Persalinan Prematur pada Pasien dengan Riwayat Keguguran Berulang yang Belum Teridentifikasi Faktor Penyebabnya: Laporan Kasus

Ilonna Putri Pertiwi, Anita Rachmawati


Abstract


Pendahuluan: Persalinan prematur dikaitkan dengan beberapa faktor, antara lain faktor kehamilan, gaya hidup dan perilaku, genetik, dan riwayat obstetrik, termasuk riwayat keguguran berulang. Pada pasien dengan riwayat keguguran berulang investigasi faktor penyebab penting dilakukan sebelum merencanakan kehamilan lagi. Dalam sebuah tinjauan sistematis dan meta-analisis riwayat keguguran berulang secara keseluruhan meningkatkan risiko persalinan prematur sebesar 1,6 kali lipat. Laporan kasus ini akan membahas persalinan prematur pada pasien dengan riwayat keguguran berulang yang belum diketahui faktor penyebabnya.
Presentasi kasus: Pasien berusia 32 tahun, G4P1A2 hamil 30 – 31 minggu, datang dengan gejala dan tanda persalinan. Kehamilan pertama cukup bulan dan bersalin normal. Pasien memiliki riwayat dua kali keguguran secara berturut-turut pada kehamilan kedua (usia gestasi 7 minggu) dan ketiga (usia gestasi 10 minggu), tanpa riwayat diabetes melitus ataupun penyakit kronik lain. Pasien tidak mengonsumsi alkohol/obat-obatan tertentu dan tidak merokok. Suami pasien juga bukan seorang perokok. Penyebab keguguran berulang belum dapat diidentifikasi karena pemeriksaan belum dilakukan secara terarah, sehingga tata laksana untuk mencegah risiko persalinan prematur pada kasus ini belum optimal.
Kesimpulan: Pada kasus ini risiko persalinan prematur mungkin terkait dengan riwayat keguguran berulang, sehingga investigasi penyebab keguguran berulang harus dilakukan agar dapat diberikan tata laksana medis yang sesuai untuk mencegah keguguran berulang dan persalinan prematur.

Preterm Birth In Patient With History Of Unexplained Recurrent Pregnancy Loss: A Case Report

Abstract
Introduction: Premature birth is associated with several factors, including pregnancy factors, lifestyle and behavior, genetics, and obstetric history, including a history of recurrent miscarriage. In patients with a history of recurrent miscarriage, investigation of risk factor is important before planning another pregnancy. In systematic review and meta-analysis a history of recurrent miscarriage increased the risk of preterm birth by 1.6-fold. This case report will discuss premature labor in a patient with a history of recurrent miscarriage whose cause is unknown.
Case Presentation: 32 year old patient, G4P1A2 30 – 31 weeks pregnant, presented with symptoms and signs of labor. The first pregnancy was full term and normal. The patient had a history of two consecutive miscarriages in the second (7 weeks' gestation) and third (10 weeks' gestation) pregnancies, without a history of diabetes melitus or other chronic diseases. The patient does not consume alcohol/certain drugs and does not smoke. The patient's husband is also not a smoker. The cause of recurrent miscarriage cannot be identified because examinations have not been carried out in a targeted manner, management to prevent the risk of preterm labor in this case is not optimal.
Conclusion: In this case risk of preterm labor may be related to history of recurrent miscarriage, an investigation into the cause of recurrent miscarriage must be carried out, and the appropriate medical treatment can be given to prevent recurrent miscarriage and premature labor.

Key words: Recurrent miscarriage, premature labor, management


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DOI: http://dx.doi.org/10.24198/obgynia.v7i1.642

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