SUPINE HYPOTENSION SYNDROME PADA KEHAMILAN

Bisri, Dewi Yulianti
Redjeki, Ike Sri
Bisri, Tatang

Majalah Kedokteran Bandung
Vol 47, No 2 (2015)

Supine hypotension syndrome (SHS) dapat terjadi mulai kehamilan trimester 2 dan didefinisikan sebagai penurunan tekanan sistol ?30% pada posisi supine dibanding dengan lateral. Tujuan penelitian mengetahui insidensi SHS pada wanita hamil aterm di Indonesia. Penelitian observasional pada 200 wanita hamil aterm, kehamilan pertama dan kedua, usia 18?40 tahun, tidak memiliki penyakit sertaan, dan akan dilakukan seksio sesarea elektif di Rumah Sakit Ibu dan Anak Melinda dalam periode Maret?Juli 2012. Pasien diberikan 500 cc cairan kristaloid Ringer laktat sebagai pengganti puasa, kemudian dilakukan pemeriksaan tekanan sistol, diastol, rata-rata, laju nadi, dan saturasi oksigen selama 5 menit dengan jarak 1 menit pada posisi supine dan miring kiri 45O. Hasil pengukuran tekanan sistol supine 113,49 (13,20) mmHg, miring 105,20 (12,08) mmHg dengan nilai p=0,93. Tekanan diastol supine  69,05 (7,31) mmHg dan miring 58,58 (7,73) mmHg (p=0,51). Tekanan darah rata-rata supine 84,59 (8,38) mmHg dan miring 75,87 (8,82) mmHg (p=0,62). Laju nadi supine 88,95 (12,19) x/menit, dan miring 86,26 (11,47) x/menit, (p=0,86). SpO2 supine 99,95 (1,11)% dan miring 99,64 (0,67)% (p=0,07). Simpulan, tidak ada perbedaan tekanan sistol, diastol, rata-rata, laju nadi, dan SpO2 wanita hamil aterm pada posisi berbaring dengan posisi miring kiri 450. [MKB. 2015;47(2):102?8]Kata kunci: Posisi supine, posisi miring kekiri, supine hypotension syndrome, wanita hamil atermSupine Hypotension Syndrome in PregnanciesAbstractSupine hypotension syndrome (SHS) can occur starting from the second trimester of pregnancy and is defined as a reduction of systolic blood pressure of ?30% in the supine position compared to lateral position. The purpose of this study was to determine the incidence of SHS in full term pregnant women in Indonesia. An observational study on 200 full term pregnant women, first and second pregnancy, aged 18?40 years, no coexisting diseases, and was going to have an elective cesarean section in Melinda Woman and Child Hospital in the period of March?July 2012. Patients were given 500 cc of Ringer?s lactate crystalloid fluid instead of fasting. Systolic and diastolic blood pressure, mean blood pressure, pulse rate, and oxygen saturation for 5 minutes were then examined every  minute. The examination was conducted in the supine and left lateral position of 45O. The results show a systolic blood pressure in supine position of 113.49 (13.20) mmHg and in lateral position of 105.20 (12.08) mmHg (p=0.93). Meanwhile, the supine diastolic blood pressure was  69.05 (7.31) mmHg and lateral position was 58.58 (7.73) mmHg (p=0.51). The mean blood pressure in supine position was 84.59 (8.38) mmHg and 75.87 (8.82) mmHg (p=0.62) in lateral position . The pulse rates for supine and lateral position were 88.95 (12.19)x/min and 86.26 (11.47) x/min (p=0.86), respectively. Supine SpO­2 was 99.95 (1.11) % and lateral SpO2 was 99.64 (0.67) % (p=0.07). In conclusion, there is no differences in systolic, diastolic, mean blood pressure, pulse rate and SpO2 of full term pregnant women in supine or left lateral position of 45O. [MKB. 2015;47(2):102?8]Key words: Full term pregnant women, left lateral decubitus, supine hypotension syndrome, supine DOI: 10.15395/mkb.v47n2.461