RELATIONSHIP PARITY AND AGE WITH GRADATIONS OF PRE

RELATIONSHIP PARITY AND AGE WITH GRADATIONS OF PRE
ECLAMPSIA IN PREGNANT
Yani Erniyawati1, Ratna Dewi2, Amellia Mardhika3
Akademi Keperawatan Pemerintah Kabupaten Lamongan
Email: [email protected]
ABSTRACT
Introduction: Pre Eclampsia represent one of the high risk of pregnancy
which can cause death of pregnant. Pre eclampsia can be influenced by parity
and age. The aims of this research is to know relation of parity and age with
gradation of pre eklamsia in pregnant. Method: Desain in this Research with
method of cross sectional. Sampel in this research taken by simple random
sampling. Data collecting use observation sheet of medical record. Data were
analysed by Chi- Square test and Spermank Rank test. Result: Result of
research show that 34,5 % pregnant of multigravida can severe of pre
eclapmsi and 1,8 % pregnant grande multigravida can mild of pre eclampsia.
Result of test of Chi- Square got p= 0,443, so p> 0,05 and its meaning no
siognificance correlation. Result of research is also got 38,1% pregnant with
low risk age experience of mild of pre eclampsi and 12,4 % pregnant which
have high risk age experience of mild of pre eclampsia. Result of test of
Spearman got p= 0,062, so p> 0,05 that mean not significance correlation
between age with gradation of pre eclampsia in pregnant. Conclusion: Health
care provider need to give early management in women who have high risk of
pre eclampsia.
Keyword: Parity, Age, Gradasi of Pre Eclampsia, Pregnant
INTRODUCTION
Pregnancy,
childbirth
and
parturition involves the normal
reproduction,
nevertheless
pregnancy,
childbirth
and
parturition normal have any risk.
High risk irregularities and
pregnancy is directly can cause
pain and mortality of maternal and
baby. The most problem that can
be found in pregnant is pre
eclampsia (Puspita, 2011). The
incident pre eclampsia highly
influenced by parity, pertaining to
a race or ethnicity.Besides also
affected by genetic predisposition
and environmental factors.
One of the causes of morbidity and
mortilitas in mother and the fetus
is pre eclampsia. According to
WHO, incident of pre eclampsia
ranged from 0,51% -38,4%
(Amelda , 2006). In an advanced
state of progress pre eclampsia is
around 6-7% and eclampsia 0,10,7%. While the figure maternal
mortality is caused pre eclampsia
and eclampsia in the developing
country is still high. In Indonesia
according to Survey Demografi
Kesehatan Indonesia (SDKI) in
2009, Maternal Mortality Rate
(MMR)
resulting
from
pre
eclampsia was still quite high that
is 390 per 100.000 life birth (SDKI,
2009) .
Factors predisposing of pre
eclampsia is parity, primigravida
pregnant too young and too old,
history of pre eclampsia in family,
obesity, chronic hypertension,
diabetes
mellitus,
double
pregnancy
(Chapman,
2006).
Parity more than 3 have higher of
maternal mortality rate. High
incidence found in primigravida in
young and old age. Primigravida in
old age have higher risk to heavy
pre
eclampsia
because
in
primigravida the formation of
antibody
barrier
(blocking
antibodies that have not perfect
raising risk of pre eclampsia
(Manuaba, 2008).
Pregnancy in teenagers and over
35 years old have very high risk of
pre eclampsia (Royston, 1994 ).
The youth with the possibility of
first pregnancy experienced stress
that can rise blood pressure. If
high blood pressure can not
handled it can be occur a decrease
in rate of filtration glomerolus that
would
improve
sodium
reabsorption so that can occur
odema (Benson, 2008). The aims
of
this
research
was
to
relationship of parity and age with
pre eclampsia in pregnant.
METHOD
Design research used is analytic
correlational with the approach
cross sectional study .In research
aims to understand relations of
parity and age with gradations pre
eclampsia for pregnant women in
Poli Hamil RSUD dr .Soegiri
Lamongan. The sample in research
conducted with simple random
sampling technique. Included in
this study is partly pregnant
women with pre eclampsia. A total
of 113 soegiri lamongan pregnant
women .Research carried out in
January and November in 2015
Poli Hamil RSUD dr .Soegiri
Lamongan.
Technique data collection in this
research is through secondary
data from record medical a patient
begins to August-October 2015.
Data then will be analyzed by the
use test chi- square to know
whether there was a correlation
between of parity with gradations
pre eklamsi for pregnant women.
While to know relations between
the ages of with gradations pre
eklamsi for pregnant women use
the correlation the spearman
RESULT
Table 1. Distribution Pregnant based on Age in Poli Hamil RSUD dr .Soegiri
Lamongan
No
Age
Frequency (n) Prosentase (%)
1
< 20 year
7
6,2
2
20- 35 year
76
67,3
3
>35 year
30
26,5
Total 113
100,0
Table 2. The parity on the distribution of pregnant women who experience
pre eclampsia in Poli Hamil RSUD dr .Soegiri Lamongan
No
Parity Frequency (n) Prosentase (%)
1
Primigravida
38
33,6
2
Multigravida
74
65,5
3
Grandemultigravida
1
0,9
Total 113
100,0
Table 3. Distribution Kind Of Age For Pregnant Women That Experienced Pre
Eclampsia in Poli Hamil RSUD dr .Soegiri Lamongan
No
Jenis Usia
Frequency (n) Prosentase (%)
1
Low risk age
76
67,3
2
High risk age
37
32,7
Total 113
100,0
Table 3 shows that the majority of or 67,3 % pregnant women that
experienced pre eclampsia having age risk low and almost all or 32.7 % have
age high risk.
Table 4 Cross Table Between Parity and Gradations of Pre Eclampsia in
Pregnant in Poli Hamil RSUD dr .Soegiri Lamongan
No
Paritas Pre eclampsia n
%
PER
PEB
n (%)
n
(%)
1
Primigravida
21
18,6
17
15,0
38
100,0
2
Multigravida
35
31,0
39
34,5
74
100,0
3
Grandemultigravida
1
1,8
0
0
1
100,0
Jumlah 57
51,4
56
49,5
113
100,0
n= 113
p= 0,443
Table 4 show that almost part or
34,5
%
pregnant
women
multigravida experienced severe
pre eclampsi weight and a small
part or 1,8 % pregnant women
grandemultigravida experienced
mild pre eklamsi. Test chi- square
with a get = 0,443 p, then p ˃ 0,05
which means not a significant
correlation exists between parity
with gradations of pre eclampsi
for pregnant.
Table 5 Cross Table Between Age
and Gradations of Pre Eclampsia
No
Usia
Pre Eclampsia
n
(%)
PER
PEB
n
(%)
n
1
Low risk
43
38,1
2
High risk
14
12,4
Total 57
50,4
56
49,6
n= 113
p= 0,062
For Pregnant in Poli Hamil RSUD
dr .Soegiri Lamongan
(%)
33
23
113
29,2
20,4
100,0
76
37
100,0
100,0
Table 5 shows that almost a part
or 38,1 % pregnant women with
age low risk experienced pretax
eklamsi light and a small part or
12.4 % pregnant mothers having
the age of high risk are
experienced pretax eklamsi light
.So it can be concluded that the
incidence of preeklamsi larger
found at the age of risk low .The
results of the study found some 76
pregnant women at the age of the
risk of low consisting of 47 or
61,84 % of mothers aged 20- 30
years and 29 or 38,16 % of
mothers 31- between the ages of
35 years. Spearman testing shows
p = 0,062, p = ˃ 0.05 which there is
a no significant corelation exists
between the ages of with
gradations pretax eclampsi for
pregnant.
DISCUSSION
The results of the study in table 2
shows that the majority of or 65,5
%
pregnant
women
that
experienced pre eklamsi with
status multigravida as many as 74
pregnant women .Of parity high
have maternal mortality rate
higher , incidence high on
primigravida young and old ,
primigravida old risk higher to pre
eklamsi difficult because in
primigravida old the formation of
antibody barrier ( blocking
antibodies that have not perfect
raising risk of pre eklamsi .
Multigravida is one of the factors
predisposing the pre eklamsi for
5
pregnant women, but in degree of
parity have been explained that
can cause scene pre eklamsi
higher
primigravida
(Bobak,
2004), where primigravida with
pregnancy first possible to stress
that it did not have experience and
this could trigger a rise in blood
pressure , and if high blood
pressure not measures can occur a
decrease in rate of filtration
glomerolus to improve reabsorbsi
sodium that can happen odema
(Benson, 2008) , but results
obtained largely or 65,5 % is
multigravida that the risk factors
lower than primigravida the pre
eklamsi not very significant good
multigravida or primigravida .This
could be caused by the acts of
preeklamsi in pregnancy ago and
preeklamsi in family history .
The results of the study in table 1
showed that the large ( 67,3 % )
pregnant women that experienced
pre eklamsi between the ages of
20- 35 years or as many as 76
pregnant women. According to
who for children aged most secure
undergo pregnancy and childbirth
is 20 to 30 years .But remember
progress the technology this , to
the age of 35 years were still
allowed to to conceive , because
spanned that age the physical
condition of woman in a state of
prima .The uterus are able to
provide protection or condition of
being maximum for pregnancy .
One of the factors predisposing the
pre eklamsi is pregnancy at the
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age of less than 20 or more than
35 years (Bobak , 2004 ) .Woman
teenagers in pregnancy first and
women aged over 35 years have
very high risk happened pre
eklamsia (Erica royston , 1994 )
.The youth with the possibility of
pregnancy first experienced stress
that it had yet to have experience
and this can trigger a rise in blood
pressure , and if high blood
pressure not handled can occur a
decrease in rate of filtration
glomerolus that would improve
reabsorbsi sodium so that can
occur odema (Benson , 2008).
The research results show that
table 3 showed that the or 50,4 %
of mothers impregnate with pre
eklamsi experienced pre eklamsi
light
with
57
pregnant
women.According to bobak in
2004, preeklamsi is a condition
specific pregnancy in which
hypertension happened on sunday
when all 20 in a woman who had
previously having normal blood
pressure.Preeklamsi is a disease
vasospastik involving many the
system and characterized by
hemoconcentration, hypertension
and proteinurin. According to
Sujiyatini, (2009 ), preeklamsi
light
is
the
hypertension
accompanied proteinuria and or
edema after age pregnancy 20
weeks or immediately after they
give birth.These symptoms can
take before age pregnancy 20
weeks
in
disease
the
trophoblast.Preeklamsi heavy is a
6
complication
pregnancy
characterized by the hypertension
160 / 110 mmhg or more
accompanied proteinuria and or
edema in pregnancy 20 week or
more.
Test results chi- square obtained p
= 0,443, so p ˃ 0.05 which means
h1 rejected it means there is no a
significant relation exists between
of parity with gradations pre
eklamsi for pregnant women in
poly pregnant rsud dr.Soegiri
lamongan.This could be caused by
factors that in being fatness or
obesity, pre eklamsi in previous
pregnancies, the process of a
chronic disease as diabetes
mellitus, hypertension, kidney
disease, vascular disease and
complication pregnancy covering
pregnancy multiple, a fetus large,
hidrop
the
fetus
and
polihidramnion.Cause
pre
eclampsia or eclampsia not yet
known until now.Many theories
who tries to explain the cause of
the disease, but none that can be
answering satisfactory.The theory
mature is much proposed as for
pre eclampsia is ischemia the
placenta will surely reveal various
symptoms pre eclampsia and
eclampsia
can
be
increase
pressure virgin
Test spearman get = 0,062 p, then
p & gt; 0,05 which means h1
rejected this means that there is
not a significant relation between
the ages of with gradations pre
eklamsi
for
pregnant
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women.Research shows 4.1 shows
that most ( 67,3 % ) pregnant
women who have pre eklamsi
aged between 20- 35 years or
some 76 pregnant women.One
factor predisposing the pre
eklamsi is pregnancy at the age of
less than 20 years or more of 35
years ( bobak, 2004 ).Women first
teenager in pregnancy and women
aged over 35 years have the very
highest pre eklamsia ( erica
royston, 1994 ).20 to age 35 years
have the risk lower than children
less than 20 and more than 35
years, the pre eklamsi not very
significant risk good age inferior
nor high risk.This could be
because that age range of pregnant
women
have
stressor
and
activities are ting
CONCLUSION
It can be conclude that
1.
the majority of pregnant
women
that
experienced
preeklamsi in Poli Hamil RSUD Dr.
Soegiri Lamongan.
2.
the majority of pregnant
women
that
experienced
preeklamsi in Poli Hamil RSUD Dr.
Soegiri Lamongan having age low
risk.
3.
pregnant women that
experienced preeklamsi in Poli
Hamil RSUD Dr. Soegiri Lamongan
experienced pre eklamsi light.
4.
there was no a significant
relation exists between of parity
with gradations pre eklamsi for
7
pregnant women in Poli Hamil
RSUD Dr. Soegiri Lamongan.
5.
there was no a significant
relation between the ages of with
gradations pre eklamsi for
pregnant women in Poli Hamil
RSUD Dr. Soegiri Lamongan.
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