<![CDATA[Kontrasepsi suntik Depot Medroxyprogesterone Acetate (DMPA) merupakan salah satu metode kontrasepsi hormonal yang banyak digunakan karena efektif dan praktis. Namun, penggunaan jangka panjang dapat menimbulkan perubahan hormonal yang berpotensi memengaruhi kondisi serviks sehingga diperlukan deteksi dini melalui pemeriksaan Inspeksi Visual dengan Asam Asetat (IVA). Laporan kasus ini bertujuan mendeskripsikan asuhan kebidanan pada akseptor KB suntik DMPA dengan hasil IVA positif di Puskesmas Kanor Kabupaten Bojonegoro. Metode: Penelitian menggunakan desain case report dengan pendekatan manajemen asuhan kebidanan metode SOAP yang meliputi pengkajian subjektif dan objektif, penetapan diagnosis aktual dan potensial, identifikasi kebutuhan tindakan segera, perencanaan, implementasi, serta evaluasi asuhan. Hasil penelitian Ny. D berusia 33 tahun telah menggunakan KB suntik DMPA selama tujuh tahun dan datang dengan keluhan keputihan serta hasil IVA positif. Asuhan kebidanan meliputi komunikasi terapeutik, edukasi efek samping kontrasepsi hormonal, dukungan psikologis, kolaborasi dengan dokter, rujukan Pap Smear, serta konseling kesehatan reproduksi. Hasil Pap Smear menunjukkan radang nonspesifik kelas II tanpa ditemukan lesi prakanker maupun keganasan. Pasien memahami kondisinya, bersedia menjalani tindak lanjut, dan menerima anjuran beralih ke kontrasepsi nonhormonal. Kesimpulannya, Asuhan kebidanan komprehensif dengan pendekatan SOAP mampu mendukung deteksi dini, penatalaksanaan, serta pencegahan progresivitas kelainan serviks pada akseptor KB suntik DMPA. Saran: Bidan perlu meningkatkan edukasi, pemantauan efek samping, serta mendorong pelaksanaan skrining IVA atau Pap Smear secara berkala pada pengguna kontrasepsi hormonal jangka panjang. Kata kunci: KB suntik DMPA; IVA positif; skrining kanker serviks; asuhan kebidanan; laporan kasus Abstract Depot Medroxyprogesterone Acetate (DMPA) injectable contraception is one of the most widely used hormonal contraceptive methods because of its high effectiveness and practicality. However, long-term use may cause hormonal changes affecting the cervix, making early cervical cancer screening through Visual Inspection with Acetic Acid (VIA) essential. Objective: This case report aimed to describe the midwifery management of a DMPA injectable contraceptive acceptor with a positive VIA result at Kanor Primary Health Center, Bojonegoro Regency. Method: This study employed a case report design using the SOAP midwifery management approach, including subjective and objective assessment, identification of actual and potential diagnoses, immediate needs, planning, implementation, and evaluation of care. Results: A 33-year-old woman who had used DMPA for seven years presented with vaginal discharge and a positive VIA result. Midwifery care included therapeutic communication, counseling, education regarding DMPA side effects, psychological support, collaboration with physicians, referral for Pap smear examination, and reproductive health counseling. Follow-up Pap smear examination revealed Class II nonspecific inflammation without evidence of precancerous lesions or malignancy. The patient demonstrated good understanding of her condition, adhered to recommendations, and agreed to switch to a non-hormonal contraceptive method. Conclusion: Comprehensive midwifery care using the SOAP approach successfully supported early detection, appropriate referral, and management of cervical abnormalities in long-term DMPA users. Recommendation: Routine VIA or Pap smear screening, continuous counseling, and individualized contraceptive selection should be strengthened to improve reproductive health outcomes and prevent cervical cancer among hormonal contraceptive users. Keywords: DMPA injectable contraception; VIA positive;,cervical cancer screening; midwifery care; case report.]]>
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