Skripsi

Perbandingan Kejadian Ekspulsi dan Malposisi AKDR CU T380A Antara Insersi Pascaplasenta dan transcesarean = A Comparative Analysis of Expulsion and Malposition Rates of the Copper T380A IUD in Postplacental versus Transcesarean Insertions.

Latar Belakang Alat kontrasepsi dalam rahim (AKDR) Cu T380A merupakan salah satu long acting reversible contraception yang dapat dipasang setelah melahirkan, baik secara normal (insersi pascaplasenta) maupun sesar (insersi transcesarean). Meski begitu, posisi AKDR di dalam rahim dapat berubah sehingga terjadi malposisi hingga ekspulsi. Penelitian ini bertujuan untuk membandingkan kejadian malposisi dan ekspulsi pada insersi AKDR pascaplasenta dan transcesarean setelah masa involusi. Metode Studi kohort retrospektif ini mengambil pasien, melalui rekam medis, yang memenuhi kriteria penelitian dan telah menjalani pemasangan AKDR, baik pascaplasenta maupun transcesarean, di RS Cipto Mangunkusumo Jakarta antara Mei-September 2024. Posisi AKDR dievaluasi menggunakan ultrasonografi. Analisis data dilakukan untuk membandingkan variabel-variabel pada kelompok insersi pascaplasenta dan transcesarean. Hasil Sebanyak 30 pasien diikutsertakan dalam penelitian, tanpa perbedaan karakteristik yang bermakna antara kedua kelompok. Tidak ditemukan kejadian ekspulsi dan terdapat 3 (60%) kejadian malposisi pada kelompok insersi AKDR pascaplasenta. Tidak ditemukan kejadian ekspulsi dan terdapat 15 (60%) kejadian malposisi pada kelompok insersi AKDR transcesarean. Hasil uji untuk membandingkan kejadian malposisi antara kedua kelompok menghasilkan nilai p 1.000. Kesimpulan Tidak ditemukan perbedaan bermakna pada kejadian ekspulsi dan malposisi antara kelompok insersi AKDR pascaplasenta dan transcesarean.
Kata Kunci: Alat kontrasepsi dalam rahim, ekspulsi, malposisi, pascaplasenta, transcesarean


Introduction The Copper T380A intrauterine device (IUD) is one of the long-acting reversible contraceptives (LARCs) that can be inserted after childbirth, either following normal delivery (postplacental insertion) or after a cesarean section (transcesarean insertion). However, the position of the IUD inside the uterus may shift, leading to malposition or even expulsion. This study aims to compare the incidence of malposition and expulsion between postplacental and transcesarean IUD insertion after the uterine involution period. Method This retrospective cohort study included patients, from medical records, who met the study criteria and had undergone IUD insertion, either postplacental or transcesarean, at Cipto Mangunkusumo Hospital Jakarta between May-September 2024. Ultrasonography was used to assess IUD positioning. Data analysis was conducted to compare the variables between the postplacental insertion group and the transcesarean insertion group. Results The study included 30 patients, showing no significant difference in characteristics between groups. No expulsion events were found and there were 3 (60%) malposition events in postplacental IUD insertion group. No expulsion events were found and there were 15 (60%) malposition events in transcesarean IUD insertion group. The statistical test comparing malposition rates yielded a p-value of 1.000. Conclusion No significant differences were found in the incidence of expulsion and malposition between the postplacental and transcesarean IUD insertion groups.
Keywords: Expulsion, intrauterine device, malposition, postplacental, transcesarean