Case study: Comprehensive midwifery care for pregnant women with gestational hypertension at PONEK Room, Simpang Lima Gumul Region Hospital, Kediri Regency

Abstract

Hypertension in pregnancy (HIP) is one of the complications of pregnancy that requires serious attention because it can increase morbidity and mortality rates in both mothers and fetuses. This condition is characterized by an increase in blood pressure to 140/90 mmHg or higher after 20 weeks of pregnancy without proteinuria. If not managed properly, HDK can progress to preeclampsia, which may lead to severe complications. Management of HIP in obstetric care facilities includes early detection, close monitoring of the mother and fetus, administration of safe antihypertensive medications, and coordination among multidisciplinary teams. This case study describes comprehensive obstetric care for Mrs. R, G7P3A3H3, 37 weeks pregnant, who came to the PONEK Room at Simpang Lima Gumul Regional General Hospital with complaints of tightness since early morning. Examination results showed blood pressure of 155/100 mmHg, fetal heart rate of 140 beats per minute, cervical dilation of 3 cm, effacement of 25%, and positive amniotic fluid. Care was provided using the seven-step Varney obstetric management approach, starting with assessment, diagnosis, identification of potential problems, immediate action, planning, implementation, and evaluation of results. Interventions included regular monitoring of vital signs and fetal heart rate, education on danger signs, collaboration with an obstetrician-gynecologist, and administration of oral nifedipine 10 mg as first-line antihypertensive therapy. The intervention resulted in decreased blood pressure, stable maternal condition, good fetal condition, and the ability to proceed with vaginal delivery. In conclusion, comprehensive midwifery care planned and implemented with appropriate pharmacological therapy can stabilize the condition of pregnant women with HDK and increase the likelihood of a safe delivery for both mother and baby .