PREEKLAMPSIA

T R I A U TA M I N I N G S I H 0 3 0 . 1 3 . 1 9 3

FK Trisakti Kepaniteraan Klinik

Ilmu Kebidanan dan Penyakit Kandungan
RUMAH SAKIT UMUM DAERAH KOTA BEKASI
2 Okt 2017 – 9 Des 2017
 • kerusakan endotel vaskular
PREEKLAMPSIA vasospasme pada kehamilan
dapat terjadi sampai 4-6
minggu setelah melahirkan.
• Mortalitas dan Morbiditas
didunia : 50.000-60.000

• Amerika: kematian 50-100

wanita preeklampsia
dikarena “near miss"

The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
SIRKULASI
UTERUS
 Nulipara
Usia > 40 Riwayat
tahun Preeklampsia

Hipertensi
SLE Kronis atau
FAKTOR ginjal kronis

RISIKO
DM Trombofilia

Riwayat
keluarga Gemeli
pre
eklampsia In vitro
fertilisasi
Gathiram P, Moodley J. Pre-eclampsia: its pathogenesis and pathophysiology. Africa: CVJ Africa. April 2 2016.
PATOGENESIS

Gathiram P, Moodley J. Pre-eclampsia: its pathogenesis and pathophysiology. Africa: CVJ Africa. April 2 2016.
REMODELLING ARTERI SPIRALIS
 GEJALA KLINIS

1. Sakit kepala yang berat

2. Gangguan penglihatan

3. Nyeri epigastrium

4. Mual dan muntah

5. Sesak napas

6. Bengkak tiba tiba pada Gejala Klinis

wajah, tangan dan kaki

The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
KLASIFIKASI DAN DIAGNOSIS
Hipertensi Hipertensi
kronis Gestasional

Hipertensi sebelum Disebabkan oleh

kehamian kehamilan

Kehamilan < 20 TD ≥ 140/90 mmHg

minggu

TD ≥ 140/90 mmHg Setelah kehamilan >

20 minggu

Berat TD ≥ 160/110
mmHg Berat TD ≥ 160/110
mmHg
NICE. Pre-eclampsia. UK: June 8 2017.
WITHOUT SEVERE FEATURES
The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
WITH SEVERE FEATURES
The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
 ATYPICAL
PREEKLAMPSIA

Hipertensi Proteinuria Edema

1/3 wanita
Edema
eklampsia

SAAT INI

Hipertensi Proteinuria

ATAU
Proteinuria Hipertensi
Sibai BM, Stella CL. Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol. 2009;200:481–3.
 Trimester I

Deteksi kadar PIGF dan sfLT-1

Terjadi ketidak seimbangan

PREEKLAMPSIA

DETEKSI DINI
NICE. Pre-eclampsia. UK: June 8 2017
PENATALAKSANAAN
American College of Obsteritician and Gynecologist. Committee opinion No. 623. Obstet Gynecol 2015;125:521-5
The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
 WITH SEVERE
FEATURES

The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
 INDIKASI PERSALINAN
IBU JANIN
Hipertensi berulang Usia kehamilan 34 minggu
Tanda bahaya IUGR
Gangguan pada ginjal Oligihidramnion
HELLP syndrome Reversed on diastolic flow
Edema pulmonal
Eklampsia
Abrupsio plasenta
Tanda persalinan dan
pecah ketuban
The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013.
KOMPLIKASI
Eklampsia

HELLP Syndrome

Stroke

Oedem pulmo

Gangguan pada ginjal dan hati

Gangguan pembekuan darah

Bayi: IUGR, distress respiratory, IUFD

NHS Choice. Preeclampsia. NHS Choice. United Kingdom: 2 June 2015.
PENCEGAHAN
1. Agen antiplatelet
2. Calcium
3. Obat antihipertensi
4. MgSO4 sebagai anti kejang
5. Diet rendah garam
6. Modifikasi gaya hidup

The American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. America: 2013 .