Background: Maternal mortality in Indonesia was still quite high. To reduce the mortality rate of the government made a health care program for pregnant women, namely antenatal care services (ANC). Education, knowledge and age of mothers were one of the determinants of maternal death. The purpose of this study was to determine the relationship of formal education levels, maternal age and level of knowledge with health to ANC. Method: Observational analytic research type with a cross-sectional approach, using primary data, namely quizerer and secondary book data KIA. Data were analyzed univariate and bivariate using Spearman Rho test. Results: Univariate analysis, pregnant women with a higher education level of 7 people (21.9%), while 8 people (25.0%), 17 people (53.1%); Pregnant women with the same high and low knowledge level, 50%; Mother's age <20 years and> 35 years 10 people (31.3%) and mothers age 20-35 years 22 people (68.8%); Pregnant women with a complete ANC status of 15 people (46.9%), and 17 people were incomplete (53.1%); Spearman Rho Bivariat Test, the relationship of the level of formal education and the level of maternal knowledge with ANC P <0.05, while maternal age relations with ANC P> 0.05. Conclusion: The majority of pregnant women with low educated with the age range of 20-35 years. There was a significant and direct relationship between the level of education and the level of knowledge with ANC status.

AbstrakPendahuluan: Kematian ibu terjadi sebagai akibat dari komplikasi selama dan setelah kehamilan dan persalinan. Sebanyak 80 % kematian ibu di dunia disebabkan perdarahan berat (terutama perdarahan setelah persalinan), infeksi, tekanan darah tinggi selama kehamilan. Menurut data Kementrian Kesehatan tahun 2010, perdarahan menempati presentasi tertinggi penyebab kematian ibu di Indonesia yaitu sebesar 28%. Laporan Kasus:Seorang wanita, 31 tahun, datang dengan penurunan kesadaran dan perdarahan banyak dari kemaluan sejak 3 jam sebelum masuk rumah sakit, nadi teraba cepat dan halus. Pasien sebelumnya melahirkan di rumah ditolong bidan 10 hari yang lalu, kakak anak lahir 30 menit setelah anak lahir dan kesan diakui bidan lengkap. Diagnosa akhir pada pasien ini Syok Hemoragik Teratasi ec Late HPP ec Sisa plasenta + Anemia Sedang (Hb 7,0 gr/dl). Simpulan: Pada kasus ini membuktikan bahwa HPP masih menjadi hal yang menakutkan sebagai penyebab kematian ibu. Dalam hal ini dirasa perlu adanya alur rujukan untuk kasus emergensi, yaitu pengelompokkan kasus pada persalinan dengan komplikasi segera dilakukan pelaporan kasus ke DINKES untuk rujukan ke RS. Setelah perawatan di RS selesai, perawatan lanjutan atau postnatal care dilakukan sesuai jadwal. Pasien diantar kembali setelah selesai perawatannya, dan hasil rujukan dilaporkan kembali ke hotline Dinkes Kabupaten/kota. AbstractIntroduction: Maternal death occurs as a result of complications during and after pregnancy and childbirth. As many as 80% of maternal deaths in the world are caused by heavy bleeding (especially bleeding after childbirth), infections, high blood pressure during pregnancy. According to data from the Ministry of Health in 2010, bleeding was the highest presentation of maternal mortality in Indonesia, which was 28%. Case Report: A woman, 31 years old, came with a decrease in consciousness and heavy bleeding from the genitals 3 hours before hospitalization, pulse felt quickly and smooth. Patients previously delivered at home were helped by a midwife 10 days ago, older siblings born 30 minutes after the child was born and the impression that the midwife was fully recognized. Final diagnosis in this patient Hemorrhagic shock Overcoming ec Late HPP ec Placental residue + Moderate anemia (Hb 7.0 gr / dl).Conclusion: In this case prove that HPP is still a frightening thing as a cause of maternal death. In this case it is felt necessary to have a referral pathway for emergency cases, namely the grouping of cases in labor with complication of immediately reporting cases to DINKES for referral to the hospital. After treatment at the hospital is complete, continued treatment or postnatal care is carried out on schedule. The patient is resettled after completion of treatment, and the referral results are reported back to the District / city Health Office hotline.

Pendahuluan: Kembar siam merupakan salah satu bentuk kecacatan kongenital yang cukup menyita perhatian dunia medis. Sekitar 75 % dari kembar siam adalah wanita dan 70% dari kembar siam itu berdempet di dada (thorachophagus) atau abdomen (omphalophagus). Kembar siam dapat dibagi menjadi 2 kategori besar, yaitu kembar siam simetris dan kembar siam asimetris. Semakin lama pemisahan secara embriologi berlangsung, semakin rumit kembar siam yang akan terjadi.Laporan Kasus: Seorang pasien wanita, umur 31 tahun, masuk KR Kebidanan RSUP M.Djamil Padang tanggal 28 Agustus 2017 jam 11.00 WIB kiriman poliklinik Fetomaternal dengan diagnosis G4P3A0H3 gravid 31-32 minggu + Conjoined Twins (Dicephalus Parapagus Dibrachius) + Polihidramnion.Kesimpulan: Kehamilan multifetus merupakan kehamilan resiko tinggi karena akan meningkatkan morbiditas dan mortalitas maternal dan perinatal. Pada kasus kehamilan multifetus dengan kembar siam/conjoined twins, penatalaksanaan multidisiplin dengan melibatkan departemen-departemen yang terkait perlu dilakukan untuk prognosis yang lebih baik bagi ibu dan janin.