberapa faktor risiko PPH, khususnya riwayat antenatal, natal, dan post-natal.Metode: Analisis menggunakan sebagian data dari studi potong lintang Riset Kesehatan Dasar (Riskedas) 2010. Subjek yang dipakai unuk analisis ini ialah wanita yang menikah berumur 13-49 tahun dan melahirkan anak terakhir antara 1 Januari 2005 sampai 31 Juli 2010. Perdarahan post-partum berdasarkan konfi rmasi petugas kesehatan tentang telah terjadinya perdarahan dua atau lebih kain (masing-masing 1,5 m) selama proses persalinan.Hasil: Pada analisis ini terdpat 601 subjek yang mengalami PPH dan 19.583 subjek tidak mengalami PPH. Eklamsia meningkatkan risiko PPH 3,5 kali (95% interval kepercayaan (CI) = 2,53–4,69), ketuban pecah dini meningkatkan risiko PPH 2,2 kali (95% CI = 1,69-2,83), placenta previa meningkatkan risiko PPH 2,1 kali (95% CI = 1,29-3,31). Dibandingkan kehamilan aterm, wanita dengan kehamilan prematur berisiko PPH 82% lebih tinggi (95% CI = 1,33–2,49), sedangkan yang dengan kehamilan post-term berisiko PPH 72% lebih tinggi (95% CI = 1,16–2,57). Dibandingkan wanita dengan paritas 1-2, risiko PPH pada wanita yang berparitas 3-5 dan 6 atau lebih berturut-turut adalah 24% dan 81% lebih tinggi.Kesimpulan: Eklampsia merupakan faktor risiko PPH terkuat. Placenta previa, ketuban pecah dini, kehamilan prematur atau post-term, serta paritas yang tinggi juga meningkatkan risiko PPH. (Health Science Indones 2011;2:66-70).Abstract Background: Post-partum haemorrhage (PPH) is one of the classic triad of causes of maternal death. This analysis aimed to evaluate several risk factors of PPH.Methods: This analysis using a cross-sectional Basic Health Research (Riskesdas) 2010 data. For this analysis, the subjects consisted of married women aged 13-49 years, who gave birth of their last child between January 1, 2005 and August 2010, who had a probability of PPH history. The PPH was defi ned as bleeding more than two wet pieces materials, 1.5 m each, during giving birth.Results: This analysis noted 601 subjects had PPH and 19,583 subjects did not have PPH. Post-partum haemorrhage related to demographic (education level, and economic level), gynecologic (parity) as well as obstetric factors. Those who had than did not have eclampsia had 3.5-fold PPH [95% confi dence interval (CI) = 2.53–4.69]. Those who had than did not have premature rupture of the membranes had 2.2-fold PPH (95% CI) = 2.53–4.69). Those who had than did not have placenta previa had 2.1-fold PPH (95% CI) =1.29–3.31). In term of uterine rupture, those who had than did not uterine rupture had 65% increase PPH (95% CI) = 1.11–2.46). Compared to women with 1-2 parity, women with 3-5 and 5 or more parity had an increased PPH risk for 24% and 81% respectively.Conclusion: Eclampsia was the strongest risk factor of PPH. Other risk factors of PPH include premature rupture of the membranes, placenta previa, premature or post-term pregnancies, and high parity. (Health Science Indones 2011;2:66-70).

Keywords

• post-partum haemorrhage, eclampsia