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Age is a risk factor for postpartum hemorrhage, according to Rahmawati's research. An association between age and bleeding due to uterine atony was also found. Mothers aged 20 to 35 years have a 12 times higher risk of experiencing postpartum hemorrhage than mothers aged 20 to 35 years (Edah, 2019). Age parity is also a risk factor for postpartum hemorrhage. Parity refers to the number of children born to a mother (both born alive or dead). Mothers with three children are more at risk of bleeding after delivery than mothers with parity 1 to 3. The aim of this study is to analyze the relationship between age and parity and the amount of bleeding that occurs in mothers who have just given birth. The literature review method was used in this study. Various scientific articles and research reports discussing risk factors for postpartum hemorrhage are thoroughly explained. The results showed that older maternal age (above 35 years) and high parity (giving birth more than once) increased the risk of postnatal bleeding. These results suggest that mothers with these characteristics should be given special attention to reduce the risk of these complications by obtaining appropriate education, supervision during pregnancy, and appropriate birth planning.

This study is a Systematic Literature Review (SLR) which aims to analyze the relationship between risk factors and the incidence of birth canal laceration and its impact on postpartum hemorrhage. The review of various studies showed that postpartum hemorrhage and perineal rupture have complex and interrelated risk factors, with placental retention, uterine atony, and birth canal laceration as the main causes (p-value <0.05). Maternal characteristics such as age, parity (especially in multiparous with a prevalence of 32.9%), history of previous bleeding (OR=7.725), and pregnancy spacing less than two years (OR=6.943) contributed significantly to the risk of complications. Birth weight had a significant association with the incidence of perineal rupture, while the innovative use of warmpad proved effective with 58.8% of cases showing an intact perineum post-delivery. The study also identified anemia in pregnancy as an important risk factor, with the distribution of causes of postpartum hemorrhage including placental retention (44%), uterine atony (28%), uterine rupture (18.6%), and uterine inversion (9.4%), confirming the importance of comprehensive monitoring during pregnancy to prevent complications.

One of the MGDS global targets is to reduce MMR and IMR. The maternal mortality rate in Indonesia is still high at 390 per 100,000 live births. Referring to the link between birth management and various countermeasures for the biggest cause of AKI is postpartum hemorrhage. Efforts have been made in problems related to bleeding, even several studies have carried out IMD in treating bleeding problems considering that the presence of IMD can affect the hormone oxytocin which is associated with bleeding. The purpose of this study was to see how IMD influences the amount of bleeding in the fourth stage.This research is a Quasi Experiment using primary data. The population and sample were all primiparous women with a total of 46 respondents using the purposive sampling method. The data analysis was univariate and bivariate using the Independent t-test. The results showed that there was a significant effect between IMD on the amount of bleeding in the fourth stage. The average number of bleeding in the fourth stage of respondents who underwent Early Breastfeeding Initiation was 150.63 with a standard deviation of 22.149. Meanwhile, for respondents who did not undergo Early Breastfeeding Initiation, the average number of bleeding in the fourth stage was 166.09 with a standard deviation of 21.580. In the statistical test, the value of P = 0.000 was obtained. With this study, it was found that there was an effect of IMD on the amount of bleeding in the fourth stage of labor. It is hoped that midwives and doctors will implement IMD in order to reduce morbidity and mortality of mothers and babies.

Mortality and morbidity in pregnant women is a serious problem for the world. The causes of maternal death are quite complex problems, which can be classified based on reproductive factors, obstetric complications, health services and economics. The government program, namely early initiation of breastfeeding or breastfeeding after giving birth for the first time, can provide many benefits for babies and mothers so that maternal and infant mortality rates can be reduced with the early initiation of breastfeeding program. This study aims to determine the effect of early initiation of breastfeeding on stopping post partum bleeding at the Tiganderket District Health Center. Tiganderket, Karo Regency. This type of research is quantitative research using a pre-designed experiment with a statistical comparison group approach / control group design only post test, and analyzed using an independent t test. Data collection uses primary and secondary data. The respondents of this research were 16 mothers who gave birth at the Tiganderket District Health Center. Tiganderket, Karo Regency The results of this study show that the average number of fourth stage blood deliveries between mothers who were given early breastfeeding initiation and mothers who were not given early breastfeeding initiation was obtained where p=0.000 so p<0.005, then Ho was rejected and Ha was accepted ..The conclusion is that there is an effect of early initiation of breastfeeding on stopping post partum bleeding at the Tiganderket District Health Center. Tiganderket, Kab. Karo in 2023

Postpartum hemorrhage is a frequent cause of death in mothers with 1,280 cases. One of the causes of postpartum bleeding is a uterus that does not contract or is called uterine atony. Uterine atony keeps the blood vessels open so that blood continues to flow. Efforts to make the uterus contract are by uterine massage. Uterine massage helps make the blood vessels close and stimulates contractions so that the height of the fundus decreases, indicating that the uterus is slowly shrinking. Research objective: to determine the effect of uterine massage on reducing the height of the uterine fundus as an effort to prevent post-partum bleeding. Method: This research uses a quasi-experimental design, namely post test control group design. The sample in this study was part of normal postpartum mothers at BPM. The sample was divided into a treatment group and a control group. The sampling technique uses purposive sampling. Data were analyzed using the unpaired sample t test. The results of the independent t test obtained a p value of 0.071 (p > 0.05). This means that there is no effect of uterine massage on reducing the height of the uterine fundus.  

Background: Sixty percent of all maternal deaths occur during the postpartum period and 45% of these cases occur within the first 24 hours postpartum (WHO, 2018). Steps that can prevent postpartum bleeding management include active third stage, administration of uterotonics and early initiation of breastfeeding. Oxytocin hormone levels will increase in the third stage after separation of the placenta and when early initiation of breastfeeding is carried out because the pituitary gland releases the oxytocin hormone through the baby's stomping, touching and licking of the mother's skin so that it can prevent postpartum bleeding and speed up the expulsion of the placenta naturally. Objective: To determine the effect of early initiation on the number of post-delivery events at the Griya Mazaya midwifery clinic in 2023. Method: The research method uses analytical observational analysis with case control. The research design used a retrospective approach with a sample size of 44 respondents divided into 22 groups of respondents who did IMD and did not do IMD with a data processing test using Mann Whitney. Results: The results of Mann Whitney data processing showed a p value of 0.000, which means p value < sig (0.05) thus proving that there is a difference in the incidence of post-delivery bleeding. Mothers who did IMD had less bleeding than mothers who did not do IMD. Conclusion: Management of early initiation of breastfeeding immediately after the new baby is born can significantly reduce the rate of postpartum hemorrhage.

Haemorrhagic stroke, or also known as spontaneous intracerebral haemorrhage (PIS), is one of the pathological types of stroke caused by intracerebral blood vessels. This condition causes neurological symptoms that occur suddenly and often followed by symptoms due to the spatial effects or increased intracranial pressure (TIK). Generally speaking, the number of strokes is increasing, according to (RISKESDAS) the Ministry of Health of the Republic of Indonesia there is an increase in stroke prevalence from 8.3 (2007) to 12.2 (2013) per 1000 people. In PIS, primary injury occurs: neuron and glia damage mechanically followed by deformation, neurotransmitter release, mitochondrial dysfunction and cell membrane depolarization. Secondary injuries due to haemoglobin breakdown and coagulation factors especially thrombin. The product will activate microglia so it produces toxic substances such as reactive oxygen species (ROS), matrix metalloproteinase (MMP), cyclooxygenase-2, prostaglandin, heme oxygenase-1 (HO-1), complement factor, tumour necrotizing factor α (TNF α), and interleukin 1β causing network injury. In addition to injury, there's also a replacement of dead cells through the neurogenesis process, which is the growth of neuronal stem cells in the subventricular and hippocampus areas. The number of hemorrhagic strokes in Asia is higher than in the West. This could be due to the high incidence of hypertension in the Asian population.

Bleeding is the most common cause of death where cases of open trauma are often found in the community, especially in traffic accidents and other accidents such as sharp object puncture wound. The purpose of this research was to find out the effect of pressure bandage education on knowledge and attitude of stopping bleeding in ordinary people in the 3rd Neighborhood Mahawu Village, Tuminting Subdistrict, Manado.  This research was conducted by using a quasy experimental method (one group prettest and posttest design). Samples were amounted to 15 respondents taken by a random sampling. The instruments used in this research was questionnaire. Then, the collected data was processed by running the SPSS computer program version 16.0 to be analyzed by a Mc Nemar test with the significance level ? = 0,05. The Mc Nemar test result showed the value of knowledge ? = 0,002 which was smaller than ? = 0,05, meaning Ha is accepted or education in pressure bandage techniques can influence the attitude of ordinary people. The conclusion of this research is that there is an effect of pressure bandage education on knowledge and attitude of stopping bleeding in ordinary people in the 3rd Neighborhood Mahawu Village, Tuminting Subdistrict, Manado. It is suggested so that the community can get education with pressure bandage material to increase knowledge, attitudes and reduce the risk of bleeding that occurs.

Anemia pada ibu hamil meningkatkan risiko terjadinya perdarahan postpartum, bila anemia terjadi sejak awal kehamilan dapat mengakibatkan terjadinya persalinan prematur. Penelitian ini bertujuan untuk mengetahui Hubungan Pengetahuan Dan Paritas Ibu Dengan Anemia Pada Ibu Hamil TrimestER III Di Puskesmas Suka Makmur Kabupaten Aceh Tenggara Tahun 2022. Jenis Penelitian ini merupakan penelitian dengan survei analitik dengan pendekatan metode cross sectional. Populasi adalah seluruh ibu hamil Trimester III Di Puskesmas Suka Makmur Kabupaten Aceh Tenggara yaitu sebanyak 58 Orang. Jumlah sampel yang digunakan adalah 58 orang yang diperoleh dengan menggunakan teknik Total sampling. Teknik analisis data menggunakan chi square. hasil yang diperoleh dalam penelitian ini adalah dari 58 responden, ada pengaruh antara pengetahuan ibu  dengan Kejadian Anemia Pada Ibu Hamil Trimester III dengan nilai p= 0,010, ada pengaruh antara paritas ibu  dengan Kejadian Anemia Pada Ibu Hamil Trimester III  dengan nilai p= 0,038. Disarankan kepada pihak puskesmas untuk meningkatkan pengetahuan ibu hamil untuk meningkatkan penyuluhan terkait kejadian anemia pada ibu hamil Trimester III. 

Hipertensi Dalam Kehamilan Merupakan 5 – 15 % penyulit kehamilan dan merupakan salah satu dari tiga penyebab tertinggi mortalitas dengan morbiditas ibu bersalin. Hipertensi gestasional merupakan hipertensi karena kehamilan dimana tekanan darah yang lebih tinggi dari 140/90 mmHg yang disebabkan oleh kehamilan itu sendiri yang terjadi pada trimester pertama dengan usia kehamilan lebih dari 20 minggu yang memiliki potensi menyebabkan gangguan serius pada kehamilan .Mortalitas maternal akibat hipertensi mencapai 16% jika dibandingkan dengan penyebab lain kematian ibu seperti sepsis, perdarahan, dan abortus. Menurut data dari Sepanjang tahun 2010-2013, di Indonesia, penyebab kematian ibu yang utama berturut-turut adalah perdarahan, hipertensi dalam kehamilan, dan infeksi. Karena tidak ada gejala atau tanda khas sebagai peringatan dini. Hipertensi dalam kehamilan atau yang disebut dengan preeklampsia, kejadian ini persentasenya 12% dari kematian ibu di seluruh dunia. Tujuan Penelitian adalah untuk meningkatkan ilmu pengetahuan atau keterampilan dalam memberikan Asuhan Kebidanan Kehamilan dengan Hipertensi Gestasional dengan menggunakan pendekatan manajemen kebidanan 7 langkah Helen Varney dan SOAP. Jenis penelitian yang digunakan penulis dalam studi kasus adalah penelitian deskriptif. Hasil Penelitian didapatkan responden dalam studi kasus ini adalah Ny. H umur 29 tahun G1P0A0 dengan usia kehamilan 28 Minggu 6 Hari, dari hasil pemeriksaan didapatkan tekanan darah yaitu 140/90 mmHg, ibu mengatakan sering merasakan pusing dan tengkuk terasa berat,tidak didapatkan odema pada tungkai kaki, ibu mengatakan kadang mengalami mual muntah, pandangan kabur selama kehamilannya dan ibu mengatakan tidak ada riwayat hipertensi sebelum hamil yang menandakan ibu mengalami hipertensi gestasional.Saran Bagi Tempat Peneliti diharapkan untuk meningkatkan kualitas pelayanan kebidanan pada ibu hamil dengan Hipertensi Gestasional di Klinik Pratama Marko Medan Johor.    

Menstruasi adalah masa perdarahan yang terjadi secara teratur setiap bulan yang disebabkan oleh pelepasan telur yang tidak dibuahi dari ovarium atau indung telur. Remaja putri yang sedang menstruasi harus menjaga kebersihan diri dan hygiene merupakan upaya untuk menjaga kebersihan diri dan kesehatan melalui perawatan diri. Perilaku hygiene saat menstruasi merupakan hal yang penting untuk diperhatikan oleh remaja SMP, jika remaja tidak melakukan personal hygiene saat menstruasi seperti tidak mengganti celana dalam saat mengganti pembalut, mengganti pembalut saat sudah penuh saja, dan jarang mandi dapat menimbulkan gangguan pada fungsi reproduksi. Hasil wawancara dengan salah pengurus PKK menyatakan bahwa siswa di RW 03 Kelurahan Mangunharjo Kecamatan Tembalang belum pernah mendapatkan penyuluhan kesehatan tentang perilaku personal hygiene pada saat menstruasi. Kegiatan   pendidikan   kesehatan   ini   bermanfaat   bagi   pengembangan   pengetahuan dan keterampilan masyarakat khususnya remaja putri pada saat mendapatkan menstruasi. Dari hasil kegiatan ini pengetahuan remaja putri meningkat dari 30% menjadi 70% sedangkan keterampilan meningkat dari 20% menjadi 80%. Saran untuk kegiatan ini dapat ditindaklajuti secara simultan dan melibatkan seluruh elemen yang ada di keluarga dan masyarakat.    

PGK merupakan suatu proses patofisiologi dengan etiologi beragam, mengakibatkan penurunan fungsi ginjal yang progresif dan umumnya berakhir dengan gagal ginjal. Selanjutnya gagal ginjal adalah suatu keadaan klinis yang ditandai dengan penurunan fungsi ginjal yang reversible, pada suatu derajat yang memerlukan terapi pengganti ginjal yang tetap, berupa dialysis atau transplantasi ginjal. Uremia adalah suatu sindroma klinik dan laboratorik yang terjadi pada semua organ, akibat penurunan fungsi ginjal pada penyakit ginjal kronik (Suwitra, 2009).   Gejala sindroma uremia dini ialah gangguan fungsi gastrointestinal. Penderita merasa  mual-mual,  muntah-muntah  dan  tidak  nafsu  makan.  Gejala-gejala  tersebut diduga akibat timbunan metabolit, antara lain: metilguanidin, asam guanidinosuksinat, asam parahidroksi-fenilasetat, fenol, indol, asam-asam aromatik, dan senyawa-senyawa amin. Metabolit-metabolit tersebut berasal dari degradasi protein (Syaifuddin, 2006).   Gejala gastrointestinal  yang lain ialah kerusakan epitel dan perdarahan, mulut kering, lidah terasa pahit, perdarahan gusi, hematemesis, melena. Kerusakan epitel dan gangguan fungsi epitel, diduga karena iritasi oleh timbunan metabolit dan gangguan metabolisme sel-sel- epitel. Gangguaan juga terjadi pada epitel kulit, garukan karena gatal meninggalkan ekskoriasi ditungkai, lengan dan di badan. Rasa gatal diduga akibat timbunan atau endapan kalsium dan ureum di dermis. Gejala kardiovaskuler dapat menyertai PGK, hipertensi, jantung hipertensif, payah jantung kongesif, perikarditis uremik, hemoperikardium, tamponade jantung (Syaifuddin, 2006).    

Perdarahan postpartum menjadi penyebab utama 40% kematian ibu di Indonesia terutama atonia uteri dan ruptur perineum. Tujuan studi kasus ini meresume asuhan kebidanan ibu bersalin primigravida dengan senam hamil terhadap pencegahan ruptur perineum dan mengidentifikasi efektivitas senam hamil terhadap ruptur perineum pada ibu bersalin primigravida. Metode penelitian studi kasus ini menggunakan metode observasional deskriptif  yang dilakukan di Puskesmas Kebakkramat I pada bulan Maret sampai April 2016 pada ibu bersalin primigravida dengan senam hamil melalui teknik pengumpulan  data primer dan sekunder dengan format asuhan kebidanan pada ibu bersalin dengan 7 langkah varney dan melaksanakan latihan senam hamil sesuai dengan SOP serta nama inisial dan surat persetujuan. Hasil penelitian didapatkan responden yang mengikuti senam hamil sejak usia kehamilan 28 minggu dengan frekuensi dan ketepatan pelaksanaan mampu mengurangi resiko terjadinya ruptur perineum sampai dengan derajat IV bersamaan dengan pelaksanaan persalinan yang aman dan nyaman. Kesimpulan senam hamil cukup efektif untuk mengurangi resiko terjadinya ruptur perineum pada ibu bersalin primigravida.