TUGAS

EVIDENCE BASED MIDWIFERY

DOSEN :

Vedjia Medhyna

OLEH :

SRIATI Am. Keb

PROGRAM STUDI D. IV KEBIDANAN

FAKULTAS KESEHATAN
UNIVERSITAS FORT DE KOCK
2020
 KATA PENGANTAR

Puji syukur kehadirat Tuhan Yang Mahakuasa karena telah memberikan

kesempatan pada penulis untuk menyelesaikan tugas ini. Atas rahmat dan
hidayah-Nya lah penulis dapat menyelesaikan tugas EVIDENCE BASED
MIDWIFERY.
Penulis menyadari makalah ini masih jauh dari kata sempurna. Oleh
karena itu, kritik dan saran yang membangun akan penulis terima demi
kesempurnaan makalah ini.

Penulis

SRIATI Am, Keb

KASUS INTERFENSI
Contoh soal:
Ny.H umur 41 tahun bersalin normal di kelinik bersalin. 6 jam setelah ospartum
ibu mengatakan tidak bisa buang air kecil .Setelah di periksa ternyata
kandungkemih penuh dan nyeri diatas ari-ari.Kemudian dilakukan
kateterisasi/pengosongan kandung kemih.Setelah itu bidan melaporkan hal ini ke
dokter dan dokter menyuruh bila hal ini terulang lagi di anjurkan memakai kateter
menetap selama 24 jam.
P: Ibu bersalin
I: Pengosongan kandungkemih
C: Pasang kateter
O: Mengosongkan kandungkemih

Abstract
Aim: This study was undertaken to determine the prevalence of post-partum
urinary retention after vaginal delivery and to examine the associated risk
factors.

Material and methods: This was a prospective observational study carried out
over a 2-month period at the major university teaching hospital in southwestern
Nigeria.

Results: Prevalence of post-partum urinary retention was 29.4%. The majority

(93.3%) of women had covert urinary retention while 6.7% had overt urinary
retention. From the bivariate analysis, episiotomy, reduced voiding desire and
primiparity were risk factors for post-partum urinary retention (66.6% vs
30.6%; P = 0.017; 47.75% vs 13.9%; P = 0.037; and 60.0% vs 30.6%; P = 0.05;
respectively).

Conclusion: Post-partum urinary retention, particularly covert retention, is a

common complication of labor and delivery in our clinical practice but is rarely
reported in the published work, especially from this part of the world. No factor
has been found to be independently associated with its occurrence, hence there
is need for vigilance in the immediate post-partum period as most cases of
urinary retention would have been avoided if women were encouraged to void
early following delivery.

Keywords: catheterization; episiotomy; labor; post-partum; urinary retention.

© 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013

Japan Society of Obstetrics and Gynecology.

KASUS ETIOLOGI
Contoh soal:
Ny. S dating ke kelinik bersalin dengan keluhan hamil anak pertama 40 minggu
mengatakan sudah dua hari tidak merasakan pergeeakan bayi dalam kandungan
nya, kemudian vbidan mendengar kan BJA (bunyi jantung anak) dengan
menggunakan dopple, tetapi BJSA tetap tidak terdengar.Kemudian bidan
merujuk pasien tersebut kedokter untuk USG.Dari hasil pemeriksaaan bayi
mengalami IUVD (Intra Uterin Vetal Deat). Dan dokter melakukan
terminasi

P: Ibu hamil
I: Melakukan USG
C: Terminasi
O: Untuk melahirkan janin
Pertanyaan:
Berapa lama pfroses terminasi untuk melahirkan janin?

Intrauterine Fetal and Neonatal Death between Small for Date and Non-Small
for Date in Small for Gestational Age Infants
Toshiya Itoh et al. Int J Med Sci. 2019.
Free PMC article
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Abstract
Objective: To demonstrate the differences in intrauterine fetal deaths and
neonatal deaths between small for date (SFD) and Non-SFD neonates by
applying a novel classification from both Z scores of placental weight (PW) and
fetal/placental weight ratio (F/P) to small for gestational age (SGA) neonates.
Methods: From 93,034 placentas/infants of mothers who vaginally delivered a
singleton infant (Japan Perinatal Registry Network database 2013), SGA
(n=7,780) was chosen according to the reference to Japanese neonatal growth
chart. They were divided into two subgroups: SFD (body weight and height less
than the 10th percentile, n=3,379) and Non-SFD (only body weight less than the
10th percentile, n=4,401). Z scores of PW and F/P based on the standard curves
for sex-, parity-, and gestational-age-specific PW and F/P were calculated. The
population was classified into 9 groups according to the combination of 'low vs.
middle vs. high' i) PW Z score and ii) F/P Z score. In both i) and ii), ± 1.28
standard deviations in the Z scores were used for classifying low vs. middle vs.
high, with 3×3 making 9 groups. From top-left to bottom-right, we labeled the
groups as Group A to Group I. Results: SFD and Non-SFD neonates distributed
in the same 6 groups (A, D, E, G, H, I). In group E, which was considered to be
balanced placental and infant growth, the incidence of intrauterine fetal death
was significantly higher in Non-SFD neonates than in SFD neonates. In group
D, which was considered to be small placenta and balanced infant growth, the
incidence of neonatal death was significantly higher in SFD neonates than in
Non-SFD neonates. Conclusion: Assessment of SGA neonates by dividing them
into SFD and Non-SFD neonates and application of a 9-group classification by
PW and F/P Z scores were informative to understand the pathophysiological
involvement of an imbalance between placental and fetal sizes.
Keywords: fetal/placental weight ratio; intrauterine fetal death; neonatal death;
placenta; small for date; small for gestational age.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interest
exists.

KAWSUS DIAGNOSIS
Contoh soal:
Ny.Z 28 tahun dan sudah 5 tahun menikah hamil anak pertama dengan usia
kehamilan 10-11 minggu.Ibu mengatakan sebelum nya sudah pernah USG dan
dokter menyaran kan untuk di lakukan kuretase, karena hasil konsepsi tidak
berkembang. Akan tetapi karena ibu sangat mengharap kan kehamilan ini si ibu
dan keluarga masih ragu.kemudian bidan menganjurkan untuk melakukan
pemeriksaan kedokter yang lain untuk melakukan second opinion .
P: Ibu hamil dan keluarga
I: USG
C: Second opinion
O: Diagnosa akurat untuk mendiag nosa janin tidak berkembang

Abstract
Background and objectives: Although legally anchored, there are no empirical
results from German second opinion programs. In this study, various aspects
within a population of a second opinion program are examined.

Methods: In this study patients were analyzed who sought a second opinion in
the period from August 2011 to December 2016. Differences in patient
characteristics, differentiated by agreement of first and second opinion, were
analyzed using multivariate logistic regression. Patients' satisfaction and quality
of life were examined one, three and six months after obtaining the second
opinion.

Results: In total, 1,414 patients sought a second opinion. Most frequently,

second opinions were sought on knee (38.7 %), back (26.8 %), hip (11.7 %),
and shoulder (10.2 %) complaints. Except for the indication (p=0.035), no
patient characteristic had influence on the conformation of the second opinion.
Approximately two out of three initial recommendations were not confirmed by
the specialists. 89 % of the patients were satisfied or very satisfied with the
second opinion and the service offered.

Conclusions: The second opinion offers patients the opportunity to seek an

additional independent medical opinion and thus provides support for decision
making. Further research is needed to examine the reasons for the high
discrepancies between the first and second opinions.

Keywords: Lebensqualität; Patientenzufriedenheit; Zweitmeinung;

Zweitmeinungsportal; agreement; patient satisfaction; quality of life; second
opinion; second opinion program; Übereinstimmung.