Ilmu Biomedis Komprehensif IV

PATOLOGI KEHAMILAN II

Program Studi Fisioterapi FIK UMS

Tiara Fatmarizka, S.Fis, M.Sc
Outlines
1. Emesis
2. Hyperemesis Gravidarum
3. Pre-eclampsia
4. Eclampsia
5. Kehamilan Ektopik
6. Kehamilan Trofoblast
7. Kehamilan anggur (mola hidatidosa)
8. Kehamilan kosong (Blighted ovum)
9. Placenta Previa
10. Abortus
11. Infeksi pada kehamilan
12. Gestational diabetes melitus

Program Studi Fisioterapi FIK UMS

Pre-eclampsia and Eclampsia

Program Studi Fisioterapi FIK UMS

Pre-eclampsia

Program Studi Fisioterapi FIK UMS https://www.figo.org/figo-releases-new-guidelines-combat-pre-eclampsia

Pre-eclampsia

Affect as many as 10% of all pregnancies worldwide are responsible for approximately 10% of all maternal deaths in the US

Program Studi Fisioterapi FIK UMS https://www.figo.org/figo-releases-new-guidelines-combat-pre-eclampsia

Pre-eclampsia

Program Studi Fisioterapi FIK UMS https://www.figo.org/figo-releases-new-guidelines-combat-pre-eclampsia

Pre-eclampsia

Program Studi Fisioterapi FIK UMS https://www.figo.org/figo-releases-new-guidelines-combat-pre-eclampsia

Pre-eclampsia

Program Studi Fisioterapi FIK UMS https://www.figo.org/figo-releases-new-guidelines-combat-pre-eclampsia

Pre-eclampsia
(PE) is a multisystem disorder that typically affects 2%–5% of pregnant women and is one of the leading
causes of maternal and perinatal morbidity and mortality, especially when the condition is of early onset.
Globally, 76 000 women and 500 000 babies die each year from this disorder. Furthermore, women in low-
resource countries are at a higher risk of developing PE compared with those in high-resource countries.

PE has been previously defined as the onset of hypertension accompanied by significant proteinuria after
20 weeks of gestation.

PE is defined as systolic blood pressure at ≥140 mm Hg and/or diastolic blood pressure at ≥90 mm Hg
on at least two occasions measured 4 hours apart in previously normotensive women and is accompanied
by one or more of the following new-onset conditions at or after 20 weeks of gestation.

Program Studi Fisioterapi FIK UMS DOI: 10.1002/ijgo.12802

Risk Factors of Pre-eclampsia
Advanced maternal age; These risks include progression to eclampsia, development

Nulliparity; of placental abruption and HELLP (hemolysis, elevated liver

enzyme, low platelet) syndrome
Previous history of PE;
Short and long interpregnancy interval; Advanced maternal age, defined as age greater than or
Use of assisted reproductive technologies; equal to 35 years at the time of delivery, is associated with

Family history of PE; 1.2 to 3-fold increased risk of developing PE

Obesity;
Afro-Caribbean and South Asian racial origin;
Co-morbid medical conditions including hyperglycemia in pregnancy;
Pre-existing chronic hypertension;
Renal disease;
Autoimmune diseases, such as systemic lupus erythematosus and antiphospholipid syndrome
Program Studi Fisioterapi FIK UMS DOI: 10.1002/ijgo.12802
Sign and Symptoms of Pre-eclampsia

Program Studi Fisioterapi FIK UMS DOI: 10.1002/ijgo.12802

Mechanism of PE

Program Studi Fisioterapi FIK UMS DOI: 10.1002/ijgo.12802

Subclassification of PE
1. Early-onset PE (with delivery at <34+0 weeks of gestation);
2. Preterm PE (with delivery at <37+0 weeks of gestation);
3. Late-onset PE (with delivery at ≥34+0 weeks of gestation);
4. Term PE (with delivery at ≥37+0 weeks of gestation).

Women who have experienced PE may also face additional health problems in later life, as the condition is
associated with an increased risk of death from future cardiovascular disease, hypertension, stroke,
renal impairment, metabolic syndrome, and diabetes.

There is also significant impact on the infants in the long term, such as increased risks of insulin
resistance, diabetes mellitus, coronary artery disease, and hypertension in infants born to pre-
eclamptic women.

Program Studi Fisioterapi FIK UMS DOI: 10.1002/ijgo.12802

Complications

Program Studi Fisioterapi FIK UMS

Pre-eclampsia

Program Studi Fisioterapi FIK UMS

Pre-eclampsia

Program Studi Fisioterapi FIK UMS

International Federation of Gynecology and Obstetrics (FIGO) recommendation

• Public health focus

• Universal screening
• Contingent screening
• Prophylactic measures

Program Studi Fisioterapi FIK UMS

Eclampsia

Program Studi Fisioterapi FIK UMS

Eclampsia
• Eclampsia represents the consequence of brain injuries caused by pre-eclampsia.

• Pre-eclampsia with the abrupt development of seizures or coma during the gestational
period or post-partum, non-attributable to other neurologic diseases that can justify the
convulsive state (namely epilepsy or cerebral stroke).

• Eclampsia is the rarest [23] and most severe [24] of all the hypertensive disorders of
pregnancy, with a high maternal and fetal mortality

• The prevalence of eclampsia globally is reported to be 0.3% (WHO)

• Women under 20 years of age, women with low levels of education, and women in their
first pregnancy are all reported to be at higher risk

Program Studi Fisioterapi FIK UMS

Rates of Eclampsia

Program Studi Fisioterapi FIK UMS https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440614/

Characteristic of eclampsia

Program Studi Fisioterapi FIK UMS https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440614/

Terima kasih
tiarafatmarizka@gmail.com

Program Studi Fisioterapi FIK UMS