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Jurnal Anestesi Obstetri Indonesia
Published by Indonesian Society of Obstetric Anesthesia and Critical Care
ISSN : -     EISSN : 2615370X     DOI : https://doi.org/10.47507/obstetri.v3i2
Core Subject : Health, Science,
Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health
We accept manuscripts in the form of Original Articles, Case Reports, Literature Reviews, both from clinical or biomolecular fields, as well as letters to editors in regards to Obstetric Anesthesia and Critical Care. Manuscripts that are considered for publication are complete manuscripts that have not been published in other national journals. Manuscripts that have been published in the proceedings of the scientific meeting can still be accepted provided they have written permission from the organizing committee. This journal is published every 6 months with 8-10 articles (March, September) by Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC).
Arjuna Subject : Kedokteran - Anesthesiology and Pain Medicine
Articles 8 Documents
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Search results for , issue "Vol 2 No 1 (2019): Maret" : 8 Documents clear
Pemberian Lidocain-Ketorolac sebagai Analgesi Lokal Infiltrasi dibandingkan dengan Parasetamol Intravena untuk Manajemen Nyeri Pascaoperasi Seksio Sesarea (SC) di RSUD Mgr. Gabriel Manek, SVD Atambua Yanti Permatasari; Willy Yant Kartolo
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.28

Abstract

Latar Belakang: Local Infiltration Analgesia (LIA) adalah teknik memberikan obat anestesi lokal yang diencerkan, dan diberikan adjuvant obat seperti anti-inflamasi nonsteroid (AINS), epinefrin, dan opioid. Tujuan: Untuk mengetahui apakah teknik LIA dapat menurunkan visual analoque scale (VAS) dan menurunkan kebutuhan analgetika dibandingkan pemberian parasetamol intravena dalam 24 jam pascaoperasi seksio sesarea (SC). Metode: Desain penelitian dengan studi intervensi pada populasi pasien wanita hamil yang akan dilakukan SC, dibagi dua kelompok yaitu menggunakan teknik LIA dan Parasetamol.Hasil: Chi-Square pada jam ke-0 menunjukkan nilai sebesar 3.354, dengan nilai p=0,340 ≥α 0,05, artinya pemberian parasetamol dan LIA belum memberikan pengaruh bermakna terhadap skala VAS, sedangkan pada uji Chi-Square jam ke-24 menunjukkan nilai sebesar 36.863, dengan nilai p=0,000 ≤α 0,05 memberikan pengaruh bermakna terhadap skala VAS pasien. Uji spearman pada jam ke-0 nilai koefisien korelasi sebesar -0.090 dengan nilai p= 0.459 ≥ α 0.05 disimpulkan tidak ada hubungan yang signifikan pemberian parasetamol dan LIA dengan skala VAS. Uji Spearman jam ke-24 menunjukkan ada hubungan bermakna antara pemberian parasetamol dan LIA dengan skala VAS dengan nilai koefisien korelasi sebesar -0.671 nilai p= 0.000 ≥α 0Simpulan: Pemberian LIA dapat menurunkan VAS dalam 24 jam pasca operasi SC dibandingkan dengan pemberian paracetamol intravena dan dapat mengurangi kebutuhan analgetik dalam 24 jam pasca-operasi SC dibandingkan dengan pemberian paracetamol intravena. Lidocain-Ketorolac as Local Infiltration Analgesi Compared to Intravenous Paracetamol for Management Postoperative Pain in Caesarean Section in RSUD Mgr. Gabriel Manek, SVD Atambua Abstract Background: LIA (Local Infiltration Analgesia) is a technique that provides localized anesthetic drugs that are diluted, and given adjuvants drugs such as NSAIDs, epinephrine, and opioids. Objective: This study aims to determine the technique of LIA can decrease VAS and decrease analgesic requirements compared to intravenous administration of paracetamol within 24 hours postoperative SC. Method: The design of this study used an intervention study with a population of pregnant women which have been done by SC and divided into two group which use technique of LIA and paracetamol. Result:Chi-Square at hour 0 show value equal to 3,354, with value p = 0,340 ≥ α 0.05, which mean giving paracetamol and LIA have not significant influence to VAS scale, while in Chi-Square test 24 hour show the value of 36.863, with the value p = 0.000 ≤ α 0.05 which means to provide a significant effect on the VAS scale of patients. In spearman test at hour 0 shows the value of correlation coefficient of -0.090 with p = 0.459 ≥ α 0.05 there is no significant relationship giving paracetamol and LIA with VAS scale. Spearman correlation test clock 24 indicate there is significant relation between giving of paracetamol and LIA with scale of VAS have value of correlation coefficient equal to -0.671 with value p = 0.000 ≥ α 0.Conclusion: LIA reduced VAS in 24 hours after SC procedure better than intravenous Paracetamol and decreased analgetic consumption in 24 hours after SC procedure than intravenous Paracetamol.
Perbandingan Pemberian Cairan Koloid Co-loading dengan Infus Efedrin terhadap Pencegahan Hipotensi akibat Anestesi Spinal pada Seksio Sesarea Alifan Wijaya; Dewi Yulianti Bisri; Tatang Bisri
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.29

Abstract

Latar Belakang: Hipotensi merupakan komplikasi anestesi spinal pada seksio sesarea karena blokade simpatis akibat vasodilatasi arteri dan vena. Pemberian koloid co-loading dapat meningkatkan volume intravaskular sedangkan infus efedrin diharapkan terjadi vasokonstriksi. Tujuan: Untuk membandingkan pemberian efedrin dan cairan koloid co-loading dalam mencegah hipotensi akibat anestesi spinal pada seksio sesarea. Metode: Uji terkontrol acak buta tunggal pada 42 pasien seksio sesarea dengan anestesi spinal yang dilakukan di Rumah Sakit Hasan Sadikin Bandung pada September sampai Oktober 2018. Subjek penelitian dibagi secara acak menjadi 2 kelompok yaitu kelompok pemberian infus efedrin dan kelompok pemberian koloid secara co-loading. Kelompok koloid diberikan cairan koloid sebanyak 7 mL/KgBB selama 20 menit sedangkan kelompok efedrin diberikan efedrin bolus 5 mg pada menit pertama dan kedua, kemudian 15 mg dalam infus selama 15 menit. Tekanan darah diukur setiap 1 menit selama 10 menit, kemudian setiap 3 menit sampai menit ke-45. Analisis statistik yang digunakan adalah uji T tidak berpasangan dan Mann Whitney. Hasil: penelitian menunjukan angka kejadian hipotensi lebih sedikit pada kelompok infus efedrin (5/21) dibandingkan dengan kelompok koloid (15/21) dengan perbedaan yang bermakna (p<0,05). Simpulan: penelitian ini menunjukan bahwa kejadian hipotensi pada pasien seksio sesarea yang dilakukan anestesi spinal lebih banyak pada kelompok koloid co-loading dibandingkan dengan kelompok infus efedrin. Comparison of Colloid Co-loading with Ephedrine Infusion on Prevention of Hypotension Due to Spinal Anesthesia in Cesarean Section Abstract Background: Hypotension is a complication of spinal anesthesia in cesarean section due to sympathetic blockade that causes arterial and venodilation. Administration co-loading of colloid can increase intravascular volume, whereas administration of ephedrine infusion expected to vasoconstric. Objective: To compare administration of co-loading colloid with ephedrine infusion on preventing hypotension due to spinal anesthesia in cesarean section. Method: A single blind randomized controlled trial in 42 patients who underwent cesarean section under spinal anesthesia, the physical status of ASA II which was randomly divided into 2 group administering ephedrine infusion and colloid co-loading. Colloid was given 7 ml/ Kg for 20 minutes, whereas ephedrine bolus 5 mg was given in the first and second minutes, then 15 mg in infusion for 15 minutes. Blood pressure is measured every 1 minute for 10 minutes, then every 3 minutes until the 45th minute. the statistical analysis used is unpaired T test and Mann Whitney. Results: The study showed a lower incidence of hypotension in the ephedrine infusion group (5/21) compared with the colloid group (15/21), this difference was statistically significant (p <0.05). Conclusions: This study show that the incidence of hypotension in cesarean section patients was more in the colloid group compared to the ephedrine group.
Low Dose Spinal dan Epidural untuk Seksio Sesarea Pasien dengan Patent Ductus Arteriosus Devi Ariani; Isngadi Isngadi
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.30

Abstract

Wanita hamil dengan penyakit jantung bawaan terjadi perubahan hemodinamik peningkatan kardiovaskular, perhatian dan terapi yang khusus dibutuhkan. Penambahan obat opioid meningkatkan dosis anestesi lokal, hemodinamik stabil, meningkatkan efek analgetik. Kasus: Satu, wanita 26 tahun gravida 30–32 minggu, PDA besar L-R shunt, hipertropi konsentrik ventrikel kiri, trivial atrium regurgitasi, pulmonal regurgitasi sedang, trikuspid regurgitasi sedang, pulmonal hipertensi berat, EF 57%. Dua, wanita 22 tahun gravida 37–38 minggu, preterm premature rupture of membrane, PDA besar L-R shunt, pulmonal hipertensi berat, penurunan fungsi sistolik ventrikel kiri, EF 54%, bekas seksio sesarea. Keduanya menggunakan teknik regional anestesi dosis rendah. Pembahasan: Teknik menggunakan combine spinal epidural (CSE) dengan spinal 5 mg bupivacain heavy 0,5% dan fentanyl 50 mcg, epidural bupivacain 0,125% dan fentanyl 30 mcg meningkatkan anestesi untuk seksio sesarea, dan hemodinamik stabil pada pasien kelainan katup. Opioid intratekal mereduksi anestesi lokal dan hipotensi, kemampuan anestesi terjaga. Simpulan: Dosis rendah CSE dengan 5 mg bupivacain heavy 0,5 % dan 50 mcg, dengan epidural bupivacain 0,125% dan fentanyl 30 mcg adekuat untuk pasien seksio sesarea dengan kelainan jantung. Low-dose Spinal and Epidural Patients for Caesarean Section Patients with Patent Ductus Arteriosus Abstract Pregnant women with congenital heart diseases hemodynamic changes during pregnancy increasing cardiovascular, it’s need attention and special treatment. Opiod addition scan decrease the dose of local anesthetic drugs, prevent hemodynamic fluctuation, increase the analgesia effect. Case: First case, female 26 years with gravida 30-32 weeks with large PDA Left to Right shunt, consentrik left ventrikel hipertrophy, trivial atrium regurgitation, moderate pulmonal regurgitation, moderate tricuspid regurgitation, severe pulmonal hypertension, EF 57%. Second case, female 22 years with gravida 37-38 weeks, PPROM , large PDA Left to Right shunt, pulmonal hypertension severe, function systolic left ventrikel decreasing, EF 54%, former section caesaria. Both of them undergoing section caesaria with low dose regional anesthesia. Discussion: In this case with used CSE with Spinal 5 mg Bupivacaine heavy 0,5 % and fentanyl 50 mcg, Epidural bupivacain 0,125 % and fentanyl 30 mcg provided adequate anaesthesia for section cesarean delivery, and haemodynamic stability in patient with valvular cardiac disease. The synergism between intrathecal opioid sareductionin the dose of local anaesthetic and reduce hypotension, while still maintaining adequate anaesthesia. Conclussion: Low dose CSE with 5 mg bupivacaine heavy 0,5% and fentanyl 50 mcg, and epidural bupivacain 0,125% and fentanyl 30 mcg provided adequate for sectio cesarian patient with cardiac disease, with stable of haemodynamic.
Manajemen Anestesi pada Seksio Sesarea Pasien dengan HIV (Human Immunodeficiency Virus) Iwan Nuryawan; Bambang Suryono; Sri Rahardjo
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.31

Abstract

Infeksi Human Immunodeficiency Virus (HIV) dan Acquired Immunodeficiency Syndrome (AIDS) adalah masalah utama dari kesehatan global. Menurut United Nations Programme on HIV/AIDS (UNAIDS), salah satu bagian dari WHO yang mengurus tentang AIDS menyebutkan, bahwa perkiraan jumlah penderita yang terinfeksi HIV/AIDS di seluruh dunia sampai dengan akhir tahun 2010 mencapai 34 juta. Kasus HIV pada anak paling sering ditemukan akibat transmisi dari ibu yang HIV positif ke anaknya. Pada laporan kasus ini dilaporkan penanganan anestesi pada penderita pasien wanita berusia 25 tahun berat badan 50 kg primigravida hamil aterm 38 minggu belum dalam persalinan dengan infeksi HIV belum mendapatkan terapi antiretroviral. Pasien diklasifikasikan ASA II dan dilakukan anestesi regional teknik blok subarakhnoid dengan obat bupivakin 0,5% hiperbarik 10 mg. Dilahirkan bayi perempuan berat lahir 2500 gram, dengan skor Apgar 9/10. Operasi berlangsung selama 1 jam dengan hemodinamik TD 90–120/60-80 mmHg, HR 65-100 x/mnt, SpO2 99–100%, perdarahan 400 cc, produksi urin 0,5 ml/kgBB/jam. Pasca operasi pasien diobservasi di ruang pemulihan hingga skor Bromage 0 sebelum dikembalikan ke bangsal. Anesthesia Management in Cesarean Section Patients with HIV (Human Immunodeficiency Virus) Abstract Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) infections are the main problems of global health. According to United Nations Programme on HIV/AIDS (UNAIDS), one part of the WHO that deals with AIDS states that the estimated number of people infected with HIV/AIDS worldwide by the end of 2010 reached 34 million. HIV cases in children are most often found due to the transmission of HIV-positive mothers to their children. We reported a 25-year-old primigravida, 38 weeks, weighing 50 kg, not in delivery with HIV infection without antiretroviral therapy underwent caesarean section. Patient was classified as ASA II and performed subarachnoid blocks with hyperbaric 0.5 mg bupivacaine 10 mg. A baby girl was born, weighing 2500 grams, with Apgar score 9/10. The operation lasts for 1 hour with hemodynamics TD 90-120/60-80 mmHg, HR 65-100 x/min, SpO2 99-100%, bleeding 400 cc, urine production 0.5 ml/kgBW/hour. In postoperative period, patient was observed in the recovery room until the Bromage score was 0 before transferred to the ward.
Manajemen anestesi pada pasien Seksio Sesarea Primigravida dengan Glioblastoma Multiforme Ratih Kumala Fajar Apsari; Bambang Suryono; Shinta Shinta
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.32

Abstract

Tumor otak pada kehamilan jarang terjadi, Glioblastoma multiforme adalah tumor otak primer yang paling agresif dan biasanya membawa prognosis yang buruk. Tumor otak pada kehamilan berkorelasi dengan terjadinya peningkatan mortalitas maternal, kelahiran premature dan intra uterine growth restriction (IUGR). Adanya tumor otak pada kehamilan akan mempengaruhi penentuan waktu persalinan, jenis dan tehnik anestesi yang akan digunakan. Kasus: Dilaporkan pasien dengan G1P0A0 Hamil 33 minggu, mengeluh sakit kepala hilang timbul sejak 6 bulan yang lalu. Sakit kepala berdenyut terutama sebelah kanan, tidak disertai mual, muntah, pandangan kabur dan kejang. Sakit kepala berkurang dengan obat paracetamol. Awal Mei 2017 pasien merasakan sakit kepala hebat disertai muntah proyektil, dilakukan pemeriksaan MRI kepala, curiga glioblastoma multiforme regio temporoparietal dextra. Diagnosa ditegakkan berdasarkan anamnesa, pemeriksan fisik dan pemeriksaan penunjang. Pasien telah dilakukan SC dengan tehnik regional anestesi epidural obat Levobupivacain 0.5% isobaric 11 ml, janin cukup viable dilahirkan dan mencegah peningkatan tekanan intracranial lebih lanjut. Pasien pulang ke rumah setelah perawatan 5 hari dalam kondisi baik. Pembahasan: Pada wanita hamil dengan tumor otak yang akan dilakukan SC, selama tidak ada kontraindikasi neuroaxial anestesi dapat dilakukan. Tehnik ini pun dilakukan dengan menjaga hemodinamik tetap stabil, mencegah peningkatan tekanan intracranial, seperti saat dilakukan dengan general anestesi. Simpulan: Selama tidak didapati kontraindikasi untuk anestesi neuroaxial, wanita hamil dengan SOL yang tidak mempunyai efek massa, hidrosefalus, atau klinis kearah peningkatan TIK, dapat dilakukan tindakan dengan neuroaxial anestesi. Anesthesia Management for Cesarean Section in Patient with Glioblastoma Multiforme Abstract A brain tumor in pregnancy is rare. Glioblastoma mutltiforme is the most aggressive tumor primary brain and usually have poor prognosis. A brain tumor in pregnancy are associated with increased mortalitas maternal, prematurity and intra uterine growth restriction. The presence of a brain tumor in pregnancy may affect the decision for timing of delivery, type and technique an anesthesia to be used. Case: Patients with G1P0A0 pregnant 33 weeks, complaining of recurrent headaches since 6 months ago. Headache pulsate especially on the right side, without nausea, vomiting, blurred vision or seizures. Headache is relieved with paracetamol. Patients felt a severe headache accompanied by projectile vomiting on May 2017. And performed head examination MRI, suspected glioblastoma multiforme temporoparietal dextra region based on anamnesis, physical examination and brain MRI. Patient has been performed caesarea section with regional anesthesia technique with epidural drug Levobupivacain 0.5% isobaric 11 ml. Patient returns home after 5 days in good condition. Discussion: A pregnant women with a brain tumor to be performed caesarea section procedure, neuroaxial anesthesia can be successfully applied as long as the patients do not have any contraindications. This technique is keeping the hemodynamics stable, preventing an increase in intracranial pressure as when performed with general anesthesia. Conclusion: As long as there is no contraindications are found for neuroaxial anesthesia, pregnant woment with space occupying lesion without mass effect, hydrocephalus or clinical evidence of increasing ICP can be treated with neuroaxial anesthesia.
Manajemen Anestesi pada Seksio Sesarea dengan Preeklamsia Berat dan Morbid Obese RTH Supraptomo; Yusmein Uyun
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.33

Abstract

Pendahuluan: Preeklampsia adalah terjadinya trias preeklampsia (hipertensi, hipoalbuminemia, dan edema) yang mendadak setelah 20 minggu kehamilan. Pasien obesitas memiliki banyak implikasi klinis dalam tatalaksana anestesi. Kasus: Wanita, 22 tahun G2P1A0 hamil 39 minggu dengan preeklampsia berat, KPD 12 jam, obesitas morbid akan dilakukan seksio sesarea emergency dengan status fisik ASA IIIE, dilakukan pembiusan dengan teknik regional anestesi subarachnoid block dengan puncture di L3–L4 median, menggunakan agen levobupivakain 15 mg dan fentanyl 25 mcg. Operasi berlangsung selama 1 jam 15 menit, dengan perdarahan 350 cc, hemodinamik stabil. Lahir bayi laki-laki, BB 3400 gr, APGAR Score 8–9–10. Diskusi: Preeklampsia adalah penyakit multiorgan yang spesifik terhadap kehamilan manusia, namun etiologi spesifik yang mendasari tetap belum diketahui. Tatalaksana bersifat suportif, melahirkan bayi dan plasenta tetap menjadi satu-satunya terapi definitif. Pasien obesitas memiliki banyak implikasi klinis untuk dipertimbangkan. Pemahaman mengenai patofisiologi akan membantu memberikan tatalaksana anestesi yang lebih baik. Simpulan: Pemilihan teknik neuraksial anestesi lebih direkomendasikan karena menghindari kemungkinan intubasi sulit pada kasus emergensi, perfusi uteroplasenta yang lebih baik, kualitas analgesi/anestesia yang baik, mengurangi obat yang masuk ke sirkulasi uteroplasenta, menurunkan stress operasi, dan psikologis ibu yang dapat melihat bayinya saat dilahirkan. Anesthesia Management in Caesarean Section with Severe Preeclampsia and Morbid Obese Abstract Introduction: Preeclampsia is a sudden triad of preeclampsia (hypertension, hypoalbuminemia and edema) after 20 weeks of pregnancy, Obese patients have many clinical implications to consider. Case: Female, 22 years old with G2P1A0, 39 weeks pregnant with severe preeclampsia, 12 hours PROM, pro morbid obesity SCTP-E with ASA IIIE physical status. Labor pain management was carried out using regional subarachnoid block anesthesia technique with puncture in median L3-L4, clear CSF (+), blood (-) using levobupivacaine 15 mg + fentanyl 25 mcg. The operation lasted for 1 hour 15 minutes, with 350 cc bleeding, hemodynamically stable. Born a baby boy, BW 3400 gr, APGAR Score 8-9-10. Discussion: Preeclampsia is a multiorgan disease that is specific to human pregnancy, and the underlying specific etiology remains unknown. Management is supportive, giving birth to the baby and placenta remains the only definitive therapy. Obese patients have many clinical implications to consider. Understanding of pathophysiology will help provide better anesthesia management. Conclusion: The neuraxial anesthesia technique is recommended to avoids the possibility of difficult intubation, better uteroplacental perfusion, good analgesia / anesthesia quality, reducing drugs that enter the uteroplacental circulation, decreasing surgical stress, and maternal psychological to be able to see the baby at birth.
Manajemen Nyeri Kronis pada Kehamilan Budi Yulianto Sarim; Bambang Suryono
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.34

Abstract

Menurut IASP ( International Association of the Study of Pain) nyeri didefinisikan sebagai “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or describe interm of such damage”. Nyeri adalah rasa inderawi dan pengalaman emosional yang tidak menyenangkan akibat adanya kerusakan jaringan yang nyata atau yang berpotensi rusak atau sesuatu yang tergambarkan seperti itu.Kelainan muskuloskeletal yang sering dialami oleh wanita hamil adalah berupa nyeri lumbopelvis pada kehamilan (pelvic girdle pain) dan nyeri kronis lumbal (low back pain).Adapun yang menyebabnya adalah faktor hormonal, faktor mekanis dan vaskuler. Manajemen untuk nyeri kronis pada wanita hamil dapat dilakukan melalui manajemen non farmakologis dan manajemen farmakologis. Manajemen non farmakologis dapat dikerjakan dengan cara fisioterapi, terapi distraksi, terapi musik, guided imaginary dan relaksasi. Untuk manajemen farmakologis, obat – obatan yang dapat diberikan adalah asetaminofen, NSAID dan analgesik opioid. Management Chronic Pain in Pregnancy Abstract According to the IASP (International Association of the Study of Pain) pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or describe the interim of such damage". Pain is a sensation and or emotional experience unpleasant and disturbing as a result of tissue damage, or potential tissue damage. Musculoskeletal disorders are often experienced by pregnant women is pelvic girdle pain and chronic pain lumbar. The etiology of that is the hormonal factor, mechanical factors and vascular factors. Management of chronic pain in pregnancy can be done through non-pharmacological management and pharmacological management. Non pharmacological management can be done by means of physiotherapy, distraction therapy, music therapy, guided imaginary and relaxation. For pharmacological management can be given is acetaminophen, NSAIDs and opioid analgesics.
Deteksi Pasien Obstetrik Kritis dengan Maternal Early Warning System Ratih Kumala Fajar Apsari
Jurnal Anestesi Obstetri Indonesia Vol 2 No 1 (2019): Maret
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v2i1.35

Abstract

Adaptasi fisiologis yang terjadi pada ibu hamil dapat menyamarkan tanda-tanda penyakit maternal berat. Ini mempersulit identifikasi kolaps maternal yang akan terjadi. Penggunaan early warning system (EWS) yang dimodifikasi untuk penggunaan pada pasien ibu hamil dan postpartum akan membantu dalam identifikasi, treatment dini, dan penanganan pasien yang memiliki, atau akan mengalami, penyakit kritis. Maternal Early Warning System (MEWS) seharusnya mengidentifikasi pasien yang berisiko untuk mengalami perburukan pada saat intervensi dini dapat mencegah perburukan ke morbiditas berat MEWS telah digunakan secara ekstensif dalam praktek obstetrik, tetapi sistem yang digunakan sangat bervariasi. Parameter-parameter yang sering dimasukkan dalam MEWS antara lain denyut jantung, tingkat pernapasan, tekanan darah, dan tingkat kesadaran. Dari berbagai MEWS yang telah dikembangkan, ada tiga MEWS utama, yaitu (1) modified early obstetric warning system (MEOWS), (2) Maternal Early Warning Criteria (MEWC), dan (3) Maternal Early Warning Trigger (MEWT) tool. Hingga kini masih belum diketahui sistem MEWS apa yang terbaik, dan setiap rumah sakit mungkin memerlukan penyesuaian dalam parameter MEWS. Literatur yang ada menunjukkan kemungkinan manfaat dan mendukung penggunaan MEWS. Implementasi dan penggunaan MEWT telah dikaitkan dengan penurunan morbiditas maternal komposit dan morbiditas maternal berat. Akan tetapi, respon apa yang optimal untuk setting tertentu agar memperbaiki pelayanan maternal setelah tanda peringatan muncul hingga kini masih belum jelas. Detection of Critically Ill Obstetric Patients with Maternal Early Warning System Abstract Physiological adaptations that develop in pregnant women may obscure signs of severe maternal diseases. These causes difficulties in identifying the impending maternal collapse. An early warning system (EWS) modified for pregnant and postpartum women may assist in identification, early treatment, and management of patients who already or will develop critical illness. Maternal Early Warning System MEWS has been extensively used in obstetric practices; however, the systems used in preactice are varied. The most considered parameters for MEWS are heart rate, respiratory rate, blood pressure, and level of consciousness. From many MEWS developed, three primary MEWS existed, (1) modified early obstetric warning system (MEOWS), (2) Maternal Early Warning Criteria (MEWC), dan (3) Maternal Early Warning Trigger (MEWT) tool. There is still no consensus regarding which MEWS is superior, and different hospitals may require adjustments in MEWS parameters. The existing literatures suggested the potential benefit of MEWS and supported MEWS in clinical practice. Implementation and adoption of MEWS had been associated with reduced composite maternal morbidities and severe maternal morbidities. However, the optimal response for certain settings to improve maternal services after warning system has been activated is still lacking.

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