Formula foods for pregnant women

For the growth and differentiation of fetal activity requires food channeled through the placenta , Food formula to pregnant women and therefore in a state of expectant mothers should receive enough food for themselves and the fetus ( eating for two ) . So for them the quality and quantity of food that is usually sufficient for health , must be added to the nutrients and energy that goes both fetal growth . Anyway in the state mother hamilseorang undergone many changes in the body to be ready to raise her fetus , facilitate birth , and for the production of breast milk for the baby to be born . For successful pregnancy maternal nutritional status at the time of conception must be in good condition , and during pregnancy get extra protein , minerals such as iron and calcium , vitamins folic acid and vitamins other , as well as energy . This extra can be done by drinking at least stengah liters of milk ( formula can now be purchased specifically for women who are pregnant and breastfeeding , as Lactomil , Prenagen , Sustagen , Mama and Vita - Nova ) every day , eat more meat , eggs , and nuts legumes as a source of protein , eat more fresh vegetables and fruits to meet the needs of minerals and vitamins as well as launch a bowel movement .
Food additives are recommended for pregnant women
Therefore, pregnant women showed that weight gain quite a lot , both for components and for the fetus itself, it is advisable for them to be food additives such as energy , protein , vitamins and minerals as well . Adequacy of the recommended list for those berlinan with women who are not pregnant , which is as follows :

    energy
    The extra energy needed during pregnancy for both the fetus and the changes kompenn contained in itself . It is estimated that approximately 27,000 kcal or 100 kcal / day is needed during pregnancy .
    protein
    Additional protein needs depend on the speed of growth of the fetus , approximately 6 grams per day in the first trimester , while during the last trimester janinsangat rapid growth to 10 g / day . When the baby is born to be increased up to an additional 15 g / day . WHO recommends an additional 0.75 g of protein / kg of body weight for women who are pregnant .
    Vitamins and minerals
    For both fetal growth also need a variety of vitamins and minerals such as vitamin C , folic acid , iron , potassium , zinc , and so on . Additional vitamins and minerals for pregnant women not exceed 100 % tekecuali for iron . With so much extra would not normally arise danger of poisoning . But we must beware of the administration tambhan excessive , especially if the vitamins are fat-soluble vitamins such as vitamins A and D.
In general, additional food formula for pregnant women mentioned more easily administered in liquid form such as a formula for women who are pregnant . By some formula manufacturers have marketed specifically for pregnant women . The content of nutrients in the formula are generally made ​​sedemikin , until the drink 2 or 3 cups per day the amount of energy , protein , vitamins and minerals and can meet the recommended additional . Lactamil , Dumex Mama Plus , Prenagan , Sustagen Mama and Vita - Nova . Cow's milk from first recommended for pregnant women as an additional source of energy and protein . The difference between the formulas for pregnant women and cow 's milk is the additional vitamindan various minerals which are lacking in cow's milk and in the need for fetal growth , such as iron , zinc , folic acid , vitamin C each day by drinking several glasses of milk formula is then additional requirements may be inadequate without giving extra iron pills , vitamin C , or folic acid .

Discussion Paper Delivery / Childbirth Fetus

background
High rates of maternal morbidity and mortality in many developing countries is mainly caused by childbirth bleeding , eclampsia , sepsis , and complications of miscarriage . Most of the major causes of maternal morbidity and mortality that could be prevented through effective prevention efforts . Maternal health care during the past two decades focused on : family planning to more prosperous members of society . Trfokus neonatal care to monitor the progress of the pregnancy symptoms and signs of danger , provide labor and willingness to face complications . Post- abortion care for emergency containment procedures miscarriage and complications as well as responsive to the needs of other reproductive health services .
Clean and safe delivery as well as prevention studies and scientific evidence shows that care delivery is clean , safe and on time is one of the effective measures to prevent morbidity and mortality . Management of complications that occurred before , during and after persalinan.dalam efforts to reduce maternal morbidity and mortality should be anticipated limitations on the ability to manage the complications of certain service levels . Competence attendant , the introduction of the type of complication and the availability of relief to be decisive for the success of the general management of complications will always be according to the circumstances and the degree of occurrence .
purpose
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Basis Theory Pengerian Childbirth
Childbirth is the process of spending komsepsi results ( janing and uri ) who had just months or can live outside the womb through the birth canal or by other means , with the help or without help ( force yourself ) ( Manuaba , 1998) .
Normal delivery is the birth of the fetus to the mother 's own power , without the aid of tools and not to hurt the mother and baby were generally lasts less than 24 hours .
Normal delivery by farer ( 2001 ) is labor that has the following characteristics .
1 . Occurs in pregnancy at term , not prmatur or postmrur .
2 . Have a spontaneous onset , is not due to induction .
3 . Completed after 4 hours and before 24 hours from the time of onset , instead of parturition Precipitate or prolonged labor .
4 . Single Janing with vertex presentation and no part of the occiput anterior pelvis .
5 . Accomplished without the help artifial .
6 . Not terdapatkomplikasi .
7 . Includes birth normal placenta .
Signs Symptoms of Labor
1 . Signs and symptoms of labor permualaan by Mochtar (1994 ) . Before the actual lifeboat labor , some women entered the week before your due day of the call when the preliminary ( preparatori stage of labor) with signs following .
a. Lightening or settling or dropping , the head down into the pelvic inlet .. in primigravida occurring before the 36th week . Lightenig caused by :
· Braxton Hicks contractions ;
· The tension of the abdominal wall ;
· Tension rotumdum ligament ;
· Gravity fetus .
When the incoming head of the inlet , the mother will feel a sense of misguided in the upper abdomen and the lower part is reduced tightness .
a. Look more dilated stomach and fundus down .
b . Frequent or difficult urination micturition .
c . Pain in the waist and belly .
d . Cervical start flabby and flat . In the multi- picture is less clear , because the fetal head had entered the pelvic menjelalan delivery .
e . The beginning of his or his fake . The nature of his false is :
· Mild pain in the lower part ;
· The data is irregular ;
· Short duration ;
· There is increased with no change in activity in the cervix .
2 . Signs of labor is as berrikut inpartu .
a. His labor occurs , with the characteristics :
· Waist pain that radiates forward ;
· The nature of the pain on a regular , shorter intervals , and greater strength ;
· Impact of change of the cervix ;
· With the move kekuan growing .
b . Passage of mucus mixed with blood .
c . Sometimes the rupture itself .
d . The results of the examination ( PD ) indicates the occurrence of softening , landings , and the opening of the cervix . Uterine contractions or his characteristics to note are : the strength of contraction / intensity , frequency , and duration . Each contraction of the uterus consists of three phases as follows .
· Incement , namely ketikabintensitas or contraction force was formed .
· ACEME , the maximum peak of the contraction .
· Decrement , when the muscles of the uterus to start contracting .
The duration of uterine contractions measured from the beginning to the end Incement decrement . frequency is calculated from the initial Incement or decrement until early next contraction .
Theories Regarding the Delivery Process
The cause of birth is not known with certainty , so several theories stating the possibility of the delivery process . According Manuaba (1998 ) , the notion of labor is as follows .
1 . Decreased Hormone Theory
A few days before parturition a decline in levels of the hormones estrogen and progesterone . So that the uterine muscles are sensitive to oxytocin . Decreased levels of progestron pda certain level causing uterine muscle contraction Molai .
2 . theory Kerengangan
Uterine muscle has the ability to stretch a limited extent . If the limit is exceeded, there will be a contraction , so that delivery can commence .
3 . Placenta Theory Being Old
Parents often semmakin placenta with increasing gestational age will mmenyebabkan fall of estrogen and progesterone , so the blood vessels spasm and the resulting contraction of the uterus .
4 . Mechanical irritation Theory
On the back of the cervix is located ganglion servikale / fleksus Fran Kenhauser . If the ganglion is shifted and suppressed or depressed to the fetus , then there will be a contraction of the uterus .
5 . Oxytocin theory Interna
According progesterone concentration due to her pregnancy resulted in increased oxytocin activity and frequent Braxton Hicks contractions , thus persalian can begin .
6 . theory Prostaglanndin
Prostaglanndinn issued by decidua konssentrasinya meninggkat since the age of 15 weeks gestation . Prostaglandins regarded as a trigger of labor , prostaglandin administration during pregnancy can cause muscle contraction pregnant .
Important Factors in Childbirth
There are several factors that play a role in labor ( Stencheveer and Sorensen , 1995 ) .
1 . Push the fetus out strength ( power )
a. His ( contraction utterus ) .
b . Prut wall muscle contraction .
c . Contraction of the pelvic diaphragm .
d . Keteganga and ligament contraction .
e . The Effectiveness force push .
f . Duration of labor .
2 . Type ( Passenger )
a. location of the fetus
b . Fetal position .
c . Presentation of the fetus .
d . Placental location .
3 . Cross type ( Passage )
a. The size and type of the pelvis .
b . Ability serviksuntuk open .
c . Ability vaginal canal and vaginal introitus to aft .
4 . Psycho ( Psyche )
a. Physical preparation for childbirth .
b . Childbirth experience .
c . Support people nearby.
d . Intergitas emotional .
Delivery mechanism
The process consists of four phases of labor / time .
First stage : the start time of the cervix opens up a complete opening of 10 cm .
Kala II : spending time fetus .
Third stage : the release time of the placenta and the expulsion of the placenta .
Kala IV : take one to two hours after delivery of the placenta .
1 . The first stage ( stage opening )
The onset of labor is marked by the release of mucus mixed with blood because the cervix begin to flatten and open . Kala du opener divided into phases ( Mochtar , 1994 ) .
a. Latent phase : cervical dilatation lasted lambbat , until the opening of 3 cm which takes place in seven to eight hours .
b . The active phase lasts six hours selanma divided into three subvase , among others .
· Acceleration period , opening to 4 cm berllangsung dive two hours .
· Maximum dilatation period , ie within 2 hours of opening to 9 cm .
· The period of deceleration , ie re- opening llambat occurred within two hours of the opening of 9 cm reach 10 cm complete . The duration of the first stage to last for 12 hours primigravida while multigravida about 8 hours . Friedman curve calculated Bardasarkan primigravida opening is 1 cm per hour and for multigravida 2 cm per hour . With these calculations , the time can be estimated pembuaan lengkkap
2 . The second stage ( when spending )
According Mochtar ( 1994 ) , when expenditures on a fetus , his coordinated , strong , 2-3 minute intervals with a duration of 50 to 100 seconds . At the end of the first stage will rupture the amniotic fluid accompanied spur spending , the fetal head entered the room down the flanks, resulting in pressure on the pelvic floor muscles which will lead to a desire to push. Therefore, the suppression of fleksus Franken Hauser , mom feel like a bowel movement because of pressure on the rectum . Signs of the second stage ( Farrer , 2001) , among others :
· Vaginal examination the cervix is ​​fully dilated .
· Usually amniotic membrane has ruptured .
· His or uterine contractions strong long lasting , and not so often instead of 2-3 minutes longer , but about 3-5 minutes.
· There may be a trickle of blood from the vagina .
· Women experience a strong urge to push.
· Sphincter ani looks berlilatasi .
· Perineum stood out .
3 . The third stage ( Uri release )
After the second stage , uterine contractions stopped about 5 to 10 minutes . Schultze the release of the placenta is usually no perarahan before delivery of the placenta and many bleed after delivery of the placenta . While the expulsion of the placenta way Duncan is separated from the edge of the placenta , blood usually flows out between the membrane ketuan ( Mochtar , 1994 ) . Release of the placenta is predictable by looking at the signs :
a. Uterine be round ;
b . strong contraction of uterine fundus ;
c . Uterine pushed upwards due to placenta lepass lower uterine segment ;
d . increased cord length ;
e . bleeding occurred
4 . Kala IV ( Observation )
stage IV is intended for observation postpartun bleeding . Most ; often occurs pendarhan pad first two hours , which need to be observed are :
a. Level of consciousness ;
b . Vital signs ;
c . Contraction of the uterus ;
d . Bleeding bleeding considered normal if the amount is not more than 500 ml .
PartografPartograf is a record chart for monitoring the progress of labor objec mother and fetus . Partograph can be regarded as an early warning system '' that will help make decisions earlier when a mother must diujuk , accelerated , or terminated labor.
anvil
Partograph based on the following principles ( sudraji , 1993) .
1 . Active phase of labor , starting at pembuakn 3 cm .
2 . Latent phase of labor , should last no more than 1 cm per hour .
3 . Grace cwaktu 4 hours between delivery and dimbilnya slowing action will not harm the fetus or mother , to avoid an unnecessary tingdakan .
4 . Check in should not be made to overly frequent ( direkomdasikan per hour ) .
5 . Should use existing partographs suda uwaspada lines and lines tindakanya .
Component Component Patograf partographs consists of the following three things :
a. Note the fetus ;
b . Note the progress of labor ;
c . Maternal calendar notes .
Progress Notes Childbirth
Components of the graph memusatka attention to the opening of the cervix according to time , which as become the latent phase and the active phase .
Latent phase : latent phase of labor begins early in labor to reach the opening of 3 cm , if this phase is more than 8 hours denganhasil twice in 10 minutes , then labor will tend to have trouble .
Phase Active : Immediately after striking 3 cm opening , then will enter the active phase of labor . At 90 % premigravida , cervix will open with a speed of 1 cm per hour or faster in the active phase . Alert line drawn from 3 cm to 10 cm are memgambarkan keecepatan opening . If the opening moves to the right of alert line melmbaat , it indicates the presence of barriers to delivery . Kemjuaan other deliveries also need observation , eg fetal head descent and his quality . Carefully monitoring the state of the fetus include fetal heart rate and fetal membrane . Mother state examination conducted regularly by recording temperature , pulse , blood pressure , and urine .
Observations were recorded on the partograph The following are the things that need to be recorded on the partograph .
1 . progress of labor
a. The opening of the cervix .
b . The fall head : palpation . Stomach ` fifth fetal head is palpable .
c . His : frequency of every 10 minutes and turasinya drawn with shading .
2 . The state of the fetus
a. The frequency of fetal heart rate .
b . Color , number , and length of rupture kutuban .
c . maulasse fetal head .
3 . The state of the mother
a. Pulse , temperature , and blood pressure .
b . Orine : volume , protoin , and acetone .
c . Drugs and intravenous fluids .
d . Penberian oxytocin .
Contraindications The following is the implementation partographs kontraindukasi of implementation partographs .
1 . Pregnant women with kuran height 145 cm .
2 . Antepartum bleeding .
3 . Severe preeclampsia and eclampsia .
4 . Premtur delivery .
5 . Former labor sectio Caesaria ( SC ) .
6 . Maternity pregnant with twins .
7 . The location of the abnormality .
8 . State of fetal distress .
9 . Labor induced .
10 . Pregnant with severe anemia .
11 . Alleged narrow pelvis .
Advantages and disadvantages of implementing partographs Advantages and disadvantages of the use of partograph is as follows .
a. profit
1 . There is enough time to do the referral ( 4 hours ) after delivery trip over the line alert .
2 . At the health center enough time to take action .
3 . Reduce infection due to the limited examination .
a. loss
Possible too fast for referral , which can actually be implemented in place .
curves Fridedman
In 1945 , Friedman conducted research on a large number of mothers in the United States that produce patterns of normal cervix . Fridedman labor functionally divide into two , namely , the latent phase which lasts 8-10 hours until the opening of 3 cm , which is followed by an active phase is characterized by the acceleration of the acceleration of the opening of 3 to 8-9 cm , and then ends with a phase deselarasi / deceleration of 9 cm to the complete opening ( 10 cm )
reference sources :Hakimi , M. 1990. Obstetrics : Pathology and Physiology Labor . Foundation Esentia MedikaManuaba , Ida Bagus . , 1998. Obstetrics , Gynecology and Family Planning . Jakarta : EGC .Mochtar , Rustam . , 1994. Synopsis of Obstetrics . Jakarta : EGCPrawiroharjo , Sarwono . , 1997. Obstetrics . 3rd edition . Jakarta : Yayasan Bina LibrarySumapraja , Sudarji . , 1996. WHO partograph . Jakarta : Center for Faculty KdokternUI Publisher

Signs and Release Mechanism Placenta

According to ( Sastrawinata , 1983 ) Signs of placental detachment there is often a sudden gush of blood , the uterus becomes globular and more solid consistency , the uterus rises toward the abdomen because the placenta that had run down into the vagina , as well as the umbilical cord is out longer . After the attachment of the placenta separates from the pressure exerted by the placenta cause the uterine wall slid toward the bottom of the uterus or upper vagina . Sometimes, the placenta can get out of this location by the presence of inter - abdominal pressure . However , the woman lying in a supine position often can not remove the placenta spontaneously . Generally , it takes action to enhance artificially high stage of labor . The usual method is done by pressing and mengklovasi uterus , along with a light tug on the cord .
Factors Affecting the Release of Placenta : 1 ) abnormalities of the uterus itself , ie anomalies of the uterus or cervix ; weakness and ineffectiveness of uterine contractions ; tetanic contractions of the uterus , as well as the formation of ring constriction . 2 ) abnormalities of the placenta , such as low-lying placenta or placenta previa ; implantation in the horn , and the presence of placenta accreta . 3 ) Error management of the third stage of labor , such as manipulation of the uterus that do not need prior to the release of the placenta causing rhythmic contractions ; improper administration of uterotonic time which can also cause cervical contraction and hold the placenta , as well as anesthesia especially debilitating uterine contractions .The mechanism of placental separation
The contractions of the uterus will reduce uri area , because the walls of the uterus become smaller and grow a few centimeters thick . Contractions had caused the loose and weak parts of the uri and the wall of the uterus , this section will be separated , at first partially and then completely and live freely in the uterine cavity . Sometimes it would be a small fraction uri is still attached to the uterine wall .
This release process is usually gradual and blood pengumpulann behind uri uri will membantuh release . When the release is complete , the uterine contractions push the placenta that has been released into the lower uterine segment , then kevagina and born .
The amniotic membrane was removed , in part by the contraction of the uterus , partly as uri discharge . In places that telepas bleeding between the placenta and decidua basalis , called retroplasenter hematoma ( Mochtar , 1998) . According to ( Sastrawinata 1983 ) . There are two methods for removal of the placenta :
a. Schultze method
The method is more common , the placenta separates from one point and slipped into the vagina through a hole in the amniotic sac , the fetal surface of the placenta appears at the vulva with membranes that follow behind like an umbrella upside down while peeling away from the wall of the uterus . Maternal surface of the placenta and the blood clot does not look to be in the bag upside down , contraction and retraction of uterine muscles that cause separation of the placenta is also firmly pressing the blood vessels and control bleeding . It could be because there are oblique muscle fibers in the upper uterine segment
b . Duncan Matthews method ,
Down through the placenta and into the side of the vulva with a first lateral barrier such as clothing fasteners are entering the hole , the placenta is not part of the sac . In this method the possibility of remaining parts of the membranes greater because the membranes are not chipped all complete Schultze method . This method is associated with a low-lying placenta in the uterus . Release process lasts longer and so much blood lost ( because there is little oblique fibers in the bottom segment .The mechanism of removal of placenta
Placenta that has been separated by uterine contractions that will be driven down by the uterus is now regarded as a foreign object . This is also aided by the abdominal pressure or straining , then the placenta to be born , 20 % spontaneously , and the rest need help . There are 3 maneuvers to determine the release of the placenta :
a. Kustner
By putting pressure on the hand with / above symfisis , the cord stretched, then when entering the umbilical cord is not yet detached , silent or advanced means it regardless .
b . His KleinSewaktu there , we push a little womb , when the umbilical cord back means the placenta has not detached , detached placenta or fall silent .
c . Strassman
Flex cord and word of the fundus , when the vibrating cord marked yet detached placenta , the placenta has been marked not vibrate loose. Normally , the placenta release ranged ¼ - ½ hours after the child was born , but we can wait a maximum of up to 1 hour . But if there is a lot of bleeding or if the labor - delivery and no history of postpartum hemorrhage , it must not wait , you should immediately dikelurkan placenta by hand . Also if bleeding is more than 500 cc or one nierbekken , the placenta should be removed manually indirectly ( Mochtar , 1998) .

Basic Concepts Examination or Pregnancy Antenatal Care (ANC)

Understanding Pregnancy Examination
Antenatal care ( ANC ) is a prenatal care to optimize mental and physical health of pregnant women . Thus able to deal with labor , postpartum stage , preparation and award of ASI reasonable return of reproductive health ( Manuaba , 1998) . And according Prawirohardjo ( 2005 ) , antenatal care ( ANC ) is an examination of pregnant women both physically and mentally as well as saving the mother and child in pregnancy , childbirth and the postpartum period , so that their condition postpartum healthy and normal , not only physically but also mentally .
From the above understanding , the authors can draw conclusions about the notion that the examination Antenatal Care : examination of pregnant women to optimize mental and physical health of pregnant women and saving the mother and child in pregnancy , childbirth and the postpartum period , so the situation is healthy and normal postpartum and breastfeeding preparation and the return of reproductive health naturally .
Understanding Pregnancy Examination Regularly
Pregnant women should ideally carry a maximum of 13 prenatal care to 15 times . And at least 4 times , which is l times in trimester 1 , 1 times in the second trimester and 2 times on trimister III . But if there are abnormalities in pregnancy , the inspection frequency is adjusted according to individual needs . It can be concluded that if the expectant mother is said to regularly perform ≥ 4 antenatal visits , less regularly : 2-3 antenatal care visits and irregular pregnant women only if the pregnancy examination < 2 visits ( WHO , 2006) .
From the above understanding , the authors concluded that regular prenatal care prenatal care is carried out in accordance with the minimum inspection requirements performed during pregnancy is 1x to 4x in the first trimester ( gestation < 14 weeks ) , 1x in the second trimester ( 14-28 weeks ) , and 2x in the third trimester ( 28-36 weeks and over 36 weeks ) .
Purpose Of Pregnancy Examination ( ANC ) is as follows :
a. According Ayuray (2009 ) the purpose of prenatal care in general is :
1 ) Monitor the progress of the pregnancy to ensure maternal health and fetal growth .
2 ) Improve and maintain physical, mental and social mothers and babies .
3 ) Know the early presence of complications that may occur during pregnancy , including the defect history in general , obstetrics and surgery .
4 ) Prepare for full-term labor , giving birth to the mother and baby survived with minimal trauma .
5 ) that the mother Mempesiapkan puerperium was normal, and exclusive breastfeeding .
6 ) Prepare the role of mother and family in order to receive the birth of a baby grow and develop normally .
7 ) Reduce morbidity and maternal and perinatal mortality .
Special b.Tujuan examination Pregnancy ( ANC ) is :
According Manuaba (1998 ) Antenatal surveillance specifically aims to:

                      1 ) Identify and handle as early as possible when there are complications of pregnancy, childbirth , and postpartum .

                      2 ) Identify and deal with diseases that accompany pregnancy, childbirth , postpartum stage .

                      3 ) Provide advice and guidance relating to pregnancy , childbirth , postpartum stage , lactation , and aspects of family planning .

                      4 ) Reduce maternal morbidity and mortality and perinatal
Pregnancy Examination Schedule
According to Saifuddin (2005 ) , antenatal visits for monitoring and supervision of the welfare of mothers and children at least four visits , known as ( K1 - K4 ) during pregnancy in the future as follows : until the first trimester of pregnancy ( < 14 weeks ) one visit ( K1 ) , and the second trimester ( 14-28 weeks ) one visit ( K2 ) , and third trimester of pregnancy ie two visits at 28-36 weeks of age kahamilan one visit ( K3 ) and after 36 weeks ( K4 ) of the visits .
Prenatal care schedule that should be done is as follows : up to 28 weeks of pregnancy check every four weeks , 28-36 weeks of pregnancy need checks every two weeks , 36-40 weeks of pregnancy once a week ( Salmah , 2006) . Preferably each pregnant woman soon late check-up when her period of at least one month . Examination performed every 4 weeks until the pregnancy . after that , the examination is done every 2 weeks , and after 36 weeks ( Prawirohardjo , 2005) .
things - things Perform At The Examined Pregnancy Examination
Which became policy in Antenatal Care by Dewitree ( 2010) , namely : service / care minimum standards including " 10T " :
1 ) ( Weigh ) weight ,2 ) measuring ( High ) body ,3 ) Measure ( pressure ) of blood ,4 ) Measure ( High ) fundus ,5 ) ( Test ) Fetal Heartbeats
6 ) ( Test ) urine ,7 ) Provision of immunization ( Tetanus Toxoid ) TT complete ,8 ) Provision ( Tablet ) iron , minimum 90 tablets during pregnancy ,
9 ) ( Test ) against Sexually Transmitted Diseases / test ( TORCH ) , 10 ) ( Meeting ) speech in preparation for the referral .
Impact of Not Checking Regularly Pregnancy
Care / antenatal care has a good benefit to know the progress of pregnant women and the fetus in the womb , it can be achieved Juka maternal antenatal care regularly and if not then it would be risky for the mother and fetus in the womb , in Ratirochmat (2009 ) , described these impacts as follows :
a. Can not be pursued healthy pregnancy
Each pregnancy can develop into problems or complications that require monitoring for pregnant women to be pursued kahamilan healthy pregnancy .
b . Unable to make early detection of complications , perform initial management and referral when necessary preparation .
With no keamilan checked regularly then not be recognized early abnormalities or complications that may occur during pregnancy, including disease history in general so that the initial management and referral of preparation can not be prepared .
c . Preparation can not perform a clean and safe delivery
With no complications are detected early , it can have an impact on the delivery and postpartum problems.
d . Mother , husband and family can not know antisipstif planning and early preparation for referral in case of complications .

Understanding Pregnancy Pregnancy Symptoms and signs

Pregnancy is a change in order to continue the descent that occurs naturally , resulting in a growing fetus inside the mother's womb ( Prawirohardjo , 2005) . whereas according to Pro Health (2008 ) , Pregnancy is a condition where a fetus conceived in a woman's body , which is preceded by the process of fertilization and then will end with the delivery process .
From the above authors to conclude that pregnancy is a process of fertilization in order to continue the descent that occurs naturally , and produce a fetus grows in the womb and then will end with the delivery process .
Signs and Symptoms of Pregnancy
a. Presumptive Signs by Manuaba (1998 ) , namely :
1 ) Amenorrhea ( no menstrual period )
Conception and nidasi cause the formation of follicles and ovulation DeGraaf . Women need to know the date of the first day of last period ( HT ) so that we can estimate the gestational age and estimated delivery ( TP ) were calculated by the formula Naegela : Commentaries Delivery : ( HPHT + 7 ) and ( HT + 3 months ) .
2 ) Nausea ( nausea ) and vomiting ( emesis )
Effect of estrogen and progesterone occurs expenditure berlebihan.Menimbulkan stomach acid nausea and vomiting , especially morning called morning sicknes . In this limit the physiological state can diatasi.Bila nausea and vomiting are often called hyperemesis.Akibat nausea and vomiting decreased appetite .
3 ) Cravings
Pregnant women often ask for certain foods or beverages , especially in the months of the first quarter .
4 ) syncope or fainting
Interference with the circulation to the head area ( central ) causes ( skemia nervous system and cause syncope or fainting ) . Situation disappears after 16 weeks of gestation .
5 ) Frequent micturition
Insistence uterus forward quickly cause bladder feels full and frequent micturition . In the second quarter had disappeared .
6 ) Skin Pigmentation
a) Approximately cheek : The release of melanophore chloasma gravidarum , stimulating hormone of the anterior pituitary causes skin pigmentation . b ) The abdominal wall : lividae striae , striae nigra , linea alba increasingly black , c ) Breast : Hyperpigmentation mammary areola , nipple increasingly prominent , prominent Montgomery glands , blood vessels surrounding the manifestation of the breast .
7 ) or the appearance of varicose veins
a) Due to the effect of estrogen and progesterone occurs appearance of veins , especially for those who have the talent . b ) The apparition occurred around blood vessels and external genital , feet , and legs and breasts . c ) The appearance of the blood vessels may disappear after delivery .
b . Definitely not pregnant according to the sign Manuaba (1998 ) , namely :
1 ) The uterus enlarges , in accordance with his pregnant , 2 ) On examination in common: a) Signs Hegar , b ) Signs Chadwicks , c ) Signs piscosect , d ) Braxton Hicks contractions , e ) Palpable ballottemen , 3 ) terbiologis positive pregnancy tests .
c . Sure sign pregnant by Mochtar (1998 ) , namely :
1 ) The movement of the fetus in the womb ,
2 ) Visible / palpable fetal movement ,
3 ) palpable fetal parts ,
4 ) the fetal heartbeat heard with a stethoscope laenec , kardiotokografi tools , tools and dofller Viewed with ultasonografi