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    Effectiveness of Oral Misoprostol To Prevent Postcesarean Section Urinary Retension

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    DaleKadal
    This study aimed to determine the effect of oral misoprostol in preventing post-cesarean urinary retention by measuring residual urine volume 6 hours after catheter removal. It found that oral misoprostol significantly increased urine volume and decreased residual urine volume compared to placebo, suggesting it may help prevent urinary retention after cesarean section.

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    Effectiveness of Oral Misoprostol To Prevent Postcesarean Section Urinary Retension

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    DaleKadal
    31 views33 pages
    This study aimed to determine the effect of oral misoprostol in preventing post-cesarean urinary retention by measuring residual urine volume 6 hours after catheter removal. It found that oral misoprostol significantly increased urine volume and decreased residual urine volume compared to placebo, suggesting it may help prevent urinary retention after cesarean section.

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    This study aimed to determine the effect of oral misoprostol in preventing post-cesarean urinary retention by measuring residual urine volume 6 hours after catheter removal. It found that oral misoprostol significantly increased urine volume and decreased residual urine volume compared to placebo, suggesting it may help prevent urinary retention after cesarean section.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    31 views33 pages

    Effectiveness of Oral Misoprostol To Prevent Postcesarean Section Urinary Retension

    Uploaded by

    DaleKadal
    This study aimed to determine the effect of oral misoprostol in preventing post-cesarean urinary retention by measuring residual urine volume 6 hours after catheter removal. It found that oral misoprostol significantly increased urine volume and decreased residual urine volume compared to placebo, suggesting it may help prevent urinary retention after cesarean section.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 33

    Telaah jurnal

    Effectiveness of oral misoprostol


    to prevent postcesarean section
    urinary retension

    Disusun oleh:
    Taschiro Yuliartha
    71 2017 046

    Pembimbing:
    dr. Ary Rinaldzi, Sp.OG
    INTRODUCTION
    Post partum urinary retention (PUR)

    An obstetric case that is often encountered in


    clinical practice.

    Prevalence PUR varies from 1,7 to 17,9% focusing on


    PUR after vaginal delivery. Groutz et al studied 125
    women with postpartum voiding difficulties, 38% of
    maternal women with the aid vacum instrumentation,
    27% with spontaneous labour and 15% with cesarean
    section.
    Some evidence to indicate the strong correlation
    between cesarean section and PUR incidence.
    Kermans et al. Stated the prevalence of post
    cesarean section PUR is higher than vaginal
    delivery (2.1% vs 3.2%).

    Intraoperative bladder manipulation is thought to be cause of


    weak detrusor muscle contraction. Patients terminated
    abdominally tend to be unable to empty the bladder due to
    inadequate contraction of detrusor muscles postoperative.
    objectives
    To determine the effect of misoprostol on the incidence of
    urinary retention in post-cesarean section patients by
    measuring maternal residual urine volume 6 hours after
    catheter removal.
    METHODS
    This is a descriptive study
    Criteria inclusion and sxclusion

    Criteria inclusion : patients undergoing cesarean


    section at Dr.Moh.Hosein Palembang hospital by
    lower uterine segment incision with regional
    anesthesia and those willing to participate in this
    research and signed informed consent

    Criteria exclusion : patients with urinary tract


    infection, having previous voiding problems prior
    to cesarean section, patients with severe
    preeklampsia, DM, renal dysfunction,
    polihidramnion, multiple pregnancies and
    induction of labor with misoprostol.
    This was a single-blind randomized controlled trial, Samples
    were patients who underwent cesarean section, either elective
    or emergencies treated at Department of Obstetrics and
    Gynecology Hospital, Dr. Mohammad Hoesin Palembang.
    Subjects were allocated into two groups:treatment group
    (receiving misoprostol) and placebo group. Urinary retention
    is diagnosed if post-voiding residual urine volume after Foley
    catheter removal was >200 ml.
    Statistical Analyses

    Using SPSS 17.0


    RESULTS
    Table 1 Mean of urination time between control
    andtreatment group was not significantly different
    (p= 0.589)

    Table 2 Mean urine volume between control group(placebo)


    and treatment group was significantly different (p =
    0.029). Mean of urine volume was higher in
    treatment group.

    Mean of residual urine volume between control group


    Table 3
    (placebo) and treatment group was significantly
    different (p =0.001). Mean of residual urine volume was
    lower in treatment group.
    DISCUSSION
    There are two parameters to diagnose urinary retention in this study
    including urination time, interpreting the time interval since folley
    catheter removal and residual urine ,which is the amount of residual urine
    post spontaneous urinations.

    The differential effectiveness of 600µg oral misoprostol with placebo in preventing


    the occurrence of postpartum urinary retention is not influenced by demographic
    characteristics.
    This study also showed there are no differences between the mean time urination
    between the control group (placebo) and misoprostol orally 600µg (p = 0.589), in
    which both the misoprostol group and placebo, all pregnant women after cesarean
    section were able to urinate 6 hours after the catheter Foley released.
    In addition to urinary and urine volume time, another parameter for
    assessing postpartum urinary retention is the volume of urine residue > 200
    ml.
    With statistical analysis, this study showed that there was a difference in
    mean residual urine volume between the control group (placebo) and 600 µg
    oral misoprostol, in which the volume of urine residues of the group
    receiving peripheral misoprostol was 600µg less than those receiving
    placebo, but no residual volume was found > 200 ml in both misoprostol and
    placebo groups.

    Some disadvantages in this study besides the small number of samples is not
    to include patients with PUR (+). All samples did not experience
    PUR, and the effectiveness analysis of misoprostol was done on non PUR
    samples. Secondly, no misoprostol was administered in different doses, so this
    study could not determine the best dose of misoprostol for PUR handling,
    CONCLUSION
    There is no difference in mean time of urination between
    the control group (placebo) with 600µg oral misoprostol.

    There is an average difference in the amount of urine


    volume and the volume of residual urine between the
    control group (placebo) with 600µg oral misoprostol.
    600µg oral misoprostol can increase the amount of urine
    and reduce the volume of urinary residue after cesarean
    section.
    TELAAH JURNAL

    Penilaian PICO VIA (Population, Intervention, Comparison, Outcome,


    Validity, Importancy, Applicability)
    Telaah Kelengkapan Jurnal
    Judul jurnal : Ada
    Pengarang dan institusi : Ada
    Abstrak : Ada
    Pendahuluan : Ada
    Metode : Ada
    Hasil : Ada
    Pembahasan : Ada
    Kesimpulan dan saran : Ada
    Daftar pustaka : Vancouver
    Lampiran : Tidak ada
    Population

    Penelitian ini menggunakan populasi 30 wanita hamil


    seksio sesaria baik elektif maupun emergensi yang
    dirawat di Departemen Obstetri dan Ginekologi RSUP
    Dr. Mohammad Hoesin Palembang. Subjek
    dialokasikan menjadi 2 kelompok yaitu 15 kelompok
    perlakuan yang menerima misoprostol dan 15
    kelompok plasebo
    Intervention

    Pada penelitian ini tidak dilakukan intervensi


    subjek penelitian.
    Comparison
    Penelitian ini untuk mengetahui efektivitas misoprostrol
    peroral terhadap perubahan residu urin sebagai
    pencegahan retensio urin pascaseksio sesarea.
    Penelitian ini dilakukan dengan cara pertama
    membandingkan waktu buang air kecil antara kelompok
    penanganan yang menerima misoprostol dan kelompok
    plasebo, kedua membandingkan volume urine yang
    dihasilkan antara kelompok perlakuan (misoprostol) dan
    kelompok kontrol (plasebo), ketiga membandingkan
    volume residu urine antara kelompok perlakuan dan
    kelompok plasebo.
    Outcome
    Pada tabel 1 menunjukkan tidak ada perbedaan rerata
    waktu berkemih antara kelompok kontrol dan kelompok
    perlakuan (p = 0,589)
    Pada tabel 2 menunjukan terdapat perbedaan rerata
    volume urine antara kelompok kontrol dan kelompok
    perlakuan (p=0,029). Kelompok perlakuan volume urine
    yang dihasilkan lebih meningkat dibandingkan dengan
    kelompok kontrol.
    Pada tabel 3 menunjukan terdapat perbedaan rerata
    volume residu urin antara kelompok kontrol dan kelompok
    perlakuan (p=0,001). Kelompok perlakuan volume residu
    urine yang dihasilkan lebih rendah dibandingkan dengan
    kelompok kontrol.
    Validity

    Is the data collected in accordance with the purpose of the


    research?
    Data yang diambil sesuai dengan tujuan penelitian. Penelitian
    ini merupakan studi uji klinik acak berpembanding
    (Randomised Control Trial) untuk mengetahui efektivitas
    misoprostrol peroral terhadap perubahan residu urin sebagai
    pencegahan retensio urin pascaseksio sesarea. Penelitian ini
    dilakukan dengan cara pertama membandingkan waktu buang
    air kecil antara kelompok perlakuan yang menerima
    misoprostol dan kelompok plasebo, kedua membandingkan
    volume urine yang dihasilkan antara kelompok perlakuan
    (misoprostol) dan kelompok kontrol (plasebo), ketiga
    membandingkan volume residu urine antara kelompok
    perlakuan dan kelompok plasebo
    Are the inclusion and exclusion criteria in this research clearly
    defined?
    Iya. Kriteria inklusi  populasi semua pasien seksio sesaria baik

    elektif maupun emergensi yang dirawat di Departemen Obstetri dan


    Ginekologi RSUP Dr. Mohammad Hoesin Palembang dengan insisi
    segmen bawah rahim dengan anestesi regional dan yang bersedia
    ikutserta dalam penelitian ini serta menandatangani surat
    persetujuan.
    Kriteria eksklusi penelitian ini yaitu perempuan yang mengalami
    masalah berkemih sebelum seksio sesaria, ISK, PEB, diabetes
    mellitus, gangguan fungsi ginjal,polihidramnion,kehamilan kembar
    dan induksi persalinan dengan misoprostol serta yang memiliki
    kebiasaan atau riwayat merokok dan konsumsi alkohol juga
    Are the research subjects explained in detail?
    Iya. Semua pasien seksio sesaria baik elektif
    maupun emergensi yang dirawat di Departemen
    Obstetri dan Ginekologi RSUP Dr. Mohammad
    Hoesin Palembang. Pasien yang mengalami
    masalah berkemih sebelum seksio sesaria,
    preeklampsia, diabetes mellitus, gangguan fungsi
    ginjal,polihidramnion,kehamilan kembar dan
    induksi persalinan dengan misoprostol serta
    kebiasaan merokok dan alkohol dikeluarkan dari
    penelitian ini.
    Randomization
    Was the randomization list concealed from patients,
    clinicians, and researchers?
    Iya. Pada penelitian ini baik pasien, peneliti maupun
    tenaga kesehatan tidak mengetahui kelompok
    perlakuan yang telah ditentukan.

    Interventions and co-interventions


    Were the perfomed interventions described in
    sufficent detail to be followed by other?
     Pada penelitian ini tidak dilakukan intervensi subjek
    penelitian.
    Importancy

    Is this study is important?


    Ya, penelitian ini penting karena hasil penelitian ini
    untuk mengetahui efektivitas misoprostrol peroral
    terhadap perubahan residu urin sebagai pencegahan
    retensio urin pascaseksio sesarea. Agar dapat
    mencegah terjadinya retensio urin pascaseksio sesaria
    dikemudian hari.
    Applicability
    Is your environment so different from the one in
    study that the methods could not be use there?
    Lingkungan pada penelitian ini tidak terdapat
    perbedaan namun harus dipertimbangkan dengan
    sampel populasi yang digunakan.
    SIMPULAN
    Berdasarkan telaah jurnal yang telah dilakukan didapatkan
    kesimpulan bahwa jurnal ini valid, penting dan dapat
    diterapkan sehingga jurnal ini dapat digunakan sebagai
    referensi.
    THANK YOU...

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