DISTOSIA

DEVA VIBIOLA AGUSTIN

1910025_S1-2A
DISTOSIA
1. Distosia adalah persalinan yang sulit yang ditandi
dengan adanya hambatan kemajuan dalam
persalinan.
2. Distosia di definisikan sebagai persalinan yang
panjang, sulit, atau abnormal, yang timbul akibat
sebagai kondisi yang berhubungan dengan
berbagai macam keadaan.
3. Distosia adalah kelambatan atau kesulitan
persalinan disebabkan kelainan his, letak dan
bentuk janin, serta kelainan jalan lahir.
 DISTOSIA KELAINAN HIS
1 2
INCORDINATE
INERSIA UTERI UTERINA ACTION
Inersia uteri adalah kelainan his yang
kekuatannya tidak adekuat untuk Incoordinate uterina action yaitu
melakukan pembukaan serviks atau kelainan his pada persalinan berupa
mendorong janin keluar. Inersia uteri perubahan sifat his, yaitu
dibagi menjadi 2 : meningkatnya tonus otot uterus, di
dalam dan di luar his, serta tidak ada
 Inersia uteri primer : terjadi pada kordinasi antara kontraksi bagian atas,
awal fase laten. tengah, dan bawah, sehingga his tidak
 Inersia uteri sekunder : terjadi pada efisien mengadakan pembukaan
fase aktif serviks.
DISTOSIA KELAINAN LETAK
1 2
POSISI OKSIPITALIS PRESENTASI PUNCAK
POSTERIOR PRESISTEN KEPALA
Presentasi puncak kepala
Pada persalinan presentasi adalah kelainan akibat
belakang kepala, kepala defleksi ringan kepala janin
janin turun melalui PAP ketika memasuki ruang
dengan sutura sagitalis panggul sehingga ubun-ubun
melintang atau miring, besar merupakan bagian
sehingga ubun-ubun kecil terendah
dapat berada di kiri
melintang, kanan
melintang, kiri depan,
kanan depan, kiri belakang
atau kanan depan
 3 4
PRESENTASI MUKA PRESENTASI DAHI
Keadaan dimana Keadaan di mana
kepala dalam kedudukan kepala berada
kedudukan defleksi di antara fleksi maksimal
maksimal, sehingga dan defleksi maksimal,
oksiput tertekan pada sehingga dahi merupakan
punggung dan muka bagian terendah, namun
yang merupakan pada umumnya keadaan ini
terendah menghadap hanya bersifat sementara
ke bawah. dan sebagian besar akan
berubah menjadi presentasi
muka.
 5 6
LETAK SUNGSANG LETAK LINTANG

Letak sungsang adalah Letak lintang ialah keadaan

janin terletak sumbu memanjang janin kira-
memanjang dengan kira tegak lurus dengan sumbu
kepala di fundus uteri memanjang tubuh. Bila sumbu
dan bokong dibawah memanjang tersebut
bagian cavum uteri. membentuk sudut lancip,
disebut letak oblik, yang
biasanya karena kemudian akan
berubah menjadi posisi
longitudinal pada persalinan.
 7
PRESENTASI GANDA
Presentasi ialah keadaan di
mana di samping kepala
janin di dalam rongga
panggul dijumpai tangan,
lengan atau kaki, atau
keadaan di mana di
samping bokong janin di
jumpai tangan. Presentasi
ganda jarang ditemukan
yang paling sering
diantaranya ialah adanya
tangan atau lengan di
samping kepala.
 DISTOSIA KELAINAN BENTUK JANIN
1 2
PERTUMBUHAN JANIN
YANG BERLEBIHAN
Berat neonatus pada umumnya <
4000 gram dan jarang melebihi
5000 gram. Yang dinamakan bayi
besar ialah berat janin > 4000
gram. Pada panggul normal, janin
dengan BB 4000-5000 gram pada
umumnya tidak mengalami
kesulitan dalam melahirkannya.
Pada janin besar faktor keturunan
memegang peranan penting,
selain itu kehamilan dengan Dm,
grande multipara, pola makan ibu
hamil dan bertambah besarnya
janin masih diragukan.
HIDROSEFALUS
Hidrosefalus ialah keadaan
terjadinya penimbunan cairan
serebrospinal dalam ventrikel otak,
sehingga kepala menjadi besar
serta terjadi pelebaran sutura-
sutura dan ubun-ubun. Cairan yang
tertimbun dalam ventrikel antara
500 sampai 1500 ml, akan tetapi
kadang-kadang mencapai 5 liter.
Hidrosefalus sering disertai dengan
spina bifida. Hidrosefalus akan
selalu menyebabkan disproporsi
sefalopelvik
 3
PROLAPS FUNIKULI
Prolaps funikuli ialah keadaan di
mana tali pusat berada di
samping atau melewati bagian
terendah janin di dalam jalan
lahir setelah ketuban pecah.
 DISTOSIA KELAINAN PELVIS
Jenis-jenis panggul mempunyai ciri penting yaitu :
•Panggul ginekoid dengan PAP yang bundar
•Panggul antropoid dengan arkus pubis menyempit
•Panggul android dengan PAP berbentuk segitiga
•Panggul platilloid dengan diameter yang lebih pendek dengan arkus
pubis yang luas.
 1
DISTOSIA PELVIS

Distosia pelvis dapat menyertai terjadinya kontraktur

diameter pelvis yang mengurangi kapasitas tulang
pelvis, termasuk pintu atas panggu (pelvicinlet), panggul
tengah (mid pelvic), pintu bawah panggul (pelvic outlet)
atau setiap kombinasi tulang tulang tersebut.kontraktur
pelvis dapat disebab kan kelainan kongenital, malnutrisi
ibu, neoplasma dan ganguan spinal bagian bawah
(lower spinaldisorder) ukuran pelvis yang tidak matur
merupakan faktor predis posisi bagi para ibu remaja
untuk mengalami distosia pelvis.deformitas pelvis
dapatterjadi akibat kecelakaan mobil dan kecelakaan
lain.
 2

DISTOSIS JARINGAN LUNAK

Ditosia jaringan lunak terjadi akibat obstruksi jalan lahir oleh
kelainan anatomi, selain kelainan pada tulang pelvis. Obstruksi .bisa
terjadi karena plasenta previa (plasenta letak rendah) yang sebagian
atau seluruhnya menutup ostium internal pada serviks.penyebab
lain seperti lelomioma (fibroid uterus) di segmen bawah uterus,
tumor ovrium, dan kandung kemih atau rektum penuh dapat
mencegah lanin masuk kewdalam pelvis.kadang kadang terjadi
edema serviks selama persalinan waktu serviks terjepit antara
bagian terendah simfisis, sehingga mencegah dilatasi lengkap.
Lingkaran bandl, suatu cincin retraksi patologis, berhubungan
dengan ruptur selaput ketuban yang lama dan partus yang lama.
Our Center
Venus has a beautiful name
and is the second planet
from the Sun. It’s terribly
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Mercury is the closest planet to
the Sun and the smallest one in
the Solar System. It’s only a bit
larger than the Moon
Vision
Venus has a beautiful name
and is the second planet from
the Sun. It’s terribly hot, even
hotter than Mercury
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16% 34%
Jupiter is the Venus has a good
biggest planet name, but it’s hot

22% 28%
Mercury is the Despite being red,
closest to the Sun Mars is cold

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 A Brief
Story
Mercury is the closest
planet to the Sun and the
smallest one in the Solar
System. It’s only a bit
larger than the Moon
Milestones Reached
2013-2015 2017-2019
Despite being red, It’s the farthest
Mars is cold from the Sun

2011-2013 2015-2017 2019-2021

Jupiter is the It’s the closest Venus has a
biggest of them all planet to the Sun beautiful name
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Jupiter Venus
Jupiter is the Venus has a
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Mercury Mars
Mercury is the Despite being
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Mercury is the closest Venus has a beautiful Despite being red,
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Mercury is the closest Despite being red, Mars is
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Venus Saturn
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Do you know what helps you make your
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Jupiter Neptune
Jupiter is the It’s the farthest
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2014 2016 2018 2020

Mars Venus
Despite being red, Venus has a
Mars is cold beautiful name
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A B C
Mercury Venus Mars
Mercury is the closest Venus has a beautiful Despite being red,
planet to the Sun name, but it’s hot Mars is a cold place

D E F
Saturn Jupiter Neptune
Yes, this is the ringed It’s the biggest planet It’s the farthest planet
one. It’s a gas giant in the Solar System from the Sun
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Jenna Doe, 25
“Neptune is the fourth largest planet by
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Fred Bloggs, 31
“Despite being red, Mars is a very cold
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John James, 36
“Mercury is the closest planet to the Sun
and the smallest of them all
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2004 2010 2014 2018

+ 12 +8 +6 + 15

Mercury is the It’s a gas giant and Venus has a Jupiter is the
smallest planet has rings beautiful name biggest of them all
Where Are We?

30%
Venus
Venus has a
beautiful name

70%
Mars
Despite being
red, Mars is cold
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