Mulyadi, Jesica and Dr. dr. Sutrisno, SpOG (K) and Dr. Diadjeng Setya Wardani, S.Si.T, M.Kes (2022) Pengaruh Kunjungan Antenatal Care dan Risiko pada Kehamilan Terhadap Outcome Preeklampsia di Kabupaten Jember. Magister thesis, Universitas Brawijaya.
Abstract
Preeklampsia merupakan salah satu komplikasi kebidanan yang menjadi penyumbang morbiditas dan mortalitas pada ibu dan janin. Preeklampsia dapat dideteksi melalui pemeriksaan tekanan darah dan protein urin. Antenatal Care (ANC) menjadi perawatan ibu hamil di fasilitas kesehatan yang dapat digunakan untuk mendeteksi adanya preeklampsia. Antenatal dapat mendeteksi preeklampsia melalui pemeriksaan 10T, meliputi pengukuran tinggi dan berat badan, pengukuran tekanan darah, pengukuran LILA (Lingkar lengan atas, untuk status gizi), tinggi fundus uterus, presentasi janin dan denyut jantun janin, tetanus toxonoid, pemberian tablet tambah darah, pemeriksaan laboratorium, tatalaksana kasus dan konseling. Pemeriksaan 10T dilakukan setiap pemeriksaan, kecuali pemeriksaan lab. Selain pemeriksaan, anamnesis juga dilakukan untuk deteksi dini faktor risiko dalam kehamilan. Adapun faktor risiko yang dideteksi melalui anamnesis, seperti keluhan yang dirasakan ibu, usia, paritas, pendidikan, pekerjaan, dan riwayat kesehatan ibu. Pemeriksaan ANC yang dilakukan secara rutin dapat mendeteksi risiko pada kehamilan, termasuk preeklampsia sejak dini, sehingga dapat dicegah dan ditangani sedini mungkin. Dengan kata lain, dapat menekan morbiditas dan mortalitas pada ibu. Tujuan penelitian ini adalah mengetahui pengaruh kunjungan antenatal care (ANC) dan risiko pada kehamilan terhadap outcome preeklampsia di Kabupaten Jember. Penelitian ini dilakukan secara observasional analitik dengan desain case control, yang dilakukan pada bulan Maret – april 2022 di Kabupaten Jember. Subyek penelitian ibu hamil >36 minggu, ibu bersalin dan ibu nifas yang telah memenuhi krikteria penelitian sebanyak 120 orang yang dibagi kedalam dua kelompok yaitu 40 orang pada kelompok kasus (ibu preeklampsia yang meninggal) dan 80 orang pada kelompok kontrol (ibu preeklampsia yang sehat). Data diambil melalui format Otopsi verbal Maternal (OVM) dan buku register ibu yang berupa usia, paritas, tinggi dan berat badan, jumlah kunjungan antenatal care (pertrimester), kadar hemoglobin, penyakit kronis, edema, kehamlian ganda, makrosomia, sakit kepala. Analisa yang digunakan Uji Chi-square yang dilanjutkan dengan analisis Regresi Logistik Biner dilakukan dengan menggunakan SPSS versi 25.0 dengan Alpha =0.05. Hasil analisis bivariat penelitian ini menunjukkan bahwa kunjungan antenatal care (ANC) (p-value = 0.000), obesitas (p-value = 0.001), dan sakit kepala menetap (p-value = 0.013) mempengaruhi outcome preeklampsia di Kabupaten Jember. Hasil penelitian ini juga menunjukkan tidak ada pengaruh usia (p-value = 0.869 ), paritas (p-value = 0.100), penyakit kronis (p-value = 0.082), edema pada muka dan atau kaki (p-value = 0.152), makrosomia (p-value = 1.000 ), anemia (p-value =1.000 ), dan kehamilan ganda (p-value = 0.472 ) terhadap outcome preeklampsia di Kabupaten Jember. Pada analisis multivariat didapat kunjungan antenatal care (ANC) (OR = 3.614 ; 95% CI = 1.334 –9.790), obesitas (OR = 7.753 ; 95% CI = 2.087 – 28.810), dan sakit kepala menetap (OR = 2.785 ; 95% CI = 1.061 – 7.308) risiko kejadian kematian ibu dengan preeklampsia di Kabupaten Jember. Penelitian ini membuktikan bahwa kunjungan ANC, obesitas, dan sakit kepala yang menetap mempengaruhi outcome preeklampsia di Kabupaten Jember dan meningkatkan risiko kejadian kematian ibu dengan preeklampsia di Kabupaten Jember.
English Abstract
Preeclampsia is one of the obstetric complications that contributes to maternal and fetal morbidity and mortality. Preeclampsia can be detected through examination of blood pressure and urine protein. Antenatal Care (ANC) is a treatment for pregnant women in health facilities that can be used to detect the presence of preeclampsia. Antenatal can detect preeclampsia through a 10T examination, including measurement of height and weight, blood pressure measurement, LILA measurement (upper arm circumference, for nutritional status), uterine fundal height, fetal presentation and fetal heart rate, tetanus toxoid, administration of blood-added tablets, laboratory examination, case management and counseling. 10T examination is carried out every examination, except for laboratory examinations. In addition to examination, history taking is also done for early detection of risk factors in pregnancy. The risk factors were detected through history taking, such as maternal complaints, age, parity, education, occupation, and maternal health history. Routine ANC examination can detect risks in pregnancy, including preeclampsia from an early age, so that it can be prevented and treated as early as possible. In other words, it can reduce maternal morbidity and mortality. The purpose of this study was to determine the effect of antenatal care (ANC) visits and risk in pregnancy on the outcome preeclampsia in Jember Regency. This research was conducted by analytical observation with a case control, which was conducted in March – April 2022 in Jember Regency. The research subjects were pregnant women >36 weeks, pregnant women and postpartum women who had met the research criteria as many as 120 people who were divided into two groups, namely 40 people in the case group (pre-eclamptic mothers who died) and 80 people in the control group (healthy pre-eclampsia mothers). Data were taken through the Maternal Verbal Autopsy (OVM) format and the mother's register in the form of age, parity, height and weight, number of antenatal care visits (per trimester), hemoglobin level, chronic disease, edema, multiple pregnancy, macrosomia, headache. The analysis used was Chi-squarefollowed by Binary Logistic Regression analysis using SPSS version 25.0 with Alpha = 0.05. The results of the bivariate analysis of this study showed that antenatal care (ANC) visits (p-value = 0.000), obesity (p-value = 0.001), and persistent headache (p-value = 0.013) affected the outcome of preeclampsia in Jember Regency. The results of this study also showed that there was no effect on age (p-value = 0.242), parity (p-value = 0.100), chronic disease (p-value = 0.082), edema of the face and/or feet (p-value = 0.152), macrosomia (p-value = 1,000), anemia (p-value =1,000), and multiple pregnancy (p-value = 0.472) on the outcome preeclampsia in Jember Regency. In multivariate analysis, antenatal care (ANC) were obtained (OR = 3.614 ; 95% CI = 1.334 –9.790), obesity (OR = 7.753 ; 95% CI = 2.087 – 28.810), dan persistent headache (OR = 2.785 ; 95% CI = 1.061 – 7.308) increase the risk of maternal death with preeclampsia. This study proves that ANC visits, body mass index, and persistent headaches affect the outcome of preeclampsia in Jember Regency and increase the risk of maternal death with preeclampsia in Jember Regency.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 042206 |
| Divisions: | S2/S3 > Magister Kebidanan, Fakultas Kedokteran |
| Depositing User: | soegeng Moelyono |
| Date Deposited: | 22 Jan 2024 02:20 |
| Last Modified: | 22 Jan 2024 02:20 |
| URI: | http://repository.ub.ac.id/id/eprint/212201 |
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