
Asuhan Kebidanan Komprehensif Pada Ny. A Di Puskesmas Karang Rejo
Pengarang : Syarifah Annisa Maryama Aljufrie - Personal Name;
Perpustakaan UBT : Universitas Borneo Tarakan., 2024XML Detail Export Citation
Abstract
Pelayanan kesehatan ibu dan bayi baru lahir yang berkualitas membutuhkan tenaga kesehatan terampil yang didukung oleh ketersediaan sarana dan prasarana yang memadai. Sebagai bidan diharapkan mampu memberikan asuhan kebidanan secara komprehensif dan berkesinambungan mulai dari kehamilan, persalinan, nifas dan perawatan bayi baru lahir. Salah satu upaya percepatan penurunan Angka Kematian Ibu (AKI) adalah dengan melaksanakan asuhan continuity of care, yaitu pelayanan yang berkesinambungan antara ibu hamil dan bidan. Bidan diharapkan dapat memberikan perawatan kebidanan yang komprehensif mulai dari perawatan kehamilan, persalinan, bayi baru lahir, hingga nifas. Pada Ny. A dengan G₃P₂A₀, dilakukan kunjungan kehamilan pada usia 38 minggu 6 hari. Pemeriksaan fisik menunjukkan hasil normal, namun pemeriksaan laboratorium menunjukkan Hb 10,5 mg/dl, sehingga Ny. A di diagnosis menderita anemia ringan. Masalah yang dikhawatirkan adalah perdarahan saat persalinan dan nifas. Asuhan yang diberikan meliputi pemberian tablet tambah darah 2x1/hari, serta edukasi tentang cara minum obat dan pemenuhan nutrisi. Pada kunjungan berikutnya pada usia kehamilan 39 minggu, pemeriksaan fisik dan laboratorium menunjukkan hasil normal dengan Hb 15,1 mg/dl, sehingga masalah anemia sudah teratasi. Persalinan Ny. A berlangsung pada tanggal 07 April 2024 pukul 15.40 WITA pada usia kehamilan 40 minggu. Kala I fase laten berlangsung selama ± 15 jam dengan induksi persalinan dan fase aktif selama ± 3 jam. Kala II berlangsung selama 5 menit, kala III selama 15 menit, dan kala IV selama 2 jam. Tidak terjadi perdarahan, namun ditemukan masalah pada kala A yaitu fase laten yang memanjang. Perawatan nifas pada Ny. A dilakukan dengan kunjungan 6 jam setelah melahirkan pada 08 April 2024, yang berjalan normal. Pemeriksaan mencakup tanda-tanda vital, proses involusi, tinggi fundus uteri, kontraksi rahim, proses laktasi, dan pengeluaran lochea, semuanya berada dalam batas normal. Kunjungan 2 hari setelah melahirkan pada 10 April 2024 juga dilakukan dengan pemeriksaan tanda-tanda vital, proses involusi, tinggi fundus uteri, kontraksi rahim, proses laktasi, pengeluaran lochea, dan laserasi jalan lahir, yang semuanya berada dalam batas normal. Kunjungan 8 hari setelah melahirkan pada 16 April 2024 juga dilakukan dengan pemeriksaan tanda-tanda vital, proses involusi, tinggi fundus uteri, kontraksi rahim, proses laktasi, pengeluaran lochea, dan laserasi jalan lahir, yang semuanya berada dalam batas normal. Dengan demikian, tidak ditemukan adanya masalah. Kunjungan bayi baru lahir usia 6 jam dilakukan pada tanggal 08 April 2024. Dari pemeriksaan fisik didapatkan hasil normal, berjenis kelamin perempuan, berat badan 3200 gram, panjang badan 48 cm, lingkar kepala 34 cm, lingkar dada 33 cm, dan tidak ada kelainan. Kunjungan bayi baru lahir usia 8 hari dilakukan pada tanggal 16 April 2024. Dari pemeriksaan fisik didapatkan hasil normal dan tidak ada masalah yang ditemukan.
Quality maternal and newborn health services require skilled health workers supported by adequate facilities and infrastructure. As midwives, they are expected to be able to provide comprehensive and continuous midwifery care starting from pregnancy, childbirth, postpartum and newborn care. One of the efforts to accelerate the reduction of the Maternal Mortality Rate (MMR) is to implement continuity of care, namely continuous services between pregnant women and midwives. Midwives are expected to be able to provide comprehensive midwifery care starting from pregnancy, childbirth, newborn care, to postpartum care. In Mrs. A with G₃P₂A₀, a pregnancy visit was conducted at 38 weeks and 6 days. Physical examination showed normal results, but laboratory examination showed Hb 10.5 mg/dl, so Mrs. A was diagnosed with mild anemia. The problem of concern is bleeding during labor and postpartum. The care provided includes the provision of iron supplements 2x1/day, as well as education on how to take medication and fulfill nutrition. On the next visit at 39 weeks of pregnancy, physical and laboratory examinations showed normal results with Hb 15.1 mg/dl, so that the anemia problem had been resolved. Mrs. A's delivery took place on April 7, 2024 at 15:40 WITA at 40 weeks of pregnancy. The first stage of the latent phase lasted for ± 15 hours with labor induction and the active phase for ± 3 hours. The second stage lasted for 5 minutes, the third stage for 15 minutes, and the fourth stage for 2 hours. There was no bleeding, but a problem was found in stage A, namely the prolonged latent phase. Postpartum care for Mrs. A was carried out with a visit 6 hours after giving birth on April 8, 2024, which went normally. The examination included vital signs, involution process, height of uterine fundus, uterine contractions, lactation process, and lochia discharge, all of which were within normal limits. A visit 2 days after giving birth on April 10, 2024 was also conducted with an examination of vital signs, involution process, height of uterine fundus, uterine contractions, lactation process, lochia discharge, and laceration of the birth canal, all of which were within normal limits. A visit 8 days after giving birth on April 16, 2024 was also conducted with an examination of vital signs, involution process, height of uterine fundus, uterine contractions, lactation process, lochia discharge, and laceration of the birth canal, all of which were within normal limits. Thus, no problems were found. A 6-hour newborn baby visit was conducted on April 8, 2024. From the physical examination, the results were normal, female, weighing 3200 grams, body length 48 cm, head circumference 34 cm, chest circumference 33 cm, and no abnormalities. A 8-day newborn baby visit was conducted on April 16, 2024. From the physical examination, the results were normal and no problems were found.