Perdarahan Antepartum: Studi Kasus Plasenta Previa Totalis
Abstract
Abstrak : Perdarahan merupakan penyebab utama kematian ibu secara global, sekitar 27% kematian di seluruh dunia disebabkan oleh perdarahan, baik perdarahan postpartum, intrapartum maupun perdarahan antepartum . Plasenta previa merupakan salah satu penyebab utama perdarahan antepartum tanpa disertai rasa nyeri. Plasenta previa dapat mengakibatkan peningkatan angka kesakitan dan kematian. Penelitian ini bertujuan untuk mengetahui faktor risiko dan penanganan kasus plasenta previa di RSUD Bangil. Metode penelitian ini adalah studi kualitatif dengan pendekatan studi kasus. Pengumpulan data berdasarkan data primer dengan melakukan anamnesis dan pemeriksaan fisik, serta data sekunder berdasarkan hasil pemeriksaan penunjang. Analisis data berdasarkan studi dengan membuat deskripsi hasil anamnesis, pemeriksaan fisik, pemeriksaan penunjang dan asuhan kebidanan. Hasil penelitian menunjukkan bahwa seorang perempuan umur 33 tahun, hamil anak keempat, usia kehamilan 28-30 minggu, ibu memiliki riwayat plasenta previa totalis pada kehamilan anak kedua dan melahirkan secara caesar. Pada kehamilan anak ketiga ibu mengalami abortus dilakukan kuretage pada tahun 2019. Hasil inspeksi vulva vagina terdapat pengeluaran darah segar dan tidak dilakukan pemeriksaan dalam. Hasil pemeriksaan USG menunjukkan letak janin sungsang dan terdapat plasenta previa totalis. Untuk itu diperlukan penanganan yang tepat pada kasus plasenta previa sesuai dengan evidence based untuk menurunkan angka morbiditas dan mortalitas baik pada ibu maupun janin.
Kata Kunci : perdarahan antepartum, plasenta previa totalis
Abstract : Hemorrhage is the leading cause of maternal death globally, approximately 27% of deaths worldwide are caused by hemorrhage, both postpartum, intrapartum and antepartum hemorrhage. Placenta previa is one of the main causes of antepartum bleeding without pain. Placenta previa can result in increased morbidity and mortality. This study aims to determine the risk factors and handling of placenta previa cases at Bangil Hospital. This research method is a qualitative study with a case study approach. Data collection is based on primary data by conducting anamnesis and physical examination, and secondary data based on the results of supporting examinations. Data analysis based on the study by making a description of the results of anamnesis, physical examination, supporting examination and midwifery care. The results showed that a 33-year-old woman, pregnant with her fourth child, 28-30 weeks gestation, the mother had a history of complete placenta previa in the second child's pregnancy and gave birth by caesarean section. In the third child's pregnancy the mother had an abortion, curettage was performed in 2019. The results of the vaginal vulva inspection were fresh blood discharge and no internal examination was performed. The results of the ultrasound examination showed the location of the breech fetus and there was complete placenta previa. For this reason, appropriate treatment is needed in cases of placenta previa in accordance with evidence based to reduce morbidity and mortality rates for both mother and fetus.
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