THE IMPORTANCE OF THE RIGHT FACTORY FAKE BUNDLE

MANAGEMENT
ON THE FETAL DISTRESS CASE
Nina Sari
Juara.djatti@gmail.com
Health Polytechnic Of Semarang

Abstract
Fetal distress over the cause of hypoxia impact fetal life threat disdain womb, during
labor, shortly after the fetus was established and a short time later after it. This study is
use a systematic review. Data taken from the literature was done via the Internet in the
form of results of research on interventions on the management of fetal distress. A
literature search is made in AJOG, RCOG, Google Scholar and others. Result:
Management of fetal distress can be taken in different ways according to the causes of the
conditions found in a fetus during fetal distress. Measures of labor per abdominal soon be
the reason rescues the baby under special conditions. The process proved vaginal delivery
can cause a risk of asphyxia and fetal distress has not always been right melatonin
oxygenation and tend to cause adverse effects on the fetus if exaggerated and not yet
found the treatment of disorders of fetal well-being in the condition of infected women.
Conclusion: determine the management of fetal distress appropriate action with some
combination of actions bundle management fetal distress. Subsequent research needs
innovation for stabilization measures esophagi fetus with fetal distress due to face a fever
in pregnant women being affected by infectious diseases.

Keyword: Fetal distress, pregnant with infection, oxygen

1. INTRODUCTION
Circumstances hypoxia or lack of oxygen since the baby still in the womb
memorial anger contribute to the improvement of infant mortality in Indonesia. Hypoxia
which caused fetal distress pecker with infant outcome in a putrid state. Fetal distress is a
condition that involves a combination of hypoxemia and metabolic and respiratory
acidosis and not just because of metabolic acidosis is a consequence of hypoxemia, but
also because the correlation has been shown between fetal distress and fetal
oxygenation(1, 2). Hypoxia, which lasts longer is capable of being harmful to the fetus.
Fetal distress can occur for many reasons including uterine activity is excessive,
hypertonic uterus, may be associated with oxytocin, maternal hypotension, epidural
anesthesia, compression of the vena cave, the supine position, uterine contractions,
placental abruption and placenta preview with bleeding (3). Infant Mortality Rate (IMR)
in the last few years has decreased within the last 20 years. This figure is always very
opposed to the percentage of infant deaths in 2016 occurred in the year Singapore is 10
deaths per 1000 live births(4).In Indonesia, being a function of data Badan Pusat Statistik
(BPS) noted that the number equation infant (IMR) reached 25.5 per 1000 infants died at
age 0-12 months(5).Because the death of a baby due to fetal distress before the baby is
born. Cases of fetal distress that end with birth asphyxia second largest after the law.
IMR in Central Java province in 2016 as many as 5485 cases or as much as 9.99 of all
deaths in Indonesia(6).While in the first trimester of 2017 has reached 851 cases(7).As
one indicator of health status, the IMR for any cause should be lowered, including over
the cause of fetal distress as a manifestation of intrauterine hypoxia, or thanks to other
reasons.
The influence of fetal distress can occur when the fetus is still in the womb in the
form of fetal death in use and can also occur after the baby is born. If the fetus can be
issued as part of life outside the womb, then it will be under a cesarean risk. Management
of fetal distress now by means of intensive monitoring by means of monitoring fetal heart
rate, intrauterine resuscitation, amniotic infusion and acceleration when two urgent
caesarean section(3).Urgency chronic emerged during lengthy periods of time during the
process before the baby gets born and during this period is critical to the existence of a
provision of appropriate interventions to prevent the fetus in hypnotic conditions.
Existing interventions for fetal distress menopausal problems such as discontinuation of
oxytocin in case the acceleration process of childbirth, repositioning mother,
amniocentesis, oxygenation and giving toxicity(3). From some research on fetal distress,
treatment of intrauterine fetal distress is a function of the cause of fetal distress or fetal
welfare state that disturbed them. However, in certain circumstances, fetal distress can
intervene in several ways to cope with the serious condition of the fetus. Until now, there
has been no recommendation/guidelines applicable for management of fetal distress.
Such as the state tachycardia fetal heart rate for mothers with extreme heat or arena
infection process.
Eden fetal distress may soon be known only after the original inspection in
routine examination during labor supervision. FHR-monitoring more manageable only if
found bradycardia and tachycardia conditions. Monitoring in breezy conditions, was
maintained at the state of women who did get a higher risk of fetal distress, such as the
state of the placenta preview, placental abruption and circumstances that induced labor.
FHR-monitoring high risk is very useful if the detection of fetal distress and fear of dying
 fetus(8). Clinical practice management of fetal distress during labor is only discussed in
one of the factors being studied only. If so, was tantamount to undergo a service capable
of implementing the termination of the deteriorating condition of the fetus with fetal
distress signs only some of them know that it. There are no systematic similarity
measures as well as alternative actions they can do. If this condition continues being
prevailing among practitioners of midwifery services in advanced service facilities, the
prevalence of IMR danger will increase.
There is required to control the incidence of fetal distress, shorten the incidence
of intra uterine fetal hypoxia intrauterine resuscitation intervention was crucial.
Magnificat very unusual for practitioners of midwifery services sector obstetric
gynecological pathology services to be in a position to get an overview and management
of fetal distress guide arrangement according factors that make it happen. Take into
account the importance of knowledge management of fetal distress, fetal distress Bundle
intervention to provide guidance to practitioners of midwifery services.

2. METHODES
This article requires a systematic review. Sources of research data collected from
the literature via the Internet in the form of results of research on interventions on the
management of fetal distress. A literature search is made in AJOG, RCOG, and GOOGLE
SCHOLAR. The purpose of this study was to determine the application bundle in
preventing fetal distress fetal hypoxia conditions. The data collection is done by selecting
the variables that support the system reviewed journals. The unit of analysis is the study
of national and international journals journal with a span of years from 2010 to 2017.
3. RESULT
Intravenous consequences of research and review journals can show in table 1
which displays on the picture of the impact of various interventions in dealing with the
problem of hypoxia in fetal distress. Samples were drawn from various hospitals in the
world. Interventions are provided for universal guidelines for regional map. This table
showed the result of some researches about fetal distress
Results Research Number of Research Researchers
Method Samples Title
applied intrauterine - survey Dutch 86 Variation in Lauren M. Bullens, b,
resuscitation method, hospitals the Suzanne Moorsa,
techniques in an using management Pieter J. van Runnard
effort to prevent questionnaire practices of Heimela, M. Beatrijs
immediate s intrapartum van der Hout-van der
.delivery fetal distress in Jagt, b, S. Guid Oeia ,
Amnioinfusion not - the b
help to improve Netherlands (2016)
neonatal and the
oxygenation, so Western world
that these
interventions are
.not recommended
No recommendations -
were made on the
use of
.hyperoxygenation
discontinuation of -
oxytocin, the
repositioning of the
mother and
direkomendasaikan
tocolytic drug
.administration
SC emergency is - double-blind, in 1012 PROTOCOL Liam Dunn, Vicki
recommended for randomized, Reducing the Flenady and Sailesh
the birth when fetal phase II risk of fetal Kumar (2016)
distress distress with
the study of
sildenafil
(RIDSTRESS)
: a double-
blind control
randomized
trial
process of - Survey 1150 Relationship Mulastin (2014)
spontaneous labor analytic types of labor
may cause a risk of studies by asphyxia
asphyxia Retrospectiv neonatorum in
e RSIA jade
siwi
Pecangaan
Jepara
oxygen inhalation, - Cross- 283 oxygen for Hamel (2014)
expecting to Sectional resuscitation
improve metabolic :intrauterine
conditions of their of Unproved
fetuses, or at least benefit and
alleviate the fetal Potentially
heart rate pattern is harmful
erratic
4. DISCUSSION
Distress fetus or commonly called fetal distress is a requirement that triggers
heightened concerns for public health professionals in the field of obstetrics will be the
condition of the fetus by patients he washes. Fetal distress is always associated with the
condition of the fetus in a state of lack of oxygen. If the condition is not immediately
hands it can be turned into a poor prognosis. Effects of hypoxia is usually the case that
led to delivering. Can infants with asphyxia as a result of respiratory depression due to
pressure changes occur in the micro environment neuromodulators constituents
respiratory neurons(9) So among practitioners birth attendance, the diagnosis of fetal
distress can be a reason for ending a pregnancy. Appropriate intervention can narrow the
dangers of fetal distress. The risk of stillbirth, intrauterine death and the death of babies
after some time the lives of many due to hypoxia that causes the baby asphyxiated as the
principal causes above. Of course, this will result in increasing infant mortality risk
contributor. On the other hand, hypoxia infants with asphyxia dislike uteri which can be
saved and can also cause residual symptoms at the next baby's life as early hearing loss or
deafness(10).
At present specific guidelines for management of fetal distress have produced
countless new ways of practice pedestrian evidence. However, apparently not all methods
were used for the hypoxia of separate causes of. Angina serious precautions until now
there is not any right. Building on research Hamel (2014), states that the provision of
oxygen can improve the metabolic condition. This is consistent with the theory that
oxygen is administered through face masks 6 liters per minute can improve oxygen
turnover Fetomaternal so that the fetus will not be hypoxia. However, there are
weaknesses in the administration of oxygen therapy is a fact that if there is a contraction
of the uterus hence oxygen delivery should be stopped because it would disrupt the
outpouring of blood to interview space. So intervention oxygenation administration has
still not been effective in preventing fetal distress (11).
According to research conducted by the Bullens, b. Suzanne Moorsa, Pieter J.
van Runnard Heimela, M. Beatrijs van der Hout-van der Jagt, b, S. Guid Oeia, b (2016),
there are some interventions that can be done or not be done. Interventions that can be
done eg intrauterine resuscitation techniques are important to understand for the
administration of oxygen can prevent tissue hypoxia directly. Termination of oxytocin in
labor induction process is recommended to prevent the occurrence of vasospasm thus
reduced intake of oxygen to the fetus. Repositioning the expectant mother is positioned in
 the left lateral position on the state of intra uterine fetal distress. Reposition tilted to the
left side in an effort to relieve compression of aorta Kaval and improve blood flow,
cardiac output and uteroplacental blood flow. Changes in a definite position in the case of
umbilical cord loops can relieve cord compression. While not recommended the use of
hyperoxygenation because it can cause toxicity in the fetus(12). In fetal distress kneading
practitioner obstetrician to take measures save the babies from final action pregnancy by
surgery (Sectio Caesarea). This delivery is the recommended delivery problem occurs
when fetal distress(8). This is supported by numerous studies that further recommend
childbirth per abdominal compared with normal birth owing to consider a wide range of
hazards and benefits.
Very deemed necessary also for the benefit of consideration of gestation number
and age of the mother during pregnancy. As the result of research Mulasti (2014),
dissemble the fact that, with the labor of the mother asphyxiated condition intrauterine
fetal hypoxia impact, spontaneous labor process, risk causing asphyxia(13).Fetal distress
cases also occur in pregnant women with febrile phase caused by the infection process.
Circumstances experienced fever pose a threat to disruption of fetal wellbeing. Often
fetuses bradycardia and tachycardia. Some communicable diseases in the mother, can
cause fever and infection risk threatening the welfare condition of the fetus(14).Until now
penetration of it is supposed to be very minimal and treatment of fetal distress thanks to
the infection process, yet.

5. CONCLUSION
Bundle interventions for the treatment of fetal distress in use can be finished with
intrauterine resuscitation, repositioning mother, the discontinuation of oxytocin,
administration and labor totalistic SC. When this has been accomplished, but AKB is still
astronomical. Therefore it takes some innovation to maximize the intervention. In
general, these interventions usually did separately depend on the cause of fetal distress
and fetal conditions as they are found in a state of intrauterine fetal distress. Not all
practitioners delivery service can combine the management of applicable actions fetal
condition and cause fetal distress. Many things can affect the course, including the helper
still approaches in treatment of fetal distress.
Of the many results of research management of fetal distress, only a few are
found research on fetal distress caused by the state of infection in the mother, and have
not found the actions management of fetal distress on because the circumstances of
 mothers with hyperthermia Therefore it is necessary to research based on management
bundle fetal distress for The purpose of this fetal distress bundle management to
maximize the results of the intervention so that AKB can be reduced.

BIBLIOGRAPHY

1.