Email this article 
Luaran Maternal dan Perinatal Kehamilan dengan HIV di RSUP dr. Kariadi Semarang Tahun 2019-2021
https://doi.org/10.22146/jkr.82517 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
Full Text:
PDFReferences
1. Fauci AS, Folkers GK, Lane HC. Human Immunodeficiency Virus Disease: AIDS and Related Disorders. In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine, 20e. New York, NY: McGraw-Hill Education; 2018.
2. Joint United Nation Programme on HIV/AIDS. UNAIDS 2021 epidemiological estimates. Joint United Nation Programme on HIV/AIDS. Geneva; 2021.
3. Joint United Nation Programme on HIV/AIDS. UNAIDS data 2021. Geneva: Joint United Nations Programme on HIV/AIDS; 2021.
4. Peters H, Francis K, Sconza R, Horn A, Peckham CS, Tookey PA, et al. UK mother-to-child HIV transmission rates continue to decline: 2012-2014. Clin Infect Dis. 2017;64(4):527–8.
5. World Health Organization. Mother-to-child transmission of HIV. Geneva. 2015.
6. Kementerian Kesehatan RI. Pedoman Program Pencegahan Penularan HIV, Sifilis dan Hepatitis B dari Ibu ke Anak. Jakarta: Kementerian Kesehatan RI; 2019.
7. Tukei VJ, Hoffman HJ, Greenberg L, Thabelo R, Nchephe M, Mots’oane T, et al. Adverse Pregnancy Outcomes Among HIV-positive Women in the Era of Universal Antiretroviral Therapy Remain Elevated Compared With HIV-negative Women. Pediatr Infect Dis J. 2021;40(9):821–6.
8. Wedi COO, Kirtley S, Hopewell S, Corrigan R, Kennedy SH, Hemelaar J. Perinatal outcomes associated with maternal HIV infection: a systematic review and meta-analysis. lancet HIV. 2016;3(1):E33–48.
9. Nagar DO, Agrawal DS, Jain DS, Sharma DA, Agrawal DG. A retrospective study of maternal and perinatal outcome of seropositive pregnant women attending PPTCT centre at a tertiary care centre. Int J Clin Obstet Gynaecol. 2019;3(1):139–43.
10. Junnisa SD, Wiyati PS, Wijayahadi N. Luaran Maternal Dan Neonatal Pada Ibu Bersalin Dengan Infeksi HIV (Analisis Faktor Jumlah Sel Cd4). J Kedokt Diponegoro. 2015;4(4):1503–13.
11. Direktorat Jenderal Pencegahan Dan Pengendalian Penyakit. Laporan Perkembangan HIV/AIDS & Penyakit Menular Seksual (PIMS) Triwulan IV Tahun 2021. Jakarta; 2021.
12. Direktorat Jenderal Pencegahan Dan Pengendalian Penyakit. Laporan Perkembangan HIV/AIDS & Penyakit Menular Seksual (PIMS) Triwulan IV Tahun 2020. Jakarta; 2020.
13. Suherlim R, Subawa AAN. Karakteristik Penderita HIV pada Ibu Hamil di Klinik Prevention Mother to Child Transmission (PMTCT) Poli Kebidanan RSUP Sanglah Denpasar Periode Juli 2013 – Juni 2014. J Cerebellum. 2015;1(3):193–201.
14. Negara IKS, Anantasika A, Putra A, Wiradnyana A, Tunas IK. Characteristics of Pregnant Women with HIV Infection Following Prevention of Mother to Child Transmission of HIV (PMTCT) Program in Sanglah General Hospital 2005-2014. Bali Med J. 2016;5(1):165.
15. Roselinda, Wibowo HA, Setiawaty V. Karakteristik Pekerjaan pada Kasus Human Immunodeficiency Virus-1 dan Subtipenya di Tujuh Provinsi di Indonesia pada tahun 2011. J Biotek Medisiana Indones. 2015;4(2):71–6.
16. Kementerian Kesehatan RI. Pedoman Pelayanan Antenatal Terpadu. 3rd ed. Jakarta: Kementerian Kesehatan RI; 2020.
17. Fatimah M, Respati SH, Pamungkasari EP. Determinants of Pregnant Women Participation on Triple Elimination of HIV, Syphilis, and Hepatitis B, in Semarang. J Heal Promot Behav. 2020;5(2):124–34.
18. Ngakan Putu Anom Harjana, Sally Nita, Meirinda Sebayang, Oldri Sherli Mukuan, Asti Setiawati Widihastuti. Determinant of service utilization for triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B among women living with HIV during COVID-19 pandemic in Indonesia. Intisari Sains Medis. 2022 Aug 12;13(2 SE-Research Article):452–9.
19. Ekawati R, Subronto Y, Hakimi M. Determinan perilaku tes HIV ibu hamil di Puskesmas Bandarharjo Kota Semarang. Ber Kedokt Masy. 2017 Mar 1;33(3):131.
20. Prihanto P, Sudiro S, Irene K M. Analisis Penyebab Putus Obat Pada Penderita HIV/AIDS Yang Berobat Di Klinik VCT. J Kesehat [Internet]. 2018 Dec 17;7(1):46–56. Available from: http://jurnal.lib-akperngestiwaluyo.ac.id/ojs/index.php/jkanwvol82019/article/view/80
21. Putri S A. Karakteristik Ibu Hamil Terinfeksi HIV yang Memanfaatkan Program Pencegahan Penularan HIV ke Anak di RSUP Haji Adam Malik Medan Tahun 2017-2019. Univ Sumatera Utara. 2019;
22. Kementerian Kesehatan RI. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/90/2019 Tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana HIV. 2019.
23. Jayani I, Susmiati, EWinarti, Sulistyawati W. The Correlation between CD4 Count Cell and Opportunistic Infection among HIV/AIDS Patients. J Phys Conf Ser. 2020;1569(3):032066.
24. Onwughara CE, Moodley D, Valashiya N, Sebitloane M. Preterm prelabour rupture of membranes (PPROM) and pregnancy outcomes in association with HIV-1 infection in KwaZulu-Natal, South Africa. BMC Pregnancy Childbirth. 2020;20(1):204.
25. Shankar P, J. M. Study of maternal and fetal outcome in HIV positive women on HAART therapy in a tertiary hospital. Int J Reprod Contraception, Obstet Gynecol. 2019;8(2):717.
26. Xiao PL, Zhou YB, Chen Y, Yang MX, Song XX, Shi Y, et al. Association between maternal HIV infection and low birth weight and prematurity: a meta-analysis of cohort studies. BMC Pregnancy Childbirth. 2015;15(1):246.
27. Kim HY, Kasonde P, Mwiya M, Thea DM, Kankasa C, Sinkala M, et al. Pregnancy loss and role of infant HIV status on perinatal mortality among HIV-infected women. BMC Pediatr. 2012;12:138.
28. Fentie EA, Yeshita HY, Bokie MM. Low birth weight and associated factors among HIV positive and negative mothers delivered in northwest Amhara region referral hospitals, Ethiopia,2020 a comparative crossectional study. Woźniakowski G, editor. PLoS One. 2022 Feb 11;17(2):1–14.
29. Ikumi NM, Matjila M, Gray CM, Anumba D, Pillay K. Placental pathology in women with HIV. Placenta. 2021 Nov;115:27–36.
30. López M, Palacio M, Goncé A, Hernàndez S, Barranco FJ, García L, et al. Risk of intrauterine growth restriction among HIV-infected pregnant women: a cohort study. Eur J Clin Microbiol Infect Dis. 2015;34(2):223–30.
31. Ndirangu J, Newell ML, Bland RM, Thorne C. Maternal HIV infection associated with small-for-gestational age infants but not preterm births: evidence from rural South Africa. Hum Reprod. 2012;27(6):1846–56.
DOI: https://doi.org/10.22146/jkr.82517
Article Metrics
Abstract views : 1531
| 
views : 2149
Refbacks
- There are currently no refbacks.
Copyright (c) 2023 The Author(s)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
SEKRETARIAT JURNAL KESEHATAN REPRODUKSI
Departemen Obstetri dan Ginekologi, FK-KMK, UGM/RS Dr. Sardjito
Jl. Kesehatan No. 1, Sekip Utara, Yogyakarta 55281
Tlp: (0274) 511329 / Faks: (0274) 544003
Email: jurnal.kesehatanreproduksi@ugm.ac.id
Cp: Dwi Astuti +6281802698043