CASE REPORT ASUHAN KEBIDANAN PADA IBU HAMIL MULTIGRAVIDA DENGAN EMESIS GRAVIDARUM DI PMB U DESA TAMBEGAN AROSBAYA

Abstrak

Kehamilan yakni proses fisiologis yang disertai perubahan hormonal sehingga dapat menimbulkan mual dan muntah (emesis gravidarum). Apabila tidak ditangani dengan baik, kondisi tersebut dapat menyebabkan gangguan pemenuhan nutrisi ibu, dehidrasi, serta berdampak pada kesehatan ibu dan janin. Tujuan case report ini yakni mendeskripsikan asuhan kebidanan pada ibu hamil multigravida trimester II dengan emesis gravidarum di PMB U Desa Tambegan Arosbaya melalui pendekatan SOAP. Case report dengan pendekatan manajemen asuhan kebidanan menggunakan SOAP. Di dalam studi kasus ini yakni Ny. I, ibu hamil multigravida G3P0A2 usia kehamilan 17–18 minggu dengan emesis gravidarum. Asuhan dilakukan melalui tiga kali kunjungan yang meliputi pengkajian, analisis, penatalaksanaan, dan evaluasi perkembangan kondisi ibu. Hasil asuhan berdasarkan pendekatan SOAP menunjukkan bahwa  ibu mengeluh mual dan muntah 5–6 kali sehari disertai pusing, lemas, penurunan nafsu makan, serta sensitif terhadap aroma menyengat. Serta menunjukkan keadaan umum baik, kesadaran composmentis, tekanan darah 110/70 mmHg, berat badan 50,4 kg, IMT 22,4 kg/m², LiLA 26 cm, wajah tidak pucat dan tidak edema, konjungtiva merah muda, sklera putih, bibir tidak pucat, ekstermitas tidak ada sianosis maupun edema, menunjukkan TFU 17 cm, turgor kulit baik, DJJ 145x/menit, serta kadar hemoglobin 12,1 g/dL. Ditegakkan G3P0A2 Uk 17-18 minggu dengan Emesis Gravidarum. Asuhan yang dilakukan yaitu mengedukasi tirah baring posisi miring ke kiri, konseling pola makan small and frequent feedings tinggi karbohidrat dan protein, Anjuran menghindari makanan berlemak, Menghindari makanan yang mengandung gas dan berbau menyengat, pemberian aromaterapi lemongrass, Memberikan konseling mengenai dukungan keluarga, serta mengedukasi mengenai tanda bahaya kehamilan. Evaluasi setelah tiga kali kunjungan menunjukkan frekuensi mual dan muntah menurun dari 5–6 kali sehari menjadi 1 kali sehari hingga tidak ada keluhan, nafsu makan meningkat, pola istirahat membaik, berat badan meningkat dari 50,4 kg menjadi 52,4 kg, serta kondisi ibu dan janin tetap baik dengan DJJ dalam batas normal. Asuhan kebidanan yang diberikan secara komprehensif melalui pendekatan SOAP efektif membantu mengurangi keluhan emesis gravidarum dan meningkatkan status kesehatan ibu hamil

Appendices Pregnancy is a physiological process accompanied by hormonal changes that can lead to nausea and vomiting (emesis gravidarum). If not managed properly, this condition can impair the mother's nutritional intake and cause dehydration, thereby affecting the health of both the mother and the fetus. The objective of this case report is to describe the midwifery care provided to a multigravida pregnant woman in her second trimester suffering from emesis gravidarum at PMB U, Tambegan Village, Arosbaya, utilizing the SOAP approach. This case report employs the SOAP Approach to midwifery care management. The subject of the study is Mrs. I, a multigravida pregnant woman (G3P0A2) at 17–18 weeks of gestation presenting with emesis gravidarum. Care was administered over three visits, encompassing assessment, analysis, management, and evaluation of the mother's condition. Care outcomes based on the SOAP approach revealed that the mother complained of nausea and vomiting 5–6 times daily, accompanied by dizziness, weakness, reduced appetite, and sensitivity to strong odors. Clinical findings showed a good general condition and clear consciousness (compos mentis); blood pressure was 110/70 mmHg, body weight 50.4 kg, BMI 22.4 kg/m², and mid-upper arm circumference (MUAC) 26 cm. Physical examination showed no facial pallor or edema; pink conjunctiva; white sclera; no lip pallor; and no cyanosis or edema in the extremities. Fundal height was 17 cm, skin turgor was good, fetal heart rate was 145 beats per minute, and hemoglobin level was 12.1 g/dL. The diagnosis established was G3P0A2 at 17–18 weeks of gestation with emesis gravidarum. The care provided included educating the patient on left-lateral recumbent positioning (lying on the left side); counseling on a diet of small, frequent meals high in carbohydrates and protein; advising against fatty, gas-producing, and strong-smelling foods; administering lemongrass aromatherapy; providing counseling on family support; and educating the patient on pregnancy danger signs. Evaluation after three visits showed a decrease in the frequency of nausea and vomiting from 5–6 times daily to once daily or none at all; improved appetite and rest patterns; a weight increase from 50.4 kg to 52.4 kg; and a stable condition for both mother and fetus, with fetal heart rates remaining within normal limits. Comprehensive midwifery care delivered via the SOAP approach proved effective in alleviating symptoms of emesis gravidarum and improving the pregnant woman's health status.