IRK

And We commanded mankind (to do good) to two of his parents; his mother had conceived him in a
state of increasing weakness, and weaned him in two years. In Al Mishbah's commentary, more
emphasis is placed on the services of the mother, as in the case of the mother who sacrificed a lot for
her child.

Pengertian

VOL. 11 NO. 1: JUNE 2021 / Original Articles Muhammad Syahrul Alam

The Effect of Knowledge on the Preparedness of Health Workers in Facing Obstetric Emergencies

Emergency is a clinical condition that requires immediate medical action to save lives and prevent
disability (Permenkes RI No. 47 of 2018).

Obstetrics is a branch of science related to pregnancy and childbirth, including the processes before,
during and after a woman gives birth.

Obstetric emergencies are life-threatening bleeding during pregnancy and near term including bleeding
that occurs in the early weeks of pregnancy (abortion, hydatidiform mole, vascular cyst,
extrauterine/ectopic pregnancy)

Objective

The goal is the same as other emergencies, namely providing fast and appropriate first aid to emergency
patients that focus on mothers and children, establishing nursing diagnoses, and efforts to save lives,
reducing patient disability and pain before being referred or taking definitive action at all levels of the
hospital. (Emergency service standards of the Directorate General of the Ministry of Health of the
Republic of Indonesia in 2011).

The maternal mortality rate in Indonesia in 2019 is still dominated by the three main causes of death,
namely bleeding as much as 32.32%, preeclampsia as much as 25.25% and infection as much as 4.9%
while the highest cause of maternal death in West Java is caused by bleeding with a percentage of 33 %,
preeclampsia by 31.8% and circulatory system disorders by 9.5%. Based on these data, it can be
concluded that preeclampsia is still the three main causes of maternal death (Kemenkes RI, 2019).

According to research conducted by the Centers for Disease Control and Prevention, trauma is the most
common cause of death in women aged 35 years and under, and it is also stated that 10-11% of deaths
in pregnant women are caused by trauma. This shows that it is very important to have an obstetric
emergency.

Intervention
For us to know first that severe preeclampsia is when blood pressure is 160/110 mmHg or more,
proteinuria is 5 grams or more per liter, Oliguria, is the amount of urine less than 500 cc per 24 hours.
There are cerebral disturbances, visual disturbances, and pain in the epigastrium. And there is
pulmonary edema and cyanosis. Risk factors for preeclampsia include age, parity, previous pre-
eclampsia, family history, multiple pregnancies, pre-existing medical conditions (type I diabetes
mellitus), obesity and insulin resistance, chronic hypertension, and others.

In severe pre-eclampsia, magnesium sulfate prophylaxis is recommended and alert for postpartum
hypertension (Leeman, 2016; Williams, 2018). Drugs commonly used in the treatment of hypertension in
pregnancy are labetalol, methyldopa, nifedipine, clonidine, diuretics, and hydralazine.

Psychosocial interventions that can reduce anxiety

a. Assess the signs and symptoms of anxiety and the client's ability to reduce anxiety
b. Describe the signs and symptoms, causes and consequences of anxiety
c. Exercises for dealing with anxiety:
1) Deep breathing relaxation techniques
2) Distraction: talk about positive things
3) Hypnosis 5 fingers focus on positive things

Preeclampsia is also considered a condition that most often precedes eclampsia, which is a condition of
pregnancy accompanied by seizures due to high blood pressure. If not treated immediately,
preeclampsia can be fatal for both the mother and the fetus. Such as imperfect fetal development,
premature birth, to death.

In an emergency setting, the goal of psychosocial intervention is for patient safety. There are phases of
psychosocial intervention in psychiatric emergencies, namely: Building Relationships, Conducting
Psychotherapy

When you are new to doing psychotherapy. what can be done to improve the mother's behavior and
lifestyle that can worsen the condition. Provide education, involve the family as a provider of support.

Khouzam HR, Gill TS, Tan DT, 2007. Handbook of Emergency Psychiatry. Elsevier's Health Science,
Philadelphia.