Prepregnancy and early pregnancy calcium

supplementation among women at high risk of pre-

eclampsia: a multicentre, double-blind, randomised,
placebo-controlled trial
(Journal Reading)

Perceptor:
Dr. Trestyawati, Sp.OG

Oleh:
Vermitia
1818012009

SMF OBSTETRI DAN GINEKOLOGI

RUMAH SAKIT UMUM JENDRAL A. YANI
METRO
2019
 Kriteria inklusi dan eksklusi

Inklusi Eksklusi Total sampel: 1355 sampel

Grup kalsium: 678
● Wanita yang ● Usia <18 tahun Grup plasebo: 677
kehamilan terakhirnya
dipersulit oleh ● Sedang hamil
preeklampsia atau
eklampsia
● Mengonsumsi
suplemen kalsium
● Wanita yang
berencana untuk ● Memiliki hipertensi
hamil kronis dengan
proteinuria persisten
Alur Penelitian
Populasi yang memenuhi kriteria inklusi dan eksklusi

Sampel sebanyak 1355 wanita.

Sampel dibagi menjadi dua kelompok secara acak

Keterangan:
Sebelum hamil – usia
kehamilan 20 minggu
Grup Kalsium
Grup
Pemberian satu tablet kunyah 500 Plasebo Usia kehamilan 20 minggu
mg (kalsium karbonat) - melahirkan

Suplementasi
kalsium 1,5 g/hari
Hasil
Penelitian
Karakteristik sampel penelitian
Telaah Kritis
 Telaah kritis secara EBM
•Hipertensi pada kehamilan masih menjadi penyebab langsung angka kematian

Problem ibu
•Rendahnya konsumsi kalsium diduga menjadi penyebab tingginya prevalensi
preeklampsia dan eklampsia dia negara berpenghasilan rendah

Intervention •Pemberian 500 mg kalsium atau plasebo sejak sebelum hamil sampai usia
kehamilan 20 minggu

Comparison •Menguji bagaimana dampak suplementasi kalsium saat sebelum kehamilan dan
awal kehamilan (<20 minggu) pada wanita dengan risiko tinggi preeklampsia

•Suplementasi kalsium yang dimulai sebelum kehamilan sampai usia kehamilan

Outcome 20 minggu, jika dibandingkan dengan plasebo, tidak menunjukkan penurunan
yang signifikan dalam angka kejadian preeklampsia
 Telaah kritis secara khusus

1 Validity

2 Important

3 Applicability
Validity
Apakah tinjauan ini valid? (Ya)
Persetujuan etik diperoleh dari lembaga peninjau etik nasional dan institusional yang berlaku sesuai dengan setiap
lokasi penelitian.

Desain Tempat
A multicentre, parallel arm, double Beberapa rumah sakit di Afrika
blind, randomised, placebo- Selatan, Zimbabwe, dan Argentina
controlled trial

Waktu Kriteria
12 Juli 2011 – 31 Oktober 2017 Inklusi dan eksklusi
 Pertanyaan validitas telaah kritis

Apakah dilakukan randomisasi dan Apakah metode analisis statistik

apakah daftar randomisasi disegel? yang digunakan dijabarkan dengan
jelas?
Ya

Apakah pemantauan subjek Apakah variabel prediktor dan

penelitian cukup lama dan lengkap? outcome dievaluasi secara
keseluruhan?
Ya

Apakah seluruh subjek yang ikut

penelitian dihitung dalam kesimpulan
akhir sesuai dengan alokasi awalnya?
Importancy
Apakah tinjauan ini penting? (Ya)
 Sebagian besar kematian ibu yang
disebabkan oleh hipertensi dalam
kehamilan terjadi di negara
berpenghasilan rendah yang
diduga berhubungan dengan
kurangnya konsumsi kalsium.

Importancy
Penelitian ini akan meninjau
Preeklampsia dan apakah suplementasi kalsium
eklampsia merupakan salah sejak sebelum hamil sampai
satu penyebab tertinggi dengan awal kehamilan dapat
morbiditas dan mortalitas mencegah terjadinya
ibu bersalin. preeklampsia pada ibu hamil
yang berisiko tinggi
Applicability
Apakah hasil dari tinjauan ini dapat diaplikasikan?
(tidak)
Kesimpulan
Suplementasi kalsium yang diberikan sejak sebelum
hamil hingga usia kehamilan 20 minggu tidak
menunjukkan hasil signifikan dalam menurunkan
preeklampsia
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