<![CDATA[Complicated labor involving prolonged active phase, meconium-stained amniotic fluid, and fetal distress is a leading cause of maternal and perinatal morbidity and mortality. This descriptive case study aimed to describe midwifery care for a primigravida with the above complications using the SOAP documentation approach. The subject was Mrs. D, aged 27 years, G1P0A0, at 41 weeks 2 days gestation, managed at RS Pratama Tanjung Keramat and RSUD dr. H. Jusuf SK on January 15, 2026. Serial intrapartum monitoring revealed progressive deterioration: fetal heart rate rose to 172 bpm (tachycardia), membranes ruptured with meconium-stained fluid, and cervical dilation stagnated at 1 cm over 6 hours (0.17 cm/hour), confirming prolonged active phase with fetal distress. Initial stabilization (left lateral positioning, oxygen 6–8 L/minute, IV RL infusion) was followed by emergency referral and emergency Cesarean section performed by an obstetrician. A male infant weighing 3,600 g was delivered and stabilized through neonatal resuscitation. Early detection, strict partograph monitoring, and timely referral were critical in preventing neonatal asphyxia and meconium aspiration syndrome in this case. Abstrak Persalinan dengan penyulit berupa fase aktif memanjang, air ketuban bercampur mekonium, dan fetal distress merupakan penyebab utama morbiditas dan mortalitas ibu serta perinatal. Studi kasus deskriptif ini bertujuan mendeskripsikan asuhan kebidanan pada primigravida dengan komplikasi tersebut menggunakan pendekatan SOAP. Subjek adalah Ny. D usia 27 tahun G1P0A0, hamil 41 minggu 2 hari, dikelola di RS Pratama Tanjung Keramat dan RSUD dr. H. Jusuf SK pada 15 Januari 2026. Pemantauan intrapartum berkala menunjukkan perburukan progresif: DJJ meningkat hingga 172 x/menit (takikardia janin), ketuban pecah bercampur mekonium, dan stagnasi pembukaan serviks 1 cm dalam 6 jam (0,17 cm/jam), mengonfirmasi diagnosis prolonged active phase disertai fetal distress. Stabilisasi awal (posisi miring kiri, oksigen 6–8 L/menit, infus RL) dilanjutkan dengan rujukan emergensi dan tindakan Sectio Caesarea. Bayi laki-laki lahir dengan berat 3.600 gram dan berhasil distabilkan melalui resusitasi neonatus. Deteksi dini, pemantauan partograf yang ketat, dan rujukan tepat waktu terbukti kritis dalam mencegah asfiksia neonatorum dan sindrom aspirasi mekonium pada kasus ini.]]>
