Syntax Literate: Jurnal Ilmiah Indonesia p–ISSN: 2541-0849 e-ISSN: 2548-1398
Vol. 9, No. 7, Juli 2024
EFFECTIVENESS OF POEDJI ROCHJATI SCORE CARD
(PRSC) FOR DETECTING HIGH RISK IN PREGNANT WOMAN AT TEGALWARU COMMUNITY HEALTH
CENTER PURWAKARTA
Prayudha Tegar Perbawa1*, Verawaty2
Community
Health Center Tegalwaru, Purwakarta,
Indonesia1,2
Email:
[email protected]*
Abstract
Pregnancy, childbirth, postpartum, and infant care are
natural physiological processes. However, there is a potential for a
life-threatening situation to arise during this period, which can pose a risk
to both the mother and the baby and, in severe cases, even lead to death. If we
can effectively detect them, we can prevent maternal deaths. One tool to detect
high-risk pregnant women is the Poedji Rochjati Score Card (PRSC). The aim of this research is to
determine the effectiveness of the Poedji Rochjati Score Card (PRSC) for detecting high risk in
pregnant women in the Purwakarta Community Health Center area, Purwakarta Regency. The
study's research design was a retrospective cohort with secondary data. The Tegalwaru Community Health Center,
Tegalwaru District, Purwakarta
Regency hosted the research from December 2023 to January 2023. In 2022, all
920 pregnant women were included in this study. This study used total
population techniques to sample. There were 617 respondents (67.1%) of low-risk
pregnant women, 279 respondents (30.3%) with high-risk pregnancies, and 24
respondents (2.6%) with very high-risk pregnancies. Pregnant women with a score
of 2 had 617 respondents (67.1%), 6 had 235 respondents (25.5%), 10 had 44
respondents (4.8%), 14 had 20 respondents (2.2%), and 18 had 4 respondents
(0.4%). The Poedji Rochjati
Score Card (PRSC) is effective for detecting high-risk pregnant women. Based on
the results of the Chi Square test, the p value was <0.001. The Poedji Rochjati Score Card (PRSC)
effectively identifies high-risk pregnancies, comprehensive care is still
necessary for pregnancies without risk, as the risk of pregnancy can fluctuate
throughout pregnancy and delivery.
Keywords : Effectiveness , Poedji Rochjati Score Card
(PRSC), Risk of Pregnancy.
Introduction
Pregnancy, childbirth, postpartum,
and infant care are inherent physiological processes. Nevertheless, there is a
possibility of a life-threatening situation occurring during this timeframe,
which might endanger both the mother and the infant and, in extreme cases,
result in fatality (Neerland, 2018). Healthcare experts with proper authorization should
assume the responsibility of overseeing pregnancy, labor,
postpartum care, and the overall well-being of infants in order to safeguard
the health and safety of both the mother and the baby (Alden et al., 2013;
Lowdermilk et al., 2019). Anticipating pregnancy difficulties in advance is a
difficult task. The risk assessment approach is unable to reliably predict the
occurrence of problems in pregnant women throughout their pregnancy. The
maternal mortality rate is the key metric for assessing the efficacy of
programs aimed at improving maternal health. Maternal deaths encompass all
fatalities that happen during pregnancy, delivery, and the postpartum phase,
excluding those caused by unrelated incidents or events. The mortality rate, or
MMR, is the number of deaths in this specific group per 100,000 live births.
The Ministry of Health is the source of this information, specifically from
2022 (Sari et al., 2024).
The global maternal mortality rate
in 2020 stood at 223 deaths per 100,000 live births. To achieve a worldwide
maternal mortality rate of fewer than 70 by 2030, an annual reduction rate of
11.6% will be required. It's important to note that achieving this rate at the
national level has been rare. The World Health Organization (WHO) reported this
in 2023 (WHO, 2024). The Ministry of Health of the Republic of Indonesia
reported a decline in maternal death rates from 390 to 189 per 100,000 live
births between 1991 and 2020, as per the statistics published in 2022. The
national medium-term development plan, which aims to achieve a rate of 183 per
100,000 live births by 2024, closely aligns with this figure. Although there is
currently a trend towards reducing maternal mortality, additional actions are
required to accelerate the decline in the maternal mortality ratio (MMR) and
achieve the Sustainable Development Goals (SDGs) target of 70 deaths per
100,000 live births by 2030. The text refers to the Indonesian Ministry of
Health's profile for 2022 (Ministry of Health of the
Republic of Indonesia, 2023).
In 2022, the number of maternal
fatalities in West Java Province, as reported by district and city health
profiles, was 678 instances, or 81.67 per 100,000 KH. This represents a
decrease of 528 cases compared to 2021, which had 1,206 cases (West Java Provincial Health
Service, 2023). Based on the Purwakarta Health Profile in
2022, the maternal mortality rate in Purwakarta
Regency in 2022 was 9 per 100,000 live births (Purwakarta District Health
Service, 2023). According to the Tegalwaru Community Health Center report, there were 75 cases of estimated neonatal
problems and high-risk pregnant women. There was only two maternal death (Tegalwaru Health Center,
2023).
Pregnancy, childbirth, and the
postpartum period are inherent stages in human life. However, it is crucial to
exercise caution in the event of any potential threats to the health of both
the mother and the infant, particularly for moms lacking access to healthcare
professionals. Efforts to decrease the Maternal Mortality Rate (MMR) primarily
involve implementing the "four pillars of safe motherhood"
initiative, which includes ensuring access to neonatal care services. Ensuring
mothers' safety during pregnancy, childbirth, the postpartum period, and when
seeking family planning services significantly reduces the incidence of illness
and death (Tulchinsky et al., 2023).
Accessing high-quality healthcare
services is important, especially for pregnant women. Skilled healthcare
professionals in healthcare facilities provide delivery assistance, postnatal
care for both the mother and baby, and specialized care and referrals in case
of any complications. Family services are also available to support the
well-being of mothers and babies. We provide family planning services, which include
postnatal and postpartum family planning. Midwives serve an important role in
the community by serving as training personnel in the national health system.
They provide services, enhance public health knowledge, and improve the
referral system (Dashraath et al., 2020).
Prompt identification of maternal mortality is crucial for
efficient strategizing and readiness to avert such incidents and guarantee the
mother's survival. The Poedji Rochjati
Score Card (PRSC) is employed as a diagnostic instrument to pinpoint pregnant
individuals who are at a heightened risk. This study aims to evaluate the
effectiveness of the Poedji Rochjati
Score Card (PRSC) in identifying pregnant women at high risk in the Tegalwaru Community Health Center
area, situated in Purwakarta Regency.
Research Method
The study research design was a
retrospective cohort approach, utilizing secondary data obtained from pregnant
women in the year 2022. We conducted the study from December to January 2023 in
the operational region of the Tegalwaru Community
Health Center, situated in the Tegalwaru
District of Purwakarta Regency, West Java. In 2022,
the population under investigation will include all expectant mothers. This
study employed a technique known as total population sampling to select the
sample. In this study, the Poedji Rochjati
Score Card (PRSC) serves as the independent variable, while the detection of
high risk in expectant moms is the dependent variable. The study utilized
secondary data obtained from maternal cohorts, annual health center reports, and KIA books within the working area of
the Tegalwaru Community Health Center.
We subsequently analyzed the data to assess the
initial scores of pregnant women using the Poedji Rochjati Score Card (PRSC), focusing on identifying
high-risk factors during pregnancy and childbirth.
Result and Discussion
Result
General data
1) Distribution of respondents based on
place of delivery
Table 1. Distribution of respondents based on place of
delivery in Community Health Center Tegalwaru 2022
|
No |
Place
of delivery |
N |
% |
|
1 |
Practicing
Midwife |
421 |
45,8% |
|
2 |
Hospital |
334 |
36,3% |
|
3 |
Community
Health Center |
165 |
17,9% |
|
Total |
920 |
100% |
|
According to the provided table, that the majority of respondents,
specifically 421 individuals (45.8%), delivered their babies with the
assistance of midwives.
2) Distribution of respondents based on
type of delivery
Table 2. Distribution of respondents based on type of
delivery in Community Health Center Tegalwaru 2022
|
No |
Type
of delivery |
N |
% |
|
1 |
Spontaneus Delivery |
832 |
90,4% |
|
2 |
Sectio Caesarea |
77 |
8,4% |
|
3 |
Vacuum
extraction |
11 |
1,2% |
|
Total |
920 |
100% |
|
According to the provided table, it is evident that the majority of
respondents experienced spontaneous labor,
specifically 832 individuals (90.4%).
3) Distribution of respondents based on
birth attendants
Table 3. Distribution of respondents based on birth
attendants in Community Health Center Tegalwaru 2022
|
No |
Birth
attendants |
N |
% |
|
1 |
Midwife |
798 |
86,7% |
|
2 |
Obstetrician/Gynaecologist |
122 |
13,3% |
|
Total |
920 |
100% |
|
According to the data in the table, it is evident that the majority of
birth respondents, specifically 798 respondents (86.7%), received assistance
from midwives.
Special Data
1) Types risk of pregnancy in pregnant
women
Table 4. Distribution of respondents based on type
risk of pregnancy in Community Health Center Tegalwaru
2022
|
No |
Types
Risk of Pregnancy |
N |
% |
|
1 |
Low
Risk |
617 |
67,1% |
|
2 |
High Risk |
279 |
30,3% |
|
3 |
Very
High Risk |
24 |
2,6% |
|
Total |
920 |
100% |
|
Based
on the provided statistics, the majority consisted of 617 respondents (67.1%)
who had low-risk pregnancies.
2) Score in pregnant women with PRSC
Table 5. Distribution of respondents based on Poedji Rochjati Score in pregnant
women with PRSC in Community Health Center Tegalwaru
2022
|
No |
Poedji Rochjati’s
Score |
N |
% |
|
1 |
Score
2 |
617 |
67,1% |
|
2 |
Score 6 |
235 |
25,5% |
|
3 |
Score
10 |
44 |
4,8% |
|
4 |
Score 14 |
20 |
2,2% |
|
5 |
Score
18 |
4 |
0,4% |
|
Total |
920 |
100% |
|
According to the provided table, it is evident that the largest
proportion of Poedji Rochjati's
score was 2, with 617 respondents accounting for 67.1%.
3)
The
Effectiveness of PRSC for Detecting High Risk in Pregnant Women
Table 6. he
Effectiveness of PRSC for Detecting High Risk in Pregnant Women in Community Health Center Tegalwaru 2022
|
|
Value |
df |
Asymptotic Significance (2-sided) |
|
Pearson
Chi-Square |
1.840.000a |
8 |
<.001 |
|
Likelihood
Ratio |
1.333.796 |
8 |
<.001 |
|
Linear-by-linear
association |
817.997 |
1 |
<.001 |
|
N of
Valid Cases |
920 |
|
|
The
Chi Square results suggest that PSRC is highly successful in identifying
high-risk pregnant women, as the p value is less than 0.001.
Discussion
1) Type Risk
of Pregnancy
The research results showed that
there were 617 respondents (67.1%) of low risk pregnant women, 279 respondents
(30.3%) with high risk pregnancies, and 24 respondents (2.6%) with very high risk pregnancies.
The risks associated with this pregnancy are variable, as
pregnant women who were once considered to have a normal risk can suddenly
become high-risk. A compromised pregnant mother's health, such as anemia, could potentially lead to a low birth weight for
the baby. Infants with low birth weight (LBW) are more susceptible to illnesses
such as lower respiratory tract infections and mortality compared to infants
born with a typical weight. A pregnancy that initially has a low risk can
gradually escalate to a high risk or even a very high danger. Special and
ongoing surveillance is necessary to prevent pregnant women with low risk from
transitioning to high risk or even extremely high risk. In involvement of
midwives and the provision of suitable treatment are highly beneficial in endeavors to decrease the maternal mortality rate (MMR) and
infant mortality rate (IMR).
2) Pregnant Women's Scores Using the
Poedji Rochjati Score Card
(PRSC)
The research results showed that respondents with a score
of 2 were 617 respondents (67,1%), a score of 6 was 235 respondents (25,5%), a
score of 10 was 44 respondents (4,8%), a score of 14 was 20 respondents (2,2%)
, and a score of 18 was 4 respondent (0,4%).
In contemporary obstetrics, there is a recognition of
inherent risk, wherein pregnancy and labor inherently
entail the potential for danger or the occurrence of difficulties.
Complications can range from moderate to severe and have the potential to
result in mortality, illness, or impairment for either the mother or the baby.
The extent of risk factors impacts the severity of complications, indicating
that the more risk factors a pregnant woman possesses, the higher her
likelihood of encountering difficulties (Zainiyah et al., 2020).
As a pregnant woman's score increases, so does the mother's
risk throughout pregnancy and childbirth, potentially endangering the baby as
well. Provision of support throughout pregnancy and implementation of a
complete treatment plan are crucial in order to minimize and effectively manage
the mother's risk factors (Widarta et al., 2015).
3) Effectiveness of the Poedji Rochjati Score Card (PRSC)
for Detecting High Risk in Pregnant Women
The research results show that the
Poedji Rochjati Score card
(PRSC) is effective for detecting high risk in pregnant women. Based on the
results of the Chi Square test, the p value was <0.001.
The Poedji
Rochjati Score Card is a diagnostic tool that
identifies and categorizes pregnancies into high-risk and low-risk categories.
This enables comprehensive midwifery care to be planned early (Yalina et al., 2017). The majority of pregnant women with a score of 2
(indicating a low-risk pregnancy) experienced no complications during pregnancy
or delivery. However, there were some cases where pregnant women initially
scored 2 but experienced complications by the end of pregnancy and at the time
of delivery. Therefore, additional care may be necessary in such situations. We
should design an all-encompassing approach not only for moms identified as high
or very high risk, but also for low risk mothers who may face potential
difficulties during pregnancy and labor (Andriani, 2019).
Conclusion
There were respondents 617 respondents (67.1%) of low risk pregnant
women, 279 respondents (30.3%) with high risk pregnancies, and 24 respondents
(2.6%) with very high risk pregnancies. Pregnant
women with a score of 2 were 617 respondents (67,1%), a score of 6 was 235
respondents (25,5%), a score of 10 was 44 respondents (4,8%), a score of 14 was
20 respondents (2,2%) , and a score of 18 was 4 respondent (0,4%). The Poedji Rochjati Score Card (PRSC)
is effective for detecting high risk in pregnant women. Based on the results of
the Chi Square test, the p value was <0.001. For respondents are required to
consistently uphold their well-being by regularly consulting healthcare
professionals and promptly seeking medical attention if any indications of risk
or difficulties arise throughout pregnancy. For the health workers enhancing
service standards and offering additional information to mothers will enable
them to identify the warning signs they may be encountering.
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Copyright holder: Prayudha Tegar Perbawa, Verawaty (2024) |
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First publication right: Syntax Literate:
Jurnal Ilmiah Indonesia |
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