ASUHAN KEBIDANAN ASUHAN KEBIDANAN KOMPREHENSIF PADA NY”K” GIIIP1001A100 DENGAN RETENSIO PLASENTA DI PMB PERMATA WILAYAH PAMEKASAN

Abstract

Childbirth is the end of pregnancy and the start of life outside the womb for newborns, which is a physiological thing. However, not all birth processes proceed normally without complications, and the result of these complications is the death of the mother and even the baby. Especially in deliveries that are at risk of placental retention, according to the World Health Organization (WHO) in 2019, it was explained that two-thirds of maternal deaths due to post-partum hemorrhage were caused by 15-20% retained placenta. Meanwhile, in Indonesia in 2020 the incidence of bleeding due to retained placenta reached 67%. Meanwhile, based on research at PMB Sari Surabaya for three periods in 2019-2020, it tends to increase, namely 2.83-4.19%. The data obtained from the incidence of placental retention at PMB Permata from February to April 2024 from 15 mothers gave birth, namely 1 mothers who experience retained placenta.After midwifery care was carried out on Mrs "K" GIII PI00I AI00 H/T head position, intrauterine, normal birth canal, mother and fetus were in good condition with chronic energy deficiency, third trimester pregnancy visit to Mrs "K" on March 1 2024 at 09:00: 00 WIB at PMB Permata with complaints of back pain. The care plan given to Mrs "K" is not to sit or sleep too much, do light massage, do leisurely walks and pregnancy exercises, nutrition. The birth process for Mrs "K" was classified as a fast delivery. In the first stage it started on March 20 2024 at 17:30 WIB with complaints of stomach ache from the lower part spreading to the waist. The care plan given to Mrs "K" was in recommend tilting to the left to speed up the labor process and lowering the head for infusion.In the second stage, Mrs "K" started on March 20 2024 at 19:00 WIB with complaints that the mother felt like she wanted to defecate and there was a desire to defecate. The care plan given to Mrs 'K' was to check that the membranes were 10 cm dilated and not yet ruptured and an amniotomy was carried out. In the third stage of Mrs 'K' starting from March 20 2024, the mother felt tired after giving birth, and said that her stomach still felt heartburn. The care plan given to Mrs 'K' included oxytocin injections, PTT, massage, in the fourth stage Starting from March 20 2024 there was a 2nd degree laceration, the care plan given to Mrs 'K' was heacting. By Mrs 'K' aged 1 hour experiencing asphyxia has resolved. The care plan given to By Mrs 'K' was carried out by HAIKAP. Neonatal visits were carried out on days 3 and 7. On day 3 the baby experienced physiological jaundice. The care given to Mrs 'K's baby was breastfeeding every 2 hours and drying in the sun. and on day 7 the jaundice has been resolved. The care plan given is daily baby care and breastfeeding. The postpartum visit was carried out twice with the first visit on day 3 and the second visit on day 7. The postpartum period with complaints of perennial suture pain. in the genitals. The care given to Mrs "K" was carrying out mobilization by tilting right, left, getting out of bed and walking a lot and maintaining personal hygiene. Birth control midwifery care is provided to the mother through counseling and care evaluation, so that the mother chooses the 3-month injectable birth control contraceptive.During pregnancy, the mother complained of back pain and underwent a light massage. In the second stage of labor, an IV was installed because the mother experienced a chronic lack of energy and normal delivery was carried out with 60 steps of APN, there was no placental retention, then heacting was carried out in the fourth stage because the birth canal was torn, asphyxia occurred in the newborn baby and HAIKAP was carried out in Neonatal visits were carried out on the 3rd day, physiologic jaundice occurred, dried in the sun and breastfed every 2 hours. On the 7th day, the jaundice resolved, then postpartum visits were carried out twice on the 3rd day. It is recommended to maintain personal hygiene and early mobilization on the 7th day, breast milk is flowing smoothly and perennial pain has been resolved, family planning visits are carried out on the 36th postpartum period and 3 monthly birth control injections are carried out It can be concluded that Mrs "K"'s midwifery care was a physiological pregnancy. The birth process did not occur with placental retention because active management of the 3rd stage was carried out appropriately and quickly after the baby was born and the birth canal was torn but it could be resolved quickly without any other complications. On examination of the baby at 1 hour of age, asphyxia occurred but it resolved. At the neonatal visit, it was found that body weight increased on the 3rd and 7th day visits. and During the postpartum period the mother complained of stitching pain in the genitals. The results of the mother's examination were normal, the perennial pain resolved. At the family planning visit, the mother wanted to use a contraceptive that would not interfere with breast milk production, and the mother chose a 3-month injectable contraceptive It is hoped that care can increase mothers' knowledge and experience regarding the factors that play a role in the occurrence of retained placenta in mothers giving birth, so that it is hoped that it can reduce the incidence of retained placenta.
Keywords: Comprehensive Midwifery Care, Retained Placenta.