AISYA, NURTIA RAHMA NOVIANTIKA (2026) CASE REPORT PADA IBU HAMIL RESIKO SANGAT TINGGI (ANEMIA, GRANDEMULTI, USIA >35 TAHUN, DAN RIWAYAT ABORTUS) DI TPMB MAULIDAWATI TONGGUH. Diploma thesis, POLTEKKES KEMENKES SURABAYA.
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Abstract
CASE REPORT ASUHAN KEBIDANAN IBU HAMIL RESIKO SANGAT TINGGI (ANEMIA, GRANDEMULTI, USIA >35 TAHUN, DAN RIWAYAT ABORTUS) DI TPMB MAULIDAWATI TONGGUH Latar Belakang: Kehamilan dengan kategori kerentanan paling tinggi terjadi ketika beberapa faktor bahaya ditemukan secara bersamaan sehingga peluang munculnya penyulit pada perempuan yang mengandung dan janin menjadi lebih besar. Defisiensi hemoglobin, grandemultiparitas, umur maternal di atas 35 tahun, serta catatan keguguran dapat memperberat angka kesakitan dan kematian maternal maupun perinatal. Kadar hemoglobin yang rendah mengurangi kemampuan darah membawa oksigen menuju jaringan maternal dan fetal. Di sisi lain, paritas sangat tinggi, umur reproduksi lanjut, serta pengalaman keguguran sebelumnya berkaitan dengan perdarahan, proses kelahiran memanjang, hambatan perkembangan fetus, dan penyulit obstetri lainnya. Pencegahan memerlukan pelayanan kebidanan menyeluruh yang dimulai dengan identifikasi awal, dilanjutkan pengawasan teratur, dan disertai tindak lanjut sesuai kebutuhan. Tujuan: Menggambarkan pelaksanaan pelayanan kebidanan bagi klien dengan kategori risiko paling tinggi akibat anemia, grandemultipara, umur di atas 35 tahun, dan catatan abortus di TPMB Maulidawati Tongguh. Metode: Kajian berbentuk case report ini memakai rancangan satu kasus. Klien ialah perempuan G6P4A1 berumur 41 tahun pada umur kehamilan 24–26 minggu dengan anemia ringan (Hb 10,4 g/dL), grandemultipara, serta riwayat abortus. Pelayanan diberikan mengikuti tujuh tahapan manajemen kebidanan Varney dan dicatat memakai format SOAP. Informasi dikumpulkan melalui anamnesis, pengamatan, evaluasi fisik, evaluasi obstetri, pengujian laboratorium, dan telaah catatan selama tiga kunjungan. Hasil Kasus: Asesmen memperlihatkan keadaan umum klien stabil, parameter vital berada pada rentang fisiologis, denyut jantung janin wajar, serta perkembangan janin sesuai umur kehamilan. Diagnosis yang ditetapkan ialah G6P4A1 umur kehamilan 24–26 minggu dengan kategori risiko paling tinggi karena anemia ringan, grandemultiparitas, umur lebih dari 35 tahun, dan riwayat abortus. Tindakan mencakup pendidikan kesehatan tentang keadaan gestasi serta tanda kegawatan, pengaturan menu seimbang kaya ferum, konsumsi Multi Micronutrient Supplement (MMS) dan tablet Fe secara konsisten, pengawasan tekanan darah serta Hb, dan penyusunan rencana kelahiran beserta rujukan. Sesudah pelayanan berkesinambungan diberikan, keadaan maternal-fetal tetap stabil, keluhan menurun, dan keteraturan mengikuti terapi membaik. Kesimpulan: Pelayanan kebidanan terpadu yang diberikan terus-menerus kepada klien berkategori risiko paling tinggi dapat mempertahankan stabilitas maternal dan fetal, memperkuat kepatuhan terapi, serta membantu menekan kemungkinan penyulit selama masa gestasi. Kata kunci: Anemia, Grandemultipara, Kehamilan risiko sangat tinggi, RiwayatAabortus, Asuhan Kebidanan. CASE REPORT OF MIDWIFERY CARE FOR PREGNANT WOMEN WITH VERY HIGH RISK (ANEMIA, GRANDEMULTI, AGE >35 YEARS, AND HISTORY OF ABORTION) AT TPMB MAULIDAWATI TOGGUH Background: High-risk pregnancies occur when multiple risk factors coexist, thereby increasing the likelihood of complications for both the pregnant woman and the fetus. Hemoglobin deficiency, grandemultiparity, advanced maternal age (over 35), and a history of miscarriage can exacerbate maternal and perinatal morbidity and mortality. Low hemoglobin levels impair the blood's oxygen-carrying capacity to maternal and fetal tissues. Meanwhile, very high parity, advanced reproductive age, and a history of miscarriage are associated with hemorrhage, prolonged labor, fetal growth restriction, and other obstetric complications. Prevention requires comprehensive midwifery care, beginning with early identification, followed by regular monitoring and appropriate follow-up.Objective: To portray the provision of midwifery services for a woman in the highest-risk category because of anemia, grand multiparity, age above 35 years, and a previous abortion at TPMB Maulidawati Tongguh. Methods: This describes the delivery of midwifery services to high-risk clients—specifically those with anemia, grand multiparity, advanced maternal age (over 35), and a history of abortion—at the independent midwifery practice of Maulidawati Tongguh. Case Results: Assessment findings indicated a stable general state, physiological vital parameters, a normal fetal heart rate, and fetal development consistent with gestational age. The diagnosis was G6P4A1 at 24–26 weeks of gestation in the highest-risk category due to mild anemia, grand multiparity, age above 35 years, and a previous abortion. Interventions comprised health education regarding the pregnancy and warning signs, a balanced iron-rich diet, consistent intake of Multi Micronutrient Supplement (MMS) and Fe tablets, surveillance of blood pressure and hemoglobin, and preparation for delivery and referral. Following continuous care, maternal and fetal status remained stable, symptoms diminished, and adherence to treatment improved. Conclusion: Integrated and continuous midwifery services for a woman in the highest-risk category can preserve maternal-fetal stability, strengthen treatment adherence, and reduce the possibility of complications throughout gestation. Keywords: Anemia, Grandemultipara, Very high risk pregnancy, History of abortion, Midwifery care.
| Item Type: | Thesis (Diploma) |
|---|---|
| Contributors: | Contribution Contributor NIDN/NIDK UNSPECIFIED Anis, Nur Laili NIDN4027027601 UNSPECIFIED Esyuananik, Esyuananik NIDN4018067502 |
| Additional Information: | 7LTA20260013 |
| Uncontrolled Keywords: | Anemia, Grandemultipara, Kehamilan risiko sangat tinggi, RiwayatAabortus, Asuhan Kebidanan. |
| Subjects: | R Medicine > Midwifery |
| Divisions: | Poltekkes Kemenkes Surabaya > Jurusan Kebidanan > Program Studi DIII Kebidanan Bangkalan |
| Depositing User: | Mesgimah |
| Date Deposited: | 14 Oct 2026 07:27 |
| Last Modified: | 14 Oct 2026 07:27 |
| URI: | http://repo.poltekkes-surabaya.ac.id/id/eprint/12726 |
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