Profil Proteinuria dan Tekanan Darah pada Pasien Preeklampsia Berat yang menggunakan Antihipertensi
Abstract
Preeklampsia berat sering terjadi pada ibu hamil. Pengobatan preeklampsia berat dapat dilakukan dengan pemberian antihipertensi untuk mencegah penyakit serebrovaskular dan kematian. Penelitian ini bertujuan untuk mendeskripsikan profil penurunan proteinuria, tekanan darah, dan penggunaan antihipertensi pada pasien preeklampsia berat di Instalasi Rawat Inap RSUD dr. Soedarso Pontianak. Metode penelitian yang digunakan adalah observasional dengan rancangan penelitian potong lintang. Pengumpulan data dilakukan secara retrospektif dari rekam medis pasien preeklampsia berat rawat inap selama periode Januari–Desember 2018. Penelitian ini dilakukan selama bulan Oktober–Desember 2019 di RSUD dr. Soedarso Pontianak. Sampel yang memenuhi kriteria inklusi dalam penelitian ini sebanyak 62 pasien. Hasil penelitian menunjukkan bahwa 32,27% pasien mengalami penurunan nilai proteinuria dengan rata-rata penurunan sebesar dipstik (+)1 sedangkan nilai proteinuria dipstik yang tetap terdapat pada 67,73% pasien dengan mayoritas pasien memiliki nilai proteinuria dipstik (+)3. Penurunan rata-rata tekanan darah sistolik/diastolik (TDS/TDD) pada pasien preeklampsia berat sebesar 28,58/17,69 mmHg. Antihipertensi yang digunakan yaitu nifedipin (14,52%), metildopa (8,06%), furosemid (1,61%). Penggunaan antihipertensi kombinasi paling banyak digunakan adalah kombinasi nifedipin dan metildopa sebanyak 40,32%. Simpulan penelitian ini adalah terdapat penurunan tekanan darah dan proteinuria pada pasien preeklampsia berat yang menggunakan antihipertensi.Walaupun demikian, beberapa pasien preeklampsia berat masih memiliki kadar proteinurianya dalam kondisi tetap. Antihipertensi yang paling banyak digunakan pada pasien preeklampsia berat di Instalasi Rawat Inap RSUD dr. Soedarso Pontianak yaitu kombinasi nifedipin dan metildopa.
Kata kunci: Antihipertensi, preeklampsia berat, proteinuria, tekanan darah
Proteinuria and Blood Pressure Profiles in Severe Preeclampsia Patients using Antihypertensive Medication
Abstract
Preeclampsia is a common occurrence among pregnant women, and in severe cases, the condition is treated using antihypertensive medication to prevent cerebrovascular disease, as well as death. This study, therefore, aimed to describe the proteinuria levels, blood pressure, and antihypertensive profile of patients with severe preeclampsia at Dr. Soedarso General Hospital, Pontianak, using a descriptive observation method with a cross-sectional design. The study was conducted from October–December 2019, however, data were collected retrospectively, based on inpatients with severe preeclampsia medical records from January to December 2018, and a total of 62 participants were selected based on the inclusion, as well as exclusion criteria. According to the results, 32,27% of the respondents experienced a reduction in proteinuria levels, with an average of proteinuria dipstick (+)1, while 67,73% experienced constant proteinuria levels, with most patients having proteinuria dipstick (+)3. Furthermore, the average systolic/diastolic blood pressure (SBP/DBP) reduction in patients with severe preeclampsia was 28,58/17,69 mmHg. The antihypertensive used were nifedipine (14,52%), methyldopa (8,06%), and furosemide (1,61%), alone or in combination, however combination medication, for instance, nifedipine + methyldopa (40,32%), was most prevalent. In conclusion, patients with severe preeclampsia experienced reductions in blood pressure and proteinuria levels after treatment with antihypertensive medication, however, several patients experienced constant proteinuria levels. Also, the most commonly used antihypertensive was discovered to be a combination of nifedipine and methyldopa.
Keywords: Antihypertensive medication, blood pressure, proteinuria, severe preeclampsia
Keywords
Full Text:
PDF (Bahasa Indonesia)References
Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2019.
American College of Obstetricians, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31. doi: 10.1097/01.AOG.0000437382.03963.88
Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1–7. doi: 10.1016/j.ejogrb.2013.05.005
Sirait AM. Prevalensi hipertensi pada kehamilan di Indonesia dan berbagai faktor yang berhubungan (riset kesehatan dasar 2007). Bull Heal Syst Res. 2012;15(2):103–9.
Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018.
Perkumpulan Obstetri dan Ginekologi Indonesia Himpunan Kedokteran Feto Maternal. Diagnosis dan tata laksana preeklamsia. 2016.
Publications Committee, Society for Maternal-Fetal Medicine; Sibai BM. Evaluation and management of severe preeclampsia before 34 weeks’ gestation. Am J Obstet Gynecol. 2011;205(3):191-8. doi: 10.1016/j.ajog.2011.07.017
Özkara A, Kaya AE, Başbuğ A, Ökten SB, Doğan O, Çağlar M, et al. Proteinuria in preeclampsia: Is it important?. Ginekol Pol. 2018;89(5):256–61. doi: 10.5603/GP.a2018.0044
Queensland Clinical Guidelines. Queensland Clinical Guidelines (QCG) Maternity and Neonatal Clinical Guideline Hypertensive disorders of pregnancy. Queensland Clinical Guidelines. 2015.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, IzzoJr JL, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42(6):1206–52. doi: 10.1161/01.HYP.0000107251.49515.c2
Andriana DD, Utami ED, Sholihat NK. Evaluasi penggunaan obat antihipertensi pada pasien pre-eklampsia rawat inap di RSUD Prof. Dr. Margono Soekarjo Purwokerto. Acta Pharm Indones. 2018;6(1):29–39. doi: 10.5281/zenodo.3707186
Sari NP, Utama BI, Agus M. Factors related with the incidence of severe preeclampsia at the Hospital Dr M Djamil Padang. J Midwifery. 2017;2(2):56-65. doi: 10.25077/jom.2.2.56-65.2017
Bahri S, Suheimi D. Severe preeclampsia-eclampsia and their associated factors. Indones J Obstet Gynecol. 2019;7(2):92–6. doi: 10.32771/inajog.v7i2.897
Kartika AR, Aldika Akbar MI, Umiastuti P. Risk factor of severe preeclampsia in Dr. Soetomo Hospital Surabaya in 2015. Maj Obstet Ginekol. 2018;25(1):6-9. doi: 10.20473/mog.V25I12017.6-9
Kashanian M, Baradaran HR, Bahasadri S, Alimohammadi R. Risk factors for pre-eclampsia: A study in tehran, Iran. Arch Iran Med. 2011;14(6):412–5.
Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:l2381. doi: 10.1136/bmj.l2381
Roberts JM, Bodnar LM, Patrick TE, Powers RW. The role of obesity in preeclampsia. Pregnancy Hypertens J. 2011;1(1):6–16. doi: 10.1016/j.preghy.2010.10.013
Tyas BD, Lestari P, Akbar MIA. Maternal perinatal outcomes related to advanced maternal age in preeclampsia pregnant women. J Family Reprod Health. 2020;13(4):191–200. doi: 10.18502/jfrh.v13i4.2646
Karima NM, Machmud R, Yusrawati. Hubungan faktor risiko dengan kejadian pre-eklampsia berat di RSUP dr. M Djamil Padang. J Kesehat Andalas. 2015;4(2):556–61. doi: 10.25077/jka.v4i2.299
Togarikar SM. Efficacy of methyldopa versus nifedipine in mild and severe pregnancy induced hypertension. Int J Reprod Contraception, Obstet Gynecol. 2017;6(10):4544–8. doi: 10.18203/2320-1770.ijrcog20174439
Miasih K. Pola peresepan antihipertensi pada pasien preeklampsia di instalasi rawat inap RSUD Wates Kulon Progo periode Juli-Oktober 2014. J Kefar Akfarindo. 2016;1(1):48–54.
Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC / ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36(10):1953–2041. doi: 10.1097/HJH.000000000000194
Tyashapsari MWE, Zulkarnain AK. Penggunaan obat pada pasien hipertensi di instalasi rawat inap Rumah Sakit Umum Pusat Dr. Kariadi Semarang. Maj Farmaseut. 2012;8(2):145–51. doi: 10.22146/farmaseutik.v8i2.24068
Gaidhankar SL, Ramanand JB, Kadam PG, Zende AM, Bhosale RR, Puram NN. A study of drug utilization and clinical outcomes in indoor patients of hypertensive disorders of pregnancy. Int J Basic Clin Pharmacol. 2017;6(10):2401–7. doi: 10.18203/2319-2003.ijbcp20174367
Sajith M, Nimbargi V, Modi A, Sumariya R, Pawar A. Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy. Int J Pharma Sci Res. 2014; 5(04):163–70.
Alam A, Zakaria SMA. Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: A randomized controlled trial. Int J Reprod Contracept Obstet Gynecol. 2019;8(5):1921–7. doi: 10.18203/2320-1770.ijrcog20191943
Peres GM, Mariana M, Cairr E. Pre-eclampsia and eclampsia: An update on the pharmacological treatment applied in Portugal. J Cardiovasc Dev Dis. 2018;5(1):1–13. doi: 10.3390/jcdd5010003
Wells BG, DiPiro JT, Schwinghammer TL, DiPiro CV. Pharmacotherapy handbook, seventh ed. United States of America: McGraw-Hill Companies; 2017.
Indhayani L. Studi penggunaan obat antihipertensi pada wanita hamil yang didiagnosis hipertensi di Rumah Sakit PMI Kota Bogor. Indones J Pharm Sci Technol. 2018;7(1):1–17.
Jayasutha J, Ismail AM, Senthamarai R. Evaluation on efficacy of methyldopa monotherapy and combination therapy with nifedipine in pregnancy-induced hypertension. Der Pharmacia Lettre. 2011;3(3):383–7.
DOI: https://doi.org/10.15416/ijcp.2021.10.2.79
Refbacks
- There are currently no refbacks.
Indonesian Journal of Clinical Pharmacy is indexed by
