Fasfas
Fasfas
OLEH:
PARTOGI ANDRES M.
G4A014017
RINDA P. ANGGUNINGTYAS
G4A014018
SILVIA ROSYADA
G4A014019
PENDAHULUAN
Preeklampsia merupakan
salah satu penyebab
morbiditas dan mortalitas
ibu dan bayi yang tertinggi
di Indonesia
TINJAUAN PUSTAKA
Faktor
resiko
Definisi
hipertensi dan
proteinuria yang timbul
setelah 20 minggu
kehamilan yang
sebelumnya normal yang
disebabkan oleh banyak
faktor (Solomon, 2006)
Faktor usia
Paritas
Kehamilan ganda
Faktor genetika
Riwayat preeklamsia
Riwayat hipertensi
kronis
Obesitas
Riwayat pemeriksaan
antenatal
PATOMEKANISME
Terdapat dua hal penting yang memegang peranan
sentral terhadap terjadinya preeklamsi (Wang dan
Alexander, 2000 ; Hladunewich dkk, 2007) :
1. Disfungsi trofoblas plasenta
2. Disfungsi endotel dalam vaskularisasi maternal
PENEGAKAN DIAGNOSIS
Anamnesis
hipertensi dan Adanya
keluhan seperti nyeri
kepala, gangguan
penglihatan, atau nyeri
epigastrium
menunjukkan penyakit
ini sudah lanjut.
Selain itu perlu
ditanyakan apakah
terjadi peningkatan
berat badan. Penderita
juga biasanya dating
dengan keluhan edema
baik local maupun
anasarka
(Cunningham, 2014).
Pemeriksaan
fisik
Keadaan
umum
Vital sign
Status
generalisata
Pemeriksaan
penunjang
Ureum dan
Elektrolit
Asam urat
Darah
Lengkap
Test Fungsi
Hati
Urinalisis
USG
KTG
Penatalaksanaan
Pencegahan
Persalinan
Prognosis
Komplikasi
PEMBAHASAN JURNAL
Abstrak
PENDAHULUAN
KOMPLEKSITAS DIAGNOSIS
Ada suatu kebutuhan yang mendesak untuk
mengembangkan suatu metode yang akurat dalam
mendiagnosis wanita yang datang dengan dugaan
preeklamsia
Rana et al 2014 meringkas cara prediksi dan diagnosis
dalam editorial terbaru : Hipertensi diklasifikasikan
sebagai tekanan darah minimal 140/90 mm Hg dan
penting dalam diagnosis pre-eklampsia
Ketidakakuratan
1. Pengukuran tekanan darah
2. Pengukuran proteinuria dipstik dan secara
kuantitas
PENGOLAAN
1. Tekanan darah
2. MgSO4
PERSALINAN
Rekomendasi persalinan NICE : manajemen
konservatif di bawah usia kehamilan 34
minggu
KESIMPULAN
Penanda angiogenik, terutama PlGF memiliki
potensi yang cukup untuk memprediksi dan
diagnosis preeklampsia
Kontrol tekanan darah yang lebih ketat
Risiko / manfaat dari persalinan elektif yang
lebih awal sedang diselidiki
Magnesium sulfat melindungi bayi prematur dari
gangguan neurologi dan penggunaan dalam
prematur preeklampsia dibenarkan
DAFTAR PUSTAKA
Acuin, Cecilia S. Khor, Geok L. Liabsuetrakul, Tippawan. Maternal, Neonatal, and child health in Southeast Asia: Towards
Greater Regional Collaboration. Lancet 2011: 377; 516-25.
Altman, D., Carroli, G., Duley, L., Farrell, B., Moodley, J., Neilson, J., Smith, D. 2002. Do women with pre-eclampsia, and
their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 359:187790.
American College of Obstetricians and Gynecologists. 2013. Task Force on Hypertension in Pregnancy: Hypertension in
pregnancy. Report of the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy.
Obstet Gynecol. 122:1122-31.
Angsar, D. 2003. Hipertensi dalam kehamilan. Edisi II. Surabaya: Lab/SMF Obstetri Ginekologi, Fakultas kedokteran
UNAIR/RSUD Dr Soetomo.
Campbell S, Diaz-Recasens J, Griffin DR, Cohen-Overbeek TE, Pearce JM, Willson K, Teague MJ: New doppler technique
for assessing uteroplacental blood flow. Lancet 1983, 1:675-7.
Chappell, L.C., Duckworth, S., Seed, P.T., Griffin, M., Myers, J., Mackillop, L., Simpson, N.,Waugh, J., Anumba, D., Kenny,
L.C., Redman., Christopher, W.G., Shennan, A.H. 2013. Diagnostic accuracy of placental growth factor in women with
suspected pre-eclampsia: a prospective multicenter study. Circulation. 128:2121-31.
Coskun, A. Ozdemir, O. 2008, To Evaluate the Role of Lipid Profile in the Etiopathogenesis of Mild and Severe
Preeclampsia. Perinatal Journal. Vol 16, issue 3 December 2008: 12-15.
Cunningham, F. Garry, Kenneth J Levano, Steven L Bloom, CatherineY Spong, Jodi S Dashe, Barbara Left Hoffman,
Brian M Casey, Jeanne S Sheffield. 2014. Williams Obstetric Ed 24. McGraww-Hill Education
Cunningham, F. Leveno, J. K. Bloom, S.L. Hauth, J. Gilstrap, L. Wenstrom, K.D. 2005. Hypertensive disorders in
pregnancy. In : Rouse, D. Rainey, B. Spong, C. Wendel, G. editors. Williams Obstetrics. 22nd . Ed. New York : McGraw Hill.
p.761-809.
Cunningham, FG, Gant, NF, Laveno, Gilstrap, LC, Hauth, JC, and Wenstrom, Kd.2007. William
McGraw-Hill Companies, NewYork.
Dekker, G.A., dan Sucharoen, N. 2004.Etiology of Preeclampsia: An Update.J Med AssocThai, 87(Suppl 3): S96-103.
Douglas KA, Redman CW: Eclampsia in the United Kingdom. BMJ 1994, 309:1395-400.
Doyle, L.W., Crowther, C.A., Middleton, P., Marret, S., Rouse, D. 2009. Magnesium sulphate for
women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst Rev.
CD004661.
Durnwald, C., Mercer, B. 2003. A prospective comparison of total protein/creatinine ratio
versus 24-hour urine protein in women with suspected pre-eclampsia. Am J Obstet Gynecol.
189:848-52.
Harrington K, Goldfrad C, Carpenter RG, Campbell S: Transvaginal uterine and umbilical
artery
Doppler examination of 12-16 weeks and the subsequent development of preeclampsia and intrau-terine growth retardation. Ultrasound Obstet Gynecol 1997, 9:94-100.
Hladunewich, M. Karumanchi. S.A. Lafayette, R. 2007. Pathophysiology of the clinical
manifestations of preeclampsia. Clinical Journal American Nephroogyl 2: 543-549.
Hurt, K. Joseph. 2011. The Johns Hopkins Manual of Gynecology and Obstetrics.
Philadelphia : Lippincott Williams & Wilkins
Kaplan, Norman M. 2006. Kaplans Clinical Hypertension. Edisi ke-9.. Hal. 734.
Karahasanovic A, Srensen S, Nilas L: First trimester pregnancy-associated plasma protein A
and human chorionic gonado-tropin-beta in early and late pre-eclampsia. Clin Chem Lab Med
.2014, 52:521-5.
Kumasawa K, Ikawa M, Kidoya H, Hasuwa H, Saito-Fujita T, Morioka Y, Takakura N, Kimura
T, Okabe M: Pravastatin induces placental growth factor (PGF) and ameliorates pre-eclampsia
in a mouse model. Proc Natl Acad Sci USA 2011, 108:1451
Lindheimer, M.D., Kanter, D.2010. Interpreting abnormal proteinuria in pregnancy: the need
for a more pathophysiological approach. Obstet Gynecol. 115:365-75.
Manuaba, I.B.G. 2010 .Ilmu Kebidanan, Penyakit Kandungan, dan KB untukPendidikan
Bidan.EGC, Jakarta.
Meiri H, Sammar M, Herzog A, Grimpel Y, Fihaman G, Cohen A, Kivity V, Sharabi-Nov A,
Gonen R:
Prediction of pre-eclampsia by placental protein 13 and background risk factors
and its prevention by aspirin. J Perinat Med 2014.
Morris, R.K., Riley, R.D., Doug, M., Deeks, J.J., Kilby, M.D. 2012. Diagnostic accuracy of spot urinary
protein and albumin to creatinine ratios for detection of significant proteinuria or adverse pregnancy
outcome in patients with suspected pre-eclampsia: systematic review and meta-analysis. BMJ.
345:e4342.
Myatt L, Clifton RG, Roberts JM, Spong CY, Wapner RJ, Thorp JM, Mercer BM, Peaceman AM,
Ramin SM, Carpenter MW, Sciscione A, Tolosa JE, Saade G, Sorokin Y, Anderson GD: Can changes
in angiogenic biomarkers between the first and second trimesters of pregnancy predict development
of pre-eclampsia in a low-risk nulliparous patient population? BJOG 2013,
120:1183-91.
Myers JE, Kenny LC, McCowan LME, Chan EHY, Dekker GA, Poston L, Simpson, NAB, North RA:
Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in
nulliparous women: a predictive test accuracy study. BJOG 2013, 120:1215-23.
NICE. 2012. CG107 Hypertension in pregnancy: NICE guideline.
Norwitz Errol R and John O Schorge. 2013. Obstetric and Gynecology at Glance Ed. 4th. John Willey
and Sons.Ltd
Norwitz, E.R. 2007.Oxford American Handbook of Obstetrics And Gynecology.Oxford University Press
: Oxford
Odibo AO, Patel KR, Spitalnik A, Odibo L, Huettner P: Placental pathology, first-trimester
biomarkers and adverse pregnancy outcomes. J Perinatol 2014, 34:186-91.
Papageorghiou AT, Yu , Christina KH, Nicolaides KH: The role of uterine artery Doppler in
predicting adverse pregnancy outcome. Best Pract Res Clin Obstet Gynaecol 2004, 18:383-96.
Papageorghiou, A T. 2008. Editorial; Predicting and preventing preeclampsia where to next?.
Ultrasound Obstet Gynecol; 31: 367370
Prawirohardjo S. 2014. Pre-eklampsia dan Eklampsia, dalam Ilmu Kebidanan.Jakarta : Yayasan
Bina Pustaka Sarwono Prawirohardjo.
Rana, S., Karumanchi, S.A., Lindheimer, M.D. 2014. Angiogenic factors in diagnosis, management,
and research in pre-eclampsia. Hypertension. 63:198-202.
Rana, S., Powe, C.E., Salahuddin, S., Verlohren, S., Perschel, F.H., Levine, R.J., Lim, K., Wenger, J.B., Thadhani, R.,
Karumanchi, S.A. 2012. Angiogenic factors and the risk of adverse outcomes in women with suspected pre-eclampsia.
Circulation. 125:911-9.
Roberge S, Villa P, Nicolaides K, Gigure Y, Vainio M, Bakthi A, Ebrashy A, Bujold E: Early
administration of low-dose
aspirin for the prevention of preterm and term pre-eclampsia: a systema-tic review and meta-analysis. Fetal Diagn Ther
2012, 31:141-6.
Rozikhan. 2007.Faktor-faktor Risiko Terjadinya Preeklamsia Berat di Rumah Sakit Dr.H.Soewondo Kendal. Universitas
Diponogoro. Semarang.
Schneuer FJ, Roberts CL, Ashton AW, Guilbert C, Tasevski V, Morris JM, Nassar N: Angiopoietin 1 and 2 serum concentrations in first trimester of pregnancy as biomarkers of adverse pregnancy outcomes. Am J Obstet Gynecol 2014, 210:345.e19.
Sharma, S. Norris, W. Kalkunte, S. 2010. Beyond the threshold: an etiological bridge between hupoxia and immunity in
preeclampsia. Journal Reproduction Immunology. Vol 1914: 1-5.
Shennan AH, Redman C, Cooper C, Milne F: Are most maternal deaths from pre-eclampsia avoidable? Lancet 2012,
379:1686-7.
Sibai, Baha M, 2005. Diagnosis, Prevention and Management of Eclampsia. The American College of Obstetricians and
Gynecologists. Feb; 105(2): 401-403.
Siljee JE, Wortelboer EJ, Koster, Maria PH, Imholz S, Rodenburg W, Visser, Gerard HA, Vries A de,
Schielen, Peter CJI,
Pennings, Jeroen LA: Identification of interleukin-1 beta, but no other inflamma-tory proteins, as an early onset preeclampsia biomarker in first trimester serum by bead-based multiplexed immunoas-says. Prenat Diagn 2013, 33:1183-8.
Sing, HJ. 2009, Pre-Eclampsia : Is It All in The Placenta?. Malaysian Journal of Medical Sciences, Vol 16, No. 1: 7-15.
Solomon, Caren G. Seely, Ellen W. 2006. Hypertension in Pregnancy. Endocrinol Metab Clin N Am 35. 157-171.
The World Health Report 2005: Make every mother and child count. World Health Organization (WHO); 2005
Velauthar L, Plana MN, Kalidindi M, Zamora J, Thilaganathan B, Illanes SE, Khan KS, Aquilina J,
Thangaratinam S:
First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta- analysis involving 55,974 women.
Ultrasound Obstet Gynecol 2014, 43:500-7.
Verdonk, K., Niemeijer, I., Hop, W., Rijke, Y, de., Steegers, E., van den Meiracker., Ah,, Visser, W. 2014. Variation of urinary
protein to creatinine ratio during the day in women with suspected pre-eclampsia. BJOG. 121:1660-5.
Villar, J., Repke, J., Markush, L., Calvert, W., Rhoads, G. 1989. The measuring of blood pressure during pregnancy. Am J
Obstet Gynecol. 161:1019-24.
Villar, J., Say, L., Shennan, A., Lindheimer, M., Duley, L., Conde-Agudelo, A., Merialdi, M. 2004. Methodological and
technical issues related to the diagnosis, screening, prevention, and treatment of preeclampsia and eclampsia. Int J Gynaecol
Obstet. 85(Suppl 1): S28-41.
Wang, Y. Alexander J.S. 2000. Placental pathophysiology in preeclampsia. Pathophysiology 6 : 261-270.