Preeklamsia

Preeklamsia
Kenali tanda dari preeklamsia di ibu hamil.

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Definisi

Preeklamsia adalah kondisi kumpulan gejala yang ditandai dengan meningkatnya tekanan darah disertai adanya protein pada urin yang terjadi pada ibu hamil usia kehamilan di atas 20 minggu. Hal ini dapat berdampak pada organ tubuh lain dan berbahaya baik bagi ibu maupun janin.

Preeklamsia terjadi ketika tekanan darah di atas usia 20 minggu kehamilan lebih dari 140/90 mmHg dan ditemukan kadar protein yang tinggi di dalam urin. Kondisi ini merupakan salah satu dari empat jenis hipertensi dalam kehamilan. Tiga kondisi lainnya yaitu:

  • Hipertensi gestasional, yaitu tekanan darah tinggi yang muncul setelah usia kehamilan 20 minggu tetapi tidak ditemukan protein di urin.
  • Hipertensi kronis, yaitu hipertensi atau tekanan darah tinggi yang dimulai sebelum kehamilan.
  • Hipertensi kronis dengan superimposed preeklampsia, yaitu kondisi memburuknya hipertensi kronis dan menyebabkan lebih banyak protein di urin serta adanya komplikasi lain.

Preeklamsia adalah kondisi yang serius dan perlu ditangani segera. Kondisi ini dapat berdampak pada asupan darah ke plasenta, serta menyebabkan kerusakan berbagai organ seperti liver, ginjal, dan penumpukan cairan pada paru.

Selayaknya penyakit tekanan darah tinggi, preeklamsia berhubungan erat dengan ras dan etnis. Namun, kondisi preeklamsia merupakan salah satu penyebab tersering persalinan prematur di dunia, bahkan salah satu penyebab kematian ibu tersering di Indonesia.

Pada preeklamsia, terminasi atau persalinan direkomendasikan sebagai terapi. Namun, semua itu bergantung dengan kondisi pasien dan usia kehamilan. Pada beberapa kasus, preeklamsia juga dapat muncul setelah bayi lahir.

 

Penyebab

Penyebab preeklamsia berlum diketahui secara pasti. Namun, adanya masalah pada plasenta masih menjadi penyebab yang dipercayai para pakar dan ilmuwan. Plasenta yang seharusnya menyediakan asupan oksigen dan nutrisi ke janin mengalami gangguan, sehingga menyebabkan naiknya tekanan darah dan berbagai komplikasi.

Dugaan penyebab lain seperti stres tidak terbukti berhubungan dengan preeklamsia. Beberapa penyebab yang berpotensi menimbulkan preeklamsia antara lain faktor genetik, kondisi pembuluh darah, dan penyakit autoimun.

 

Faktor Risiko

Preeklamsia lebih sering terjadi pada kehamilan pertama. Selain itu, beberapa faktor di bawah ini dapat meningkatkan risiko preeklamsia, seperti:

  • Riwayat hipertensi
  • Etnis Afrika
  • Gangguan ginjal
  • Riwayat diabetes sebelum kehamilan
  • Kehamilan kembar
  • Usia di bawah 18 tahun atau di atas 40 tahun
  • Kehamilan dari proses bayi tabung
  • Riwayat preeklamsia sebelumnya
  • Riwayat keluarga yang mengalami preeklamsia
  • Adanya penyakit autoium seperti lupus eritematosus
  • Adanya gangguan tidur 
  • Riwayat obesitas

 

Gejala

Gejala preeklamsia bervariasi, dari mulai tidak bergejala hingga gejala berat. Gejala awal preeklamsia adalah tekanan darah tinggi, adanya protein di urin, dan bengkak pada kedua kaki. 

Gejala lainnya dari preeklamsia meliputi:

  • Nyeri kepala
  • Pandangan kabur
  • Sensitif terhadap cahaya
  • Nyeri pada perut bagian kanan
  • Pembengkakan di tangan dan wajah (edema)
  • Sesak napas 

Penting untuk membagikan dan mengatakan kondisi yang sesungguhnya kepada dokter yang memeriksa. Banyak pasien yang tidak sadar jika mereka terkena preeklamsia, hingga mereka melakukan pemeriksaan darah dan urin pada konsultasi kehamilan rutin.

Kondisi preeklamsia dapat memburuk dan terjadi gejala-gejala berikut ini:

  • Krisis hipertensi (tekanan darah diatas 160/110 atau lebih tinggi)
  • Penurunan fungsi liver dan ginjal
  • Penumpukan cairan di paru
  • Kadar trombosit yang rendah atau disebut trombositopenia
  • Penurunan produksi urin

 

Diagnosis

Diagnosis dari preeklamsia meliputi proses anamnesis atau wawancara antara dokter dan pasien, pemeriksaan fisik, dan pemeriksaan penunjang.

Dokter akan melakukan tanya jawab dengan menanyakan keluhan utama pasien, keluhan penyerta, riwayat kehamilan, gaya hidup dan riwayat aktivitas sehari – hari, riwayat penyakit terdahulu, riwayat pengobatan, dan riwayat penyakit keluarga.

Dilanjutkan dengan pemeriksaan fisik, pemeriksaan fisik dilakukan dengan menilai keadaan umum pasien dengan memeriksa tekanan darah, suhu tubuh, nadi, dan laju napas. Kemudian dokter akan melakukan pemeriksaan fisik untuk melihat apakah ada pembengkakan pada anggota tubuh, nyeri perut, pandangan kabur, dan gejala lain.

Selanjutnya, dokter akan melakukan pemeriksaan penunjang. Pemeriksaan penunjang yang penting untuk dilakukan adalah pemeriksaan urin untuk melihat kadar protein di urin, pemeriksaan laboratorium darah untuk melihat kadar trombosit, USG, dan bila perlu dokter akan melakukan pemeriksaan non stress test (NST) dan pemeriksaan biofisik janin untuk melihat kondisi kesehatan dan kesejahteraan janin.

 

Tata Laksana

Tata laksana preeklamsia bergantung pada keparahan dan usia kehamilan. Bila usia kehamilan sudah mendekati usia cukup bulan (37 minggu), persalinan adalah hal yang direkomendasikan. Metode persalinan yang disarankan biasanya akan melalui operasi sesar. 

Selain itu, beberapa pengobatan dapat diberikan bila usia kehamilan belum cukup bulan. Dokter dapat memberikan obat antihipertensi untuk menurunkan tekanan darah, antikejang sebagai pencegahan kejang, dan obat kortikosteroid yang bertujuan untuk mematangkan fungsi paru.

Setelah melahirkan, Anda dan bayi akan dipantau ketat. Anda harus dipastikan tidak memiliki gejala seperti perubahan lapang pandang, mual, muntah, kejang, nyeri kepala, dan nyeri perut sebelum kembali ke rumah.

 

Komplikasi

Komplikasi dari preeklamsia dapat berupa:

  • Kejang dan berkembang menjadi kondisi eklamsia
  • Gagal jantung
  • Kebutaan
  • Perdarahan setelah melahirkan
  • Stroke
  • Mengalami preeklamsia kembali pada kehamilan selanjutnya
  • Sindrom HELLP atau kumpulan gejala berupa penghancuran sel darah merah, peningkatan enzim hati, dan kadar trombosit yang rendah. Hal ini dapat berdampak pada kerusakan liver dan berhubungan dengan proses pembekuan darah.

 

Pencegahan

Sejauh ini, belum ada pencegahan khusus preeklamsia. Namun, Anda dapat mengurangi risiko terjadinya komplikasi kehamilan dengan melakukan hal berikut:

  • Melakukan pemeriksaan kehamilan secara rutin
  • Mencukupi kebutuhan nutrisi ibu dan janin dengan diet gizi seimbang sesuai panduan dan anjuran dokter spesialis kandungan
  • Hindari stres
  • Mengurangi asupan garam dan gula
  • Minum banyak air putih yang cukup setiap hari
  • Beristirahat pada sisi tubuh bagian kiri
  • Tidur yang cukup
  • Menghindari konsumsi kafein berlebih (lebih dari 200 mg per hari)

 

Kapan Harus ke Dokter?

Segera ke rumah sakit terdekat bila mengalami kondisi berikut:

  • Kejang
  • Sesak napas
  • Nyeri hebat pada perut bagian kanan
  • Pandangan kabur
  • Nyeri kepala hebat
  • Terdapat bintik hitam di lapang pandang yang tidak kunjung hilang

Apabila Anda memiliki riwayat tekanan darah tinggi sebelum hamil atau mengalami salah satu faktor risiko preeklamsia, konsultasikan diri Anda ke dokter spesialis kebidanan & kandungan secara rutin.

 

Mau tahu informasi seputar penyakit lainnya? Cek di sini, ya!

Writer : dr Lovira Ai Care
Editor :
  • dr Ayu Munawaroh, MKK
Last Updated : Minggu, 16 April 2023 | 22:07

Cleveland Clinic - Preeclampsia. (2021). Retrieved 25 October 2022, from https://my.clevelandclinic.org/health/diseases/17952-preeclampsia

Healthline - Preeclampsia. (2021). Retrieved 25 October 2022, from https://www.healthline.com/health/preeclampsia#causes

Mayo Clinic - Preeclampsia. (2022). Retrieved 25 October 2022, from https://www.mayoclinic.org/diseases-conditions/preeclampsia/diagnosis-treatment/drc-20355751

Medscape - Preeclampsia. (2022). Retrieved 25 October 2022, from https://emedicine.medscape.com/article/1476919-overview#a1

WebMD - Preeclampsia. (2021). Retrieved 25 October 2022, from https://www.webmd.com/baby/preeclampsia-eclampsia

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      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • WebController.php#1385aicare_prod_new10.55msselect `posts`.*, `post_tag`.`tag_id` as `pivot_tag_id`, `post_tag`.`post_id` as `pivot_post_id` from `posts` inner join `post_tag` on `posts`.`id` = `post_tag`.`post_id` where `post_tag`.`tag_id` = 4176
      Bindings
      • 0: 4176
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • app/Http/Controllers/WebController.php:1385
      • app/Http/Controllers/WebController.php:372
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • CategoryHealtTopics.php#11aicare_prod_new990μsselect * from `categories` where (`slug` != 'penyakit-a-z' and `slug` != 'obat-a-z' and `slug` != 'pemeriksaan-a-z' and `parent_id` = '0') and `categories`.`deleted_at` is null order by `order` asc
      Bindings
      • 0: penyakit-a-z
      • 1: obat-a-z
      • 2: pemeriksaan-a-z
      • 3: 0
      Hints
      • Use SELECT * only if you need all columns from table
      • The != operator is not standard. Use the <> operator to test for inequality instead.
      Backtrace
      • app/Repositories/Categories/CategoryHealtTopics.php:11
      • app/Http/Controllers/WebController.php:376
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • WebController.php#377aicare_prod_new114msselect * from `posts` where `status` = 1 and `publish_date` <= '2025-01-12 18:45:15' and `content_type` = 'article' order by RAND() limit 7
      Bindings
      • 0: 1
      • 1: 2025-01-12 18:45:15
      • 2: article
      Hints
      • Use SELECT * only if you need all columns from table
      • ORDER BY RAND() is slow, try to avoid if you can. You can read this or this
      Backtrace
      • app/Http/Controllers/WebController.php:377
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:205
    • WebController.php#391aicare_prod_new8.95msupdate `posts` set `views_count` = 646 where `id` = 5425
      Bindings
      • 0: 646
      • 1: 5425
      Backtrace
      • app/Http/Controllers/WebController.php:391
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
      • vendor/laravel/framework/src/Illuminate/Routing/Route.php:205
    • ActivityLogger.php#174aicare_prod_new6.2msinsert into `activity_log` (`log_name`, `properties`, `batch_uuid`, `event`, `subject_id`, `subject_type`, `description`, `updated_at`, `created_at`) values ('default', '[]', null, 'updated', 5425, 'App\\Models\\Admin\\Post', 'updated', '2025-01-12 18:45:15', '2025-01-12 18:45:15')
      Bindings
      • 0: default
      • 1: []
      • 2: 
      • 3: updated
      • 4: 5425
      • 5: App\Models\Admin\Post
      • 6: updated
      • 7: 2025-01-12 18:45:15
      • 8: 2025-01-12 18:45:15
      Backtrace
      • vendor/spatie/laravel-activitylog/src/ActivityLogger.php:174
      • vendor/spatie/laravel-activitylog/src/Traits/LogsActivity.php:88
      • app/Http/Controllers/WebController.php:391
      • vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
    • single-post-healthpedia.blade.php#37aicare_prod_new1.28msselect * from `users` where `users`.`id` = 44 limit 1
      Bindings
      • 0: 44
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::web.v2.single-post-healthpedia:37
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new7.03msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7249 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7249
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.9msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 7351 and `categories`.`deleted_at` is null
      Bindings
      • 0: 7351
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.87msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 9866 and `categories`.`deleted_at` is null
      Bindings
      • 0: 9866
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.93msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 4966 and `categories`.`deleted_at` is null
      Bindings
      • 0: 4966
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.83msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 8144 and `categories`.`deleted_at` is null
      Bindings
      • 0: 8144
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.91msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 5652 and `categories`.`deleted_at` is null
      Bindings
      • 0: 5652
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • article-popular.blade.php#8aicare_prod_new9.72msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 4116 and `categories`.`deleted_at` is null
      Bindings
      • 0: 4116
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new9.13msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 2010 and `categories`.`deleted_at` is null
      Bindings
      • 0: 2010
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new9.17msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 2149 and `categories`.`deleted_at` is null
      Bindings
      • 0: 2149
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new9.19msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 3123 and `categories`.`deleted_at` is null
      Bindings
      • 0: 3123
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new8.6msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 3209 and `categories`.`deleted_at` is null
      Bindings
      • 0: 3209
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new8.59msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 4709 and `categories`.`deleted_at` is null
      Bindings
      • 0: 4709
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#122aicare_prod_new1.19msselect * from `pages` where `slug` = 'about-us' limit 1
      Bindings
      • 0: about-us
      Hints
      • Use SELECT * only if you need all columns from table
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:122
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#547aicare_prod_new920μsselect * from `faqs` limit 1
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      • LIMIT without ORDER BY causes non-deterministic results, depending on the query execution plan
      Backtrace
      • view::layouts.v2.web_layout:547
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • web_layout.blade.php#551aicare_prod_new1.29msselect * from `term_policies`
      Hints
      • Use SELECT * only if you need all columns from table
      • The SELECT statement has no WHERE clause and could examine many more rows than intended
      Backtrace
      • view::layouts.v2.web_layout:551
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    App\Models\Admin\Post
    134Post.php#?
    App\Models\Admin\Category
    24Category.php#?
    App\Models\Admin\Tag
    6Tag.php#?
    App\User
    3User.php#?
    App\Models\TermPolicy
    3TermPolicy.php#?
    App\Models\Admin\Page
    1Page.php#?
    App\Models\Admin\Faq
    1Faq.php#?
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        id
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        97LZjRUXe602xsxzLiKeWLiU2RuuHpwVUpTGa6c1
        _previous
        array:1 [ "url" => "https://ai-care.atmatech.id/healthpedia-penyakit/preeklamsia" ]
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        array:2 [ "old" => [] "new" => [] ]
        path_info
        /healthpedia-penyakit/preeklamsia
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
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        []
        
        request_request
        []
        
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        request_cookies
        0 of 0
        array:2 [ "XSRF-TOKEN" => "97LZjRUXe602xsxzLiKeWLiU2RuuHpwVUpTGa6c1" "laravel_session" => "NZPpHWKemTXdAAUcRFo33ltSfmKZJY9acqFnZwG6" ]
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