Asuhan Kebidanan Continuity of Care (COC) pada Ny. S Umur 34 Tahun G2P1A0 dengan Preeklamsia Berat di UPTD RSD dr. H. Soemarno Sosroatmodjo Tanjung Selor

Abstract

Maternal and Child Health services aim to reduce maternal and neonatal morbidity and mortality through quality, continuous, and comprehensive care. Severe preeclampsia is a high-risk obstetric condition that requires early detection, close monitoring, and interprofessional collaboration because it can cause complications for both mother and fetus. Continuity of Care (COC) provides integrated midwifery care from pregnancy, childbirth, postpartum period, newborn care, to family planning. This case study aims to describe Continuity of Care midwifery care for Mrs. S, 34 years old, G2P1A0, with severe preeclampsia at UPTD RSD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Method: This study used a descriptive case study approach. Data were collected through interviews, observation, physical examination, obstetric examination, supporting examination results, and documentation using SOAP midwifery management. The care was provided from the third trimester of pregnancy until postpartum, newborn, and family planning care. Results: During antenatal care, Mrs. S initially complained of frequent urination, fatigue, and back pain. On the next visit, blood pressure was 156/99 mmHg with urine protein +2 and edema, accompanied by oligohydramnios based on medical evaluation. Collaborative management with an obstetrician was performed, including monitoring, education on danger signs, magnesium sulfate, antihypertensive therapy according to medical advice, and preparation for Sectio Caesarea. The baby was delivered by Sectio Caesarea on 15 February 2026 with female sex, birth weight 3500 grams, length 51 cm, APGAR score 7/8, and good adaptation. Postpartum care showed gradual recovery, normal wound healing, successful breastfeeding, and no signs of infection. Neonatal visits showed active movement, strong sucking reflex, normal growth, and no danger signs. Family planning counseling resulted in the selection of condoms as a non-hormonal method suitable for breastfeeding. Continuity of Care for Mrs. S supported early identification of severe preeclampsia, appropriate referral and collaboration, safe delivery, and continuous monitoring of mother and baby. Continuous midwifery care is recommended to strengthen maternal and newborn health services, especially in high-risk pregnancies.

Abstrak

Pelayanan Kesehatan Ibu dan Anak (KIA) bertujuan menurunkan kesakitan dan kematian ibu serta bayi melalui pelayanan yang bermutu, berkelanjutan, dan komprehensif. Preeklamsia berat merupakan kondisi obstetri risiko tinggi yang membutuhkan deteksi dini, pemantauan ketat, serta kolaborasi antar tenaga kesehatan karena dapat menimbulkan komplikasi pada ibu dan janin. Continuity of Care (COC) merupakan asuhan kebidanan berkesinambungan mulai dari kehamilan, persalinan, nifas, bayi baru lahir, neonatus, hingga keluarga berencana. Tujuan: Studi kasus ini bertujuan menggambarkan asuhan kebidanan Continuity of Care pada Ny. S umur 34 tahun G2P1A0 dengan preeklamsia berat di UPTD RSD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Metode: Penelitian menggunakan metode deskriptif dengan pendekatan studi kasus. Data dikumpulkan melalui wawancara, observasi, pemeriksaan fisik, pemeriksaan obstetri, hasil pemeriksaan penunjang, dan dokumentasi menggunakan manajemen kebidanan SOAP. Asuhan diberikan sejak kehamilan trimester III hingga persalinan, nifas, bayi baru lahir/neonatus, dan keluarga berencana. Hasil: Pada asuhan kehamilan awal, Ny. S mengeluh sering BAK, mudah lelah, dan nyeri punggung. Pada kunjungan berikutnya ditemukan tekanan darah 156/99 mmHg, protein urine +2, edema kaki, serta oligohidramnion berdasarkan evaluasi medis. Penatalaksanaan dilakukan melalui kolaborasi dengan dokter SpOG, pemantauan kondisi ibu dan janin, edukasi tanda bahaya, pemberian MgSO4 dan antihipertensi sesuai advis, serta persiapan Sectio Caesarea. Bayi lahir tanggal 15 Februari 2026 secara Sectio Caesarea, jenis kelamin perempuan, berat badan 3500 gram, panjang badan 51 cm, APGAR score 7/8, dan beradaptasi baik. Masa nifas menunjukkan pemulihan bertahap, luka operasi baik, ASI lancar, dan tidak terdapat tanda infeksi. Kunjungan neonatus menunjukkan bayi aktif, menyusu kuat, tumbuh baik, dan tidak ditemukan tanda bahaya. Pada asuhan KB, Ny. S memilih kondom karena bersifat nonhormonal dan tidak mengganggu produksi ASI. Simpulan: Pendekatan Continuity of Care pada Ny. S membantu deteksi dini preeklamsia berat, kolaborasi tepat, persalinan aman, serta pemantauan berkelanjutan ibu dan bayi. Asuhan kebidanan berkesinambungan perlu diterapkan secara optimal terutama pada kehamilan risiko tinggi.