Continuity of Midwifery Care for a High-Risk Pregnancy Complicated by Hypertension and a Prolonged Interpregnancy Interval: A Case Study
DOI:
https://doi.org/10.53713/htechj.v4i5.745Keywords:
continuity of care, high-risk pregnancy, hypertension in pregnancy, interpregnancy interval, midwifery careAbstract
Continuity of care is an important approach in maternal and neonatal health services, particularly for pregnancies complicated by multiple risk factors. Maternal hypertension combined with a prolonged interpregnancy interval requires systematic surveillance across pregnancy, childbirth, the postpartum period, and neonatal care. This study aimed to describe the implementation and clinical outcomes of comprehensive continuity of midwifery care in a high-risk pregnancy involving hypertension and an interpregnancy interval of more than 10 years. A single-case study was conducted at the Cempaka Mulia Public Health Center in Cempaga District, East Kotawaringin Regency, Indonesia, from February to April 2025. The participant was a 31-year-old woman, G2P1A0, at 34 weeks of gestation. Care was provided from the third trimester through intrapartum, neonatal, postpartum, and family planning services using Varney’s seven-step midwifery management approach and SOAP documentation. Antenatal assessment identified hypertension with a blood pressure of 147/98 mmHg. Labor progressed spontaneously, with a blood pressure of 119/89 mmHg at admission. A male infant was delivered vaginally with a birth weight of 2,900 g, body length of 46 cm, and an Apgar score of 9/10. No major maternal or neonatal complications were documented during follow-up. Four postpartum visits were completed, and a three-month injectable contraceptive was provided on postpartum day 48. Comprehensive continuity of midwifery care supported systematic risk monitoring, coordinated maternal and neonatal management, and sustained postpartum and reproductive health follow-up in this high-risk pregnancy.
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