PERSALINAN

BERESIKO

KELOMPOK 1
Fuadah Febryany KHGC21135
Rini Rianti KHGC21130
Intan Islamiawati KHGC21152
Eva Nuratifah KHGC21153
Andri Firdaus KHGC21132
 Pengertian
Persalinan beresiko adalah Persalinan dimana ibu dan
janin atau bahkan keduanya beresiko lebih tinggi untuk
mengalami masalah kesehatan selama
persalinan.Persalinan adalah proses pengeluaran hasil
konsepsi (janin dan uri) yang telah cukup bulan atau dapat
hidup diluar kandungan melalui jalan lahir atau melalui jalan
lain, dengan bantuan atau tanpa bantuan (kekuatan sendiri)
(Manuaba,2010).
Persalinan dan kelahiran merupakan kejadian fisiologis
yang normal dalam kehidupan. Hal ini bertujuan untuk
mendeteksi adanya komplikasi yang beresiko pada saat
persalinan nanti.Kelancaran persalinan tergantung 3 faktor
yaitu kekuatan ibu (power), keadaan jalan lahir (passage)
dan keadaan janin (passanger). Faktor lainnya psikologi
ibu, penolong saat bersalin dan posisi saat bersalin.
dengan adanya keseimbangan antara faktor tersebut, bila
ada gangguan pada faktor ini dapat terjadi kesulitan atau
gangguan pada jalannya persalinan. kelambatan atau
kesulitan persalinan
Jenis Persalinan Bersiko

Distosia 01

Persalinan Prematur 02

Kehamilan Postmatur 03
 DISTOSIA
Distosia adalah persalinan yang panjang, sulit atau abnormal yang
timbul akibat berbagai kondisi yang berhubungan dengan lima factor
persalinan. (Bobak, 2004). Distosia adalah Kesulitan dalam jalannya
persalinan (Rustam Mukhtar, 1994). Distosia adalah kelambatan atau
kesulitan persalian disebabkan kelainan his, letak dan bentuk Janin
serta kelainan jalan lahir (Komalasari, 2005)

Etiologi
 Dystosia karena kekuatan-kekuatan yang mendorong anak keluar
kurang kuat
 Karena kelainan his : Inertia uteri atau kelemahan his merupakan
sebab terpenting dari dystosia.
 Karena kekuatan mengejan kurang kuat, misalnya karena cicatrix
baru pada dinding perut, hernia, diastase musculus rectus
abdominalis atau karena sesak napas
 Dystosia karena kelainan letak atau kelainan anak, misalnya letak
lintang, letak dahi, hydrocephalus atau monster.
 Dystosia karena kelainan jalan lahir : panggul sempit, tumor-tumor
yang mempersempit jalan lahir.
Manifestasi Klinis
Manifestasi klinik pada Ibu :
• Gelisah, Letih
• Suhu tubuh meningkat
• Nadi dan pernafasan cepat
• Edema pada vulva dan servik
• Ketuban berbau
• Pergerakan janin pada bagian kiri lebih dominan.
• Nyeri hebat dan janin sulit dikeluarkan.
• Terjadi distensi berlebihan pada uterus.
• Dada teraba seperti punggung ,belakang kepala terletak berlawanan
dengan letak dada, teraba bagian-bagian kecil dan denyut jantung janin
terdengar leih jelas pada dada.
Pada Janin, denyut jantung janin cepat dan tidak teratur
Klasifikasi Distosia
KELAINAN HIS
His yang tidak normal baik kekuatan atau sifatnya sehingga menghambat kelancaran persalinan Faktor-faktor
yang mempengaruhi antara lain kehamilan primi gravida tua atau multi gravida, herediter, emosi dan kekuatan,
kelainan uterus, kesalahan pemberian obat, kesalahan pimpinan persalinan, kehamilan kembar dan post matur,
dan letak lintang. Kelainan his dapat berupa inersia uteri hipotonik dan hipertonik

Insersia uteri hipotonik

adalah kelainan his dengan kekuatan yang lemah / tidak adekuatuntuk melakukan pembukaan serviks atau
mendorong anak keluar. Disini kekuatan his lemah dan frekuensinya jarang. Sering dijumpai pada penderita dengan
keadaan umum kurang baik seperti anemia, uterus yang terlalu teregang misalnya akibat hidramnion atau kehamilan
kembar atau makrosomia, grandemultipara atau primipara, serta pada penderita dengan keadaan emosi kurang
baik. Inersia uteri primer, terjadi pada permulaan fase laten. Inersia uteri sekunder, terjadi pada fase aktif kala I atau
kala II. Permulaan his baik, kemudian pada keadaan selanjutnya terdapat gangguan / kelainan.

Insersia uteri hipertonik

Inersia uteri hipertonik adalah kelainan his dengan kekuatan cukup besar (kadang sampai melebihi normal)
namun tidak ada koordinasi kontraksi dari bagian atas, tengah dan bawah uterus, sehingga tidak efisien untuk
membuka serviks dan mendorong bayi keluar.
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