Asuhan Kebidanan Komprehensif pada Ny. PSB G1P0A0 dengan Ketuban Pecah Dini di RSU Banyumanik 2 Semarang

Abstract

Continuity of Care (CoC) in midwifery is a continuous and integrated health service, particularly in midwifery care, which ensures patients receive comprehensive and integrated care from early pregnancy, childbirth, postpartum, newborn care, and family planning programs. Providing continuous midwifery care (CoC) aims to build a trusting relationship between patients and healthcare professionals, allowing optimal monitoring of patients' conditions, early detection of problems and complications, improving well-being, and reducing maternal and infant mortality rates. This study used a case study method with a midwifery management approach and documented the care in the form of SOAP (Subjective, Objective, Analysis, Management). Data were collected through interviews, physical examinations, and observations in monitoring the development of the condition of the mother and baby. This study began from May 16, 2025 to November 19, 2025. Midwifery care provided to Mrs. PSB from pregnancy, childbirth, postpartum, neonate to family planning with a frequency of 10 pregnancy visits, 4 postpartum visits, and 3 neonatal visits. In the second trimester of pregnancy there were no complaints during ANC visits, while during the third trimester ANC visits complained of back pain. To address these complaints, acupressure therapy was administered. During labor, Mrs. PSB experienced premature rupture of membranes, uterine inertia, and labor pain, so she was given antibiotics, uterotonics, and complementary therapies (acupressure and counter pressure). After 7 hours of in-partum observation, the baby was born vaginally. The postpartum period was normal, there was no bleeding, uterine contractions were good, vaginal discharge was within normal limits, there was a second-degree perineal tear, and breast milk was released. The newborn's anthropometric examination results were within normal limits. Mrs. PSB decided to use condoms and the lactational amenorrhea method as contraception.

Abstrak

Continuity of Care (CoC) dalam kebidanan adalah pelayanan kesehatan yang berkelanjutan dan terintegrasi, terutama dalam asuhan kebidanan, yang memastikan pasien menerima perawatan yang komprehensif dan terpadu mulai dari awal kehamilan, persalinan, nifas, perawatan bayi baru lahir, hingga program keluarga berencana. Pemberian asuhan kebidanan yang berkelanjutan (CoC) bertujuan untuk membangun hubungan yang terpercaya antara pasien dan tenaga kesehatan, sehingga dapat memantau kondisi pasien secara optimal, mendeteksi masalah dan komplikasi sedini mungkin, meningkatkan kesejahteraan dan menurunkan angka kematian ibu dan bayi. Penelitian ini menggunakan metode studi kasus dengan pendekatan manajemen kebidanan dan mendokumentasikan asuhan tersebut dalam bentuk SOAP (Subjektif, Objektif, Analisis, Penatalaksanaan). Data dikumpulkan melalui wawancara, pemeriksaan fisik, dan observasi dalam memantau perkembangan kondisi ibu dan bayi. Penelitian ini dimulai sejak 16 Mei 2025 sampai dengan 19 November 2025. Asuhan kebidanan yang diberikan pada Ny. PSB sejak dari masa kehamilan, persalinan, nifas, neonatus sampai dengan KB dengan frekuensi kunjungan hamil sebanyak 10 kali, nifas 4 kali, dan neonatus 3 kali. Pada  kehamilan trimester II tidak ada keluhan saat kunjungan ANC, sedangkan pada kunjungan ANC trimester III  mengeluh nyeri punggung.  Untuk menangani keluhan tersebut, maka diberikan terapi akupresur. Pada proses persalinan Ny. PSB mengalami ketuban pecah dini, inersia uteri, dan nyeri persalinan sehingga diberikan antibiotik, uterotonika dan terapi komplementer (akupresur dan counter pressure). Setelah dilakukan observasi inpartu selama 7 jam, bayi lahir pervaginam. Masa nifas berlangsung normal tidak ada pendarahan, kontraksi uterus baik, pengeluaran pervaginam dalam batas normal, robekan perineum derajat 2 dan ASI sudah keluar. Pada bayi baru lahir, hasil pemeriksaan antropometri dalam batas normal. Ny. PSB memutuskan menggunakan kontrasepsi kondom dan metode amenore laktasi.