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Severe preeclampsia is a condition characterized by systolic blood pressure exceeding 160 mmHg and diastolic pressure exceeding 110 mmHg, occurring after 20 weeks of gestation and accompanied by edema and proteinuria. One intervention used to save both mother and fetus is a cesarean section. This final nursing scientific paper analyzes the implementation of evidence-based practice, specifically warm foot soak therapy, for mothers with severe preeclampsia during the pre- and postpartum periods who are at risk for ineffective cerebral perfusion. This descriptive case study method used a nursing care approach. Assessment results identified five major nursing problems, including the risk for ineffective cerebral perfusion. After four days of warm foot soak therapy, this problem was resolved, as blood pressure decreased from 147/101 mmHg to 120/88 mmHg. Conclusion: Warm foot soak therapy effectively lowers blood pressure in pre- and postpartum mothers with severe preeclampsia. Recommendation: Nurses can implement warm

Low Birth Weight (LBW) remains a critical global health issue that significantly contributes to neonatal morbidity and mortality, particularly in developing countries such as Indonesia. The main challenge in addressing LBW lies in its complex and multifactorial risk profile, which involves biological, social, environmental, and healthcare-related determinants. This study aims to analyze and synthesize the risk factors associated with LBW based on recent scientific literature. A literature review method was applied by searching articles from Portal Garuda, DOAJ, PubMed, and Google Scholar published between 2020 and 2025 using relevant keywords. The findings indicate that maternal age, interpregnancy interval, nutritional status, anemia, preeclampsia, infections, socioeconomic conditions, environmental exposure, and the quality of antenatal care are significant determinants of LBW. The synthesis of evidence confirms that LBW is influenced by the interaction of multiple individual and healthcare system factors rather than a single cause. In conclusion, this study highlights the urgent need to strengthen antenatal care services, improve maternal nutritional status, control maternal diseases during pregnancy, and implement community-based promotive and preventive strategies as key efforts to reduce the incidence of LBW.

Anemia during pregnancy is a significant maternal health issue with serious impacts on maternal and perinatal outcomes, including complications such as severe preeclampsia, postpartum hemorrhage, and low birth weight (LBW), all of which contribute to increased morbidity and mortality rates. This literature review aims to analyze the clinical impacts of pregnancy anemia, related complications, and effective management strategies based on the latest scientific evidence (2020-2024). The study examines the relationship between anemia and preeclampsia, LBW, and postpartum hemorrhage, as well as the importance of nutritional fulfillment in prevention and management. Five research articles from indexed journals were collected from the Scopus database, with inclusion criteria of studies with clear designs, focusing on pregnancy anemia, and published in Indonesian or English. The analysis results show that pregnancy anemia is a predisposing factor for preeclampsia through mechanisms such as placental hypoxia and oxidative stress. Anemia is also closely related to an increased incidence of LBW and postpartum hemorrhage, particularly due to lower hemoglobin reserves and uterine contractility issues. Adequate nutritional fulfillment is influenced by socioeconomic barriers, supplementation side effects, and lack of family support. Anemia management requires a comprehensive approach, including routine screening, prophylactic supplementation, nutritional education, and effective referral systems for complex cases. Prevention through early detection and timely intervention is crucial in reducing maternal and perinatal morbidity.

Preeclampsia is a pregnancy complication that contributes significantly to maternal and perinatal morbidity and mortality, especially in developing countries. Despite various preventive measures, preeclampsia is still frequently found at the primary health care level. This study aims to analyze the factors influencing the incidence of preeclampsia in pregnant women at the Tiley Care Community Health Center. This study used an observational analytical design with a cross-sectional approach. The study population was all pregnant women who visited antenatal care at the Tiley Care Community Health Center, with a sample of 60 respondents selected using a total sampling technique. Data were collected through a review of medical records and KIA books, then analyzed univariately and bivariately using the Chi-Square test with a significance level of α = 0.05. The results showed that maternal age, history of hypertension, nutritional status based on body mass index, and adherence to antenatal care visits had a statistically significant relationship with the incidence of preeclampsia. Meanwhile, parity did not show a significant relationship with the incidence of preeclampsia. This study concluded that the incidence of preeclampsia is influenced by various maternal factors and maternal health behaviors during pregnancy. These findings underscore the importance of implementing risk-based antenatal care through early screening, ongoing monitoring, and increased adherence to antenatal care visits as a preventative measure for preeclampsia at the primary healthcare level.

Background: Early marriage remains prevalent among adolescents aged 15–19 years, a period during which individuals are often medically and psychologically unprepared to assume marital responsibilities. Decisions to marry early are influenced by internal factors such as psychological readiness, emotional maturity, and critical thinking ability, as well as external factors including family pressure, cultural norms, and economic challenges. Objective: This study aims to explore the factors influencing adolescents' decisions to engage in early marriage and examine its impacts on their lives. Method: This research employed a qualitative descriptive design. A purposive sampling technique was used to select 10 adolescents who had experienced early marriage. Data were collected through in-depth interviews and document review, and analyzed thematically. Results: The primary factors contributing to early marriage in Delu Depa Village, Kodi Bangedo District, were premarital pregnancy (2 cases), economic hardship (4 cases), and limited educational attainment (4 cases). The consequences included psychological, health, and social impacts. Psychologically, participants reported experiencing stress, anxiety, and depression. Health-related risks included complications associated with immature reproductive organs, such as premature birth, obstructed labor, and preeclampsia. Social impacts included stigma, limited social interaction, school dropout, and employment in low-skilled jobs to fulfill daily needs. Conclusion: Early marriage poses significant risks to adolescents' psychological well-being, physical health, and social functioning. Strengthened preventive efforts and targeted interventions are needed to reduce its prevalence and mitigate negative consequences.

Maternal mortality remains a challenge in Indonesia, and one contributing factor is chronic malnutrition (CED), which impacts pregnancy, childbirth, the postpartum period, and the newborn. The 2022 registration report shows that of the 3,249,203 pregnant women whose MUAC was measured, 283,833 had a MUAC of less than 23.5 cm (at risk of CED), meaning 8.7% of these pregnant women were at risk of CED. In the Brebes area, the 2022 report recorded 3,475 pregnant women with CED. At the Bantarkawung Community Health Center in 2023, there were 36 cases of preeclampsia, 22 cases of transverse lie, 107 cases of CED, and anemia. Objective: Provide comprehensive midwifery care in accordance with standards of care for pregnant women, women giving birth, newborns, postpartum women, and family planning. Research method: Qualitative descriptive method, the type of research approach used in this study is a comprehensive case study approach. Results: Comprehensive care was provided to Mrs. R who suffered from chronic energy deficiency, and was successfully overcome. Delivery was carried out by caesarean section, the baby was born normally, and the postpartum period went smoothly, and the mother chose a contraceptive method, namely a three-monthly birth control injection. Conclusion: Comprehensive obstetric care has been proven effective in overcoming chronic energy deficiency, ensuring a safe delivery, a normal baby born, a normal postpartum period, and compliance with contraceptive methods.

Preeclampsia is one of the most serious complications in pregnancy, characterized by hypertension and proteinuria, and it poses a significant risk of maternal and fetal morbidity and mortality if not detected and managed promptly. Early detection is crucial, yet clinical diagnosis often faces challenges due to the variability of symptoms and uncertainty in medical decision-making. To address this issue, this study aims to develop an expert system for diagnosing preeclampsia by employing the Dempster-Shafer method, which is known for its ability to handle uncertainty and incomplete information in complex domains such as healthcare. A case study was conducted at Bidadari General Hospital, where data on clinical symptoms and patient medical records were collected and analyzed. The development process of the expert system followed systematic stages, including knowledge acquisition from obstetrics specialists, designing the knowledge base, constructing inference rules, and integrating the Dempster-Shafer algorithm for decision support. The system was subsequently tested using real-case scenarios of pregnant women suspected of having preeclampsia. Evaluation results demonstrated that the system achieved an accuracy rate of 92% in differentiating between preeclampsia and eclampsia, based on belief and plausibility measures combined with symptom analysis. These findings indicate that the proposed system can effectively support medical personnel by providing diagnostic recommendations with a high degree of reliability. In addition, the system offers efficiency in the clinical workflow by minimizing diagnostic errors and reducing delays in treatment initiation. Therefore, this expert system has the potential to become a valuable clinical decision support tool for early detection, risk assessment, and management of preeclampsia. Future development may focus on expanding the knowledge base, integrating real-time patient monitoring data, and enhancing usability to ensure broader applicability in diverse healthcare settings.

The leading causes of maternal mortality are thought to include hemorrhage, sepsis, obstructed labor, and hypertensive disease of pregnancy. For many years, demographic and health surveys have been used to study maternal and perinatal health in developing countries. However, few nationwide population surveys have used formally validated questionnaires. Objectives: The purpose of this study was to determine the validity of maternal self-reports of obstetrical complications. Methods: A cross-sectional study was conducted among 300 women at Two Hospitals and one public health center. A questionnaire recorded mothers’ perceptions of obstetrical complications while hospital medical records. Sensitivity, specificity, predictive values, and percent agreement were obtained for obstetrical conditions. Result: In general, women’s reports of obstetrical complications did not match medical diagnoses. The highest agreement was obtained for reporting eclampsia, with less agreement for postpartum haemorrhage. Conclusion: The validity of the survey questionnaires varies between studies due to differences in the questionnaires. Health surveys based on maternal self-report must be interpreted with consideration of this limitation.

Based on the data obtained, 157 babies were born with LBW in 2016. In 2017 there were 142 babies born with LBW. In 2018 there were 134 babies born with LBW. Based on the results of an initial survey conducted by researchers at the TK IV 07.01 Lhokseumawe Hospital, the prevalence of LBW every month is still high from the last 3 years. The purpose of this study was to analyse the risk factors for the incidence of low birth weight babies at the Hospital TK IV 07.01 Lhokseumawe in 2024. The design of this study was quantitative research with a retrospective approach. The population of this study was 138 people, the sample was obtained by saturated sampling technique as many as 138 people. Univariate analysis, bivariate using chi-square and multivariate using multiple logistic regression at 95% confidence level. The results showed that the variables that had a risk with the incidence of LBW in Hospital TK IV 07.01 Lhokseumawe in 2024 were multiple pregnancies (p=0.026 <0.05) and a history of premature birth (p=0.017 <0.05). Variables that did not have a risk with the incidence of LBW were maternal age (p=0.847 >0.05), preeclampsia/eclampsia (p=1.000 >0.05), pregnancy distance (p=0.0322 <0.05) and premature rupture of membranes (p=0.439 >0.05). The study concluded that the incidence of LBW was influenced by 2 factors, namely multiple pregnancies and a history of preterm birth. The most dominant factor influencing it is the history of premature pregnancy.

Infertility is a global health problem that has significant social and psychological impacts. Factors such as environmental and occupational factors, physical activity, and poor nutrition can increase the risk of infertility. Assisted reproductive technology (ART) is one of the main interventions used to treat infertility, with in vitro fertilization (IVF) being the most common method. In IVF, there are two methods of embryo transfer: frozen embryo transfer (FET) and fresh embryo transfer (ET). This study aims to compare the live birth rate between frozen and fresh embryo transfer in IVF programs and assess the risk of preeclampsia associated with both embryo transfer methods. A literature review was conducted by searching 20 scientific articles from PubMed, Google Scholar, and ScienceDirect using inclusion criteria and the PICO strategy and PRISMA flow chart. Inclusion criteria included publications from the last 10 years, English language, and human studies. The results showed that both methods produced comparable live birth rates (LBR) with FET slightly superior to ET, depending on the patient's condition and characteristics. On the other hand, there was a significantly increased risk of preeclampsia in FET, especially in patients using the artificial cycle protocol (AC-FET). The conclusion of this review is that FET and ET methods are effective in achieving pregnancy and there is an increased risk of preeclampsia in FET especially AC-FET which needs further consideration.

Premature ovarian failure (POF) is a condition where the ovaries stop functioning before the age of 40 years, resulting in permanent infertility. IVF with own eggs in POF patients has a very low success rate, so egg donation is the most effective alternative. This review aims to evaluate the effectiveness of using egg donors in IVF programs in women with POF, through an analysis of 20 studies systematically selected from international scientific databases. The results of the study showed that egg donation consistently increased the clinical pregnancy and live birth rates in POF patients, although accompanied by obstetric risks such as gestational hypertension and preeclampsia. New reproductive technologies such as in vitro maturation (IVM), stem cell therapy, and platelet-rich plasma (PRP) also provide additional prospects for restoring ovarian function. In conclusion, egg donation is a major strategy in the management of infertility due to POF, which requires the support of an integrated clinical, ethical, and policy approach.

At present, little is known in Nigeria and globally about the association between stress and cortisol secretion in normotensive and preeclamptic pregnant women. Preeclampsia is a pregnancy complication that involves high blood pressure and organ damage, and it has been associated with various physiological alterations. This study aims to determine the comparative levels of cortisol, a stress marker, in preeclamptic pregnant women in the third trimester of pregnancy. Cortisol levels are known to fluctuate in response to stress, and altered levels may indicate an underlying pathophysiological process. Forty (40) consenting pregnant women were recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. Blood samples were collected and spun in a bucket centrifuge at 2500 RPM (rounds per minute) for 10 minutes. The plasma was stored frozen in plain sample bottles and analyzed for cortisol levels using the enzyme-linked immunosorbent assay (ELISA) method. The data obtained were analyzed using GraphPad Prism 9 software. Results were expressed as mean ± SEM, and a P-value of ≤ 0.05 was considered statistically significant. The study found that cortisol levels significantly increased from 226.4 ± 36.53 nmol/L in normotensive women to 370.7 ± 36.47 nmol/L in preeclamptic women (p<0.05, <0.0081). This increase was statistically significant, suggesting that elevated cortisol levels in preeclamptic women may be linked to stress and potentially to oxidative stress cascade activation. These findings contribute to the understanding of stress-related physiological changes in preeclampsia and may offer insights for future diagnostic or therapeutic approaches.

The potential of cardiac markers in predicting preeclampsia, such as Creatinine Kinase (CK) and Tyrosine Kinase 1 (TK1), has emerged as promising due to their involvement in the pathophysiology of this pregnancy complication. Preeclampsia is characterized by hypertension and organ dysfunction, and it can lead to significant maternal and fetal morbidity if not detected early. Early identification of preeclampsia is critical for preventing severe complications, and biomarkers like CK and TK1 can provide valuable insights. This study aimed to investigate the role of CK and TK1 as potential predictors of preeclampsia in the third trimester of pregnancy. Forty (40) consenting pregnant women were recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. Participants were divided into two groups: twenty (20) normotensive pregnant women and twenty (20) preeclamptic pregnant women in their third trimester. Blood samples were collected and processed using a bucket centrifuge at 2500 RPM for 10 minutes, and plasma was stored frozen for further analysis. Tyrosine Kinase 1 was analyzed by fluorescence immunoassay, and Creatinine Kinase was measured using a spectrophotometric method. Data obtained were analyzed using GraphPad Prism 9, with results expressed as mean ± SEM. Statistical significance was set at a P-value of ≤ 0.05. The study found a statistically significant increase in the levels of both CK and TK1 in preeclamptic women compared to normotensive controls. These findings suggest that CK and TK1 could serve as predictive biomarkers for identifying and monitoring preeclampsia, aiding in early diagnosis and timely interventions

The use of ECG patterns as predictors of preeclampsia offers a promising approach, as it is a widely available and cost-effective tool. Specific ECG patterns, including angle of deviation, QRS Complex (Right Ventricular Hypertrophy (RVH) , Left Ventricular Hypertrophy (LVH)), and T wave amplitudes as a potential tool for predicting preeclampsia. The aim of this study is to investigate the predictive role of angle of deviation, QRS Complex (Right Ventricular Hypertrophy (RVH) , Left Ventricular Hypertrophy (LVH)), and T wave amplitudes in preeclamptic pregnant women during the third trimester. Fourty (40) consenting pregnant women were recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. These subjects consisted of  twenty (20) normotensive  and twenty (20) preeclamptic pregnant women in their  third trimester of pregnancy. After the subjects were  identified and recruited into the study, they were taken to the laboratory where their vital signs was taken and their ECG patterns recorded with ECG machine. Data obtained from this study were analysed using Graph Pad Prism 9. Results generated were expressed as mean ± SEM and a P-value of ≤ 0.05 were considered statistically significant. Results from this present study show no significant differences were observed in QRS complex angles related to right ventricular hypertrophy (RVH) between normotensive and preeclamptic pregnant women. Notably, there was a significant increase in QRS complex related to left ventricular hypertrophy (LVH) in preeclamptic pregnant women, indicating left ventricular remodeling's importance. Moreover, there was a significant increase in T wave amplitude, this suggests underlying myocardial electrical remodeling or dysfunction in preeclampsia, emphasizing the need for cardiovascular monitoring. The study underscores the multifactorial nature of cardiovascular changes in preeclampsia and highlights the potential of ECG parameters in aiding early detection.

Early detection and prediction of preeclampsia are crucial to prevent severe complications and ensure timely interventions, Specific ECG patterns, including PR segment, Q wave duration and amplitude, ST segment, U wave, and sinus rhythm were under study for their potential indicators of preeclampsia. This study aims to investigate the predictive role of these ECG patterns in preeclamptic pregnant women in the third trimester of pregnancy. Fourty (40) consenting pregnant women were recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. These subjects consisted of  twenty (20) normotensive  and twenty (20) preeclamptic pregnant women in their  third trimester of pregnancy. After the subjects were  identified and recruited into the study, they were taken to the laboratory where their vital signs was taken and their ECG patterns recorded with ECG machine. Data obtained from this study were analysed using Graph Pad Prism 9. Results generated were expressed as mean ± SEM and a P-value of ≤ 0.05 were considered statistically significant. results from this present study show no significant differences were observed in the P-R segment, R-R interval, Q wave duration, Q wave amplitude The study underscores the multifactorial nature of cardiovascular changes in preeclampsia and highlights the potential of ECG parameters in aiding early detection, risk stratification, and management of the condition, despite  parameters showing no significant differences. However, PR Segment, Q Wave duration and amplitude, ST Segment , U wave and Sinus rhythm cannot be used to predict preeclampsia  

The ultimate goal of predicting preeclampsia that can enhance early detection and risk stratification in pregnant women, by leveraging the diagnostic potential of ECG patterns, we hope to improve maternal and fetal outcomes and contribute to the development of personalized care strategies for preeclamptic patients. Current diagnostic methods for preeclampsia rely primarily on routine blood pressure monitoring and proteinuria assessment, which have limited sensitivity and specificity. The aim of this study is to investigate the predictive role of P wave duration, amplitudes and morphology in preeclamptic pregnant women during the third trimester. Fourty (40) consenting pregnant women were recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. These subjects consisted of  twenty (20) normotensive  and twenty (20) preeclamptic pregnant women in their  third trimester of pregnancy. After the subjects were  identified and recruited into the study, they were taken to the laboratory where their vital signs was taken and their ECG patterns recorded with ECG machine. Data obtained from this study were analysed using Graph Pad Prism 9. Results generated were expressed as mean ± SEM and a P-value of ≤ 0.05 were considered statistically significant. Results from this present study show statistically significant increases in P wave duration, amplitude and abnormal M pattern among preeclamptic compare to normotensive pregnant women, consistent with prior research, abnormal M pattern in P wave morphology is linked to atrial pathology in preeclampsia. The study underscores the multifactorial nature of cardiovascular changes in preeclampsia and highlights the potential of ECG parameters in aiding early detection, risk stratification, and management of the condition.

Bell’s Palsy is an acute peripheral facial nerve paralysis that causes unilateral facial weakness. The exact cause remains unclear but is suspected to involve anatomical factors, infections, viral reactivation (especially Herpes Simplex Virus), ischemia, inflammation, and cold exposure. The incidence is 20-30 per 100,000 people annually, with no gender or age preference, though it is more common in middle-aged and elderly individuals. Risk factors include diabetes, pregnancy, preeclampsia, obesity, and hypertension. Symptoms develop suddenly, peaking within 48 hours, and include facial asymmetry, difficulty closing the eyes, eating, speaking, and sensory-motor disturbances. Most cases recover spontaneously within weeks to months, but corticosteroids and antiviral therapy can accelerate recovery. Proper diagnosis is crucial as Bell’s Palsy is often mistaken for stroke or other neurological disorders.

Carcinoembryonic antigen (CEA) is a glycoprotein normally produced during fetal development, but presence of tissue damage and inflammation, its levels increase and this may be linked to  Carcinoembryonic antigen in the pathophysiology of preeclampsia. This study aims to assess the  level  of Carcinoembryonic antigen (CEA) in preeclamptic pregnant women in the third trimester of pregnancy. Forty (40) consenting pregnant women were recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. After the subjects were  identified and recruited into the study, they were taken to the laboratory where their vital signs was taken and 10 milliliters (10 ml) of venous blood was drawn from consenting participants and placed in a lithium heparin sample bottles analyzed for Carcinoembryonic antigen (CEA) levels  by fluorescence immunoassay. Data obtained from this study were analysed using Graph Pad Prism 9. Results generated were expressed as mean ± SEM and a P-value of ≤ 0.05 were considered statistically significant. The present study showed that there was statistically significant increase in the level of Brain injury marker (CEA) was observed in preeclamptic women compared to normotensive pregnant women, indicating various underlying pathophysiological processes such as Brain injury in preeclampsia.

Approximately 287,000 cases of maternal death occur during pregnancy, childbirth, and postpartum. One of the targets in the global Sustainable Development Goals (SDGs) is to reduce MMR to 70 per 100,000 live births by 2030. WHO data shows that 72.5% of maternal deaths are caused by direct factors, while the remaining 27.5% are caused by indirect factors. This study aims to determine the factors associated with maternal death in Sintang Regency in 2019-2023. The research design uses quantitative with a Cross Sectional approach. The study population is all data on maternal death cases from pregnancy, childbirth and postpartum periods from January 2019 - December 2023 obtained from the Sintang Regency Health Office. The sampling technique uses total sampling . The results of the study obtained variables of bleeding (p value 0.017), infection (p value 0.847), eclampsia (p value 0.026), age (p value 0.018) and parity (p value 0.900). There is a relationship between bleeding, eclampsia and age with maternal mortality in Sintang Regency in 2019-2023. There is no relationship between infection and parity with maternal mortality in Sintang Regency in 2019-2023. It is hoped that the relevant health services will improve health service efforts to reduce MMR.

The predictive role of oxidative stress in the pathophysiology of human pregnancy is of particular interest, as oxidative stress is increased in normotensive pregnant women through systemic inflammatory response, reactive oxygen species (ROS), and reactive nitrogen species (RNS). This study involved 40 consenting pregnant women recruited from St. Philomina Catholic Hospital, Edo State, Nigeria. Data obtained were analyzed using GraphPad Prism 9. Results were expressed as mean ± SEM, with a P-value of ≤ 0.05 considered statistically significant. Malondialdehyde (MDA) increased from 3.75 ± 0.42 U/L in normotensive women to 4.53 ± 0.59 U/L in preeclamptic women. However, this increase was not statistically significant (p<0.05; 0.2903). Catalase activity decreased from 114 ± 8.07 U/L in normotensive women to 84.02 ± 21.58 U/L in preeclamptic women, but this decrease was also not statistically significant (p<0.05; 0.1909). Superoxide dismutase (SOD) increased from 40.82 ± 1.23 U/L in normotensive women to 71.90 ± 5.61 U/L in preeclamptic women. This increase was statistically significant (p<0.05; <0.0001). Glutathione peroxidase (GSH) decreased from 66.74 ± 10.35 U/L in normotensive women to 50.63 ± 8.96 U/L in preeclamptic women, but this decrease was not statistically significant (p<0.05; 0.2466). These findings suggest the potential predictive roles of these biomarkers in identifying and monitoring preeclampsia.