ASUHAN KEBIDANAN KOMPREHENSIF PADA NY"U" DENGAN TINGGI BADAN KURANG DARI 145 CM DI PMB ASPA BISAPA KEBUPATEN PAMEKASAN

Abstract

• Pregnancy starts from conception until the birth of the fetus. Pregnancy usually lasts up to 40 weeks or 9 months starting from the first day of the last menstruation. Even in normal pregnancies there can be high risks, including height ≤145 cm, pregnant women who have a height ≤145 cm usually find it difficult to give birth normally due to the narrow size of the pelvis, resulting in the fetus' head not entering the pelvic outlet (PAP). The mother's height during pregnancy is the simplest measurement but has an influence on the birthing process.[2] Based on research at the Maluku Bodoa Community Health Center, Makassar City in 2018 group with height > 145 cm (69.0%) and control group with height > 145 cm (75.9%) while the smallest were in the case group with height < 145 cm (31.0%) and the control group at a height <145 cm (24.1%) [1] Based on research at Dewi Sertika General Hospital in 2022, it shows that mothers with a body height <145 cm who experienced cephalopelvic disproportion numbered 26 people (42.6%) out of 61 mother giving birth. There were 35 mothers with a height >145cm who had cephalopervic and 61 people (100%) who did not have cephalopelvic. Based on research at PMB ASPA BISAPA, S.ST Bdn, there was one pregnant woman with a height of ≤145cm from January-March 2024 [3]. Factors causing height ≤145cm are genetic and environmental factors. For example, nutrition and cell health during pregnancy and development can influence the size of the pelvis in adulthood [3] and the impact that occurs on pregnant women with a height of ≤145 cm is that it can cause a narrow pelvis because the size of the pelvis is related to the size of the body and spine. Those who are taller tend to have wider and larger hips, while those who are shorter tend to have narrower and smaller hips. This is because the pelvis is part of the spine, so the size of the spine can affect the size of the pelvis. The most influential height factor in the pregnancy process is the birth process with a mother's height ≤145cm, because she has the potential to have a narrow pelvis, so there is a risk of having a caesarean section (SC) delivery. And pregnant women with a height of ≤145cm have the potential to experience a narrow pelvis, and 1 low birth weight (LBW). As well as shorter mothers also have a higher risk of obstructed labor, so assisted birth, especially Caesarean delivery, obstructed labor is related to the woman's pelvis. shorter and narrower ones, where the baby's head or shoulders are obstructed [3].
  The solution to prevent complications in pregnant women with a height ≤145 cm is by encouraging the mother to check with a SPOG doctor so that they can detect if there are complications in pregnancy, then provide counseling and direction so that the mother carries out pregnancy checks on time and encourage the mother to carry out integrated ANC regularly, carry out fetal weight examination (TBJ) and encourage the mother to eat nutritious foods to maintain her pregnancy.
  Kegel exercises are a complementary therapy that can be done to prevent narrow pelvis or cephalopelvic disproportion CPD during childbirth. Kegel exercises are to strengthen the pelvic floor muscles before childbirth, the aim is to help prevent urinary incontinence problems, and can flex the perennial tissue as a birth canal. baby. So all mothers must be motivated to move their pelvic floor muscles as little as possible and as often as possible, slowly and quickly as labor approaches. The Kegel exercise procedure can be remembered and carried out along with activities related to the mother's daily activities. There are several benefits of Kegel exercises, namely strengthening the pelvic muscles, helping to control urine output during intercourse, increasing satisfaction during intercourse because it increases the grip of the vagina, increasing sensitivity to sexual stimulation, preventing "small peeing" when coughing or laughing, and smoothing the birthing process. without tearing the birth canal and speeding up post-natal healing. And Kegel exercises can be done at least 2 times a week starting from the trimester [4].