Partus Lama
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Transcript of Partus Lama
![Page 1: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/1.jpg)
PARTUS LAMA
![Page 2: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/2.jpg)
Definisi
• Persalinan yang berlangsung lebih dari 18 jam, yang dimulai dari tanda-tanda kelahiran
![Page 3: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/3.jpg)
Epidemiologi
• Penyebab kematian ibu dan bayi
• Insidensi 1-7%
![Page 4: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/4.jpg)
Etiologi
• Disporposi fetopelvik
• Malpresentasi dan malposisi
• Kerja uterus tidak efisian
• Serviks kaku
• Primigravida
• Ketuban pecah dini
• Analgesia dan anstesia yang berlebihan
• Wanita dependen
![Page 5: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/5.jpg)
![Page 6: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/6.jpg)
Tanda dan gejala
• Dehidrasi
• Oliguria
• Keto-asidosis
• sepsis
![Page 7: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/7.jpg)
![Page 8: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/8.jpg)
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Diagnosis
• Analisis grafik persalinan (patograf)
• Kondisi janin : DJJ, mekonium
• Status maternal : kelelahan, dehidrasi
• Px. Vaginam : keadaan servix, ukur kepala, posisi kepala
![Page 10: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/10.jpg)
penatalaksanaan
• Pencegahan – Perawatan antenatal yang baik dan persiapan
mental pasien– Persalinan jangan dipacu sebelum cervix siap– Partograf
![Page 11: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/11.jpg)
• Tindakan suportif :– Dukungan mortil untuk ibu– Intake cairan cegah dehidrasi– Intake makanan + kalori– Penggunakan sedatif dan analgetik secara
bijaksana– Pemeriksaan vaginal dengan indikasi jelas
![Page 12: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/12.jpg)
• Fase laten memanjang– Servix matang : amniotomi, oksitosin– Servix belum matang : terapi suportif
• False labor : pasien dipulangkan• Persalinan efisien dan servix dilatasi• Stimulasi dengan oksitosin
![Page 13: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/13.jpg)
• Fase aktif memanjang– Amniotomi (bila ketuban intak)– Bila kecepatan pembukaan pada fase aktif
<1jam/cm nilai kontaksi uterus– Bila kontrasi kuat kemungkinan CPD SC
![Page 14: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/14.jpg)
Komplikasi
• Maternal – Cidera persalinan– Atonia uteri– Laserasi– Perdarahan– Infeksi– Kelelahan ibu dan shok
![Page 15: Partus Lama](https://reader033.fdokumen.com/reader033/viewer/2022061323/563db886550346aa9a947fa6/html5/thumbnails/15.jpg)
• Janin– Asfiksia– Trauma serebri– Trauma akibat tindakan obstetrik– Infeksi akibat ketuban pecah