Taking In
Itu adalah masa ketergantungan. Berlangsung 1-2 hari postpartum. Ibu lebih fokus pada dirinya sendiri. Ibu berulang kali mengatakan proses pengiriman. Ibu merasa tidak nyaman dalam bentuk bagal, nyeri pada jahitan, kurang tidur dan kelelahan. Karena lelah dengan sesuatu yang baru, secara psikologis ibu menjadi mudah marah dan menangis. Kehadiran suami dan keluarga yang sangat diperluan dalam fase ini.
Taking Hold
Berlangsung pada hari ke 3 sampai hari ke-10. Pada fase ini timbul rasa ketidakmamuan ketakutan dan rasa tanggung jawab dalam merawat bayi. Ibu sensitif dan mudah marah.
Letting go
Merupakan periode di mana seorang ibu tidak bisa menerima tanggung jawab untuk peran barunya. Berlangsung 10 hari setelah postpartum. Ibuku memiliki ketergantungan bayi bisa menerima padanya.
2010-10-25
how to improve the quality of care
> Drink a quart of milk per day
> Leaf shoots katuk and salted vegetables make more milk out
> Additionally, important factors soul, mothers spend more tranquil life of the mother's milk which is in grief
> Performing breast care
> With drugs, according to doctor's instructions
> Leaf shoots katuk and salted vegetables make more milk out
> Additionally, important factors soul, mothers spend more tranquil life of the mother's milk which is in grief
> Performing breast care
> With drugs, according to doctor's instructions
2010-10-17
Stages Of Growth and Development
Fetus
Ninth gestational week to birth.
Neonate
Birth to four weeks.
Infant
Four weeks to one year.
Toddler
One to three years.
Preschool
Three to six years.
School Age
Six to twelve years.
Adolesence
12-18 years
Ninth gestational week to birth.
Neonate
Birth to four weeks.
Infant
Four weeks to one year.
Toddler
One to three years.
Preschool
Three to six years.
School Age
Six to twelve years.
Adolesence
12-18 years
Waterbirth
Alternative birthing in the water
Waterbirth is a birth process that is done in warm water. At the time in the womb, the baby is in the amniotic fluid. By birth in the same environment, will be more comfortable for babies, as well as lowering stress levels mama.
What are the benefits?
• Water is soothing, comforting, and increases energy.
• buoyancy mama lose weight, making it possible to move more freely. It will also produce a more efficient contraction. Blood flow will flow more smoothly.
• Water can reduce the causes of stress hormones, and make mama body produce endorphins, pain reducer.
Do not do waterbirth if ....
• Mama suffering from herpes. Herpes is easily transmitted through water.
• Babies in the breech position. consult your doctor.
• Mom diagnosed with severe bleeding and infections of pregnancy.
• baby twins, in this case consult a physician.
Does warm water is not harmful to pregnancy?
Depending on the temperature. If the water is too hot, dehydration can be risky for the mother and her baby, also can raise body temperature and heart rate baby mama. So, make sure the water temperature is stable at temperatures 36 degrees C and the amount is sufficient. Should provide adequate drinking water and a cold cloth to wipe the face and neck mama, mama to prevent dehydration.
How long a baby can survive in water?
In the United States, usually the baby out of the water in the first 10 seconds after birth. Appropriate measures to do is lift the baby without hurry and put him to sleep in mommy's arms.
Water Birth
Water birth is a method of giving birth, the which involves immersion in warm water. Proponents believe That this method is safe and Provides many benefits for both mother and infant, Including pain relief and a less traumatic birth experience for the baby. However, critics argue That the procedure introduces unnecessary risks to the infant Such as infection and water inhalation.
Newborn with umbilical cord still attached after a water birth
Benefits
For the baby
Childbirth cans be a strenuous experience for the baby. Properly heated water [4] helps to ease the transition from the birth canal to the outside world Because the warm liquid resembles the familiar intra-uterine environment, and softens light, colors and noises.
For the mother
Pain management
Full immersion in water promotes physiological responses in the mother That reduce pain Including a redistribution of blood volume, the which stimulates the release of oxytocin and vasopressin (Katz 1990), the latter Also the which increases oxytocin blood levels (Odent 1998). No evidence was found That this benefit was associated with poorer outcomes for babies or longer labours. "It has Also been found That in waterbirths the buoyancy of the mother and the baby, allow for a gravitational pull. This pull not only opens up the mother's pelvis Also but allows the baby to descend more Easily
Intact perineum / decreased episiotomy
Water birth is believed to aid stretching of the perineum and Decrease the risk of skin tears. Support from the water slows crowning of the infant's head and offers perineal support, the which decreases the risk of tearing and reduces the use of episiotomy, a surgical procedure cans the which cause a number of complications. Indeed, there is a zero episiotomy rate in the waterbirth literature (Harper 2000). Moreover, "perineal trauma is reported to be Generally less severe, with more intact perineums for multips, but in Some literature about the Same frequency of tears for primips in or out of the water," (Harper 2000; Also see Burn 1993 and Garland 1997).
Risks and concerns
Infection
Due to the rigorous protocols for cleaning birthing tubs Between labors (especially in Hospitals), there is little (if any) risk of transferring bacteria from infant to mother or mother to infant. In a 1999 study of bacterial Cultures carried out at the Oregon Health Sciences University Hospital, there were the resource persons Cultured no instances of bacteria from the birth pool Itself. While Pseudomonas bacteria (common in tap water) were the resource persons present, even those Infants That tested positive for the bacteria needed no treatment for infections.
Slowed labor
Due to the documented relaxing effects of water, laboring in water is Sometimes associated with a Decrease in the intensity of contractions, and is thus thought to slow labor. While home birth experts (eg Harper, RN) argue That this must be evaluated on a case-by-case basis, Some Hospitals have adopted a "5 centimeter" rule, allowing women to enter the tub only once the cervix has already expanded to 5 centimeters (Harper 2000).
Maternal blood loss
For care providers, Who Are inexperienced in delivery in water, it May be Difficult to assess the amount of maternal blood loss. While well-developed methods of determining the maternal blood loss in water do exist, many providers prefer to deliver the placenta "on land" for this reason (eg the University of Michigan hospital.)
On the other hand, Some doctors and midwives see waterbirths That Actually have been known to reduce the amount of blood loss. The Water Surrounding the mother Actually lowers the mother's blood pressure and heart rate. Mothers still lose significant amount of blood through the passing of the placenta [13].
Waterbirth is a birth process that is done in warm water. At the time in the womb, the baby is in the amniotic fluid. By birth in the same environment, will be more comfortable for babies, as well as lowering stress levels mama.
What are the benefits?
• Water is soothing, comforting, and increases energy.
• buoyancy mama lose weight, making it possible to move more freely. It will also produce a more efficient contraction. Blood flow will flow more smoothly.
• Water can reduce the causes of stress hormones, and make mama body produce endorphins, pain reducer.
Do not do waterbirth if ....
• Mama suffering from herpes. Herpes is easily transmitted through water.
• Babies in the breech position. consult your doctor.
• Mom diagnosed with severe bleeding and infections of pregnancy.
• baby twins, in this case consult a physician.
Does warm water is not harmful to pregnancy?
Depending on the temperature. If the water is too hot, dehydration can be risky for the mother and her baby, also can raise body temperature and heart rate baby mama. So, make sure the water temperature is stable at temperatures 36 degrees C and the amount is sufficient. Should provide adequate drinking water and a cold cloth to wipe the face and neck mama, mama to prevent dehydration.
How long a baby can survive in water?
In the United States, usually the baby out of the water in the first 10 seconds after birth. Appropriate measures to do is lift the baby without hurry and put him to sleep in mommy's arms.
Water Birth
Water birth is a method of giving birth, the which involves immersion in warm water. Proponents believe That this method is safe and Provides many benefits for both mother and infant, Including pain relief and a less traumatic birth experience for the baby. However, critics argue That the procedure introduces unnecessary risks to the infant Such as infection and water inhalation.
Newborn with umbilical cord still attached after a water birth
Benefits
For the baby
Childbirth cans be a strenuous experience for the baby. Properly heated water [4] helps to ease the transition from the birth canal to the outside world Because the warm liquid resembles the familiar intra-uterine environment, and softens light, colors and noises.
For the mother
Pain management
Full immersion in water promotes physiological responses in the mother That reduce pain Including a redistribution of blood volume, the which stimulates the release of oxytocin and vasopressin (Katz 1990), the latter Also the which increases oxytocin blood levels (Odent 1998). No evidence was found That this benefit was associated with poorer outcomes for babies or longer labours. "It has Also been found That in waterbirths the buoyancy of the mother and the baby, allow for a gravitational pull. This pull not only opens up the mother's pelvis Also but allows the baby to descend more Easily
Intact perineum / decreased episiotomy
Water birth is believed to aid stretching of the perineum and Decrease the risk of skin tears. Support from the water slows crowning of the infant's head and offers perineal support, the which decreases the risk of tearing and reduces the use of episiotomy, a surgical procedure cans the which cause a number of complications. Indeed, there is a zero episiotomy rate in the waterbirth literature (Harper 2000). Moreover, "perineal trauma is reported to be Generally less severe, with more intact perineums for multips, but in Some literature about the Same frequency of tears for primips in or out of the water," (Harper 2000; Also see Burn 1993 and Garland 1997).
Risks and concerns
Infection
Due to the rigorous protocols for cleaning birthing tubs Between labors (especially in Hospitals), there is little (if any) risk of transferring bacteria from infant to mother or mother to infant. In a 1999 study of bacterial Cultures carried out at the Oregon Health Sciences University Hospital, there were the resource persons Cultured no instances of bacteria from the birth pool Itself. While Pseudomonas bacteria (common in tap water) were the resource persons present, even those Infants That tested positive for the bacteria needed no treatment for infections.
Slowed labor
Due to the documented relaxing effects of water, laboring in water is Sometimes associated with a Decrease in the intensity of contractions, and is thus thought to slow labor. While home birth experts (eg Harper, RN) argue That this must be evaluated on a case-by-case basis, Some Hospitals have adopted a "5 centimeter" rule, allowing women to enter the tub only once the cervix has already expanded to 5 centimeters (Harper 2000).
Maternal blood loss
For care providers, Who Are inexperienced in delivery in water, it May be Difficult to assess the amount of maternal blood loss. While well-developed methods of determining the maternal blood loss in water do exist, many providers prefer to deliver the placenta "on land" for this reason (eg the University of Michigan hospital.)
On the other hand, Some doctors and midwives see waterbirths That Actually have been known to reduce the amount of blood loss. The Water Surrounding the mother Actually lowers the mother's blood pressure and heart rate. Mothers still lose significant amount of blood through the passing of the placenta [13].
Hyperemesis Gravidarum
Persistent, severe vomiting which is an extreme form of “morning sickness”.
Symptoms
Frequent vomiting which may occur at any time of day or night
Loss of weight
Little or no preceding nausea
Duration
Vomiting in pregnancy usually starts after the 4th week of pregnancy and has cleared by the 14th – 16th week.
Causes
The exact cause is not known, but vomiting may due to the changes in the levels of hormones or the effects of the growth of the uterus. Fears and worries may then aggrevate the tendency to vomit.
Complication
The patient may become very short of body fluids, minerals and vitamins.
Symptoms
Frequent vomiting which may occur at any time of day or night
Loss of weight
Little or no preceding nausea
Duration
Vomiting in pregnancy usually starts after the 4th week of pregnancy and has cleared by the 14th – 16th week.
Causes
The exact cause is not known, but vomiting may due to the changes in the levels of hormones or the effects of the growth of the uterus. Fears and worries may then aggrevate the tendency to vomit.
Complication
The patient may become very short of body fluids, minerals and vitamins.
GENERAL OBSTETRIC’s DEFINITION
Gravida
Any pregnancy, regardless of duration: also, the number of pregnancies, including the one in progress, if applicable.
Nulligravida
A woman who has never been pregnant.
Primigravida
A woman who is pregnant for the first time.
Multigravida
A woman who has been pregnant before. Regardless of the duration of the pregnancy.
Para
A woman who has given birth to one or more children who reached the age of viability (20 weeks gestation). Regardless of the number of fetuses delivered and regardless of whether those children are now living.
Multipara
A woman who has given birth to two or more children (past the point of viability), regardless of whether the children were alive. The term is also used informally to describe a woman before a birth of her second child.
Nullipara
A woman who has not given birth to a child who reached the point of viability.
Abortion
Termination of pregnancy before viability (20 weeks gestation), either spontaneously of induced.
Gestational age
Prenatal age of the developing fetus calculated from the first day of the woman LNMP.
Fertilization age
Prenatal age of the developing fetus calculated from the date of cpnception: approximately 2 weeks shorter than the gestational age.
Age of viability
A fetus that has reached the stages (usually 20 weeks) where it is capable of living outside the uterus.
Any pregnancy, regardless of duration: also, the number of pregnancies, including the one in progress, if applicable.
Nulligravida
A woman who has never been pregnant.
Primigravida
A woman who is pregnant for the first time.
Multigravida
A woman who has been pregnant before. Regardless of the duration of the pregnancy.
Para
A woman who has given birth to one or more children who reached the age of viability (20 weeks gestation). Regardless of the number of fetuses delivered and regardless of whether those children are now living.
Multipara
A woman who has given birth to two or more children (past the point of viability), regardless of whether the children were alive. The term is also used informally to describe a woman before a birth of her second child.
Nullipara
A woman who has not given birth to a child who reached the point of viability.
Abortion
Termination of pregnancy before viability (20 weeks gestation), either spontaneously of induced.
Gestational age
Prenatal age of the developing fetus calculated from the first day of the woman LNMP.
Fertilization age
Prenatal age of the developing fetus calculated from the date of cpnception: approximately 2 weeks shorter than the gestational age.
Age of viability
A fetus that has reached the stages (usually 20 weeks) where it is capable of living outside the uterus.
Fetal Heart Rate
Signs and symptoms
1.Decreased movement felt by the mother
2.Meconium in the amniotic fluid
3.Cardiotocography signs
a.increased or decreased fetal heart rate (tachycardia and bradycardia),
especially during and after a contraction
b.decreased variability in the fetal heart rate
4.Biochemical signs, assessed by collecting a small sample of baby's blood from a
scalp prick through the open cervix in labour
a.fetal acidosis
b.elevated fetal blood lactate levels indicating the baby has a lactic acidosis.
Abnormal Fetal Heart Rate :
a.A normal fetal heart rate may slow during a contraction but usually recovers to
normal as soon as the uterus relaxes.
b.A very slow fetal heart rate in the absence of contractions or persisting after
contractions is suggestive of fetal distress.
c.A rapid fetal heart rate may be a response to maternal fever, drugs causing rapid
maternal heart rate (e.g. tocolytic drugs), hypertension or amnionitis. In the
absence of a rapid maternal heart rate, a rapid fetal heart rate should be
considered a sign of fetal distress.
Some of these signs are more reliable predictors of actual distress than others. For example, cardiocartography can give high false positive rates, even when interpreted by highly experienced medical personnel. Acidosis is a highly reliable predictor, but is not always available. A highly effective method of assessment of distress would be to use fetal heart rate as a first indicator of distress, to be confirmed with a more reliable method of diagnosis before radical treatment is performed.
Causes
There are many causes of fetal distress:
a.Breathing problems
b.Abnormal position and presentation of the fetus
c.Multiple births
d.Shoulder dystocia
e.Umbilical cord prolapse
f.Nuchal cord
g.Placental abruption
h.Premature closure of the fetal ductus arteriosus
Risk Factors
Women with a history of:
a.Stillbirth
b.Intrauterine growth retardation (IUGR)
c.Oligohydramnios or polyhydramnios
d.Multiple pregnancies
e.Rhesus sensitization
f.Hypertension
g.Diabetes and other chronic diseases
h.Decreased fetal movements
i.Posterm pregnancy.
There is some evidence that maternal age over 35 years is an independent risk factor for uteroplacental insufficiency and fetal distress.
Complication
a.Asfiction
b.Fetal death
In many situations fetal distress will lead the obstetrician to recommend steps to urgently deliver the baby. This can be done by induction, or in more urgent cases, a caesarean section may be performed.
General Management
a.Prop up the woman or place her on her left side.
b.Stop oxytocin if it is being administered.
Something must be done by the midwife if there are any indications like the text below :
a.If a maternal cause is identified (e.g. maternal fever, drugs), initiate
appropriate management.
b.If a maternal cause is not identified and the fetal heart rate remains abnormal
throughout at least three contractions, perform a vaginal examination to check
for explanatory signs of distress:
c.If there is bleeding with intermittent or constant pain, suspect abruptio
placentae;
d.If there are signs of infection (fever, foul-smelling vaginal discharge) give
antibiotics as for amnionitis;
e.If the cord is below the presenting part or in the vagina, manage as prolapsed
cord.
f.If fetal heart rate abnormalities persist or there are additional signs of
distress (thick meconium-stained fluid), plan delivery:
g.If the cervix is fully dilated and the fetal head is not more than 1/5 above the
symphysis pubis or the leading bony edge of the head is at 0 station, deliver by
vacuum extraction or forceps;
h.If the cervix is not fully dilated or the fetal head is more than 1/5 above the
symphysis pubis or the leading bony edge of the head is above 0 station, deliver
by caesarean section.
Meconeum
a.Meconium staining of amniotic fluid is seen frequently as the fetus matures and
by itself is not an indicator of fetal distress. A slight degree of meconium
without fetal heart rate abnormalities is a warning of the need for vigilance.
b.Thick meconium suggests passage of meconium in reduced amniotic fluid and may
indicate the need for expedited delivery and meconium management of the neonatal
upper airway at birth to prevent meconium aspiration (page S-143).
c.In breech presentation, meconium is passed in labour because of compression of
the fetal abdomen during delivery. This is not a sign of distress unless it
occurs in early labour.
1.Decreased movement felt by the mother
2.Meconium in the amniotic fluid
3.Cardiotocography signs
a.increased or decreased fetal heart rate (tachycardia and bradycardia),
especially during and after a contraction
b.decreased variability in the fetal heart rate
4.Biochemical signs, assessed by collecting a small sample of baby's blood from a
scalp prick through the open cervix in labour
a.fetal acidosis
b.elevated fetal blood lactate levels indicating the baby has a lactic acidosis.
Abnormal Fetal Heart Rate :
a.A normal fetal heart rate may slow during a contraction but usually recovers to
normal as soon as the uterus relaxes.
b.A very slow fetal heart rate in the absence of contractions or persisting after
contractions is suggestive of fetal distress.
c.A rapid fetal heart rate may be a response to maternal fever, drugs causing rapid
maternal heart rate (e.g. tocolytic drugs), hypertension or amnionitis. In the
absence of a rapid maternal heart rate, a rapid fetal heart rate should be
considered a sign of fetal distress.
Some of these signs are more reliable predictors of actual distress than others. For example, cardiocartography can give high false positive rates, even when interpreted by highly experienced medical personnel. Acidosis is a highly reliable predictor, but is not always available. A highly effective method of assessment of distress would be to use fetal heart rate as a first indicator of distress, to be confirmed with a more reliable method of diagnosis before radical treatment is performed.
Causes
There are many causes of fetal distress:
a.Breathing problems
b.Abnormal position and presentation of the fetus
c.Multiple births
d.Shoulder dystocia
e.Umbilical cord prolapse
f.Nuchal cord
g.Placental abruption
h.Premature closure of the fetal ductus arteriosus
Risk Factors
Women with a history of:
a.Stillbirth
b.Intrauterine growth retardation (IUGR)
c.Oligohydramnios or polyhydramnios
d.Multiple pregnancies
e.Rhesus sensitization
f.Hypertension
g.Diabetes and other chronic diseases
h.Decreased fetal movements
i.Posterm pregnancy.
There is some evidence that maternal age over 35 years is an independent risk factor for uteroplacental insufficiency and fetal distress.
Complication
a.Asfiction
b.Fetal death
In many situations fetal distress will lead the obstetrician to recommend steps to urgently deliver the baby. This can be done by induction, or in more urgent cases, a caesarean section may be performed.
General Management
a.Prop up the woman or place her on her left side.
b.Stop oxytocin if it is being administered.
Something must be done by the midwife if there are any indications like the text below :
a.If a maternal cause is identified (e.g. maternal fever, drugs), initiate
appropriate management.
b.If a maternal cause is not identified and the fetal heart rate remains abnormal
throughout at least three contractions, perform a vaginal examination to check
for explanatory signs of distress:
c.If there is bleeding with intermittent or constant pain, suspect abruptio
placentae;
d.If there are signs of infection (fever, foul-smelling vaginal discharge) give
antibiotics as for amnionitis;
e.If the cord is below the presenting part or in the vagina, manage as prolapsed
cord.
f.If fetal heart rate abnormalities persist or there are additional signs of
distress (thick meconium-stained fluid), plan delivery:
g.If the cervix is fully dilated and the fetal head is not more than 1/5 above the
symphysis pubis or the leading bony edge of the head is at 0 station, deliver by
vacuum extraction or forceps;
h.If the cervix is not fully dilated or the fetal head is more than 1/5 above the
symphysis pubis or the leading bony edge of the head is above 0 station, deliver
by caesarean section.
Meconeum
a.Meconium staining of amniotic fluid is seen frequently as the fetus matures and
by itself is not an indicator of fetal distress. A slight degree of meconium
without fetal heart rate abnormalities is a warning of the need for vigilance.
b.Thick meconium suggests passage of meconium in reduced amniotic fluid and may
indicate the need for expedited delivery and meconium management of the neonatal
upper airway at birth to prevent meconium aspiration (page S-143).
c.In breech presentation, meconium is passed in labour because of compression of
the fetal abdomen during delivery. This is not a sign of distress unless it
occurs in early labour.
Pregnancy
DANGER SIGN IN PREGNANCY
1.Suddent gush of fluid from vagina
2.Vaginal bleeding
3.Abdominal pain
4.Persistent vomiting
5.Epigastric pain
6.Edema of face and hands
7.Severe, persistent headache
8.Blurred vision or dizziness
9.Chills with fever over 38 degres celcius
10.Painful urination or reduced urine output
The Characteristic of High Risk Pregnancies
1.Relate to the pregnancy itself
2.Occur because the woman has a medical condition or injury that complicates the
pregnancy.
3.Result from the environmental hazards that effect on the mother or her fetus
4.Arise from maternal behaviours or lifestyle that have a negative effect on the
mother or fetus.
1.Suddent gush of fluid from vagina
2.Vaginal bleeding
3.Abdominal pain
4.Persistent vomiting
5.Epigastric pain
6.Edema of face and hands
7.Severe, persistent headache
8.Blurred vision or dizziness
9.Chills with fever over 38 degres celcius
10.Painful urination or reduced urine output
The Characteristic of High Risk Pregnancies
1.Relate to the pregnancy itself
2.Occur because the woman has a medical condition or injury that complicates the
pregnancy.
3.Result from the environmental hazards that effect on the mother or her fetus
4.Arise from maternal behaviours or lifestyle that have a negative effect on the
mother or fetus.
2010-10-16
menstrual
Menstruation is the release of the uterine lining (endometrium) that is accompanied by bleeding and occur repeatedly every month except during pregnancy.
First menstruation (menarche) is common at the age of 11, but also can terjadin at the age of 8 years or 16 years. The first day of perharahan calculated as the beginning of each menstrual cycle (Heri to-1). The cycle ends just before the next menstrual cycle. Mrnstruasi cycle ranges from 21-40 days. Only 10-15% of women who have a 28-day cycle.
The distance between the most oanjang cycles usually occur shortly after menarche and immediately before menopause. At first, the cycle may be irregular. The distance between 2 cycles can last for 2 months or within 1 month may occur 2 cycles. This is normal, after a long cycle will become more regular.
And duration of the menstrual cycle can be known by making notes on a calendar. By using the calendar, you can know your cycle pattern and this will assist you in estimating the cycle that would come. Mark every day 1 with a cross, then count to the next cross. Thus you can find out your cycle. Every month after the 5th day of menstrual cycle, the endometrium begins to grow and thicken in preparation for the possibility of pregnancy.
Source: Kissanti, Annia. 2009. Book Smart Women Health and Beauty. Araska.
First menstruation (menarche) is common at the age of 11, but also can terjadin at the age of 8 years or 16 years. The first day of perharahan calculated as the beginning of each menstrual cycle (Heri to-1). The cycle ends just before the next menstrual cycle. Mrnstruasi cycle ranges from 21-40 days. Only 10-15% of women who have a 28-day cycle.
The distance between the most oanjang cycles usually occur shortly after menarche and immediately before menopause. At first, the cycle may be irregular. The distance between 2 cycles can last for 2 months or within 1 month may occur 2 cycles. This is normal, after a long cycle will become more regular.
And duration of the menstrual cycle can be known by making notes on a calendar. By using the calendar, you can know your cycle pattern and this will assist you in estimating the cycle that would come. Mark every day 1 with a cross, then count to the next cross. Thus you can find out your cycle. Every month after the 5th day of menstrual cycle, the endometrium begins to grow and thicken in preparation for the possibility of pregnancy.
Source: Kissanti, Annia. 2009. Book Smart Women Health and Beauty. Araska.
2010-06-29
PAP SMEAR
Definition
Pap smear test is a test that is safe and inexpensive and has been used for many years to detect abnormalities that occur in cells of the cervix.
Pap smear test is a method of examination of cells taken from the cervix and then examined under a microscope to see the changes that occur from the cell.
examination time
:) A week or two weeks after the end of your menstrual period.
:) If you have menopause, a Pap smear test you can do anytime.
:) If the bladder uterus and cervix have been removed or surgery (hysterectomy or surgical removal of the bladder uterus and cervix), you no longer need
Pap smear test because you're free from the risk of cancer cervix.
:) Pap smear test is usually done every two years, and better done regularly.
:) It should always remember is never too late to do Pap smearstest.
:) Pap smear test is always required even if you no longer perform activities sexual.
Pap smear test is a test that is safe and inexpensive and has been used for many years to detect abnormalities that occur in cells of the cervix.
Pap smear test is a method of examination of cells taken from the cervix and then examined under a microscope to see the changes that occur from the cell.
examination time
:) A week or two weeks after the end of your menstrual period.
:) If you have menopause, a Pap smear test you can do anytime.
:) If the bladder uterus and cervix have been removed or surgery (hysterectomy or surgical removal of the bladder uterus and cervix), you no longer need
Pap smear test because you're free from the risk of cancer cervix.
:) Pap smear test is usually done every two years, and better done regularly.
:) It should always remember is never too late to do Pap smearstest.
:) Pap smear test is always required even if you no longer perform activities sexual.
LEMBAR OTOPSI VERBAL KEMATIAN IBU
KUESIONER OTOPSI VERBAL KEMATIAN IBU
I. IDENTITAS IBU
1. Nama ibu : ___________________________Umur Ibu : ___________tahun
2. Alamat : Desa ____________________Kecamatan_________________
Kab/Kodya______________________________________________________
3. Ibu meningga pada saat hamil _________ minggu.
4. Jumlah persalinan sebelumnya :
a. Lahir hidup ____ b. Lahir mati ____ c. Keguguran ____
5. Pada waktu bersalin, apa yang keluar dahulu ?
a. Kepala [ ] b. Kaki [ ] c. Bokong [ ] d. Tangan [ ] e. Tidak tahu [ ]
6. Cara persalinan :
a. Biasa, tanpa alat [ ] b. Dengan alat [ ] c. Operasi [ ]
7. Tempat bersalin :
a. Rumah sendiri [ ] d. Pondok bersalin [ ] f. RS [ ]
b. Rumah dukun [ ] e. Puskesmas/Pustu [ ] g. Lain-lain [ ]
c. Rumah bidan [ ]
8. Penolong persalinan, dan siapa namanya : ______________________________
a. Dukun tak terlatih [ ] d. Dokter [ ]
b. Dukun terlatih [ ] e. Dokter spesialis [ ]
c. Bidan [ ] f. Keluarga [ ]
II. RIWAYAT PENYAKIT
1. Berapa lama ibu merasa perut mulas sampai melahirkan atau sampai meninggal? ___ jam
2. Adakah perdarahan pada ibu ? a. Tidak [ ] b. Ada [ ]
Bila ada : a. Sebelum melahirkan [ ]
b. Pada waktu melahirkan [ ]
c. Setelah melahirkan [ ]
3. Apakah uri sudah dilahirkan? a. Sudah [ ] b. Belum [ ]
4. Apakah ada tanda-tanda sebagai berikut?
a. Panas tinggi Ada [ ] Tidak [ ]
b. Keluar cairan berbau Ada [ ] Tidak [ ]
c. Kaki bengkak Ada [ ] Tidak [ ]
d. Kesadaran menurun Ada [ ] Tidak [ ]
e. Kejang-kejang Ada [ ] Tidak [ ]
f. Lain-lain, sebutkan________________________________________
III. Tanggal menerima laporan kematian___________________________
Tanggal pelaksanaan otopsi verbal______________________________
IV. KESIMPULAN
Sebab kematian maternal : _______________________________________
Mengetahui : Tanggal
Dokter Puskesmas, Bidan/Perawat Pencatat
( _________________ ) ( _________________ )
I. IDENTITAS IBU
1. Nama ibu : ___________________________Umur Ibu : ___________tahun
2. Alamat : Desa ____________________Kecamatan_________________
Kab/Kodya______________________________________________________
3. Ibu meningga pada saat hamil _________ minggu.
4. Jumlah persalinan sebelumnya :
a. Lahir hidup ____ b. Lahir mati ____ c. Keguguran ____
5. Pada waktu bersalin, apa yang keluar dahulu ?
a. Kepala [ ] b. Kaki [ ] c. Bokong [ ] d. Tangan [ ] e. Tidak tahu [ ]
6. Cara persalinan :
a. Biasa, tanpa alat [ ] b. Dengan alat [ ] c. Operasi [ ]
7. Tempat bersalin :
a. Rumah sendiri [ ] d. Pondok bersalin [ ] f. RS [ ]
b. Rumah dukun [ ] e. Puskesmas/Pustu [ ] g. Lain-lain [ ]
c. Rumah bidan [ ]
8. Penolong persalinan, dan siapa namanya : ______________________________
a. Dukun tak terlatih [ ] d. Dokter [ ]
b. Dukun terlatih [ ] e. Dokter spesialis [ ]
c. Bidan [ ] f. Keluarga [ ]
II. RIWAYAT PENYAKIT
1. Berapa lama ibu merasa perut mulas sampai melahirkan atau sampai meninggal? ___ jam
2. Adakah perdarahan pada ibu ? a. Tidak [ ] b. Ada [ ]
Bila ada : a. Sebelum melahirkan [ ]
b. Pada waktu melahirkan [ ]
c. Setelah melahirkan [ ]
3. Apakah uri sudah dilahirkan? a. Sudah [ ] b. Belum [ ]
4. Apakah ada tanda-tanda sebagai berikut?
a. Panas tinggi Ada [ ] Tidak [ ]
b. Keluar cairan berbau Ada [ ] Tidak [ ]
c. Kaki bengkak Ada [ ] Tidak [ ]
d. Kesadaran menurun Ada [ ] Tidak [ ]
e. Kejang-kejang Ada [ ] Tidak [ ]
f. Lain-lain, sebutkan________________________________________
III. Tanggal menerima laporan kematian___________________________
Tanggal pelaksanaan otopsi verbal______________________________
IV. KESIMPULAN
Sebab kematian maternal : _______________________________________
Mengetahui : Tanggal
Dokter Puskesmas, Bidan/Perawat Pencatat
( _________________ ) ( _________________ )
2010-01-06
Umbilical Cord
Morbidity and mortality of infants at birth with umbilical cord menumbung still quite high. Perinatal mortality rate ranges from approximately 0.3-0.6%.
The incidence of labor with umbilical cord menumbung can occur at birth with latitude location, presentation buttocks legs, premature babies, and the presentation of the head. In addition to labor with head presentation, talipusat menumbung terjadikarena PAP not terisipenuh by the fetus. In labor with head presentation accompanied with talipusat menumbung, fetal death rate will increase along with the occurrence of fetal asfiksi.
With the increased morbidity and mortality in infants with birth accompanied menumbung umbilical cord, then attempted some effort to avoid the occurrence of labor with umbilical cord menumbung, one of them is by trendelenberg position.
Goal
The purpose of the handling of labor with umbilical cord menumbung among others:
1. Provide first aid in birthing mother by the umbilical cord menumbung.
2. Decrease the mortality rate in the fetus.
3. Saves fetus from asfiksi threat.
Definition
According to Prof. Dr. Roestam Mochtar, MPH, 1998. Menumbung umbilical cord is palpable when out and usually have ruptured membranes.
Menumbung umbilical cord is a condition in which the umbilical cord was in front or beside the bottom of the fetus, or the umbilical cord has been in the birth canal before the baby and the situation gets worse when the umbilical cord depressed.
Classification Menumbung Cord
Menumbung umbilical cord, fetal membrane rupture. The umbilical cord occupies one of the 3 position, namely:
1. Menumbung cord in PAP, located next to the bottom of the fetus in PAP
2. Menumbung umbilical cord into her vagina, down into the vagina
3. Menumbung cord through and out of the vaginal introitus
Etiology
1. Fetal etiology
a. Abnormal Presentation
Most of the umbilical cord presentation menumbung occur in the head but
could also be because the location of latitude and the location of the breech / posterior presentation,
especially the posterior leg.
b. Prematurity
Frequent abnormal position on premature births, one of whom
due to small babies who are not resistant to trauma and anoksia.
c. Multiple pregnancy
These factors include disorders that affect the adaptation, the frequency
larger abnormal presentation, high incidence hydramnion
rupture second child.
d. Hydramnion
When the membranes rupture, a large amount of fluid flowing out and the umbilical cord
drifting downward.
2. Etiology of Maternal
a. Pelvic disproportion head
Disproportion between the pelvis and the baby's head can not cause the fall and
rupture of the membranes can be followed menumbung umbilical cord.
b. Lower part of the high
Delays decreased head for a while to happen though pelvis
normal, especially in multiparous.
3. The etiology of umbilical cord and placenta
a. Long umbilical cord
The longer the cord the more easily menumbung
b. The placenta lies low
If the placenta near the cervix so it will block the decrease in the
lowest. In addition, insertion of the umbilical cord closer to the cervix.
Diagnosis
Diagnosis of umbilical cord menumbung made in 2 ways:
1. Seeing the umbilical cord outside of the vulva
2. Touching the umbilical cord on vaginal examination (check in)
Vaginal examination should be performed:
a. In the event of fetal distress which is not known why and trauma if the
bottom has not dropped.
b. When the membranes rupture with the lowest part is still high.
c. When all the cases at the time of membrane rupture malpresentasi
d. When clearly premature baby
e. In cases of twins
Prognosis
Menumbung cord does not endanger the mother and not complicate the delivery, but threatening to the fetus. Hope for the baby depends on the degree and duration of cord compression and the interval between diagnosis and the birth of a baby.
Factors that influence the fate of the fetus:
1. The better the state of the fetus at the time the diagnosis is made, the greater the expectation
his life. Loud pulsating umbilical cord reduce both symptoms and
otherwise weak pulsating umbilical cord is not good.
2. The sooner the baby is born after the umbilical cord drops down, the better
results. The decline more than 30 minutes enlarge fetal death 4 x.
3. The fetus of the older age pregnancy is also a greater ability to survive
of traumatic processes.
4. More and less trauma to the baby's birth, the better the prognosis for mother and
children.
5. Opening the cervix may be the most important factor. If the opening is
complete at the time the diagnosis is made it will be many babies that can
saved. The smaller the opening of the bad prognosis. Exceptions
for this is if it can be done caesarea section immediately, in terms of
where the prognosis as good or better at the opening of the cervix that are still
small.
6. Fetal death increased with increasing length of the interval between the outbreak of
membranes and the birth of a baby.
Handling
The umbilical cord is left and labor menumbung forwarded the following circumstances:
1. When the fetus is dead
2. When the fetus is known abnormal
3. When the fetus is still very premature, so there is no hope to be able to live
Efforts to reduce cord compression and improve fetal condition is as follows:
1. Helper inserting one hand into the vagina and push the lowest to
top away from the umbilical cord. At the same time made preparations for
help delivery.
2. The patient is placed in a knee-chest position (knee CHOST) or Trendelenburg with
above your hips and head downstairs.
3. Given oxygen by mask to the mother
4. Fetal heart rate frequently checked
5. Vaginal examination to determine the presentation, the opening of the cervix,
decrease in the lowest and the state of the umbilical cord.
If the opening is complete:
1. Presentation of the head, head low in the pelvis: extraction with forceps
2. Presentation of the head, head height: Version extraction in this way contain hazards
occurrence of uterine rupture but because this is a business in a state
desperate to save the child then the risk must be taken
3. Presentation buttocks. Second leg is lowered and the baby was born as a presentation
ass feet as quickly as possible.
4. The location of latitude. Version in a presentation leg and immediately performed
extraction.
If the opening is not complete:
1. Sectio Caesaria, is the choice for a baby just month and in a state
good. The fate of infants in Caesaria section much better than the birth
other way. The danger to the mother is also very less compared to having a baby
forced the opening of the incomplete. While the preparation done
held operating businesses to reduce the compression of the umbilical cord as
mentioned above.
2. Reposition the cord to start if not feasible caesarea section.
The umbilical cord under upward into the uterus, while the lowest in the fetus
push down into the pelvis and then the resistance is sometimes repositioning the umbilical cord
successful but generally we lose much valuable time to time
do.
3. If these efforts do not succeed, keep the patient in the Trendelenburg position
in the hope that the umbilical cord was not pressured, so the baby can still live up to
opening to be wide enough to allow the birth of a baby.
4. Manual cervical dilatation, cervical incision and other ways to
impose the cervical opening will never be accepted. Little success has
whereas the risk for major capital.
KB Calendar
Definition
Periodic Abstinence or better known as the Calendar System is a way / simple contraceptive method that can be done alone by the couple by not doing sexual intercourse during fertile. This method is effective if done properly and correctly. With the use of calendar systems each pair is possible to plan every pregnancy.
Benefits
As Contraception
a. Can be used to avoid or achieve pregnancy.
b. There are no health risks associated with contraception.
c. There are no side effects.
d. Low or no cost.
As Nonkontrasepsi
a. Increasing the involvement of husbands in family planning.
b. Adding knowledge about the reproductive system in the husband and wife.
c. Allows strengthen relationships / relationship nelalui enhancing communication between husband and wife or partner.
Weaknesses and Advantages KBA Calendar System
1. Weakness
a. The length of each woman's menstrual cycle is not the same.
b. Only a few women who have regular menstrual cycles
c. Ovulation does not always occur on day 14.
d. Determination of infertility based on the ability of live sperm cells in the female reproductive tract is 5 days.
e. Bleeding that sometimes comes along with ovulation can be interpreted as menstruation. As a result, the calculation of infertility before ovulation and infertility after ovulation becomes inaccurate.
f. Determination of infertility is not based on the menstrual cycle itself.
g. Lack of understanding of the relationship between ovulation.
h. The notion that the first day of the menstrual cycle is calculated from the end of menstrual bleeding so all the calculations determining the fertile period did not automatically become wrong.
i. Husband and wife can not have sex at all times when not wanted the pregnancy. Though there is no biological necessity of time constraints. My wife actually libido increases during the fertile period. For that family planning calendar system should be combined with contraceptive use condoms. At the time of the fertile time of husband and wife can still make the marital relationship but by using condoms.
Excess
a. In terms of Economics: KB calendar done naturally and without any cost so it does not need to pay for the purchase of contraceptives.
b. In terms of Health: This calendar system is obviously far more healthy because it can avoid the harmful side effects as well as using other contraceptive devices (especially in the form of the drug).
c. From the psychological aspect: the system of this calendar does not reduce the enjoyment of the relationship itself, such as when wearing a condom for example. Although, of course, on the other side of the pair of self-control required for strict abstinence during the fertile period.
How To Calculate The Fertile with KBA Calendar System
Before using this method, of course, married couples must know the fertile period. Cycles in each woman's fertile period is not the same. For that we need the observation of at least 6 times of the menstrual cycle. Here's how to find and calculate the fertile period:
When regular menstrual cycles (28 days):
* The first day of the menstrual cycle is calculated as the day-to-1
* The fertile is the day of the 12th until the 16th day of the menstrual cycle
example:
A wife got my period started on 2 October. October 2 is counted as day 1. So the 12th day falls on October 13th and 16th day falls on October 17th. So the fertile period is from October 12 until October 17th. On these dates may not be husband and wife have sex with wife (relations agency.) because if the wife violated the possibility of pregnancy is very big.
If an irregular menstrual cycle:
Record number of days in a menstrual cycle for 6 months (6 cycles). The menstrual cycle is calculated from the first day of menstruation at this time until the first day of next menstruation.
Shortest number of days in menstrual cycle minus 6 times 18. This count determines the first day of fertile period. The number of the longest day for 6 menstrual cycles minus 11. This count determines the last day of fertile period.
Formulas:
The first day of the fertile period = Number of days the shortest - 18
The last day of fertile period = Number of days the longest - 11
Example:
A wife got my period with the state: the shortest cycle of 26 days and the longest cycle of 32 days (beginning the first day of menstruation until the next menstruation).
The calculations are: 26-18 = 8 and 32-11 = 21. so the fertile period is to begin day-to-8 to the 21 from the first day of menstruation. At this time bersanggama.setelah spouses should not be allowed to pass from the new.
How To Calculate The Infertile with KBA Calendar System
How to calculate infertility is fairly easy. First of all, for 12 months, long menstrual cycles were recorded. Menstrual cycle is calculated starting from the first day of menstruation until the day before the first day of next menstruation. Of note will be seen whether or not regular menstrual cycles. For those who have irregular menstrual cycles, please note the number of days the shortest period and the number of days the longest period.
Then, after the menstrual cycle record is obtained, stay longer count infertility. Counting time is not fertile before ovulation by subtracting the shortest period with 21. 21 Figures derived from the sum of the egg maturation time (16 days) and the ability of live sperm cells in the uterus (5 days). For example, the shortest period is 28 days, the period is not fertile before ovulation is the first day until the seventh day (28-21). If the shortest period of 25 days, then infertility is the first day to the fourth (25-21).
Calculation of infertility after ovulation did not differ significantly. The difference is only used during menstrual periods and rate reduction. Infertility after ovulation is calculated by subtracting the longest period minus 9. Number 9 is obtained from the reduction in egg maturation shortest time (11 days) with an egg cell survival (20 days). For example, the longest period is 28 days, the period of infertility after ovulation from day 19 to the next menstruation. If the longest period of 30 days, then infertility starting day 21 until the next menstruation.
Women who Can & Should Not Use KBA Calendar System
1. Women who can
a. For contraception
All the female during reproduction, either regular menstrual cycles and irregular, not good because haik and premenopausal breast.
All women with any parity including nulliparous.
Women's skinny or fat
Women who smoke
Women with certain health reasons among others hiertensi medium, varicose veins, disminorea, moderate or severe headache, uterine myomas, endometritis, ovarii cysts, iron deficiency anemia, viral hepatitis, malaria, deep-vein thrombosis or pulmonary embolism.
Couples with religious or philosophical reasons for not menggunkaan other methods
Women who can not use other methods.
Couples who want abstinence intercourse more than a week of each menstrual cycle.
Couples who want and are motivated to observe, record, and assess signs and symptoms of fertility.
b. To conception
Couples who want mancapai pregnancy, intercourse during fertile done to achieve a pregnancy.
2. Women who should not use
Women in terms of age, parity or health problems make pregnancy a high risk of a condition.
Women before getting your period (breastfeeding, immediately after the abortion), except MOB.
Women with irregular menstrual cycles, except MOB
Women whose partners do not cooperate (abstinence) during certain times of the menstrual cycle.
Women who do not like touching daetah genetalianya.
Periodic Abstinence or better known as the Calendar System is a way / simple contraceptive method that can be done alone by the couple by not doing sexual intercourse during fertile. This method is effective if done properly and correctly. With the use of calendar systems each pair is possible to plan every pregnancy.
Benefits
As Contraception
a. Can be used to avoid or achieve pregnancy.
b. There are no health risks associated with contraception.
c. There are no side effects.
d. Low or no cost.
As Nonkontrasepsi
a. Increasing the involvement of husbands in family planning.
b. Adding knowledge about the reproductive system in the husband and wife.
c. Allows strengthen relationships / relationship nelalui enhancing communication between husband and wife or partner.
Weaknesses and Advantages KBA Calendar System
1. Weakness
a. The length of each woman's menstrual cycle is not the same.
b. Only a few women who have regular menstrual cycles
c. Ovulation does not always occur on day 14.
d. Determination of infertility based on the ability of live sperm cells in the female reproductive tract is 5 days.
e. Bleeding that sometimes comes along with ovulation can be interpreted as menstruation. As a result, the calculation of infertility before ovulation and infertility after ovulation becomes inaccurate.
f. Determination of infertility is not based on the menstrual cycle itself.
g. Lack of understanding of the relationship between ovulation.
h. The notion that the first day of the menstrual cycle is calculated from the end of menstrual bleeding so all the calculations determining the fertile period did not automatically become wrong.
i. Husband and wife can not have sex at all times when not wanted the pregnancy. Though there is no biological necessity of time constraints. My wife actually libido increases during the fertile period. For that family planning calendar system should be combined with contraceptive use condoms. At the time of the fertile time of husband and wife can still make the marital relationship but by using condoms.
Excess
a. In terms of Economics: KB calendar done naturally and without any cost so it does not need to pay for the purchase of contraceptives.
b. In terms of Health: This calendar system is obviously far more healthy because it can avoid the harmful side effects as well as using other contraceptive devices (especially in the form of the drug).
c. From the psychological aspect: the system of this calendar does not reduce the enjoyment of the relationship itself, such as when wearing a condom for example. Although, of course, on the other side of the pair of self-control required for strict abstinence during the fertile period.
How To Calculate The Fertile with KBA Calendar System
Before using this method, of course, married couples must know the fertile period. Cycles in each woman's fertile period is not the same. For that we need the observation of at least 6 times of the menstrual cycle. Here's how to find and calculate the fertile period:
When regular menstrual cycles (28 days):
* The first day of the menstrual cycle is calculated as the day-to-1
* The fertile is the day of the 12th until the 16th day of the menstrual cycle
example:
A wife got my period started on 2 October. October 2 is counted as day 1. So the 12th day falls on October 13th and 16th day falls on October 17th. So the fertile period is from October 12 until October 17th. On these dates may not be husband and wife have sex with wife (relations agency.) because if the wife violated the possibility of pregnancy is very big.
If an irregular menstrual cycle:
Record number of days in a menstrual cycle for 6 months (6 cycles). The menstrual cycle is calculated from the first day of menstruation at this time until the first day of next menstruation.
Shortest number of days in menstrual cycle minus 6 times 18. This count determines the first day of fertile period. The number of the longest day for 6 menstrual cycles minus 11. This count determines the last day of fertile period.
Formulas:
The first day of the fertile period = Number of days the shortest - 18
The last day of fertile period = Number of days the longest - 11
Example:
A wife got my period with the state: the shortest cycle of 26 days and the longest cycle of 32 days (beginning the first day of menstruation until the next menstruation).
The calculations are: 26-18 = 8 and 32-11 = 21. so the fertile period is to begin day-to-8 to the 21 from the first day of menstruation. At this time bersanggama.setelah spouses should not be allowed to pass from the new.
How To Calculate The Infertile with KBA Calendar System
How to calculate infertility is fairly easy. First of all, for 12 months, long menstrual cycles were recorded. Menstrual cycle is calculated starting from the first day of menstruation until the day before the first day of next menstruation. Of note will be seen whether or not regular menstrual cycles. For those who have irregular menstrual cycles, please note the number of days the shortest period and the number of days the longest period.
Then, after the menstrual cycle record is obtained, stay longer count infertility. Counting time is not fertile before ovulation by subtracting the shortest period with 21. 21 Figures derived from the sum of the egg maturation time (16 days) and the ability of live sperm cells in the uterus (5 days). For example, the shortest period is 28 days, the period is not fertile before ovulation is the first day until the seventh day (28-21). If the shortest period of 25 days, then infertility is the first day to the fourth (25-21).
Calculation of infertility after ovulation did not differ significantly. The difference is only used during menstrual periods and rate reduction. Infertility after ovulation is calculated by subtracting the longest period minus 9. Number 9 is obtained from the reduction in egg maturation shortest time (11 days) with an egg cell survival (20 days). For example, the longest period is 28 days, the period of infertility after ovulation from day 19 to the next menstruation. If the longest period of 30 days, then infertility starting day 21 until the next menstruation.
Women who Can & Should Not Use KBA Calendar System
1. Women who can
a. For contraception
All the female during reproduction, either regular menstrual cycles and irregular, not good because haik and premenopausal breast.
All women with any parity including nulliparous.
Women's skinny or fat
Women who smoke
Women with certain health reasons among others hiertensi medium, varicose veins, disminorea, moderate or severe headache, uterine myomas, endometritis, ovarii cysts, iron deficiency anemia, viral hepatitis, malaria, deep-vein thrombosis or pulmonary embolism.
Couples with religious or philosophical reasons for not menggunkaan other methods
Women who can not use other methods.
Couples who want abstinence intercourse more than a week of each menstrual cycle.
Couples who want and are motivated to observe, record, and assess signs and symptoms of fertility.
b. To conception
Couples who want mancapai pregnancy, intercourse during fertile done to achieve a pregnancy.
2. Women who should not use
Women in terms of age, parity or health problems make pregnancy a high risk of a condition.
Women before getting your period (breastfeeding, immediately after the abortion), except MOB.
Women with irregular menstrual cycles, except MOB
Women whose partners do not cooperate (abstinence) during certain times of the menstrual cycle.
Women who do not like touching daetah genetalianya.
Vasektomi
Pengertian
Vasektomi adalah istilah dalam ilmu bedah yang terbentuk dari dua kata yaitu vas dan ektomi. Vas atau vasa deferensia artinya adalah saluran benih yaitu saluran yang menyalurkan sel benih jantan (spermatozoa) keluar dari buah zakar (testis) yaitu tempat sel benih itu diproduksi menuju kantung mani (vesikulaseminalis) sebagai tempat penampungan sel benih jantan sebelum dipancarkan keluar pada saat puncak sanggama (ejakulasi). Ektomi atau ektomia artinya pemotongan sebagian.
Jadi vasektomi artinya adalah pemotongan sebagian (0.5 cm – 1 cm) saluran benih sehingga terdapat jarak diantara ujung saluran benih bagian sisi testis dan saluran benih bagian sisi lainya yang masih tersisa dan pada masing-masing kedua ujung saluran yang tersisa tersebut dilakukan pengikatan sehingga saluran menjadi buntu/tersumbat.
Efektivitas
Efektifitas : 99% lebih
Cara Kerja
Saluran vas deferens yang berfungsi mengangkut sperma dipotong dan diikat, sehingga aliran sperma dihambat tanpa mempengaruhi jumlah cairan semen. Jumlah sperma hanya 5% dari cairan ejakulasi. Cairan semen diproduksi dalam vesika seminalis dan prostat sehingga tidak akan terganggu oleh vasektomi.
Keuntungan dan Kerugian
1. Keuntungan
a. Tidak akan mengganggu ereksi, potensi seksual, produksi hormon.
b. Perlindungan terhadap terjadinya kehamilan sangat tinggi. Dapat digunakan seumur hidup.
c. Tidak menggangugu kehidupan seksual suami istri.
d. Tidak mengganggu produksi ASI (untuk kontap wanita).
e. Lebih aman (keluhan lebih sedikit)
f. Lebih praktis (hanya memerlukan satu kali tindakan)
g. Lebih efektif (tingkat kegagalannya sangat kecil)
h. Lebih ekonomis (hanya memerlukan biaya untuk sekali tindakan)
i. Tidak ada mortalitas/kematian.
j. Pasien tidak perlu dirawat di rumah sakit.
k. Tidak ada resiko kesehatan.
l. Tidak harus diingat-ingat, tidak harus selalu ada persediaan.
m. Sifatnya permanen.
Kerugian
a. Memerlukan operasi bedah
b. Prosedur ini hanya untuk pasangan yang sudah memutuskan untuk tidak akan punya anak lagi.
c. Harus dengan tindakan pembedahan.
d. Harus memakai kontrasepsi lain (kondom) selama beberapa hari atau minggu sampai sel mani menjadi negatif.
e. Tidak dapat dilakukan dengan orang yang masih ingin mempunyai anak lagi
Kegagalan
Walaupun vaektomi dinilai paling efektif untuk mengontrol kesuburan pria, namun masih mungkin dijumpai suatu kegagalan.
Vasektomi dikatakan gagal bila :
a. Terjadi rekanalisasi spontan
b. Istri (pasangan) hamil
c. Pada analisis sperma setelah 3 bulan pasca vasektomi atau setelah 15 – 20 kali ejakulasi masih dijumpai spermatozoa.
d. Dijumpai spermatozoa setelah sebelumnya azoosperma.
e. Gagal mengenal dan memotong saluran vas deferens
f. Adanya anomali anatomi, mis ; ada 2 saluran vas deferens di kiri atau di kanan
a. Hubungan badan di lakukan sebelum kantong seminal benar- benar kosong
Efek Samping & Komplikasi
1. Efek Samping
a. Timbul rasa nyeri.
b. Abses pada bekas luka.
c. Hematoma
Biasanya terjadi bila daerah skrotum diberi beban yang berlebihan, missal naik sepeda, duduk terlalu lama dalam kendaraan dalam jalanan yang rusak dan sebagainya.
Komplikasi
a. Pendarahan
b. Peradangan bila sterilisasi/ alat proses kurang
Indikasi & Kontraindikasi
1. Indikasi
a. Menunda kehamilan
b. Pria yang ingin mengakhiri kesuburan
c. Pria yang ingin membatasi kehamilan
d. Setiap pria, suami dari suatu pasangan usia subur yang telah memiliki jumlah anak cukup dan tidak ingin menambah anak.
2. Kontraindikasi
a. Peradangan kulit atau jamur pada kemaluan.
b. Peradangan pada alat kelamin pria.
c. Penyakit kencing manis.
d. Kelainan mekanisme pembekuan darah.
e. Infeksi didaerah testis (buah zakar) dan penis
f. Hernia (turun bero)
g. Varikokel (varises pada pembuluh darah balik buah zakar)
h. Buah zakar membesar karena tumor
i. Hidrokel (penumpukan cairan pada kantong zakar)
j. Buah zakar tidak turun (kriptokismus)
k. Penyakit kelainan pembuluh darah
Tempat Pelayanan
Rumah Sakit, Puskesmas, Klinik KB yang mempunyai tenaga terlatih untuk melakukan vasektomi, Dokter, Bidan Swasta.
Vasektomi adalah istilah dalam ilmu bedah yang terbentuk dari dua kata yaitu vas dan ektomi. Vas atau vasa deferensia artinya adalah saluran benih yaitu saluran yang menyalurkan sel benih jantan (spermatozoa) keluar dari buah zakar (testis) yaitu tempat sel benih itu diproduksi menuju kantung mani (vesikulaseminalis) sebagai tempat penampungan sel benih jantan sebelum dipancarkan keluar pada saat puncak sanggama (ejakulasi). Ektomi atau ektomia artinya pemotongan sebagian.
Jadi vasektomi artinya adalah pemotongan sebagian (0.5 cm – 1 cm) saluran benih sehingga terdapat jarak diantara ujung saluran benih bagian sisi testis dan saluran benih bagian sisi lainya yang masih tersisa dan pada masing-masing kedua ujung saluran yang tersisa tersebut dilakukan pengikatan sehingga saluran menjadi buntu/tersumbat.
Efektivitas
Efektifitas : 99% lebih
Cara Kerja
Saluran vas deferens yang berfungsi mengangkut sperma dipotong dan diikat, sehingga aliran sperma dihambat tanpa mempengaruhi jumlah cairan semen. Jumlah sperma hanya 5% dari cairan ejakulasi. Cairan semen diproduksi dalam vesika seminalis dan prostat sehingga tidak akan terganggu oleh vasektomi.
Keuntungan dan Kerugian
1. Keuntungan
a. Tidak akan mengganggu ereksi, potensi seksual, produksi hormon.
b. Perlindungan terhadap terjadinya kehamilan sangat tinggi. Dapat digunakan seumur hidup.
c. Tidak menggangugu kehidupan seksual suami istri.
d. Tidak mengganggu produksi ASI (untuk kontap wanita).
e. Lebih aman (keluhan lebih sedikit)
f. Lebih praktis (hanya memerlukan satu kali tindakan)
g. Lebih efektif (tingkat kegagalannya sangat kecil)
h. Lebih ekonomis (hanya memerlukan biaya untuk sekali tindakan)
i. Tidak ada mortalitas/kematian.
j. Pasien tidak perlu dirawat di rumah sakit.
k. Tidak ada resiko kesehatan.
l. Tidak harus diingat-ingat, tidak harus selalu ada persediaan.
m. Sifatnya permanen.
Kerugian
a. Memerlukan operasi bedah
b. Prosedur ini hanya untuk pasangan yang sudah memutuskan untuk tidak akan punya anak lagi.
c. Harus dengan tindakan pembedahan.
d. Harus memakai kontrasepsi lain (kondom) selama beberapa hari atau minggu sampai sel mani menjadi negatif.
e. Tidak dapat dilakukan dengan orang yang masih ingin mempunyai anak lagi
Kegagalan
Walaupun vaektomi dinilai paling efektif untuk mengontrol kesuburan pria, namun masih mungkin dijumpai suatu kegagalan.
Vasektomi dikatakan gagal bila :
a. Terjadi rekanalisasi spontan
b. Istri (pasangan) hamil
c. Pada analisis sperma setelah 3 bulan pasca vasektomi atau setelah 15 – 20 kali ejakulasi masih dijumpai spermatozoa.
d. Dijumpai spermatozoa setelah sebelumnya azoosperma.
e. Gagal mengenal dan memotong saluran vas deferens
f. Adanya anomali anatomi, mis ; ada 2 saluran vas deferens di kiri atau di kanan
a. Hubungan badan di lakukan sebelum kantong seminal benar- benar kosong
Efek Samping & Komplikasi
1. Efek Samping
a. Timbul rasa nyeri.
b. Abses pada bekas luka.
c. Hematoma
Biasanya terjadi bila daerah skrotum diberi beban yang berlebihan, missal naik sepeda, duduk terlalu lama dalam kendaraan dalam jalanan yang rusak dan sebagainya.
Komplikasi
a. Pendarahan
b. Peradangan bila sterilisasi/ alat proses kurang
Indikasi & Kontraindikasi
1. Indikasi
a. Menunda kehamilan
b. Pria yang ingin mengakhiri kesuburan
c. Pria yang ingin membatasi kehamilan
d. Setiap pria, suami dari suatu pasangan usia subur yang telah memiliki jumlah anak cukup dan tidak ingin menambah anak.
2. Kontraindikasi
a. Peradangan kulit atau jamur pada kemaluan.
b. Peradangan pada alat kelamin pria.
c. Penyakit kencing manis.
d. Kelainan mekanisme pembekuan darah.
e. Infeksi didaerah testis (buah zakar) dan penis
f. Hernia (turun bero)
g. Varikokel (varises pada pembuluh darah balik buah zakar)
h. Buah zakar membesar karena tumor
i. Hidrokel (penumpukan cairan pada kantong zakar)
j. Buah zakar tidak turun (kriptokismus)
k. Penyakit kelainan pembuluh darah
Tempat Pelayanan
Rumah Sakit, Puskesmas, Klinik KB yang mempunyai tenaga terlatih untuk melakukan vasektomi, Dokter, Bidan Swasta.
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