Tesis

Prevalensi Kejadian Retensio Urine Pascapersalinan Tipe Covert dan Hubungannya dengan Faktor Risiko Persalinan di RSCM dan RS Jejaring Pendidikan FKUI Tahun 2019-2020 = Prevalence and Risk Factors of Covert Type Postpartum Urinary Retention in Cipto Mangunkusumo National General Hospital and Faculty of Medicine, Universitas Indonesia’ Teaching Hospitals in 2019-2020.

Latar belakang: Retensio urine pasca persalinan merupakan salah satu komplikasi tersering dalam persalinan. Salah satu jenis retensi urine yang sulit diketahui adalah tipe covert yang tidak bergejala. Akan tetapi, retensi urine tipe covert dapat menyebabkan retensi urine persisten yang dapat menurunkan kualitas hidup. Diperlukan suatu studi untuk meneliti faktor risiko terjadinya retensi urine tipe covert agar dapat dideteksi lebih dini. Tujuan: Mengetahui faktor risiko retensi urine pasca persalinan tipe covert. Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang (cross sectional). Subjek dari penelitian ini merupakan ibu yang melakukan persalinan pervaginam di RSUPN Cipto Mangunkusumo, RSUP Persahabatan, RSUD Koja, RSUD Kabupaten Tangerang, dan RSUD Karawang pada 20 September 2019 hingga 27 Februari 2020. Pasien dengan riwayat retensi urine sebelumnya, penggunaan kateter menetap, atau memiliki nyeri VAS 5 meski sudah diberikan analgetik dieksklusi dari penelitian. Pasien yang tidak berkemih 6 jam pasca persalinan termasuk dalam drop out. Hasil: Didapatkan sebanyak 520 subjek yang memenuhi kriteria inklusi dan eksklusi. Tidak terdapat hubungan antara usia ibu dengan kejadian retensio urine pascapersalinan tipe covert (p > 0,05). Paritas primipara lebih berisiko mengalami kejadian retensio urine pascapersalinan tipe covert (p < 0,001, OR 3,8 IK95% 1,87-7,72). Durasi persalinan kala II ≥ 20 menit lebih berisiko mengalami kejadian retensio urine pascapersalian tipe covert (p < 0,001, OR 36,69 IK95% 14,9-90,20). Ruptur perineum berat (derajat 3 atau 4) lebih berisiko mengalami kejadian retensio urine pascapersalinan tipe covert (p = 0,050, OR 8,54 IK95% 1,00-73,66). Berat bayi saat lahir > 3.000 gram lebih berisiko mengalami kejadian retensio urine pascapersalinan tipe covert (p < 0,001, OR 8,54 IK95% 1,76-7,59). Persalinan pervaginam menggunakan alat lebih berisiko mengalami kejadian retensio urine pascapersalinan tipe covert (p = 0,002, OR 4,79 IK95% 1,75-12,99). Tidak terdapat hubungan antara volume urine kala III dengan kejadian retensio urine pascapersalinan tipe covert (p > 0,05). Kesimpulan: Faktor risiko terjadinya retensi urine pasca persalinan tipe covert adalah paritas primipara, durasi persalinan kala II memanjang, ruptur perineum berat, berat badan lahir bayi besar, dan persalinan pervaginam dengan bantuan alat.
Kata kunci: Retensi urine pasca persalinan, retensi urine tipe covert


Background: Postpartum urine retention is one of the most common complications in labor. One type of urine retention that is difficult to know is the asymptomatic covert type. However, covert type urine retention can cause persistent urine retention which could reduce quality of life. A study is needed to examine the risk factors for covert type urine retention so that they can be detected early. Objective: To determine the risk factors for the occurrence of covert urinary retention after delivery. Method: This study was an observational analytic study with cross sectional. method. The subjects of this study were mothers delivering vaginal deliveries at Cipto Mangunkusumo General Hospital, Friendship Hospital, Koja Regional General Hospital, Tangerang District General Hospital, and Karawang General Hospital from September 20 th 2019 to February 27 th 2020. Patients with a history of previous urinary retention, moderate catheter use, or moderate pain even though analgesics have been excluded from the study. Patients who did not urinate 6 hours after delivery were dropped out. Result: There were 520 subjects who met the inclusion and exclusion criteria. There was no relationship between maternal age and the incidence of covert postpartum urine retention (p > 0.05). Primiparous parity was more at risk of having covert postpartum urine retention (p < 0.001, OR 3.8% 95.97-7.72). Duration of second stage of labor ≥ 20 minutes is more at risk of covert postpartum urine retention (p < 0.001, OR 36.69 IK95% 14.9-90.20). Severe perineal rupture (grade 3 or 4) is more at risk of having covert postpartum urine retention (p = 0.050, OR 8.54 IK95% 1.00-73.66). The birth weight > 3,000 grams is more at risk of having covert postpartum urine retention (p < 0.001, OR 8.54 IK95% 1.76-7.59). Vaginal delivery using a tool is more at risk of having covert postpartum urine retention (p = 0.002, OR 4.79 IK95% 1.75-12.99). There is no relationship between the volume of urine stage III with the incidence covert postpartum urine retention (p > 0.05). Conclusion: Risk factors of covert type urine retention are primiparous parity, prolonged duration of second stage of labor, severe perineal rupture, birth weight of large infants, and vaginal delivery with the aid of a tool.
Keywords: Postpartum urine retention, covert type urine retention