Sartika Jaya, Sri Wahyuni, Apriliani Yulianti Wurningsih

EFEKTIFITAS MANAJEMEN AKTIF KALA IV TERHADAP RISIKO PERDARAHAN PADA PASIEN POST OPERASI SECTIO CAESAREA DI RUMAH SAKIT

Introduction

Efektifitas manajemen aktif kala iv terhadap risiko perdarahan pada pasien post operasi sectio caesarea di rumah sakit. Pelajari efektivitas manajemen aktif kala IV dalam mengurangi risiko perdarahan postpartum pada pasien pasca-operasi Sectio Caesarea. Direkomendasikan sebagai standar perawatan.

Abstract

Postpartum hemorrhage is a major cause of maternal morbidity and mortality, including in post-cesarean section patients. The fourth stage is a critical phase in the first two hours after delivery that requires intensive monitoring to prevent bleeding. Objective: To determine the effectiveness of active management of the fourth stage on the risk of bleeding in post-cesarean section patients. Method: This study used a quasi-experimental design with a post-test only approach with a control group. The sample consisted of 40 post-cesarean section mothers who were divided into an intervention group and a control group using a consecutive sampling technique. The intervention was in the form of implementing active management of the fourth stage during the first two hours after surgery. The variables measured included the amount of bleeding, decreased hemoglobin levels, and the incidence of postpartum hemorrhage. Data analysis used independent t-test and chi-square tests with a significance level of 0.05. Results: There was a significant difference in the amount of bleeding and decreased hemoglobin levels between the intervention and control groups (p < 0.05). The incidence of postpartum hemorrhage was lower in the group receiving active management of the fourth stage of labor. Conclusion: Active management of the fourth stage of labor effectively reduces the risk of bleeding in post-cesarean section patients and is recommended as part of standard postpartum nursing care.

Review

This study addresses a critical clinical issue, the prevention of postpartum hemorrhage (PPH) in post-cesarean section patients, a significant contributor to maternal morbidity and mortality. The objective to determine the effectiveness of active management of the fourth stage of labor in this specific population is highly relevant. The abstract clearly outlines a quasi-experimental design with a control group, measuring important clinical outcomes such as the amount of bleeding, hemoglobin levels, and the incidence of PPH. This focus on a high-risk group and the practical nature of the intervention make the study's findings potentially impactful for clinical practice. The methodology, employing a post-test only design with a control group, provides a reasonable framework for evaluating the intervention's effect. The sample size of 40 mothers, divided into intervention and control groups, allows for statistical comparison, and the use of independent t-test and chi-square tests is appropriate for the types of data collected. The results strongly support the intervention, demonstrating a statistically significant reduction in both the amount of bleeding and the decrease in hemoglobin levels, alongside a lower incidence of PPH in the group receiving active management. These clear findings lead to a robust conclusion that active management of the fourth stage effectively reduces bleeding risk, advocating for its integration into standard postpartum nursing care. While the findings are promising and offer valuable insights, certain aspects warrant consideration. The quasi-experimental, post-test only design, while practical, inherently limits the ability to control for all potential confounding variables compared to a randomized controlled trial. The abstract also mentions consecutive sampling, which might introduce selection bias if not carefully managed. Furthermore, the study was conducted in a single hospital, which could limit the generalizability of the results to other healthcare settings with different patient populations or care protocols. Future research could benefit from a multi-center, randomized controlled trial with a larger sample size to further strengthen the evidence base and explore long-term outcomes, solidifying the recommendation for widespread implementation.

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