Distosia Bahu
description
Transcript of Distosia Bahu
![Page 1: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/1.jpg)
Distosia bahuDistosia bahu
Dr. murtiningsihDr. murtiningsih
![Page 2: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/2.jpg)
definisidefinisi
Tertahannya bahu depan diatas simfisisTertahannya bahu depan diatas simfisis Ketidakmampuan melahirkan bahu pada Ketidakmampuan melahirkan bahu pada
persalinan normalpersalinan normal InsidensiInsidensi
1-2/ 1000 kelahiran1-2/ 1000 kelahiran
16/1000 kelahiran bayi > 4000 gr16/1000 kelahiran bayi > 4000 gr
![Page 3: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/3.jpg)
Komplikasi distosia bahuKomplikasi distosia bahu
BayiBayi Kematian, asfiksia dan komplikasinyaKematian, asfiksia dan komplikasinya fraktur klavikula, humerusfraktur klavikula, humerus Kelumpuhan pleksus brakialisKelumpuhan pleksus brakialis
IbuIbu Perdarahan pospartumPerdarahan pospartum Ruptur uteriRuptur uteri
![Page 4: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/4.jpg)
Faktor risikoFaktor risiko
Kehamilan lewat waktuKehamilan lewat waktu Obesitas ibuObesitas ibu Bayi makrosomiaBayi makrosomia Riwayat distosia bahu sebelumnyaRiwayat distosia bahu sebelumnya Kelahiran lewat operasiKelahiran lewat operasi Persalinan lamaPersalinan lama Diabetes tak terkontrolDiabetes tak terkontrol
![Page 5: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/5.jpg)
diagnosisdiagnosis
Kepala bayi melekat pada perineumKepala bayi melekat pada perineum Kala II persalinan yang memanjangKala II persalinan yang memanjang Gagal lahir walau dengan usaha Gagal lahir walau dengan usaha
maksimal dan gerakan yang benarmaksimal dan gerakan yang benar
![Page 6: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/6.jpg)
Ask for hellpAsk for hellp Lift- bokong kakiLift- bokong kaki manuver Mc Robert manuver Mc Robert Anterior disimpaction of shoulderAnterior disimpaction of shoulder rotate rotate
to oblique, suprapubic pressureto oblique, suprapubic pressure Rotation of posterior shoulderRotation of posterior shoulder Wood Wood
manuvermanuver Manual of removal of posterior armManual of removal of posterior arm
![Page 7: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/7.jpg)
![Page 8: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/8.jpg)
Gherman et al Obstet Gynecol 95:43 ,2000
McRoberts manoeuvre: X ray pelvimetry study
![Page 9: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/9.jpg)
Wood manuverWood manuver
![Page 10: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/10.jpg)
By inserting a hand into the posterior
vagina and ventrally rotating the arm at
the shoulder
delivery over the perineum
![Page 11: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/11.jpg)
1. The head first manually rotated to the occipito anterior
(Pre-restitution) position
![Page 12: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/12.jpg)
![Page 13: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/13.jpg)
2.Flexion of the head, Returning it to the vagina with upward constant firm pressure, followed by CS
![Page 14: Distosia Bahu](https://reader035.fdocuments.net/reader035/viewer/2022062314/563dbb56550346aa9aac4d39/html5/thumbnails/14.jpg)