PERBANDINGAN KEJADIAN PERTUMBUHAN JANIN TERHAMBAT ANTARA PREEKLAMPSIA BERAT ONSET DINI DENGAN PREEKLAMPSIA BERAT ONSET LAMBAT

JOHAN TARUNA, dr. Rukmono Siswishanto, M.Kes., SpOG(K).; dr. Nuring Pangastuti, SpOG(K)

2017 | Tesis-Spesialis | SP Ilmu Kebidanan dan Penyakit Kandungan

Latar belakang: Preeklampsia dan eklampsia masih merupakan permasalahan kegawatdaruratan dalam bidang obstetri. Preeklampsia dibedakan menjadi dua subtipe berdasarkan waktu munculnya penyakit, preeklampsia onset dini (early onset) yang terjadi sebelum usia kehamilan 34 minggu dan preeklampsia onset lambat (late onset) yang terjadi saat usia kehamilan 34 minggu atau lebih. Preeklampsia onset dini diyakini memiliki hubungan yang kuat dengan disfungsi plasenta. Hal ini menyebabkan risiko PEB onset dini lebih besar untuk terjadi pertumbuhan janin terhambat. Tujuan Penelitian: Untuk mengetahui hubungan antara preeklampsia onset dini dan onset lambat terhadap pertumbuhan janin (berat badan lahir) dan perbandingan kejadian pertumbuhan janin terhambat antara kedua kelompok preeklampsia. Rancangan Penelitian: Kohor retrospektif Bahan dan cara penelitian: Data pasien bersalin dengan preeklampsia onset dini dan onset lambat beserta berat bayi yang dilahirkan di RSUP Dr. Sardjito dicatat. Dicatat pula umur, paritas, indeks masa tubuh dan riwayat hipertensi. Data yang diambil dari rekam medik menggunakan metode sampling konsekutif. Hasil: Terdapat sampel sebanyak 81 wanita untuk setiap kelompok. Sebanyak 51 bayi (63%) dari wanita PEB onset dini mengalami PJT sedangkan pada PEB onset lambat hanya 33 bayi (40,7%). Hal ini bermakna secara statistik dengan risiko 1,54 kali (IK 95% 1,13-2,11) mengalami PJT. Tidak ada perbedaan yang bermakna untuk kejadian PJT pada subyek berdasarkan umur, paritas, indeks masa tubuh dan riwayat hipertensi. Kesimpulan: Preeklampsia berat onset dini memiliki risiko kejadian pertumbuhan janin terhambat lebih besar dibandingkan preeklampsia onset lambat.

Background: Preeclampsia and eclampsia still become obstetrical emergency challenges. Preeclampsia was distinguished into two subtypes according to its onset: early preeclampsia which occured before 34th weeks of pregnancy and late onset preeclampsia, which occured at 34th of pregnancy or later. Early onset preeclampsia had been thought to be strongly related to placental dysfunction. This early onset gave rise to higher risk of fetal growth restriction. Objective: To review the association between the onset of preeclampsia and fetal growth (fetal birth weight) and to compare the incidence of fetal growth restriction between two groups of preeclampsia according ti its onset. Study design: Retrospective cohort Method and subject: Data of obstetrics patient delivered with early and late onset preeclampsia, along with birth weight of babies delivered at Dr. Sardjito Hospital were recorded. The age, parity, body mass index, and history of hypertension of each subject were recorded. Data was collected from medical record using consecutive sampling method. Result: Eighty one subjects for each group were included in this study. Fifty one babies (63%) from early onset were diagnosed with FGR, compared to 33 babies (40,7%) from late onset group. This result was statistically, in which the early onset group had 1.54 times risk of having FGR (CI 95%, 1.13-2.11). No statistically significant differences of delivering baby with FGR according to age, parity, body mass index and history of hypertension. Conclusion: Early onset severe preeclampsia had significant correlation with fetal growth restriction.

Kata Kunci : Preeklampsia onset dini, Preklampsia onset lambat, Pertumbuhan janin terhambat, early onset preeclampsia, late onset preeclampsia, fetal growth restriction