Laporan Pendahuluan Antenatal Care (Anc)

LAPORAN PENDAHULUAN ASUHAN KEPERAWATAN PADA KLIEN  ANTENATAL CARE (ANC) DENGAN ANTENATAL DIRUANG POLI KANDUNGAN RSUD. DR. H. MOCH. ANSARI SALEH BANJARMASIN

Tanggal 11-13 Jl! "#1$

Ol%& ' Anna Mal!na Mal !na Kan!% K an!% * S.K%+ S.K %+ NIM I,B11"#31

PROGRAM STUDI ILMU KEPERAWATAN AKULTAS KEDOKTERAN UNIERSITAS LAMBUNG MANGKURAT "#1$

LEMBAR PENGESAHAN

 NAMA  NIM JUDUL LP

: : :

Anna Maulina Kustantie, S.Kep I4B112031 I4B112031 Asuhan Kepea!atan pa"a Klien "en#an Antenatal Antenatal Care $AN%& "i uan# p'li (an"un#an )SUD. D. *. M'+h. Ansai Saleh Bana-asin

Bana-asin, Juli 201

Men#etahui, Pe-/i-/in# A(a"e-i(

Pe-/i-/in# Lahan

-a"aanti, S.Kep., Ns  NIP.1  NIP .10321 0321 201101 201101 2 012 012

A. D%/!n!!

Asuhan antenatal a"alah suatu p'#a- teen+ana /eupa '/se5asi, e"u(asi, "an  penan#anan -e"i+ pa"a i/u ha-il, untu( -e-pe'leh suatu p'ses (eha-ilan "an  pesalinan an# a-an "an -e-uas(an. Asuhan antenatal a"alah pen#a!asan teha"ap (eha-ilan untu( -en"apat(an in6'-asi -en#enai (esehatan u-u- i/u, -ene#a((an se+aa "ini penua(it an# -enetai (eha-ilan, -ene#a((an se+aa "ini ('-pli(asi (eha-ilan, "an -enetap(an esi(' (eha-ilan $esi(' tin##i, esi(' -ea#u(an, esi(' en"ah&. Asuhan antenatal  u#a untu( -e-pesiap(an pesalinan -enuu (elahian /ai an# /ai( $!eel /'n  /a/& "an (esehatan i/u an# /ai( $!ell health -'the&, -e-pesiap(an pe-elihaaan  /ai "an la(tasi, -e-6asilitasi pulihna (esehatan i/u an# 'pti-al pa"a saat a(hi (ala ni6as.

B. T0an

Menuut /u(u Matenal "an Ne'natal, $Sai6u"in A/"ul Bai, 2002:&, tuuan Ante Natal Care $AN%& a"alah: 1. Me-antau (e-auan (eha-ilan untu( -e-asti(an (esehatan i/u "an tu-/uh (e-/an# /ai. 2. Menin#(at(an "an -e-petahan(an (esehatan 6isi(, -ental "an s'sial i/u "an  /ai. 3. Men#enali se+aa "ii a"ana (eti"a(n'-alan atau ('-pli(asi an# -un#(in tea"i sela-a ha-il, te-asu( i!aat pena(it se+aa u-u-, (e/i"anan "an  pe-/e"ahan. 4. Me-pesiap(an pesalinan +u(up /ulan, -elahi(an "en#an sela-at, i/u -aupun /aina "en#an tau-a se-ini-al -un#(in. 7. Me-pesiap(an i/u a#a -asa ni6as /ealan n'-al "an pe-/eian ASI e(s(lusi6. . Me-pesiap(an pean i/u "an (elua#a "ala- -enei-a (elahian /ai a#a  "apat tu-/uh (e-/an# se+aa n'-al

C. P2% %&a4!lan a. 8etilisasi

9aitu /ete-una sel telu "an sel spe-a. e-pat /ete-una '5u- "an spe-a palin# sein# a"alah "i"aea# a-pulla tu/a. Se/elu- (e"uana  /ete-u, -a(a a(an tea"i 3 6ase aitu: 1. ahap pene-/usan (''na a"iate: Dai 200 ; 300 uta hana 300 ; 700 an# sa-pai "i tu/a 6all'pi an# /isa -ene-/us (''na a"iata (aena su"ah -en#ala-i p'ses (apasitasi. 2. Pene-/usan <'na pellusi"a: Spe-at'<'a lain tenata /isa -ene-pel "i<'na pellusi"a, tetapi hana satu telihat -a-pu -ene-/us ''sit. 3. ahap penatuan ''sit "an -e-/an sel spe-a: Setelah -enatu -a(a a(an "ihasil(an la(i&  /. Pe-/elahan Setelah itu
a(hina -en#hilan# sehin##a t'6'/last /isa -asu( 

en"'-etiu- "an siap /ei-plantasi $7 ;  hai& "ala- /entu( /last'(ista tin#(at lanut. +. Ni"asi ? i-plantasi 9aitu penana-an sel telu an# su"ah "i/uahi $pa"a sta"iu- /last'(ista& (e"ala- "in"in# uteus pa"a a!al (eha-ilan. Biasana tea"i pa"a pas supei' ('pus utei /a#ian antei'?p'stei'. Pa"a saat i-plantasi selaput len"i ahi- se"an# /ea"a pa"a 6ase se(et'i( $ 2 ; 3 hai setelah '5ulasi&. Pa"a saat ini, (elena ahi- "an pe-/uluh na"i -ena"i /e(el'( ; (el'(. Jain#an ini -en#an"un# /ana( +aian. ". Petu-/uhan "an Pe(e-/an#an -/i' 1. Masa pe e-/'ni+: Belan#sun# sela-a 2 -in##u sesu"ah tea"ina 6etilisasi tea"i p'ses pe-/elahan sa-pai "en#an ni"asi. Ke-u"ian

 /a#ian inne +ell -ass a(an -e-/entu( 3 lapisan uta-a aitu e(st'"e-, en"'"e- seta -es'"e-. 2. Masa e-/'ni+: Belan#sun# sea( 2 ;  -in##u siste- uta-a "i"alatu/uh telah a"a "i"ala- /entu( u"i-ente. Jantun# -en'n'l "ai tu/uh "an -ulai /e"enut. Sein#(ali "ise/ut -asa '#an'#enesis? -asa  pe-/entu(an '#an. 3. Masa 6etal: Belan#sun# setelah 2 -in##u (e> sa-pai "en#an /ai lahi. D. P%5a&an /!!2l2g! +a6a !5 &a4!l 1. Uteus a. U(uan: (aena hipet'pi "an hpeplasia 't't p'l's ahi- 30  27  20 +-

"en#an (apasitas 400 ++ $pa"a (ela-in +u(up /ulan&. 5. Beat: "ai 30 # ; 1000 #. 7. Bentu( "an ('nsistensi: /ulan peta-a sepeti alpu(at, usia 4 /ulan  /e/entu( /ulat, a(hi (eha-ilan /e/entu( /uu telu. 6. P'sisi: a!al ante6le(si?et'6le(si, 4 /ulan /ea"a pa"a 'n##a pel5is, a(hi  'n##a peut sa-pai hati. %. Se5i(s: -ena"i luna( an# "ise/ut tan"a /''"ellC ". In"un# telu $5aiu-& a. 5ulasi tehenti. 5. Masih te"apat ('pus luteu- #a5i"as sa-pai te/entu(na ui. 3. Ea#ina "an Eul5a a. Ea#ina "an 5ul5a telihat le/ih -eah "an (e/iuan. 5. Fana lipi" pa"a 5a#ina "an p'ti' se5i(s "ise/ut tan"a Chadwick C, hipe5as(ulaisasi. Peu/ahan an# tea"i u#a tea"i pa"a '#an "an siste- laina, sepeti: 1. Siste- Si(ulasi Daah a. E'lu-e "aah: tea"i penin#(atan pa"a 5'lu-e "aah "an plas-a.  /. P'tein "aah: u-lah p'tein "an al/u-in -enuun, pa"a ti-este 1 se+aa  /etahap -enin#(at sa-pai a(hi (eha-ilan. +. *itun# enis "an */: *t -enuun (aena 5'lu-e plas-a "aah eit'sit -enin#(at untu( (e/utuhan '(si#en. ". Na"i "an D: D -enuun, na"i -enin#(at ata>ata 4?-enit. e. Jantun#: p'-pa antun# -enin#(at pa"a ti-este 1 sa-pai -enuun pa"a -in##u tea(hi, KG (a"an# -e-pelihat(an "e5iasi a(sis (e (ii. 2. Siste- Pena6asan a. Sesa( "an napas pen"e( sa-pai usus tete(an (e aah "ia6a#-a a(i/at  pe-/esaan ahi-.  /. Kapasitas 5ital pau -enin#(at. +. Na6as "ala- "an an# le/ih -en'n'l pena6asan "a"a. 3. Siste- Pen+enaan

a. Sali5a -enin#(at, -ual "an -untah.  /. 'nus 't't saluan pen+enaan -enuun sehin##a -'tilitas. +. Muntah $e-esis #a5i"au-& pa"a pa#i hai $morning sickness&. 4. ulan# "an Gi#i a. Sen"i pan##ul teasa le/ih l'n##a sa-pai li#a-ent "an -eluna(.  /. Kalsiu- -atenal pa"a tulan# panan# -enuun untu( -e-enuhi (e/utuhan 7.

.

.

.

(alsiu- anin. Kulit ea"i hipepi#-entasi pa"a: a. Mu(a: +l'as-a #a5i".  /. Pau"aa: putin# susu "an ae'la pau"aa. +. Peut: linea ni#a. Kelena n"'(in a. Kelena ti'i": "apat -e-/esa se"i(it.  /. Kelena hip'6ise: "apat -e-/esa teuta-a l'/us antei'. +. Kelena a"enal: ti"a( satu /epen#auh $>&. Pau"aa a. Pau"aa /eta-/ah /esa, te#an# "an /eat.  /. Dapat tea/a n'"uli>n'"uli a(i/at hipet'6i (elena al5e'li. +. Baan#an 5ena le/ih -e-/iu. ". Kalau "ipeas (elua ('l'stu- /e!ana (unin#. Meta/'lis-e a. BM) -enin#(at 17 ; 20H teuta-a ti-este (eti#a.  /. Ke/utuhan p'tein -enin#(at untu( petu-/uhan 6etus, pau"aa. +. Sein# haus, na6su -a(an (uat, sein# (en+in#. ". K'leste'l -ein#(at (aena s'-at't''pin -e-/entu( le-a(. e. BB /u-il -enin#(at ,7 ; 1 (# "ise/a/(an 'leh: anin, ui, ai (etu/an, uteus, pau"aa, "aah, le-a(, p'tein, etensi uine.

E. Man!/%a! Kl!n! K%&a4!lan ". an"a pesu-si a.  Su/e(ti6: A-en'hea: Dapat "ise/a/(an 'leh: #an##uan en"'(in, a/n'-alitas •

siste- saa6, pena(it in6e(si, ane-ia, '/stu(si se5i(al, atau (ete#an#an • •

e-'si Kele-ahan?"an (eletihan, "apat "ia(i/at(an (aena ane-ia atau in6e(si. Mual "an -untah $-'nin# si+(ness&: Meupa(an esp'n a!al tu/uh teha"ap tin##ina (a"a p'#este'n, "apat "ise/a/(an (aena #an##uan  pa"a saluan +ena atau ale#i. ea"i antaa -in##u (e>2> "an -en#hilan# pa"a -in##u (e>12. Peu/ahan pau"aa: easa penuh "an nei, hipepi#-entasi ae'la -a--ae, peu/ahan nipple, se(esi ('l'stu-, pele/aan 5ena.

Penin#(atan se(esi /e(e-ih: K'n#esti "aah pa"a '#an>'#an pel5i(  -enin#(at(an sensiti5itas ain#an, te(anan (aena pe-/esaan uteus -ensti-ulasi saa6 "an -enti##e (ein#inan untu( /e(e-ih sela-a ha-il. Dapat pula "ise/a/(an 'leh pena(it in6e(si saluan (en+in#, tau-a "an petu-/uhan tu-' 5esi(a uinaia. Peu/ahan -''": letih, pusin#, sa(it (epala. Leu('ea ui+(enin#: Sensasi a"ana #ea(an "apat "iasa(an pa"a -in##u (e> 22 pa"a pi-ipaa "an -in##u (e>20 pa"a -ultipaa.  /. /e(ti6 $p'/a/ilitas& Peu/ahan 6isi'l'#i "an anat'-i • Penin#(atan te-peatu /asal tu/uh $/asal /'" te-peatue& • Peu/ahan (ulit: Stiae #a5i"au- "an pi#-entasi $(l'as-a, linea ni#a& • Peu/ahan pau"aa • Pe-/esaan a/"'-en • Peu/ahan ahi- "an 5a#ina • 3. an"a (e-un#(inan ha-il Meupa(an tan"a>tan"a an# "apat "i'/se5asi 'leh pe-ei(sa. Bila "i#a/un# "en#an tan"a "an #eala pesu-si, -a(a tan"a (e-un#(inan -e-/ei "u#aan (uat a"ana (eha-ilan. an"ana -eliputi: Pe-/esaan )ahi• Utein sh'u66le a"alah #'an#an, "esian na"i an# te"en#a "i atas • • •

uteus i/u ha-il. K'nta(si Bat'n *i+(s Ball'te-ent: pantulan an# tea"i (eti(a /ai pe-ei(sa -en#etu( anin an# -en#apun# "ala- uteus, -ene/a/(an anin /eenan# -enauh "an

(e-u"ian (e-u"ian (e-/ali (e p'sisina se-ula. *e#a si#n: -eluna(na se#-en /a!ah )ahi• G''"ell si#n : -eluna(na se5i(s. • est (eha-ilan p'siti6. • 4. an"a p'siti6 (eha-ilan $a/s'lut& elihat /entu( tu/uh anin -elalui USG "an an#(a anin pa"a =>)a • e"en#a "eta( antun# anin • ea/a /a#ian>/a#ian anin • ea/a #ea(an anin. • . San6a +%la8anan an%naal Pelaanan antenatal -en#a+u pa"a ('nsep  aitu: 1. i-/an# /a"an "an u(u /a"an, tuuanna a"lah untu( -en#etahui sesuai

ti"a(na /eat /a"an i/u. Pe-ei(saan /eat /a"an "ila(u(an setiap /e(unun# (e te-pat pelaanan (esehatan. Sela-a ti!ulan I /eat /a"an i/u haus nai( 0,7

sa-pai "en#an 0,7 (# setiap /ulan, pa"a ti!ulan (eti#a haus nai( 0,27 (# setiap -in##una. Dan pa"a tise-este III /eat /a"an i/u haus nai( se(ita  0,7 (# setiap -in##una, atau se+aa u-u- /eat /a"an -enin#(at se(ita  (# sela-a (eha-ilan. 2. U(u te(anan "aah. uuanna untu( -en"ete(si apa(ah te(anan "aah n'-al atau ti"a(. Pe-ei(saan ini u#a "ila(u(an pa"a setiap (unun#an. e(anan "aah an# tin##i "apat -e-/uat i/u (ea+unan (eha-ilan, /ai( in#an -aupun  /eat /ah(an sa-pai (ean#>(ean#. Se-entaa te(anan "aah an# en"ah -ene/a/(n pusin# "an le-ah. 3. S(inin status i-unisasi etanus ''i" $&. uuanna untu( -elin"un#i i/u "an /ai an# "ilahi(an nanti "ai tenanus ne'nat'u-. I-unisasi  "i/ei(an  pa"a (unun#an antenatal I, 2 "e/ei(an e-pat -in##u setelah 1, 3 "i/ei(an setelah ena- /ulan 2, 4 "i/ei(an 1 ahun setelah 3, "an 7 "i/ei(an setelah setahun 4 4. U(u tin##i 6un"us utei. uuanna untu( -elihat pe-/esaan ahi-, "ila(u(an "en#an +ea -ea/a peut "ai lua, selain itu untu( -en#etahui pesentasi anin, seta -en#etahui p'sisi anin "ala- ahi-. Pa"a pe-ei(saan ini u#a "ila(u(an  pn#u(uan tin##i pun+a( ahi- untu( (e-u"ian "isesuai(an "en#an u-u  (eha-ilan. Ji(a "ipe'leh /esana ahi- ti"a( sesuai "en#an u-u (eha-ilan -a(a "ien+ana(an pe-ei(saan lanutan. 7. Pe-/eian ta/let /esi $0 a/let& sela-a (eha-ilan. Pe-/eian ta/let /esi "i/ei(an sesuai "en#an (e/ia(an nasi'nal an# /ela(u "iseluuh pus(es-as "i In"'nesia. Pe-/eian satu ta/let /esi sehai sese#ea -un#(in setelah asa -ual hilan# pa"a a!al (eha-ilan . e-u !i+aa? pe-/eian ('-uni(asi intepes'nal atau ('nselin#. Untu(  -en#hin"ai (esalahan penan#anan (eha-ilan, ('-uni(asi "en#an sua-i "an (elua#a

"ipelu(an

#unan

-e-pesiap(an

uu(an

nantina.

Den#an

-anae-en uu(an an# /ena, +epat, "an tepat -a(a i/u "an anin a(an -e-pe'leh pelaanan pesalinan "an (elahian an# /ena sehin##a -e-/antu -enuun(an an#(a (e-atian i/u "an /ai. P'#a- ini le/ih "iuta-a(an pa"a te-pat pelaanan (esehatan tepen+il "an auh "ai a(ses tans6'tasi an# -e-a"ai . est la/'at'iu- se"ehana $*/,P'tein, "an Uine& /e"asa(an in"i(asi $*/sA#, si6ilis, *IE, -alaia, tu/e(ul'sis pau $B%& , PMS&. Fanita an#

se"an# ha-il -eupa(an (el'-p'( "en#an isi(' tin##i teha"ap pena(it -enula se(sual an# "apat -eni-/ul(an (e-atian pa"a i/u "an anin an# "i(an"un#na. G. Ja69al n0ngan !5 &a4!l

Ja"!al (unun#an haus le/ih (etat. Na-un, /ila (eha-ilan n'-al a"ual asuhan +u(up e-pat (ali $K1, K2, K3 "an K4&. 1. Kunun#an i/u ha-il Kl: Kunun#an /au i/u ha-il a"alah (unun#an i/u ha-il an# peta-a (ali pa"a -asa (eha-ilan. Ana-nesis len#(ap, pe-ei(saan 6isi(   '/steti, Pe-ei(saan la/., Ant'p'-eti, penilaian esi(' (eha-ilan, KI. 2. Kunun#an II? Kunun#an ulan# $2 ; 32 pe(an&: Kunun#an ulan# a"alah ('nta( i/u ha-il "en#an tena#a (esehatan an# (e"ua "an seteusna, untu(  -en"apat(an pelaanan antenatal sesuai "en#an stan"a sela-a satu pei'"e (eha-ilan /elan#sun#. Ana-nesis, USG, Penilaian esi(' (eha-ilan, Nasehat  pea!atan pau"aa  Sena- ha-il&,  I 3. Kunun#an III $ 34 pe(an&: Ana-nesis, pe-ei(saan ulan# la/.  II 4. K4 $Kunun#an 4&: Ana-nesis, pea!atan pau"aa 

pesiapan

 pesalinan kecuali i(a "ite-u(an (elainan ? 6a(t' isi(' an# -e-elu(an  penatala(sanaan -e"i( lain, pe-ei(saan haus le/ih sein# "an intensi6. K4 a"alah ('nta( i/u ha-il "en#an tena#a (esehatan an# (e e-pat atau le/ih untu( -en"apat(an pelaanan Ante Natal Care $AN%& sesuai stan"a an# "itetap(an "en#an saat: a. Satu (ali "ala- ti-este peta-a $se/elu- 14 -in##u&.  /. Satu (ali "ala- ti-este (e"ua $antaa -in##u 14>2& +. Dua (ali "ala- ti-este (eti#a $antaa -in##u 2>3 "an setelah -in##u (e 3&. ". Pe-ei(saan (husus /ila te"apat (eluhan>(eluhan tetentu

H. K%l&an +a6a Maa K%&a4!lan

Keluhan pa"a -asa ha-il a"alah suatu ('n"isi /esi6at su/e(ti6 "i-ana pa"a in"i5i"u an# ha-il tea"i p'ses a"aptasi teha"ap (eha-ilanna $Dep(es )I, 14&. Keluhan>(eluhan tese/ut "apat "iuai(an se/a#ai /ei(ut: 1. Keluhan pa"a ti!ulan I $usia (eha-ilan 1 ; 3 /ulan&

a. Mual "an -untah : euta-a tea"i pa"a pa#i hai "an a(an hilan# -enelan#

ten#ah hai $-'nin# si+(ness&. 5. Peasaan ne# atau -ual: euta-a /ila -en+iu- /au an# -enen#at. 7. Pusin# teuta-a /ila a(an /an#un "ai ti"u, hal ini tea"i (aena a"ana #an##uan (esei-/an#an, peut ('s'n#. 6. Sein# (en+in#: Kaena te(anan uteus an# -e-/esa "an -ene(an pa"a (an"un# (en+in#. %. Keputihan $le('ea&: Pen#auh penin#(atan h'-'n (eha-ilan $est'#en "an  p'#este'n& an# -e-pen#auhi -u('sa se5i(s "an 5a#ina. /. Pen#eluaan "aah pe5a#ina-: Bila tea"i pe"aahan pe5a#ina- pelu "i!aspa"ai a"ana a/'tus. g. Peut -e-/esa. &. Psi('l'#is: Peasaan #e-/ia

"en#an

penei-aan

(eha-ilan

a(an

-e-pen#auhi penei-aan i/u teha"ap (elainan>(elainan an# ti-/ul. Se/ali(na (aena -en'la( (eha-ilan, (eluhan tese/ut -eni-/ul(an as a ti"a(  na-an "an -eni-/ul(an antipati teha"ap (eha-ilanna. Pa"a -asa ini sein# ti-/ul('n6li( (aena pen#ala-an /au, sehin##a i/u ha-il pelu -en"apat(an 2.

 pehatian "an "u(un#an sua-i. Keluhan pa"a ti!ulan II $usia (eha-ilan 4 ;  /ulan&. Pa"a -asa ini (eluhan an# /esi6at su/e(ti6 su"ah /ea(hi, sehin##a /ila a"a i/u ha-il -asih -en"apat(an (eluhan sepeti pa"a ti-este I, pelu "i!aspa"ai (e-un#(inan a"ana 6a(t' psi('l'#is. Pa"a ti!ulan ini sein# "itan"ai a"ana a"aptasi i/u teha"ap (eha-ilanna,  peasaan i/u +en"eun# le/ih sta/il, (aena (eluhan an# tea"i pa"a ti!ulan I su"ah tele!ati. I/u -easa(an pen#ala-an /au, -ulai -eassa(an #ea(an  /ai, te"en#ana DJJ, -elalui alat "'pt'ne atau -elihat #a-/a?p'sisi -elalui  pe-ei(saan USG. i!ulan II u#a "i(ata(an 6ase a-an untu( (eha-ilan,

sehin##a a(ti6itas i/u "apat /ealan tanpa #an##uan /eati. 3. Keluhan pa"a ti!ulan III $usia (eha-ilan  ;  /ulan&. Kea"ian an# sein# ti-/ul antaa lain: a. Pusin# "isetai pan"an#an /e(unan#>(unan#. *al ini "apat -enunu((an (e-un#(inan tea"i ane-ia "en#an */  10 #H.  /. Pan"an#an -ata (a/u "isetai pusin#. *al ini "apat "i#una(an uu(an (e-un#(inan a"ana hipetensi. +. Ka(i e"e-a. "e-a pa"a (a(i pelu "i+ui#ai (aena se/a#ai salah satu #eala "ai tias (lasi( e(la-si. Sesa( napas pa"a ti!ulan III pelu "i+ui#ai (e-un#(inan a"ana (elainan leta( $sun#san#&.

". Pe"aahan. Pa"a ti!ulan III /isa tea"i pe"aahan pe5a#ina- pelu "i+ui#ai a"ana pla+enta pae5ia atau s'lusi' plasenta. e. Kelua +aian "i te-pat ti"u pa"a sian# atau -ala- hai, /u(an pa"a saat (en+in#, pelu "i!aspa"ai a"ana (etu/an pe+ah "ini. 6. Sein# (en+in#. A(i/at pene(anan pa"a (an"un# (en+in# a(i/at -asu(na (epala (e pintu atas pan##ul. #. Psi('l'#is: Ke#e-/iaan i/u (aena a(an lahina se'an# /ai. I. K24+l!a! %5aga! a!5a langng %&a4!lan 1. *ipee-isis #a5i"au2. *ipetensi "ala- (eha-ilan 3. Pe"aahan ti-este I $a/'tus& 4. Pe"aahan antepatu7. Keha-ilan e(t'pi(  . Keha-ilan (e-/a  . M'lah"ati"'sa . In('-pati/ilitas "aah . Kelainan "ala- la-ana (eha-ilan 10. Pena(it seta (elainan plasenta "an selaput anin. J. P%4%!aan an%naal 7a% 1.  pe-ei(saan la/'at'iu-. U-u-na pe-ei(saan an# "ipa(ai aitu tes

untu( -en"ete(si (e/ea"aan h%G. *u-an %h'i'ni+ G'na"'t'pin $*%G& "apat "iu(u "en#an a"i'i-un'esai "an "ete(si "ala- "aah ena- hai setelah ('nsepsi atau se(ita 20 hai sea( pei'"e -enstuasi tea(hi. Ke/ea"aan h'-'ne ini "ala- uin pa"a (eha-ilan -eupa(an "asa "ai  /e/a#ai tes (eha-ilan "i /e/a#ai la/'at'iu- "an (a"an#>(a"an# "apat "i"ete(su "ala- uine 14 hai setelah ('nsepsi. 2. Den#an PP a"alah ta(sian pe(iaan patus. PP  t#l *P*   ; 3 /ulan *P*  1 tahun *P*  

Atau PP  t#l *P*     /ulan "ai *P* 3. Menentu(an usia (eha-ilan "ila(u(an -anu5e Le'p'l": a. Le'p'l" I: Untu( -ene-u(an pesentasi "en#an +aa -en#i"enti6i(asi  /a#ian tu/uh 6etus apa an# /ea"a "i 6un"us "an "aeah pel5i(. %aana: Men#ha"ap (e (epala pasien, #una(an ai>ai (e"ua tan#an -e-palpasi 6un"us utei. Ji(a (epala an# /ea"a "i 6un"us -a(a a(an teassa (eas, /ulat "an -elentin#. Ji(a /'('n# tea/a "i 6un"us, -a(a a(an teasa le-/ut, ti"a( /ulat "an #ea(an (uan#.

 /. Le'p'l" II: Untu( -ene-u(an p'sisi anin $pun##un# anin&. %aana: Men#ha"ap pa"a (epala pasien, leta((an (e"ua tan#an pa"a (e"ua sisi a/"'-en. Leta((an tan#an pa"a satu sisi "an tan#an lain -e-palpasi sisi an# /e/e"a untu( -ene-u(an /a#ian pun##un# anin. Ji(a pun##un# a(an tea/a +e-/un# "an esisten. +. Le'p'l" III: Untu( -en#i"enti6i(asi /a#ian apa "ai anin an# "e(at "en#an "aeah pel5i(. %aana: Leta((an 3 ai peta-a tan#an an# "'-inan pa"a sisi a/"'-en "i atas si-pisis pu/is "an -inta pasien -enai(

napas

panan#

"an

-en#he-/us(anna.

Pa"a

saat

-en#elua(an napas, #ea((an tan#an tuun pelahan "an -ene(an se(ita "aeah tese/ut. Ji(a (epala a(an tea/a (eas, /ulat, "an /e#ea(   i(a "isentuh. Ji(a /'('n# a(an tea/a le-/ut "an ti"a( /eatuan. ". Le'p'l" IE: Untu( -en#i"enti6i(asi /a#ian an# -en'n'l "ai /a#ian teen"ah anin -asu( (e pintu atas pan##ul. %aana: Men#ha"ap (e (a(i pasien "en#an le-/ut #ea(an tan#an tuun (e sisi a/"'-en -en"e(ati pel5is sa-pai salah satu tan#an -easa(an /a#ian tulan# an# ti-/ul. A"a 3 (ea"aan aitu: K'n5e#en aitu i(a /a#ian an# -asu(   /au se/a#ian (e+il, seaa aitu i(a /a#ian an# -asu( /au seten#ah, "i5e#en aitu i(a ha-pi se/a#ian /esa "ai tu/uh anin -asu( (e "ala- 'n##a pan##ul. 4. Pe-ei(saan pan##ul lua  uuan : a. Men#etahui pan##ul sese'an# n'-al atau ti"a(   /. Me-u"ah(an "ala- -en#a-/il tin"a(an selanutna +. Men#etahui /entu( atau (ea"aan pan##ul sese'an#. Pe-ei(saan pan##ul "ila(u(an: a. Pa"a pe-ei(saan peta-a (ali /a#i i/u ha-il.  /. Pa"a i/u an# penah -elahi(an /ila a"a (elainan pa"a pesalinan an# lalu. +. I/u an# a(an /esalin /ila se/elu-na /elu- penah -e-ei(sa(an "ii teuta-a pa"a pi-ipaa. U(uan>u(uan lua an# tepentin#: a. Distansia spinau- : aa( antaa spina illia(a antei' supei' (anan "an (ii $ n'-al: 23>2 +-&.  /. Distansia +istau- : aa( an# tepanan# antaa +ista illia+a (anan "an (ii $n'-al: 2>2&.

+. %'nu#ata e(stena : $B'u"el'+ue& : aa( antaa pin##i atas si-pisis "an uun# p'sessus spin'sus $uas tulan# lu-/al (e li-a& $n'-al: 10> 20 +-&. ". Lin#(a pan##ul : aa( "ai pin##i atas si-pisis -elalui spina illia+a antei' supei' (anan (e peten#ahan t'+hante -a' (anan (e  peten#ahan t'+hante -a' (ii (e peten#ahan spina illia+a antei'  supei' (ii (e-u"ian (e-/ali (e atas si-pisis $n'-al : 0>0 +-&. K. A&an K%+%a9aan An%naal 1. P%nga0!an P%naal a. A(ti5itas "an Istiahat, e(anan "aah a#a( le/ih en"ah "aipa"a n'-al $ ; 12 -in##u& (e-/ali pa"a tin#(at pa (eha-ilan sela-a seten#ah (eha-ilan tea(hi. Denut na"i "apat -enin#(at 10 ; 17 DPM. Mu-u sist'li( pen"e( "apat tea"i sa-pai "en#an  penin#(atan 5'lu-e epis'"e sin#('pe. Eaises. Se"i(it e"e-a e(ste-itas /a!ah?tan#an -un#(in a"a $teuta-a pa"a tise-este  a(hi&  /. Inte#itas #': Menunu((an peu/ahan pesepsi "ii +. li-inasi: Peu/ahan pa"a ('nsistensi ? 6e(uensi "e6e(asi, Penin#(atan 6e(uensi pe(e-ihan, Uinalisis: Penin#(atan /eat  enis, *e-''i" ". Ma(anan?%aian: Mual "an -untah, teuta-a tise-este peta-aO nei ulu hati u-u- tea"i, Pena-/ahan /eat /a"an: 2 sa-pai 4 l/ tise-este peta-a, tise-este (e"ua "an (eti#a -asin#>-asin# 11  ; 12 l/, Me-/an -u('sa (ein#: hipet'pi ain#an #usi "apat tea"i -u"ah /e"aah, */ "an *t en"ah -un#(in "ite-ui $ane-ia 6isi'l'#is&, Se"i(it e"e-a "epen"en, Se"i(it #li('suia -un#(in a"a, Diastasis e+ti $sepaasi 't't e(tus& "apat tea"i pa"a a(hi  (eha-ilan. e. Nei "an Kena-anan: Ka- (a(iO nei te(an "an /en#(a( pa"a  pau"aaO ('nta(si Bat'n *i+(s telihat setelah 2 -in##uO nei  pun##un# 6. Penapasan: *i"un# tesu-/atO -u('sa le/ih -eah "aipa"a n'-al,

8e(uensi

penapasan

"apat

-enin#(at

teha"ap

u(uan?tin##iO penapasan t'a(al. #. Kea-anan: Suhu tu/uh  ; ,7 8 $3,1 ; 3, %&, Ia-a Jantun# Janin $IJJ& te"en#a "en#an D'pt'ne $-ulai 10 ; 12 -in##u& atau

6et's('p $1 > 20 -in##u&, Gea(an anin teasa pa"a pe-ei(saan setelah 20 -in##u. Sensasi #ea(an anin pa"a a/"'-en "iantaa 1 "an 20 -in##u, Ball'tte-ent a"a pa"a /ulan (ee-pat "an (eli-a. h. Se(sualitas: Pen#hentian -enstuasi, Peu/ahan esp'n ?a(ti5itas se(sual, Leu('sa -un#(in a"a, Penin#(atan p'#esi6 pa"a uteus -is: 8un"us a"a "i atas si-6isis pu/is $pa"a 10 ; 12 -in##u& pa"a u-/ili('lis $pa"a 20 ; 30 -in##u& a#a( (e /a!ah (atila#' ensi6'$pa"a 3 -in##u&, Peu/ahan pau"aa: pe-/esaan ain#an a"ip'sa, penin#(atan 5as(ulaitas luna( /ila "ipalpasi, penin#(atan "ia-ete

"an

pi#-entasi

ain#an a+'la,

hipet'6i

t/e(el

-'nt#e-e, sensasi (ese-utan $tise-este peta-a "an (eti#a&O (e-un#(inan stial #a5i"au- ('l'stu- "apat ta-pa( setelah 12 -in##u, Peu/ahan pi#-entasi: (l'as-a, linea ni#a, pal-a eite-a, spi+le ne5i, i.

stial #a5i"au-,

S+h"!i+( p'siti6. Inte#itas S'sial:

an"a>tan"a G''"ell, *e#a 

Bin#un#?-ea#u(an

peu/ahan

pean

an#

"intisipasi, ahap -atuasi?pe(e-/an#an /e5aiasi "an "apat -un"u "en#an stess' (eha-ilan, )esp'ns an##'ta (elua#a lain  .

"apat /e5aiasi "ai p'siti6 "an -en"u(un# sa-pai "is6un#si'nal. Penuluhan?Pe-/elaaan: *aapan in"i5i"u teha"ap (eha-ilan,  pesalinan?-elahi(an te#antun# pa"a usia, tin#(at pen#etahuan,

 pen#ala-an paitas, (ein#inan teha"ap ana(, sta/ilitas e('n'-i(. (. Pe-ei(saan Dia#n'sti(  1& DL -enunu((an ane-ia, he-'#l'/inipatis $-is: sel sa/it& 2& #'l'n#an "aah: AB DAN )h untu( -en#i"enti6i(asi esi(' teha"ap in('-pati/ilitas 3& Usap 5a#ina?e+tal: tes untu( Neisseia #'n'hea, %hla-"ia 4& es se'l'#i: -enentu(an a"ana se6ilis $)P): )api" Plas-a )ea#en& 7& Pena(it *u/un#an Kela-in lain $P*S& sepeti "iin"i(asi(an 'leh (util 5a#ina, lesi, a/as a/n'-al. & S(inin#: teha"ap *IE, hepatitis, tu/e+ul'sis & Papani+'la'! S-ea: -en#i"enti6i(asi ne'plasia,

hepes

si-ple(s tipe 2 & Uinalisis: s(in untu( ('n"isi -e"ia $-is: pe-astian (eha-ilan in6e(si, "ia/etes pena(it #inal&

& e seu-?uin untu( #a"a"'t'pin (ai'ni( -anusia $*%G&  p'siti6  10& ite u/ella Q a : a  -enunu((an i-unitas 11& es s'n'#a6i: a"a anin setelah #estasi  -in##u 12& S(in #lu('sa seu- ? 1 a- tes #lu('sa:  140 a- -#?"l $/iasana "ila(u(an antaa 24 sa-pai 2 -in##u. 5aluasi selanutna "ai 6'lus pen#(aian "ila(u(an pa"a setiap (unun#an penatal. ". D!agn2a K%+%a9aan 8ang la:!4 4n7l a. Keti"a(sei-/an#an nutisi (uan# "ai (e/utuhan tu/uh, esi(' tin##i teha"ap /?" -ual -untah  /. )esi(' (e(uan#an 5'lu-e +aian 6. -untah 7. Ansietas /?" a"ana 6a(t'>6a(t' esi(' (husus, (isis situasi, an+a-an pa"a ('nsep "ii, ('n6li( "isa"ai "an ti"a( "isa"ai tentan# nilai>nilai esensial "an tuuan hi"up, (uan# in6'-asi. ". Kuan# pen#etahuan /?" (uan# pe-aha-an teha"ap (eha-ilan. %. Keti"a(e6e(ti6an p'la na6as /?" pene(anan?pe#esean "ia6a#-a. 6. #an##uan eli-inasi uin /?" pene(anan pa"a 5esi(a uinaia. #. Gan##uan p'la ti"u /?" stess psi('l'#i(, peu/ahan p'la tin#(at a(ti5itas, sesa(. &.  Nei /?" peu/ahan 6isi(, pen#auh h'-'nal !. Int'leansi a(ti5itas /?" (ele-ahan 3. R%n7ana K%+%a9aan a. Keti"a(sei-/an#an nutisi (uan# "ai (e/utuhan tu/uh, esi('

tin##i teha"ap /?" -ual -untah Inte5ensi: Men#i(uti "iet an# "ianu(an "an Men#('nsu-si suple-en
3& Bei(an in6'-asi tetulis "an 5e/al an# tepat tentan# "iet, )asi'nal:

Matei e6eensi an# "apat "ipelaai "i u-ah,

-enin#(at(an (e-un#(inan (lien -e-ilih "iet sei-/an# 4& i-/an# /eat /a"an, pasti(an /eat /a"an pe#a5i" /iasana, )asi'nal: Keti"a(a"e(uatan pena-/ahan BB penatal "an atau "i /a!ah /eat /a"an n'-al -asa (eha-ilan, -enin#(at(an esi(' eta"asi ;petu-/uhan intauine $IUG)& pa"a anin "en#an /eat /a"an lahi en"ah 7& Pantau (a"a he-'#l'/in $*/&

?

*t,

)asi'nal:

Men#i"enti6i(asi a"ana ane-ia "an p'tensial penuunan (apasitas pe-/a!a '(si#en i/u  /. )esi(' (e(uan#an 5'lu-e +aian 6. -untah uuan: Klien -en#('nsu-si +aian "en#an u-lah an# sesuai setiap hai Inte5ensi: 1& Aus(ultasi "enut antun# anin )asi'nal: A"ana "enut antun# -e-asti(an a"ana anin  /u(an -'la hi"ati"'sa 2& entu(an 6e(uensi?/eatna -ual atau -untah )asi'nal: Me-/ei(an "ata /e(enaan "en#an se-ua ('n"isi. Penin#(atan (a"a *'-'n G'na"'t'pin K'i'ni( $*%G&,  peu/ahan -ata/'lis-e (a/'hi"at "an penuunan -'tilitas #asti+ -e-pe/eat -ual "an -untah pa"a tise-este peta-a. 3& inau ulan# i!aat (e-un#(inan -asalah -e"is lain. $Misalna u(lus, pepti(u-, #astitis, ('lesistisis& )asi'nal: Me-/antu "ala- -en#ena-pin#(an pene/a/ lain. Untu( -en#atasi -asalah (husus "ala- -en#i"enti6i(asi inte5ensi 4& Kai suhu "an tu#' (ulit, -e-/an -u('sa, D, suhu, -asu(an haluaan "an /eat enis uine. )asi'nal: In"i(at' "ala- -e-/antu untu( -en#e5aluasi tin#(at?(e/utuhan hi"asi 7& Anu(an penin#(atan -asu(an -inu-an /i(a/'nat -a(an ena- (ali sehai "en#an u-lah an# se"i(it "an -a(anan tin##i (a/'hi"at )asi'nal: -e-/antu

"ala-

-e-ini-al(an

"en#an -enuun(an (easa-an la-/un#.

-ual?-untah

+. Ansietas /?" a"ana 6a(t'>6a(t' esi(' (husus, (isis situasi, an+a-an pa"a ('nsep "ii, ('n6li( "isa"ai "an ti"a( "isa"ai tentan# nilai>nilai esensial "an tuuan hi"up, (uan# in6'-asi. uuan: Setelah "i/ei(an asuhan (epea!atan

"ihaap(an

(e+e-asan /e(uan#?hilan#. Inte5ensi: 1& Kai, si6at, su-/e "an -ani6estasi (e+e-asan. )asi'nal: -en#i"enti6i(asi pehatian pa"a /a#ian (husus "an -enentu(an aah "an (e-un#(inan pilihan? inte5ensi. 2& Bei(an in6'-asi tentan# peni-pan#an #eneti+ (husus, esi(' an# "ala- ep'"u(si "an (etese"iaan tin"a(an?pilihan "ia#n'sa. )asi'nal: "apat -en#hilan#(an ansietas /e(enaan "en#an (eti"a(tahuan

"an

-e-/antu

(elua#a

-en#enai

stess,

-e-/uat (eputusan, "an /ea"aptasi se+aa p'siti6 teha"ap  pilihan. 3& Ke-/an#(an si(ap /e/a#i asa se+aa teus -eneus. )asi'nal: (ese-patan /a#i (lien?pasan#an untu( -e-ui  pe-e+ahan situasi. in#(at (e+e-asan /iasana le/ih tin##i  pa"a

pasan#an

an#

telah

 peni-pan#an ('-'s'-. 4& Bei(an /i-/in#an antisipasi

-elahi(an "ala-

ana( hal

"en#an

peu/ahan

6isi(?psi('l'#is. )asi'nal: "apat -en#hilan#(an (e+e-asan? "epesi pa"a  pasan#an. ". Kuan# pen#etahuan /?" (uan# pe-aha-an teha"ap (eha-ilan. uuan: Klien -enunu((an peila(u pea!atan "ii sen"ii Inte5ensi: 1& Buat hu/un#an salin# pe+aa antaa pea!at ; (lien )asi'nal: Me-/ei(an in6'-asi "an -enin#(at(an hu/un#an salin# pe+aa 2& Klai6i(asi (esalah paha-an )asi'nal: Keta(utan /iasana ti-/ul "ai (esalahpaha-an in6'-asi "an "apat -en##an##u pe-/elaaan selanutna. 3& entu(an "eaat -'ti5asi untu( /elaa  )asi'nal: Klien "apat -en#ala-i (esulitan "ala- /elaa  tese/ut elas. 4& Petahan(an si(ap te/u(a teha"ap (ea(inan pasan#an

)asi'nal:

Penei-aan pentin# untu( -en#e-/an#(an "an

-e-petahan(an hu/un#an. 7& Jelas(an utinitas (unun#an (ant' "an asi'nal "ai inte5ensi )asi'nal: Men#uat(an hu/un#an antaa pen#(aian (esehatan "an hasil p'siti6 i/u?/ai. e. Keti"a(e6e(ti6an p'la penapasan

/?"

pene(anan?pe#esean

"ia6a#-a. uuan: Klien -elap'(an penuunan 6e(uensi?/eatna (eluhan. in"a(an: 1& Kai status penapasan )asi'nal: Menentu(an luas?/eatna -asalah an# tea"i pa"a (ia>(ia 0 H (lien penatal, -es(ipun (apasitas 5ital -enin#(at. "ia6a#-a

8un#si untu(

penapasan tuun

pa"a

"iu/ah inspiasi.

saat

(e-a-puan

Be(uan#

'leh

 pe-/esaan ul(us. 2& Anu(an sein# istiahat )asi'nal: Menuun(an (e-un#(inan #eala>#eala penapasan an# "ise/a/(an (ele/ihan 3& Anu(an -en##una(an p'sisi se-i 6'!le untu( "u"u(  )asi'nal: Pen#u/ahan p'sisi te#a( -enin#(at(an e(spansi  pau. 4& Kai *t ? */ )asi'nal: Penin#(atan (a"a plas-a pa"a #estas -in##u (e 24  ; 32 -en#en+e(an (a"a */. Men#a(i/at(an (e-un#(inan ane-ia "an -enuun(an (apasitas pe-/a!a 2. 6. #an##uan eli-inasi uin /?" pene(anan pa"a 5esi(a uinaia. uuan: Setelah "i/ei(an asuhan (epea!atan "ihaap(an peu/ahan eli-inasi teatasi. Inte5ensi: 1& Bei(an in6'-asi tentan# peu/ahan pe(e-ihan sehu/un#an "en#an ti-este (eti#a. )asi'nal: -e-/antu (lien -e-aha-i alas an 6isi'l'#i "an 6e(uensi /e(e-ih "an?n'(tuia pe-/esaan uteus ti-este  (eti#a -enuun(an (apasitas (an"un# (e-ih -en#a(i/at(an sein# /e(e-ih. 2& Bei(an in6'-asi -en#enaia peluna -asu(an +aian  ;  #elas sehai.

)asi'nal: -e-petahan(an tin#(at +aian "an pe6usi #inal a"e(uat an# -en#uan#i natiu- "iet untu( -e-petahan(an status is't'ni(. 3& Bei(an in6'-asi -en#enai /ahaa -en##una(an "iueti+ "an  pen#hilan#an natiu- "an "iet. )asi'nal:

(ehilan#an?pe-/atasan

natiu-

"apat

-ene(an

e#ulat' ennin>an#i'tensin> al"'ste'n "an (a"a +aian, -en#a(i/at(an "ehi"asi?hip'5'le-ia /eat. #. Gan##uan p'la ti"u /?" stess psi('l'#i(, peu/ahan p'la tin#(at a(ti5itas, sesa(. uuan: Setelah "i/ei(an asuhan (epea!atan "ihaap(an #an##uan  p'la ti"u teatasi. Inte5ensi: 1& inau ulan# (e/utuhan peu/ahan ti"u n'-al /e(enaan "en#an (eha-ilan, teus(an p'la ti"u saat ini. )asi'nal: -e-/antu -en#i"enti6i(asi (e/utuhan -enetap(an  p'la ti"u an# /e/e"a !a(tu ti"u -ala- "an ti"u sian# le/ih "ini. 2& Pehati(an (eluhan (esulitan /enapas (aena p'sisi. Anu(an ti"u pa"a p'sisi se-i 6'!le. )asi'nal: pa"a p'sisi e(u-/en, pe-/esaan uteus seta '#an a/"'-en -ene(an "ia6a#-a hin##a -e-/atasi e(spansi pau,  pen##unaan p'sisi se-i 6'!le -e-un#(in(an "ia6a#-a -enueun, -e-/antu -en#e-/an#(an e(spansi pau "en#an 'pti-al. 3& Kai tin#(at ins'-nia "an esp'ns (lien teha"ap penuunan ti"u, anu(an alat Bantu untu( ti"u sepeti te(ni( ela(sasi, -e-/a+a, -an"i ai han#at, "an penuunan a(ti5itas tepat se/elu- /eistiahat. )asi'nal:

ansietas

an#

/ele/ihan,

(e#e-/iaan,

(eti"a(na-anan 6isi(, n'(tuia, "an a(ti5itas anin "apat -e-pesulit ti"u.

h. Nei /?" peu/ahan 6isi(, pen#auh h'-'nal. uuan: Setelah "i/ei(an asuhan (epea!atan "ihaap(an nei  /e(uan#. Inte5ensi: 1& Kai se+aa teus -eneus (eti"a(na-anan (lien. )asi'nal: "ata "asa te/au untu( -een+ana(an pea!atan. 2& Kai status penapasan (lien. )asi'nal: penuunan (apasitas penapasan saat uteus -ene(an "ia6a#-a,

-en#a(i/at(an

"ispnea

(hususna

pa"a

-ulti#a5i"a, an# ti"a( -en#ala-i (ele#aan "en#an i(atan antaa /ai "ala- (an"un#anna. 3& Pehati(an a"ana (eluhan (ete#an#an pa"a pun##un# "an  peu/ahan +aa alan. )asi'nal: l'"'sis "an e#an#an 't't "ise/a/(an pen#auh h'-'ne $elain#>p'#este'n& pa"a sa-/un#an pel5is "an i.

 pepin"ahan pusat #a5itasi sesuai "en#an pe-/esaan uteus. Int'leansi a(ti5itas /?" (ele-ahan. uuan: Setelah "i/ei(an asuhan (epea!atan "ihaap(an (lien "apat t'leansi "en#an a(ti5itas. Inte5ensi: 1& entu(an si(lus ti"u /an#un an# n'-al "an ('-it-en teha"ap pe(eaan, (elua#a, ('-unitas "an "ii sen"ii. )asi'nal: -e-/antu -enusun pi'itas an# ealisti+ "an !a(tu untu( -en#ui ('-it-en. 2& Anu(an ti"u sian# 1 sa-pai 2 a- setiap hai. )asi'nal: istiahat untu( -e-enuhi (e/utuhan -eta/'li+  /e(enaan "en#an petu-/uhan ain#an i/u?anin. 3& Pantau (a"a */. Jelas(an pean
DATAR PUSTAKA 1.

B'/a(. $2007&. Bu(u Aa Kepea!atan Matenitas. G%: Ja(ata. 2. D'en#es. . Maillin. $2001&. )en+ana Kepea!atan Matenal?/ai. "isi 2. G%: Ja(ata 3. 8ae, *. 2001. Pea!atan Matenitas. "isi 2. G%: Ja(ata. 4. Manua/a. $1&. Il-u Ke/i"anan, Pena(it Kan"un#an "an Kelua#a Been+ana untu( Pen"i"i(an Bi"an. G% : Ja(ata. 5. Sal-ah at all $200&. Asuhan (e/i"anan antenatal +ae. G%: Ja(ata . *e"-an, .*. 2017. Nan"a Intenati'nal In+. Dia#n'sis Kepea!atan: "e6inisi  Klasi6i(asi 2017>201. "isi 10. Ja(ata: G%. . Jh'ns'n, Mai'n "((. 200. Nusin# ut+'-es %lassi6i+ati'n $N%&. St. L'uise, Mis'ui: M's/, In+. . M+%l's(e, J'anne %, 200. Nusin# Inte5enti'n %lassi6i+ati'n $NI%&. St. L'uise, Mis'ui: M's/, In+.