Asuhan Kebidanan Komunitas pada Kehamilan Trimester I dengan Emesis Gravidarum: Laporan Kasus di Wilayah Kerja Puskesmas Batu Nyala Kabupaten Lombok Tengah
Kata Kunci:
emesis gravidarum; first trimester; community midwifery care; ginger therapy; case reportAbstrak
Background: Nausea and vomiting of pregnancy (emesis gravidarum) affects most women in the first trimester and, when unmanaged, can progress to hyperemesis gravidarum with dehydration and nutritional deficiency. Case-level documentation of community midwifery management for first-trimester nausea and vomiting remains limited compared with population-level prevalence studies. Objective: This case report describes community midwifery care using the Subjective-Objective-Analysis-Planning (SOAP) framework for a primigravid woman with emesis gravidarum at Batu Nyale Primary Health Care Center, Central Lombok Regency. Method: A descriptive case-study design was used. Data were collected through interview, physical examination, vital signs, anthropometry, and laboratory testing at 10-11 weeks of gestation. Results: The client, a 21-year-old primigravida (G1P0A0H0), presented with morning nausea and vomiting three to four times daily, fatigue, dizziness, reduced appetite, and a 2-kg weight loss since before pregnancy. Examination and vital signs were normal with no dehydration; Hb was 12.4 g/dL. The client was diagnosed with physiological first-trimester pregnancy with mild emesis gravidarum and was managed through small frequent meals, avoidance of fatty/spicy/strong-smelling food, ginger-based herbal therapy, folic acid, danger-sign education, and a scheduled follow-up, with physician collaboration identified as a contingency should symptoms progress toward hyperemesis gravidarum. Conclusion: This case illustrates how a holistic, evidence-informed SOAP-based midwifery approach can manage first-trimester emesis gravidarum at the primary-care level while maintaining vigilance for progression to hyperemesis gravidarum. Findings support strengthening early antenatal counselling on first-trimester discomforts as a complementary strategy to reduce complications of unmanaged nausea and vomiting in pregnancy.
Referensi
Amiliano, R. (2018). Dampak emesis gravidarum yang tidak tertangani pada kehamilan. Jurnal Kesehatan Ibu dan Anak, 6(1), 12–18.
Ani, S., Rahmawati, D., & Susanti, E. (2020). Pengaruh aromaterapi lavender terhadap intensitas mual muntah pada ibu hamil trimester I. Jurnal Kebidanan dan Kesehatan, 12(2), 88–95.
Evi, N., & Fatchiatur, R. (2015). Perubahan hormonal dan keluhan mual muntah pada kehamilan trimester I. Jurnal Kebidanan, 4(2), 55–61.
Farida, L., & Lola, S. (2020). Ketidaknyamanan kehamilan trimester I dan penatalaksanaannya. Nuha Medika.
Glare, P., Miller, J., Nikolova, T., & Tickoo, R. (2016). Treating nausea and vomiting in palliative care: A review. Clinical Interventions in Aging, 6, 243–259. https://doi.org/10.2147/CIA.S13109
Gunawan, S., Prabowo, E., & Rahayu, D. (2016). Efektivitas air rebusan jahe terhadap penurunan mual muntah pada ibu hamil trimester I. Jurnal Ilmu Kebidanan, 4(1), 21–27.
Ika, P. (2020). Hiperemesis gravidarum: Patofisiologi dan penatalaksanaan. Nuha Medika.
Kementerian Kesehatan Republik Indonesia. (2019). Profil kesehatan ibu dan anak Indonesia tahun 2019. Kemenkes RI.
King, A., & Murphy, K. (2019). Nausea and vomiting in pregnancy: A review of nonpharmacologic and pharmacologic interventions. Journal of Midwifery & Women's Health, 64(1), 33–41. https://doi.org/10.1111/jmwh.12921
Koren, G., Boskovic, R., Hard, M., Maltepe, C., Navioz, Y., & Einarson, A. (2002). Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. American Journal of Obstetrics and Gynecology, 186(5), S228–S231. https://doi.org/10.1067/mob.2002.123054
Kusmiyati, Y., & Wahyuningsih, H. P. (2015). Asuhan kebidanan kehamilan. Fitramaya.
Lee, N. M., & Saha, S. (2016). Nausea and vomiting of pregnancy. Gastroenterology Clinics of North America, 40(2), 309–334. https://doi.org/10.1016/j.gtc.2011.03.009
Lola, S., & Sri, W. (2020). Terapi farmakologis dan non-farmakologis pada emesis gravidarum. Jurnal Kesehatan Reproduksi, 8(1), 40–47.
Manuaba, I. B. G. (2018). Ilmu kebidanan, penyakit kandungan, dan keluarga berencana untuk pendidikan bidan (3rd ed.). EGC.
Matthews, A., Haas, D. M., O'Mathúna, D. P., & Dowswell, T. (2015). Interventions for nausea and vomiting in early pregnancy. Cochrane Database of Systematic Reviews, 2015(9), CD007575. https://doi.org/10.1002/14651858.CD007575.pub4
Nur'aini, & Sarwinanti. (2019). Efektivitas aromaterapi terhadap mual muntah pada ibu hamil trimester I. Jurnal Kesehatan Samodra Ilmu, 10(2), 101–108.
Rahayu, S. (2018). Pengaruh pemberian aromaterapi lavender terhadap penurunan mual muntah ibu hamil trimester I. Jurnal Kebidanan Indonesia, 9(1), 15–22.
Rahmatullah, I., Handayani, S., & Kurniawati, D. (2016). Manajemen nutrisi pada ibu hamil dengan emesis gravidarum. Jurnal Gizi Klinik Indonesia, 13(1), 30–36.
Rasida, S. (2020). Hiperemesis gravidarum dan komplikasinya pada kehamilan. Nuha Medika.
Sarwono, P. (2019). Ilmu kebidanan (5th ed.). Bina Pustaka Sarwono Prawirohardjo.
Tiran, D. (2014). Mual dan muntah kehamilan: Penyebab dan penatalaksanaan (alih bahasa). EGC.
Varney, H., Kriebs, J. M., & Gegor, C. L. (2004). Varney's midwifery (4th ed.). Jones & Bartlett Learning.
Viljoen, E., Visser, J., Koen, N., & Musekiwa, A. (2014). A systematic review and meta-analysis of the effect and safety of ginger in the treatment of pregnancy-associated nausea and vomiting. Nutrition Journal, 13, 20. https://doi.org/10.1186/1475-2891-13-20
Wiknjosastro, H. (2014). Ilmu kebidanan (4th ed.). Bina Pustaka Sarwono Prawirohardjo.
Wiraharja, R. S. (2016). Manajemen mual muntah kehamilan: Faktor psikologis dan farmakologis. Jurnal Kedokteran, 5(2), 77–84.
World Health Organization. (2019). Global report on maternal morbidity: Nausea and vomiting in pregnancy. WHO.
