JOURNAL READING

“Study of Causes and Complications of Intra

Uterine Fetal Death (IUFD)”

PEMBIMBING :
dr. Deflina, Sp. OG

Yayan Samayang Putra Latuconsina

2015730133

STASE OBSTETRI DAN GINEKOLOGI RS SEKARWANGI

FAKULTAS KEDOKTERAN DAN KESEHATAN
TAHUN 2019
PENDAHULUAN
Menurut WHO
“Kematian sebelum
pengeluaran hasil konsepsi
01
janin dari ibunya, kematian
ditunjukkan oleh tidak
adanya bukti kehidupan
seperti denyut jantung,
pulsasi tali pusat, atau
gerakan otot.”
Definisi
02 • Definisi kelahiran mati
bervariasi di setiap negara.
• Sebagian besar negara
mewajibkan melaporkan
kematian janin pada usia
kehamilan 20 minggu atau
minimal berat lahir 350
gram.
• Mewajibkan melaporkan
kematian janin dengan berat
lahir 500 gram atau usia
kehamilan ≥ 22 minggu.
METOD
E 01
Penelitian observasional retrospektif
(April - Juni 2014)

Rumah sakit tersier

02 Pasien pedesaan, perkotaan, negara bagian yang
datang untuk berobat

03 Catatan kasus pasien yang memiliki IUFD

keadaan darurat atau rawat jalan, usia, paritas,

04 riwayat obstetrik dahulu, penyebab IUFD, cara
melahirkan, pemeriksaan laboratorium, komplikasi
maternal dan rincian transfusi darah.

05 Kriteria IUFD -> usia gestasi 20 minggu atau lebih.

 WHO : “lahir mati karena kehilangan
kehamilan pada atau setelah 28 minggu
kehamilan, atau berat lahir paling sedikit
1000 g.”
seluruh dunia, kelahiran mati pada tahun
1995 22.1 per 1000 kelahiran, pada tahun
2009 menurun menjadi 18.9 per 1000
kelahiran.

Negara dengan pendapatan rendah dan

menengah untuk menghitung kelahiran
mati merupakan tantangan dikarenakan
system yang sangat buruk
 Dalam penelitian ini, kejadian IUFD sebesar 56 (70%) kegawat daruratan lebih tinggi
dibandingkan dengan yang rawat jalan sebesar 24 (30%).

Sejalan dengan penelitian Kurangnya asuhan antenatal (ANC) yang tidak adekuat adalah
Korde NV dkk. dan Anjali masalah terpenting yang perlu mendapat perhatian.
C et Al. Kameshwaran
dkk.
dilaporkan penyebab dari Jika ANC secara teratur dapat menurunkan resiko
IUFD adalah solusio
plasenta 21,9% dan PIH-
komplikasi (Anemia) dan menurunkan resiko IUFD
eklampsia 18,7%. 70%

Showghy dkk. Penyebab utama IUFD ->

kehamilan di usia <16
anemia, perdarahan
tahun ↑ resiko IUFD 4x.
Frett dkk. usia >35 tahun ↑
risiko kematian janin pada
rata-rata 1,5 kejadian.
Paritas pasien
mempengaruhi hasil
kehamilan.
Dalam penelitian ini, faktor yang
menyebabkan kematian janin dapat
diidentifikasi lebih dari 61,3% kasus

Penyebab lahir mati diidentifikasi sebesar

81,2%. Perawatan antenatal dan intranatal
yang memadai bersamaan dengan tepat
waktu masuk ke rumah sakit bisa
membantu tidak hanya dalam pencegahan
namun sebagai penanganan anemia berat,
penyakit kuning dan komplikasi lainnya.
KESIMPULAN

Anemia, perdarahan adalah penyebab utama IUFD. Mayoritas wanita

yang IUFD adalah dalam keadaan gawat darurat dan kurang mendapat
perawatan antenatal yang memadai. Proporsi IUFD yang signifikan
dapat dicegah dengan pendidikan kesehatan kepada pasien dan
masyarakat untuk perawatan antenatal reguler, tentang tanda
peringatan selama masa antenatal, persalinan di rumah sakit dan
rujukan awal.
 THANK
T H A N K Y O U
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 THANK
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