Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome

Abstract

Maternal Mortality Rate at East Ogan Komering Ulu (East OKU) Regional Public Hospital Over a Four Year Period: Trends, Its Associated Factors and Neonatal Outcome Angka Kematian Ibu di RSUD Ogan Komering Ulu Timur (OKU Timur) dalam Periode Empat Tahun : Pola, Faktor yang Berkaitan dan Luaran Neonatus Cindy Kesty, Hendra S Saputra East Ogan Komering Ulu (East OKU) Regional Public Hospital, Sumatera Selatan Abstract Abstrak Objective : To determine the MMR trends, its associated factors, and neonatal outcome at East Ogan Komering Ulu Regional Public Hospital from 2013 until 2016. Tujuan : Untuk menentukan pola, faktor yang berkaitan, dan luaran neonatus di RSUD Ogan Komering Ulu Timur dari 2013 hingga 2016. Methods : This descriptive study was performed from January 2013 until December 2016 in maternity ward and Intensive Care Unit (ICU) of East Ogan Komering Ulu Regional Public Hospital, South Sumatera. Data were collected from medical records. There were 17 maternal deaths, but one was excluded due to lack of data. Metode : Studi deskriptif dilakukan dari Januari 2013 hingga Desember 2016 di bangsal kebidanan dan unit perawatan intensif RSUD Ogan Komering Ulu Timur, Sumatera Selatan. Data dikumpulkan dari rekam medik. Terdapat 17 kematian ibu, tetapi 1 data dieksklusi karena data yang kurang lengkap. Results : We recorded 2,191 pregnancies and 17 maternal deaths. Over four years, the lowest MMR occurred in 2013 (229/100,000) and achieved its peak in 2014 (1,306/100,000). Then, MMR followed a downward trend dropping from 1,087/100,000 in 2015 until 588/100,000 in 2016. Most of the deceased were childbearing age women (50.0%), multigravida (62.5%), but nulliparous (50.0%), and aterm (87.5%). The major aetiology of maternal deaths were hypertensive disorders (37.5%), followed by hypertensive disorders combined with haemorrhage and hypertensive disorders combined with infection in the same proportion. MMR was higher in inborn cases (87.5%), born via C-section (87.5%), and treated for less than 48 hours (93.75%). Alive neonatal were born in most cases (62.5%). Hasil : Terdapat 2.191 kehamilan, dan 17 kematian ibu. Selama 4 tahun, AKI terendah terjadi pada 2013 (229/100.000) dan mencapai puncaknya pada 2014 (1.306/100.000). Kemudian, AKI mengalami penurunan dari 1.087/100.000 pada 2015 hingga 588/100.000 pada 2016. Mayoritas sampel berusia reproduktif (50,0%), multigravida (62,5%) dan nulipara (50,0%), serta aterm (87,5%). Mayoritas kematian ibu disebabkan oleh hipertensi dalam kehamilan (HDK) (37,5%), diikuti oleh HDK + perdarahan dan HDK + infeksi dalam jumlah yang sama. AKI lebih tinggi pada ibu yang melahirkan di RS (87,5%), melahirkan melalui seksio sesarea (87,5%), dan dirawat selama kurang dari 48 jam (93,75%). Mayoritas neonatus dilahirkan hidup (62,5%). Kesimpulan : Pola AKI di RSUD berfl uktuasi dengan pola menurun, tetapi masih jauh lebih tinggi dari target MDGs pada tahun 2015 (102/100,000). Hipertensi dalam kehamilan berperan signifi kan terhadap kematian ibu. Mayoritas neonatus dilahirkan hidup. Studi ini diharapkan dapat menjadi masukan bagi rumah sakit untuk melakukan audit maternal dan perinatal. Conclusions : MMR trends in our hospital were fl uctuating with a downward trend, but still much higher than the MDGs target in 2015 (102/100,000). Hypertensive disorder plays a signifi cant role in maternal deaths. In addition, most of the neonates were born alive. We hope that this study can be feedback for the hospital to do maternal and perinatal audit. Kata kunci : angka kematian ibu, faktor, luaran neonatus, pola, rumah sakit umum daerah Keywords : factors, maternal mortality rate, neonatal outcome, regional public hospital, trends