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Perbandingan pemberian sulfas magnesikus intramuskular dan intravena pada preeklamsia berat terhadap luaran maternal dan perinatal

RACHMAN, Irwan Taufiqur, dr. H. Zain Alkaff, SpOG(K)

2004 | Tesis | PPDSI Obstetri dan Ginekologi

Irwan T Rachman, Zain Alkaff, HR Siswosudarmo – Perbandingan pemberian Sulfas Magnesikus intramuskukar dan intravena pada preeklamsia berat terhadap luaran maternal dan perinatal. Latar belakang: Preeclampsia occurs in about 0,52-38,4% of all pregnancy with maternal mortality in about 30-40% and perinatal mortality in about 30-50%. These replace hemorrhage as major cause maternal mortality. The used of MgSO4 as drug of choice to prevent seizure has decreased maternal and perinatal morbidity and mortality. Aim: To compare effectiveness and safety of intramuscular and intravenous MgSO4 administration for severe preeclampsia treatment Tujuan: To compare effectiveness and safety of intramuscular and intravenous MgSO4 administration for severe preeclampsia treatment. Desain penelitian: Historical cohort. Bahan dan cara: Samples were collected from medical record of Sardjito and Sleman hospital from January 1st, 2002 to December 31st, 2003. The population was matched the inclusion and exclusion criteria. The inclusion criteria were gestational age more than 28 weeks, singleton pregnancy, life fetus when administered hospital. The exclusion criteria consist of major congenital abnormality of the fetus, the history of maternal hypertension, mother with severe or systemic disease and end-stage maternal condition. The parameters were the decrease of blood pressure after MgSO4 administration, maternal and perinatal morbidity, post delivery complication and fetal outcome. The data was analyzed with Ttest, chi-square, Mentel-Haenszel odds ratio and relative risk using computer software. Hasil: There were 154 severe preeclampsia cases in Sardjito and Sleman hospital. One hundred and nine cases were included. Sixty cases in Sardjito hospital administered intramuscular MgSO4 and 46 cases in Sleman hospital administered intravenous MgSO4. The decrease of blood pressure after administration of MgSO4 was evaluated in these groups. There was systolic and diastolic decrease in both group, but statistically not significant. This matched with current hypothesis that there was no difference between intramuscular and intravenous administration. Perinatal complication, adverse effect of MgSO4 administration, which are fetal asphyxia, low APGAR score and perinatal mortality, was studied. There was no significant statistic difference. There was no significant statistic difference in perinatal morbidity such as fetal distress and asphyxia caused by MgSO4 administration. There was three perinatal mortality cases (4,8%) in intramuscular administration and none in intravenous administration. Simpulan: Effectiveness and safety of the two groups are same. Perinatal morbidity and mortality in intramuscular group were higher but there was no significant statistical difference.

Irwan T Rachman, Zain Alkaff, HR Siswosudarmo – Comparison between Magnesium Sulphate intramuscular Vs. intravenous drip on severe preeclampsia on maternal-perinatal outcome Background: Preeclampsia occurs in about 0,52-38,4% of all pregnancy with maternal mortality in about 30-40% and perinatal mortality in about 30-50%. These replace hemorrhage as major cause maternal mortality. The used of MgSO4 as drug of choice to prevent seizure has decreased maternal and perinatal morbidity and mortality. Aim: To compare effectiveness and safety of intramuscular and intravenous MgSO4 administration for severe preeclampsia treatment. Study design: Historical cohort. Material and method: Samples were collected from medical record of Sardjito and Sleman hospital from January 1st, 2002 to December 31st, 2003. The population was matched the inclusion and exclusion criteria. The inclusion criteria were gestational age more than 28 weeks, singleton pregnancy, life fetus when administered hospital. The exclusion criteria consist of major congenital abnormality of the fetus, the history of maternal hypertension, mother with severe or systemic disease and end-stage maternal condition. The parameters were the decrease of blood pressure after MgSO4 administration, maternal and perinatal morbidity, post delivery complication and fetal outcome. The data was analyzed with T-test, chi-square, Mentel-Haenszel odds ratio and relative risk using computer software. Result: There were 154 severe preeclampsia cases in Sardjito and Sleman hospital. One hundred and nine cases were included. Sixty cases in Sardjito hospital administered intramuscular MgSO4 and 46 cases in Sleman hospital administered intravenous MgSO4. The decrease of blood pressure after administration of MgSO4 was evaluated in these groups. There was systolic and diastolic decrease in both group, but statistically not significant. This matched with current hypothesis that there was no difference between intramuscular and intravenous administration. Perinatal complication, adverse effect of MgSO4 administration, which are fetal asphyxia, low APGAR score and perinatal mortality, was studied. There was no significant statistic difference. There was no significant statistic difference in perinatal morbidity such as fetal distress and asphyxia caused by MgSO4 administration. There was three perinatal mortality cases (4,8%) in intramuscular administration and none in intravenous administration. Conclusion: Effectiveness and safety of the two groups are same. Perinatal morbidity and mortality in intramuscular group were higher but there was no significant statistical difference.

Kata Kunci : Persalinan,Preeklamsia Berat,Pengobatan MgSO4, sever preeclampsia – perinatal morbidity/mortality - intramuscular/ intravenous MgSO4


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