Adenomiosis Berdampak Buruk terhadap Keberhasilan in Vitro Fertilization

William Alexander Setiawan

doi:10.24198/obgynia.v4i2s.175

Adenomiosis Berdampak Buruk terhadap Keberhasilan in Vitro Fertilization

William Alexander Setiawan

Abstract

Abstrak
Tujuan: Memaparkan etiologi dan faktor risiko, diagnosis banding, patofisiologi, pemantauan, terapi, komplikasi, rekurensi dan tindakan preventif pada kasus preeklamsia pascasalin.
Metode: Tinjauan pustaka dengan berbagai referensi yang diakses melalui mesin pencarian seperti Pubmed dan Sci-Hub dengan menggunakan kata kunci preeclampsia, hypertension, postpartum, management. Sumber referensi yang digunakan yaitu guidelines, jurnal, dan buku teks yang diterbitkan dalam 15 tahun terakhir.
Kesimpulan: Insiden preeklamsia di Indonesia yaitu 128.273/tahun atau sekitar 5,3%. Sebanyak 0,3 – 27,5% kasus yang dilaporkan mengalami preeklamsia atau hipertensi pascasalin. Gejala-gejala preeklamsia pascasalin muncul setelah melahirkan. Mayoritas kasus berkembang dalam 48 jam setelah persalinan, walaupun sindrom dapat muncul hingga 6 minggu setelah persalinan. Periode pascasalin merupakan waktu kritis bagi spesialis obstetri dan ginekologi untuk menjamin wanita dengan riwayat preeklamsia untuk dipantau dalam jangka waktu pendek dan panjang. Akan tetapi, pemantauan pascasalin sangatlah rendah, berkisar antara 20-60%. Pemilihan antihipertensi pasca salin yaitu berikatan kuat dengan protein dan solubilitas lipid yang rendah sehingga lebih sedikit yang masuk ke ASI. Selain itu, dipengaruhi juga oleh ionisasi, berat molekul dan konstituen ASI (kandungan lemak, protein, dan air). Agen lini pertama untuk preeklamsia pascasalin adalah labetalol dan hidralazin intravena serta nifedipin. Wanita dengan hipertensi gestasional ataupun preeklamsia biasanya dapat menghentikan antihipertensi dalam 6 minggu pasca salin.

Postpartum Preeclampsia

Abstract
Objective: To explain about etiologies and risk factors, differential diagnosis, pathophysiology, follow up, treatment, complications, recurrence, and prevention of preeclampsia post delivery discharged.
Method: Literature review with several references accessed through search engines such as Pubmed and Sci-Hub by using keywords preeclampsia, hypertension, postpartum, management. Reference sources used are guidelines, journals, and textbooks published in the last 15 years.
Conclusion: The incidence of preeclampsia in Indonesia is 128,273/year or around 5.3%. As many as 0.3-27.5% of cases reported postpartum preeclampsia or hypertension. Symptoms of postpartum preeclampsia appear after delivery. The majority of cases develop within 48 hours after delivery, although the syndrome can appear up to 6 weeks after delivery. The postpartum period is a critical time for obstetricians and gynecologists to ensure women with a history of preeclampsia are monitored in the short and long term. However, postpartum monitoring is very low, ranging from 20-60%. The choice of antihypertensive postpartum is that it is strongly bound to protein with low lipid solubility so that fewer enter breast milk. In addition, it is also influenced by ionization, molecular weight and constituents of breast milk (fat content, protein, and water). The first line agent for postpartum preeclampsia is intravenous labetolol and hydralazine and also nifedipine. Women with gestational hypertension or preeclampsia can usually stop antihypertension within 6 weeks postpartum.

Key word: postpartum preeclampsia, antihypertension

Keywords

preeklamsia pascasalin, antihipertensi

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References

James D, Steer PJ, Welnder CP, Gonik B, Crowther CA, Robson SC. High risk pregnancy: Management options. St. Louis: ElSevier Saunders, 2011.

Bramham K, Nelson-Piercy C, Brown MJ, Chappell LC. Postpartum management of hypertension. BMJ. 2013;346(7897):1-9.

Ybarra N, Laperouse E. Postpartum preeclampsia. J Obstet Gynecol Neonatal Nurs. 2016;45(3):S20.

Cairns AE, Pealing L, Duffy JMN, et al. Postpartum management of hypertensive disorders of pregnancy : A systematic review. BMJ Open. 2017;7:1−14.

LD Levine, C Nkonde-Price, M Limaye and SS. Factors associated with postpartum follow-up and persistent hypertension among women with severe preeclampsia. J Perinatol. 2016;36(12):1079-1082.

Sibai BM. Etiology and management of postpartum hypertension-preeclampsia. Am J Obstet Gynecol. 2012;206(6):470−5.

Peres GM, Mariana M, and Cairrao E.Pre- eclampsia and eclampsia: An update on the pharmacological treatment applied in Portugal . J. Cardiovasc. Dev. Dis. 2018, 5, 3.

Duhig K, Vandermolen B, Shennan A. Recent advances in the diagnosis and management of pre-eclampsia. F1000Research. 2018;7:242.

American College of Obstetricians and Gynecologists Bulletin. Gestacional hypertension and preeclampsia. Am Coll Obstet Gynecol. 2019;95(76):1−9.

Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene MF. Creasy & Resnik’s Maternal- Fetal Medicine: Principles and Practice, 7th Edition. Philadelphia: ElSevier Saunders, 2014.

James PR, Nelson-Piercy C. Management of hypertension before, during, and after pregnancy. Heart. 2004;90(12):1499−504.

Perkumpulan Obstetri dan Ginekologi. Pedoman Nasional Pelayanan Kedokteran. Diagnosis dan tatalaksana preeklamsia. 2016: 1-48.

Pregnancy HD. Committee opinion emergent therapy for severe hypertension e175. 2019;133(767):174−80.

Wikström AK, Haglund B, Olovsson M, Lindeberg SN. The risk of maternal ischaemic heart disease after gestational hypertensive disease. BJOG An Int J Obstet Gynaecol. 2005;112(11):1486-91.

Ying W, Catov JM, Ouyang P. Hypertensive disorders of pregnancy and future maternal cardiovascular risk. J Am Heart Assoc. 2018;7:e009382.

Suvisaari JM, Taxell-Lassas V, Pankakoski M, Haukka JK, Lonnqvist JK, and Hakkinen LT. Obstetrics complications as risk factors for schizophrenia spectrum psychoses in offspring of mothers with psychotic disorder. Schizophr Bull. 2013;39(5): 1056-66.

Cunningham F. Gary, Kenneth JL, Steven LB, Jodi SD, Barbara LH, Brian MC, et al. Williams obstetrics. 25th edition. New York: McGraw-Hill Education, 2018.

World Health Organization. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. 2011: 1−38.

Viteri OA, Alrais MA, Pedroza C, Hutchinson M, Chauhan SP, Blackwell SC, et al. Torsemide for prevention of persistent postpartum hypertension in women with preeclampsia. Obstet Gynecol 2018;132:1185-91.

Kamravamanesh M, Kohan S, Rezavand N, Farajzadegan Z. A comprehensive postpartum follow-up health care program for women with history of preeclampsia: Protocol for a mixed methods research. Reprod Health. 2018;15:81.

DOI: http://dx.doi.org/10.24198/obgynia.v4i2s.175