Tesis

Kejadian Dispareunia pada 3 sampai 6 Bulan Pasca Ruptur Perineum Akibat Persalinan dan Hubungannya dengan Faktor Risiko = The risk of dyspareunia in postpartum women with history of perineal tear: A cross-sectional study.

Pendahuluan: Dispareunia adalah beban utama pada wanita usia reproduktif. Kondisi ini memiliki dampak langsung pada kehidupan pernikahan, sosial dan professional dari wanita usia reproduktif. Faktor yang dapat berkontribusi dalam terjadinya dyspareunia adalah rupture perineum. Metode: Desain studi potong lintang digunakan dengan memberikan kuesioner Female Sexual Function Index (FSFI) terhadap wanita postpartum yang terdiagnosis dengan ruptur perineum akibat persalinan per vaginam. Penelitian ini dilakukan di Rumah Sakit Cipto Mangunkusumo dan Rumah Sakit Umum Tangerang pada bulan Oktober sampai Desember 2017. Pasien yang memiliki inflamasi panggul kronis dan riwayat dispareunia sebelumnya dieksklusi. Hasil: Sebanyak 93 subjek terlibat dalam studi ini.; 59 subjek memiliki ruptur perineum ringan (derajat I dan II) sedangkan 34 subjek lainnya memilki ruptur perineum derajat berat (derajat III dan IV). Ditemukan bahwa ruptur perineum berkaitan dengan tejradinya dyspareunia setelah 3-6 bulan setelah terjadi rupture perineum. Kesimpulan: Ruptur perineum derajat III dan IV meningkatkan risiiko terjadinya dyspareunia 3-6 bulan postpartum sampai 5 kali lipat. Studi prospektif selanjutnya dengan jumlah sampel yang lebih besar yang menginvestigasi risiko dispareunia pada perempuan dengan rupture perineum sebaiknya dilakukan.
Kata kunci: dispareunia, rupture perineum, postpartum


Introduction: Dyspareunia is major burden in reproductive-aged women. In fact, it has a direct impact on their marital, social and professional life. One factor that may contribute to the risk of developing dyspareunia is perineal tear. To this date, studies regarding the association between perineal trauma and dyspareunia 3 to 6 months after perianal rupture are scarce. This study aims to investigate the association between both variables. Methods: A cross-sectional study design was used by giving Female Sexual Function Index (FSFI) questionnaires to postpartum women diagnosed with perineal tear due to vaginal birth. The study was conducted at Cipto Mangukusumo Hospital and Tangerang General Hospital between October and December 2017. Those who had chronic hip inflammation and previous history of dyspareunia were excluded. Results: A total of 93 subjects were involved in this study; 59 had mild (first- and second- degree while 34 had third- and fourth- degree perineal tears. We found that perineal tear was associated with the occurrence of dyspareunia after 3 to 6 months after perineal rupture. Conclusions: Grade III to IV perineal tear increased the risk of dyspareunia 3 to 6 months postpartum up to 5-fold. Further prospective studies with larger samples assessing the risk of dyspareunia in those with perineal tear should be conducted.
Keywords: dyspareunia, perineal tear, postpartum