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Interventions for leg cramps in pregnancy (Review)

Luo L, Zhou K, Zhang J, Xu L, Yin W

Luo L, Zhou K, Zhang J, Xu L, Yin W.

Interventions for leg cramps in pregnancy.
Cochrane Database of Systematic Reviews 2020, Issue 12. Art. No.: CD010655.
DOI: 10.1002/14651858.CD010655.pub3.

www.cochranelibrary.com

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
 Cochrane Trusted evidence.

Library Informed decisions.

Better health. Cochrane Database of Systematic Reviews

Interventions for leg cramps in pregnancy (Review)

[Intervention Review]

Interventions for leg cramps in pregnancy

Li Luo1,2, Kunyan Zhou1,2,3, Jing Zhang1,2,3, Liangzhi Xu1,2,3, Weiyao Yin4

1 Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China. 2Key
Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
3Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.
4West China Second University Hospital, Sichuan University, Chengdu, China

Contact address: Kunyan Zhou, zhoukunyan2006@126.com.

Editorial group: Cochrane Pregnancy and Childbirth Group.

Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 12, 2020.

Citation: Luo L, Zhou K, Zhang J, Xu L, Yin W. Interventions for leg cramps in pregnancy. Cochrane Database of Systematic Reviews
2020, Issue 12. Art. No.: CD010655. DOI: 10.1002/14651858.CD010655.pub3.

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

ABSTRACT

Background
Leg cramps are a common problem in pregnancy. Various interventions have been used to treat them, including drug, electrolyte and
vitamin therapies, and non-drug therapies. This Cochrane Review is an update of a review first published in 2015.

Objectives
To assess the effectiveness and safety of different interventions for treating leg cramps in pregnancy.

Search methods

We searched Cochrane Pregnancy and Childbirth’s Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry
Platform (ICTRP) (25 September 2019), and reference lists of retrieved studies.

Selection criteria
Randomised controlled trials (RCTs) of any intervention for the treatment of leg cramps in pregnancy compared with placebo, no
treatment or other treatments. Quinine was excluded for its known adverse effects. Cluster-RCTS were eligible for inclusion. Quasi-RCTs
and cross- over studies were excluded.

Data collection and analysis

Three review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The
certainty of the evidence was assessed using the GRADE approach.

Main results
We included eight small studies (576 women). Frequency of leg cramps was our primary outcome and secondary outcomes included
intensity and duration of leg cramps, adverse outcomes for mother and baby and health-related quality of life. Overall, the studies were
at low or unclear risk of bias. Outcomes were reported in different ways, precluding the use of meta-analysis and thus data were limited
to single trials. Certainty of evidence was assessed as either low or very-low due to serious limitations in study design and imprecision.

Oral magnesium versus placebo/no treatment

The results for frequency of leg cramps were inconsistent. In one study, results indicated that women may be more likely to report never
having any leg cramps a er treatment (risk ratio (RR) 5.66, 95% confidence interval (CI) 1.35 to 23.68, 1 trial, 69 women, low-certainty
evidence); whilst fewer women may report having twice-weekly leg cramps (RR 0.29, 95% CI 0.11 to 0.80, 1 trial, 69 women); and more

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Library Informed decisions.

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Interventions for leg cramps in pregnancy (Review) 1

women may report a 50% reduction in number of leg cramps a er treatment (RR 1.42, 95% CI 1.09 to 1.86, 1 trial, 86 women, low-
certainty evidence). However, other findings indicated that magnesium may make little to no difference in the frequency of leg cramps
during differing periods of treatment.

For pain intensity, again results were inconsistent. Findings indicated that magnesium may make little or no difference: mean total pain
score (MD 1.80, 95% CI -3.10 to 6.70, 1 trial, 38 women, low-certainty evidence). In another study the evidence was very uncertain about
the effects of magnesium on pain intensity as measured in terms of a 50% reduction in pain. Findings from another study indicated that
magnesium may reduce pain intensity according to a visual analogue scale (MD -17.50, 95% CI -34.68 to -0.32,1 trial, 69 women, low-
certainty evidence). For all other outcomes examined there may be little or no difference: duration of leg cramps (low to very-low
certainty); composite outcome - symptoms of leg cramps (very-low certainty); and for any side effects, including nausea and diarrhoea
(low certainty).

Oral calcium versus placebo/no treatment

The evidence is unclear about the effect of calcium supplements on frequency of leg cramps because the certainty was found to be very
low: no leg cramps a er treatment (RR 8.59, 95% CI 1.19 to 62.07, 1 study, 43 women, very low-certainty evidence). In another small
study, the findings indicated that the mean frequency of leg cramps may be slightly lower with oral calcium (MD -0.53, 95% CI -0.72 to
-0.34; 1 study, 60 women; low certainty).

Oral vitamin B versus no treatment

One small trial, did not report on frequency of leg cramps individually, but showed that oral vitamin B supplements may reduce the
frequency and intensity (composite outcome) of leg cramps (RR 0.29, 95% CI 0.11 to 0.73; 1 study, 42 women). There were no data on
side effects.

Oral calcium versus oral vitamin C

The evidence is very uncertain about the effect of calcium on frequency of leg cramps a er treatment compared with vitamin C (RR 1.33,
95% CI 0.53 to 3.38, 1 study, 60 women, very low-certainty evidence).

Oral vitamin D versus placebo

One trial (84 women) found vitamin D may make little or no difference to frequency of leg cramps compared with placebo at three weeks
(MD 2.06, 95% CI 0.58 to 3.54); or six weeks a er treatment (MD 1.53, 95% CI 0.12 to 2.94).

Oral calcium-vitamin D versus placebo

One trial (84 women) found oral calcium-vitamin D may make little or no difference to frequency of leg cramps compared with placebo a
er treatment at three weeks (MD -0.30, 95% CI -1.55 to 0.95); and six weeks (MD 0.03, 95% CI -1.3 to 1.36).

Oral calcium-vitamin D versus vitamin D

One trial (84 women) found oral calcium-vitamin D may make little or no difference to frequency of leg cramps compared with vitamin Da
er treatment at three weeks (MD -1.35, 95% CI -2.84 to 0.14); and six weeks a er treatment (MD -1.10, 95% CI -2.69 to 0.49).

Authors' conclusions
It is unclear from the evidence reviewed whether any of the interventions provide an effective treatment for leg cramps. This is primarily
due to outcomes being measured and reported in different, incomparable ways so that data could not be pooled. The certainty of
evidence was found to be low or very-low due to design limitations and trials being too small to address the question satisfactorily.

Adverse outcomes were not reported, other than side effects for magnesium versus placebo/no treatment. It is therefore not possible to
assess the safety of these interventions.

The inconsistency in the measurement and reporting of outcomes meant that meta-analyses could not be carried out. The development
of a core outcome set for measuring the frequency, intensity and duration of leg cramps would address these inconsistencies and mean
these outcomes could be investigated effectively in the future.

PLAIN LANGUAGE SUMMARY

Interventions for leg cramps during pregnancy What

is the issue?

Leg cramps are experienced as sudden, intense involuntary contractions of the leg muscles. They are a common problem in pregnancy,
especially in the third trimester. They are painful and can interfere with daily activities, disrupt sleep, and reduce quality of life. Various

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
 Cochrane Trusted evidence.

Library Informed decisions.

Better health. Cochrane Database of Systematic Reviews

Interventions for leg cramps in pregnancy (Review) 2

interventions have been used during pregnancy to treat leg cramps, including drug, electrolyte (magnesium, calcium, sodium) and
vitamin therapies, and non-drug therapies such as muscle stretching.

Why is this important?

The goal of this review was to find out what is effective and safe for treating leg cramps during pregnancy.

What evidence did we find?

We searched for evidence in September 2019 and identified eight randomised controlled studies, with a total of 576 women who were 14
to 36 weeks pregnant, comparing either magnesium, calcium, calcium-vitamin D or vitamin B with placebo or no treatment, and
comparing vitamin C with calcium. All treatments were given as tablets to be chewed or swallowed.

Magnesium supplements may reduce how o en women experienced leg cramps when compared with placebo or no treatment, although
findings were not consistent. Studies measured this in different ways, sometimes showing that magnesium helped reduce the number of
leg cramps but sometimes showing that it made little or no difference. Likewise, evidence about whether magnesium reduced the
intensity of pain was inconclusive with one study showing a reduction while others showed no difference. There was little or no difference
in the experience of side effects, such as nausea and diarrhoea.

Calcium did not consistently reduce how o en women experienced leg cramps a er treatment compared to women who did not receive
any treatment. The evidence was also found to be of very low quality and so we cannot be sure of the results.

More women who received vitamin B supplements fully recovered compared with those women receiving no treatment; however these
results were from a small sample and the study had design limitations.

The frequency of leg cramps was no different between women treated with calcium and those treated with vitamin C.

The calcium-vitamin D and the vitamin D supplements had no effect on the frequency, length, and pain intensity of leg cramps a er
treatment compared to women who received placebo.

What does this mean?

The level of evidence was found to be of low or very low quality. This was mainly due to the small sample size of studies and poor study
design. Four studies were well-conducted and reported. The other four had design limitations: women were not allocated to different
treatment groups in the best way in several studies, and in two studies women knew whether they were receiving treatment or not.
Adverse effects such as any effect of the treatment on pregnancy complications, labour and the baby were not reported. Several of the
studies focused mainly on serum calcium and magnesium levels. The frequency and intensity of cramps and the duration of pain were
not reported in a consistent way and o en information was lacking on how they were measured, either during treatment, at the end of
treatment or a er treatment had stopped.

It is not clear from the evidence reviewed whether any of the oral interventions (magnesium, calcium, calcium-vitamin D, vitamin B
vitamin D or vitamin C) provide an effective and safe treatment for leg cramps in pregnancy. Supplements may have different effects
depending on women's usual intake of these substances. No trials considered therapies such as muscle stretching, massage, relaxation
or heat therapy.

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
 Cochrane Trusted evidence.

Library Informed decisions.

Better health. Cochrane Database of Systematic Reviews

Interventions for leg cramps in pregnancy (Review) 3

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
 DOI Number: 10.5958/0976-5506.2019.02061.8

The Effect of Prenatal Yoga in Reducing Pregnancy

Complaints

Anna Veronica Pont1, Ni Made Rosiyana2, Vira Pratiwi2, Enggar2, Nurfatimah1, Kadar Ramadhan1
1Health Polytechnic of Palu, City of Palu, Indonesia, 2Cenderawasih Nursing Academy, City of Palu, Indonesia

Abstract
There are physical and psychological changes during pregnancy which could lead to discomfort, especially
during third trimester of pregnancy. Prenatal yoga is one of pregnant treatments with benefits to reduce signs
and symptoms commonly experienced by pregnant women. The aim of this study is to find the effectiveness
of prenatal yoga in reducing maternal discomfort at third trimester of pregnancy. We used quasi-experiment
design with one group pretest – posttest design. This study was performed from July to October 2017 in four
different primary healthcare units (Public Health Center) in Palu: Talise, Sangurara, Mabelopura, and
Mamboro. Samples were obtained from pregnant women at third trimester of pregnancy, fit with our criteria
in these Public Health Centers, amounted to 34 respondents in total. We collected the information by
performing interview, observation and prenatal yoga as direct intervention. The data were then analyzed using
Wilcoxon test. We found that the average complaints experienced by pregnant women during pretest were
7.21 with deviation standard (SD) of 3.4. Post-test data showed a mean of 3.06 with SD 1.7. Our statistical
analysis of those comparison was p=0.000. There was significant difference of complains before and after
prenatal yoga. Prenatal yoga could reduce pregnancy complains during third trimester of pregnancy.

Keyword: Prenatal Yoga, Pregnancy Complaints, third trimester of pregnancy.

Introduction lordosis posture. It causes the mother to feel sore waist,

varicose veins and cramps in the legs. Muscle spasm is
Anatomical, physiological, and biochemical caused by traction of a number of nerves and muscles
adaptation will occur during pregnancy. Most of these and is associated with lordosis posture in pregnancy 1,2.
changes begin shortly after fertilization occurs, and will
continue to happen throughout the gestation period 1. Changes in uterine size and body metabolism cause
Dramatic weight gain makes pregnant women easily feel pregnant women to experience frequent urination,
tired, have difficulties to fall asleep, breath shortness, feeling hot flashes/ feverish heat, varicose veins in the foot
and hand edema2. In line with fetal growth, there limbs, hemorrhoids and constipation1,3,4.
are changes in the shape and size of chest cavity due
fetal growth, causing pregnant women to experience Pregnant women are advised to do light exercise to
breath shortness1,2. during pregnancy to keep their bladder healthy and reduce
the problems normally appear during pregnancy 5–7. Yoga
Increased height of the uterine fundus accompanied is one of the mild exercise choices that can be done by
by enlarged abdomen makes the body weight fall in the pregnant women8,9.
front. It happens so as an effort of adjusting to excessive
body weight to push the spine backwards, creating Prenatal yoga focuses attention on the breath
rhythm, prioritizes comfort and safety in training, thus
providing many benefits10. Yoga is similar to body, mind
and mental exercise that is highly helpful for pregnant
Corresponding Author:
Anna Veronica Pont, women to flex joints and calm the mind, especially in the
Health Polytechnic of Palu, Indonesia, third trimester. Prenatal yoga has five ways, for instance
E-mail: yoga physical exercise, breathing (pranayama), position
annaveronikapont@gmail.com
 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8 1219

(mudra), meditation and deep relaxation that can be used complaints of pregnant women in the third
trimester to get benefits during pregnancy. It can also help smooth, before (pre-test) and after (post-test) prenatal
yoga. After natural, and healthy pregnancy and childbirth8. conducting interview for pre-test, Yoga was
held for 8 times: twice every week for a month. Yoga were held
The objective of this research was to determine the in the morning and evening, according to the joint time
effectiveness of yoga in reducing complaints of pregnant contract between the researcher and the respondents.
women in the third trimester of pregnancy in Public Yoga was conducted with duration of 30-60 minutes, Health
Center of Palu. including whole movement and relaxation/ meditation.
Material and Method Each movement was done for 10 second, and 3 minutes
for relaxation, meditation for breathing, respectively. The
Research design movements used in this research covered Mudhasana
(child posture), Utkasana (seat posture), pelvic rocking,
The present research was quasi-experimental design
squatting posture, Baddha Konasana (butterfly posture),
research with the design of one group pretest-posttest
Sufi twirl, and meditation11.
design, as it measured changes in the level of complaints
of mothers in the third trimester after performing a Data analysis
certain treatment, namely yoga. The research conducted
observation before treatment (pretest) and after yoga To analyze the data collected, the technique used
intervention (post-test). was univariate analysis, with frequency distribution of
respondent characteristics, independent variables and
Samples dependent variables. Bivariate analysis was to see the
difference in the level of complaint of the experimental
The respondents as samples of this research was 34
group before intervention. After the final treatment, in
total, using purposive sampling, namely the sampling Wilcoxon test was used with a significance value of 0.05
taken from the entire pregnant women population in the
using a confidence interval of 95%
work area of Mamboro, Sangurara, Mabelopura and
Talise public health centers in August 2017, according Results
to the inclusion criteria. The inclusion criteria for this
research: willingness to be put under study, no pregnancy Based on the level of education and employment
complications, and no preterm labor in previous (Table 1), it appears that the majority of pregnant
women pregnancies, the growth and development of the fetus earned higher education (82,4%); and most of
them are according to gestational age, and no mental disorder. housewives. Based on age, it was known that
the average age of pregnant women was 27.08 years old mean age of
Data collection 28 years old, and SD 4.8, the youngest was 19, while the
oldest was 37.
The research was carried out by examining the

Table 1. Characteristics of respondents

Characteristics n %

Education :
High 28 82.4
Low 6 17.6

Occupation:
Employed women 5 14.7
Housewives 29 85.3
1220 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8

Age (Year)
Mean ± SD 27,08 ± 4,8
Min – Max 19 – 37

Table 2. Distribution of Respondent Complaints, before and after Prenatal Yoga

Pre Test Post Test

No. Respondent Complaints
n % n %
1 Easily exhausted 26 76,5 9 26,4
2 Difficulties to fall asleep 22 65 5 14,7
3 Breath shortness 18 53 2 5,8
4 Foot and hand edema 7 21 5 15
5 Low back pain 19 56 12 35,2
6 Muscle spasm 9 26,4 0 0
7 Anxiety 14 41,1 3 9
8 Lower abdominal pain 23 68 17 50
9 Feverish heat and hot flashes 22 65 9 26,4
10 Frequent urination 31 91,1 17 50
11 Foot Cramps 19 56 3 9
12 Fake Contractions 16 47 3 9
13 Varicose veins 5 15 3 9
14 Hemorrhoids 3 9 1 3
15 Stretch March 14 41,2 7 20,5
16 Constipation 10 29,4 7 20,5

From 34 respondents, interviews were conducted

to 16 complaints mostly felt by pregnant women. As
shown in Table 2, frequent urination was the most
common complaint during pre-test (91.1%), while
the least perceived complaint was hemorrhoids (9%).
After Yoga, post-test interviews were conducted with the
results showing that all respondents no longer felt muscle
spasms (0%). Even so, lower abdominal pain and frequent
urination were felt by half (50%) of the total respondents.
Table 3. Statistical Result Analysis of
Effectiveness, before and after Prenatal Yoga

Com-
N Mean rank Z p-value
plaints

Pre test
34 4,7 -4,68 0.000
Post test
 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8 1221

Discussions
This bivariate analysis used paired T test for the There are sixteen pregnancy complaints as a
hypothesis to see the difference on reduced complaints measurement of the effectiveness of prenatal Yoga in
perceived by pregnant women in the third trimester, this research: fatigue, difficulty to fall asleep, breath
before and after prenatal yoga. Therefore, the normality shortness, edema, low back pain, muscle spasm, anxiety,
test result of Shapiro-Wilk test produced a probability lower abdominal pain, feverish heat and hot flashes,
value (p) <α (0.05), which meant that the data were not frequent urination, feet cramps, fake contractions,
normally distributed, Therefore, the hypothesis test used varicose vein, hemorrhoids, stretch marks, and
was Wilcoxon test. The results of the statistical analysis constipation.
(Table 3) show that the mean score of pre-test and post-
test complaints is 4.7. Wilcoxon test obtains significance Data analysis, in general, shows a significance value
p value of = 0,000, therefore the p value is = 0,000 <α = of p = 0,000 (p <0.05), indicating that prenatal exercise
0,05. It can be concluded that prenatal yoga is effective has real and significant potential in reducing pregnancy in
reducing complaints in third trimester of pregnancy. complaints. A number of movements performed in Yoga
have an impact on various organ systems that each plays proven to have been reduced through Yoga. Practicing a
role in causing complaints in the third trimester of yoga on regular basis can improve muscle health, blood
pregnancy. circulation, balance and range of motion. Relaxation
that appears through Yoga can also help muscle relaxation
Systemic inflammatory response and increased CRP which results in reduced musculoskeletal complaints 23.
level occur during pregnancy. Lack of physical activity,
coupled with psychological factors can turn pregnant The scientific explanation of the physiological
women vulnerable to inflammation and other disorders effects of each movement in prenatal Yoga makes these
associated with inflammation and hormonal fluctuations sixteen movements in this research usable as basic Yoga
12–16. Hot flashes are generally felt by women who movement. The results of this research also illustrate have
reached menopause17health, or lifestyle factors. the significance of changes in complaints, before and
METHODS We followed 3198 women enrolled in the after the research. These movements, therefore, can be
Study of Women’s Health Across the Nation during 1996 recommended for use in Public Health Centers and other
through 2002. We analyzed frequency of vasomotor institutions that wish to include prenatal yoga as one of
symptom reporting using longitudinal multiple logistic their programs.
regressions. RESULTS Rates of vasomotor symptom
reporting were highest among African Americans The present research is not conducted throughout the
(adjusted odds ratio [OR]=1.63; 95% confidence third trimester, but only for 1 month. Further research,
interval [CI]=1.21, 2.20. However, these symptoms especially conducted throughout the third trimester, is can
also occur in pregnant women due to hormonal needed to determine the effects of this exercise within
fluctuations18. Physical activity can help improve lengthy period of time. Also, items of physiological
changing body’s metabolism during pregnancy 19, thus pregnancy disorders that may change during pregnancy
reducing complaints of hot flashes. However, frequent can be added in the third trimester as effectiveness and
regular physical activity is needed to completely indicators of prenatal yoga.
eliminate the complaints 19,20. Conclusion
Frequent complaints of frequent urination are Yoga has considerably good effectiveness in
caused by the influence of progesterone hormone. controlling and reducing complaints during the
Increased glomerular filtration is sometimes exacerbated pregnancy.
by the occurrence of pyelonephritis as another effect of
anatomical changes in the ureter, causing this complaint Ethical Clearance: Taken from Health Polytechnic to
be quite common21. Yoga, besides playing a role in of Palu committee.
helping control hormonal fluctuations 18–20, can also
Source of Funding: Self funding
help reduce symptoms of anatomical and physiological
changes during pregnancy3. Conflict of Interest: None
1222 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8

Disorders of the circulatory system and respiration References

see a decrease after doing Yoga. It is evident from the
reduced complaints of fatigue and breath shortness. 1.
Anatomical changes due to pressure from pregnancy
on the diaphragm which narrowed chest cavity could McGraw-Hill Companies; 2010.
be handled through exercise. Mechanical adaptation 2.
the respiratory system, including increased resting
inspiration capacity and bronchodilator, leads to
increased VT expansion when pregnant women are
engaged in physical activity. Through regular activities,
therefore, fatigue and breath shortness complaints can be
resolved properly22.
Musculoskeletal complaints, i.e. low back pain,
muscle spasm, stretch marks, and foot cramps are
Cunningham FG, Leveno KJ, Bloom SL, Hauth
JC. Williams Obstetrics. 23rd ed. USA: The
Bobak IM, Lowdermilk D, Jensen MD. to
Keperawatan maternitas. 4th ed. Jakarta: EGC;
2005.
3. Romundstad PR, Torjusen IH, Mørkved S. Does
regular exercise including pelvic floor muscle
training prevent urinary and anal incontinence
during pregnancy ? A randomised controlled trial.
BJOG: An International Journal of Obstetrics &
also Gynaecology. 2012;1270–80.
1223 Indian Journal of Public Health Research & Development, August 2019, Vol. 10, No. 8

4. Hinman SK, Smith KB, Quillen DM, Smith 14. Clarke PE, Gross H. Women’s behaviour, beliefs
MS. Exercise in Pregnancy : A Clinical Review. and information sources about physical exercise
Sports Health: A Multidisciplinary Approach. in pregnancy. Midwifery. 2004 Jun;20(2):133–41.
2015;7(6):527–31. 15. Sun Y-C, Hung Y-C, Chang Y, Kuo S-C. Effects of
5. Wang Y, Cupul-uicab LA, Rogan WJ, Eggesbo M, a prenatal yoga programme on the discomforts of
Travlos G, Wilson R, et al. Recreational Exercise pregnancy and maternal childbirth self-efficacy in
before and during Pregnancy in relation to Plasma Taiwan. Midwifery. 2010 Dec;26(6):e31–6. C-
Reactive Protein Concentrations in Pregnant 16. Hawkins M, Braun B, Marcus BH, Iii ES,
Women. Journal of Physical Activity and Health. Markenson G, Chasan-taber L. The impact of
2016;12(6):770–5. an exercise intervention on C - reactive protein
6. Uebelacker LA, Hospital B, Battle CL, during pregnancy : a randomized controlled trial.
Hospital B, Sutton KA, Magee SR, et al. A pilot BMC Pregnancy & Childbirth. 2015;1–12.
randomized controlled trial comparing prenatal 17. Gold EB, Colvin A, Avis N, Bromberger J,
yoga to perinatal health education for antenatal Greendale GA, Powell L, et al. Longitudinal
depression. Archives of Women’s Mental Health. Analysis of the Association Between Vasomotor
2017;19(3):543–7. Symptoms and Race/Ethnicity Across the
7. Mary AJK, Latheef F. Effectiveness of selected Menopausal Transition: Study of Women’s Health
mind body interventions on anxiety related to Across the Nation. American Journal of Public
childbirth and labour outcomes. NISCAIR-CSIR. Health. 2006 Jul;96(7):1226–35.
2017;16(June):122–8. 18. Thurston RC, Luther JF, Wisniewski SR, Eng
8. Indiarti M. Panduan lengkap kehamilan, persalinan H, Wisner KL. Prospective Evaluation of Hot
dan perawatan bayi. 10th ed. Yogyakarta: Flashes during Pregnancy and Postpartum. Fertil
Diglossia media; 2009. Steril. 2013;100(6):1667–72.
9. Wiadnyana MS. The Power Of Yoga For 19. Mparmpakas D, Goumenou A, Zachariades E,
Pregnancy And Post-Pregnancy. Jakarta: Taruna Pados G, Gidron Y, Karteris E. Immune system
Grafika; 2011. function , stress , exercise and nutrition profile
10. Krisnadi, Rifayani S. Sinopsis Yoga Untuk can affect pregnancy outcome : Lessons from
Kehamilan: Sehat, Bahagia Dan Penuh Makna a Mediterranean cohort. Experimental and
[Internet]. 2010. Available from: www.bukukita. Therapeutic Medicine. 2013;411–8. com
20. Melzer K, Schutz Y, Boulvain M, Kayser B.
11. Sindhu P. Yoga Untuk Kehamilan Sehat, Bahagia, Physical Activity and Pregnancy: cardiovascular
& Penuh Makna, Edisi yang diperkaya. Bandung: adaptations, recommendations and pregnancy
Qanita; 2014. outcomes. Sports Medicine. 2010 Jun
1;40(6):493–507.
12. Sacks GP, Studena K, Sargent K, Redman
CW. Normal pregnancy and preeclampsia both 21. Nugroho T, Nurrezki, Warnaliza D, Wilis.
produce inflammatory changes in peripheral Buku Ajar Asuhan Kebidanan I (Kehamilan).
blood leukocytes akin to those of sepsis. American Yogyakarta: Nuha Medika; 2014.
journal of obstetrics and gynecology. 1998 22. Jensen D, Webb KA, Davies GAL, Donnell
Jul;179(1):80–6. DEO. Mechanical ventilatory constraints during
13. Klajnbard A, Szecsi PB, Colov NP, Andersen MR, incremental cycle exercise in human pregnancy :
Jørgensen M, Bjørngaard B, et al. Laboratory implications for respiratory sensation. The Journal
reference intervals during pregnancy, delivery and of Physiology. 2008;19:4735–50.
the early postpartum period. Clinical Chemistry 23. Dykema R. Yoga for Fitness and Wellness. and
Laboratory Medicine. 2010 Jan 1;48(2):237– Belmont: Thomson Wadsworth; 2006.
48.
EFEKTIFITAS PRENATAL YOGA TERHADAP PENGURANGAN
KETIDAKNYAMANAN IBU SELAMA HAMIL

Ni Kadek Ayu Sri Susilawati¹, Chichik Nirmasari²

Prodi D-IV Kebidanan
Fakultas Ilmu Kesehatan Universitas Ngudi Waluyo
email :nikadekayusrisusilawati@gmail.com
email :chichik_ns@yahoo.co.id

ABSTRAK

Kehamilan adalah rangkaian peristiwa yang baru terjadi bila ovum dibuahi dan
pembuahan ovum akhirnya berkembang sampai menjadi fetus aterm.Selama
pertumbuhan dan perkembangan kehamilan dari bulan ke bulan diperlukan kemampuan
seorang ibu hamil untuk beradaptasi dengan perubahan-perubahan yang terjadi pada fisik
dan mentalnya.Agar ibu hamil dapat beradaptasi dengan perubahan yang terjadi baik fisik
maupun mentalnya, perlu dilakukan asuhan antenatal yang bertujuan untuk
mempersiapkan kematang fisik dan mental selama menjalani kehamilan tersebut.
Melakukan prenatal yoga merupakan salah satu solusi self help yang menunjang proses
kehamilan dan sampai pada proses persalinan.Dimana prenatal yoga ini merupakan suatu
asuhan yang dapat meringankan ketidaknyamanan pada ibu hamil tanpa
menggunakan therapy farmologi.Tujuan penelitian ini adalah untuk mengetahui
efektifitas prenatal yoga terhadap pengurangan ketidaknyamanan ibu selama hamil.
Metode penelitian yang digunakan adalah literature review terhadap hasil penelitian yang
berkaitan dengan efektifitas prenatal yoga terhadap pengurangan ketidaknyamanan
yang dialami oleh ibu selama hamil, yang dipublikasikan pada google scholer. Artikel
yang dipilih merupakan artikel berbahasa Indonesia dan berbahas Inggris yang
terbit sejak tahun 2013 sampai 2016.Dimana dalam artikel tersebut ditemukan
secara signifikan bahwa prenatal yoga mempunyai pengaruh terhadap pengurangan
ketidaknyamanan yang dialami oleh ibu hamil.

Kata Kunci: Ibu Hamil, Ketidaknyamanan, Prenatal Yoga

PENDAHULUAN Untuk memelihara kesehatan ibu
Kehamilan merupakan suatu proses hamil, perlu dilakukan perawatan kehamilan
yang dimulai sejak bertemunya sperma dan yaitu salah satunya dengan melakukan
ovum di dalam rahim wanita. Pertemuan olahraga.Bagi ibu hamil, olahraga juga
sperma dan ovum lebih dikenal dengan mempunyai banyak manfaat.Olahraga dapat
nama fertilisasi atau konsepsi yang membantu dalam perubahan metabolism
membentuk zygote, berimplantasi ke dalam tubuh selama kehamilan yang berdampak
uterus dan berkembang sampai dilahirkan pada tingginya konsumsi oksigen pada
menjadi seorang bayi. Setiap kehamilan tubuh, aliran darah jantung, volume dan
merupakan proses alamiah, bila tidak curah jantung. Hal ini mengakibatkan
dikelola dengan baik akan memberikan perubahan peran jantung selama kehamilan
komplikasi pada ibu dan janin dalam yang berguna untuk membantu fungsi
keadaan sehat dan aman (Nugroho, 2014). jantung, sehingga ibu hamil akan merasa
Selama kehamilan, tubuh ibu hamil lebih sehat, dan juga dapat mengurangi
mengalami perubahan besar yang bisa frekuensi nyeri punggung akibat kehamilan
membuat ibu hamil seringkali merasa tidak dengan cara membantu mempertahankan
nyaman, baik itu perubahan fisiologis portur tubuh yang lebih baik (Putra, 2016).
maupun psikologis.Perubahan ini Bentuk olahraga yang dapat
menimbulkan gejala spesifik sesuai dengan membantu ibu hamil merasakan
tahapan kehamilan yang terdiri dari tiga kenyamanan saat kehamilan atau pun
trimester.(Andriana, 2014). sampai proses melahirkan yaitu prenatal
Berat badan yang meningkat drastis yoga. Prenatal yoga adalah keterampilan
menyebabkan ibu hamil cepat merasa lelah, mengolah pikiran, berupa teknik
sukar tidur, nafas pendek, kaki dan tangan pengembangan kepribadian secara
odema.Sejalan dengan pertumbuhan janin menyeluruh baik fisik, psikologi dan
dan mendorong diafragma ke atas, bentuk spiritual.Prenatal yoga ini diantaranya dan
ukuran rongga dada berubah.Volume mencakup berbagai relaksasi, mengatur tidal,
volume ventilator permenit, dan postur olah napas dan meditasi yang dapat ambilan
oksigen meningkat. Karena bentuk dilakukan oleh ibu hamil setiap hari(Amalia, dari
rongga thorak berubah dan karena 2015).
bernafas lebih cepat, sekitar 60% ibu hamil Tujuan dari tinjauan literature ini
mengeluh sesak nafas .peningkatan tinggi untuk mengetahui efektifitas dari prenatal
fundus uteri yang disertai pembesaran perut, yoga terhadap pengurangan
membuat beban tubuh lebih di depan. Dalam ketidaknyamanan selama kehamilan.
upaya menyesuaikan dengan beban tubuh Dengan mengetahui efektifitas dari prenatal
yang berlebihan sehingga tulang belakang yoga ini dapat dijadikan strategi oleh tenaga
mendorong ke arah belakng, membentuk kesehatan untuk mengurangi
postur lordosis. Hal ini yang menyebabakan ketidaknyamanan pada ibu hamil.
rasa pegal pada punggung, varises dan
merasakan krampada kaki (Purwati, 2015).
METODE HASIL
 Study ini merupakan suatu tinjauan
literature (Literature Riview) yang mencoba
menggali informasi mengenai efektifitas
prenatal yoga terhadap pengurangan
ketidaknyamanan ibu selama hamil. Sumber
untuk melakukan tinjauan literature ini
meliputi studi pencarian sistematis database
komputerisasi (Pubmed, NCBI, Google
Cendikia) bentuk jurnal penelitian yang
digunakan berjumlah 7. Jurnal penelitian
dipergunakan dari tahun 2013 sampai 2016.
Pencarian artikel dilakukan pada
pangkalan data (data base) dengan kata
kunci tertentu. Artikel yang digunakan dan
memenuhi criteria sebanyak 7 artikel, yang
terdiri dari 5 artikel yang menggunakan
desain quasi eksperimen dan dua artikel
menggunakan metode analitik cross
cestional.Berikut data artikel yang diuraikan
dalam bentuk tabel.

Tabel. 1 Ekstrasi Data Penelitian

No Penulis Metode Penelitian Hasil Penelitian
1 Field., et al (2013) Desain penelitian yang Hasil dari penelitian ini adalah yoga
digunakan adalah quasi mempunyai efek positif bagi ibu
eksperimen dengan hamil yaitu untuk menurunkan
menggunakan pre and post test tingkat stress dan nyeri punggung.
without control group design
yang dilakukan selama 12
minggu, dimana jumlah sampel
sebanyak 92 orang ibu hamil.
2 Rahma (2014) Desain penelitian yang Hasil penelitian ini menunjukkan
digunakan adalah Single Case bahwa terdapat peningkatan kualitas
Research dengan desain B-A-B tidur pada ibu hamil sesudah
pada ibu hamil trimester tiga dilakukan prenatal yoga.
yang berjumlah 15 orang yang
selama 3 minggu. Penelitian ini
dilakukan dengan menilai
sebelum, selama dilakukan dan
sesudah dilakukan prenatal
yoga.
3 Mediarti., et al Desain penelitian yang Hasil penelitian ini menunjukkan
(2014) digunakan adalah quasi bahwa ada perbedaan keluhan ibu
exsperimendengan desain pre- hamil sebelum dan sesudah
test dan post-test pada ibu hamil dilakukan prenatal yoga. Dimana
trimester tiga sebanyak 35 keluhan yang dimaksud adalah nyeri
orang yang dilakukan selama 4 punggung, susah tidur, kram
minggu kaki dan cemas.
4 Sumiatik., et al Desain penelitian ini adalah Hasil penelitian ini adalah ada
(2014) cross sectional dengan jenis hubungan antara melakukan prenatal
penelitian analitik. Teknik yoga dengan mengurangi
pengumpulan data pada kecemasan pada kehamilan trimester
penelitian ini adalah tiga.
menggunkan purposive

No Penulis Metode Penelitian Hasil Penelitian sampling

pada ibu hamil
 trimester tiga dengan jumlah
sampel sebanyak 22 orang.
5 Newham., et al Desain penelitian yang
(2014) digunakan adalah quasi
exsperimendengan desain pre-
test dan post-test pada ibu hamil
sebanyak 31 orang ibu hamil
selama 8 minggu.
6 Fauziah., et al Desain penelitian ini adalah
(2016) quasi eksperimen interrupted
time-series design yang diukur
sebanyak tiga kali sebelum
treatment dan tiga kali sesudah
treatment yang dilakukan pada
tiga orang ibu hamil.
7 Sari., et al Desain penelitian ini adalah
(2016) penelitian kuantitatifdengan
metode cross sectional pada ibu
hamil trimester tiga dengan
jumlah responden sebanyak 24
Hasil penelitian ini adalah ada
hubungan antara melakukan prenatal
yoga dengan mengurangi
kecemasan pada kehamilan.
Hasil dari penelitian ini adalah
prenatal yoga dapat memberikan
efek dalam penurunan kecemasan
pada ibu hamil trimester tiga.
Hasil dari penelitian ini adalah
adanya hubungan prenatal yoga
dengan kesiapan fisik dan psikologi
dalam menjalani kehamilan pada ibu
hamil trimester tiga.

orang.

DISKUSI 2. Mengurangi nyeri punggung

Berdasarkan hasil diskusi dari keenam
artikel didapatkan hasil bahwa efektifitas
prenatal yoga terhadap pengurangan
ketidaknyamanan ibu selama hamil yaitu :
1. Mengurangi kecemasan/stress
Menurut Field., et al (2013), Mediarti.,
(2014), Sumiatik., et al (2014),
Newham., et al (2014), Fauziah., et al
(2016) dan Sari., et al (2016), prenatal
dapat mengurangi kecemasan
karena 3. Meningkatkan kualitas tidur
dengan melakukan prenatal yoga
secara teratur akan membawa efek
relaksasi pada tubuh ibu hamil, baik
yang bersifat relaksasi pernafasan
maupun relaksasi otot, sehingga ibu
hamil akan merasakan keadaanyang
tenang, santai, rileks dan nyaman dan
menjalani kehamilannya.
Terciptanya rileksasi
menghilangkan suara-suara
Menurut Field., et al (2013), Mediarti.,
et al (2014) dan Sari., et al (2016),
prenatal yoga dapat mengurangi nyeri
punggung karena gerakan-gerakan
yang ada pada prenatal yoga ini akan
dapat melenturkan otot-otot yang ada et al
disekitar tulang punggung dan
kelenturan tubuh. Sehingga rasa nyeri
akan berkurang dan pergerakan tubuh yoga
akan terasa nyaman. atau stress pada ibu hamil
Menurut Rahma (2014), Mediarti., et
al (2014) dan Fauziah., et al (2016),
prenatal yoga dapat meningkatkan
kualitas tidur ibu hamil diakrenakan
oleh gerakan yoga yang terjadi pada
tubuh diawali dengan terciptanya
suasana relaksasi alam sadar yang
secara sistematis membimbing pada
keadaan rileks yang mendalam.
akan Tanggal 06 Maret 2017. Jam 19.40
dalam WIB.
 pikiran sehingga tubuh akan mampu Field., et al. 2013. Yoga Reduces Prenatal
melepas ketegangan otot..Ketika tubuh Depression, Anxiety And Sleep
mulai rileks nafas menjadi santai Disturbance. Complementary
dalam, sengga system pernafasan dapat Therapies In Clinical Practice 19
tidur. (2013) 6-10.
4. Mengurangi kram pada kaki Mediarti., et al. 2014. Pengaruh
Yoga Menurut Mediarti., et al (2014) dan Antenatal Terhadap
Pengurangan Fauziah., et al (2016), prenatal yoga Keluhan Ibu Hamil
Trimester dapat mengurangi kram pada kaki III.Jurnal Kedokteran
dan karena gerakan-gerakan yang ada Kesehatan.Volume 1.No. 1. pada
prenatal yoga dapat merilekskan Oktober 2014 : 47-53.
otot-otot dan memperlancar sirkulasi Newham., et al (2014). Effects Of Antenatal
peredaran darah, sehingga saluran Yoga On Maternal Anxiety And
peredaran darah tidak akan tersumbat., Depression. Wiley Periodicals, Inc.
peredaran darah akan lancer sehingga Depression And Anxiety 00 : 1 -10
kram pada kaki akan berkurang. (2014).
Nugroho. 2014. Buku Ajar ASKEB I
KESIMPULAN DAN SARAN Kehamilan. Yogyakarta : Nuha
Kesimpulan Medika.
Dari pembahasan diatas dapat Purwati, 2015.Pengaruh Senam Hamil
disimpulkan bahwa prenatal yoga efektif Terhadap Penurunan Skala Nyeri
dalam mengurangi ketidaknyamanan pada Punggung Pada Ibu Hamil
kehamilan yaitu diantaranya : mengurangi Trimester II Dan III : PPNI
kecemasan/stress, mengurangi nyeri Mojokerto. punggung, meningkatkan
kualitas tidur, Putra. 2016. Cara Mudah Melahirkan. mengurangi kram pada kaki.
Yogyakarta : Laksana.
Rahma. 2014. Hubungan Prenatal Yoga
REFERENSI Terhadap Kualitas Peningkatan
Amalia.2014. Tetap Sehat Dengan Tidur Pada Ibu Hamil Trimester
Yoga.Jakarta : Gagas Media. III. UMS. 07. 2014. Halm. 54.
Andriana. 2014. Melahirkan Tanpa Rasa Diakses Tanggal 06 Maret 2017,
Sakit. Jakarta : PT. Bhuana Ilmu Jam 19.30 WIB.
Populer. Sari., et al. 2016. Hubungan Senam Yoga Fauziah.,
et al. 2016. Efektivitas Latihan Dengan Kesiapan Fisik Dan Yoga
Prenatal Dalam Menurunkan Psikologi Ibu Hamil Dalam Kecemasan
Pada Ibu Hamil Menjalani Kehamilan Trimester Primigravida
Trimester III.Kemas 8 III.Jurnal Terpadu Ilmu Kesehatan, (2) (2016) 145-152.
Diakses Volume 5. No 2. November 2016, hlm 110-237.
Sumiatik., et al. 2014. Hubungan Prenatal
Yoga Dengan Mengurangi Kecemasan
Pada Kehamilan

Trimester III.Jurnal Maternal dan Neonatal,

12/05 (2016), 8-14.