Impact of Obesity with Chronic Hypertension in Pregnancy Age 35 Years
Abstract
The incidence of pregnancy with obesity in Indonesia reaches 21.8%. This can be more serious, if the pregnant woman is too old (≥ 35 years) then there will be more complications for the mother and fetus. This case study was written based on midwifery management, in the form of subjective, objective documentation, analysis, and management. Based on a case study conducted on GIP0A0 gestational age 36 weeks, 35 years old with obesity and old age. The impact of obesity found is chronic hypertension which will reduce the supply of oxygen and food from the mother to the baby so that the fetus is diagnosed with suspected Intrauterine Growth Restriction (IUGR). The mother is categorized as level II obese, obesity increases the risk of narrowing of the blood vessels by the accumulation of fat, which causes poor blood circulation which transports O2 and nutrients to the baby so that the fetus's weight does not match the gestational age, what is detected from TFU does not match the gestational age, in fact, accompanied by minimal amniotic conditions (oligohydramnios). To prevent complications for the mother and baby, delivery is carried out by cesarean section (SC). The mother's baby was a High Social Value Baby (HSVB), and after SC there was no success in providing exclusive breastfeeding, due to the mother's lack of knowledge about how and the benefits of breastfeeding. The mother chose IUD contraception which was inserted at the time of delivery. In conclusion, appropriate care provided by midwives during pregnancy, childbirth, newborns, postpartum and family planning is very important for the health of mothers and babies. So that early detection of risk factors can be minimized and possible complications can be prevented.
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References
Bakouei, F., Delavar, M. A., Mashayekh-Amiri, S., Esmailzadeh, S., & Taheri, Z. (2020). Efficacy of n-3 fatty acids supplementation on the prevention of pregnancy-induced hypertension or preeclampsia: A systematic review and meta-analysis. In Taiwanese Journal of Obstetrics and Gynecology (Vol. 59, Issue 1, pp. 8–15). Elsevier Ltd. https://doi.org/10.1016/j.tjog.2019.11.002
Basu, A., Feng, D., Planinic, P., Ebersole, J. L., Lyons, T. J., & Alexander, J. M. (2021). Dietary Blueberry and Soluble Fiber Supplementation Reduces Risk of Gestational Diabetes in Women with Obesity in a Randomized Controlled Trial. Journal of Nutrition, 151(5), 1128–1138. https://doi.org/10.1093/jn/nxaa435
Bernardi, S., Tonon, F., Barbieri, M., Zamagni, G., Nuredini, R., Perer, L., Comar, S., Toffoli, B., Ronfani, L., Ricci, G., Fabris, B., & Stampalija, T. (2024). A longitudinal study on the effect of obesity upon circulating renin-angiotensin system in normal pregnancy. Nutrition, Metabolism and Cardiovascular Diseases, 34(3), 771–782. https://doi.org/10.1016/j.numecd.2023.10.030
Bhutani, N., Jethani, V., Jethani, S., & Ratwani, K. (2022). Coagulation profile and platelet parameters in pregnancy induced hypertension cases and normotensive pregnancies: A cross-sectional study. Annals of Medicine and Surgery, 80. https://doi.org/10.1016/j.amsu.2022.104124
Bodnar, L. M., Johansson, K., Himes, K. P., Khodyakov, D., Abrams, B., Parisi, S. M., & Hutcheon, J. A. (2024). Gestational weight gain below recommendations and adverse maternal and child health outcomes for pregnancies with overweight or obesity: a US cohort study. The American Journal of Clinical Nutrition. https://doi.org/10.1016/j.ajcnut.2024.06.011
Brown, S. D., Hedderson, M. M., Ehrlich, S. F., Galarce, M. N., Tsai, A. L., Quesenberry, C. P., & Ferrara, A. (2019). Gestational weight gain and optimal wellness (GLOW): Rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity. BMC Pregnancy and Childbirth, 19(1). https://doi.org/10.1186/s12884-019-2293-8
Chang, W. S., Lin, L. Te, Hsu, L. C., Tang, P. L., Tsui, K. H., & Wang, P. H. (2018). Maternal pregnancy-induced hypertension increases the subsequent risk of transient tachypnea of the newborn: A nationwide population-based cohort study. Taiwanese Journal of Obstetrics and Gynecology, 57(4), 546–550. https://doi.org/10.1016/j.tjog.2018.06.013
Chen, S., Li, N., Mei, Z., Ye, R., Li, Z., Liu, J., & Serdula, M. K. (2019). Micronutrient supplementation during pregnancy and the risk of pregnancy-induced hypertension: A randomized clinical trial. Clinical Nutrition, 38(1), 146–151. https://doi.org/10.1016/j.clnu.2018.01.029
Chen, S. N., Wang, P. H., Hsieh, M. F., Tsai, H. W., Lin, L. Te, & Tsui, K. H. (2019). Maternal pregnancy-induced hypertension increases the subsequent risk of neonatal candidiasis: A nationwide population-based cohort study. Taiwanese Journal of Obstetrics and Gynecology, 58(2), 261–265. https://doi.org/10.1016/j.tjog.2019.01.017
Dai, C., Zhao, C., Xu, M., Sui, X., Sun, L., Liu, Y., Su, M., Wang, H., Yuan, Y., Zhang, S., Shi, J., Sun, J., & Li, Y. (2021). Serum lncRNAs in early pregnancy as potential biomarkers for the prediction of pregnancy-induced hypertension, including preeclampsia. Molecular Therapy Nucleic Acids, 24, 416–425. https://doi.org/10.1016/j.omtn.2021.03.010
Dunne, S., Gibney, E., McGillicuddy, F., & Feeney, E. (2023). P24-041-23 Effects of LDL Phenotype and Differences in Risk Stratification in Response to Dairy Fat Consumption. Current Developments in Nutrition, 7, 100332. https://doi.org/10.1016/j.cdnut.2023.100332
Dwitama, M. A., Masni, Nur, R., Indarty, A., Tahir A, M., Mallongi, A., Basir, M., Mahfudz, & Ansyari, A. (2021). Mapping of high-risk detection of women pregnancy on antenatal care in Talise Health Center, Palu City, Indonesia. Gaceta Sanitaria, 35, S152–S158. https://doi.org/10.1016/j.gaceta.2021.10.015
Ferrara, A., Hedderson, M. M., Brown, S. D., Ehrlich, S. F., Tsai, A.-L., Feng, J., Galarce, M., Marcovina, S., Catalano, P., & Quesenberry, C. P. (2020). A telehealth lifestyle intervention to reduce excess gestational weight gain in pregnant women with overweight or obesity (GLOW): a randomised, parallel-group, controlled trial. In www.thelancet.com/diabetes-endocrinology (Vol. 8). www.thelancet.com/diabetes-endocrinology
González-Plaza, E., Bellart, J., Martínez-Verdú, M. Á., Arranz, Á., Luján-Barroso, L., & Seguranyes, G. (2022). Pre-pregnancy overweight and obesity prevalence and relation to maternal and perinatal outcomes. Enfermería Clínica (English Edition), 32, S23–S30. https://doi.org/10.1016/j.enfcle.2021.04.006
Hart, T. L., Petersen, K. S., & Kris-Etherton, P. M. (2022). Nutrition recommendations for a healthy pregnancy and lactation in women with overweight and obesity – strategies for weight loss before and after pregnancy. In Fertility and Sterility (Vol. 118, Issue 3, pp. 434–446). Elsevier Inc. https://doi.org/10.1016/j.fertnstert.2022.07.027
Holmquist, E., Brantsæter, A. L., Meltzer, H. M., Jacobsson, B., Barman, M., & Sengpiel, V. (2021). Maternal selenium intake and selenium status during pregnancy in relation to preeclampsia and pregnancy-induced hypertension in a large Norwegian Pregnancy Cohort Study. Science of the Total Environment, 798. https://doi.org/10.1016/j.scitotenv.2021.149271
Kirkham, K., Tohill, S., Hutcheon, J. A., Dorling, J., Gkini, E., Moakes, C. A., Stubbs, C., Thornton, J., von Dadelszen, P., & Magee, L. A. (2023). WILL (When to induce labour to limit risk in pregnancy hypertension): Protocol for a multicentre randomised trial. Pregnancy Hypertension, 32, 35–42. https://doi.org/10.1016/j.preghy.2023.03.002
Li, J. Y., Wang, P. H., Vitale, S. G., Chen, S. N., Marranzano, M., Cianci, A., Lin, L. Te, & Tsui, K. H. (2019). Pregnancy-induced hypertension is an independent risk factor for meconium aspiration syndrome: A retrospective population based cohort study. Taiwanese Journal of Obstetrics and Gynecology, 58(3), 396–400. https://doi.org/10.1016/j.tjog.2018.11.034
Luna, S. D., & Martinovic, T. C. (2023). Hypertension and pregnancy: review of the literature. Revista Medica Clinica Las Condes, 34(1), 33–43. https://doi.org/10.1016/j.rmclc.2023.01.006
Mossie, A., Ali, S. A., & Tesema, H. G. (2022). Anesthetic implications of morbid obesity during pregnancy; a literature based review. In International Journal of Surgery Open (Vol. 40). Elsevier Ltd. https://doi.org/10.1016/j.ijso.2022.100444
Nishino, K., Yamamoto, E., Oda, Y., Watanabe, E., Niimi, K., Yamamoto, T., & Kajiyama, H. (2021). Short tandem repeat analysis to identify the causative pregnancy of high-risk gestational trophoblastic neoplasia: Molar versus nonmolar pregnancy and its relation to the outcome. Placenta, 112, 28–35. https://doi.org/10.1016/j.placenta.2021.06.015
Pylypjuk, C., Bokhanchuk, A., Day, C., ElSalakawy, Y., & Seshia, M. M. (2022). Antenatal breastfeeding promotion amongst pregnancies at high-risk for newborn admission to the NICU: A cross-sectional study. European Journal of Obstetrics and Gynecology and Reproductive Biology: X, 15. https://doi.org/10.1016/j.eurox.2022.100160
Shaban, M., Antonio, M., Guerra, R., Ruiz-Matuk, C., Victoria, M., Valenzuela González, A. C., Paula, A., Neme, U., & Taha, M. (2023). Spotlight on Special Topics ECHOCARDIOGRAPHIC EPICARDIAL FAT THICKNESS AS A PREDICTOR FOR RECURRENCE OF PREGNANCY-INDUCED HYPERTENSION IN EGYPTIANS Presentation Number: 1814-042 (Vol. 81, Issue 8).
Sominsky, L., O’Hely, M., Drummond, K., Cao, S., Collier, F., Dhar, P., Loughman, A., Dawson, S., Tang, M. L., Mansell, T., Saffery, R., Burgner, D., Ponsonby, A. L., & Vuillermin, P. (2023). Pre-pregnancy obesity is associated with greater systemic inflammation and increased risk of antenatal depression. Brain, Behavior, and Immunity, 113, 189–202. https://doi.org/10.1016/j.bbi.2023.07.005
Sureshchandra, S., Marshall, N. E., Mendoza, N., Jankeel, A., Zulu, M. Z., & Messaoudi, I. (n.d.). Functional and genomic adaptations of blood monocytes to pregravid obesity during pregnancy. https://doi.org/10.1016/j.isci
Valencia, S. A., Barrientos Gómez, J. G., Gómez Ramirez, M. C., Luna, I. F., Caicedo, H. A., Torres-Silva, E. A., & Díaz, E. S. (2023). Evaluation of a telehealth program for high-risk pregnancy in a health service provider institution. International Journal of Medical Informatics, 179. https://doi.org/10.1016/j.ijmedinf.2023.105234
Van Denakker, T. A., Haddaway, K., Cunningham, A., Leonard, K., Darwin, K., Meeks, M., Lawson, S. M., Vaught, A., Moliterno, A., Frank, S. M., Tobian, A., Crowe, E., Bloch, E., & Rai, H. (2023). Overcoming challenges in managing a high-risk pregnancy with placenta previa and newly diagnosed Bombay phenotype. Transfusion and Apheresis Science, 62(6). https://doi.org/10.1016/j.transci.2023.103832
Villamizar-Durán, R., Mosquera, W., Gutiérrez, J., Mena, J., & Guzmán, G. (2017). La hipertensión pulmonar en el recién nacido con cierre del ductus arterioso en el útero y secuencia de la perfusión arterial reversa en el embarazo gemelar. Revista Colombiana de Cardiologia, 24(4), 410.e1-410.e6. https://doi.org/10.1016/j.rccar.2016.11.007
Yata, K., Hashimoto, R., Masahara, H., Oyamada, M., & Maeno, T. (2020). Changes in choroidal circulation and pulse waveform in a case of pregnancy-induced hypertension with serous retinal detachment. American Journal of Ophthalmology Case Reports, 20. https://doi.org/10.1016/j.ajoc.2020.100911
Zhang, L., Sun, J., Zhang, M., Lin, Y., Fang, L., Fang, X., Mai, W., & Yin, Z. (2019). The significance of combined detection of CysC, urinary mAlb and β2-MG in diagnosis of the early renal injury in pregnancy-induced hypertension syndrome. Saudi Journal of Biological Sciences, 26(8), 1982–1985. https://doi.org/10.1016/j.sjbs.2019.07.013
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