Anemia adalah kondisi ibu dengan kadar haemoglobin (Hb) dalam darahnya kurang dari 12 gr% (Wiknjosastro, 2002). Sedangkan anemia dalam kehamilan adalah kondisi ibu dengan kadar haemoglobin dibawah 11 gr% pada trimester I dan III atau kadar <10,5>1. Kurang gizi (malnutrisi)
2. Kurang zat besi dalam diit
3. Malabsorpsi
4. Kehilangan darah banyak seperti persalinan yang lalu, haid dan lain-lain
5. Penyakit-penyakit kronik seperti TBC paru, cacing usus, malaria dan lain-lain
GEJALA ANEMIA PADA IBU HAMIL
Gejala anemia pada kehamilan yaitu ibu mengeluh cepat lelah, sering pusing, mata berkunang-kunang, malaise, lidah luka, nafsu makan turun (anoreksia), konsentrasi hilang, nafas pendek (pada anemia parah) dan keluhan mual muntah lebih hebat pada hamil muda.
KLASIFIKASI ANEMIA DALAM KEHAMILAN.
Klasifikasi anemia dalam kehamilan menurut Mochtar (1998), adalah sebagai berikut:
1. Anemia Defisiensi Besi
Adalah anemia yang terjadi akibat kekurangan zat besi dalam darah. Pengobatannya yaitu, keperluan zat besi untuk wanita hamil, tidak hamil dan dalam laktasi yang dianjurkan adalah pemberian tablet besi.
a. Terapi Oral adalah dengan memberikan preparat besi yaitu fero sulfat, fero glukonat atau Na-fero bisirat. Pemberian preparat 60 mg/ hari dapat menaikan kadar Hb sebanyak 1 gr%/ bulan. Saat ini program nasional menganjurkan kombinasi 60 mg besi dan 50 nanogram asam folat untuk profilaksis anemia (Saifuddin, 2002).
b. Terapi Parenteral baru diperlukan apabila penderita tidak tahan akan zat besi per oral, dan adanya gangguan penyerapan, penyakit saluran pencernaan atau masa kehamilannya tua (Wiknjosastro, 2002). Pemberian preparat parenteral dengan ferum dextran sebanyak 1000 mg (20 mg) intravena atau 2 x 10 ml/ IM pada gluteus, dapat meningkatkan Hb lebih cepat yaitu 2 gr% (Manuaba, 2001).
Untuk menegakan diagnosa Anemia defisiensi besi dapat dilakukan dengan anamnesa. Hasil anamnesa didapatkan keluhan cepat lelah, sering pusing, mata berkunang-kunang dan keluhan mual muntah pada hamil muda. Pada pemeriksaan dan pengawasan Hb dapat dilakukan dengan menggunakan alat sachli, dilakukan minimal 2 kali selama kehamilan yaitu trimester I dan III.
Hasil pemeriksaan Hb dengan sachli dapat digolongkan sebagai berikut:
1. Hb 11 gr% : Tidak anemia
2. Hb 9-10 gr% : Anemia ringan
3. Hb 7 – 8 gr%: Anemia sedang
4. Hb < href="http://materi-kuliah-akper.blogspot.com/2010/06/askep-anemia-pada-bumil.html">Kebutuhan zat besi pada wanita hamil yaitu rata-rata mendekatai 800 mg. Kebutuhan ini terdiri dari, sekitar 300 mg diperlukan untuk janin dan plasenta serta 500 mg lagi digunakan untuk meningkatkan massa haemoglobin maternal. Kurang lebih 200 mg lebih akan dieksresikan lewat usus, urin dan kulit. Makanan ibu hamil setiap 100 kalori akan menghasilkan sekitar 8–10 mg zat besi. Perhitungan makan 3 kali dengan 2500 kalori akan menghasilkan sekitar 20–25 mg zat besi perhari. Selama kehamilan dengan perhitungan 288 hari, ibu hamil akan menghasilkan zat besi sebanyak 100 mg sehingga kebutuhan zat besi masih kekurangan untuk wanita hamil (Manuaba, 2001).
2. Anemia Megaloblastik
Adalah anemia yang disebabkan oleh karena kekurangan asam folik, jarang sekali karena kekurangan vitamin B12.
Pengobatannya:
a. Asam folik 15 – 30 mg per hari
b. Vitamin B12 3 X 1 tablet per hari
c. Sulfas ferosus 3 X 1 tablet per hari
d. Pada kasus berat dan pengobatan per oral hasilnya lamban sehingga dapat diberikan transfusi darah.
3. Anemia Hipoplastik
Adalah anemia yang disebabkan oleh hipofungsi sumsum tulang, membentuk sel darah merah baru. Untuk diagnostik diperlukan pemeriksaan-pemeriksaan diantaranya adalah darah tepi lengkap, pemeriksaan pungsi ekternal dan pemeriksaan retikulosi.
4. Anemia Hemolitik
Adalah anemia yang disebabkan penghancuran atau pemecahan sel darah merah yang lebih cepat dari pembuatannya. Gejala utama adalah anemia dengan kelainan-kelainan gambaran darah, kelelahan, kelemahan, serta gejala komplikasi bila terjadi kelainan pada organ-organ vital.
Pengobatannya tergantung pada jenis anemia hemolitik serta penyebabnya. Bila disebabkan oleh infeksi maka infeksinya diberantas dan diberikan obat-obat penambah darah. Namun pada beberapa jenis obat-obatan, hal ini tidak memberi hasil. Sehingga transfusi darah berulang dapat membantu penderita ini.
EFEK ANEMIA PADA IBU HAMIL, BERSALIN DAN NIFAS
Anemia dapat terjadi pada setiap ibu hamil, karena itulah kejadian ini harus selalu diwaspadai. Anemia yang terjadi saat ibu hamil Trimester I akan dapat mengakibatkan: Abortus, Missed Abortus dan kelainan kongenital. Anemia pada kehamilan trimester II dapat menyebabkan: Persalinan prematur, perdarahan antepartum, gangguan pertumbuhan janin dalam rahim, asfiksia aintrauterin sampai kematian, BBLR, gestosis dan mudah terkena infeksi, IQ rendah dan bahkan bisa mengakibatkan kematian. Saat inpartu, anemia dapat menimbulkan gangguan his baik primer maupun sekunder, janin akan lahir dengan anemia, dan persalinan dengan tindakan yang disebabkan karena ibu cepat lelah. Saat post partum anemia dapat menyebabkan: tonia uteri, rtensio placenta, pelukaan sukar sembuh, mudah terjadi febris puerpuralis dan gangguan involusio uteri.
SIMPULAN
Kejadian anemia pada ibu hamil harus selalu diwaspadai mengingat anemia dapat meningkatkan risiko kematian ibu, angka prematuritas, BBLR dan angka kematian bayi. Untuk mengenali kejadian anemia pada kehamilan, seorang ibu harus mengetahui gejala anemia pada ibu hamil, yaitu cepat lelah, sering pusing, mata berkunang-kunang, malaise, lidah luka, nafsu makan turun (anoreksia), konsentrasi hilang, napas pendek (pada anemia parah) dan keluhan mual muntah lebih hebat pada kehamilan muda.
KEPUSTAKAAN
Manuaba, I.B.G.1998. Ilmu Kebidanan Penyakit Kandungan dan Keluarga Berencana. Jakarta: EGC
Manuaba, I.B.G. 2001. Kapita Selekta Penatalaksanaan Rutin Obstetri Ginekologi dan Keluarga Berencana. Jakarta: EGC
Mochtar, R. 1998 . Sinopsis Obstetri. Edisi 2. Jakarta: EGC
Notobroto. 2003. Insiden Anemia. http://adln.lib.unair.ac.id. diperoleh 24 Februari, 2006.
Saifudin, A.B. 2002. Buku Acuan Nasional Pelayanan Kesehatan Maternal dan Neonatal. Jakarta: YBP-SP
Winkyosastro, H. 2002. Ilmu Kebidanan. Jakarta: YBP-SP
Jumat, 23 Oktober 2009
The Easiest Way to Lose Weight Fast
Have you ever looked into a mirror and hoped that you’d be a bit thinner, but then remembered how though it is to be on a diet and how useless you felt when you noticed that you had gained all that weight back pretty soon after going off the diet? Do you think you are a lost case when it comes to losing weight? Luckily that does not have to be true. Read on to find out more about the easiest way to lose weight fast without having to starve yourself and face another failure.
Most of the diets fail for two reasons, which are hunger and strict diet limits. You can have all the willpower in the world, but the longer you suffer from hunger or have to keep saying no to all your favorite foods, the bigger are the odds that you will fail in your dieting efforts. However, there is one diet plan which doesn’t cause these problems. It is the carbohydrate conscious lifestyle, which basically means avoiding sugar in (almost) all its forms. It is easier than it sounds and actually quite enjoyable.
If you want to limit your carbohydrate intake, avoid starches, grains and sugar. Stay away from packed foods which are often full of unwanted ingredients, like food additives. Instead, eat food high in nutrients. Shop fresh products and prepare them at home. Buy foods with as few ingredients as possible (meat, eggs, vegetables…).
When you reduce the amount of carbs in your diet, you need to get your energy from somewhere. That’s when it is time to start eating more natural fats. Fats are a great source of energy and also something your brain, skin and heart need to function properly. Fats have another benefit: they keep you satisfied for longer, which is great if you are trying to lose weight. Once you have eaten a proper breakfast you will not get hungry right away, which is the case when you eat a meal high in carbohydrates. Get natural fats from butter, cream, olive oil, coconut oil and the meats you eat. Avoid trans-fats. Also take care of your protein intake. Proteins are our body’s building blocks and also important for the immune system.
Granted, the low-carbohydrate diet is not the easiest diet to get started with. You will have to study it a bit before giving it a shot, or at least buy yourself a book with a detailed low-carb diet menu plan. There are several good ones around, and that’s probably the easiest way to get started with this lifestyle. It might help to use a low-carb cookbook like the Stella cookbooks in the beginning to learn more about the diet, but soon when you get used to it, you can start improvising in the kitchen again.
If you want to plan your diet yourself, it is a good idea to start a food diary where you list everything you have eaten or are planning to eat to see how the macro-nutrients are broken down. A food diary will teach you a lot about different foods and their nutritional values. Get ready for some surprises: you will notice that some foods you thought as healthy ones are actually sugar bombs (cereals being a good example). The best food diaries out there can even suggest you foods to eat to keep your nutrient intake within the limits you have set.
The carbohydrate conscious lifestyle is a sustainable lifestyle you can keep up for the rest of your life. It is a great way to keep your weight in control without having to worry about your calorie intake. The people following the diet are saying that they eat less than they used to, because there is no more constant hunger nor cravings. At the same time they eat when they get hungry and until they feel themselves satisfied. That doesn’t sound that bad, does it? Give it a try!
Most of the diets fail for two reasons, which are hunger and strict diet limits. You can have all the willpower in the world, but the longer you suffer from hunger or have to keep saying no to all your favorite foods, the bigger are the odds that you will fail in your dieting efforts. However, there is one diet plan which doesn’t cause these problems. It is the carbohydrate conscious lifestyle, which basically means avoiding sugar in (almost) all its forms. It is easier than it sounds and actually quite enjoyable.
If you want to limit your carbohydrate intake, avoid starches, grains and sugar. Stay away from packed foods which are often full of unwanted ingredients, like food additives. Instead, eat food high in nutrients. Shop fresh products and prepare them at home. Buy foods with as few ingredients as possible (meat, eggs, vegetables…).
When you reduce the amount of carbs in your diet, you need to get your energy from somewhere. That’s when it is time to start eating more natural fats. Fats are a great source of energy and also something your brain, skin and heart need to function properly. Fats have another benefit: they keep you satisfied for longer, which is great if you are trying to lose weight. Once you have eaten a proper breakfast you will not get hungry right away, which is the case when you eat a meal high in carbohydrates. Get natural fats from butter, cream, olive oil, coconut oil and the meats you eat. Avoid trans-fats. Also take care of your protein intake. Proteins are our body’s building blocks and also important for the immune system.
Granted, the low-carbohydrate diet is not the easiest diet to get started with. You will have to study it a bit before giving it a shot, or at least buy yourself a book with a detailed low-carb diet menu plan. There are several good ones around, and that’s probably the easiest way to get started with this lifestyle. It might help to use a low-carb cookbook like the Stella cookbooks in the beginning to learn more about the diet, but soon when you get used to it, you can start improvising in the kitchen again.
If you want to plan your diet yourself, it is a good idea to start a food diary where you list everything you have eaten or are planning to eat to see how the macro-nutrients are broken down. A food diary will teach you a lot about different foods and their nutritional values. Get ready for some surprises: you will notice that some foods you thought as healthy ones are actually sugar bombs (cereals being a good example). The best food diaries out there can even suggest you foods to eat to keep your nutrient intake within the limits you have set.
The carbohydrate conscious lifestyle is a sustainable lifestyle you can keep up for the rest of your life. It is a great way to keep your weight in control without having to worry about your calorie intake. The people following the diet are saying that they eat less than they used to, because there is no more constant hunger nor cravings. At the same time they eat when they get hungry and until they feel themselves satisfied. That doesn’t sound that bad, does it? Give it a try!
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