Profil plasenta akreta di Rumah Sakit dr. Zainoel Abidin Banda Aceh : studi retrospektif periode Agustus 2018 - Agustus 2022
Abstract
Abstrak. Plasenta akreta adalah perlekatan plasenta abnormal pada miometrium. Penatalaksanaannya secara histerektomi ataupun konservatif seperti Surabaya Modified Procedure for Uterine Conservation Surgery (SuMPUC). Penelitian ini bertujuan untuk mengetahui profil plasenta akreta di Rumah Sakit dr. Zainoel Abidin Banda Aceh. Populasi adalah seluruh pasien yang didiagnosis plasenta akreta. Kriteria inklusi adalah pasien yang didiagnosis dengan plasenta akreta, kriteria eksklusi adalah data rekam medis tidak lengkap. Metode total sampling terhadap rekam medis periode Agustus 2018 - Agustus 2022. Dari 92 total subjek, sebanyak 58 (63.0%) tergolong usia 20-35 tahun. Suluruh 92 (100.0%) multigravida, 77 (83.7%) multipara dan 22 (23.9%) memiliki riwayat abortus. Sebanyak 90 (97.8%) subjek pernah menjalani seksio sesarea. Tidak ada riwayat prosedur/tindakan medis lainnya yang dikaji (kuretase, manual plasenta, embolisasi arteri-uteri, miomektomi dan lainnya). Penatalaksanaan berupa histerektomi terhadap 64 (69.6%) subjek dan 28 (30.4%) SuMPUC. Usia gestasi 52 (56.5%) subjek tergolong preterm, 40 (43.5%) aterm. Plasenta previa totalis dialami 89 (96.7%) subjek. 80 (87.0%) subjek hidup dan 12 (13.0%) meninggal. Diantara subjek hidup, 75 (81.5%) mendapatkan rawatan intensif di ICU, 9 (9.8%) di HCU dan 8 (8.7%) di ruang rawat inap pasca operasi. Pengkajian riwayat penyakit dan manajemen plasenta akreta harus dilakukan secara komprehensif. Pendekatan multidisiplin akan memperbaiki luaran klinis pasien.
Kata kunci: plasenta akreta, seksio sesarea, histerektomi, SuMPUC
Abstract. Placenta accreta is abnormal placental attachment to myometrium. The management is hysterectomical or conservative such as Surabaya Modified Procedure for Uterine Conservation Surgery (SuMPUC). This study aims to determine the profile of placenta accreta at dr. Zainoel Abidin Hospital, Banda Aceh. The population is patient diagnosed with placenta accreta. The inclusion criterion is patient diagnosed with placenta accreta, the exclusion criterion is incomplete medical record data. Total sampling was conducted for medical records of August 2018 - August 2022. Of the 92 total subjects, 58 (63.0%) were aged 20-35 years. 92 (100.0%) were multigravid, 77 (83.7%) were multiparity and 22 (23.9%) had history of abortion. 90 (97.8%) subjects had undergone cesarean section. No history of other medical procedures were studied (curettage, manual placenta delivery, arterial-uterine embolization, myomectomy etc). 64 (69.6%) subjects were managed by hysterectomy and 28 (30.4%) conservatively, SuMPUC. 52 (56.5%) subjects gestational age classified as preterm, 40 (43.5%) aterm. Complete placenta previa in 89 (96.7%) subjects. 80 (87.0%) subjects survived and 12 (13.0%) died. Among the survived subjects, 75 (81.5%) received ICU care, 9 (9.8%) HCU and 8 (8.7%) in inpatient room post-surgery. The comprehensive assessment, multidisciplinary approach management of placenta accreta will improve the clinical outcome.
Keywords: placenta accreta, cesarean section, hysterectomy, SuMPUC
References
Daftar Pustaka
Bartels HC, Postle JD, Downey P, Brennan DJ. Placenta Accreta Spectrum: A Review of Pathology, Molecular Biology, and Biomarkers. Dis Markers [Internet]. 2018 Jul 3;2018:1–11. Available from: https://www.hindawi.com/journals/dm/2018/1507674/
Piñas Carrillo A, Chandraharan E. Placenta accreta spectrum: Risk factors, diagnosis and management with special reference to the Triple P procedure. Womens Health (Lond Engl) [Internet]. 15:1745506519878081. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31578123
Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study. PLoS One [Internet]. 2012;7(12):e52893. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23300807
Qatrunnada A, Antonius PA, Yusrawati. Faktor Risiko dan Luaran Maternal Plasenta Akreta di RSUP Dr. M. Djamil Padang. Obgynia. 2018;1(2).
Wardana G. Faktor Risiko Plasenta Previa. Cerminan Dunia Kedokt. 2007;34(5):229–32.
Morlando M, Collins S. Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies. Int J Womens Health [Internet]. 2020;12:1033–45. Available from: http://www.ncbi.nlm.nih.gov/pubmed/33204176
Yeni CM, Handayani H, Nasir A, Indirayani I, Razali R. The Association betweeen Cesarean Section and Placenta Accreta. Indones J Obstet Gynecol [Internet]. 2022;10(3). Available from: https://inajog.com/index.php/journal/article/view/1572
Dutta S, Dey B, Chanu S, Marbaniang E, Sharma N, Khonglah Y, et al. A Retrospective Study of Placenta Accreta, Percreta, and Increta in Peripartum Hysterectomies in a Tertiary Care Institute in Northeast India. Cureus [Internet]. 2020 Nov 9; Available from: https://www.cureus.com/articles/43747-a-retrospective-study-of-placenta-accreta-percreta-and-increta-in-peripartum-hysterectomies-in-a-tertiary-care-institute-in-northeast-india
Garmi G, Goldman S, Shalev E, Salim R. The effects of decidual injury on the invasion potential of trophoblastic cells. Obstet Gynecol [Internet]. 2011 Jan;117(1):55–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21173644
Jauniaux E, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, et al. Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green-top Guideline No. 27a. BJOG [Internet]. 2019 Jan;126(1):e1–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30260097
American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. Obstetric Care Consensus No. 7: Placenta Accreta Spectrum. Obstet Gynecol [Internet]. 2018;132(6):e259–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30461695
Nieto‐Calvache AJ, Palacios‐Jaraquemada JM, Osanan G, Cortes‐Charry R, Aryananda RA, Bangal VB, et al. Lack of experience is a main cause of maternal death in placenta accreta spectrum patients. Acta Obstet Gynecol Scand [Internet]. 2021 Aug 24;100(8):1445–53. Available from: https://onlinelibrary.wiley.com/doi/10.1111/aogs.14163
Jauniaux E, Bunce C, Grønbeck L, Langhoff-Roos J. Prevalence and main outcomes of placenta accreta spectrum: a systematic review and meta-analysis. Am J Obstet Gynecol [Internet]. 2019 Sep;221(3):208–18. Available from: https://linkinghub.elsevier.com/retrieve/pii/S000293781930287X
Touhami O, Allen L, Flores Mendoza H, Murphy MA, Hobson SR. Placenta accreta spectrum: a non-oncologic challenge for gynecologic oncologists. Int J Gynecol Cancer [Internet]. 2022 Jun;32(6):788–98. Available from: https://ijgc.bmj.com/lookup/doi/10.1136/ijgc-2021-003325
DOI: 10.24815/jks.v22i4.29408
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