Tesis

Pertumbuhan Tinggi Fundus Uteri Pada Ibu Hamil Underwieght, Normal, Overweight, Obesitas, serta Faktor-Faktor yang Mempengaruhinya di Jakarta.

Latar Belakang: Kualitas tumbuh kembang anak dipengaruhi oleh kondisi ibu dan janin sejak masa kehamilan. Pemantauan kehamilan idealnya dilakukan melalui pelayanan antenatal komprehensif, namun keterbatasan fasilitas kesehatan dapat menghambat deteksi dini gangguan pertumbuhan janin. Oleh karena itu, diperlukan metode pemantauan yang sederhana dan aplikatif, seperti pengukuran tinggi fundus uteri, dengan interpretasi yang mempertimbangkan karakteristik maternal. Metode: Penelitian ini merupakan studi analitik observasional dengan desain kohort retrospektif terhadap 1.118 ibu hamil yang menjalani perawatan antenatal di RSUP Nasional dr. Cipto Mangunkusumo, RSU Budi Kemuliaan, dan Klinik Ibu dan Anak Kecamatan Pekojan selama periode Januari 2023–Desember 2024. Luaran yang dianalisis adalah laju pertumbuhan tinggi fundus uteri berdasarkan kelompok indeks massa tubuh (IMT) ibu. Hasil: Laju pertumbuhan tinggi fundus uteri menunjukkan penurunan seiring bertambahnya usia kehamilan pada seluruh kelompok IMT, dengan pertumbuhan tertinggi pada usia kehamilan 16–32 minggu. Perbedaan bermakna tinggi fundus uteri ditemukan pada usia kehamilan 24, 30, 34, dan 39 minggu pada kelompok obesitas (p < 0,05). Kesimpulan: Laju pertumbuhan tinggi fundus uteri bervariasi antar kelompok indeks massa tubuh ibu. Penilaian tinggi fundus uteri sebaiknya mempertimbangkan IMT maternal untuk meningkatkan akurasi pemantauan pertumbuhan janin, terutama pada fasilitas dengan keterbatasan pemeriksaan ultrasonografi.
Kata Kunci: Tinggi Fundus Uteri, Laju Pertumbuhan, indeks massa tubuh


Background: Beyond maternal morbidity and mortality, optimal physical, socioemotional, and cognitive development of the fetus is essential for improving longterm population health outcomes. These developmental trajectories are strongly influenced by maternal and fetal conditions throughout pregnancy and childbirth. Comprehensive antenatal care, including accurate gestational age assessment, physical and obstetric examination, ultrasonography, and laboratory evaluation, is critical for monitoring fetal growth. However, in many low-resource settings, limited access to advanced diagnostic modalities may delay the detection of fetal growth abnormalities. Consequently, a simple, reliable, and widely applicable method for monitoring fetal growth remains necessary. Symphysis–fundal height measurement represents a practical alternative, yet its variation across maternal body mass index (BMI) categories requires further clarification. Methods: This retrospective cohort study analyzed 1,118 singleton pregnancies attending obstetric outpatient services at Dr. Cipto Mangunkusumo National Referral Hospital, RSU Budi Kemuliaan, and the Pekojan Maternal and Child Health Clinic between January 2023 and December 2024. Fundal height growth trajectories were evaluated across gestational age intervals and stratified according to maternal BMI categories (underweight, normal weight, overweight, and obese). Results: Fundal height growth demonstrated a progressive decline with advancing gestation across all BMI groups. The highest growth rates were observed between 16–32 weeks of gestation, followed by a marked deceleration after 33 weeks. Variations in fundal height measurements were significantly associated with maternal BMI, with statistically significant differences identified in the obese group at 24, 30, 34, and 39 weeks of gestation (p < 0.05). Conclusion: Fundal height growth patterns differ according to maternal BMI and gestational age. These findings support the need for BMI-adjusted interpretation of fundal height measurements to enhance the accuracy of fetal growth surveillance, particularly in settings with limited access to ultrasonography.
Keywords: Fundal Height, Growth Rate, Body Mass Index