Case Report: High-Risk Factors in an Elderly Primigravida with Dwarfism and Chronic Energy Deficiency at Ngariboyo Community Health Center

Fauzia Prima Hadianita; Rahayu Sumaningsih; Triana Septianti Purwanto

doi:10.33846/%x

Case Report: High-Risk Factors in an Elderly Primigravida with Dwarfism and Chronic Energy Deficiency at Ngariboyo Community Health Center

Fauzia Prima Hadianita, Rahayu Sumaningsih, Triana Septianti Purwanto

Abstract

Background: High-risk pregnancy in elderly primigravida with dwarfism and Chronic Energy Deficiency (CED) presents complex challenges due to anatomical constraints and nutritional insufficiency. This case report describes the midwifery care provided to a 36-year-old primigravida with dwarfism (height 136 cm) and CED at Ngariboyo Community Health Center, Magetan Regency. Objective: To comprehensively describe the clinical condition and midwifery management of a high-risk pregnancy involving advanced maternal age, dwarfism, and CED through the Continuity of Care approach. Case Presentation: Mrs. K, a 36-year-old primigravida at 22 weeks gestation with G1P00000, presented with dwarfism (height 136 cm), pre-pregnancy BMI of 17.60 kg/m², and MUAC of 20 cm indicating CED. The KSPR score of 10 classified her as high-risk. Comprehensive antenatal care was delivered through five home visits from January to April 2026. Interventions: Midwifery management included nutritional education emphasizing high-calorie and high-protein foods, complementary therapies (lime water, acupressure, relaxation techniques, aromatherapy), family-centered care with husband involvement, interprofessional collaboration, and delivery planning through the P4K program. Results: Over the monitoring period, the patient showed significant improvement evidenced by weight gain from 33.95 kg to 39 kg (total gain 6.5 kg), MUAC increase from 20 cm to 22 cm, resolution of dizziness, fatigue, and constipation complaints, improved appetite and dietary patterns, and stable maternal and fetal conditions. Fetal growth progressed with estimated fetal weight increasing from 465 grams to 2,323 grams. Conclusion: The Continuity of Care approach incorporating nutritional interventions, family support, complementary therapies, and comprehensive monitoring proved effective in improving maternal nutritional status and maintaining maternal-fetal well-being throughout pregnancy in this complex high-risk case.
Keywords: Elderly primigravida, Dwarfism, Chronic Energy Deficiency, High-risk pregnancy, Continuity of Care

References

Kasmiati, Purnamasari D, Ernawati., Juwita, Salina, Puspita WD, et al. Asuhan Kehamilan. 1st ed. Ira Atika Putri, editor. Malang: PT. Literasi Nusantara Abadi Grup; 2023. 199 p.

Marbun U, Irnawati, Dahniar, Asrina A, Kadir A, Jumriani, et al. Asuhan Kebidanan Kehamilan. 1st ed. Helmaria Ulfa, editor. Bandung: Widina Media Utama; 2023. 228 p.

Widyaningsih S, Rismayani, Maulani N. Buku Ajar Asuhan Kebidanan Pada Kehamilan (Praktik). K-Media, editor. STIKES Sapta Bakti Bengkulu. 1st ed. Yogyakarta: K-Media; 2023. 27 p.

O’Connor D, Menzies R, Cao X, Berndl A. Preterm birth risk in women with skeletal dysplasias and short stature. Journal of Pediatric Rehabilitation Medicine. 2022;15(4):639–46. doi:10.3233/PRM-210117 PubMed PMID: 36530102.

Nthenge S, Smith L, Ho S, Mitra M. Experiences of Women of Short Stature during the Perinatal Period. J Obstet Gynecol Neonatal Nurs. 2023;1(1):1–15. doi:10.1016/j.jogn.2022.03.006.Experiences

Nugraha KWD. Profil Kesehatan Indonesia 2023. 1st ed. Farida Sibuea, editor. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023. 550 p.

Masykuroh E, Supriati E, Hariyanto W, Wibawanto A, Kolis N. Building the Welfare of East Java Migrant Workers Through the Maqashid Syariah Approach in Economic and Social Empowerment. Muslim Heritage. 2025;10(2):283–307. doi:10.21154/muslimheritage.v10i2.11917

Magetan BPSK. BPS Magetan. Magetan; 2024.

Aneka R, Sadewi T, Sofiyanti I. Keberhasilan Persalinan Normal pada Ibu Bertubuh Pendek melalui Pendekatan Continuity of Care. Vol. 4. 2025;4(2):1736–44.

Paruhum Tiruon Ritonga, Kabupaten S, Utara T. Pentingnya Pemantauan Status Gizi pada Ibu Hamil dan 1000 Hari Pertama Kehidupan dalam Pencegahan Stunting di Desa Sangkaran Kabupaten Tapanuli Utara. Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM). 2024;7(1):2822–36. doi:https://doi.org/10.33024/jkpm.v7i7.14919

Farming, Aisa S, Kartini, Sabur F. Buku Pintar Ibu Hamil Dan Suami / Kelurga Dalam Mendeteksi Kehamilan Berisiko. 1st ed. Hayuwaskita AA, editor. Purbalingga: Eureka Media Aksara; 2024. 143 p.

Harna, Irawan, Andi Muh Asrul, Rahmawati, Sapang, Mertien. Kekurangan Energi Kronik (KEK). 1st ed. Yogyakarta: PT penamuda Media; 2023. 120 p.

Marani, Ketut Resmaniasih LA. Hubungan Kekurangan EnergiKronis (KEK) Dengan Anemia Pada Ibu Hamil Di Ruang Kia Blud Upt Puskesma Pahandhut Kota Palangka Raya. Forum Kesehatan. 2024;14 Nomor 1(1):7.

Politeknik Kesehatan Kemenkes Palangka Raya. Asuhan kebidanan kehamilan 2019. Palangka Raya; 2019. (2).

Damayanty S, Ade Rachmat Yudiyanto, Indra Agussamad, Rahmi Larasati. Faktor-Faktor yang Mempengaruhi Kehamilan Risiko Tinggi di Klinik Evie Kecamatan Babalan Kabupaten Langkat Provinsi Sumatera Utara Tahun 2024. OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan. 2024;2(3):211–9. doi:10.61132/obat.v2i3.675

Fatimah S, Nur Islami A, Hamid N. TRAUMA SOSIAL DALAM HUBUNGAN INTERPERSONAL MAHASISWA : PERSPEKTIF TEORI PSIKOANALISIS SIGMUND FREUD. didaktik. 2026;12(02):214–27. doi:10.36989/didaktik.v12i02.13375

Baloch F, Grosu L. Pregnancy and Delivery in a Woman With Achondroplasia: A Multidisciplinary Management Approach. Cureus. 2025;17(12):8–13. doi:10.7759/cureus.98733

Demsa S, Jumiyati, Rahmadi A. Pencegahan dan Penanggulangan Kurang Energi Kronik (KEK) dan Anemia Pada Ibu Hamil. 1st ed. Herlambang Rahmadhani, editor. Yogyakarta: Cv Budi Utama; 2018. 123 p.

Iswati N, Suryaningsing EK. Pola Makan Pada Ibu Hamil Dengan Kekurangan Energi Kronik (KEK) Di Klinik Amanah Husada. Jurnal Keperawatan dan Kesehatan Masyarakat. 2025;14(14):7–16.

Fitriah AH, Supariasa IDN, Riyadi BD, Bakri B. Buku Praktis Gizi Ibu Hamil. 1st ed. Abidn F, editor. Malang: Media Nusa Creative; 2018. 84 p.

Hasyim H, Aulia DG, Farina Eka Agustine, Rava E, Aprillia N, Iswanto I. Faktor Faktor yang Berhubungan Dengan Kekurangan Energi Kronik (KEK) pada Ibu Hamil (Literatur Review). Jik Jurnal Ilmu Kesehatan. 2023;7(1):87. doi:10.33757/jik.v7i1.637

Ekayanti, Rohmawati M. Bina generasi ; jurnal kesehatan. Jurnal Kesehatan. 2023;16(1):53–60.

Kasanova E, Widia L, Stefanicia S. Study Kasus pada Ny. H Usia 35 Tahun dengan Resiko Tinggi Terlalu Pendek ≤ 145 Cm di Puskesmas Barimba Kabupaten Kapuas. Jurnal Surya Medika. 2025;11(2):316–26. doi:10.33084/jsm.v11i2.10471

F. Gary Cunningham, Kenneth J. Leveno, Jodi S. Dashe BL. Williams Obstetrics. 1st ed. F. Gary Cunningham D, editor. New York: McGraw-Hill; 2022. 1304–1328 p.

Erina Eka Hatini. Asuhan Kebidanan Kehamilan. 1st ed. Hatini EE, editor. Malang: Wineka Media; 2019. 126 p.

Erna Mulati. Pelayanan Antenatal Terpadu. In: Cambari, editor. Pelayanan Antenatal Terpadu BAB II. 3rd ed. Jakarta: Kementerian Kesehatan Republik Indonesia; 2020. p. 14.

Anjelika. Jurnal ilmiah karya kesehatan. Identifikasi Potensi Bahaya, Penilaian Dan Pengendalian Penyakit Anemia Pada Ibu Hamil Di Wilayah Kerja Puskesmas Puuwatu Kota Kendari. 2021;01(July):1–7. doi:https://stikesks-kendari.e-journal.id/jikk

Manuaba IBG. Ilmu Kebidanan, Penyakit Kandungan dan Keluarga Berencana Untuk Pendidikan Bidan. 3rd ed. Setiawan, editor. Jakarta: ECG; 2019. 439 p.

Indrawati ND, Damayanti FN, Nurjanah S. Buku Ajar Pendidikan Keshatan Kehailan Resiko Tinggi Berbasis Tinggi (LCD dan Leaflet). 1st ed. Semarang; 2016. 1–174 p.

Handayani SR, Mulyanti TS. Dokumentasi Kebidanan. 1st ed. Bangun Asmo Darmanto, editor. Jakarta: Kementrian Kesehatan Republik Indonesia; 2017. 232 p.

Desmarita, Surmiasih, Riska Hediya Putri. Asuhan Keperawatan Pada Ibu Hamil Dengan Masalah Keperawatan Neusea Dengan Penerapan Perasan Jeruk Nipis Air. Journal of Innovative and Creativity. 2026;6(1):6142–51.