PERBEDAAN EFIKASI PENGGUNAAN MISOPROSTOL SUBLINGUAL TERHADAP LUARAN DALAM TATA LAKSANA ABORTUS INKOMPLIT MENURUT KETEBALAN SISA KONSEPSI ≤ 20 DAN >20 MM

Hengky, Fernando Darmawan (2016) PERBEDAAN EFIKASI PENGGUNAAN MISOPROSTOL SUBLINGUAL TERHADAP LUARAN DALAM TATA LAKSANA ABORTUS INKOMPLIT MENURUT KETEBALAN SISA KONSEPSI ≤ 20 DAN >20 MM. Masters thesis, Universitas Andalas.

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Abstract

ABSTRACT THE DIFFERENCE IN SUBLINGUAL MISOPROSTOL EFFICACY IN THE OUTCOME OF INCOMPLETE ABORTION MANAGEMENT BETWEEN RETAINED PRODUCT OF CONCEPTION THICKNESS OF ≤20MM AND >20MM Hengky Fernando D, Syahredi S.A, Hafni Bachtiar Department of Obtetrics and Gynecology Faculty of Medicine Andalas University Dr. M. Djamil Central General Hospital Padang Background: Misoprostol is widely used as an alternative of curettage in incomplete abortion management, but the efficacy in different retained product of conception thickness was still unknown and needs further study. Objective: To know the difference in sublingual misoprostol efficacy in the outcome of incomplete abortion management with retained product of conception thickness of ≤ 20 and >20 mm. Methods: This research was conducted by clinical trial and post test control group design in PONEK and maternal ward room of RSUP Dr. M. Djamil Padang and satellite hospital since November 2015 until April 2016, until the sample size is met with 30 of incomplete abortion patient with retained product of conception thickness of ≤ 20mm, and 30 of incomplete abortion patient with retained product of conception thickness of >20mm, who met the inclusion criteria and no exclusion criteria, both were examined by transvaginal ultrasonography. All patients were treated with 600µg of sublingual misoprostol (single dose) and observed within 24 hours, the efficacy of misoprostol use was determined after that, whether the therapy is effective, which the retained product of conception thickness reach ≤8 mm, or not effective, which the retained product of conception thickness is >8 mm. Then statistical analytics using Chi-Square test was performed to determine whether there was difference in sublingual misoprostol efficacy in the outcome of incomplete abortion management between retained product of conception thickness of ≤ 20 and >20 mm. Result: Maternal age and the age of pregnancy percentage was not statistically influenced the result of this research, with p value >0.05 (p=0,319 and 0,132). But the age of pregnancy’s average was statistically different with p value <0.05 (p=008). The difference in sublingual misoprostol efficacy in the outcome of incomplete abortion management between retained product of conception thickness of ≤ 20 and >20 mm was statistically significant with p value <0.05 (p=0.019). Conclusion: There is difference in sublingual misoprostol efficacy in the outcome of incomplete abortion management between retained product of conception thickness of ≤ 20 and >20 mm Keywords: Incomplete abortion, misoprostol, retained product of conception thickness. ABSTRAK Hengky Fernando D, Syahredi S.A, Hafni Bachtiar Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Andalas RSUP Dr. M. Djamil Padang Latar belakang: Misoprostol telah digunakan secara luas sebagai alternatif tindakan kuretase pada tatalaksana abortus inkomplit namun efekasinya pada berbagai ketebalan sisa konsepsi belum diketahui sehingga dibutuhkan penelitian lebih lanjut. Tujuan: Mengetahui perbedaan efikasi penggunaan misoprostol sublingual terhadap luaran dalam tata laksana abortus inkomplit pada ketebalan sisa konsepsi ≤ 20 dan >20 mm. Metode: Penelitian ini merupakan penelitian clinical trial dengan desain post test control group design di PONEK dan ruang rawatan Obstetri dan Ginekologi RSUP Dr. M. Djamil Padang dan Rumah Sakit Jejaring sejak November 2015-April 2016, sampai jumlah sampel terpenuhi, yaitu 30 pasien abortus inkomplit dengan ketebalan sisa konsepsi ≤20 mm, dan 30 pasien abortus inkomplit dengan ketebalan sisa konsepsi >20 mm, yang memenuhi kriteria inklusi dan tidak didapatkan kriteria eksklusi, keduanya dinilai dengan ultrasonografi transvaginal. Semua pasien mendapatkan terapi misoprostol 600µg (single dose) secara sublingual dan diobservasi selama 24 jam, setelah itu dinilai apakah pemberian terapi misoprostol tersebut efektif, dimana ketebalan sisa konsepsi diharapkan dapat mencapai ≤8 mm, atau tidak efektif, dimana ketebalan sisa konsepsi paska pemberian misoprostol mencapai >8 mm. Kemudian dilakukan analisis statistik dengan tes Chi-Square untuk mengetahui apakah terdapat perbedaan efikasi penggunaan misoprostol sublingual terhadap luaran dalam tata laksana abortus inkomplit pada ketebalan sisa konsepsi ≤ 20 dan >20 mm. Hasil: Usia ibu dan persentase usia kehamilan secara statistik tidak mempengaruhi hasil penelitian, dengan nilai p>0.05 (p=0,319 dan p=0,132). Namun rata-rata usia kehamilan secara statistik berbeda bermakna dengan nilai p<0.05 (p=008). perbedaan efikasi penggunaan misoprostol sublingual terhadap luaran dalam tata laksana abortus inkomplit pada ketebalan sisa konsepsi ≤ 20 dan >20 mm bermakna secara statistik dengan nilai p<0.05 (p=0.019). Kesimpulan: Terdapat perbedaan efikasi penggunaan misoprostol sublingual terhadap luaran dalam tata laksana abortus inkomplit pada ketebalan sisa konsepsi ≤ 20 dan >20 mm. Kata Kunci: Abortus inkomplit, misoprostol, ketebalan sisa konsepsi.

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