Kebidanan
1. KUSTNER :
Dengan meletakkan satu tangan disertai tekanan pada / diatas simfisis pubis,
dengan tangan kiri/kanan tali pusat ditegangkan, bila tali pusat masuk, berarti
belum lepas, diam atau maju, berarti sudah lepas.
2. STRASSMAN :
Tegangkan tali pusat & ketok pada fundus, bila tali pusat bergetar, berarti
belum lepas, jika tidak bergetar berarti sudah lepas
3. KLEIN :
Sewaktu ada his, rahim kita dorong sedikit, bila tali pusat kembali masuk,
berarti belum lepas, jika diam atau turun, berarti sudah lepas
Macam-macam pelepasan
plasenta :
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Kala IV Persalinan
Kala IV adalah kala
pengawasan, dari 1-6
jam setelah bayi dan
plasenta lahir untuk
memantau kondisi
ibu.
Hal penting dalam masa nifas :
Proses Involusi Organ genitalia, Proses
Laktasi, Proses Haemokonsentrasi
Proses Involusi Uterus :
Perobahan Bentuk : Seperti buah Alpukad
gepeng ( 15 X 12 X 10 cm ) Perobahan
besar : 2 jari dibawah pusat ( post
partum ), setengah simpisis pusat ( hari ke
5 ) tidak teraba ( 12 hari ) sempurna 6
minggu. Perobahan berat : post partum
1000 gr, 1 minggu 500 gr, 2 minggu 300 gr
dan 6 minggu 30 gr ( normal )
Bagaimana involusi uteri terjadi :
Kontraksi uterus post partum Adanya
proteolisis pada miometrium Pada
Endometrium : trombosis, degenerasi dan
nekrosis pada implantasi plasenta. Servik
Uteri : Post partum : membuka seperti
corong, berwarna kemerahan dan
konsistensi lunak. 2 jam : hanya terbuka 2
– 3 jari 1 minggu : terbuka 1 jari
Perubahan Masa Nifas
Retensio Placenta :
Lepasnya plasenta tdk bersamaan sehingga sebagian masih melekat pada tempat implantasi
Terlambatnya kelahiran plasenta selama setengah jam setelah kelahran bayi
Inversio Uteri :
Keadaan dimana fundus uteri terbalik sebagian atau seluruhnya masuk kedalam kavum uteri
Plasenta ahesiva
implantasi yang kuat dari jonjot korion plasenta sehingga
menyebabkan kegagalan mekanisme separasi fisiologis..
Plasenta akreta
implantasi jonjot korion plasenta hingga mencapai sebagian lapisan
miometrium
Plasenta inkreta
implantasi jonjot korion plasenta hingga mencapai/melewati lapisan
miometrium
Plasenta perkreta
implantasi jonjot korion plasenta yang menembus lapisan
miometrium hingga mencapai lapisan serosa dinding uterus
Plasenta inkarserata
tertahannya plasenta di dalam kavum uteri, disebabkan oleh
konstriksi ostium uteri
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Cianjur, 28 April 2021
Sesi 6 : Hecting Episiotomi &
Pemantauan