Luaran Perinatal Pada Pasien Ibu Dengan Covid-19 Di Daerah Istimewa Yogyakarta

HERVIANTO MUKTI U, dr. Irwan Taufiqur Rachman, Sp.O.G,Subsp.K.FM.; dr. R. Detty Siti Nurdiati, MPH, PhD, Sp.O.G,Subsp.K.FM

2022 | Tesis-Spesialis | OBSTETRI DAN GINEKOLOGI

Latar Belakang: Jarang kasus COVID-19 yang tercatat pada bayi baru lahir dan belum ada bukti yang meyakinkan untuk mendukung kemungkinan adanya penularan vertikal. Penelitian yang berkaitan dengan luaran perinatal pada ibu dengan COVID-19 masih sedikit. Tujuan: Mengetahui karakteristik luaran perinatal pada pasien ibu dengan infeksi COVID-19 di D.I Yogyakarta. Metode: Desain penelitian deskriptif. Subjek penelitian adalah bayi yang lahir dari wanita hamil dengan infeksi COVID-19 di RSUP Dr. Sardjito Yogyakarta dan Rumah Sakit Akademik UGM sejak Maret 2020 sampai Agustus 2021. Hasil : Dari 436 ibu hamil dengan COVID-19 di RSUP Dr. Sardjito dan RSA UGM terdapat 348 bayi yang lahir, terdiri dari 337 bayi lahir hidup dan 11 bayi lahir dengan kondisi IUFD. Terdapat 67 bayi (19,88%) yang lahir preterm, 272 bayi (80,71%) lahir BBLC, 41 bayi (14,24%) lahir BBLR, 13 bayi (3,86%) BBLSR, 2 bayi (0,59%) BBLER, dan 2 bayi (0,59%) BBLB. Ditemukan 76 bayi (22,55%) dengan skor APGAR <7 (asfiksia). Kejadian neonatal pneumonia terjadi pada 47 bayi (13,95%), 3 bayi (0,89%) membutuhkan invasive ventilation, 56 bayi (16,62%) membutuhkan perawatan NICU, 267 bayi dengan lama perawatan <=2 hari, 14 bayi (14,15%) meninggal dunia, 32 bayi (9,50%) terinfeksi COVID-19 dan 2 diantaranya meninggal. Kesimpulan: Ditemukan kondisi luaran perinatal pada ibu dengan COVID-19 sangat beragam. Bayi yang lahir dari ibu dengan COVID-19 tidak mempengaruhi secara signifikan terhadap luaran-luaran perinatal pada bayi yang lahir dari ibu dengan COVID-19. Pada penelitian ini ditemukan adanya bayi yang terkonfirmasi positif COVID-19 yang lahir dari ibu dengan COVID-19. Namun, hal ini belum bisa membuktikan adanya penularan vertikal karena tidak dilakukan pemeriksaan virologi pada air ketuban, plasenta, dan air susu ibu.

Background: Rare cases of COVID-19 have been recorded in newborns and there is no convincing evidence to support the possibility of vertical transmission. There are few studies related to perinatal outcomes in mothers with COVID-19. Objective: To determine the characteristics of perinatal outcomes in maternal patients with COVID-19 infection in D.I Yogyakarta. Methods: Descriptive research design. The subjects of the study were babies born to pregnant women with COVID-19 infection at RSUP Dr. Sardjito Yogyakarta and UGM Academic Hospital from March 2020 to August 2021. Results: From 436 pregnant women with COVID-19 at RSUP Dr. Sardjito and UGM Academic Hospital there were 348 babies born, consisting of 337 live births and 11 babies born with IUFD. There were 67 babies (19.88%) born preterm, 272 babies (80.71%) born EBW, 41 babies (14.24%) born LBW, 13 babies (3.86%) VLBW, 2 babies (0, 59%) ELBW, and 2 babies (0.59%) BBW. Found 76 infants (22.55%) with Apgar score <7 (asphyxia). The incidence of neonatal pneumonia occurred in 47 infants (13.95%), 3 infants (0.89%) requiring invasive ventilation, 56 infants (16.62%) requiring NICU care, 267 infants with length of stay more than 2 days, 14 infants (14.15%) died, 32 infants (9.50%) were infected with COVID-19 and 2 of them died. Conclusion: Perinatal outcome conditions found in mothers with COVID-19 were very diverse. Infants born to mothers with COVID-19 did not significantly affect perinatal outcomes in infants born to mothers with COVID-19. In this study, it was found that there were babies who were confirmed positive for COVID-19 born to mothers with COVID-19. However, this has not been able to prove the existence of vertical transmission because virological examinations have not been carried out on amniotic fluid, placenta, and breast milk.

Kata Kunci : COVID-19, kehamilan, kelahiran, luaran perinatal, pregnancy, birth, perinatal outcome