Tesis

Waktu Optimal Pemeriksaan Ultrasonografi Kepala untuk Mendeteksi Germinal Matrix-Intraventricular Hemorrhage Pada Bayi Prematur Usia Gestasi Kurang Dari Sama Dengan 34 Minggu = Optimal Timing for Early Detection of Germinal MatrixIntraventricular Hemorrhage Using Head Ultrasonography in Premature Infants with Gestational Age Less Than or Equal to 34 Weeks.

Latar belakang: Kelahiran prematur, yang terjadi sebelum usia gestasi 37 minggu, menjadi masalah kesehatan global dengan sekitar 15 juta kasus setiap tahun. Di Indonesia, prevalens kelahiran prematur mencapai 14,2% hingga 15,5%, dengan Rumah Sakit Cipto Mangunkusumo mencatat angka hingga 38,5%. Komplikasi dari kelahiran prematur, seperti cedera otak, menjadi penyebab utama kematian neonatus. Pemeriksaan ultrasonografi kepala untuk mendeteksi cedera otak, tidak dapat dilakukan secara rutin pada fasilitas terbatas. Tujuan: Penelitian ini bertujuan untuk menentukan waktu optimal pemeriksaan ultrasonografi kepala untuk mendeteksi germinal matrix-intraventricular hemorrhage (GM-IVH) pada bayi prematur usia gestasi kurang dari sama dengan 34 minggu. Metode: Penelitian ini menggunakan desain kohort prospektif di RSCM. Terdapat 140 subyek bayi prematur dengan usia gestasi kurang dari atau sama dengan 34 minggu yang dilakukan pemeriksaan ultrasonografi kepala sejak usia 0 hingga 10 hari atau hingga ditemukannya GM-IVH. Hasil: Dari analisis yang dilakukan, ditemukan bahwa angka kejadian GM IVH di RSCM mencapai 58,5% (82 dari 140 subyek). Waktu optimal pemeriksaan ultrasonografi kepala untuk mendeteksi GM IVH dengan persentase angka kejadian tertinggi yaitu 85,37% adalah pada hari kelima. Simpulan: Penelitian ini merekomendasikan untuk melakukan pemeriksaan ultrasonografi kepala setidaknya pada usia 5 hari setelah lahir agar dapat meningkatkan penanganan serta luaran yang baik untuk bayi prematur dengan usia gestasi kurang dari atau sama dengan 34 minggu.
Kata kunci: GM-IVH, Prematur, ultrasonografi


Background: Preterm birth, defined as delivery before 37 weeks of gestation, represents a global health issue, with approximately 15 million cases annually. In Indonesia, the prevalence of preterm birth ranges from 14.2% to 15.5%, with Cipto Mangunkusumo Hospital reporting rates as high as 38.5%. Complications associated with preterm birth, such as brain injury, are the leading causes of neonatal mortality. Cranial ultrasonography, a diagnostic tool for detecting brain injuries, is often not routinely available in resourcelimited settings. Objective: This study aims to determine the optimal timing for cranial ultrasonography to detect germinal matrix-intraventricular hemorrhage (GM-IVH) in preterm infants with a gestational age of ≤34 weeks. Methods: A prospective cohort study was conducted at Cipto Mangunkusumo Hospital, involving 140 preterm infants with a gestational age of ≤34 weeks. Cranial ultrasonography was performed from day 0 to day 10 or until GM-IVH was detected. Results: Analysis revealed that the incidence of GM-IVH at Cipto Mangunkusumo Hospital was 58.5% (82 out of 140 subjects). The optimal timing for cranial ultrasonography to detect GM-IVH, with the highest detection rate of 85.37%, was on the fifth day of life. Conclusion: This study recommends performing cranial ultrasonography at least on the fifth day of life to enhance management and outcomes for preterm infants with a gestational age of ≤34 weeks. Keywords: GM-IVH, preterm, ultrasonographyBackground: Preterm birth, defined as delivery before 37 weeks of gestation, represents a global health issue, with approximately 15 million cases annually. In Indonesia, the prevalence of preterm birth ranges from 14.2% to 15.5%, with Cipto Mangunkusumo Hospital reporting rates as high as 38.5%. Complications associated with preterm birth, such as brain injury, are the leading causes of neonatal mortality. Cranial ultrasonography, a diagnostic tool for detecting brain injuries, is often not routinely available in resourcelimited settings. Objective: This study aims to determine the optimal timing for cranial ultrasonography to detect germinal ma trix-intraventricular hemorrhage (GM-IVH) in preterm infants with a gestational age of ≤34 weeks. Methods: A prospective cohort study was conducted at Cipto Mangunkusumo Hospital, involving 140 preterm infants with a gestational age of ≤ 34 weeks. Cranial ultrasonography was performed from day 0 to day 10 or until GM-IVH was detected. Results: Analysis revealed that the incidence of GM-IVH at Cipto Mangunkusumo Hospital was 58.5% (82 out of 140 subjects). The optimal timing for cranial ultrasonography to detect GM-IVH, with the highest detection rate of 85.37%, was on the fifth day of life. Conclusion: This study recommends performing cranial ultrasonography at least on the fifth day of life to enhance management and outcomes for preterm infants with a gestational age of ≤ 34 weeks.
Keywords: GM-IVH, preterm, ultrasonography