Dampak riwayat cedera sfingter ani obstetrik terhadap outcome persalinan dan kesehatan ibu pada kehamilan selanjutnya: sebuah tinjauan sistematis
Bibliographic record
Abstract
Obstetric Anal Sphincter Injury (OASI) is a severe form of perineal trauma occurring during vaginal delivery, affecting approximately 5.9% of all cases, with higher rates in primiparous women. OASI can lead to long-term complications such as fecal incontinence and perineal pain, significantly impacting quality of life. This systematic review evaluates the impact of prior OASI on subsequent pregnancies, focusing on delivery outcomes, recurrence risk, and maternal health. A comprehensive search was conducted across PubMed, Cochrane Library, and Science Direct, selecting studies based on predefined PICOS criteria. Data extraction and quality assessment were performed using the Newcastle-Ottawa Scale (NOS). Key findings reveal that women with a history of OASI face a higher risk of recurrence in future deliveries, influenced by factors such as infant birth weight, maternal age, and instrumental deliveries. Clinical guidelines suggest that women with severe OASI symptoms or anal sphincter defects consider cesarean delivery as a safer option. Episiotomy has been found to reduce recurrence risk by up to 80%. This review synthesizes evidence from six studies, highlighting the need for individualized clinical management and comprehensive counseling for women with prior OASI. The findings provide valuable insights for medical practitioners in making informed decisions regarding delivery methods for these patients. Obstetric Anal Sphincter Injury (OASI) merupakan bentuk cedera perineum yang parah yang terjadi selama persalinan pervaginam, yang memengaruhi sekitar 5,9% dari semua kasus, dengan angka kejadian yang lebih tinggi pada wanita primipara. OASI dapat menyebabkan komplikasi jangka panjang seperti inkontinensia feses dan nyeri perineum, yang secara signifikan memengaruhi kualitas hidup. Tinjauan sistematis ini mengevaluasi dampak riwayat OASI pada kehamilan berikutnya, dengan fokus pada hasil persalinan, risiko kekambuhan, dan kesehatan ibu. Pencarian menyeluruh dilakukan di PubMed, Cochrane Library, dan Science Direct, dengan memilih studi berdasarkan kriteria PICOS yang telah ditentukan sebelumnya. Ekstraksi data dan penilaian kualitas dilakukan menggunakan Newcastle-Ottawa Scale (NOS). Hasil utama menunjukkan bahwa wanita dengan riwayat OASI memiliki risiko kekambuhan yang lebih tinggi pada persalinan berikutnya, yang dipengaruhi oleh faktor-faktor seperti berat lahir bayi, usia ibu, dan persalinan dengan alat bantu. Pedoman klinis menyarankan bahwa wanita dengan gejala OASI yang parah atau defek sfingter anus mempertimbangkan persalinan sesar sebagai pilihan yang lebih aman. Episiotomi diketahui dapat mengurangi risiko kekambuhan hingga 80%. Tinjauan ini menyintesis bukti dari enam studi, menyoroti pentingnya manajemen klinis yang dipersonalisasi dan konseling yang komprehensif bagi wanita dengan riwayat OASI. Temuan ini memberikan wawasan berharga bagi praktisi medis dalam membuat keputusan yang tepat terkait metode persalinan untuk pasien tersebut.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".