Faktor-faktor yang Memengaruhi Terjadinya Kehamilan dengan Spektrum Plasenta Akreta: Systematic Review
DOI:
https://doi.org/10.32583/keperawatan.v17i1.2171Keywords:
plasenta adherent, plasenta inkreta, plasenta invasive, plasenta perkreta, spektrum plasenta akretaAbstract
Analisis faktor-faktor yang dapat memicu terjadinya spektrum plasenta akreta (SPA) menjadi hal yang penting untuk dilakukan agar dapat dilakukan deteksi dini pada masa antepartum sehingga manajemen pengelolan pasien dapat dilakukan dengan tepat. Tujuan: Untuk mengetahui faktor-faktor apa saja yang memengaruhi terjadinya kehamilan dengan SPA. Metode: Systematic review dengan menggunakan tujuh database, yaitu Pubmed, Sciene Direct, Proquest, Scopus, Clinical Key, Sage, dan Taylor & Francis online dengan kata kunci risk factors OR clinical factors OR influencing factors AND placenta accreta OR increta OR percreta OR adherent placenta OR invasive placenta. Artikel yang disertakan dalam kurun waktu 5 tahun dan berbahasa Inggris. Telusur artikel menggunakan format PRISMA. Data yang diperoleh dilakukan ekstraksi meliputi nama penulis, tahun terbit, judul, desain, sampel, dan hasil. Analisis critical appraisal dilakukan dengan menggunakan format JBI. Hasil: Diperoleh 22 artikel yang menyertakan 4.235.031 kehamilan dengan 14.186 kasus SPA. Faktor-faktor risiko yang ditemukan meliputi section caesarean (SC), plasenta previa, Assissted Reproductive Technology (ART), riwayat pembedahan pada uterine, abortus, multiparitas, usia >35 tahun, merokok, alkohol, Obesitas (BMI > 30 Kg/m^2), dan interval kehamilan yang pendek. Diskusi: Pada prinsipnya, kejadian spektrum plasenta akreta dipicu oleh kerusakan lapisan endometrium dan lapisan otot halus pada myometrium sehingga extravillious trophoblast (EVT) dapat menembus dinding uterine ke lapisan yang lebih dalam. Simpulan: Faktor-faktor risiko terjadinya SPA adalah riwayat SC, plasenta previa, riwayat pembedahan uterus, ART, riwayat abortus, multiparitas, merokok, dan alkohol. Usia bukan faktor independent SPA, namun dapat memengaruhi terjadinya SPA. Obesitas dan interval kehamilan yang pendek bukan merupakan faktor risiko SPA.
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