Characteristics Of Clinical Symptoms In Pregnancy With Coronavirus Disease (Covid-19)

Latar Belakang. Penyakit Coronavirus 2019 (COVID-19) merupakan penyakit yang saat ini mewabah hampir di seluruh dunia dan disebut Coronavirus-2 (SARS-COV2) dengan sindrom pernafasan akut yang parah. Pertama kali dilaporkan pada 31 Desember 2019, dari daerah Wuhan, provinsi Hubei, China, kasus pertama pneumonia tanpa penyebab yang diketahui. Data WHO per 7 Maret 2020 mengidentifikasi 90.870 kasus terkonfirmasi dengan total kematian 3.112 orang. Sampai dengan 22 Juli 2020, WHO telah melaporkan 14.971.036 kasus yang dikonfirmasi dengan 618.017 kematian di seluruh dunia (Case Fatality Rate/CFR 4,1%).

Tujuan. Diketahuinya Karakteristik gejala klinis pada kehamilan dengan Coronavirus Disease (COVID-19) di RSPAD Gatot Soebroto Periode Maret 2020 – Februari 2021”.

Metode. Jenis penelitian kuantitatif dengan deskriptif analitik dengan pendekatan retrospektif secara cross sectional, lokasi penelitian dilaksanakan di Poli Fetomaternal RSPAD Gatot Soebroto Jakarta Pusat pada bulan Maret 2020 – Februari 2021. Populasi 201 ibu hamil yang melakukan kunjungan ANC, sampel 75 ibu hamil dengan covid, instrumen yang digunakan adalah data dari rekam medik. Variabel yang digunakan adalah usia, paritas, usia kehamilan, penyakit penyerta kehamilan, derajat Covid-19.

Hasil. Usia ibu paling banyak antara usia 24 tahun sebesar 6 orang (8%), usia 28 tahun sebesar 8 orang (10,7%), usia 30 tahun sebesar 8 orang (10,7%), usia 34 tahun sebesar 6 orang (8%), usia 39 tahun sebesar 6 orang (8%), dengan usia minimal 21 tahun dan usia maksimal 42 tahun, dari 75 ibu hamil dengan covid. Ibu hamil dengan covid usia beresiko sebesar 15 orang (20%), dan ibu hamil dengan covid usia tidak beresiko sebesar 60 orang (80%). Terdapat multigravida sebesar 59 orang (78,7%), sedangkan primigravida sebesar 16 orang (21,3%). Usia kehamilan aterm sebanyak 72 (96.0%), sebagian kecil usia kehamilan preterm 3 (4%) Penyakit penyerta kehamilan pada ibu hamil dengan covid-19 rata-rata tidak memiliki penyakit penyerta, penyakit penyerta kehamilan yang paling banyak adalah PEB 8 (10.7), HbSag (+) sebesar 3 (4%), dan asma sebesar 2 (2.7%). Derajat covid-19 pada ibu hamil mayoritas adalah derajat ringan 63 (84.0%), serajat berat hanya 3 (4%).

Kesimpulan. Hasil penelitian melalui telaah literatur review menunjukan ibu hamil berusia 28 dan 30 tahun merupakan usia ibu hamil terbanyak yaitu sebesar 10,7%, sebagian besar ibu hamil berjumlah 59 orang merupakan multigravida yaitu sebesar 78,7%, sebagian besar ibu hamil berjumlah 72 orang berada pada usia kehamilan aterm sebesar 96,0%, penyakit penyerta ibu hamil paling banyak adalah PEB berjumlah 8 orang sebesar 10,7%, serta derajat covid-19 pada ibu hamil  mayoritas merupakan derajat ringan sejumlah 63 orang dan berjumlah 84,0%.

Saran Derajat covid-19 pada ibu hamil mayoritas adalah derajat ringan 63 (84.0%), serajat berat hanya 3 (4%), maka saat disarankan untuk ISOMAN prosedur pemulangan pasien saat ibu hamil dinyatakan boleh ISOMAN maka rumah sakit menyusun prosedur pemulangan pasien hamil dengan covid yang dapat menularkan meskipun dengan gejala ringan.

Kata kunci: Covid-19, Ibu hamil, derajat Covid-19. penyakit penyerta kehamilan, usia, paritas, usia kehamilan

ABSTRACT

Background. Coronavirus disease 2019 (COVID-19) is currently endemic almost all over the world and is called Coronavirus-2 (SARS-COV2) with the severe acute respiratory syndrome. It was first reported on December 31, 2019, from Wuhan, China, with the first case of pneumonia with no known cause. As of March 7, 2020, WHO data identified 90,870 confirmed cases with a total death of 3,112 people. As of July 22, 2020, WHO has reported 14,971,036 confirmed cases with 618,017 deaths worldwide (case fatality rate/CFR 4.1%).

Purpose. This study aims to know the characteristics of clinical symptoms in pregnancy with Coronavirus Disease (COVID-19) at RSPAD Gatot Soebroto from March 2020 to February 2021.

Method. The research design used was descriptive-analytic using a cross-sectional retrospective time approach. The research was conducted at the Fetomaternal room at RSPAD Gatot Soebroto Jakarta from March 2020 to February 2021. The instrument used was data from medical records. The variables used were age, parity, gestational age, comorbidities of pregnancy, and the severity of COVID-19.

Results. The age of most pregnant women was between the age of 24 years in six people (8%), age 28 years in eight people (10.7%), age 30 years in eight people (10.7%), age 34 years in six people (8%), and age 39 years in six people (8%), with a minimum age of 21 years and a maximum age of 42 years, from 75 pregnant women with COVID-19. Pregnant women with COVID-19 age at risk were 15 people (20%), and pregnant women with COVID-19 at no risk age were 60 people (80%). In addition, 59 people had multigravida (78.7%), while primigravida was in 16 people (21.3%). The term gestational age was present in 72 mothers (96.0%), and a small proportion of preterm gestational age was present in three mothers (4%). Among pregnant women with COVID-19, on average, they had no comorbidities, and the most common comorbidities of pregnancy were PEB in eight women (10.7), HBsAg (+) in three women (4%), and asthma in two women (2.7%). Furthermore, the majority of the severity of COVID-19 in pregnant women was mild in 63 women (84.0%) and severe only in three women (4%).

Conclusion. The study results through the literature review showed that pregnant women aged 28 and 30 years were the most age of pregnant women, namely 10.7%. Most of the pregnant women were multigravida with 78.7%. In addition, 96.0% of pregnant women were at term gestational age. Then, the most comorbidities of pregnant women were pre-eclampsia at 10.7%. Meanwhile, the 84% majority severity of COVID-19 in pregnant women was at mild levels.

Suggestions: Most COVID-19 levels in pregnant women were mild at 63 mothers (84.0%) and severe only in three mothers (4%). Thus, it is recommended to self-isolate. For returning patients, when pregnant women are declared to self-isolate, the hospital arranges procedures for the discharge of pregnant patients with COVID-19 who can transmit, even with mild symptoms.

Keywords: Age, COVID-19, pregnancy comorbidities, gestational age, pregnant women, parity, the severity of COVID-19.