Pre-Referral Management, Maternal and Perinatal Outcome of Preeclampsia Patients with Severe Feature In Coastal Region

Abstrak

Preeclampsia (PE) with severe features, as one of the hypertensive disorders in pregnancy, often becomes a problem in health services for pregnant women. West Nusa Tenggara or Nusa Tenggara Barat (NTB) Province is in the Eastern part of Indonesia with archipelagic characteristics. Sea transportation is the main transportation used to refer patients live in coastal area and small islands. Travel distance, limited facilities on ships and weather conditions are challenges for the referral system in this province. This study aims to determine the characteristics of pre-referral management in cases of preeclampsia with severe features and type of maternal and perinatal outcomes. This study found a total of 60 subjects. Of the four pre-referral treatments for preeclamptic pregnant women, administration of MgSO4 is the most common therapy. There were 80% (n=48) of subjects receiving antihypertensives. 21 subjects (35%) were given steroids. Only one subject with a history of taking aspirin. As many as 30% of patients experienced eclampsia, 6.7% with HELLP syndrome, 20% with severe hypertension and one with CVA. The majority of babies born with APGAR scores <7 at one and five minutes, 10% with RDS and 21.7% in the NICU for >3 days. Our findings show pre-referral care needs to be better, especially for patients living on the coast as it takes more challenges due to extreme weather and distance. The provision of low-dose aspirin in groups at high risk of preeclampsia needs to be improved.