P ARTOGRAF

No. Register : ____________________ Nama Ibu : Umur : G: P: A:

No. Puskesmas : ____________________ Tanggal : Jam : HPHT : HTP :
Ketuban Pecah Sejak : Mules sejak jam : TBJ :

200
190
180
170
160
DJJ / mnt 150
140
130
120
110
100
90
80

Ketuban
Penyusupan

10
9
8
7
6
5
4
3
2
1
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Waktu( J a m)

5
< 20 4
20 - 40 3
> 40 2
de tik 1

Oxyto s in
IVFD tts /mnt

Oba t dan ca iran

180
170
160
150
140
• Nadi 130
120
110
100
Teka nan 90
Da rah 80
70
60
Te m pera tur °C

P ro tein
Urin As e to n
Vo lum e

Hidras i
Hb
 CATATAN PERSALINAN

1. Tanggal : - - - Penolong Persalinan : _______________________________________

2. Tempat Persalinan : Rumah Ibu Polindes Klinik Swasta Puskesmas Lainnya : ___________________________________
3. Alamat Tempat Persalinan :
___________________________________________________________________________________________
KALA I
4. Partograf melewati garis waspada
5. Lain-lain
sebutkan : ........................................................................................................................................................................................................................
6. Penalaksanaan yang dilakukan pada masalah
tersebut : ...........................................................................................................................................................
7. Bagaimana hasilnya :
..........................................................................................................................................................................................................................
KALA II ______ ________________
8. Lama Kala II ............... menit Epesiotomi : ya tidak, Indikasi :
....................................................................................................................
9. Pendamping pada saat persalinan : suami keluarga teman dukun tidak ada
10. Gawat Janin : miringkan ibu kesisi kiri minta ibu narik nafas Episiotomi
11. Distosia bahu : Manuver Mc.Robert Ibu merangklak Lainnya : ...........................................................................................................................
12. Penalaksanaan yang dilakukan pada masalah tersebut :
...........................................................................................................................................................
13. Lain-lainnya, sebutkan :
...............................................................................................................................................................................................................
14. Bagaimana hasilnya : ....................................................................................................................................................................................................................
KALA III ______ ______ ______
15. Lama Kala III : ............... menit Jumlah perdarahan : ................... ml.
a. Pemberian Oxitosin 10 IU ( IM ) < 2 menit? ya tidak, Alasan :
..................................................................................................................
Pemberian Oxitosin ( 2x )? ya, Alasan :
..................................................................................................................
b. Penangana tali pusat terkendali : ya tidak, Alasan :
............................................................................................................ ....
c. Massage pundus uteri : ya tidak, Alasan :
.................................................................................................................
16. Laserasi perineum derajat : .................................... Tindakan : penjahitan dengan/ tanpa )* Anestesi
17. Atonia Uteri : Kompres Bimanual Interna Metal Ergotamin 0,2 mg/ml Oxitosin drip
18. Lain-lainnya, sebutkan :
............................................................................................................................................................................................................
19. Penalaksanaan yang dilakukan pada masalah tersebut :
.......................................................................................................................................................
20. Bagaimana hasilnya :
.................................................................................................................................................................................................................
BAYI BARU LAHIR ______ ______
21. Berat Badan : .................... gram Panjang Badan : ................. cm. Jenis Kelamin : L / P )* Nilai APGAR : ............. /
............
22. Pemberian ASI : 1 jam ya tidak : alasan :
.......................................................................................................
23. Bayi Lahir pucat/biru/lemas mengeringkan menghangatkan bebaskan jalan nafas
Simulasi Rangsangan Taktil Lain-lain, sebutkan :
....................................................................
24. Cacat bawaan : ......................................................................................... hipotermia
25. Lain-lain, sebutkan :
..............................................................................................................................................................................................................
26. Penalaksanaan yang dilakukan pada masalah tersebut :
.......................................................................................................................................................
27. Bagaimana hasilnya :
.................................................................................................................................................................................................................
PEMANTAUAN KALA IV PERSALIANAN
Jam Waktu TD Nadi Temp. Kontraksi Uterus Kandung Kemih Perdarahan
1

Masalah Kala IV : ..........................................................................................................................................................................................................................................................................

Penatalaksanaan yang dilakukan pada masalah tersebut :
....................................................................................................................................................................................................................................................................................................................