Manajemen Aktif kala III

Summary

The transcript details a clinical procedure focused on childbirth and post-delivery care. It covers steps such as ensuring a single pregnancy, administering medication like oxytocin, delivering the placenta, and performing necessary checks to ensure no complications. The video script emphasizes proper techniques for handling the placenta, avoiding uterine inversion, and ensuring complete delivery. It also outlines the post-delivery steps, such as checking for any tears or excessive bleeding, and ensuring the mother’s recovery. The procedure is conducted with a focus on safety, efficiency, and the well-being of both mother and baby.

Takeaways

• 😀 Ensure that the pregnancy is a single pregnancy by palpating and confirming no other fetus is present.
• 😀 Administer oxytocin to the mother to help speed up the delivery process, ensuring proper technique by aspirating first to avoid injecting blood.
• 😀 Proper handling of the umbilical cord is essential to prevent uterine inversion and facilitate the birth of the placenta.
• 😀 When signs of placenta delivery are observed (e.g., uterus rounding, umbilical cord lengthening, and blood flow), begin manual traction to assist in expulsion.
• 😀 Use a gentle, rotational motion to remove the placenta once it is visible at the vulva to avoid trauma or incomplete expulsion.
• 😀 Massage the mother's abdomen post-delivery for 15-20 seconds to promote uterine contractions and ensure a firm uterus.
• 😀 Carefully examine the placenta for completeness, checking both maternal and fetal sides to confirm no parts are left behind.
• 😀 After placenta delivery, ensure no lacerations or excessive bleeding by inspecting the birth canal and performing appropriate checks.
• 😀 Clean the patient with antiseptic solution to reduce infection risk after the delivery process is completed.
• 😀 After delivery, ensure the baby is well and that the mother is comfortable before assisting with breastfeeding and postnatal care.

Q & A

What is the first step in the procedure described in the transcript?

The first step involves confirming the status of the pregnancy, ensuring it is a single pregnancy and checking the health of the baby.

What is the purpose of administering oxytocin during the delivery process?

Oxytocin is administered to help speed up the delivery of the placenta by stimulating uterine contractions.

How is oxytocin injected, and what precautions are taken?

Oxytocin is injected intramuscularly at a 90° angle into the outer third of the upper thigh. Before injection, aspiration is done to ensure no blood is drawn, and the medication is injected slowly.

What role does the healthcare provider's hand positioning play in the procedure?

The healthcare provider uses their hands to apply controlled pressure and tension during the delivery process, ensuring the placenta is expelled properly and preventing uterine inversion.

How is the placenta delivered after it begins to show signs of detachment?

Once signs of detachment are observed, such as the uterus becoming rounder, the umbilical cord lengthening, and a sudden burst of blood, the provider uses a downward stretching motion and manual manipulation to deliver the placenta.

What steps are taken to ensure the completeness of the placenta after delivery?

After the placenta is delivered, the provider checks for completeness by examining the cotyledons (sections of the placenta) and ensuring no fragments are left inside the mother’s body.

What is done if there is a suspected tear or excessive bleeding?

The healthcare provider checks for any tears in the birth canal and assesses the amount of bleeding to ensure that there is no abnormal hemorrhage or injury.

What is the significance of massaging the uterus after the placenta is delivered?

Massaging the uterus helps to stimulate further contractions, which are necessary to reduce the risk of hemorrhage and to ensure the uterus returns to its normal size.

Why is it important to confirm the length of the umbilical cord?

Confirming the length of the umbilical cord is essential for ensuring that the placenta has been fully expelled and there are no remnants of the cord left inside the uterus.

What safety measures are taken when cleaning the mother post-delivery?

After delivery, the healthcare provider cleans the mother using a chlorinated solution to reduce the risk of infection and ensure the area is hygienic.