PROGRAM STUDI D -III KEBIDANAN FAKULTAS … filei asuhan. kebidanan ibu nifas pada ny. g p 1 a 0 umur 25 tahun dengan perdarahan postpartum primer akibat robekan portio, perineum derajat

ASUHAN KEBIDANAN IBU NIFAS PADA NY. G P1A0 UMUR 25 TAHUN

DENGAN PERDARAHAN POSTPARTUM PRIMER AKIBAT

ROBEKAN PORTIO, PERINEUM DERAJAT II, DAN

HEMATOMA VAGINA DI RSUD KARANGANYAR

KARYA TULIS ILMIAH

Diajukan Untuk Memenuhi Sebagian Persyaratan Ujian Akhir Program Kompetensi

Bidan di Program Studi D III Kebidanan Fakultas Kedokteran

Universitas Sebelas Maret

Oleh :

Brian Sahar Afifah

NIM R0313005

PROGRAM STUDI D-III KEBIDANAN FAKULTAS KEDOKTERAN

UNIVERSITAS SEBELAS MARET SURAKARTA

2016

perpustakaan.uns.ac.id digilib.uns.ac.id

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ASUHAN KEBIDANAN IBU NIFAS PADA NY. G P1A0 UMUR 25 TAHUN

DENGAN PERDARAHAN POSTPARTUM PRIMER AKIBAT

ROBEKAN PORTIO, PERINEUM DERAJAT II, DAN

HEMATOMA VAGINA DI RSUD KARANGANYAR

KARYA TULIS ILMIAH

Diajukan Untuk Memenuhi Sebagian Persyaratan Ujian Akhir Program Kompetensi

Bidan di Program Studi D III Kebidanan Fakultas Kedokteran

Universitas Sebelas Maret

Oleh :

Brian Sahar Afifah

NIM R0313005

PROGRAM STUDI D-III KEBIDANAN FAKULTAS KEDOKTERAN

UNIVERSITAS SEBELAS MARET SURAKARTA

2016


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ABSTRAK

BRIAN SAHAR. R0313005. ASUHAN KEBIDANAN IBU NIFAS PADA Ny.

G P1A0 DENGAN PERDARAHAN POSTPARTUM PRIMER AKIBAT

ROBEKAN PORTIO, PERINEUM DERAJAT II, DAN HEMATOMA

VAGINA DI RSUD KARANGANYAR. PROGRAM STUDI DIII

KEBIDANAN FAKULTAS KEDOKTERAN UNIVERSITAS SEBELAS

MARET.

Latar Belakang. AKI disebabkan perdarahan 30,3%. Di RSUD Karanganyar

kasus perdarahan akibat laserasi jalan lahir 11%. Tujuan untuk mempelajari dan

memahami asuhan kebidanan pada kasus perdarahan akibat laserasi jalan lahir di

RSUD Karanganyar.

Metode. Observasional deskriptif dengan pendekatan studi kasus. Subjek

penelitian Ny. G P1A0 perdarahan postpartum primer akibat robekan portio,

perineum, dan hematoma vagina. Di RSUD Karanganyar. Cara pengambilan data:

wawancara, observasi langsung, studi dokumen, rekam medik. Analisis data

deskriptif berdasar Varney.

Hasil. Ny.G postpartum 1 jam akibat robekan portio, perineum derajat II, robekan

portio dan hematoma vagina. PPV : ±550cc. Dilakukan tindakan penjahitan dan

pemberian terapi. Keadaan pasien pasca tindakan membaik, perdarahan berhenti.

Pasien dipindah ke Bangsal Nifas.

Kesimpulan. Asuhan kebidanan ibu nifas dengan perdarahan postpartum primer

akibat robekan portio, perineum derajat II, dan hematoma vagina pada Ny.G telah

dilakukan secara komprehensif. Terdapat kesenjangan diagnosa awal salah karena

kurang cermat pemeriksaan objektif dan tidak dilakukan anastesi pada re hecting

kedua.

Kata kunci : Asuhan Kebidanan Ibu Nifas, Perdarahan Postpartum Primer.


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ABSTRACT

BRIAN SAHAR. R0313005. MIDWIFERY CARE OF POSTPARTUM

MOTHERS ON Mrs. G P1A0 WITH PRIMARY POSTPARTUM

BLEEDING DUE TO PORTIO LACERATION, LEVEL-II PERINEAL

LACERATION, AND VAGINAL HEMATOMA AT LOCAL GENERAL

HOSPITAL OF KARANGANYAR. THE STUDY PROGRAM OF

DIPLOMA III IN MIDWIFERY SCIENCE THE FACULTY OF

MEDICINE, SEBELAS MARET UNIVERSITY, 2016.

Background: The maternal mortality rate caused by bleeding was 30.3%. At

Local General Hospital of Karanganyar, the percentage of postpartum mothers

with bleeding due to the birth canal laceration was 11%. The objective of this

research is to study and comprehend the midwifery care on bleeding case due to

the birth canal laceration at Local General Hospital of Karanganyar.

Method: This research used the observational descriptive method with the case

study approach. Its subject was Mrs. G P1A0 with primary postpartum bleeding

due to portio laceration, perineal laceration, and vaginal hematoma. It was

conducted at the aforementioned hospital. The data of research were collected

through in-depth interview, direct observation, content analysis, and medical

record. They were analyzed by using the descriptive model of analysis with

Varney’s Seven Steps.

Result: Mrs. G was postpartum for one hour due to due to the perineal laceration

of Level II, portio laceration, and vaginal hematoma with the PPV: ±550cc. She

was exposed to suture intervention and therapy, and the bleeding stopped

completely. Then the client was transferred to postpartum ward.

Conclusion: The midwifery care of postpartum mothers on Mrs. G with primary

postpartum bleeding due to portio laceration, Level-II perineal laceration, and

vaginal hematoma was done comprehensively. There was a discrepancy that the

initial observation was not right due to the less accuracy in the objective

examination and the absence of anesthesia in the secondary re-suture.

Keywords: Midwifery care of postpartum mothers, primary postpartum

bleeding.


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DAFTAR ISI

HALAMAN JUDUL ........................................................................................... i

HALAMAN PERSETUJUAN ........................................................................... ii

HALAMAN PENGESAHAN ............................................................................. iii

SURAT KETERANGAN KEASLIAN KTI ..................................................... iv

KATA PENGANTAR ........................................................................................ v

ABSTRAK ........................................................................................................... vii

ABSTRACT .......................................................................................................... viii

DAFTAR ISI ........................................................................................................ ix

DAFTAR LAMPIRAN ....................................................................................... xii

BAB I. PENDAHULUAN ................................................................................. 1

A. Latar Belakang ................................................................................ 1

B. Perumusan Masalah ......................................................................... 3

C. Tujuan .............................................................................................. 3

D. Manfaat ............................................................................................ 5

BAB II. TINJAUAN PUSTAKA ....................................................................... 6

A. Teori Medis ...................................................................................... 6

1. Masa Nifas ................................................................................. 6

2. Perdarahan Postpartum Primer atau Dini .................................... 6

a. Definisi ................................................................................. 6

b. Etiologi ................................................................................. 7

3. Robekan Perineum ..................................................................... 9


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a. Pengertian ............................................................................. 9

b. Etiologi ................................................................................. 10

c. Patofisiologi ......................................................................... 11

d. Faktor Presdiposisi ............................................................... 11

e. Faktor Risiko ........................................................................ 12

f. Keluhan Subjektif................................................................. 13

g. Tanda Klinis dan Laboratoris ............................................... 13

h. Prognosis .............................................................................. 14

i. Penatalaksanaan dan Pengobatan Robekan Perineum ......... 17

B. Teori Manajemen Kebidanan ........................................................... 20

C. Follow Up Catatan Perkembangan Kondisi Klien .......................... 29

BAB III. METODE PENELITIAN STUDI KASUS ........................................ 32

A. Jenis Penelitian ................................................................................. 32

B. Tempat dan Waktu Penelitian .......................................................... 32

C. Subjek Penelitian .............................................................................. 32

D. Jenis Data ......................................................................................... 33

E. Teknik Pengambilan Data ................................................................ 33

F. Analisis Data .................................................................................... 35

G. Jadwal Pelaksanaan .......................................................................... 35

BAB IV. HASIL PENELITIAN DAN PEMBAHASAN ................................. 36

A. Hasil Penelitian ................................................................................ 36

B. Pembahasan ..................................................................................... 43


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BAB V. PENUTUP ............................................................................................. 49

A. Simpulan .......................................................................................... 49

B. Saran ............................................................................................... 51

DAFTAR PUSTAKA .......................................................................................... 53

LAMPIRAN


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DAFTAR LAMPIRAN

Lampiran 1 Jadwal Pelaksanaan Studi Kasus.

Lampiran 2 Surat Permohonan Ijin Pengambilan Kasus di RSUD Karanganyar.

Lampiran 3 Surat Balasan Perijinan Pengambilan Kasus di RSUD

Karanganyar.

Lampiran 4 Surat Permohonan Responden.

Lampiran 5 Surat Persetujuan Responden (Informed Consent).

Lampiran 6 Asuhan Kebidanan Ibu Nifas, serta Follow Up Data Perkembangan

Kondisi Klien (SOAP).

Lampiran 7 Surat Selesai Penelitian Pengambilan Kasus di RSUD

Karanganyar.

Lampiran 8 Lembar Konsultasi Pembimbing Utama.

Lampiran 9 Lembar Konsultasi Pembimbing Pendamping.

Lampiran 10 SOP Penanganan Perdarahan Postpartum RSUD Karanganyar.

Lampiran 11 SAP (Satuan Acara Penyuluhan) Kebutuhan Nutrisi Ibu Nifas.

Lampiran 12 SAP (Satuan Acara Penyuluhan) Perawatan Perineum pada Ibu

Nifas.

Lampiran 13 SAP (Satuan Acara Penyuluhan) KB Ibu Menyusui


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Documents

PROGRAM STUDI D -III KEBIDANAN FAKULTAS … filei asuhan. kebidanan ibu nifas pada ny. g p 1 a 0 umur 25 tahun dengan perdarahan postpartum primer akibat robekan portio, perineum derajat