Luaran Maternal dan Perinatal Kehamilan dengan HIV di RSUP dr. Kariadi Semarang Tahun 2019-2021
Christian Agustin Tapa(1), M.Besari Adi Parmono(2), Setyo Gundi Pramudi(3), Ratnasari Dwi Cahyanti(4*)
(1) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Diponegoro
(2) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Diponegoro
(3) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Diponegoro
(4) Departemen Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Diponegoro
(*) Corresponding Author
Abstract
Background: Human Immunodeficiency Virus (HIV) remains a global health crisis. HIV infection during pregnancy is associated with an increased risk of adverse maternal and perinatal outcomes.
Objective: To determine the maternal and perinatal outcomes of HIV in pregnant women.
Method: The descriptive study of pregnant women with HIV infection was done at Central General Hospital dr. Kariadi Semarang January 2019 – December 2021.
Results and Discussion: From 122 cases of pregnancy with HIV infection, the majority of cases were found in 20-34 years old group (75,4%), finished high school education (51.6%), working as a housewife (55.7%), 37-41 weeks pregnancy (84.4%), primiparity (35.2%), mean frequency of antenatal care 5 (0-10), was diagnosed with HIV during the third trimester of pregnancy (27.9%), received ARV therapy during the third trimester (30.3%), history of drug withdrawal 13 cases, CD4 cell count 200-500 cells/mm3 (41.8%), hospital referral (47.5%), emergency referral (94.9%), cesarean section (95.9%), opportunistic infections (19.7%), and co-morbidities (56.6%). Maternal outcomes included preterm delivery (15.6%), premature rupture of membranes (PROM) (11.5%), and postpartum hemorrhage (0.8%), and there was no maternal mortality case. Perinatal outcomes included small gestational age (SGA) (30.3%), low birth weight (LBW) (21.3%), asphyxia (19.7%), and prematurity (15.6%). There were no perinatal deaths and fetal growth restrictions.
Conclusion: The incidences of pregnancies with HIV infection in 2019-2021 were found in 122 cases. The most common maternal outcome was preterm delivery and PROM. The most common perinatal outcome was SGA, LBW, asphyxia, and prematurity.
Keywords: HIV; maternal; outcomes; perinatal; pregnancy
Abstrak
Latar Belakang: Human Immunodeficiency Virus (HIV) masih menjadi krisis kesehatan global. Infeksi HIV pada ibu hamil memiliki hubungan dengan peningkatan risiko luaran maternal dan perinatal yang buruk.
Tujuan: Mengetahui luaran maternal dan perinatal kehamilan dengan HIV.
Metode: Penelitian deskriptif pada seluruh ibu hamil dengan HIV yang bersalin di RSUP dr. Kariadi Semarang Januari 2019 – Desember 2021.
Hasil dan Pembahasan: Dari 122 kasus kehamilan dengan HIV, ibu hamil mayoritas berusia 20-34 tahun (75,4%), pendidikan terakhir SMA (51,6%), pekerjaan sebagai ibu rumah tangga (55,7%), usia kehamilan 37-41 minggu (84,4%), paritas primipara (35,2%), rata-rata frekuensi ANC yaitu 5(0-10), waktu terdiagnosis HIV pada trimester 3 (27,9%), terapi ARV dimulai pada trimester 3 (30,3%), riwayat putus obat 13 ibu, jumlah sel CD4 200-500 sel/mm3 (41,8%), asal rujukan rumah sakit (47,5%), rujukan kegawatdaruratan (94,9%), bedah sesar (95,9%), infeksi oportunistik (19,7%), dan penyakit penyerta (56,6%). Luaran maternal meliputi persalinan prematur (15,6%), ketuban pecah dini (11,5%), perdarahan postpartum (0,8%) dan tidak ada kematian maternal. Luaran perinatal meliputi kecil massa kehamilan (30,3%), berat badan lahir rendah (BBLR) (21,3%), asfiksia (19,7%), dan prematuritas (15,6%). Tidak ditemukan kematian perinatal dan pertumbuhan janin terhambat (PJT).
Kesimpulan: Kejadian kehamilan dengan HIV tahun 2019-2021 adalah sebanyak 122 kasus. Luaran maternal terbanyak adalah persalinan prematur dan KPD, sedangkan luaran perinatal terbanyak adalah KMK, BBLR, asfiksia dan prematuritas.
Kata kunci: HIV; kehamilan; luaran; maternal; perinatal
Keywords
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DOI: https://doi.org/10.22146/jkr.82517
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