TUGAS KELOMPOK

KEGAWATDARURATAN (PRE-EKLAMSI)

Kelas : C7
Disusun Oleh :
Wardah Chumairah 183112540120234
Feni Ramdani 183112540120297
Ai Muhayah 183112540120343
Nadya Namira 183112540120346
Surada Dwi Tiara 183112540120344
Muhimatul 183112540120

FAKULTAS ILMU KESEHATAN PROGRAM STUDI

SARJANA TERAPAN KEBIDANAN JAKARTA
2018/2019
 Format Resume Jurnal I

Judul Jurnal : The performance of pre-delivery serum

concentrations of angiogenic factors in predicting
postpartum antihypertensive drug therapy
following abdominal delivery in severe
preeclampsia and normotensive pregnancy

Latar Belakang : The imbalance between circulating concentrations

of anti- and pro-angiogenic factors is usually
intense in preeclampsia with severe features
(sPE). It is possible that pre-delivery circulating
levels of angiogenic factors in sPE may be
associated with postpartum antihypertensive drug
requirements.

Tujuan : To determine the predictive association between

maternal pre-delivery serum concentrations of
angiogenic factors and the use of ≥3 slow- and/or
a rapid-acting antihypertensive drug therapy in
sPE on postpartum days zero to three following
caesarean delivery.

Metodologi : Women with sPE (n = 50) and normotensive

pregnancies (n = 90) were recruited prior to
childbirth. Serum samples were obtained from
each participant < 48 hours before delivery to
assess the concentrations of placental growth
factor (PIGF) and soluble fms-like tyrosine kinase-
1 (sFlt-1) using the Roche Elecsys platform. Each
participant was followed up on postpartum days
zero, one, two and three to monitor BP and
confirm antihypertensive treatment. The optimal
cut-off thresholds of sFlt-1/PIGF ratio from
receiver operating characteristic curve predictive
of the antihypertensive therapy were subjected to
diagnostic accuracy assessment.

Hasil : The majority 58% (29/50) of sPE had multiple

severe features of preeclampsia in the antenatal
period with the commonest presentation being
severe hypertension in 88% (44/50) of this group,
followed by features of impending eclampsia
which occurred in 42% (21/50). The median
gestational age at delivery was 38 (Interquartile
range, IQR 1) vs 36 (IQR 6) weeks, p < 0.001 in
normotensive and sPE groups respectively.
Notably, the median sFlt-1/PIGF ratio in
normotensive and sPE groups were 7.3 (IQR 17.9)
and 179.1 (IQR 271.2) respectively, p < 0.001. Of
the 50 sPE participants, 34% (17/50) had early-
 onset preeclampsia. The median (IQR) of sFlt-
1/PIGF in the early- and late-onset preeclampsia
groups were 313.52 (502.25), and 166.59(195.37)
respectively, p = 0.006. From postpartum days
zero to three, 48% (24/50) of sPE received ≥ 3
slow- and/or a rapid-acting antihypertensive drug.
However, the daily administration of ≥ 3 slow-
and/or a rapid-acting antihypertensive drug in sPE
were pre-delivery 26% (13/50), postpartum day
zero 18% (9/50), postpartum day one 34% (17/50),
postpartum day two 24% (12/50) and postpartum
day three 20% (10/50). In sPE, the pre-delivery
sFlt-1/PIGF ratio was predictive of administration
of ≥3 slow- and/or a rapid-acting antihypertensive
drug on postpartum days zero, one and two with
the optimal cut-off ratio being ≥315.0, ≥181.5 and ≥
267.8 respectively (sensitivity 72.7–75.0%,
specificity 64.7–78.6%, positive predictive value
40.0–50.0% and negative predictive value 84.6% -
94.3%). The predictive performance of sFlt-1/PIG
ratio on postpartum day 3 among the sPE was not
statistically significant (area under receiver
operating characteristic curve, 0.6; 95% CI, 0.3–
0.8).

Kesimpulan : A pre-delivery sFlt-1/PIGF ratio (< 181.5) is a

promising predictor for excluding the need for ≥3
slow- and/or a rapid-acting antihypertensive drug
therapy in the immediate postpartum period in
sPE.

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 Format Resume Jurnal II

Judul Jurnal : RISK FACTORS RELATED TO EVENTS

PREECLAMPSIA IN PREGNANT WOMEN
(CASE STUDY IN RSUD KABUPATEN BREBES
2014)
Latar Belakang : The incidence of preeclampsia in Brebes District
was increasing from year to year. In 2011 there
were 215 cases
(1,547 births), in 2012 there were 170 cases (1,957
births), in 2013 there were 225 cases (1,811 births)
and until
September 2014 there were 180 cases (2,316
births)
Tujuan : The purpose of this research was to determine the
risk factors
associated with the incidence of preeclampsia in
pregnant women from Brebes district hospital in
2014.
Metodologi : This
research was an analytical survey with case
control approach. The total sample was 145
people for each case and
control group which was taken with simple
random sampling technique
Hasil : The data was analyzed using chi-square
test with α = 0,05. The results of this research
showed that the risk factors associated with the
incidence of
preeclampsia was age (p value = 0,0001; OR =
15,731), gravida status (p value = 0,009; OR =
2,173), heredity
profile (p value = 0,033; OR = 2,618), antenatal
examination (p value = 0,0001; OR = 17,111),
history of
preeclampsia (p value = 0,0001; OR = 20,529),
history of hypertension (p value = 0,0001; OR =
6,026).
Kesimpulan : The
variables that were not related was the type of
work, level of education, history of diabetes
mellitus, and history
of multiple pregnancy.
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Format Resume Jurnal III

Judul Jurnal : Health Behavior Analysis and Risk Factors for

Preeclampsia
In Pregnant Women in the Gynecology Obstetrics
Polyclinic of Kediri District Hospital
Latar Belakang : Preeclampsia is associated with significant
pathological changes in maternal and fetal
blood vessels and placenta.
Tujuan : The purpose of this study is to determine the
health behavior
and risk factors that affect the incidence of
preeclampsia in pregnant women in Obstetric
Gynecology Polyclinic of Kediri Regency Hospital.
Metodologi : The study design used is descriptive
analytic with cross sectional approach. This study
was conducted in June-August 2017
in Obstetric Gynecology Polyclinic of Kediri
Regency Hospital. The population in this
study were all mothers who came to check their
pregnancy in Obstetric Gynecology
Polyclinic of Kediri Regency Hospital with the
number of samples obtained was 181
pregnant women in random sampling.
Hasil : Data were analyzed in univariate, bivariate with
chi square and multivariate test with multiple
logistic regression test. The result of study
showed that there was a correlation between
weight gain (p = 0.005) and medical history
(p = 0.022) to incidence of preeclampsia while
education level, family income, service
range, transportation, nutritional status, ANC
examination, KIA book ownership, mother
age, parity, family history of preeclampsia,
obesity, twin pregnancy, gestational interval
and gestational diabetes, there is an insignificant
relationship. The result of multivariate
analysis showed that the weight gain (p = 0.007)
and medical history (p = 0.029) had a
significant association with the incidence of
preeclampsia in pregnant women.

Kesimpulan : Health behaviors and risk factors that affect the

incidence of preeclampsia in pregnant women
is the increase in maternal weight during
pregnancy and medical history suffered by the
mother before pregnancy.
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