PEMBERIAN IKAN GABUS DALAM PENYEMBUHAN LUKA PERINEUM PADA IBU POST PARTUM

Background: Perineal wound is a tear that occurs in the perineum during delivery and occurs in almost all first deliveries and not infrequently also in subsequent deliveries. Care and proper nutrition, the healing process will be faster and avoid the incidence of infection due to perineal wounds. In 2020 in America, of the 26 million women who gave birth, 40% experienced perineal rupture. In Asia, the problem of perineal tears is quite a lot in the community, 50% of the incidence of perineal tears in the world occurs in Asia. Purpose: This study is to determine the effect of cork fish on the healing of perineal wounds in postpartum mothers at the Niar Clinic in Medan.Methods: The design in the study is a quasi-experimental method (Quasi Experiment Design) Whith Control Group with a Post Test Design approach. The population in this study were 20 people with the sampling technique using purposive sampling technique, the number of samples in this study amounted to 20 people. Data analysis used descriptive and bivariate analysis.Results: Showed that the data for postpartum mothers who had perineal injuries who were given snakehead fish and not snakehead fish were not normally distributed with a value of ρ value 0.000 <0.05. Based on the test results there was an effect of snakehead fish on healing perineal wounds with a sig = 0.004 <0.05.Conclusion: this study is that there is the effect of giving cork fish on the healing of perineal wounds on the healing of perineal wounds in post partum mothers at the Niar Clinic in Medan. Suggestion The results of this study can be used for postpartum mothers who experience perineal injuries to consume a high protein source, namely snakehead fish. Keywords : Fish Cork, Perineal Wound Healing ABSTRAK Latar Belakang: Luka perineum adalah robekan yang terjadi pada perineum sewaktu persalinan dan terjadi pada hampir semua persalinan pertama dan tidak jarang juga pada persalinan berikutnya. Perawatan dan nutrisi yang tepat, proses penyembuhan akan semakin cepat dan terhindar dari kejadian infeksi akibat dari luka perineum. Pada tahun 2020 di Amerika dari 26 juta ibu bersalin, terdapat 40% mengalami ruptur perineum. Di Asia masalah robekan perineum cukup banyak dalam masyarakat, 50% dari kejadian robekan perineum di dunia terjadi di Asia. Tujuan Penelitian: Tujuan penelitian ini untuk mengetahui Pengaruh Pemberian Ikan Gabus Terhadap Penyembuhan Luka Perineum Pada Ibu Post Partum Di Klinik Niar Medan.Metode Penelitian: Desain dalam Penelitian adalah metode eksperimen semu (Quasi Eksperiment Design) Whith Control Group dengan pendekatan Post Test Design. Populasi dalam penelitian ini sebanyak 25 orang dengan teknik pengambilan sampel menggunakan teknik purposive sampling, jumlah sampel dalam penelitian ini berjumlah 20 orang. Analisa data menggunakan analisis deskriptif dan bivariat.Hasil: peneitian menunjukkan bahwa data ibu post partum yang mengalami luka perineum yang diberikan ikan gabus dan tidak diberikan ikan gabus tidak terdistibusi normal dengan nilai ρ value 0,000 < 0,05. Berdasarkan hasil uji ada pengaruh pemberian ikan gabus terhadap penyembuhan luka perineum dengan nilai sig= 0,004 < 0,05.Kesimpulan: penelitian ini yaitu ada Pengaruh Pemberian Ikan Gabus Terhadap Penyembuhan Luka Perineum Terhadap Penyembuhan Luka Perineum Pada Ibu Post Partum Di Klinik Niar Medan.Saran Hasil peneltian ini dapat digunakan untuk para ibu post partum yang mengalami luka perineum untuk mengkonsumsi sumber protein yang tinggi yaitu ikan gabus. Kata Kunci : Ikan Gabus, Penyembuhan Luka Perineum

The Effect of Betel Leaf Water Decoction on Perineal Wound Healing among Post Partum Women

The prevalence of maternity women with perineal injuries in Indonesia in the 25-30 year age group waa 24%, while the 32-39 year old was 62%. Perineal wounds are the cause of postpartum maternal bleeding. Postpartum causes are the main cause of 40% of maternal deaths in Indonesia. This study aimed to determine the effect of betel leaf water decoction on post partum women perineal wound healing at the Independent Practice of midwife R. Agustina in West Bandung in 2021. This research used the Quasi Experimental Design method, with the Post Only Control Group approach. The population in this study were all postpartum women who had grade I and II perineal injuries at PMB R. Agustina in July 2021 which consisted of 30 respondents. The location of this research was carried out at the Independent Practice of the midwife R. Agustina West Bandung in July 2021. The variables of this study were betel leaf boiled water and perineal wounds. The research instrument was the REEDA Scale. The results showed that the average perineal wound healing before intervention in the experimental group was 10.60 and after intervention was 5.87, while the average perineal wound healing before test was 10.87 and after the test was 6.93. There were differences in perineal wound healing between the experimental and control groups at PMB R. Agustina West Bandung (p-value = 0.012). This intervention is expected to be used by the community as a method in overcoming the problem of perineal wound healing among post partum women.

Magnitude and outcomes of complex perineal injury – A retrospective analysis of five years’ data from a Level 1 trauma centre

Complex perineal injuries pose a major diagnostic and therapeutic challenge to trauma surgeons. A retrospective review of the hospital records of 29 patients with complex perineal injury following blunt trauma was done. Demographic profile, management and outcomes were collected. Quality of life analysis was conducted for patients with complex perineal injuries who were discharged. The most predominant mode of injury was a road crash: being a pedestrian run over by a heavy motor vehicle. Pelvic fracture was seen in 20, anorectal involvement in 22 and urogenital injuries in 14. Urgent surgical debridement was done in all patients, faecal diversion in 27 and urinary diversion in 14. There were nine deaths, three from haemorrhage, and the remainder from sepsis and multi-organ dysfunction. Complex perineal injury remains a major cause of morbidity and mortality in trauma patients. There is a need to ensure adequate rehabilitation services for such patients.

A rare off-site aperture of the anal canal following an obstetric anal sphincter trauma.

Obstetric anal sphincter injury is a common complication of vaginal delivery. Such injuries are more likely to result in postpartum fecal incontinence and thus diagnosis and restoration of perineal injuries at the time of vaginal delivery is of paramount importance.

Possibilities for predicting perineal birth injury

Hypothesis/aims of study. To date, intranatal injuries of the genital tract and their adverse effects on the womans body remain one of the most important issues in obstetrics and gynecology. Despite the improved management of childbirth, the frequency of the birth canal tissue injuries has no tendency to decrease and amounts to 10.239.0%. The aim of this study was to assess the possibility for predicting intranatal perineal injuries. Study design, materials and methods. The study included a prospective analysis of 90 cases of labor through the natural birth canal based on data obtained from Ufa and Chita perinatal centers in the years 20172019. To determine the elasticity of perineal tissues, a perineoelastomer has been developed, which allows expressing the elasticity of the vulvar ring tissues by a special conditional coefficient. Data was processed using the IBM SPSS Statistics V25.0 software package. Results. Based on the assessment of the obtained data, a probability coefficient of perineal injuries was developed. Its calculation is based on a nonlinear regression analysis and is expressed by the formula: T = (100 ∙ CFH) / (PAA ∙ FBD ∙ ∙ ), where CFH is the circumference of the fetal head at the level of visual tubercles (mm), PAA is the pubic arch angle (degrees), FBD is the distance from the front to the back of the adhesion of the vulvar ring (cm), is the coefficient of elastic deformation of the perineum. When the coefficient T is more than 1, perineal rupture in labor is predicted. Conclusion. In the development of obstetric injuries of the perineum, a major role is played by the ratio of the circumference of the fetal head and the maximum perimeter of the extension of a vulvar ring, which, together with the value of the pubic arch angle and the coefficient of elastic deformation of the perineum, may be a criterion in favor of performing surgical protection of the perineum in case of a threatening rupture.

Maternal and perinatal outcomes in multiple versus singleton pregnancies in Dakar, Senegal: a cross sectional study over 10 years

Background: The birth of twins is a singular event in most societies, and even more when it comes to multiple births. The objective of this study was to investigate maternal and perinatal outcomes in multiple versus singleton pregnancies.Methods: Cross-sectional study carried out at Philippe Maguilen Senghor health center in Dakar, Senegal from January 1, 2011 to June 30, 2019. Data were extracted from this E-perinatal electronic database and then analyzed in statistical package for social science software (SPSS 24, Mac version).Results: A total 42,870 mothers delivered 44,149 newborns including 1250 twins (2.8%) and 29 triplets. The mean maternal age was 27 years. Mothers with multiple pregnancies had 3 times the odds of poor maternal outcome compared to mothers with single pregnancies (OR 2.42, 95% CI; 1.98-2.94, p <0.001, for high blood pressure; OR, 2.66; 95% CI, 2.11-3.32, p= <0.001, for severe pre-eclampsia; and OR, 3.04; 95% CI, 1.64-5.66, p <0.001, for postpartum hemorrhage). Likewise, women with multiple gestations had significantly higher rates of preterm birth (OR 5.62; 95% CI: 4.91-6.41, p <0.001), breech presentations (OR = 11.02; CI = 9.68-12.53, p <0.001) and neonatal deaths (OR = 2.94; CI = 9.6852-12.5328 p= 0.004) as compared to women with singleton gestations. Furthermore, women with multifetal gestations had increased risk for caesarean section (OR 2.14; 95% CI: 1.91-2.41, p <0.001) compared with their singleton counterparts. The risks for episiotomy and perineal injuries were higher for women with singleton gestations as compared to multiple gestation mothers.Conclusions: This study results are in line with previous findings and contradict others. Particular attention should always be paid to multiple pregnancies’ management. However, the pattern of certain complications traditionally correlated with multiple pregnancies is to be confirmed.

Complex Obstetric Perineal Injury Reconstruction Using Antropyloric Valve Transposition

Despite significant advancements in the field of medicine, management of complex obstetric perineal injuries remains a challenge. Although several surgical techniques have been described, no techniques have provided satisfactory long-term results. Recently, a perineal transposed antropyloric valve has been used for anorectal reconstruction in patients with damaged or excised anal sphincters. We describe this technique in the case of complex obstetric perineal trauma with extensive tissue loss, presenting with end stage fecal incontinence. The functional outcome after this procedure was evaluated. The patient tolerated the surgery well, and there were no procedure-related upper gastrointestinal disturbances. Short-term functional outcomes were encouraging. At the 36-month follow-up, the patient’s neoanal resting and squeeze pressures were 50 and 70 mmHg, respectively. The postoperative St. Mark’s incontinence score was 7. Perineal antropyloric valve transposition is feasible and can be successfully applied in the management of end-stage fecal incontinence associated with complex obstetric perineal injury.

Pengaruh derajat laserasi perineum terhadap skala nyeri perineum pada ibu post partum

Lacerations of the birth canal in addition to the weight factor of the baby and the type of delivery, the factor of the perineum/legs of the perineum is especially influential. Perineal injuries are usually very painful by the puerperal mother but apparently, some puerperal mothers do not feel pain even though there is a laceration in the perineum. This happens because the pain for each person is different. The purpose of this study was to determine the effect of the degree of laceration with perineal pain in postpartum mothers at the Bandarhardjo Public Health Center in Semarang City. This type of research is analytic, the sample in this study is postpartum mothers who have perineal laceration but there are no complications of 30 people. The research instrument uses a questionnaire. The results showed the majority of respondents experienced a degree 2 perineal laceration, the majority of respondents experienced a mild pain scale (rating scale 3) and there was an influence of the degree of tear perineum on the perineal pain scale.

A Surgical Technique to Repair Perineal Body Disruption Secondary to Sexual Assault

Perineal trauma is uncommon in the pediatric population and it is estimated that 5 to 21% is secondary to sexual abuse. We aim to present a proposed surgical technique to repair perineal injuries secondary to sexual assault in female children. The technique is based on the posterior sagittal anorectoplasty (PSARP) for repairing anorectal malformations and, between 2017 and 2019, it was used to treat three girls (2 months, 2 years, and 8 years of age) with fourth-degree perineal injuries secondary to sexual assault. One of them underwent laparotomy and Hartmann's colostomy for an acute abdomen. Two underwent wound debridement and suturing and only had a stoma fashioned at 5 days and 6 weeks posttrauma, respectively. The perineal repair was performed 2, 6, and 7 weeks postinjury and done as follows: with the child prone in jack-knife position, stay-sutures are placed on the common wall between the rectum and the vagina. Using a needle tip diathermy, a transverse incision is performed below the sutures lifting the anterior rectal wall up. Stay sutures are then positioned on the posterior wall of the vaginal mucosa. The incision between the walls is deepened until the rectum and the vagina are completely separated. The deep and superficial perineal body is then reconstructed using absorbable sutures and an anterior anoplasty and an introitoplasty are performed. The stoma in each was closed 6 weeks postreconstruction. At follow-up, now 1 year or more postrepair, all patients have an excellent cosmetic outcome and are fully continent for stools.