CASE REPORT PRIMIGRAVIDA TRIMESTER I DENGAN KURANG ENERGI KRONIS (KEK) DI TPMB “H’’ BERBELUK AROSBAYA

Abstrak

Kurang Energi Kronis (KEK) pada ibu hamil merupakan salah satu masalah gizi yang ditandai dengan Lingkar Lengan Atas (LiLA) <23,5 cm akibat kekurangan asupan energi dan protein yang berlangsung dalam waktu lama. KEK pada ibu hamil dapat meningkatkan risiko anemia, abortus, persalinan prematur, bayi berat lahir rendah (BBLR), gangguan pertumbuhan janin, serta meningkatkan morbiditas dan mortalitas ibu maupun bayi. Berdasarkan data SKI tahun 2023, prevalensi ibu hamil dengan KEK di Indonesia sebesar 16,9%, sedangkan di Jawa Timur sebesar 9,2%. Berdasarkan studi pendahuluan di TPMB Husnul Hosi'ah Berbeluk Arosbaya pada bulan Maret–April 2026 masih ditemukan 2 kasus ibu hamil dengan KEK. Penanganan KEK dilakukan melalui edukasi gizi seimbang, pemberian makanan tambahan (PMT) berbahan lokal, pemberian Multiple Micronutrient Supplement (MMS), pemantauan berat badan dan LiLA, serta dukungan keluarga secara berkelanjutan. Tujuan laporan kasus ini adalah mendeskripsikan asuhan kebidanan  pada ibu primigravida trimester I dengan Kurang Energi Kronis (KEK) di TPMB Husnul Hosi’ah Berbeluk Arosbaya Kabupaten Bangkalan. Pendekatan laporan kasus (case report) manajemen asuhan kebidanan ini dilakukan berdasarkan empat langkah utama, yaitu: pengkajian data subjektif, pengkajian data objektif, analisa, dan penatalaksanaan. Sesuai hasil pengamatan, Ny. M usia 19 tahun, primigravida trimester I usia kehamilan 9 minggu mengalami Kurang Energi Kronis (KEK) disertai keluhan mual dan muntah serta kecemasan karena berat badan belum mengalami peningkatan. Penatalaksanaan yang diberikan meliputi edukasi mengenai kebutuhan nutrisi ibu hamil, pemberian PMT berbahan lokal yang tinggi energi dan protein, anjuran konsumsi MMS 1×1 tablet per hari, pemantauan berat badan dan LiLA, edukasi tanda bahaya kehamilan, pemenuhan kebutuhan istirahat, dukungan keluarga, serta kolaborasi dengan ahli gizi. Hasil evaluasi menunjukkan ibu memahami pentingnya pemenuhan kebutuhan gizi selama kehamilan, patuh mengonsumsi MMS, bersedia mengonsumsi PMT secara teratur, dan berkomitmen menerapkan pola makan bergizi untuk meningkatkan status gizinya. Dalam memberikan asuhan kebidanan pada ibu hamil dengan KEK, bidan diharapkan mampu melakukan deteksi dini, memberikan edukasi yang tepat, serta melakukan pemantauan status gizi secara berkesinambungan sehingga komplikasi pada ibu maupun janin dapat dicegah.

Kurang Chronic Energy Deficiency (KEK) in pregnant women is a nutritional issue characterized by a Mid-Upper Arm Circumference (MUAC) of <23.5 cm, resulting from prolonged insufficient energy and protein intake. CED in pregnancy increases the risk of anemia, miscarriage, preterm birth, low birth weight (LBW), and fetal growth disorders, while also raising maternal and infant morbidity and mortality rates. Data from the 2023 Indonesian Health Survey (SKI) indicate a CED prevalence of 16.9% among pregnant women nationally, and 9.2% in East Java. A preliminary study conducted at the Husnul Hosi'ah Independent Midwifery Practice (TPMB) in Berbeluk, Arosbaya, between March and April 2026, identified two cases of pregnant women with CED. Management of CED involves education on balanced nutrition, the provision of locally sourced supplementary food (PMT), administration of Multiple Micronutrient Supplements (MMS), monitoring of body weight and MUAC, and ongoing family support. The purpose of this case report is to describe the midwifery care provided to a first-trimester primigravida with Chronic Energy Deficiency (CED) at the Husnul Hosi’ah Independent Midwifery Practice (TPMB) in Berbeluk, Arosbaya, Bangkalan Regency. This midwifery care case report follows a four-step approach: subjective data assessment, objective data assessment, analysis, and management. Observations revealed that Mrs. M, a 19-year-old primigravida in her first trimester (9 weeks of gestation), was suffering from CED accompanied by nausea, vomiting, and anxiety regarding her lack of weight gain. Management provided included education on nutritional needs during pregnancy, provision of high-energy and high-protein locally sourced supplementary food, a recommendation to take one MMS tablet daily, monitoring of weight and MUAC, education on pregnancy danger signs, ensuring adequate rest, family support, and collaboration with a nutritionist. Evaluation results indicate that the mother understands the importance of meeting nutritional needs during pregnancy, adheres to the consumption of Multiple Micronutrient Supplements (MMS), is willing to consume Supplementary Feeding (PMT) regularly, and is committed to adopting a nutritious diet to improve her nutritional status. When providing midwifery care to pregnant women with Chronic Energy Deficiency (CED), midwives are expected to perform early detection, provide appropriate education, and continuously monitor nutritional status to prevent complications for both the mother and the fetus.