Alcohol Abuse in Pregnancy (Case Report)

Putri Rahmani, M. Ikhsan Arfiantama, Ahmad Sofyan Lubis, Luthfi Rahman


Abstract


Introduction: Alcohol abuse is an uncommon but significant health issue among pregnant women in Indonesia. Even minimal alcohol consumption can cause substantial harm to both individuals and society. However, there are currently no national service standards for screening, recording, or counseling regarding alcohol use during pregnancy in Indonesia.
Case Report: A 25-year-old woman, gravida 2 para 1 abortus 0 (G2P1A0), at 20-21 weeks of gestation, presented to the emergency room with decreased consciousness after consuming alcohol suspected to contain ethanol. Clinical assessment and laboratory tests indicated that the patient was suffering from metabolic encephalopathy and severe metabolic acidosis. The patient was promptly intubated and resuscitated. Despite receiving intensive care in the ICU, the patient experienced seizures and intrauterine fetal demise (IUFD), followed by spontaneous labor the next day. Unfortunately, the patient’s condition continued to deteriorate, and she succumbed to multi-organ failure due to high blood alcohol concentration on the ninth day of treatment.
Conclusion: From the case we can conclude that alcohol use during pregnancy is closely linked to the patient’s psychological condition. To optimize patient care, obstetricians and gynecologists are encouraged to employ routine screening techniques, clinical laboratory tests, brief interventions, and appropriate treatment referrals, one of them is ASSIST by WHO. Unfortunately, many pregnant women in Indonesia lack access to specialist care. Therefore, it is crucial to disseminate information about the health risks associated with alcohol consumption and abortion within informal community sectors to effectively reach vulnerable groups.

Penyalahgunaan Alkohol pada Kehamilan (Laporan Kasus)

Abstrak
Pendahuluan: Penyalahgunaan alkohol merupakan masalah kesehatan yang jarang ditemukan pada ibu hamil di Indonesia, meski konsumsi alkohol dalam jumlah berapa pun dapat menimbulkan kerugian besar bagi individu dan masyarakat. Namun, saat ini belum ada standar layanan nasional untuk skrining, pencatatan, dan konseling mengenai penggunaan alkohol pada ibu hamil di Indonesia.
Laporan Kasus: Seorang perempuan berusia 25 tahun, gravida 2 para 1 abortus 0 (G2P1A0), dengan usia kehamilan 20-21 minggu, datang ke IGD dengan kondisi penurunan kesadaran setelah meminum minuman beralkohol yang diduga mengandung etanol. Pemeriksaan klinis dan hasil laboratorium menunjukkan bahwa pasien menderita ensefalopati metabolik dan asidosis metabolik berat. Pasien segera diintubasi dan diresusitasi. Setelah satu hari perawatan di ICU, pasien mengalami kejang dan intrauterine fetal demise (IUFD), yang kemudian disusul dengan persalinan spontan keesokan harinya. Kondisi pasien terus memburuk selama perawatan dan meninggal pada hari kesembilan akibat kegagalan multiorgan karena tingginya kadar alkohol dalam darah. Hasil alloanamnesis dari keluarga pasien menunjukkan bahwa pasien mengalami tekanan psikologis akibat kehamilan yang tidak diinginkan, yang diduga terkait dengan percobaan aborsi.
Kesimpulan: Dalam kasus ini dapat disimpulkan bahwa konsumsi alkohol selama kehamilan erat kaitannya dengan kondisi psikologis pasien. Untuk mengoptimalkan perawatan, dokter obstetri dan ginekologi didorong untuk mempelajari dan menggunakan teknik skrining rutin, tes laboratorium klinis, intervensi singkat, dan rujukan pengobatan yang tepat dengan skrining ASSIST dari WHO. Sayangnya, masih banyak ibu hamil di Indonesia yang tidak memiliki akses terhadap dokter spesialis. Oleh karena itu, informasi mengenai risiko kesehatan akibat alkohol dan aborsi penting untuk disebarluaskan kepada masyarakat di sektor informal sehingga kelompok rentan dapat dijangkau dengan baik.

Kata kunci: intoksikasi alkohol, kehamilan, penyalahgunaan alkohol, aborsi


Keywords


alcohol intoxication, pregnancy, alcohol abuse, abortion

Full Text:

PDF

References


Bailey BA, Sokol RJ. Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. Alcohol Res Health. 2011;34(1):86-91. PMID: 23580045; PMCID: PMC3860553.

ACOG Committee Opinion(2015). Alcohol Abuse and Other Substance Use Disorders: Ethical Issues in Obstetric and Gynecologic Practice. 633: 1-6.

Oei JL. Alcohol use in pregnancy and its impact on the mother and child. Addiction. 2020 Nov;115(11):2148-2163. doi: 10.1111/add.15036. Epub 2020 Jun 3. PMID: 32149441.

Abel EL. Maternal alcohol consumption and spontaneous abortion. Alcohol Alcohol. 1997 May-Jun;32(3):211-9. doi: 10.1093/oxfordjournals.alcalc.a008260. PMID: 9199721.

LaHood AJ, Kok SJ. Ethanol Toxicity. [Updated 2023 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557381/

Atluri P, Vasireddy D, Malayala SV. Toxic Alcohol Ingestion: A Case Report and Review of Management Pathways. Cureus. 2021 Feb 3;13(2):e13092. doi: 10.7759/cureus.13092. PMID: 33728115; PMCID: PMC7934107.

Shankar K, Ronis MJ, Badger TM. Effects of pregnancy and nutritional status on alcohol metabolism. Alcohol Res Health. 2007;30(1):55-9. PMID: 17718402; PMCID: PMC3860435.

Asamoah, B.O., Agardh, A. Alcohol consumption in relation to maternal deaths from induced-abortions in Ghana. Reprod Health 9, 10 (2012). https://doi.org/10.1186/1742-4755-9-10

Wubetu, A.D., Habte, S. & Dagne, K. Prevalence of risky alcohol use behavior and associated factors in pregnant antenatal care attendees in Debre Berhan, Ethiopia, 2018. BMC Psychiatry 19, 250 (2019). https://doi.org/10.1186/s12888-019-2225-1

Bailey BA, Sokol RJ. Prenatal alcohol exposure and miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. Alcohol Res Health. 2011;34(1):86-91. PMID: 23580045; PMCID: PMC3860553.

Centers for Disease Control and Prevention. Alcohol screening and counseling: an effective but underused health service. CDC Vital Signs . Atlanta (GA): CDC; 2014. Available at: http://www.cdc.gov/vitalsigns/pdf/2014-01-vitalsigns.pdf. Retrieved October 24, 2014.

Screening Brief Intervention and Referral to Treatment SBIRT. Perpustakan BNN. Available at: https://perpustakaan.bnn.go.id/sites/default/files/Buku_Digital_2020-08/Screening_Brief_Intervention_and_Referral_to_Treatment_SBIRT.pdf




DOI: http://dx.doi.org/10.24198/obgynia.v7i3.713

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.


     
 

Creative Commons License
Indonesian Journal of Obstetrics & Gynecology Science is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
  Web Analytics
  View My Stat