Electronic Theses and Dissertation

Prolaps Organ Panggul (POP) merupakan kondisi klinis yang sangat berdampak pada kualitas hidup wanita, dimana persalinan pervaginam dikenal sebagai faktor risiko utama. Studi kohort prospektif ini menganalisis hubungan panjang hiatus genitalis, kadar serum vitamin D, dan kekuatan otot levator ani dengan kejadian POP pada 55 primigravida yang melahirkan secara pervaginam di Banda Aceh (priode Agustus 2024-April 2025). Pengukuran hiatus genitalis dan kekuatan levator ani (menggunakan perineometer) dilakukan saat hamil dan 8 minggu pascapersalinan. Kadar serum vitamin D dianalis menggunakan metode CMIA, sedangkan diagnosis POP ditetapkan berdasarkan sistem POP-Q. Hasil penelitian menunjukkan 10,9% (6/55) responden mengalami POP, tanpa menunjukkan hubungan signifikan antara panjang hiatus genitalis dengan kejadian POP (p=0,807). Kadar vitamin D yang lebih rendah secara bermakna (11,92±2,98 vs 23,42±9,53 ng/mL; p=0,001) dan kekuatan levator ani yang lebih lemah (median 18,00 vs 23,00 cmH₂O; p=0,001) ditemukan pada kelompok POP. Analisis multivariat menunjukkan kekuatan levator ani sebagai faktor determinan POP (p=0,002; OR 95% CI=13,674-34,455), sementara vitamin D tidak berperan sebagai prediktor independen. Temuan ini menegaskan pentingnya evaluasi rutin kekuatan otot dasar panggul bagi primigravida pascapersalinan dalam upaya pencegahan POP.

Kata Kunci: Prolaps Organ Panggul, Hiatus Genitalis, Vitamin D, Otot Levator Ani, Persalinan Primigravida

Pelvic organ prolapse (POP) is a significant condition that can greatly impact the quality of life for women, with vaginal delivery being its primary risk factor. This prospective cohort study examined the relationship between genital hiatus length, serum vitamin D levels, and levator ani muscle strength with the occurrence of POP among 55 primigravid women who delivered vaginally in Banda Aceh from August 2024 to April 2025. Measurements of genital hiatus length and levator ani strength (using a perineometer) were taken during pregnancy and at 8 weeks postpartum. Serum vitamin D levels were analyzed using the CMIA method, and POP diagnosis was determined using the POP-Q system. The study found a POP incidence of 10.9% (6/55), with no significant correlation between genital hiatus length and POP occurrence (p=0.807). The POP group had notably lower vitamin D levels (11.92±2.98 vs 23.42±9.53 ng/mL; p=0.001) and weaker levator ani strength (median 18.00 vs 23.00 cmH₂O; p=0.001). Multivariate analysis identified levator ani strength as the sole determinant of POP (p=0.002; adjusted OR 95% CI=13.674-34.455), while vitamin D showed no independent predictive value. These results emphasize the importance of routine pelvic floor muscle assessment for primigravid women during postpartum care as a preventive measure against POP. Keywords: Pelvic Organ Prolapse, Genital Hiatus, Vitamin D, Levator Ani Muscle, Primigravida Delivery