TERAPI BIRTHING BALL UNTUK MENGURANGI NYERI KALA I PERSALINAN PADA IBU BERSALIN DI RSUD KOTA MATARAM

ABSTRAKBirthing ball merupakan salah satu metode active birth menggunakan bola pilates yang membantu ibu inpartu kala I. Penggunaan bola pilates dengan melakukan gerakan seperti duduk dibola dan bergoyang-goyang, membuat kemajuan persalinan, memberikan rasa nyaman dan, serta meningkatkan sekresi endoprin disebabkan kelenturan dan kelengkungan bola merangsang reseptor dipanggul. Tujuan dari pengabdian masyarakat ini adalah memberikan penyuluhan dan pelatihan tentang birth ball. Metode yang digunakan antara lain ceramah/penyampaian materi menggunakan leaflet, praktikum atau pelatihan langsung kepada peserta serta tanya jawab guna mendukung pengetahuan ibu tentang terapi birthing ball. Hasil dari kegiatan pengabdian dibuktikan dengan keaktifan peserta dalam kegiatan ini, pelaksanaan kegiatan telah mampu meningkatkan pengetahuan ibu bersalin dalam mengurangi nyeri pada kala I persalinan, dapat mengelola rasa nyeri saat kontraksi dan ketidaknyaman ibu seperti rasa cemas berlebih dan mengelola pernafasan serta dapat mengurangi sakit punggung, sesak nafas. Hasil kegiatan ini sangat berdampak positif pada proses persalinan ibu yang lahir dengan normal atau pervaginam tanpa adanya intervensi dilakukan tindakan Sectio Caesaria. Kata kunci: birthing ball; nyeri kala I persalinan; ibu bersalin. ABSTRACTBirthing ball is one of the active birth methods using a pilates ball that helps pregnant women in the first stage. The use of a pilates ball by doing movements such as sitting on a ball and rocking, makes labor progress, provides a sense of comfort and, and increases the secretion of endorphins due to the flexibility and curvature of the ball. stimulate hip receptors. The purpose of this community service is to provide counseling and training about birth balls. The methods used include lectures/delivery of material using leaflets, practicum or direct training to participants and questions and answers to support mother's knowledge about birthing ball therapy. The results of the service activities are evidenced by the activeness of the participants in this activity, the implementation of the activities has been able to increase the knowledge of maternity mothers in reducing pain in the first stage of labor, can manage pain during contractions and maternal discomfort such as excessive anxiety and manage breathing and can reduce back pain, out of breath. The results of this activity have a very positive impact on the delivery process for mothers who are born normally or vaginally without any intervention by performing Sectio Caesaria. Keywords: birthing ball; pain in the first stage of labor; mother gave birth.

The ‘occiput-spine angle’: a new sonographic index of fetal head deflexion during first stage of labor as predictor of course of labor and outcome

Background Labor is a physiologic process during which the products of conception (i.e. the fetus, membranes, umbilical cord, and placenta) are expelled outside of the uterus. Labor is achieved with changes in the biochemical connective tissue and with gradual effacement and dilatation of the uterine cervix as a result of rhythmic uterine contractions of sufficient frequency, intensity, and duration. Labor is divided into three stages that include cervical dilatation, fetal delivery and delivery of the placenta. Objective The aims of this study were to quantify the degree of fetal head deflection via the use of Ultrasound during the first stage of labor and to determine whether a parameter derived from ultrasound examination (the occiput-spine angle) has a relationship with the progress of labor, subsequent effect on maternal, fetal complications and rate of cesarean delivery. Methods This is a prospective cohort study which includes a total of 200 women with gestational age 37-42 weeks were assessed in this study in Ain shams Maternity hospital labor ward by 2 dimensional ultra sound. Examinations were performed after a verbal and written consent from the patient with the patient lying in the dorsal supine position. And exclusion of Occiput-posterior position, multigravida, Indication for cesarean, Medical disorder eg hypertension or diabetes, pre labor rupture of membranes to correlate between the Occiput- spine angle (OSA) and the outcome of labor regarding the progress of labor, incidence of cesarean section, maternal and fetal complications. Results This study demonstrates that the sonographic measurement of the angle formed by the fetal occiput and the spine (occiput-spine angle) is feasible and reproducible, the occiput-spine angle in the first stage of labor is positively correlated with the clinically established station and the risk of obstructed labor requiring an operative delivery ie, Occiput-spine angle have been statistically significantly lower in cases underwent operative delivery. Occiput-spine angle had a statistically significant low diagnostic performance in predicting operative delivery. Conclusion The occiput-spine angle in the first stage of labor correlates significantly with the risk of obstructed labor Compared with spontaneous vaginal deliveries, cases that require obstetric intervention demonstrated a smaller occiput-spine angle at a similar station, suggesting diminished flexion of the fetal head. For occiput anterior fetuses, the greater the degree of fetal head deflexion, the greater risk of operative delivery due to labor arrest.

PENGARUH KOMBINASI PIJAT ENDORPHIN DAN MURROTAL TERHADAP NYERI PERSALINAN KALA I DI PMB NY. N PASPAN KABUPATEN BANYUWANGI

Introduction: During labor, uterine contractions, cervical dilatation and stretching of the lower uterine segment cause pain. Pain during labor that is not resolved properly can affect the physiological mechanisms of a number of body systems. In addition to labor pain can be overcome with endorphin massage, can also be overcome with murottal therapy. Objective : To examine the effect of endorphin and Murrotal massage therapy on labor pain in the first stage at PMB Miss. N Paspan Banyuwangi Regency. Methods: The design of this study used Quasy Experimental with pre-test – post test control group. A sample of 20 mothers who gave birth were divided into 10 women who gave birth in the treatment group and 10 women who gave birth in the control group. The measuring tools used are questionnaires and observation sheets, the data collected is then tested with the Wilcoxon Signed Rank. Results: There is an effect of a combination of endorphin and Murrotal massage on labor pain in the first stage with a significant degree of < 0.05. Conclusion: The implication of this study is to reduce labor pain in the first stage of labor by using a combination of endorphin and murrotal massage.

Efektifitas Massage Counter Pressure Pada Nyeri Persalinan Kala I Fase Aktif

Labor pain is a subjective experience of physical sensations associated with uterine contractions, cervical dilation and thinning, and fetal decline during labor. Severe pain condition during the first stage of labor allows mothers to tend to choose the easiest and fastest way to relieve pain. Efforts that can be made to deal with the first stage of labor pain are non-pharmacological methods, one of which is counter pressure massage. To determine the difference in pain before and after counter pressure massage in the active phase I labor pain. This type of research is a quasi-experimental design with a pretest and posttest control group design. The sampling method was accidental sampling with a sample size of 15 people. Statistical test analysis using Dependent T-Test. The average labor pain before counter pressure massage was 3,600 with a standard deviation of 0.507 and after counter pressure massage the respondent's pain value was 2,666 with a standard deviation of 0.617, it was seen that there was a difference in value or decrease before and after the counter pressure massage was carried out, namely 0.933 with standard deviation of 0.258 and the statistical test results obtained p = 0.000. There was a significant difference between pain before and after counter pressure massage at Alin's Medical Clinic. It is hoped that health workers, especially midwives, can provide counter pressure massage to mothers who give birth in order to reduce morbidity and mortality in mothers. ABSTRAK Nyeri persalinan merupakan pengalaman subjektif tentang sensasi fisik yang terkait dengan kontraksi uterus, dilatasi dan penipisan serviks, serta penurunan janin selama persalinan. Kondisi Nyeri yang hebat pada kala I persalinan memungkinkan para ibu cenderung memilih cara yang paling gampang dan cepat untuk menghilangkan rasa nyeri. Upaya yang dapat dilakukan untuk mengatasi nyeri persalinan Kala I adalah dengan metode non farmakologis salah satunya dengan massage counter pressure. Untuk mengetahui perbedaan nyeri sebelum dan sesudah massage counter pressure pada nyeri persalinan kala I Fase Aktif. Jenis penelitian yang digunakan adalah quasi eksperimen dengan rancangan one group pretest dan posttest desgn. Metode pengambilan sampel secara accidental sampling dengan jumlah sampel 15 orang. Analisis uji statistik menggunakan Dependent T-Test. Rata-rata nyeri persalinan sebelum dilakukan massage counter pressure adalah 3.600 dengan standar deviasi 0.507 dan setelah dilakukan massage counter pressure nilai nyeri responden yaitu 2.666 dengan standar deviasi 0.617, terlihat adanya perbedaan nilai atau penurunan sebelum dan sesudah dilakukan massage counter pressure yaitu 0.933 dengan standar deviasi 0.258 serta hasil uji statistik didapatkan p=0.000. Ada perbedaan yang signifikan antara nyeri sebelum dan sesudah dilakukan massage counter pressure di Alin’s Medical Clinic. Diharapkan petugas kesehatan terutama bidan dapat memberikan massage counter pressure pada ibu bersalin agar dapat mengurangi angka morbiditas dan mortalitas pada ibu

Impact of epidural labor analgesia using sufentanil combined with low-concentration ropivacaine on maternal and neonatal outcomes: a retrospective cohort study

Background Whether epidural administered sufentanil combined with low-concentration ropivacaine affected labor progress as well as maternal and neonatal outcomes still remained unknown. The aim of this study was to assess the impact of epidural sufentanil plus ropivacaine on maternal and neonatal outcomes. Methods This is a retrospective cohort study. Data of singleton full-term pregnancy women who received epidural labor analgesia for vaginal delivery from May 2018 to June 2020 were collected. Parturients were divided into two groups (the R group and the SR group) according to different medication regimens for epidural labor analgesia. The implementation of epidural analgesia during labor was performed with 0.167 % ropivacaine in the R group and 0.1 % ropivacaine in combination with 0.5 µg/ml sufentanil in the SR group. The primary outcome of our study included the duration of labor progress and the incidence of maternal fever, postpartum hemorrhage, fetal distress and neonatal Apgar scores less than 7 at 1 and 5 min. The secondary outcome included the incidence of episiotomy, instrumental delivery, caesarean section and grade III meconium-stained amniotic fluid. Results There were a total 3778 deliveries during the study period, 1994 and 1784 parturients were included in the R group and in the SR group, respectively. The length of the first stage of labor was remarkably shorter in the R group in comparison to the SR group (548.0 ± 273.0 vs. 570.9 ± 273.0, P = 0.013). No significant difference was found in the incidence of maternal fever, postpartum hemorrhage, fetal distress and in the neonatal Apgar scores less than 7 at 1 and 5 min between two groups. Other Maternal outcomes were comparable in the R group and the SR group. Conclusions 0.5 µg/ml sufentanil plus 0.1 % ropivacaine for epidural labor analgesia prolonged the duration of the first stage of labor, but did not have additional impact on maternal and neonatal outcomes compared with the sole 0.167 % ropivacaine. Trial registration Clinical Research Information Service with registration number ChiCTR2100045162. Registered 7 April 2021.

Massage Using Frangipani Aromatherapy Oil to Speed up The Duration of Childbirth

Excessive anxiety during childbirth can cause changes in bodily functions. The impact is that the labor process takes longer, causing complications to both mother and baby. One of the non-pharmacological ways that can be done so that the labor process is gone naturally is by providing complementary massage therapy and frangipani aromatherapy. This research aims to determine the effect of back massage using frangipani aromatherapy oil in the first stage of labor on the duration of childbirth. The type of this research is Quasi-Experimental Design, posttest control group design. The sample is 80 people consisting of the control group of 40 people and the treatment group of 40 people. The sampling technique used is Consecutive Nonprobability Sampling. The data were recorded in the observation sheet. Also. The data analysis was done through univariate and bivariate "unpaired t-test". The results showed that the average duration of childbirth in the control group was 31.25 minutes, while the treatment group was 23.75 minutes. There is an effect of massage using frangipani aromatherapy oil in the first stage of labor on the duration of childbirth at a significance level of 0.01 (p &lt;0.05). In conclusion, there is the effect of massage using frangipani aromatherapy oil in the first stage of labor on the duration of childbirth. It is hoped that midwives will use complementary frangipani aromatherapy massage in providing midwifery care during the first stage of normal labor.

Intrapartum Fetal Electrocardiogram in Small- and Large-for-Gestational Age Fetuses

Objective This study aimed to evaluate whether intrapartum fetal electrocardiogram (ECG) tracings with ST-elevation or depression occur more frequently in each stage of labor in small-for-gestational age (SGA) or large-for-gestational age (LGA), as compared with appropriate-for-gestational age (AGA) fetuses. Study Design We conducted a secondary analysis of a large, multicenter trial in which laboring patients underwent fetal ECG waveform-analysis. We excluded participants with diabetes mellitus and major fetal anomalies. Birth weight was categorized as SGA (<10th percentile), LGA (>90th percentile), or AGA (10–90th percentile) by using a gender and race/ethnicity specific nomogram. In adjusted analyses, the frequency of ECG tracings with ST-depression or ST-elevation without depression was compared according to birthweight categories and labor stage. Results Our study included 4,971 laboring patients in the first stage and 4,074 in the second stage. During the first stage of labor, there were no differences in the frequency of ST-depression in SGA fetuses compared with AGA fetuses (6.7 vs. 5.5%; adjusted odds ratio [aOR]: 1.41, 95% confidence interval [CI]: 0.93–2.13), or in ST-elevation without depression (35.8 vs. 34.1%; aOR: 1.17, 95% CI: 0.94–1.46). During the second stage, there were no differences in the frequency of ST-depression in SGA fetuses compared with AGA fetuses (1.6 vs. 2.0%; aOR: 0.69, 95% CI: 0.27–1.73), or in ST-elevation without depression (16.2 vs. 18.1%; aOR: 0.90, 95% CI: 0.67–1.22). During the first stage of labor, there were no differences in the frequency of ST-depression in LGA fetuses compared with AGA fetuses (6.3 vs. 5.5%; aOR: 0.97, 95% CI: 0.60–1.57), or in ST-elevation without depression (33.1 vs. 34.1%; aOR: 0.80, 95% CI: 0.62–1.03); during the second stage of labor, the frequency of ST-depression in LGA compared with AGA fetuses (2.5 vs. 2.0%, aOR: 1.36, 95% CI: 0.61–3.03), and in ST-elevation without depression (15.5 vs. 18.1%; aOR: 0.83, 95% CI: 0.58–1.18) were similar as well. Conclusion The frequency of intrapartum fetal ECG tracings with ST-events is similar among SGA, AGA, and LGA fetuses. Key Points