ANALYSIS OF FACTORS CAUSING EPIOSTOMY IN THE BIRTH PROCESS: SCOPING REVIEW
DOI:
https://doi.org/10.34011/jmp2k.v35i3.2803Keywords:
episiotomy, faktor, indikasi, robekan perineum, scoping reviewAbstract
Episiotomi merupakan tindakan insisi perineum yang umum dilakukan dalam proses persalinan, namun praktik ini masih menuai kontroversi. Sejak tahun 1996, sebagian besar literatur menyimpulkan bahwa episiotomi rutin tidak diperlukan dan bahkan berisiko meningkatkan kejadian laserasi perineum derajat tiga atau empat. Meskipun Organisasi Kesehatan Dunia (WHO) telah merekomendasikan pembatasan praktik episiotomi rutin sejak 1990-an, kenyataannya tindakan ini masih sering dilakukan, terutama di negara berkembang, termasuk Indonesia. Scoping review ini bertujuan untuk menganalisis faktor yang mendasari tindakan episiotomi pada ibu bersalin. Scoping review menggunakan PRISMA-ScR Ceklist. Pencarian database dari Pubmed, Scopus, Wiley Online Library, dan Science Direct. dengan kata kunci pencarian “Factor” AND “indication” OR “episiotomy” OR “laceration” OR “rupture perineum”. Kriteria inklusi yang digunakan meliputi artikel orisinal yang membahas topik relevan serta artikel yang diterbitkan dalam lima tahun terakhir, yaitu antara tahun 2018 hingga 2023. Sebanyak 18 artikel terpilih dianalisis menggunakan checklist dari Joanna Briggs Institute (JBI) melalui proses Critical Appraisal. Tinjauan ini menghasilkan sub tema tehadap faktor yang berhubungan dengan tindakan episiotomy yaitu jarak kelahiran, BMI ibu, gawat janin, berat lahir, paritas, kehamilan ganda, Perineum pendek, perineum kaku, kala II lama, TFU >32 cm, penggunaan oksitosin, dan persalinan instrumen. Dapat disimpulkan bahwa paritas dan berat janin yang paling banyak ditemukan dalam kasus episiotomy. Temuan ini memiliki implikasi penting bagi praktik klinis dan kebijakan pelayanan kebidanan, khususnya dalam mengembangkan panduan pengambilan keputusan berbasis bukti yang lebih selektif dan rasional terkait tindakan episiotomi, guna meminimalkan risiko komplikasi serta meningkatkan keselamatan ibu dan bayi.
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