Asuhan Kebidanan Berkelanjutan (Continuity of Care) pada Ibu Inpartu dengan Ruptur Perineum Derajat II di Klinik Pratama Sarfina Kecamatan Medan Polonia Tahun 2026 - Roswita Zalukhu; Eva Ratna Dewi; Nur Azizah; Kamelia Sinaga; Sarfina Br Sembiring (Jurnal Ners, 2026)
AbstrakPendahuluan: Ruptur perineum merupakan komplikasi persalinan yang sering terjadi dan dapat berdampak padakesehatan fisik maupun psikologis ibu pascasalin. Salah satu faktor kunci pencegahan robekan jalan lahir adalahpemilihan posisi meneran yang ergonomis serta perlindungan perineum yang tepat pada kala II. World HealthOrganization memperkirakan 85–95% persalinan pervaginam berisiko mengalami ruptur perineum derajat I–II,sementara di negara berkembang ruptur perineum derajat II mencapai 24%. Tujuan: Melaksanakan asuhan kebidananberkelanjutan (Continuity of Care) pada Ny. E dengan ruptur perineum derajat II mulai dari kehamilan, persalinan, nifas,bayi baru lahir, hingga keluarga berencana menggunakan manajemen kebidanan tujuh langkah Helen Varney danpendokumentasian SOAP. Metode: Studi kasus deskriptif dengan pendekatan Continuity of Care pada Ny. E, usia 24tahun, G2P1A0, di Klinik Pratama Sarfina, Kecamatan Medan Polonia, sejak 23 Juli 2025 hingga 16 Februari 2026. Datadikumpulkan melalui anamnesis, observasi, pemeriksaan fisik, dan studi dokumentasi rekam medis serta buku KIA.Hasil: Empat kali kunjungan antenatal berlangsung normal. Persalinan spontan tanggal 31 Desember 2025 pukul 20.55WIB melahirkan bayi laki-laki, BB 3.255 gram, PB 50 cm, APGAR 10, disertai ruptur perineum derajat II yang ditanganidengan penjahitan teknik matras. Empat kunjungan nifas dan neonatus menunjukkan involusi uteri baik, ASI lancar, danbayi sehat; ibu memilih Metode Amenore Laktasi (MAL) sebagai kontrasepsi. Kesimpulan: Asuhan kebidananberkelanjutan berbasis tujuh langkah Varney terbukti efektif dalam deteksi dini dan penanganan ruptur perineum derajatII serta mempertahankan luaran ibu dan bayi yang optimal.Kata Kunci: Asuhan Kebidanan Berkelanjutan; Continuity of Care; Ruptur Perineum Derajat II; Manajemen Varney;Posisi MeneranAbstractIntroduction: Perineal rupture is a common complication of childbirth that may affect the physical and psychologicalhealth of postpartum women. Selection of an ergonomic pushing position and appropriate perineal protection during thesecond stage of labor is key to its prevention. The World Health Organization estimates that 85–95% of vaginal birthscarry a risk of first- to second-degree perineal tears, while in developing countries, second-degree tears occur in up to24% of vaginal deliveries. Objective: To implement continuity of care (CoC) midwifery services for Mrs. E with second-degree perineal rupture from pregnancy, delivery, postpartum, newborn, to family planning using the seven-step HelenVarney management and SOAP documentation. Methods: A descriptive case study with a continuity-of-care approachwas conducted on Mrs. E, a 24-year-old G2P1A0 woman, at Sarfina Primary Clinic, Medan Polonia District, from 23July 2025 to 16 February 2026. Data were collected through in-depth interviews, observation, physical examination, andreview of medical records and the maternal and child health book. Results: Four antenatal visits proceeded normally.Spontaneous delivery occurred on 31 December 2025 at 20:55 local time, producing a male infant weighing 3,255 g,length 50 cm, APGAR 10, with a second-degree perineal tear managed by mattress-suture repair. Four postpartum andneonatal visits showed adequate uterine involution, effective lactation, and a healthy newborn; the mother chose theLactational Amenorrhea Method (LAM) as her contraceptive. Conclusion: Continuity-of-care midwifery based on theseven-step Varney management proved effective in the early detection and management of second-degree perinealrupture while maintaining optimal maternal and neonatal outcomes.Keywords: Continuity of Care; Second-Degree Perineal Rupture; Midwifery Care; Varney Management; PushingPosition