PERSALINAN MACET

SKENARIO I

A 30 years old woman came to the emergency department at 10 o’clock with chief complain of
abdominal pain through to the rear. On Anamnesis, found that the woman was pregnant for the
third child, whereas the first and second child was laboured normally. The chief complain was felt
since last night. On the first physical examination, Vital sign within normal limit, Fundus height 3
fingers below Xyphoideus processus, the fetus spine was on the right side, the most lower part was
head, and 3/5. Distance between Simphysis os pubis and height of Fundus was 35 cm, Abdominal
circumference 88 cm. Fetal Heart Rate 136x/minute, His 3 times within 10 minutes with duration of
25-30 second. Cervical opening 4 cm, membranes palpable, alightning match with Hodge 2 and inner
pelvic condition is enough. At 14 o’clock (second examination), On Physical examinations , fetal
heart rate 152 x/mnt. His 4 times within 10 minutes with duration of 30-35 seconds. the most lower
part was head, and 3/5. Cervical opening 6 cm, membranes not palpable, Alightning match with
Hodge 3.

SKENARIO II

A 21 years old woman, come to the emergency department at 19,30 o’clock, referenced by a
midwife in primary care with note : labor not advanced. On Anamnasis, we gain information that
the woman was pregnant for the first time, with no prehistorical pregnancy examination to the
midwife, abdominal paint through the rear since 13 o’clock this noon with discharge of mucus and
blood. By 21 o’clock the woman felt straining, full cervical opening (10 cm), the membranes was
break but the head wasnt entering the hip. The labor was observed and conducted by the midwife at
the community health center but no progress and the midwife wasnt sure about the mothers hip.
On physical examination, mother height 144 cm, on obstetric examination : Fundus height 3 fingers
below Xyphoideus processus, Distance between Simphysis os pubis and height of Fundus was 34 cm,
Abdominal circumference 85 cm. Fetal heart rate 134x/minute. His 4 times within 10 minutes with
duration of 40-45 second. On outer hip examination found distansia spinarum 22 cm, distansia
cristarum 25 cm and Konjugata externa (Boudeloque) 14 cm. On intra vaginal examination, cervical
opening 10 cm, membranes not palpable, The head was H1 pushable (BAP), inner hip examination
arcus pubis <90 degree and interspinarum 10 cm