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Proses Adaptasi Fisiologis & Psikologis Dalam Masa Kehamilan

Proses Adaptasi Fisiologis & Psikologis Dalam Masa Kehamilan

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Nelly Yuana, SST ASKEB 1 1

TATAP MUKA I
LANJUTAN
PROSES ADAPTASI FISIOLOGIS
DAN PSIKOLOGIS DALAM
KEHAMILAN
Nelly Yuana, SST ASKEB 1 2
Peru!"u#an $an %er&e!"an'an
#a()l &*n(e%()
+
Peru!"u#an $an %er&e!"an'an e!"r)*
+
Sru&ur $an ,un'() a!n)*n
+
Sru&ur, ,un'() $an ()r&ula() al) %u(a
+
Sru&ur, ,un'() $an ()r&ula() %la-ena
+
S)r&ula() $ara# %eu(
+
Menenu&an u()a &e#a!)lan
+
Menenu&an %er)*$e &e#a!)lan
Nelly Yuana, SST ASKEB 1 .
1/ Peru!"u#an $an %er&e!"an'an
e!"r)*
Peru!"u#an 0an)n %a$a a&#)r )a% "ulan 1
+
A&#)r 1 "ulan
2
Ba$an "ay) (an'a !elen'&un'
2
Pan0an' 3,4 2 15 !!
2
Ke%ala 16. $ar) (eluru# !u$)'a#
2
Saluran yan' a&an !en0a$) 0anun' er"enu& 7
(u$a# "er$enyu
2
Da(ar 2 $a(ar ra-u( $)'e()8u( (u$a# na!%a&
2
Per!ulaan &a&) 7 an'an "er"enu& *n0*lan
Nelly Yuana, SST ASKEB 1 9
+
Pa$a a&#)r 2 "ulan
2
Mu&anya (u$a# 0ela( "er"enu& !u&a
!anu()a
2
Su$a# !e!%unya) an'an 7 &a&) $en'an 0ar)
$an an'an
2
Ala &ela!)n (u$a# na!%a&, :alau%un "elu!
$a%a $)enu&an 0en)(nya
2
Pan0an'nnya ; 2,4 -!
+
A&#)r . "ulan
2
Pan0an' 3<= -!
2
Su$a# a$a %u(a 2 %u(a %erulan'an
2
Kela!)n (u$a# a$a 7 (u$a# $a%a $)enu&an
2
Jan)n (u$a# $a%a "er'era&, ea%) "elu!
$a%a $)ra(a&an *le# )"unya
2
G)n0al (u$a# !e!"enu& (e$)&) a)r &en-)n'
Nelly Yuana, SST ASKEB 1 4
+
A&#)r 9 "ulan
2
Pan0an' 15 2 13 -!, "era 155'r
2
Ala &ela!)n luar ()$a# $a%a
!enenu&an 0en)(nya
2
Kul) $)u!"u#) ra!"u yan' #alu(
1lanu'*>
2
Per'era&an ana& !un'&)n (u$a# $a%a
$)ra(a&an *le# )"u
+
A&#)r 4 "ulan
2
Pan0an' 1? 2 23 -!, "era .55'r
2
Buny) 0anun' (u$a# $a%a $)$en'ar
2
Kalau la#)r (u$a# "eru(a#a "erna,a(
Nelly Yuana, SST ASKEB 1 @
+
A&#)r @ "ulan
2
Pan0an' 2? 2 .9 -!, "era @55'r
2
Kul) &er)%u 7 le!a& !ula) $))!"un $)
"a:a# &ul)
2
Kul) eruu% *le# 8ern)A -a(e*(a unu&
!el)n$un') &ul)
2
Bern)& -a(e*(a C -a!%uran (el 2 (el e%)#el
&ul), lanu'*, $an (e&re &elen0ar le!a&
+
A&#)r 3 "ulan
2
Pan0an' .4 2 .? -!, "era ; 1555'r
2
Kalau la#)r $a%a #)$u% $) $un)a luar,
:alau%un &e!un'&)nan #)$u% eru( !a()#
&e-)l
2
Kalau !enan')( !en'eluar&an (uara yan'
le!a#
Nelly Yuana, SST ASKEB 1 3
+ A&#)r ? "ulan
2 Pan0an' 92,4 -!, "era 1355 'r
2 Per!u&aan &ul) !a()# !era# 7 &er)%u (e%er) &ul) *ran' ua
+ A&#)r = "ulan
2 Pan0an' 9@ -!, "era 2455 'r
2 Su$a# a$a la%)(an le!a& $) "a:a# &ul)
+ A&)r 15 "ulan
2 Jan)n ($# -u&u% "ulan 1!aur, a er!>
2 Pan0an' 45 -!, "era .555 'r
2 BB "ay) la&) 2 la&) D "era $ar) BB "ay) %ere!%uan
2 Kul) #alu( #a!%)r )$a& a$a lanu'* la'), ea%) !a()# a$a
8ern)A -a(e*(a
2 Ke%ala $)u!"u#) ra!"u, &u&u !ele")#) u0un' 0ar)
2 La&) 2la&), e()( ($# a$a (-r*u!/ Ean)a la")a !ay*ra
!enuu%) la")a !)n*ra
Nelly Yuana, SST ASKEB 1 ?
+
Peru!"u#an 0an)n $)%en'aru#)
*le#
1/ Fa&*r )"u C TB, &ea$aan ')F),
)n'')nya e!%a )n''al, %e!)nu!,
%er*&*&, &ela)nan %e!"ulu# $ara#,
&ela)nan ueru(, &e#a!)lan 'an$a
2/ Fa&*r ana& C 0en)( &ela!)n, &ela)nan
'ene)(, )n,e&() )nra uer)n erua!a
8)ru(, &ela)nan &e'en)al la)nnya
./ Fa&*r %la-ena C )n(u,)()en() $ar)
%la-ena $a%a !enye"a"&an !al
nur)()*n )nra uer)n
Nelly Yuana, SST ASKEB 1 =
2/ Sru&ur $an ,un'() a!n)*n
+
Mula 2 !ula ruan'an a!n)*n
!eru%a&an r*n''a &e-)l (a0a
&e!u$)an !en'el)l)n') (eluru# 0an)n
+
Ruan' a!n)*n "er)() a)r &eu"an
+
A!n)*n )&u !e!"enu& (ela%u
0an)n yan' er$)r) $ar) C la%)(an
a!n)*n, !e(*$er!, -#*r)*n, $an
la%)(an )%)( $ar) $e-)$ua
Nelly Yuana, SST ASKEB 1 15
L)Gu*r a!n)) 1a)r &eu"an>
+
Ruan' a!n)*n "er)() 1 2 1,4 LT a)r &eu"an
+
Banya&nya &a$an' 2 &a$an' (an'a "er"e$a H
2
M'' &e .@ C 15.5 --
2
M'' &e 95 C 3=5 --
2
M'' &e 9. C 295 --
+
P*ly#)$ra!n)*n6#y$ra!n)*n C a)r &eu"an D 2
L
+
Ol)')#y$ra!n)*n C a)r &eu"a I 455 --
+
Bera 0en)( 1/553 2 1/524, rea&()nya al&al)(
+
A)r &eu"an er$)r) $ar) H 2.J "a#an *r'an)&
1%r*e)n, 8ern)A -a(e*(a, lanu'*, Fa le!a&,
le())n 7 (%)n'*!)el)n>, =3J < =?J "a#an
an*r'an)& 1a)r, 'ara! yan' laru $ala! a)r
Nelly Yuana, SST ASKEB 1 11
+
Pere$aran -a)ran &eu"an (e&)ar
455--60a! aau (e&)ar 1J yan'
$)elan "ay) $an $)&eluar&an (e"a'a)
a)r &en-)n'
+
S),a a)r &eu"an "er"e$a $en'an a)r
&en-)n'
2
A)r &en-)n' C rea&() a(a!, "au %e()n',
:arna 0ern)# )$a& !en'an$un' 8ern)A
-a(e*(a
2
A)r &eu"an C rea&() al&al)(, "aunya
&#a(, :arnanya ")(a 0ern)#, &eru#,
!en'an$un' 8ern)A -a(e*(a
Nelly Yuana, SST ASKEB 1 12
+
H)$ra!n)*! $)0u!%a) %a$a &a(u(
2
Anen-e,alu(
2
S%)na"),)$a
2
A'ene()( ')n0al
2
K*r)* an'e*!a %la-ena
+
A)r &eu"an $)'una&an (e"a'a) "a#an
%enel))an unu& H
2
Menenu&an 0en)( &ela!)n 1a!n)*-ene()(>
2
Ke!aan'an %aru 2 %aru 0an)n
2
G*l*n'an $ara#
2
Fa&*r r#e(u(
2
Kela)nan &*n'en)al la)nnya
Nelly Yuana, SST ASKEB 1 1.
Fun'() a)r &eu"an
+
Saa #a!)l "erlan'(un'
2
Me!"er)&an &e(e!%aan
"er&e!"an'nya 0an)n $en'an "e"a( &e
(e'ala ara#
2
Menye"ar&an e&anan ")la er0a$)
rau!a lan'(un'
2
Se"a'a) %enyan''a er#a$a% %ana( $an
$)n')n
2
Men'#)n$ar) rau!a lan'(un' er#a$a%
0an)n
Nelly Yuana, SST ASKEB 1 19
Fun'() a)r &eu"an, lan0uan
+
Saa )n%aru
2
Menye"ar&an &e&uaan #)( (e#)n''a
(er8)&( $a%a !e!"u&a
2
Me!"er()#&an 0alan la#)r &arena
!e!%unya) &e!a!%uan (e"a'a)
(e$)n,e&an
2
Se"a'a) %el)-)n (aa %er(al)nan
Nelly Yuana, SST ASKEB 1 14
./ Sru&ur, ,un'() $an ()r&ula()
al) %u(a
+
Tal) %u(a er$a%a anara %u(a 0an)n $an
%er!u&aan ,*eal %la-ena
+
Earnanya $ar) luar %u)# 7 "u&an !eru%a&an
al) yan' luru( ea%) yan' "er%)l)n
+
Pan0an'nya ;44-! 1.5 2 155-!> 7 $)a!eer
1<1,4-!
+
Pe!"ulu#<%e!"ulu# $ara#nya ")a(anya le")#
%an0an' $ar) al) %u(anya (en$)r) (e#)n''a
%e!"ulu# "er&el*&<&el*&
+
Ka$an'<&a$an' !en)!"ul&an *n*lan %a$a
%er!u&aan al) %u(a 7 $)"er na!a ()!%ul
%al(u
Nelly Yuana, SST ASKEB 1 1@
+ In(er()6lea& al) %u(a &e %la-ena H
2 Tengah : insertio sentralis
2 Sedikit ke samping : insertio paracentralis
2 Samping : insertio lateralis
2 Pinggir : insertio marginalis
2 Di luar placenta/di selaput janin : insertio velamentosa
+ Tal) %u(a $)l)%u) *le# a!n)*n, yann' (an'a era
!ele&a
+ Tal) %u(a !en'an$un' 2 arer) u!")l)&al)( 7 1 8ena
u!")l)&al)(, (ee")#nya er)() *le# Fa (e%er) a'ar 2
a'ar yan' $)(e"u (ele :#ar*n 1:#ar*nK( 0elly>
+ :#ar*nK( 0elly !en'an$un' "anya& a)r, !a&a
(eela# "ay) la#)r, al) %u(a !u$a# !en0a$) &er)n'
$an le&a( erle%a( $ar) %u(ar "ay)
+ Tal) %u(a 0u'a !en'an$un' ()(a<()(a $ar) &an$un'
&un)n' elur 7 allan*)( yan' #anya $)l)#a $en'an
!)-r*(-*%
Nelly Yuana, SST ASKEB 1 13
9/ Sru&ur, ,un'() $an ()r&ula()
%la-ena
+
Sru&ur %la-ena
2
Pla-ena "er"enu& "un$ar6#a!%)r
"un$ar H $)a!eer 14<25-! 7 e"al
;2,4-!, "era raa<raa 455'r
2
U!u!nya %la-ena er"enu& len'&a%
%a$a &e#a!)lan I 1@ !'' $en'an
ruan' a!n)*n ela# !en')() (eluru#
&a8u! uer)
Nelly Yuana, SST ASKEB 1 1?
+
Lea& %la-ena u!u!nya $) $e%an6$)
"ela&an' $)n$)n' ueru(, a'a& &e aa(
&eara# ,un$u( uer)
+
Karena ala(an ,)()*l*')(, %er!u&aan
"a')an aa( &*r%u( uer) le")# lua(,
(e#)n''a le")# "anya& e!%a unu&
"er)!%le!ena()
+
J)&a $)el)) "enar, !a&a %la-ena
(e"enarnya "era(al $ar) (e"a')an "e(ar
$ar) "a')an 0an)n, ya)u 8)ll)
&*r)ale(60*n0* -#*r)*n 7 (e"a')an &e-)l
$ar) "a')an )"u yan' "era(al $ar) $e()$ua
"a(al)(
Nelly Yuana, SST ASKEB 1 1=
Fun'() %la-ena
+
Nur)), H (e"a'a) ala yan' !e!"er)
!a&anan %a$a 0an)
+
E&(&re() H (e"a'a) ala yan'
!en'eluar&an "e&a( !ea"*l)(!e
+
Re(%)ra() H (e"a'a) ala yan' !e!"er) Fa
a(a! $an !en'eluar&an LO2
+
Se"a'a) ala yan' !e!"enu& #*r!*n
+
Se"a'a) ala yan' !enyalur&an %el"a'a)
an)"*$y &e 0an)n
Nelly Yuana, SST ASKEB 1 25
S)r&ula() %la-ena
+
Dara# )"u y' "era$a $) ruan' )ner8)ller "era(al
$ar) (%)ral arer)e( yan'n "era$a $) $e()$ua
"a(al)(
+
Pa$a ()(*(el $ara# $)(e!%r*&an $en'an
e&anan 35<?5!!#' (e%er) a)r !an-ur &e $ala!
ruan' )ner8)ler (a!%a) !en-a%a) -#*r)*n)-
%lae, %an'&al &*)le$*n<&*)le$*n 0an)n
+
Dara# er(e"u !e!"a(a#) (e!ua 8)ll) &*r)ale(
7 &e!"al) %erla#an<la#an $en'an e&anan
?5!!#' &e 8ena<8ena $) $e()$ua
+
D)e!%a<e!%a erenu %a$a )!%lana()
%la-ena era%a 8ena 2 8ena yan' le"ar 1()nu(>
unu& !ena!%un' $ara# &e!"al)
Nelly Yuana, SST ASKEB 1 21
S)r&ula() %la-ena lan0uanM/
+
Dara# )"u yan' !en'al)r $)(eluru#
%la-ena $)%er&)ra&an !ena)& $ar)
.55!l6!en) %a$a &e#a!)lan 25 !'' 2
@55!l6!en) %a$a &e#a!)lan 95 !'
+
Seluru# ruan' )ner8)ller an%a 8)ll)
&*r)ale( !e!%unya) 8*lu!e ; 145<245
!l
+
Per!u&aan (e!ua 8)ll) &*r)ale(
$)%er&)ra&an (elua( ; 11!2
+
Den'an $e!)&)an %eru&aran Fa<Fa
!a&anan er0a!)n "enar
Nelly Yuana, SST ASKEB 1 22
4/ S)r&ula() $ara# %eu(
+
S)(e! %ere$aran $ara# 0an)n
$)enu&an *le# ,a&*r<,a&*r H
2
F*ra!en *8ale anara &e$ua ar)u!
2
Du&u( arer)*(u( "*#all) anara arer)
%ul!*nal)( $en'an a*ra
2
Du&u( 8en*(u( aran)) $) $ala! #e%ar
!enu0u 8ena -a8a )n8er)*r
2
Pa$a u!")l)0u( er$a%a (au 8ena
u!")l)&u( $an 2 arer) u!")l)&al)(
Nelly Yuana, SST ASKEB 1 2.
Pere$aran $ara# 0an)n "erlan'(un'H
1/ Dara# yan' &aya $en'an nur)() 7 O2
$)al)r&an !elalu) 8ena u!")l)&al)( !enu0u
#a), $)!ana er$a%a $u&u( 8en*(u( aran)),
lan'(un' !enu0u 7 !a(u& &e 8ena &a8a
)n,er)*r lalu !a(u& &e ar)u! &anan 0anun'
0an)n
2/ Dar) ar)u! &anan 0an)n (e"a')an "e(ar $ara#
!a(u& &e ar)u! &)r) !elalu) ,*ra!en *8ale
./ Se"a')an &e-)l $ara# $ar) ar)u! &anan !a(u&
&e 8enr)&el &anan
9/ Dara# yan' !a(u& &e ar)u! &)r) a&an
$)%*!%a &e 8enr)&el &)r) 7 $ar) 8enr)&el &)r)
$)%*!%a !a(u& &e a*ra 7 (elan0unya
$)al)r&an &e (eluru# u"u# 0an)n
Nelly Yuana, SST ASKEB 1 29
4/ La"an' a*ra $)"a')an "a:a# !en0a$) 2 arer)
#)%*'a(r)&a )nerna, yan' !e!%unya) -a"an'
arer) u!")l)&al)(
@/ Dara# $ar) 8enr)&el &anan $)%*!%a !enu0u
%aru 2 %aru, ea%) &arena %aru<%aru "elu!
"er&e!"an' !a&a $ara# yan' er$a%a %a$a
arer) %ul!*nal)( $)al)r&an !enu0u a*ra
!elalu) $u&u( arer)*(u( "*#al))
3/ Dara# yan' $)al)r&an !enu0u %aru<%aru a&an
$)al)r&an &e!"al) !enu0u 0anun' !elalu)
8ena %ul!*nal)(
?/ Dara# y' !enu0u %la-ena !elalu) arer)
u!")l)-al)( er%e-a# !en0a$) &a%)ler unu&
!en$a%a&an nur)() $an O2 unu&
%eru!"u#an $an %er&e!"an'an 0an)n
=/ S)(a !ea"*l)(!e 0an)n 7 LO2 $)le%a(&an &e
$ala! ()r&ula() rer*%la-ener unu&
(elan0unya $)"uann' !elalu) ala %e!"uan'an
yan' er$a%ar $)u"u# )"u
Nelly Yuana, SST ASKEB 1 24
@/ Menenu&an u()a &e#a!)lan
1/ Ru!u( Nea'le
2/ Gera&an %eu(
./ Per&)raan T)n'') Fun$u( uer)
1TFU>
9/ USG
Nelly Yuana, SST ASKEB 1 2@
Ru!u( Nae'le
+
S)&lu( 2? #ar) H N3<.N1
+
S)&lu( 2= #ar) H N?<.N1
+
S)&lu( .5 #ar) H N=<.N1
+
S)&lu( .1 #ar) H N15<.N1
+
S)&lu( .2 #ar) H N11<.N1
+
S)&lu( .. #ar) H N12<.N1
+
S)&lu( .9 #ar) H N1.<.N1
+
S)&lu( .4 #ar) H N19<.N1
+
L*n*# H ()&lu( 2? #ar) H
HPHT H = 2 ? 2 255 TP H 1@ 2 4 < 2551
Nelly Yuana, SST ASKEB 1 23
Gera&an %era!a ,eu(
+
Den'an !e!%er&)ra&an er0a$)nya
'era&an %era!a ,eu( %a$a u!ur
#a!)l 1@ !''69 "ulan, !a&a
%er&)raan u!ur $a%a $)ea%&an
+
Per&)raan )n) )$a& e%a aau &uran'
e%a
Nelly Yuana, SST ASKEB 1 2?
Per&)raan TFU
+ Le*%*l$
2 Se"elu! "ulan &e . H ,un$u( uer) "elu! $a%a $)ra"a $ar)
luar
2 A&#)r "ulan &e .612 !'' H 1<2 0ar) $) aa( (y!%#)()(
2 A&#)r "ulan &e 961@ !'' H %eren'a#an anara (y!%#)()( 2
%u(a
2 A&#)r "ulan &e 4625 !'' H . 0ar) $) "a:a# %u(a
2 A&#)r "ulan &e @629 !'' H (e)n'') %u(a
2 A&#)r "ulan &e 362? !'' H . 0ar) $) aa( %u(a
2 A&#)r "ulan &e ?6.2 !'' H %eren'a#an Pr*-Ae(u(
Ay%#*)$eu( 2 %u(a
2 A&#)r "ulan &e =6.@ !'' H . 0ar) $) "a:a# Pr*-Ae(u(
Ay%#*)$eu(
2 A&#)r "ulan &e 15695 !'' H %eren'a#an Pr*-Ae(u(
Ay%#*)$eu( 2 %u(a
Nelly Yuana, SST ASKEB 1 2=
+
Meeran6M-/ D*nal$
2
25-! H 4 "ulan
2
2.-! H @ "ulan
2
2@-! H 3 "ulan
2
.5-! H ? "ulan
2
..-! H = "ulan
Nelly Yuana, SST ASKEB 1 .5
USG
+
Unu& !enenu&an u!ur #a!)l
!elalu) USG $en'an !en'u&ur
na')an 0an)n H
2
Menenu&an $)a!eer &an*n' 'e(a()
2
Menenu&an 0ara& &e%ala<"*&*n'
2
Menenu&an 0ara& ulan' ")%ar)eal
2
Menenu&an l)n'&aran %eru
2
Menenu&an %an0an' ulan' ,e!ur
Nelly Yuana, SST ASKEB 1 .1
3/ Menenu&an %er)*$e
&e#a!)lan
+
Ke#a!)lan $)"a') !en0a$) )'a
r):ulan, ya)u H
2
Tr):ulan %era!a H 5 2 12 !''
2
Tr):ulan &e$ua H 1. 2 2? !''
2
Tr):ulan &e)'a H 2= 2 92 !''

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