Explorative Study on Hipertension Treatment among Pregnant Women

Anis Ristyaningsih, Fivy Kurniawati, N. M. Yasin
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Abstract

Maternal mortality in Indonesia is relatively high, hypertension becomes one of the causes. Hypertension and complication give particular contribution on morbidity and mortality on neonatal and maternal. On the other hand, antihypertensive drug use in  pregnancy has both benefit and risk. Therefore, appropriate hypertension management needs to be assesed in order to minimize the risk in mother and baby. The aim of the study is to determine the utilization pattern of antihypertensive drugs that will be assesed for suitability with the standard of medical service and American College of Obstetrics and Gynecologists (ACOG) guideline, as well as to determine clinical outcome of the therapy, which includes achieving target blood pressure, proteinuria, and edema. This study was a cross-sectional study with retrospective data collected from hospitalized patients’ medical record in RS PKU Muhammadiyah Yogyakarta from 2012 – 2015. The data of patients’ medical records according to inclusion and exclusion criteria was obtained using consecutive sampling method. Data obtained was analyzed descriptively and reviewed with the suitability of standard of medical service and ACOG guideline. Research shows that most widely used antihypertensive drugs are nifedipine by 51,8%, methyldopa by 2,6%, and amlodipine by 2,6%. Based on the evaluation of sensibility of treatment, 75,3% stated right indication, 100% right patient, and right medication and dosage. Clinical outcome includes blood pressure that had achieved the target as many as 77 patient, with negative value of proteinuria and edema. Blood pressure when patients were dismissed from the hospital was on average of 128,9±15,9/85±10,9 mmHg. In general, the utilization pattern of hypertension drugs in pregnant women has been well and according to the standards used.
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孕妇高血压治疗的探索性研究
印度尼西亚产妇死亡率较高,高血压成为其中一个原因。高血压和并发症对新生儿和产妇的发病率和死亡率有特别的贡献。另一方面,妊娠期使用降压药既有益处,也有风险。因此,需要评估适当的高血压管理,以尽量减少母亲和婴儿的风险。该研究的目的是确定降压药的使用模式,并根据医疗服务标准和美国妇产科学会(ACOG)指南评估其适用性,以及确定治疗的临床结果,包括达到目标血压、蛋白尿和水肿。本研究是一项横断面研究,回顾性数据收集了2012 - 2015年在日惹穆罕默迪亚大学住院患者的医疗记录。采用连续抽样方法获得符合纳入和排除标准的患者病历资料。对获得的数据进行描述性分析,并根据医疗服务标准和ACOG指南的适用性进行审查。研究表明,最广泛使用的降压药是硝苯地平(51.8%)、甲基多巴(2.6%)和氨氯地平(2.6%)。在治疗敏感性评价中,75.3%的人认为适应证正确,患者100%正确,用药剂量正确。临床结果包括77例患者血压达标,蛋白尿和水肿均为阴性。患者出院时血压平均为128,9±15,9/85±10,9 mmHg。总体而言,孕妇高血压药物的使用模式良好,符合使用标准。
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