ADLN Perpustakaan Universitas Airlangga DAFTAR ISI

ADLN Perpustakaan Universitas Airlangga

DAFTAR ISI

Sampul Depan Sampul Dalam.......................................................................................................... i Surat Pernyataan..................................................................................................... ii Lembar Persetujuan............................................................................................... iii Penetapan Panitian Penguji Skripsi........................................................................ iv Lembar Pengesahan................................................................................................ v Ucapan Terima Kasih............................................................................................. vi Ringkasan............................................................................................................. viii Abstract.................................................................................................................. ix DAFTAR ISI.......................................................................................................... x DAFTAR TABEL............................................................................................... xii DAFTAR GAMBAR.......................................................................................... xiii DAFTAR LAMPIRAN...................................................................................... xiv BAB I PENDAHULUAN 1.1 Latar Belakang Masalah.............................................................................. 1 1.2 Identifikasi Masalah.................................................................................... 3 1.3 Rumusan Masalah....................................................................................... 4 1.4 Tujuan Penelitian........................................................................................ 4 1. Tujuan Umum....................................................................................... 4 2. Tujuan Khusus...................................................................................... 4 1.5 Manfaat Penelitian ..................................................................................... 5 1.6 Ruang Lingkup Penelitian........................................................................... 5 BAB II LANDASAN TEORI 2.1 Definisi Preeklampsia................................................................................. 7 2.2 Etiologi Preeklampsia................................................................................. 8 2.3 Faktor Resiko.............................................................................................. 8 2.4 Patofisiologi Preeklampsia........................................................................ 12 2.4.1 Teori Kelainan Vaskularisasi Plasenta........................................ 12 2.4.2 Teori Iskemia Plasenta, Radikal bebas dan Disfungsi Endotel... 13 2.4.3 Teori Intoleransi Imunologik Antara Ibu dan Janin.................... 16 2.4.4 Teori Adaptasi Kardiovaskular................................................... 17 2.4.5 Teori Defisiensi Gizi................................................................... 18 2.4.6 Teori stimulus Inflamasi............................................................. 19 2.5 Manifestasi Klinik..................................................................................... 20 2.5.1 Perubahan Pada Plasenta dan Uterus.......................................... 21 2.5.2 Perubahan Pada Ginjal................................................................ 21 2.5.3 Perubahan Pada Retina................................................................ 22 2.5.4 Perubahan Pada Paru-Paru.......................................................... 22 2.5.5 Perubahan Pada Otak.................................................................. 22 2.5.6 Metabolisme Air dan Elektrolit................................................... 23 2.6 Gejala Preeklampsia.................................................................................. 23 2.7 Klasifikasi Preeklampsia........................................................................... 24 2.7.1 Preeklampsia Ringan................................................................... 24

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FAKTOR-FAKTOR YANG BERHUBUNGAN..

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2.7.2 Preeklampsia Berat...................................................................... 24 2.8 Komplikasi Preeklampsia.......................................................................... 25 2.9 Penanganan Preeklampsia......................................................................... 28 2.9.1 Preeklampsia Ringan................................................................... 29 2.9.2 Preeklampsia Berat...................................................................... 30 BAB III KERANGKA KONSEPTUAL DAN HIPOTESIS PENELITIAN 3.1 Kerangka Konsep Penelitian..................................................................... 31 3.2 Hipotesis.................................................................................................... 32 BAB IV METODE PENELITIAN 4.1 Desain Penelitian....................................................................................... 34 4.2 Kerangka Kerja......................................................................................... 35 4.3 Populasi, Sampel,Besar Sampel dan Sampling......................................... 36 4.3.1 Populasi....................................................................................... 36 4.3.2 Sampel......................................................................................... 36 4.3.3 Besar Sampel............................................................................... 37 4.3.4 Sampling..................................................................................... 38 4.4 Identifikasi Variabel...................................................................................38 4.4.1 Variabel Independent...................................................................38 4.4.2 Variabel Dependent......................................................................38 4.5 Definisi Operasional.................................................................................. 39 4.6 Pengumpulan dan Pengolahan Data.......................................................... 40 4.6.1 Instrument................................................................................... 40 4.6.2 Lokasi.......................................................................................... 40 4.6.3 Prosedur Pengumplan Data......................................................... 40 4.6.4 Cara Pengolahan Data................................................................. 41 4.6.5 Tahap Analisa Data..................................................................... 42 4.7 Masalah Etika............................................................................................ 44 4.7.1 Anonimity (Tanpa Nama) ............................................................ 44 4.7.2 Confidentiality (Kerahasiaan) ...................................................... 44 4.8 Keterbatasan.............................................................................................. 44 BAB V HASIL DAN PEMBAHASAN PENELITIAN 5.1 Hasil Penelitian.......................................................................................... 45 5.2 Pembahasan Penelitian.............................................................................. 57 BAB V HASIL DAN PEMBAHASAN PENELITIAN 6.1 Kesimpulan............................................................................................... 63 6.2 Saran.......................................................................................................... 63 DAFTAR PUSTAKA

Skripsi


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DAFTAR TABEL Tabel 4.1

Halaman Definisi Operasional...................................................................... 39

Tabel 5.1

Distribusi Frekuensi Umur Ibu Bersalin....................................... 47

Tabel 5.2

Distribusi Frekuensi Paritas Ibu Bersalin...................................... 48

Tabel 5.3

Distribusi Frekuensi Riwayat Hipertensi Ibu Bersalin.................. 48

Tabel 5.4

Distribusi Frekuensi Ibu Bersalin Yang Mengalami Kehamilan Ganda............................................................................................ 49

Tabel 5.5

Hubungan Umur Ibu Bersalin Dengan Kejadian Preeklampsia.... 50

Tabel 5.6

Hubungan Paritas Ibu Bersalin Dengan Kejadian Preeklampsia.. 51

Tabel 5.7

Hubungan Riwayat Hipertensi Ibu Bersalin Dengan Kejadian Preeklampsia................................................................................. 52

Tabel 5.8

Hubungan Kehamilan Ganda Dengan Kejadian Preeklampsia..... 53

Tabel 5.9

Daftar Variabel Kandidat untuk Regresi Logistik....................... 55

Tabel 5.10

Hasil Analisa Multivariat Regresi Logistik Umur, Paritas Dan Riwayat Hipertensi Dengan Kejadian Preeklampsia.................... 56

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DAFTAR GAMBAR Halaman

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Gambar 3.1

Kerangka Konsep Penelitian......................................................... 31

Gambar 4.1

Gambar Desain Penelitian Case – Control................................... 34

Gambar 4.2

Kerangka Kerja Penelitian............................................................ 35


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DAFTAR LAMPIRAN Halaman Lampiran 1

Gent Chart..................................................................................... 67

Lampiran 2

Master Tabel.................................................................................. 68

Lampiran 3

Outpt SPSS.................................................................................... 72

Lampiran 4

Surat Izin Pengambilan Data Awal............................................... 83

Lampiran 5

Surat Permohonan pengambilan data Awal.................................. 85

Lampiran 6

Surat Izin Penelitian...................................................................... 86

Lampiran 7

Surat Permohonan Pertimbangan Izin Penelitian.......................... 87

Lampiran 8

Surat Komite Etik Penelitian Kesehatan....................................... 88

Lampiran 9

Surat keterangan Telah Selesai Melakukan Penelitian................. 89

Lampiran 10 Lembar konsultasi......................................................................... 90

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FENI ANDRIANI


RINGKASAN Preeklampsia ada lah terjadinya pe ningkatan tekanan darah paling s edikit 140/90 da n pr oteinuria. P reeklampsia be rat merupakan risiko yang da pat membahayakan ibu serta j anin. Sampai s aat ini te rjadinya p reeklampsia belum diketahui pe nyebabnya. Faktor pr edisposisi preeklampsia adalah um ur i bu yang ekstrim <20 t ahun a tau > 35 t ahun, kehamilan pertama, memiliki riwayat hipertensi, dan lain-lain. Masalah dari pe nelitian ini ada lah preeklampsia merupakan ur utan ke -2 di RSU Dr. Soetomo Surabaya, dan terjadi peningkatan presentase dari 13,8% kasus menjadi 17,3% p ada t ahun 2009. T ujuan da ri pe nelitian i ni a dalah unt uk mengetahui faktor – faktor yang berhubungan dengan kejadian preeklampsia dan seberapa besar hubungan faktor – faktor tersebut secara bersama – sama terhadap kejadian preeklampsia. Metode penelitian, a nalitik obs ervasional dengan desain penelitian case control study. Populasi terbagi menjadi dua, populasi kasus (seluruh ibu bersalin yang mengalami p reeklampsia) da n popul asi kon trol ( seluruh i bu be rsalin yang tidak mengalami kom plikasi pr eeklampsia). Besar s ampel yaitu 54 ka sus yang diambil secara simple sandom sampling dengan perbandingan kasus:kontrol (1:1). Variabel independent yaitu umur, paritas,riwayat hipertensi dan kehamilan ganda. Instrument pe ngumpulan da ta pada p enelitian ini adalah f ormat pe ngumpulan data. Analisa data secara chi-square. Hasil pe nelitian i ni m enunjukkan ba hwa f aktor-faktor yang be rhubungan dengan ke jadian pr eeklampsia be rdasarkan analisa mul tivariat yaitu umur (p=0,033; O R = 2,872; 95% C I 1,088 – 7,582), paritas (p = 0,003; OR = 4,053; 95% CI 1,634 – 10,056), dan riwayat hipertensi (p = 0,002; OR = 6,369; 95% CI 2,031 – 19,977). Probabilitas ibu untuk mengalami preeklampsia dengan memiliki faktor-faktor r esiko di a tas a dalah 95% . Faktor yang t idak m emiliki hubung an bermakna adalah kehamilan ganda. Hasil pe nelitian ini da pat di simpulkan, ibu yang m empunyai um ur <20 tahun a tau > 35 t ahun, primigravida, r iwayat h ipertensi a kan memiliki r esiko terjadinya preeklampsia sebesar 95%. Kata kunci : preeklampsia, faktor resiko preeklampsia

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FENI ANDRIANI


ABSTRACT

Preeclampsia i s de fined a s a c ondition, t he s ymptoms of w hich are excessive blood pressure at least 140/90 and proteinuria (the presence of protein in the urine). Serious preeclampsia endangers the mother’s fetus. Up to now, the etiology o f s erious pr eeclampsia i s s till unkn own. Predisposing f actors of preeclampsia ha ppens i s t hat ex treme m aternal a ge <20 years or > 35 years, first pregnancy, had a history of hypertension, and others. The problem of this study is pre-eclampsia form the second sequence in Dr. Soetomo Hospital, a nd an increase i n pe rcentage f rom 13.8% t o 17.3% during 2009. The objective of the study was to determine the factors associated with the incidence preeclampsia and how great t hese factors i nfluenced together on the incidence of preeclampsia. Research method used was observational analytic with reseach design case control s tudy. The popu lation i s di vided i nto t wo, t he popul ation of c ases ( all birthing m others who experienced pr eeclampsia) a nd c ontrol popul ation ( all birthing m others w ho d id not e xperience c omplications of pr eeclampsia). T he sample size of 54 cases taken by simple random sampling with comparison cases: control (1:1). Independent variables were age, parity, history of hypertension and multiple pregnancy. The data was analyzed by using chi-square test. The r esult s howed t hat f actors associated with the oc currence of preeclampsia were based on multivariate analysis were age (p=0,033; OR = 2,872; 95% CI 1,088 – 7,582), parity (p = 0,003; OR = 4,053; 95% CI 1,634 – 10,056), and a history of h ypertension (p = 0,002; OR = 6,369; 95% C I 2,031 – 19,977). The pr obability o f mother t o experience pr eeclapmsia which h ad t he f actors mentioned above is 95%. The factors that did not associated with the occurence of preeclampsia is multipel pregnancy. The results of this study can be concluded, mothers who have age <20 years or> 35 years ol d, pr imigravida, hi story of h ypertension w ill ha ve t he r isk of preeclampsia by 95%. Keywords : preeclampsia, risk factors of preeclampsia

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ADLN Perpustakaan Universitas Airlangga DAFTAR ISI

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