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All Journal Jurnal Anestesi Obstetri Indonesia Jurnal Medicare
Prima, Dian
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Kesenjangan Manajemen Anestesi pada Seksio Sesarea dengan Placenta Akreta di RS Dr. Saiful Anwar Malang: Sebuah Pembelajaran Prima, Dian; Isngadi, Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 7 No 2 (2024): Juli
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v7i2.152

Abstract

Plasenta akreta (plasenta yang melekat secara abnormal) adalah salah satu dari dua penyebab perdarahan peripartum yang paling umum dengan jumlah perdarahan yang banyak, sehingga menjadi penyebab untuk dilakukan histerektomi peripartum. Perdarahan saat persalinan dengan seksio sesarea pada maternal dengan plasenta akreta di RS Dr Saiful Anwar Malang rata-rata adalah: 3000–4000cc lebih banyak daripada maternal bukan plasenta akreta. Keadaan tersebut sering menjadi penyebab perubahan manajemen anestesi; yang semula direncanakan dengan regional anestesi harus dikonversi ke anestesi umum, begitu juga tatalaksana pembedahannya sering mengalami perubahan dan harus konsul disiplin ilmu lain durante operasi. Oleh karena itu, maternal dengan plasenta akreta yang telah terdiagnosis perlu pendekatan multidisiplin agar luaran pasca persalinan menjadi lebih baik. Akan tetapi sering terjadi kesenjangan manajemen anestesi pada pasien plasenta akreta yang dilakukan seksio sesarea. Kasus: wanita berusia 35 tahun dengan plasenta akreta, berat badan 73 kg, G3P2A0, menjalani seksio sesarea elektif. Anestesi Combined Spinal Epidural (CSE) dilakukan dan setelah bayi lahir, pasien mengalami perdarahan aktif 5000–15.000cc dalam waktu 30 menit pertama. Manajemen anestesi dirubah ke anestesi umum dan histerektomi dilakukan. Selama operasi, ditemukan plasenta yang mengalami infiltrasi hingga vena iliaka. Pasien akhirnya dinyatakan meninggal dunia akibat perdarahan masif selama operasi. Mayoritas pasien dengan plasenta akreta dilakukan histerektomi. Karena USG tidak dapat menegakkan diagnosis secara pasti, diagnosis hanya dapat ditentukan selama pembedahan. Dalam kasus ini, sulitnya diagnosis dan adanya komplikasi anatomis membuat pembedahan menjadi sulit dan akhirnya menyebabkan kematian pada pasien
MIDWIFE, COUNSELING AND ADOLESCENT REPRODUCTIVE HEALTH RIGHTS IN COVID-19 PANDEMIC Sumiari, Karlina; Lufiana, Indrie; Prima, Dian
Jurnal Medicare Vol. 1 No. 1 (2022): JANUARY 2022
Publisher : Rena Cipta Mandiri

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62354/jurnalmedicare.v1i1.3

Abstract

Cases related to adolescent health have increased during the COVID-19 pandemic. Midwives have a very important role in conducting counseling related to adolescent health. This is a form of commitment in fulfilling the right to health of adolescents. The role of the midwife is stated in terms of reproductive health in accordance with the Regulation of the Minister of Health of the Republic of Indonesia Number 28 of 2017 concerning Permits and Implementation of Midwifery Practices article 21a. The purpose of this research is to know the role of midwives in the implementation of adolescent counseling as the fulfillment of adolescent reproductive health rights. Qualitative research methods, with a sociological juridical approach. The study used in-depth interviews with midwife and adolescent informants. The research was conducted from May to June 2021. Data analysis was carried out by qualitative data analysis. The results of the study show that BIdans have carried out their authority and obligations in the role of counselors based on the Midwifery Law Number 4 of 2019 and the Regulation of the Minister of Health of the Republic of Indonesia Number 28 of 2017 concerning Permits and Implementation of Midwifery Practices article 21a. The role of midwives in the implementation of adolescent counseling is to increase knowledge of reproductive health as a fulfillment of adolescent reproductive health rights. Midwives are implementers of youth health service programs. Reproductive health rights in adolescents based on the International Conference on Population and Development (ICPD) in Cairo in 1994 there are 12 rights of which 11 reproductive health rights have been well fulfilled.
Co-Authors Isngadi Isngadi Lufiana, Indrie Sumiari, Karlina