Hubungan Asupan Cairan Ibu Hamil terhadap Indeks Cairan Amnion

ENI FATMAWATI, dr. Diah Rumekti Hadiati, M.Sc., Sp.OG(K)

2016 | Tesis-Spesialis | SP Ilmu Kebidanan dan Penyakit Kandungan

HUBUNGAN ASUPAN CAIRAN IBU HAMIL TERHADAP INDEKS CAIRAN AMNION Eni Fatmawati, Diah Rumekti Hadiati, Heru Pradjatmo Departemen Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada RSUP Dr Sardjito Yogyakarta ABSTRAK Latar belakang: Volume cairan amnion yang reguler adalah syarat untuk perkembangan janin intra uteri dan keluaran kehamilan / neonatus yang baik. Kecukupan asupan cairan ibu hamil dapat meningkatkan indeks cairan amnion baik pada oligohidramnion maupun normoamnion, tetapi dasar ilmiah bagi kecukupan harian cairan yang dianjurkan belum jelas. Pentingnya konseling asupan cairan selain asupan nutrisi kepada ibu hamil. Tujuan: Memperoleh gambaran asupan cairan pada ibu hamil dan mengetahui perbedaan rerata indeks cairan amnion pada asupan cairan cukup dibandingkan asupan cairan kurang. Metode penelitian: Penelitian ini menggunakan studi observasional kohort prospektif, dilakukan pada ibu hamil trimester tiga di Puskesmas Mergangsan dan Tegalrejo Yogyakarta pada bulan Juli s.d September 2014. Subyek penelitian yang memenuhi kriteria inklusi dibagi dalam kelompok asupan cairan cukup dan kurang. Hubungan antara asupan cairan dan indeks cairan amnion dianalisis dengan t test dan regresi linear. Hasil penelitian: Subyek penelitian yang memenuhi kriteria sebanyak 27 orang terdiri dari 12 orang kelompok asupan cairan cukup dan 15 orang asupan cairan kurang. Nilai rerata asupan cairan subyek 2078 ml (cukup), nilai rerata AFI 12,76 cm (normoamnion). Didapatkan perbedaan bermakna secara statistik rerata AFI kelompok asupan cairan cukup dibandingkan asupan cairan kurang sebesar 3,50 cm (IK 95%; 1,5-5,48); P < 0,05. Test regresi linear sederhana menunjukkan pengaruh asupan cairan terhadap AFI sebesar 31,7%; dengan perkiraan besarnya AFI = 7,710 + 3,493 x asupan cairan (ARS = 31,7%). Test regresi linear ganda, pengaruh asupan cairan terhadap AFI sebasar 44,5% dengan perkiraan besarnya AFI = 10,686 + 3,545 x asupan cairan - 1,015 x umur - 1,317 x pendidikan + 0,314 x pekerjaan (ARS = 44,5%). Variabel luar (umur, pendidikan, dan pekerjaan) tidak mempunyai pengaruh bermakna terhadap AFI. Kesimpulan: Gambaran rerata asupan cairan ibu hamil trimester tiga di Yogyakarta adalah cukup dan didapatkan perbedaan bermakna AFI ibu hamil asupan cairan cukup dibanding asupan cairan kurang. Kata kunci: Asupan cairan, indeks cairan amnion, AFI

THE RELATIONSHIP BETWEEN PREGNANT WOMAN FLUID INTAKE AND AMNIOTIC FLUID INDEX Eni Fatmawati, Diah Rumekti Hadiati, Heru Pradjatmo Abstract Background: The regular amniotic fluid volume is an essensial requisite for intrauterine development and a good neonatal / pregnancy outcome. The adequate pregnant woman fluid intake increased the amniotic fluid index both in pregnancies with oligohydramnios and in those with a normal amniotic fluid index, but the basic science for adequacy fluid intake recommendation was unclear. It was essential to counseling fluid intake besides nutrients intake to pregnant woman. Objective: Known pregnant woman fluid intake and the difference of mean amniotic fluid index between adequate fluid intake and inadequate fluid intake. Methods: Prospective observational cohort study, the subject was third trimester pregnant woman in Mergangsan and Tegalrejo Public health, periode July - September 2014. The subjects devided two groups, adequate fluid intake and inadequate fluid intake. The relationship between fluid intake and amniotic fluid index analysed with t test and linear regression analysis. Results: There were 27 subjects meet inclusion criterias , 12 subjects with adequate fluid intake and 15 subjects inadequate fluid intake. Mean fluid intake was 2078 ml (adequate fluid intake), mean amniotic fluid index was 12,76 cm (normoamnion). The difference of amniotic fluid index between two groups was statistically significant, 3,5 cm (95% CI; 1,5 - 5,48); P < 0,05. Simple linear regression analysis was used to quantify relationship fluid intake with AFI, that was 31,7%; with predictive value of AFI = 7,710 + 3,493 x fluid intake (ARS = 31,7%). Multivariate linear regression analysed relationship fluid intake and other variables with AFI, 44,5%; with predictive value of AFI = 10,686 + 3,545 x fluid intake - 1,015 x age - 1,317 x education + 0,314 x occupation (ARS = 44,5%). Confounding variable (age, education, and occupation) have no statistically significant relationship with AFI. Conclusion: The pregnant woman fluid intake in third trimester in Yogyakarta was adequate, and there was significant difference of mean amniotic fluid index between adequate pregnant woman fluid intake with inadequate fluid intake. Key words: Fluid intake, amniotic fluid index, AFI

Kata Kunci : Kata kunci: Asupan cairan, indeks cairan amnion, AFI