KEPERAWATAN MATERNITAS “ABORTUS”
KELOMPOK 2 1. 2. 3. 4.
NUR ASRI ASRI WULAND WULANDARI ARI SISCA AYU VAMELA SITI SITI RAHMA RAHMA SUCI SUCI INDAH INDAH PRAT PRATIWI
(PO.71 (PO.71.20 .20.4. .4.14. 14.027 027)) (PO.71.20. (PO.71.20.4.14. 4.14.042) 042) (PO.71 (PO.71.20 .20.4. .4.14. 14.043 043)) (PO.71 (PO.71.20 .20.4. .4.14 14.04 .044) 4)
TINGKAT : II DOSEN
: ISMAR AGUSTIN! S.K"! M.K#"
KEMENTERIAN KESEHATAN REPUBLIK INDONESIA POLITEKNIK POLITEK NIK KESEHATAN KESEHATAN PALEMBANG PRODI DIV KEPERAWATAN TAHUN TAHUN 2015 KATA KATA PENGANTAR PENG ANTAR
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BAB I PENDAHULUAN 1.1.
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BAB II KONSEP DASAR MEDIS 2.1.
D!,-$-*-
A*+$' ,/,, #*,&*-, '$,+$ #,&,- (# ,&,+,&,+ +#*+#-+$) ,+,$ '##$ #,&,- +#*'#$+ #*$'&, 22 &-$ ,+,$ $, #,&,- #$ ,"$ $-+$ &/$" /&$,* ,-/$-,- (S,*6-! 200>). A*+$' ,+,$ #$$*,- ,/,, +#*#-+&-, #,&,- '##$ %,-&- /,",+ #*+,,- &/$"! ,&+$ '##$ #,&,- #*$'&, 22 &-$ ,+,$ #*,+ %,-& #$ #-9,",& =00 *,. A*+$' &,',-, /&+,-/,& /#-,- +#*%,/&-, "#*/,*,,- ",/, 6,-&+, ,- '#/,- ,&! /#-,- ,/,-, "#*,,+,- USG! '#,*,- /,",+ /&#+,$& ,6, ,*+$' /,",+ /&#/,,- #-%,/& 2 %#-&'! ,- "#*+,, ,/,, ,*+$' ,*#-, #,,,- "#*#,-,- %,-&- /&,-, ,,*,USG #-$-%$,- ,-+- #,&,- ,- '-! '#/,-,- %#-&' ,- #/$, ,/,, ,*+$' ,*#-, #,+&,- %,-&-! /&,-, %,-&- +&/, #-$-%$,- +,-/, +,-/, #&/$",- '#"#*+& /#-$+ %,-+$- ,+,$ "#*#*,,- ,- '#'$,& /#-,- $'&, #,&,- ('+#+*&9 ",+& K UNPAD).
2.2.
Et-"%-
##*,", ,+* ,- /,",+ #-#,,- ,*+$' ,-+,*, ,&-: 1. ,+* %,-&-! ,+* %,-&- "#-#, #$$*,- ,/,, #,&-,- #-#+&! /,- &-& +#*%,/& ",/, =0>0B ,'$' #$$*,-! ,+* #,&-,- ,- ",&- '#*&- /&%$",& ",/, ,*+$' ,/,, ,-$,- "#*+$$,- F&+! #*&! %,-&- ,+,$ ",'#-+,. K#,&-,- +#*'#$+ &,',-, #-#,,- ,*+$' ",/, +*&#'+#* "#*+,,! ,-& : ,. K#,&-,- +#$*! +#$* '- (blighted ovum)! #*$',,- #*&! ,+,$ #,&-,- *' (-'&! +*&'&! ,+,$ "&"&/&) . E*& /#-,- #,&-,- 9, c. A-*,&+,' "##-+$,- ",'#-+, (hipoplasi trofoblas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
I-#'& +#*,'$ &-#'& ,- /&,&,+,- # TORC (Toksoplasma, Rubella, Cytomegalovirus) /,- ,,*&,. I-#'& &-+*,$+#*&-# '#*&- /&$$-,- /#-,,*+$' '"-+,- #*$,-. O*,-&'*,-&'# ,- '#*&- /&/$, '#,,& "#-#,
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Chlamydia,
Ureaplasma,
Mycoplasma,
Cytomegalovirus, Listeria moocytogees /,- To!oplasma godii. ?. ,+* &$-& T#*/,",+ ,-+&/&,*/&&"&/ ,- #-,&,+,- "##$,-
/,*,
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
2.(.
Pat,-*-"%-*
P,/, ,6, ,*+$' +#*%,/& "#*/,*,,- /,, /#'&/$, ,',&'! /&&$+& -#*&'& %,*&-,- ,- #-#,,- ,'& -'#"'& +#*#",' /,- /&,-," #-/,
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bleghted ovum)! $-&- "$, %,-&- +#, ,+& ,, (missed aborted). A",&, $/&, ,- ,+& +&/, /&#$,*,- /,, 6,+$ '&-,+! ,, &, /,",+ /&&"$+& # ,"&',- #$,- /,*,. I-& $+#*$' /&-,,,- , *#+,. #-+$ &-& #-%,/& , ,*-', ,",&, "&#- /,*, +#, /&'#*," /,, '&'&-, +#*%,/& *,-&','&! '#&-, '#$,-, +,", '#"#*+& /,&-. #-+$ ,&,/,, , +$#*', /,, , &-& ,-&- +,", #*#-%#-% ,*#-, +#*%,/& #,+, ,-+,*, ,&- /,- *&-. P,/, %,-&- ,- +#, #-&-, /,- +&/, /&#$,*,- /,",+ +#*%,/& "*'#' /&&,'& %,-&- -#*&- /,- ,*#-, 9,&*,- ,&- #-%,/& $*,- # '#, /&'#*,". I, #-%,/& ,, #"#- (fetus kompresus). D,, +&-,+ #& ,-%$+ &, #-%,/& +&"&' '#"#*+& #*+,' "&#-"#*,#-. K#$-&-,- ,&- ",/, %,-&- ,+& ,- +&/, #,' /&#$,*,- &,, +#*%,/&-, ,'#*,'&! $+#*,",'! +#-*, #-%,/& ##! "#*$+ ##',* ,*#-, +#*,', 9,&*,- /,- '#$*$ %,-&- #*6,*-, ##*,#*,,- (',*6- 200>)
2./.
K"a*-,-#a*- !*!rta ta$ata$a$a
A*+$' /,",+ /&,& #-%,/& : 1. "bortus spota! ,/,, ,*+$' ,- +#*%,/& +&/, /&/,$$& ,+*,+* #,-& ,+,$"$- #/&'&-,&'! '#,+,,+, /& '#,,- # ,+* ,,&, (20B /,*& '#$, ,*+$') 2. "bortus provokatus! ,-& ,*+$' ,- /&'#-,%, ,& /#-,- ,+,+,,$"$- ,,+,,+ ,*+$'.
3. "bortus Medisiaalis, ,*+$' ,*#-, +&-/,,- &+, '#-/&*& /#-,- ,,', &, #,&,- /&,-%$+,- /,",+ #,,,,- %&6, &$ (#*/,',*,&-/&,'& #/&') 4. "bortus krimialis! #*$",,- ,*+$' ,- /&'#-,%, ,*#-, +&-/,,- +&-/,,- ,- +&/, #, ,+,$ +&/, #*/,',*,- &-/&,'& #/&'. =. Usafe abortio! ,/,, $",, $-+$ +#*&-,'& #,&,- $/, /&,-, "#,',,- +&-/,,- +#*'#$+ +&/, #"$-,& 9$$" #,&,- /, "*'#/$* '+,-/,* ,- ,,- '#&-, #,,,,- #',,,+,- %&6, ",'-. >. "bortus immies, ,&+$ +#*%,/& "#*/,*,,- #*9, ,- #-$-%$ ,-9,,+#*,/," #,-'$-,- '$,+$ #,&,-. D,, -/&'& '#"#*+& &-& #,&,- ,'& $-&- #*,-%$+ ,+,$ /&"#*+,,-,-! /&+,-/,& /#-, "#*/,*,,- #*9, &-, '#/,-! '#*;&' +#*+$+$" ( ,*#-, ",/, ',,+ "##*&',,- /,, #$ ,/, "#$,,-) $+#*$' '#'$,& $'&, #'+,'&! *, "#*$+ ,6,! -#*& #&& ,*#-, -+*,'& +&/, ,/, ,+,$ '#/&&+ '#,&! +&/, /&+#$,- #,&-,- ",/, '#*;&'. 7. "bortus #sipies, +#*%,/& "#*/,*,,- *&-,- &-, '#/,- ",/, #,&,- $/, /&,-, ,'& -'#"'& ,'& #*,/, /,, ,;$ $+#*&. K-/&'& &-& #-$-%$,- "*'#' ,*+$' '#/,- #*,-'$- /,- ,, #*,-%$+ #-%,/& ,*+$' &-"&+ ,+,$ "&+! /#-,- +,-/,+,-/, "#*/,*,,- '#/,- &-, ,'&,-,! ,/,-,/,- #$,* $",,/,*,! '#*;&' +#*$,! $+#*$' '#'$,& ,', #,&,-! *, -#*& "#*$+ ,6, ,*#-, -+*,'& *,& $,+! ,&,+ -+*,'& $+#*$' +#*%,/& "#$,,-! #$ +#*%,/& #'"$'& ,'& -'#"'&. ?. "bortus #kompit, "#*/,*,,- ",/, #,&,- $/, /&,-, '#,&,- /,*& ,'& -'#"'& +#, #$,* /,*& ,;$ $+#*& #,$& ,-,&' '#*;&' ,- +#*+&-, ",/, /#'&/$, ,+,$ ",'#-+,. @. "bortus komplit, ,-& "#*/,*,,- ",/, #,&,- $/, /&,-, '#$*$ /,*& ,'& -'#" +#, /&#$,*,- /,*& ,;$ $+#*&! /&+,-/,& /#-, "#*/,*,,- ,*9, &-, '#/,-! '#*;&' +#*+$+$"+#*$,! $+#*$' #& #9& /,*& $'&, #'+,'&! '#/&&+ ,+,$ +,-", -#*& "#*$+ ,6, /,*& *&6,,+ ,'& -'#"'&! ",/, ,*+$' "&+ "#*/,*,,- '##*, #*$*,- '#+#, &'& *,& /&#$,*,- /,- '#,,+,,+-, /,, 10 ,*& "#*/,*,, #*#-+& ',, '#,&! ,*#-, /,, ,', &-& $, *,& +#, '#$ /,-
#"&+#&','& +#, '##',& /,- %&, /,, 10 ,*& '#+#, ,*+$' ,'& ,/, "#*/,*,,- %$,! ,, ,*+$' &-"&+ ,+,$ #/#+*'&' "'+ ,*+$ ,*$' /&"&&*,-. 10. Missed abortus, "#*/,*,,- ",/, #,&,- $/,! /&'#*+,& *#+#-'& ,'& -'#"'& ,- +#, ,+&! &-, ? &-$ #& /#-,- #%,, /&%$",& ,#-#*#. 11. "bortus hubitualis, '$,+$ #,/,,- /&,-, "#-/#*&+, #-,,& #$$*, #*+$*$++$*$+ 3 ,& ,+,$ #&.
2.5.
Ma$-,!*ta*- K"-$-*
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
2.3.
P!$ata"a#*a$aa$
I$ ,& '#,&-, '##*, #-#$& /+#* ,",&, "#*/,*,,- +#*%,/& '#,, #,&,-. I$ ,*$' &'+&*,,+ ++, /,- /&,-%$*,- $-+$ *#,','&. T#+,"& &-+*,;#-, ,+,$ +*,-'$'& /,*, /,",+ /&,$,- &, /&"#*$,-. P,/, ,'$' ,*'&
&-"#+ /&$',,,- $-+$ #-'-,- $+#*$' #,$& "##/,,-. #&+$ %$, /#-,- ,'$' missed abortio %&, %,-&- +&/, #$,* '"-+,-. &, "#-#,-, ,/,, &-#'&! #;,$,'& &'& $+#*$' '#,&-, /&+$-/, ',",& /,",+ "#-#, ,- ",'+& $-+$ #$,& +#*,"& ,-+&&+&.
2.4.
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