<![CDATA[Background: High-risk pregnancy in elderly primigravida with dwarfism and Chronic Energy Deficiency (CED) presents complex challenges due to anatomical constraints and nutritional insufficiency. This case report describes the midwifery care provided to a 36-year-old primigravida with dwarfism (height 136 cm) and CED at Ngariboyo Community Health Center, Magetan Regency. Objective: To comprehensively describe the clinical condition and midwifery management of a high-risk pregnancy involving advanced maternal age, dwarfism, and CED through the Continuity of Care approach. Case Presentation: Mrs. K, a 36-year-old primigravida at 22 weeks gestation with G1P00000, presented with dwarfism (height 136 cm), pre-pregnancy BMI of 17.60 kg/m², and MUAC of 20 cm indicating CED. The KSPR score of 10 classified her as high-risk. Comprehensive antenatal care was delivered through five home visits from January to April 2026. Interventions: Midwifery management included nutritional education emphasizing high-calorie and high-protein foods, complementary therapies (lime water, acupressure, relaxation techniques, aromatherapy), family-centered care with husband involvement, interprofessional collaboration, and delivery planning through the P4K program. Results: Over the monitoring period, the patient showed significant improvement evidenced by weight gain from 33.95 kg to 39 kg (total gain 6.5 kg), MUAC increase from 20 cm to 22 cm, resolution of dizziness, fatigue, and constipation complaints, improved appetite and dietary patterns, and stable maternal and fetal conditions. Fetal growth progressed with estimated fetal weight increasing from 465 grams to 2,323 grams. Conclusion: The Continuity of Care approach incorporating nutritional interventions, family support, complementary therapies, and comprehensive monitoring proved effective in improving maternal nutritional status and maintaining maternal-fetal well-being throughout pregnancy in this complex high-risk case. Keywords: Elderly primigravida, Dwarfism, Chronic Energy Deficiency, High-risk pregnancy, Continuity of Care]]>
