Gambaran Faktor Risiko Prolaps Organ Panggul Pasca Persalinan Vaginal di Daerah Istimewa Yogyakarta

Abstract

Prolaps organ panggul merupakan salah satu bentuk disfungsi dasar panggul pada perempuan. Disfungsi dasar panggul adalah keadaan terganggunya fungsi dasar panggul merupakan salah satu kondisi kesehatan yang banyak dikeluhkan perempuan. Lebih dari 46% perempuan dengan riwayat persalinan vaginal mengalami disfungsi dasar panggul,dan peningkatan jumlah paritas berkorelasi dengan peningkatan kejadian prolaps organ panggul. Tujuan penelitian ini adalah untuk mengetahui gambaran karakteristik faktor risiko prolaps organ panggul pasca persalinan vaginal di wilayah Daerah Istimewa Yogyakarta. Penelitian dilakukan pada Januari–Maret 2018. Hasil penelitian didapatkan 51 subjek penelitian dengan persalinan vaginal yang dapat dilakukan pemeriksaan POPQ pada 3 bulan pascapersalinan. Prolaps organ panggul didapatkan pada sebagian besar pasien pascasalin, yaitu sejumlah 46 orang, prolaps uteri 33 orang, sistokel 44 orang, serta rektokel pada 46) orang. Hanya 5 orang yang tidak memiliki gambaran prolaps organ panggul pada 3 bulan pascapersalinan.Dari penelitian ini dapat disimpulkan bahwa faktor risiko prolaps organ panggul pascapersalinan vaginal di Daerah Istimewa Yogyakarta terdiri atas faktor intrinsik (usia ibu, panjang genital hiatus maupun perineal body), dan ekstrinsik (paritas, indeks massa tubuh overweight dan obes, kenaikan berat badan selama hamil >15 kg, serta dilakukan episiotomi dan terjadi robekan perineum). Upaya pencegahan terutama edukasi, perbaikan gaya hidup, pengendalian indeks massa tubuh, pengaturan diet, olahraga penguatan otot dasar panggul, pembatasan jumlah kehamilan dan persalinan, serta pertolongan persalinan sesuai Asuhan persalinan normal.

 Kata kunci: Disfungsi dasar panggul, faktor risiko, persalinan vaginal, prolaps organ panggul

Risk Factors for Pelvic Organ Prolapse in Women with History of Vaginal Delivery in Yogyakarta

Pelvic organ prolapse is one form of pelvic floor dysfunctions in women that impairs the pelvic floor function and also one of the most frequently conditions complained by women. More than 46% women with history of vaginal delivery have experienced pelvic floor dysfunction where higher number of parity correllates to increased pelvic organ prolapse incident. The aim of this study was to understand the  characteristic risk factors of pelvic organ prolapse incident post vaginal delivery in Special Region of Yogyakarta. The study ws performed during the period of January to March 2018 on 51 subjects with history of vaginal delivery evaluated using POPQ in 3 months postpartum. Pelvic floor dysfunction was present in most postpartum patients, i,e, 46 people while 33 experienced uterine prolapse, 44 experienced cystocele, and 46 experienced rectocele. Only 5 subjects had no pelvic floor dysfunction in any form. Risk factors for pelvic organ prolapse in post vaginal delivery in the Special Region of Yogyakarta consist of intrinsic factors (maternal age, genital length of hiatus, and perineal body), and extrinsic factors (parity, overweight status and obese status based on body mass index, weight gain during pregnancy exceeding 15 kg,  episiotomy and the occurrence of perineal rupture). Prevention actions include  education followed by lifestyle improvement, control of body mass index, dietary regulation, exercise, restrictions on the number of pregnancies and childbirth, and safe delivery according to normal birth care standard.

Key words: Pelvic floor dysfunction, pelvic organ prolapse, risk factors, vaginal delivery