HUBUNGAN KADAR HEMOGLOBIN, HEMATOKRIT, JUMLAH ERITROSIT DENGAN KADAR FERRITIN PADA KEHAMILAN TRIMESTER II DAN III

Abstract

Back ground: Iron deficiency anaemia is still the major problem in pregnancy, which will increase the mother and foetal morbidity and mortality. In the first trimester of pregnancy, the requirement of iron about 0,8 mg/day, during second trimester about 4 mg/day while third trimester will be reached until 6,3 mg/day. The mobilisation of ferritin was the consequence of increasing iron.. During the first until third trimester, the blood volume will increase but near delivery it will be stable, so the mean increasing blood volume is about 42% In the pregnant women there was a specific pattern of erythropoesis, but because of the increasing the blood volume is not incorcordant with the pattern of erythropoesis it will cause haemodilution as consequence. The indicator of iron deficiency anaemia was haemoglobin, haematocrite and erythrocyte count as the fiinctional component, while ferritin can be the iron storage. In iron deficiency anaemia the two indicator will give a different manifestation. This condition will influence the diagnose of iron deficiency anaemia Objective: This study will explain the correlation between ferritin and haemoglobin level, haematocrite ang erythrcyte count in the second and the third trimester of pregnancy. Methode: A cross sectional study was done in the Kecamatan Karang Awen, Demak, Toward 19 women in the second trimester and 59 women in the third trimester. The level of serum ferritin was measured by IRMA methode,while the level of haemoglobin, haematocrite and erythrocyte count by automated haematology analyser Analysis: Pearson statistical correlation. Result: In the second trimester of the pregnancy there was no significant correlation between ferritin level and haemoglobin level (r0,208.p=0,392), ferritin level and haematocrite (r=0,055, p=0,822), while there was a significant correlation between ferritin level and erythrocyte count (r-0,479, p=0,038; p< 0,05). In the third trimester of the pregnancy there were no significant correlation between ferritin level respectively with haemoglobin level (=0,231, p=0,I03), haematocrite (=0,181; p=0,541), and erythrocyte count (=0,088; p=0,541). Conclusion :Ferritin was suggested in define of iron status in the second and third trimester of pregnancy. A BSTRA K. Latar belakang: Anemia defisiensi besi masih merupakan salah satu masalah besar pada wanita hami I, karena meningkatkan angka kematian dan kesakitan ibu dan anak. Pada kehamilan trimester I, besi dibutuhkan 0,8 mg/hari, kehamilan trimester II 4 mg/hari, sedangkan trimester III akan meningkat 6,3 mg/hari, sehingga mengakibatkan mobilisasi ferritin. Selama kehamilan trimester I hingga trimester III volume darah akan meningkat tetapi menjelang persalinan menjadi stabil, sehingga rata-rata peningkatan volume darah sekitar 42% Pada wanita hamil terdapat pola eritrpoesis khusus, tetapi karena peningkatan volume darah tidak sejajar dengan pola eritropoesis , maka akan menyebabkan hemodilusi. Indikator anemia defisiensi besi adalah kadar hemoglobin, hematokrit, jumlah eritrosit dan kadar ferritin. Kadar hemoglobin, hematokrit dan jumlah eritrosit mengukur komponen fungsional, sedang ferritin mengukur s'mpanan besi. Pada defisiensi besi tikedua komponen tersebut menyebabkan manifes si yang berbeda .Kondisi tersebut akan mempengaruhi diagnosis anemia defisiensi besi. Tujuan : Penelitian ini bertujuan menjelaskan hubungan kadar ferritin dan kadar hemoglobin,hematokrit dan jumlah eritrosit pada wanita dengan umur kehamilan trimester II dan III. Metoda : Penelitian ini memakai pendekatan belah lintang di Kecamatan Karang Awen Kabupaten Demak Sampel terdiri dari 19 orang dengan kehamilan trimester H dan 51 orang trimester HI. Kadar ferritin diperiksa menggunakan metoda IRMA sedangkan kadar hemoglobin, hematokrit dan jumlah eritrosit diperiksa dengan automated haematology analyser. Analisis: Untuk mengetahui hubungan antar variable digunakan korelasi Pearson. Basil: Pada kehamilan trimester II tidak terdapat hubungan yang bermakna antara kadar ferritin dan kadar hemoglobin (r=0,208,p=0,392),kadar ferritin dan hematokrit (r=0,055;p=0,392), dan terdapat hubungan yang bermakna antara kadar ferritin dengan jumlah eritrosit (r=0,479; p=0,038; p<0,05). Pada kehamilan trimester III tidak terdapat hubungan yang bermakna antara kadar ferritin dan kadar hemoglobin (r=0,231,p=0,103),kadar ferritin dan hematokrit (r=0,181;p=05412),kadar ferritin dengan jumlah eritrosit (r=0,088,p=0,541). Kesimpulan:Penentuan anemia pada wanita hamil trimester II dan III,sebaiknya dilengkapi dengan pemeriksaan status besi yaitu dengan ferritin serum.