Strategi Menurunkan Kematian Ibu Karena Preeklamsi dan Eklamsi - Johanes C. Mose (Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran, 2020)
Tujuan: Menyimpulkan beberapa hasil penelitian tentang preeklamsi dan upaya menurunkan kematian ibu di negara maju maupun berkembang termasuk di Indonesia dan RSHS Bandung untuk menyusun strategi menurunkan kematian ibu karena preeklamsi.Metode: Dilakukan penelitian potong silang dengan rancangan observasional analitik dengan membandingkan data ibu hamil dengan preeklamsi/eklamsi yang melahirkan di RS Hasan sadikin Bandung periode Maret sampai September 2012 (sebelum JKN) dan 1 Januari 2016 sampai 31 Desember 2017(saat JKN dilaksanakan). Data dianalisis menggunakan uji statistik chi kuadrat untuk membandingkan perbedaan dengan kemaknaan nilai p< 0,05. Hasil: Terjadi kenaikan prevalensi preeklamsi dari 15,53% sebelum JKN, menjadi 25,04% saat JKN dilaksanakan. Terjadi peningkatan prevalensi preeklmasi menurut usia ibu, usia kehamilan, paritas, tingkat pendidikan, jumlah ANC, dan penyakit penyerta hipertensi dan kelainan jantung sebelum dan saat JKN dilaksanakan.Diskusi: Strategi menurunkan kematian ibu karena preeklamsi/eklamsi, adalah : mendukung program pemerintah untuk mengatasi kemiskinan, pendidikan dan kesulitan transportasi; melaksanakan program sosialisasi kepada masyarakat tentang tanda dan gejala preeklamsi; deteksi dini kelompok risiko dan diagnosis PE dengan pengukuran tekanan darah dan proteinuria serta pemberian pencegahan dengan aspirin dosis rendah dan kalsium; pelatihan pemeriksaan Doppler arteri uterina untuk SpOG serta sosialisasi protokol pengelolaan PE, dan pelatihan ‘preeclampsia special team’ di RS rujukan.Strategies for Reducing Maternal Mortality Due to Preeclampsia and EclampsiaAbstractObjective: To compile the result of studies on preeclampsia-eclampsia and strategies to reduce its maternal mortalities conducted in western and developing countries including Indonesia and Bandung aiming at developing strategies for reducing maternal mortality due to preeclampsia and eclampsia.Method: This is a cross sectional analytic survey by taking the data from medical record to compare and analyze data of mothers with preeclampsia-eclampsia who delivered at Dr. Hasan Sadikin General Hospital Bandung from March to September 2012 (before the implementation of National Health Insurance Program-NHIP) and from January 2016 to December 2017(during the implementation of NHIP). Data was analyzed by mean of Chi-square test and significant difference criteria of p<0.05. Result: There was a significant increase (p<0.05) in prevalence of preeclampsia before (15,53%) and during (25,04%) the implementation of NHIP. There was a significant increase (p<0.05) of incidence by maternal age, age of pregnancy, multiparity, low educational level, ANC of >4, and evidence of hypertension and cardiac complications before and during the implementation of NHIP. Discussion: The strategies for reducing maternal mortality due to preeclampsia are as follows : supporting the government programs to overcome poverty, education and transportation; socializing signs and symptoms of preeclampsia to the community; early detection of risk factors, blood pressure measurement and urine protein followed by administration of low dose aspirin and calcium tablets for prevention; training on Doppler examination of uterine arteries for OBGYN specialist and socializing standard guidelines and protocol for the management of preeclampsia; and training for a ‘preeclampsia special team’ in referral hospitals.Key words: Preeclampsia, maternal mortality, strategy for reducing maternal mortality.