
Asuhan Kebidanan Komprehensif Pada Ny. H Di Puskesmas Gunung Lingkas
Pengarang : Kristiani Roy - Personal Name;
Perpustakaan UBT : Universitas Borneo Tarakan., 2024XML Detail Export Citation
Abstract
Asuhan Kebidanan Komprehensif adalah asuhan yang diberikan secara berkesinambungan kepada ibu selama kehamilan, persalinan, nifas, bayi baru lahir dan KB. Tujuan asuhan komprehensif adalah untuk menurunkan Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB) supaya kesehatan ibu dan bayi terus meningkat dengan cara memberikan asuhan kebidanan secara berkala mulai dari masa kehamilan, bersalin, nifas, bayi baru lahir dan KB (Prapitasari, 2021).
Asuhan kebidanan komprehensif pertama kali dilakukan pada saat kunjungan kehamilan di trimester III pada tanggal 07 Maret 2024 dengan usia kehamilan ibu 37 minggu 3 hari, dan kunjungan kedua ibu dilakukan pada usia kehamilan 39 minggu 1 hari dengan ketidaknyamanan sering BAK dan telah di berikan KIE tentang ketidaknyamanan trimester III. Asuhan kehamilan yang di berikan sesuai dengan standar 10 T dengan hasil pemeriksaan pada kunjungan awal didapatkan hasil TB 154 cm, BB 55 kg, TD 129/79 Mmhg, N 82x/m, RR 20x/m, TFU 32 cm, DJJ 140x/m, IMT 23,1, LILA 24 cm. Dan pada pemeriksaan kunjungan ulang di dapatkan hasil BB 55,5 kg, TD 127/83 Mmhg, N 95x/m, RR 20x/m, TFU 32cm, statu imunisasi TT di dapatkan sudah lengkap dan table fe sudah sesuai standar minimal 90 tablet selama kehamilan HB 11,3gr/dl penatalaksanaan kasus sudah di lakukan sesuai dengam wewenang bidan.
Asuhan persalinan diberikan pada tanggal 20 Maret 2024 pada usia kehamilan ibu 39 minggu. Asuhan yang diberikan sesuai dengan standar 60 langkah Asuhan Persalinan Normal (APN), didapatkan kala I berlangsung selama 4 jam 30 menit, dan kala II berlangsung selama 20 menit, dilakukan penilaian sepintas, bayi lahir cukup bulan, segera menangis, warna kulit kemerahan, dan tonus otot baik. Kala III berlangsung salama 7 menit setelah oksitosin disuntikkan, plasenta lahir lengkap dan tidak ada kelainan. Asuhan kebidanan pada kala IV dilakukan selama 2 jam dengan memantau tanda-tanda vital ibu, dan didapatkan hasil dalam batas normal, perdarahan kurang lebih 100 cc, terdapat laserasi perineum derajat 2 dan telah dilakukan penjahitan dengan anastesi TFU 2 jari di bawah pusat kandung kemih kosong.
Kunjungan nifas dan bayi baru lahir dilakukan pada tanggal 23 Maret 2024, dengan hasil pemeriksaan fisik dan tanda-tanda vital ibu dan perdarahan masa nifas dalam batas normal, TFU 3 jari dibawah pusat, terdapat pengeluaran lochea rubra dan bekas jahitan perenium masih basah dan tidak ada tanda-tanda infeksi. Asuhan yang dilakukan pada bayi berupa pengkuran antropometri. Didapatkan hasil bayi berjenis kelamin perempuan, berat badan 3.000 gr, panjang badan 48 cm, lingkar kepala 32 cm, dan lingkar dada 33 cm, tampak tali pusat sudah mengering dan bayi menyusu kuat dan telah di berikan KIE tentang tanda bahaya masa nifas dan KIE perawatan tali pusat pada bayi.
Telah dilakukan asuhan komprehensif pada Ny. H selama masa kehamilan, persalinan, nifas, dan bayi baru lahir dengan didapatkan bahwa tidak tedapat kesenjangan antara teori dan praktek. Asuhan kebidanan yang berkelanjutan jika diberikan secara aktif dapat meningkatkan kesehatan ibu dan anak.
Comprehensive Midwifery Care is care that is provided continuously to mothers during pregnancy, childbirth, postpartum, newborns and family planning. The purpose of comprehensive care is to reduce the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) so that the health of mothers and babies continues to improve by providing regular midwifery care starting from pregnancy, childbirth, postpartum, newborns and family planning (Prapitasari, 2021). The first comprehensive midwifery care was carried out during the pregnancy visit in the third trimester on March 7, 2024 with the mother's gestational age of 37 weeks 3 days, and the mother's second visit was carried out at 39 weeks 1 day of gestation with frequent urination discomfort and IEC had been given regarding the discomfort of the third trimester. Pregnancy care provided is in accordance with the 10 T standards with the results of the examination at the initial visit obtained the results of TB 154 cm, BB 55 kg, BP 129/79 Mmhg, N 82x / m, RR 20x / m, TFU 32 cm, DJJ 140x / m, BMI 23.1, LILA 24 cm. And on the follow-up visit examination, the results were obtained BB 55.5 kg, BP 127/83 Mmhg, N 95x / m, RR 20x / m, TFU 32cm, TT immunization status was obtained complete and the fe table was in accordance with the minimum standard of 90 tablets during pregnancy HB 11.3gr / dl case management has been carried out in accordance with the authority of the midwife. Delivery care was provided on March 20, 2024 at a gestational age of 39 weeks. The care provided was in accordance with the 60-step standard of Normal Delivery Care (APN), obtained that the first stage lasted for 4 hours 30 minutes, and the second stage lasted for 20 minutes, a cursory assessment was carried out, the baby was born full-term, cried immediately, had reddish skin color, and good muscle tone. The third stage lasted for 7 minutes after oxytocin was injected, the placenta was born completely and there were no abnormalities. Midwifery care in the fourth stage was carried out for 2 hours by monitoring the mother's vital signs, and the results were within normal limits, bleeding was approximately 100 cc, there was a second-degree perineal laceration and suturing had been performed with TFU anesthesia 2 fingers below the center of the empty bladder. Postpartum and newborn visits were carried out on March 23, 2024, with the results of physical examination and vital signs of the mother and postpartum bleeding within normal limits, TFU 3 fingers below the center, there was lochia rubra discharge and the perineum stitches were still wet and there were no signs of infection. The care given to the baby was in the form of anthropometric measurements. The results showed that the baby was female, weighing 3,000 grams, body length 48 cm, head circumference 32 cm, and chest circumference 33 cm, the umbilical cord appeared to have dried up and the baby was breastfeeding strongly and had been given IEC on signs of danger during the postpartum period and IEC on umbilical cord care for babies. Comprehensive care was given to Mrs. H during pregnancy, childbirth, postpartum, and newborns and it was found that there was no gap between theory and practice. Continuous midwifery care if given actively can improve the health of mothers and children.