Research Article

Sistem skoring faktor risiko sebagai model prediktor kejadian cedera sfingter ani obstetrik

Arufiadi Anityo Mochtar , Surahman Hakim, Tyas Priyatini, Shirley Anggraini Tunggadewi, Erwinanto Erwinanto, M Thohar Arifin

Arufiadi Anityo Mochtar
Urogynecology Consultant Program, Faculty of Medicine, Indonesia UniversityCIpto Mangunkusumo General Hospital. Email: arufiadi.am@gmail.com

Surahman Hakim
Obstetric and Gynacology Department, Faculty of Medicine, Indonesia University-Cipto Mangunkusumo General Hospital

Tyas Priyatini
Obstetric and Gynacology Department, Faculty of Medicine, Indonesia University-Cipto Mangunkusumo General Hospital

Shirley Anggraini Tunggadewi
Obstetric and Gynaecology Department, Fatmawati General Hospital

Erwinanto Erwinanto
Obstetric and Gynaecology Department, Faculty of Medicine, Diponegoro University-Dr. Kariadi General Hospital

M Thohar Arifin
Neurosurgery Department, Faculty of Medicine, DIponegoro University,-Dr. Kariadi General Hospital
Online First: December 15, 2018 | Cite this Article
Mochtar, A., Hakim, S., Priyatini, T., Tunggadewi, S., Erwinanto, E., Arifin, M. 2018. Sistem skoring faktor risiko sebagai model prediktor kejadian cedera sfingter ani obstetrik. Intisari Sains Medis 9(3). DOI:10.15562/ism.v9i3.333


ABSTRACT

Introduction: anal sphincter injury is one of the complications that often occur in vaginal delivery. The impact of anal sphincter injury after vaginal delivery can reduce quality of life by causing various complaints such fecal incontinence, voiding disorders, sexual dysfunction, perineal pain and rectovaginal fistula. Assessment of risk factors is important to watch out for patients who are more prone to injury to the anal sphincter. This study aims to obtain a scoring system of various antenatal risk factors that can be used to predict the incidence of obstetric anal sphincter injury.

Methods: This study is a diagnostic test that uses predictive factors for various risk factors for anal sphincter injury in vaginal delivery. The research was carried out in maternity service at Dr. Cipto Mangunkusumo General Hospital and Fatmawati General Hospital in the period February - July 2016. Analysis of the data in this study uses SPSS version 21.0. The analysis test used in this study is the calculation of odds ratio, logistic regression test, ROC curve analysis test to assess sensitivity and specificity of the scoring system.

Results: Nulliparous, estimated fetal weight ≥ 3,500 gr, perineum length ≤ 25 mm, estimated head circumference ≥33.5 were risk factors for obstetric anal sphincter injury (OR> 1; p <0.05). Through the scoring modeling system all risk factors can be converted into scores 1. The probability values of scores 1, 2, 3, 4 are 7%, 30%, 70% and 90% respectively. The sensitivity and specificity of the scoring system developed were 61.3% and 91.3% with a cut-off score of 2.

Conclusion: By knowing the prediction score before delivery, action can be taken to prevent the possibility of sphincter injury in obstetrics.

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