Scientific Research Paper / Journal, Courtesy of / ABSTRACT

Produced By Karya Bunda Husada Midwifery

Academy
Student ID Number: 13030, May 2016, Page: 1- 31 In the light of presented background, perineum
ruptures is still the main leading cause to
CORRELATION BETWEEN THE deliveries that is desperately in need of intimate,
MATERNAL AND FETAL/ intricate, unique yet prompt / urgent, detailed
attention at play due to to the alarmingly intense
GESTATIONAL FACTORS AS
increase of the death and hemorrhage cases of
JUXTAPOSED TO PERINEUM women in labor. Perineum rupture events / cases
RUPTURES taken place at teh “Y” Birth Clinic were
EVENTS/RATES/TRENDS escalating in numbers during the past two years
/CASES OF LABORING WOMEN – with 307 delivery cases in 2014,comprising
AT “Y” CLINIC IN TANGERANG ruptured subjects of 283 in total (76%) of the
CITY DURING YEAR 2015 dated patients, whilst on the other hand, the 321
cases of 2015 had exhausted 250 cases (78%),
wether they were the spontaneous or by
Liza Anggraeni, Ilah Kholilah
selection of episiotomies – in conclusion: the
Karya Bunda Husada Midwifery Academy, Jl. Imam last two years’ cases really took its toll on its
Bonjol No.77 Rt. 02/Rw. 01, ‘victims’ due to the unsettling, rapid mass
Karawaci Tangerang, 15115, Tangerang City –
Indonesia
ruptures data on performing the tasks (of saving
Telp. 021-551 5694 ; Fax : 021-551 5695 lives of mother and child) at hand. Therefore,
Website : the author is highly intriqued, moved / driven /
http://akbidkaryabundahusada.blogspot.com; E-mail inspired / motivated to conduct / explore /
: akbid_kbh@yahoo.co.id
exercise a cross-sectional sampling research
*Ila Kholilah,1 * Liza Anggraeni, S. Psi, M. paper concerning the contributing ‘motherly’/
Si.,2 gestational stages & fetus factors related to
1 Author / Co-researcher -Mahasiswi AKBID KBH perineum ruptures in women giving birth at
Tangerang Student, Batch XII, Year 2015-2016
2 Presenter, Lecturer Clinic “Y”, bringing up the media landscape of
highly industrious Tangerang City around year
ARTICLE INFO 2015. Results indicated that there is a
correlation amongst a woman’s delivery
Article History: process, ‘paritas’ (P value=0.015), a woman’s
Date received: May, 2016 current age (P value=0,004), precipitated
Date revised: October, 2016
Date published: partus / birth (P value=0,000), gestational /
Writer’sCorrespondence: fetal weight (P value=0,000) linked to perineum
liza7124@gmail.com,
+62 21 821 90298232
ruptures in birthing mothers executed at the “Y”
Clinic of Tangerang City district throughout
Keywords: year 2015.
Ruptured perineum / Perineum ruptures
Spontaneous ruptures / ruptured perineum
Ruptures / ruptured perineum by episiotomy
Paritas (woman giving birth for the 1st time)
Partus presipitatus (precipitated births)
Post-partum hemorrhage / bleeding (PPH)
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
1
INTRODUCTION
Deliveries may often suffer from
injuries of the openings and pathways
of birth canal. The lacerations are
somewhat minor/mild, however –
harmful wounds tend to take over,
therefore requesting vulva and
perineum check in order. Labor open
cuts / tears / rips are bound to happen
someway on most of initial / first
deliveries then continuing on to the
next ones. These incidents can be
prevented / avoided, managed
properly or diminished / decreased /
minimized by controlling / setting up
the speed of the baby head making its
way faster to reach the bottom of the
pelvic area (Yeyeh,2010).
Throughout the world in 2009
approximately 2,7 million ruptured
perineum cases took place and caused
quite a scare in birthing mothers. This
number is estimated to go up to 6.3
millions in year 2020, alongside with
the midwives who are clueless or not
well-trained / educated enough with
proper needed skills and knowledge
and lack there of; when it comes to
self-care / home-treatments for
mothers at their livelihood /
households
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
2
(http://stikesharapanmama.blogspot2
009).
In South East Asia, the ruptured
perineums massively occur in our
society – 50% of the perineum
ruptures of the world are attacking
Asia. The prevalence of birthing
mothers with ruptured perineums in
Indonesia alone are invading the age
range of 25-30 yo. women, stated
24%, and in 32 to 39 year-old mothers
as much as 62%
(http://stikesharapanmama.blogspot2
009).
The side effect of ruptured perineum
happenings in delivering moms also
came to a losing streak due to infected
wound / scar stitches’, where the
urinary tract or the birth canal could
lead to the urinary tract / bladder
infection, moreover – the birth canal
infection. Another thing is also the
repeating / ongoing / overflowing /
irregular bloodshow/bleeding
(excessive) from the poor blood
vessels / arteries, not closing up neatly
/ normally. Slow response to
treatments of following complications
may result death in post-partum
mothers, considering the weak and
tired physical conditions.
According to the research data taken
at the “Y” Clinic, the delivery cases in
2014 amounted to 370, with ruptured
perineum patients as many as 283
people (76%), whether it may vary
between spontaneous or episiotomy
(Yohana Clinic Profile, 2014). The
research data brought by “Y” Clinic ,
the number of deliveries can live up to
321 cases, and the subjects with
ruptured perineums of 250 persons
(78%), given take the spontaneous or
the episiotomy ones (Yohana Clinic
Profile,2015).
In most cases, ruptured perineum
cases are often perceived to be the
number one cause of excessive
bleeding / blood show, had the risks
be taken to be much higher if are not
carefully sorted out. Perineum
ruptures requires special attention
because it can potentially damage the
women’s reproductive organs
dysfunctionally as a source of
bleeding and the gateway / cesspool
of germs that may end in death by
bleeding and infections
(Manuaba,2003).
The ruptured perineum cases
displayed a rapidly rising score,
injuries and ruptures during deliveries
are the second-rank most provoking
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
3
cases of post-partum phase found in
birthing women. Per vaginam/Vaginal
labors/delivery are often intertwined /
intermitten/ linked with ruptures, for
sure, supposedly. In certain cases,
these ruptures tend to be more hurtful,
painstaking and risky – especially in
primiparas. Ruptures can occur
spontaneously throughout per
vaginam delivery. Beside the
bleeding, the neglected/abandoned
ruptures can cause immense loss of
blood, gradually – and lasting, for
hours (Llewellyn,2008).
Based on these backgrounds, the
author/writer took an interest in
carrying out researches to figure out
correlations between mother’s parity
and the baby / fetal weight as
compared to ruptured perineums of
women during labor at the “Y” Clinic
- Tangerang City in 2015.
PROBLEM STATEMENT /
RESEARCH PROBLEM
Referring to the background above,
ruptured perineums are the main
causes of bleeding / blood show in
normal deliveries and therefore
calling out for serious attention on the
matter, since these occasions usually
lead to deaths of mothers giving birth.
The events of ruptured perineums at
“Y” Clinic are through the roof and
off the chain in the last 2 years, the
delivery cases in 2014 had reached
370 with 283 perineum cases (76%),
where as the number of deliveries in
year 2015 had also peaked to 321
cases, with perineum patients of 25
(78%) cases, leaving it to be
spontaneous or episiotomy-based –
the remaining numbers are said to be
skyrocketing. Thus the opportunity
knocks, as the author herself will be
executing a research on correlation
between maternal factors and fetal
factors as compared to perineum
ruptures in delivering mothers at
Clinic “Y”, located in central/mid-
rural Tangerang City, 2015.
PURPOSE OF RESEARCH
General
To grasp and acknowledge the
relationship / connection between the
maternal and fetal factors in women
during labor / delivery at Clinic “Y”
Tangerang City, in year 2015.
Specific
To distinguish the correlation between
maternal and fetal factors as
compared to ruptured perineums in
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
4
birthing mothers of “Y” Clinic in
2015.
To comprehend a connectivity
between partus presipitatus with
perineum ruptures in birthing moms
of “Y” Clinic in Tangerang City,
2015.
To discover a relationship between
baby weight as compared to perineum
ruptures in birthing moms of “Y”
Clinic, Tangerang City 2015.
RENDERED BENEFITS /
ADVANTAGES
For “Y” Clinic
The result of the research can be an
outlet of inputs, as for the
caregivers/health care service
providers of Midwifery alongside
stakeholders & shareholders in
upgrading safe, sound and first labor
care by handling ruptured perineum-
accidental/prone cases.
For The Author
Broadening horizons and sharpening
gained knowledge on ruptured
perineum cases pertaining to “how-
to”/need-to-know-basis.
For The Institution
With this research being held, it is The size of sample taken were the
expected to establish, encourage and expecting mothers with ruptured
endorse educational feedback; perineum of 250 people, spontaneous
emphasizing on teaching materials to or episiotomy included. Utilizing
forecast next awaited information for Slovin formula as follows:
upcoming research in mind.
n= N
RESEARCH DESIGN
_____
This research is descriptively a
1 + N (d2)
mindset of framing work based on
cross-sectional aspects, with a Details:
purpose to acquire the association
n=Size of sample
between maternal and fetal factors as
both being compared to through N=Population size
ruptured perineum trends / rates in
birthing women at the Clinic “Y” of D=Level of Trust
Tangerang district throughout 2015. Earlier known:
PLACE & TIME OF RESEARCH N=250
This research was initiated and carried d=10%
out at the courtesy of Clinic “Y” -
Tangerang City, 2015. Thus :

RESEARCH SAMPLE AND n=250

POPULATION ______
POPULATION 1 + 250 (0.1 2)
The chosen population in this research =250
were expecting mothers with ruptured
perineums in Clinic “Y”, Tangerang, _____
ongoing year 2015 - representing a
1+250 (0,01)
total of 250 active / open cases.
=250
SAMPLING
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
5
_____
1+2,5
=71, 428
Overall data saved : 71 cases
b. Sample Drafting
Random sampling were applied from
the existing population which was
easier and quicker in moderation.
DATA COLLECTING
COMPILING
Datas were classified & collected by
using the guidelines of data
compilation aligned with the
matching variable in tact.
RESEARCH INSTRUMENTS
This research relied upon secondary-
source data, consisting labored
mothers with ruptures in perineum,
spontaneously or episiotomy-wise at
“Y” Clinic - Tangerang City, Year
2015.
DATA PROCESSING
The procedures, comprising flow /
mechanisms in commanding the
research are below:
a. Data Checking (Editing)
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
Data gathered were to be examined to
determine its precision & completion,
all the way through management.
b. Data Coding (Coding)
Data classification were seen from
independent variables, naming: fetal
weight, mother’s parity and age.
c. Data Tabulation (Tabulating)
Entering data in tables according to
/ their research category variables of a
couple lines / rows and columns used
to portray/describe a group of
variables resulting from survey /
observations or other such researches
so they will be readable/literate /
’user-friendly’ and easily understood
in layman’s terms or for further
manual uses.
UNIVARIATE ANALYSIS
Data pool were to be analyzed
bivariately to find out frequency
distribution from each examined
variables.
Formula :
χ
__ 100%
n
6
Details: are categoric datas, then the statistic
tests used were Chi Square with the
x=data pulled
following formula:
n=total sample amount
If 𝑥2 = (𝑥 + 𝑎)𝑛 =
𝑛
Later frequency distribution were
∑ (𝑛𝑘)𝑥 𝑘 𝑎𝑛−𝑘 , then df = (k – 1)(b
interpreted using these criterias: 𝑘=0
– 1)
0%: Not one / none
𝑥 2 = Uji Chi Square Test
1-25%: A little / Less than
O= Observation Result Frequency
26-49%: Less than half
E= (Number of row x number of
50%: Half column) / Number of data
51-75%: More than half The presumed variables on which the
76-99%: Mostly bivariate analysis conducted upon
were executed in several mentioned
100%: All / In total steps:
(Arikunto,2002) 1. Proportion analysis percentage
BIVARIATE ANALYSIS with comparing, contrasting or
cross-distributing two
Analisa data bivariat digunakan untuk connecting variables.
menganalisis adanya kemaknaan 2. Analysis & Statistic Tests (chi
hubungan antara variabel dependen square test, Z test, 1 test)
dan independen. Karena data Looking at the results, then it
dependen dan independen adalah data will be determined whether the
kategorik, maka uji statistic yang relationship is significant or
digunakan dalam analisis adalah uji not. Sometimes two conjoining
Chi Square, adapun rumus yang variables are connected in
digunakan sebagai berikut: Bivariate percentage, however -
analysis were utilized to analyze the statisticly speaking, they are
existence of significance between not sometimes.
dependent & independent variables
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
7
 The analysis and statistic between independent and
measures were taken (chi dependent variable
square test, Z test, 1 test, etc.
RESEARCH RESULTS
Judging from the result, it can
be concluded that there is a THE “Y” CLINIC PROFILE -
correlation between these YEAR 2016
intervening variables whether it
would be significant or not and Background / History
this statistic examinations could The Clinic “Y” (Yohana Clinic) was
also confirm that between these established in 1993 at Total Persada
two percentages are bound by Raya – as time passed BPS moved on
percentage / percentage wise, January 2nd, 2007, to Alamanda Raya
but not of value / worthless, Street, Block D5, No. 21, Wisma
statistically speaking. Harapan (Hope Cluster / Compound /
3. The relationship / depth of the Complex) - Tangerang.
two stated variables, by looking
at the odd ratio value (OR). Number of Human Resources /
The quantity of the OR value Care Providers
depicts the tightness of the two The total amount in BPS “Y” year
tested variables. 2016 consisted of 4 (four) persons,
A systematic statistics test result was with educational background in
implemented to examine the opposing Midwifery Diploma.
hypothesis (null or alternative). Facilities of Clinic “Y” includes:
1. If P value ≤ 0,05 then the Ha is a). 24-Hour Delivery Assistanceb).
accepted, meaning that the
b). Pregnancy Check-up (Antenatal
correlation between the
independent and dependent Care Package)
variables. c). Family Planning Information &
2. If P value > 0,05 then the Ha is
Services.
denied and the Ho is proven /
accepted, explaining that there d). Immunization Scheduling /
is no relationship confirmed Program.
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
8
 No. Paritus Amount Percentage
(Frequency) (%) Tangerang During Year 2015
Source : Secondary Data (2015)
1. Primipara 38 53,5
2. Multipara 33 46,5 Table 5.2.1.1 showed that ruptured
perineums were mostly found in
TOTAL 71 100 primiparas of 38 people (53.5%) and
the lowest were from multiparas of 33
people (46,5%).
RESEARCH PROGRESS /
PROCESS
Bivariate Analysis
This research was carried out in BPS Table 5.2.1.2.
“Y” Tangerang during January-
December 2015 by filling out the Frequency Distribution Between
checklists according the patients’ Woman’s Age and Ruptured
medical records. The size of the Perineum
sample taken were 71 respondents as Source : Secondary Data (2015)
subjects meeting the predetermined
criterias. Table 5.2.1.2 clarified that ruptured
perineums were mostly found in ages
Univariate Analysis < 20 yo and > 35 yo, of 39 people
Table 5.2.1.1. (54,9%).
Frequency Distribution of where as the lower remaining were
Ruptured Perineums Based on deducted from multiparas of 32
Paritas at the “Y” Clinic in people (45,1%).
No. Woman’s Amount Percentage
Age (Frequency) (%)

1. 20-35 yo 32 45,1
2. <20 & 35 yo 39 54,9

TOTAL 71 100

CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO

PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
9
 Table 5.2.1.3.

Frequency Distribution of Table 5.2.1.4.

Ruptured Perineums Based on
Frequency Distribution of
Partus Presipitatus at The Clinic
Ruptured Perineums Based on
“Y” in Tangerang During Year
Fetal Weight At The “Y” Clinic in
2015
Tangerang During Year 2015
Source : Secondary Data (2015)

Table 5.2.1.3 depicts that most No. Paritus Amount Persentage

Precipitatus (Frequency) (%)
ruptured perineums occured in partus
precipitatus pregnancies of 38 people 1. Yes 38 53,5
(53,5%) where the lower half were 2. No 33 46,5
found in non-partus precipitatus
pregnancies of 33 women (46,5%). TOTAL 71 100

Woman’s Ruptured Perineum

Parity Total P Value OR
Spontaneous Episiotomy (Odds
Ratio)
n % n % N %
Primipara 8 21,1 30 78,9 38 100,0
Multipara 17 51,5 16 48,5 33 100,0 0,015 0,251
TOTAL 25 35,2 46 64,8 71 100,0

Source: Secondary Data (2015)

No. Fetal Amount Persentage
Tabel 5.2.1.4 describes that more
Weight (Frequency) (%)
(grams) ruptured perineums were discovered
1. ≤3500 17 23,9 in fetal weights over 3500 grams, of
2. >3500 54 76,1 54 people, while the lower were
gathered in fetal weight ranging from
TOTAL 71 100 2500 – 3500 grams, of 17 people
(23,9%).
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
10
 Table 5.2.2.1. Table 5.2.2.2.

The Correlation Between Women’s The Relevance Between Mother’s

Parity and Perineum Ruptures in Age Range and Ruptured
Laboring Women at The Clinic “Y” Perineums of Laboring Women of
Tangerang Year 2015 Clinic “Y” Tangerang Year 2015

Figure / Table 5.2.2.1 displays that the respondents experiencing ruptured

highest respondents suffering from
ruptured perineums with episiotomy
in primiparas amounted to 30 people
(78,9%) and the largest respondents
with multiparas’ ruptured perineums
were detected, of 17 people (51,5%).
perineum by episiotomy in mothers
aging from 20-35 years old of
27people (84,4%) while the highest
grossing respondents with
spontaneous ruptured perineums
happened in women under 20 years

Woman’s Ruptured Perineum

Age Range Total P Value OR
Spontaneous Episiotomy (Odds
Ratio)
n % N % n %
Yes 5 13,2 33 86,8 38 100,0
No 20 60,6 13 39,4 33 100,0 0,000 0,095
TOTAL 25 35,2 46 64,8 71 100,0

old and over 35 years old, a total of

20 persons (51,3%).
Originating from the statistic tests
run, P value of 0,015 (p < 0,05) was Based on the statistics, P value of
obtained; meaning that a 0,004 (p<0,05) tells that there is a
correspondence remains evident / connection between a woman’s age
existent between a mother’s parity
and ruptured perineum in delivering
mothers of Clinic “Y” Tangerang and ruptured perineum in birthing
year 2015. mothers of Clinic “Y” during 2015.
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
11
 Partus Ruptured Perineum
Precipitatus Total P Value OR
Spontaneous Episiotomy (Odds
Ratio)
n % N % n %
Yes 5 13,2 33 86,8 38 100,0
No 20 60,6 13 39,4 33 100,0 0,000 0,095
TOTAL 25 35,2 46 64,8 71 100,0
The odds ratio value of 0,251 is
derived, meaning that primiparas own
presenting no case of precipitated
a 0,251 times chance to undergo a
births / partus precipitatus, which
ruptured perineum episiotomy, where
were 20 people (60,6%). P-value of
0,00 (p<0,05) was inferred, meaning
that there is a likeness, indicating a
as multiparas have the slight
connectivity between partus
possibility of 0,251 times of
presipitatus cases and perineum
spontaneous ruptured perineum
ruptures of women in labor performed
incident.
by Clinic “Y” Tangerang, year 2015.
Table 5.2.2.3.
The odds ratio equivalent to 0,095 can
The Relevance Between Partus be interpreted that mothers-to-be with
Presipitatus/Precipitated Births and precipitated partuses / births have the
Ruptured Perineums of Laboring tendency of 0,095 times to endure
Women of Clinic “Y” Tangerang episiotomy-oriented ruptured
Year 2015 perineums, as juxtaposed to expecting
mothers without precipitated births
are at risk to have 0,095 times of
ruptured perineums.

Table 5.2.2.3 illustrates that the Tabel 5.2.2.4.

respondents with episiotomy-bound
The Interdependence Between The
ruptured perineums transpired in
Fetal / Gestational Weight and
women with precipitated births /
Perineum Ruptures of Laboring
partus presipitatus of 33 people
Women at “Y” Clinic Tangerang
(86,8%) and hence the respondents of
During Year 2015
spontaneous ruptured perineums,
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
12
 Fetal Ruptured Perineum
Weight Total P Value OR
Spontaneous Episiotomy (Odds
Ratio)
n % n % N %
≤ 3500 14 82,4 3 17,6 17 100,0
>3500 11 20,4 43 79,6 54 100,0 0,000 18,242
TOTAL 25 35,2 46 64,8 71 100,0

Table 5.2.2.4 portrays that the highest
number of respondents experiencing
spontaneous ruptured perineums due
to fetal weight of ≤ 3500 grams were
14 (82,4%) in comparison to the
highest number of respondents
encountering episiotomy-bound
perineum ruptures due to fetal weight
of >3500 gram, a total of 43 people
(79,6%). Referring to the statistics
measures, P/p-value of 0,00 (p<0,05),
translating a reciprocity between fetal
weight and ruptured perineums in
delivering mothers at “Y” Clinic year
2015.
Odds ratio of 18,242 can be translated
that the fetus weight of ≤ 3500 gram
withstands a chance of spontaneous
ruptured perineums – as to the fetal
weight with the possibility of bearing
18.242 times of episiotomy-bound
ruptured perineum facts / causes.
CONSTRAINTS OF RESEARCH
Concerning the width of the
underlying issue, the limited
knowledge of the researcher in
methodology, impacting on the
restrictions / ramifications /
repercussions are on process and
result such as the capability, the prior
data compiled, organization, budget,
human resources availability / help
needed and the scarcity of literature
sources from the library or the
internet connection for browsing and
lack there of, all supporting elements
to the task at hand. For the process
lacks on the ability, the knowledge,
the given time, therefore the author
limits this research in terms of parity,
partus presipitatus (precipitated
births), age and fetal weight.

CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO

PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
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RESEARCH DISCUSSION
The Connectivity Between Mother’s
Parity As Compared to Ruptured
Perineums
Depending on statistics, a p value of
0,015% (p<0,05), meaning that there
is a correlation between mother’s
parity with ruptured perineum in
delivering mothers at Clinic “Y”
Tangerang year 2015. Odds ratio of
0,251 is translated that primiparas
own 0,251 time a chance of suffering
from episiotomy-induced perineum
ruptures, whilst multiparas have the
possibility of 0,251 times a
spontaneous ruptures.
This findings are in line with the
theoretical framework of Prawihardjo
(2010) stating that the yet unexplored
birth canal by baby’s head were
causing muscle tensions/restraints and
stiffness.When the baby’s heads were
pushing the rigid perineum and not
able to provide the optimum/required
stretch – risking more harmful, harsh
and serious ruptures.
Correlation of Mother’s Age and
Ruptured Perineum
From the research, the analysis
bivariate shows that the highest
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
14
respondents with ruptured perineum
by episiotomy in mothers with age
ranging from 20-35 years old of 27
people (84,4%) and the highest
respondents experiencing spontaneous
perineum ruptures in mothers ranging
< 20 dan > 35 years of age tend to risk
having 0,176 times spontaneous
perineum ruptures.
These findings affirm Siswodharmo
& Emilia’s theory (2008), stating that
women less than 20 years dan more
than 35 years of age are on a brink of
perineum laceration risks due to
women’s reproductive system that is
not fully developed and functioning
yet, phasewise. On the other hand,
approaching 35 years and over in
women’s reproductive system
translates to the decline of
performance as compared to life
stages in reproductive functions
normalcy, enabling the possibilities of
post-birth complications, particularly
bleeding - to occur. This data also
confirms Prawirohardjo’s theory
(2010), saying that women over
healthy reproductive age are risky in
bringing about higher post-partum
hemorrhage (PPH) as supposed to
women in their primal / optimum
reproductive age, from 25 to 30 years.
The hemorrhage, in which was caused
by ruptured perineums, being one of
the rationed reasons.
The Interconnection Between
Partus Presipitatus (Precipitated
Births) and Ruptured Perineums
From the bivariate analysis research,
it can be inferred that the the
respondents with the most cases of
ruptured perineums by episiotomy in
precipitated partus were of 33 mothers
(86,8%) as the resemblaces pointed
out to spontaneous ruptured
perineums in mothers with
precipitated partus cases of 20 people
(60,6%). Based on the statistics, p-
value of 0,000 (p<0,05) was gained –
meaning that there is a alternate
correspondence between partus
presipitatus as juxtaposed to ruptured
perineums in mothers giving birth at
“Y” Clinic throughout year 2015. The
odds ratio of 0,095 was interpreted as
such that, for mothers with
precipitated partus owned risk of
0,095 times on perineum ruptures by
episiotomy - as contrasted to non-
precipitated partus mothers, having
risk of 0,095 times on spontaneous
ruptured perineums.
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
15
This collates with the theory proposed
by Saifuddin (2010) divulging that
precipitated partus can lead to
ruptured perineums, moreover cervix
lacerations / teared cervix, serving a a
gateway post-partum hemorrhage
(PPH).
Relationship Between Fetal Weight
and Ruptured Perineum
Bivariate analysis announced that
more respondents encountering
spontaneous ruptured perineums by
fetal weight of ≤ 3500 grams, made
up of 14 persons (82,4%) aswell to
disclose the respondents with the most
cases of ruptured perineums by
episiotomy in fetal weight of > 3500
grams, comprising 43 people (79,6%).
Referring to the p-value of 0,000 (p <
0,05), there by declares the
relationship between the fetal weight
and ruptured perineum in mothers
giving birth at “Y” Clinic -
Tangerang, year 2015. The odds ratio
of 18, 242 expressed that fetala
weight of or less than 3500 grams
possess the possibility of 18, 242
times spontaneous ruptured perineums
as for the fetal weight of more / over
than 3500 grams were risking 18, 242
times episiotomy-induced ruptured
perineums.
This acquired data is then confirmed
by the theories of Indonesia’s Health
Department (2015) proclaiming that
fetal weight more than 3500 grams
can potentially cause perineum
ruptures due to the vaginal partus
traumas like distosia and damaged /
ruins or tearings of soft tissues in
birthing mothers. This finding is also
in accordance with the statement from
Manuaba (2010), presenting that fetal
weight can be a factor to perineum
rupture, spotting the ones over 3500
grams as they cause risk traumas by
vaginal partus / births, shoulder
distosias and soft tissue damage in
birthing mothers.
CONCLUSIONS
Based on the results of secondary data
compilation during year 2015,
including total respondents of 71
birthing mothers with cases of
ruptured perineums at “Y” Clinic, the
following judgments or decisions
reached by reasoning came to several
conclusion points below / as follow:
1. There is a correlation between a
mother’s paritas (a number of
successful live births experienced by a
woman in her lifetime) and ruptured
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
16
perineums of women during labor in
“Y” Clinic in year 2015; inferring the
largest number of 30 respondents
(78,9%), undergoing ruptured
perineums by episiotomy in
primiparas ( a woman, a mother-to-be,
giving birth for the first time); as for
the spontaneous ruptured perineum
cases in multiparas amounting to 17
people (51,5%).
P value of 0,007 (p < 0,05) means that
there is a connection between
mother’s paritas and ruptured
perineums in women giving birth at
“Y” Clinic, Tangerang in year 2015.
Odds ratio of 0, 251 interpretes that
the primiparas tend to risk 0, 251
times ruptured perineums by
episiotomy, where as the multiparas
bear the chance of 0, 251 times
spontaneous ruptured perineums.
2. There is a relationship between
ruptured perineums in laboring
women at “Y” Clinic in Tangerang
during year 2015, disclosing
respondents with the most cases of
perineum ruptures by episiotomy in
birthing mothers of 20 to 35 years of
age, of 27 people (84,4%), as to the
remaining respondents with
spontaneous ruptured perineums in
laboring mothers with age ranging
under 20 to over 35 years old, of 20
ladies (51,3%).
P value of 0,002 (p < 0, 05) indicates
that there is an association between a
woman’s age as juxtaposed to
ruptured perineum in birthing mothers
at Clinic “Y”, Tangerang during year
2015.
Odds ratio of 0,176 implies that
mothers of 20 to 35 years of age are at
risk of having 0, 176 times ruptured
episiotomy by episiotomy, as for
mothers with age ranging under 20
and over 30 bear the incidence of 0,
176 times spontaneous kind of
perineum ruptures.
3. There is a linked correspondence
between precipitated partus and
ruptured perineums in laboring
women at Clinic “Y”, Tangerang in
year 2015, resulting respondents with
more ruptured perineums by
episiotomy in mothers suffering from
precipitated partus of 33 people
(86,8%) where as the respondents
with spontaneous perineum ruptures
in non-partus precipitatus women, of
20 persons (60,6%).
P value obtained of 0,000 (p < 0,05)
means a complement between partus
CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO
PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
17
precipitatus and ruptured perineum in
birthing mothers at “Y”Clinic,
Tangerang during year 2015.
Where as odds ratio of 0,095 explains
that women with partus precipitatus
cases are 0,095 times ruptured
perineum by episiotomy – prone, as to
mothers with spontaneous perineum
ruptures bear the same times of risk.
4. A tie-in / tie-up between partus
precipitatus (precipitated births) in
birthing women at Clinic “Y”,
Tangerang during year 2015, exerting
larger respondents with spontaneous
ruptured perineum cases in fetal
weight of or under 3500 grams, of 14
people (82,4%) as for the rest of the
respondents experiencing spontaneous
perineum ruptures in fetal weight over
3500 grams, encompassing 43 people
(79,6%).
In conjuction, P value of 0,000 (p <
0,05) means there is an
interdependence between fetal weight
and ruptured perineum in birthing
women at the “Y” Clinic, Tangerang
during year 2015.
While the odds ratio of 18,242 can be
understood that fetal weight of or less
than 3500 grams are at risk of having
ruptured their perineums
spontaneously; while the lower With this research being conducted,
remaining ones potentially will may it be beneficial and resourceful in
inevitably endure or tolerate the near future or in the long run to
spontaneous perineum ruptures add as a literature reference with the
judging the fetal weight over 3500 capacity to measure the students’
grams, by episiotomy. skills and knowledge to apply
themselves in theories learned – from
classrooms to communities / societies.
SUGGESTIONS
For Next / Upcoming Researchers
For Clinic “Y”, Tangerang City
A sustainability is very key and
It is highly expected that the utterly important in preserving the
midwives who assisted the labor / wholistic approach (cognitive,
delivery in the appointed clinic could affective and conative) in real
anticipate / overcome / tackle / handle documented social settings as
the given cases more hands-on, direct extended movements / actions need to
and quick precision in order to emphasize on psychological aspects
perform the required / needed, of the subject / field, as well as
necessary actions, dedicated to building on the technical foundations
laboring women with spontaneous or on physiological realms; by
episiotomy-induced ruptured embarking, exploring and exercising
perineums. on social-clinical interventions such
as Appreciative Inquiry (AI), CBT
For The Academy / Institution (Cognitive-Behavioral Therapy),
Dengan dilakukan penelitian maka assertivity training, self-concept, self-
jurnal penelitian ilmiah ini dapat efficacy & actualization and mental
dimanfaatkan untuk menambah health, towards a relaxed, spiritual,
referensi literature kepustakaan serta empowering, pleasant, less traumatic
mampu mengukur atau mengevaluasi and lastly – a much more natural
kemampuan mahasiswa dalam process of births / delivery
menerapkan teori yang telah dipelajari (introduction to hypnobirthing, for
pada saat mengikuti proses instance).
perkuliahan.
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PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
18
THANK YOU NOTES
I would like to express my greatest
token of gratitude to Allah Almighty,
for it was by Allah’s grace and glory
– that this assignment is completed
wholesomely and concocted
wholeheartedly. It is with utmost
ultimate hope and faith, that this
research may finally able to touch and
benefit the stakeholders and
society, first and foremost if not,
substantially – as the study evolves to
a higher level from becoming to being
and again, allowing us more rooms to
activate humbled and honored
humanity as agents of change –
rewriting history in a woman’s life
stages as events of personal and a
general accomplishments / accolades.
Cunningham, 2012. Obstetri
Williams. Edisi 23, Jakarta : EGC.
Depkes RI. 2015. Modul Safe
Motherhood, Jakarta : FKMUI.
JNPK-KR, 2012, Pelatihan Klinik
Asuhan Persalinan Normal, Jakarta :
EGC.
Harry Oxorn, William R. Forte, 2008,
Ilmu Kebidanan Patologi & Fisiologi
Persalinan, Yogyakarta.
its Henderson & Jones.
2006.http://www.poltekkes-solo.ac.id.
Downloaded on 02/05/2016 at 13.00.
Hilmi.2009.http://stikesharapanmama.
blogspot.com. Downloaded on
02/05/2016, 14.00.
Lieweelyn, D. 2008. Dasar-dasar
Obstetri & Ginekologi. 6th Ed.,
Jakarta : Hippokrates.
Manuaba, IBG. 2010. Ilmu
Kandungan Penyakit Kandungan &
KB. Jakarta : ECG.

BIBLIOGRAPHIES Manuaba. 2010. Pengantar Kuliah

Obstetri. Jakarta: EGC.

Arikunto, Suharsimi, 2010. Prosedur Other supporting documented

Penelitian Suatu Penelitian Praktik. literatures for references.

CORRELATION BETWEEN THE MATERNAL AND FETAL/ GESTATIONAL FACTORS AS JUXTAPOSED TO

PERINEUM RUPTURES EVENTS/RATES/TRENDS /CASES OF LABORING WOMEN AT “Y” CLINIC IN
TANGERANG CITY DURING YEAR 2015
{Liza Anggraeni, S.Psi., M.Si. - Karya Bunda Husada Midwifery Academy – Tangerang, 2016}.
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