CASE REPORT: MIDWIFERY CARE FOR A GRANDE MULTIGRAVIDA PREGNANCY RESULTING FROM IUD FAILURE WITH GESTATIONAL DIABETES AND A HISTORY OF CESAREAN SECTION
Abstract
Grande multigravida pregnancies carry a high risk of various complications for both mother and baby. Such conditions require comprehensive midwifery care to detect complications early and safeguard the health of both the mother and the fetus. This case report aims to describe the midwifery care provided for a grande multigravida pregnancy involving IUD failure, gestational diabetes, and a history of Cesarean section. Methods: A case study approach utilizing the midwifery management process was employed. Data collection involved history taking, physical examinations, diagnostic tests, observation, and documentation regarding Mrs. A at the Plaosan Community Health Center (Puskesmas) between January and May 2026. Results and Discussion: Midwifery care focused on monitoring maternal and fetal status, managing gestational diabetes through education on diet and physical activity, monitoring blood glucose levels, counseling on high-risk pregnancy danger signs, and planning for postpartum contraception. Following comprehensive care, the mother’s condition showed positive progress; random blood glucose (RBG) levels decreased, and hemoglobin (Hb) levels reached 14.4 g/dL, resulting in a stable maternal condition. Conclusion: Midwifery care delivered over a three-month period— encompassing assessment, education, counseling, and evaluation—successfully improved the mother's understanding of high-risk pregnancy. Pregnant women with gestational diabetes can prevent complications by adhering to a lowcarbohydrate and low-glucose diet, engaging in daily exercise (such as walking), and avoiding strenuous activities.Keywords
Grande Multigravida, IUD Failure, Gestational Diabetes, History of Cesarean Section
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