partus ex vacum

7/21/2019 Partus Ex Vacum

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PERSALINAN DENGAN

EKSTRAKSI VAKUM

DEBORA LUSIANA HERMAN

11 2014 052



IDENTITAS PASIEN

• Nama : Ny. GP

• Umur : 27 Tahu

• A!ama : I"#am

• A#ama$ :



&ELUHAN UTAMA

• Ru'u(a )ar% &#%%( )*!a +*m,u(aa - $%)a( ma'u.

• #*(/*( "*'a( 2 har% ya! #a#u



RIAAT PENA&IT SE&ARANG

• Dua har% SMRS 3" m*!a$a(a (*#uar *(/*( 3(#a$ )ar% (*ma#ua. &*mu)%a O" )a$a!Bu)a u$u( m*#a(u(a +*m*r%("aa. D%(a$a(a ,aha a)a +*m,u(aa 1 )a O" )%+*r,3

u$u( +u#a! )ahu#u. &*mu)%a 3" m*ra"a mu#a" h%#a! $%m,u# )a (*m,a#% (* (#%%( )a

+*m*r%("aa )a m*ya$a(a ,aha +*m,u(aa )ua. Namu 3" ma"%h )%+*r,3#*h(a +u

• Sa$u har% SMRS 3" m*!a$a(a mu#a" ma(% $*ra"a "a(%$ )a 3" )a$a! (* (#%%( Bu)a (

m*#a(u(a +*r"a#%a. T*$a+% +*m,u(aa $%)a( $*r'a)% (*ma'ua. &*mu)%a O" )a$a! (*

Sa(%$ Bha($% u)ha )*!a ru'u(a )ar% &#%%( $*r"*,u$. O" m*!a$a(a %% (*ham%#a ya

O" $%)a( m*!*#uh mua#6 mu$ah6 +u"%!6 ma$a ,*r(ua!6 )a ma$a $%)a( (a,ur. O" m*

ru$% m*m*r%("a(a (*ham%#aya "*$%a+ ,u#a (* ,%)a. S*#ama %% $%)a( +*rah m*m%#%(

$*(aa )arah $%!!%6 ,a%( "*,*#um )a "*#ama +*m*r%("aa (*ham%#a6 3" $%)a( m*m%#%(

"a(%$ (r3%". O" m*m%#%(% r%aya$ m*"$rua"% $*ra$ur. O" m*!a$a(a HPHT 1 Mar*$ 2015

22 D*"*m,*r 2015. Saa$ %% +a"%* ham%# 40 m%!!u.



• Riwayat Menstruasi:

• M*arh* : 15 $ahu

• D%"m*3rrh*a : 8/9

• L*u(3rrh*a : 8/9

• M*3+au"* : 8/9

• S%(#u" : 2 har%

• Lama : 4 har%

• Riwayat Perkawinan

• P*r(a%a 1 (a#%6 u"%a 2 $ahu6 "*#ama 1 $ahu

• Riwayat Kehamilan

• AN; ru$% )% ,%)a6 $%)a( a)a ma"a#ah ya! )%$*



• Riwayat Kehamilan Sekaran:

• HPHT : 1 Mar*$ 2015

• HPL : 22 D*"*m,*r 2015

•

• Riwayat K"ntrase#si:

• 8 / 9 P%# &B 8 / 9 IUD

• 8 / 9 Su$%(a - ,u#a 8 / 9 La%/#a%

• 8 / 9 Su"u( &B

• Riwayat Penyakit Dahulu:

• T%)a( +*rah m*)*r%$a +*ya(%$ 'a$u!6 )arama%"6 a"ma )a a#*r!%

• Riwayat Penyakit Keluara:

• T%)a( a)a a!!3$a (*#uar!a ya! m*)*r%$

)arah $%!!%6 (*%! ma



PEMERI&SAAN ISI&

• Pemeriksaan Umum

• &*a)aa umum : Tam+a( "a(%$ "*)a!

• &*"a)ara: ;3m+3" m*$%"

• T*(aa )arah : 1-0<0 mmH!

• Na)% : =2><m*%$ 8(ua$ a!(a$6 r*!u#*r9

• P*ra?a"a : 24><m*%$ 8a,)3m%3/$3ra(a#9

• Suhu : -63;

• T%!!% Ba)a : 10 m

• B*ra$ : 0 (!



• Ma$a : &3'u!$%@a a*m%" 8/</96 "#*ra %($*r%( 8/</9

• a$u! : B I/II r*!u#ar mur%6 !a##3+ 8/96 murmur 8/9

• Th3ra> : SN 8<96 r3(h% 8/</96 h**C%! 8/</9

• A,)3m* : Tam+a( m*m,u%$ "*"ua% ma"a (*ham%#a6 $a

#%*a %!ra )a "$r%a* !ra@%)arum. B%"%! u"u" 896 y*r% $*(a

•

E("$r*m%$a" : Ta!a E)*ma /</6 (a(% *)*ma /</6 r**> "%3#3!

• r**> +a$3#3!%" 8/</96 A(ra# ha!a$ $a!a )a (a(% <

• G**$a#%a : L*)%r )arah 896 )arah 896 m*(3%um 8/9



PEMERIKSAAN $%STETRIK

•P*m*r%("aa Luar

• I"+*("%

• a'ah : h#3a"ma !ra@%)arum 8/9

• Payu)ara : +*m,*"ara 896 +u$%! "u"u m*3'3#6 a%ra )ar% +u$%!8/9

• A,)3m* : m*m,u%$ m*ma'a! #%*a %!ra 896 "$r%a* !ra@%)arum 89 "$r%a* #%@%)* 8/96 "$r%a* a#,%a" 8/9 ,

• Pa#+a"%

• TU : -2 m

• L*3+3#) I : T*ra,a ,u#a$6 #ua(6 )a $%)a( m*#*$%! 8,3(3!9.

• L*3+3#) II : T*ra,a ,a!%a m*ma'a! )a (*ra" )% "*,*#ah (%r% 8PU&I9

• L*3+3#) III : T*ra,a ,a!%a ,u#a$6 m*#*$%!6 )a (*ra" 8(*+a#a9

• L*3+3#) I : &*+a#a "u)ah ma"u( PAP

•



• D : 144 ><m*%$

• H%" : 89 -> )a#am 10 m*%$ "*#ama -0 )*$%(6 (ua$.

• P*m*r%("aa )a#am:

• P*m,u(aa : 10 m

• && : /

• Ea*m*$ : 100

•

P3r$%3 : $%)a( $*ra,a #a!% ,%,%r +3r$%3• H3)!* : I

• P3%$ 3? )%r*$%3 : UUB

• Pr*"*$a"% : (*+a#a



PEMERI&SAAN PENUNANG

• P*m*r%("aa La,3ra$ur%um $a!!a# +*r%("a 21 D*"*m,*r 2015

• HEMATOLOGI

• Darah ru$%

• H*m3!#3,% 1165 !<)L 8N: 1167 15659

• L*u(3"%$ 6 r%,u H 8N: -.00 11.0009

• H*ma$3(r%$ -- 8N: -0/4-9

•

Tr3m,3"%$ 1.000 8N: 150.000/440.0009• a($u +*r)araha<BT 46-0 m*%$ 8N: 1/-9

• a($u +*m,*(ua<;T 11.00 m*%$ 8N: 2/9

• GDS =0 m!<)#



DIAGNOSIS &ERA

• G1 P0 A0 27 $ahu ham%# 40 m%!!u

• D%"$3"%a &a#a II

• Par$u" E("$ra("% a(um



TINAUAN PUSTA&



PARTUS LAMA ATAU DISTOSIA

De&nisi

• P*r"a#%a ya! "u#%$ J )%$a)a% 3#*h $*r#a#u #am,a$ya (*ma'ua+*r"a#%aK )%maa +a)a ?a"* %+ar$u (a#a II $%)a( $*r'a)% (*ma'ua+*urua 'a% (*$%(a %,u m*!*'a.

E#i'emi"l"i

• u"%a 20 -5 $ahu: 7-66

• u"%a -5 $ahu 2-61

• u"%a 20 $ahu -6-



ETIOLOGI

•(akt"r kekuatan i)u•&*#a%a h%"

I*r"%a u$*r% : Pr%m*r : h%" ,%a"a6(3$ra

$*r#a#u #ama

S*(u)*r : h%" (ua$ u$u( a($u

#ama 8(*#*#aha 3$3$ u$*ru"9



• H%" ya! $*r#a#u (ua$ :

•P*r#u(aa +a)a 'a#a #ah%r

•Bay%: +*r)araha )a#am $*!(3ra

(ar*a ,a!%a $*r"*,u$ m*!a#a$*(aa (ua$ )a#am a($u y! "%



&*(ua$a u$*ru" ya! $%)a( $*r(33r)%a"%• T)( "%(r3%"a"% a$ara ,a!%a a$a"6 $*!a,aah )a+a$ m*!a(%,a$(a ra"a y*r% m*

•H%+3("%a 'a%

•&*#a%a m*!*'a•O$3$ )%)%! +*ru$ #*mah



•R**(" m*!*'a h%#a! 3#*h (ar*a +*m,*r%a a$au a*"$*"%

•&*#*#aha 83$3$ )%)%! +*ru$ m*'a)% #*mah9

•(akt"r *anin• 'a% ya! ,*"ar6 a)aya ma#+3"%"% )a ma#+r*"*(*#a%a #*$a( ,a!%a 'a%6 )%"$3"%a ,ahu6 ma#?3r)a (*ham%#a !a)a



•(akt"r *alan lahir

Dist"sia karena kelainan #anul

• &*"*m+%$a +%$u a$a" +a!!u#

• (3'u!a$a @*ra (ura! )ar% 10 m a$au )%am*$*r $ra"@*r"a (uram

• &*"*m+%$a +a!!u# $*!ah

• 'um#ah )%am*$*r %$*r"+%arum )%am*$*r "a!%$a#%" +3"$*r%3r 1-

• N 1065 5 m 1565 m



• &*"*m+%$a +%$u ,aah +a!!u#• D%"$a"%a %$*r$u,*rum m )%am*$*r "a!%$a# +3"$*r%3 15 m

• N 11 m 765 m 165



• (akt"r #en"l"n• Sa#ah +%m+%

• (akt"r #sik"l"is

• &*$a(u$a )a (**ma"a6 ma(a )%+*r#u(a AN; ya

u$u( )a+a$ m*#ah%r(a )*!a mu)ah.



EKSTRAKSI VAKUM

De&nisi• E("$ra("% @a(um a)a#ah "ua$u +*r"a#%a ,ua$a )%maa 'a%

)%#ah%r(a )*!a *("$ra("% $*a!a *!a$%? 8@a(um9 +a)a (*+aA#a$ %% )%ama(a *("$ra($3r @a(um a$au ventouse.



%ENTUK DAN %AGIAN+%AGIANEKSTRAKT$R VAKUM

•

1. Ma!(u( 8Cup9• Ba!%a ya! )%+a(a% u$u( m*m,ua$ (a+u$ "u("*)a*um ar$%"%a#%". D*!a ma

(*+a#a )%*("$ra("%. D%am*$*r ma!(u( : -64656 m. Pa)a )%)%! ,*#a(a! ma!$*r)a+a$ $3'3#a6 u$u( $a)a #*$a( )*3m%a$3r.

• 2. B3$3#

• T*m+a$ m*m,ua$ $*a!a *!a$%? 8@a(um9. Pa)a $u$u+ ,3$3# $*r)a+a$ ma3m*$*rm*u'u +3m+a +*!h%"a+6 )a "a#ura m*u'u (* ma!(u( ya! )%#*!(a+% )*!

• -. &ar*$ P*!hu,u!

• 4. Ra$a% P*!hu,u! A$ara Ma!(u( D*!a P*m*!a!

• 5. P*m*!a! 8extraction handle9

• . P3m+a P*!h%"a+ 8vacuum pump9.



I,u• U$u( m*m+*r+*)*( (a#a II6 m%"a#ya:

• P*ya(%$ +aru (3m+*"a$a

• P*ya(%$ +aru +aru ,r3$%• a($u: (a#a II y! m*ma'a!

• a% Gaa$ 'a%

K"ntrain'ikasi

• I,u•

Ru+$ur* u$*r% m*m,a(a$• Pa)a +*ya(%$ +*ya(%$ )% maa %,u "*ara mu$#a( $%)a( ,3#*h m*!*'a 8+ayah 'a$u!9.

• a%• L*$a( mu(a

• a% +r*$*rm



Syarat Ekstraksi Vakum

• P*m,u(aa #*!(a+ a$au ham+%r #*!(a+ 7

• P*urua (*+a#a 'a% ,3#*h +a)a h3)!* III

• Haru" a)a (3$ra("% rah%m )a a)a $*a!a +*!*'aa %,u ya$*r(33r)%a"%

• &*$u,a "u)ah +*ah<)%+*ah

• T%)a( a)a ;PD



Kriteria Ekstraksi Vakum Gaal

• a($u )%#a(u(a $ra("%6 ma!(u( $*r#*+a" "*,aya( - (a#%• T*a!a @a(um $*r#a#u r*)ah.

• T*(aa *!a$%? )%,ua$ $*r#a#u *+a$

• S*#a+u$ (*$u,a m*#*(a$ a$ara (u#%$ (*+a#a )a ma!(u(

• Ba!%a/,a!%a 'a#a #ah%r 8@a!%a6 "*r@%("9 a)a ya! $*r'*+%$ (* )a#am

• &*)ua $a!a (%r% )a $a!a (aa +*3#3! $%)a( ,*(*r'a "ama

• Tra("% $*r#a#u (ua$

• ;aa$ 8defect 9 +a)a a#a$



•

Da#am a($u "*$*!ah 'am )%#a(u(a $ra("%6 'a% $%)a( #ah%r.

• Pa)a "aa$ +*ar%(a u+ ya! "u)ah $*r+a"a! $*ra"a ,*ra$ )

a)a +*urua



Keunulan Ekstraksi Vakum'i)an'inkan Ekstraksi ,unam

• P*ma"a!a mu)ah

• Ma!(u( $%)a( m*am,ah ,*"aru(ura (*+a#a ya! haru"

m*#a#u% 'a#a #ah%r.

• Trauma +a)a (*+a#a 'a% #*,%h

r%!a.

Keruian Ekstraksi Vakum 'i)an'inkan Den

• P*r#u a($u ya! #*,%h #ama.

• P*m*#%haraaya #*,%h "u(ar6 (ar*a ,a!%a/,a$*r,ua$ )ar% (ar*$ )a haru" "*#a#u (*)a+ u)ara



DIS&USI



•

Par$u" Lama a$au )%"$3"%a )%)*%"%(a "*,a!a% +*r"a#%a ya)a )%$a)a% 3#*h $*r#a#u #am,a$ya (*ma'ua +*r"a#%a. Pa)a

)*!a u"%a 27 $ahu )*!a +ar%$a" 0 m*m+uya% r%"%(3 $%!

)%"$3"%a $*r#%ha$ )ar% )a$a ,*r%(u$: I"%)*" )%"$3"%a +a)a u"%a 2

$ahu "*,*"ar 7-66 u"%a -5 $ahu 2-61 )a u"%a 20 $a

-6-. Pa)a +ar%$a" 0 )*!a +*r"*$a"% "*,*"ar 4-626 +ar%$a

)*!a +*r"*$a"% "*,*"ar -56= )a +a)a +ar%$a" - )*!a+*r"*$a"% "*,*"ar 206=.



•

Dar% 4 ?a($3r ya! m*m+*!aruh% +r3"*" +*r"a#%a6 ya%$u +3*r6+a""*!*r6 +r3@%)*r<+"%(%" a(a )%'a,ar(a "*,a!a% ,*r%(u$:

• T*a!a a$au &*(ua$a 8+3*r9 : T%)a( )%)a+a$(a a)aya (*#a%a+a"%*. H%" ya! muu# u(u+ a)*(ua$6 ya%$u - (a#% )a#am 10 m*"*#ama -5 )*$%(. T%)a( )%)a+a$(a a)aya %*r"%a u$*r% ,a%( +r%m*mau+u "*(u)*r6 h%" ya! $*r#am+au (ua$6 a$au+u incoordinatecontraction.

• a% 8+a""a!*r9 : T%)a( )%)a+a$(a a)aya (*#a%a #*$a( 'a%6 'a%6 +r*"*$a"% 'a% )a ,*$u( 'a%.



•

a#a L%$a" 8+a""a!*9 : T%+* +a!!u# +a"%* a)a#ah $%+* !%*(3%)6 "*h%m*'a)% +*y*,a, +*r"a#%a #ama. S*)a!(a u$u( (*ur%!aa $*rh)a+a$ )%"%!(%r(a (ar*a (*+a#a "u)ah $uru h%!!a h3)!* III6 ya!m*a)a(a ,aha +%$u a$a" )a +%$u $*!ah +a!!u# $%)a( "*m+%$S*)a!(a u$u( +%$u ,aah +a!!u# 'u!a 3rma#6 (ar*a aru" +u,"*h%!!a (*#a%a +a)a 'a#a #ah%r )a+a$ )%"%!(%r(a.

• P"%(%" : +*r"%a+a "%( u$u( m*#ah%r(a6 )u(u!a 3ra! $*r)*(a$ )a%$r*!%$a" *m3"%3a# "u)ah u(u+ ,a%( +a)a +a"%* %%. S*#a% (ar*a (

,%"a 'u!a )%+*!aruh% 3#*h ?a($3r +*3#3! 8+r3@%)*r9 : +%m+%a ya! Da#am ha# %% +r3@%)*r "u)ah m*m%m+% +*r"a#%a +a)a "aa$ $*ra+a%+*m,u(aa #*!(a+ m*"(%+u ,*#um )%)a+a$(aya )3ra6 $*(u"6 +*



U$u( +*a$a#a("aaa +a"%* )*!a +ar$u" +a)a (a"u" )% a$a"6 $%)a(a ya! )%#ya%$u:

• A$%,%3$%( : I'. ;*?3$a>%m* 1 !r

• E("$ra("% @a(um6 (ar*a "yara$/"yara$ @a(um $*r+*uh%.

• P*m,u(aa #*!(a+ a$au ham+%r #*!(a+ 7

• P*urua (*+a#a 'a% ,3#*h +a)a h3)!* III

• Haru" a)a (3$ra("% rah%m )a a)a $*a!a +*!*'aa %,u ya! $*r(33r)%a"%

• &*$u,a "u)ah +*ah<)%+*ah

• T%)a( a)a ;PD



•

S*$*#ah )%,*r%(a a$%,%3$%(6 "*#a'u$ya )%#a(u(a *("$ra("% @aS*+u#uh m*%$ "*$*#ah )%#a(u(a *("$ra("% @a(um6 #ah%r ,ay%

+*r*m+ua6 BBL: -200 !ram.

• S*$*#ah ,ay% #ah%r6 )%%(u$% )*!a #ah%rya +#a"*$a. P#a"*$a #a

"+3$a6 (*"a #*!(a+. Namu -0 m*%$ +3"$+ar$um6 "aa$ )%*

(*m,a#%6 $am+a( +*r)araha 506 )*!a $%!!% ?u)u" u$*

a$a" um,%#%(u". N3rma#ya "*$*#ah 'a% )%#ah%r(a ?u)u" u$*r

"*$%!!% +u"a$K "*!*ra "*$*#ah +#a"*$a #ah%r6 $%!!% ?u)u" u$*

'ar% )% ,aah +u"a$.. S*$*#ah )%raa$ "*#ama 2 har%6 (*a)aa u

,ay% )a %,u m*m,a%(6 (*mu)%a )%+*r,3#*h(a +u#a!.

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