Midwifery Care for a Primigravida in the Second Trimester with Chronic Energy Deficiency Through Nutritional Intervention

revana kurnia ekawati

Abstract


Chronic Energy Deficiency (CED) in pregnant women is a condition resulting from prolonged inadequate energy intake that may affect maternal nutritional status and pregnancy outcomes. One indicator used to identify the risk of CED is an Upper Arm Circumference (MUAC) of less than 23.5 cm. This article aims to describe the implementation of midwifery care for a second-trimester primigravida with CED through nutritional intervention and monitoring of maternal and fetal conditions. A descriptive method with a case study approach was used involving Mrs. H, a second-trimester primigravida diagnosed with CED, who received midwifery care through home visits in the working area of Taji Public Health Center, Magetan Regency, from April to May 2026. Data were collected through interviews, observations, physical and obstetric examinations, anthropometric measurements, available laboratory examinations, and documentation. The care provided included counseling on adequate energy and protein intake, implementation of a high-calorie and high-protein diet, provision of supplementary food, intake of supplements as recommended, and monitoring of maternal weight, MUAC, and fetal growth and condition. At the initial assessment at 25 weeks of gestation, the mother had a MUAC of 21 cm, a pre-pregnancy BMI of 18.1 kg/m², and a body weight of 45 kg. After three visits, her body weight increased to 45.8 kg, accompanied by improvements in appetite and dietary patterns, while complaints of fatigue and dizziness decreased. However, her MUAC remained at 21 cm, indicating that CED still required continued monitoring and further nutritional intervention. In conclusion, continuous midwifery care combined with nutritional intervention showed positive progress in maternal weight, dietary patterns, appetite, and maternal complaints. Nevertheless, continued monitoring of nutritional status is necessary to support maternal health and fetal well-being.
Keywords: Chronic Energy Deficiency; Primigravida; Midwifery Care.

References


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DOI: https://doi.org/10.33846/%25x

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ISSN: 2621-8224 ----- Publisher: Alliance of Health Activists (AloHA) ----- Address: Jl. Ngurah Rai 18, Bangli, Bali, Indonesia