Adolescence Eclampsia and Maternal Mortality within Sociocultural Problem in Indonesia: A Case Report
Abstract
Introduction: Preeclampsia and eclampsia in adolescent pregnancy is closely related, especially in low-middle income countries. It becomes a public health issue not only in the present but also in the future due to potential complications and as a reflection of the social conditions of a country. This case aims to highlight adolescence eclampsia and current sociocultural and economic problem in Indonesia.
Case Report: A 15-year-old, 9-months primigravida (G1P0A0), was referred to our center due to eclamptic seizure. Blood pressure was 160/110 mmHg and cervical dilation is 4 cm with adequate pelvic diameter. After 4 hours, cervical dilation progressed to 6 cm but followed by infrequent fetal heartbeat and CTG reveals category III with late deceleration. Emergency C-section was performed and patient admitted to ICU for 5 days afterwards. However, she was deteriorated and passed away.
Conclusion: In addition to physiological immaturity, adolescence pregnancies often face sociocultural problems that lead to higher rates of hypertensive disorders of pregnancy in this population. Early recognition and knowledge of risk factors for preeclampsia are essential for good management, and a faster referral system will reduce maternal mortality.
Eklamsia pada Remaja dan Kematian Ibu dalam Masalah Sosial Budaya di Indonesia: Sebuah Laporan Kasus
Abstrak
Pendahuluan: Preeklamsia dan eklamsia pada kehamilan remaja sangat erat kaitannya, terutama di negara-negara berpenghasilan menengah ke bawah. Hal ini menjadi masalah kesehatan masyarakat tidak hanya di masa sekarang, tetapi juga di masa depan karena potensi komplikasi dan sebagai cerminan kondisi sosial suatu negara. Laporan kasus ini bertujuan untuk menyoroti eklamsia pada remaja dalam kaitannya dengan masalah sosial budaya dan ekonomi saat ini di Indonesia.
Laporan Kasus: Seorang perempuan berusia 15 tahun, primigravida 9 bulan (G1P0A0), dirujuk ke Rumah Sakit Hasan Sadikin, Bandung karena kejang eklamsia. Tekanan darah 160/110 mmHg dan dilatasi serviks 4cm degan diameter panggul yang memadai. Setelah 4 jam, dilatasi serviks berkembang menjadi 6cm, etapi diikuti oleh detak jantung janin yang jarang dan CTG menunjukkan kategori III dengan deselerasi lambat. Operasi caesar darurat dilakukan dan pasien dirawat di ICU selama 5 hari. Namun, keadaan pasien memburuk dan meninggal dunia.
Kesimpulan: Selain imaturitas fisiologis, kehamilan remaja sering menghadapi masalah sosiokultural yang menyebabkan tingginya angka hipertensi kehamilan pada populasi ini. Pengenalan dini dan pengetahuan tentang faktor risiko preeklamsia sangat penting untuk manajemen yang baik, dan sistem rujukan yang lebih cepat akan mengurangi angka kematian ibu.
Kata kunci: eklampsia, kehamilan remaja, kematian ibu, masalah sosiokultural
Keywords
Full Text:
PDFReferences
Brosens I, Muter J, Ewington L, Puttemans P, Petraglia F, Brosens JJ, et al. Adolescent Preeclampsia: Pathological Drivers and Clinical Prevention. Reprod Sci. 2019 Feb;26(2):159–71.
Macedo TCC, Montagna E, Trevisan CM, Zaia V, de Oliveira R, Barbosa CP, et al. Prevalence of preeclampsia and eclampsia in adolescent pregnancy: A systematic review and meta-analysis of 291,247 adolescents worldwide since 1969. Eur J Obstet Gynecol Reprod Biol. 2020 May;248:177–86.
UNICEF. Roadmap of SDGs Indonesia: A Highlight [Internet]. Ministry of National Development Planning/National Development Planning Agency. 2019 [cited 2024 May 24]. Available from: https://www.unicef.org/indonesia/reports/roadmap-sdgs-indonesia
Rosales-Ortiz S, Sánchez Rodríguez O, Borbolla-Ramos M, D. García-Pérez K. Adolescence and Preeclampsia. In: Prediction of Maternal and Fetal Syndrome of Preeclampsia. IntechOpen; 2019.
de Carvalho RCM, Campos H de H, Bruno ZV, Mota RMS. Predictive factors for pregnancy hypertension in primiparous adolescents: analysis of prenatal care, ABPM and microalbuminuria. Arq Bras Cardiol. 2006 Oct;87(4):487–95.
Chakole S, Akre S, Sharma K, Wasnik P, Wanjari MB. Unwanted Teenage Pregnancy and Its Complications: A Narrative Review. Cureus. 2022 Dec;14(12):e32662.
DPR RI. Undang-Undang Nomor 19 Tahun 2019. 2019.
Mahkamah Agung RI. Himpunan Peraturan Perundang-Undangan yang Berkaitan dengan Kompilasi Hukum Islam dengan Pengertian dalam Pembahasannya. Perpustakaan Nasional RI. Jakarta; 2011.
Bastomi H. PERNIKAHAN DINI DAN DAMPAKNYA (TINJAUAN BATAS UMUR PERKAWINANMENURUT HUKUM ISLAM DAN HUKUM PERKAWINAN INDONESIA). Jurnal Pemikiran Hukum dan Hukum Islam. 2016;7(2).
Utomo B, Sucahya PK, Utami FR. Priorities and realities: addressing the rich-poor gaps in health status and service access in Indonesia. Int J Equity Health. 2011;10(1):47.
Mahendradhata Y, Trisnantoro L, Listyadewi S, Soewondo P, Marthias T, Harimurti P, et al. The Republic of Indonesia health system review. Health Syst Transit [Internet]. 2017 [cited 2024 May 24];7(1). Available from: https://iris.who.int/handle/10665/254716
Nurdiawan W, Koto ARH, Zulvayanti Z, Atik N, Susiarno H, Hidayat D, et al. Comparison of Maternal and Neonatal Outcomes in Teenage and Reproductive Age Pregnancy at Tertiary Hospital in West Java, Indonesia. Open Access Maced J Med Sci. 2021 Oct 8;9(B):1080–4.
Baethmann A, Maier-Hauff K, Schürer L, Lange M, Guggenbichler C, Vogt W, et al. Release of glutamate and of free fatty acids in vasogenic brain edema. J Neurosurg. 1989 Apr;70(4):578–91.
DOI: http://dx.doi.org/10.24198/obgynia.v7i3.697
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.