Maternal Deaths due to Obstetric Hemorrhage in Padang, Indonesia: A Case-Control Study

Abstract

Maternal Deaths due to Obstetric Hemorrhage in Padang, Indonesia: A Case-Control Study Kematian Maternal Akibat Perdarahan Obstetri di Kota Padang, Indonesia: Sebuah Studi Kasus-Kontrol Dini F. Omari, Yusrawati, Satya W. Yenny Department of Obstetrics and Gynecology Faculty of Medicine Universitas Andalas Dr. M. Djamil General Hospital Padang Abstract Abstrak Objective: To analyse the association between determinants of maternal deaths and obstetric haemorrhage in Padang, Indonesia. Tujuan: Menganalisis hubungan determinan kematian maternal akibat perdarahan obstetri di Kota Padang. Methods: A retrospective case-control study was conducted in Padang, Indonesia from 2015 to 2019. Maternal deaths that occurred due to obstetric haemorrhage in Padang Health Department was compared to three mothers who survived from obstetric haemorrhage (controls) in Dr. M. Djamil General Hospital, Padang, Indonesia. Metode: Sebuah studi retrospektif case-control dilakukan di Kota Padang dari tahun 2015–2019. Setiap kasus kematian ibu akibat perdarahan obstetri dari tahun 2015–2019 yang dilaporkan oleh Dinas Kesehatan Kota Padang dibandingkan dengan tiga kasus perdarahan obstetri yang tidak berakibat kematian di RSUP Dr. M. Djamil Padang. Analisis data menggunakan uji Chi-square. Results: There were 20 deaths caused by obstetric haemorrhage during 2015 to 2019. Death records could only be found in 16 cases. The most common aetiology of obstetric haemorrhage was uterine atony (62.5%). Determinants associated with maternal deaths due to obstetric haemorrhage were interval between pregnancies (p=0.045; OR:10.846), history of previous labour (p=0.003; OR:8.556), and antenatal care (p=0.003; OR:21.364). Age, parity, birth attendant, and mother’s educational level were not signifi cantly associated with maternal deaths due to obstetric hemorrhage. Hasil: Ada 20 kasus kematian akibat perdarahan obstetri selama tahun 2015–2019. Catatan kematian hanya dapat diperoleh pada 16 kasus. Etiologi terbanyak kematian akibat perdarahan obstetri ialah atonia uteri. Determinan yang berhubungan dengan kematian akibat perdarahan obstetri ialah jarak kehamilan (p=0.045; OR:10.846), riwayat persalinan sebelumnya (p=0.003; OR:8.556), dan antenatal care (p=0.003; OR:21.364). Tidak terdapat hubungan yang signifi kan antara usia, paritas, penolong persalinan, dan tingkat pendidikan ibu dengan kematian maternal akibat perdarahan obstetri. Conclusions: Uterine atony was the most frequent aetiology of maternal deaths due to obstetric haemorrhage. There was a signifi cant association between pregnancy intervals, history of previous labour, and antenatal care with maternal deaths due to obstetric haemorrhage. Kesimpulan: Atonia uteri merupakan etiologi tertinggi kematian maternal akibat perdarahan obstetri. Ada hubungan yang signifi kan antara jarak kehamilan, riwayat persalinan sebelumnya, dan antenatal care dengan kematian maternal akibat perdarahan obstetri. Keywords: determinant, obstetric haemorrhage, maternal death. Kata kunci: determinan, kematian maternal, perdarahan obstetri.