SESI 2
CHAPTER XV
PREGNANCY, CHILBIRTH AND
THE PUERPERIUM
(O00-O99)
BAB XV
Kehamilan, Persalinan dan Masa Nifas
1
DESCRIPTION
Pembahasan materi meliput pengenalan istilah-istilah
gangguan Kehamilan, Kelahiran & Masa Nifas,
cara menentukan kode diagnosis agar akurat, tepat
dan berhasilguna menunjang sistem informasi morbiditas
dan mortalitas maternal yang dikembangkan
2
TUJUAN INSTRUKSIONAL UMUM
Mampu menentukan kode diagnosis gangguan
kehamilan, persalaian dan nifas dengan presisi
akurat dan tepat, berhasil mengumpulkan,
menyimpannya dan mengambil kembali bagi
kepentingan penyelesaian sistem pelaporan
rutin morbidtas dan mortalitas maternal yang
diterapkan fasilitas asuhan pelayanan ataupun
yang suatu waktu diperlukan oleh manajemen
kesehatan maternal.
3
TUJUAN INSTRUKSIONAL KHUSUS
Menjelaskan:
Definisi berbagai gangguan kehamilan, persalaiann
dan nifas.
Kekhususan Bab XV
Note, excludes, dan includes serta tanda baca
lain-lian yang menyertai nomor kode kategori
dan subkategori Bab XV
kode metode persalinan (bisa untuk menggantikan
kode tindakan sistem klasifikasi lain).
Cara mencari dan memilih kode diagnosis gangguan
kehamilan, persalinan dan nifas dengan presisi, akurat
dan tepat
Latihan soal dengan bimbingan di kelas
Latihan soal mandiri
4
BAB XV, KEHAMILAN, KELAHIRAN & MASA NIFAS
(O00-O99)
EXCLUDESs (Tidak termasuk ke Bab ini) adalah:
• [HIV] diseases (B20-B24)
• Cedera, keracunan & konsekuensi lain akibat
sebab luar (S00-T98)
• Gangguan mental & prilaku yang terkait masa
nifas (F53.-)
• Tetanus obstetrik (A34)
• Nekrosis postpartum kelenjar pituitari (E23.0)
• Osteomalacia postpartum (M83.0)
• Supervisi dari: Kehamilan berisiko tinggi (Z35-)
Kehamilan normal (Z34.-)
5
Bab XV (Lanjutan-1)
Bab ini meliput 8 blok sebagai berikut: (hal. 1-721)
O00-O08
Kehamilan dengan abortus
O10-O16
Edema, proteinuira & gangguan hipertensi
pada kehamilan, kelahiran & nifas
O20-O29
Gangguan-2 maternal lain yang utamanya
terkait kehamilan.
O30-O48
Asuhan maternal terkait janin, kantung
ketuban yang kemungkinan menimbulkan
masalah persalinan/kelahiran
O60-O75
Komplikasi persalinan dan kelahiran
O80-O84
Kelahiran/Metode persalinan
O85-O92
Komplikasi yang utamanya berkaitan
dengan masa nifas
O95-O99
Kondisi-2 lain obstetrik, NEC
6
Kehamilan dengan hasil Abortus
(O00-O08)
EXCLUDES: kehamilan berlanjut setelah satu atau
lebih dari satu janin gugur pada suatu kehamilan
multipel.
Perhatikan:
O00 Kehamilan di luar kandungan
Includes: …
Use additional code dari …O08.O01 Mola hidatidiform
Use additional code dari … O08.O02.- Produk konsepsi abnormal lain-lian
Use additional code dari … O08.Excludes: …
dst. Perhatikan Excludes yang ada di masing code 7
Kehamilan dengan hasil Abortus (O00-O08) (Lanjutan-1)
Perhatikan:
• Penjelasan di bagian atas halaman 724 Volume 1:
Ada tersedia subdivisi dengan tambahan code
karakter ke-4 untuk melengkapi O03-O06
• Adanya:
[See above for subdivisions] atau
[See page 724 for subdivisions]
yang ada pada masing-masing code terkait.
 lihat ke halaman 724 sebelum menentukan
kodenya.
8
Kehamilan dengan hasil Abortus
(O00-O08) (Lanjutan-2)
O08
Complicating following abortion & ectopic &
molar pregnancy
Note: This code is provided primary for morbidity
coding. For use of this category reference
sholud be made to the morbidity coding
rules & quidlines in Volume 2.
O10-O16 meliput gangguan edema, proteinuria &
gangguan hipertensi pada kehamilan,
perslianan & nifas.
Includes: the listed conditions with pre-existing
proteinuria
Excludes: that with increased or superimposed
proteinuria (O11)
9
Kehamilan dengan hasil Abortus (O00-O08) (Lanjutan-3)
Perhatikan penjelasan pada masing-masing code
O15
Eclampsia
Ada koreksi dengan tambahan:
- eclampsia with pregnancy –induced or
pre-existing hypertension.
(Lihat corrigenda di buku Vol. 3)
O16
Unspecified maternal hypertension.
10
Other maternal disorders predominantly
related to pregnancy (O20-O29)
Note: Categories O24.- and O25 include the listed
conditions even if they occure during childbirth
or the puerperium.
Excludes: maternal:
• care related to the fetus and amniotic cavity &
possible delivery problems (O30-O48)
• Disease classifiable elsewhere but complicating
pregnancy, labour (labor) and delivery, and the
puerperium.
11
Other maternal disorders predominantly
related to pregnancy (O20-O29)
Perhatikan definisi untuk:
O20 Haemorrhage in early pregnancy
Excludes: …
Perhatikan definisi pada:
O21 Excessive vomiting in pregnancy
O22 Venous complications in pregnancy
Excludes: …
O24 Diabetes mellitus in pregnancy
Includes: …
12
Other maternal disorders predominantly related to pregnancy
(O20-O29) (Lanjutan)
Perhatikan Excludes yang menyertai masing
kategori.
O28 Abnormal findings on antenatal screening of
mother
Excludes:
Diagnostic findingd classified elsewhere –
see Alphabetical Index.
Maternal care related to the fetus & amniotic
cavity & possible delivery problems
(O30-O48)
13
Other maternal disorders predominantly related to pregnancy (O20O29)
O29 Complication of anaesthesia during
pregnancy
Includes: …
Excludes:
Maternal care related to the fetus & amniotic cavity
& possible delivery problems (O30-O48)
Perhatikan Includes & Excludes yang ada.
14
Complications of Labour & Delivery
(O60-O75)
O60 Preterm delivery
Perhatikan definisi untuk ini (hal 1-744)
O63 Long labour
Perhatikan hubungan long labour dengan
kala persalinan.
O64 Obstructed labour due to malposition &
malpresentation of fetus (sebab adalah
letak/presentasi janin)
O65 Obstructed …
(sebab adalah pinggul bumil)
15
Complications of Labour & Delivery (O60-O75) (Lanjutan-1)
O66 Other obstructed …
O67 Persalinan & kelahiran terkomplikasi
perdarahan intrapartum, yang tidak
terklasifikasi di tempat lain.
O68 - idem - terkomplikasi oleh fetal stress [distress]
O69 - idem – complicated by umbilical cord
complications
O70 Perineal laceration during delivery
(Luka lecet/gores pada perineum saat
proses kelahiran)
Includes: episiotomy extended by laceration
Excludes: obstetric high vaginal laceration
alone (O71.4)
16
Complications of Labour & Delivery (O60-O75) (Lanjutan-2)
O71
O72
O73
O74
O75
Other obstetric trauma
Includes: damage from instruments.
Postpartum haemorrhage
Includes: haemorrhage after …
Retained placenta & membranes, without
haemorrhage.
Complications of anaesthesia during labour &
delivery
Includes: …
Other complications of labour & delivery, not
elsewhere
classified.
Excludes: puerperal:
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DELIVERY (PERSALINAN)
(O80-O84)
Note: Kode O80-O84 tersedia untuk kepentingan code
morbiditas.
Kode-2 di blok ini hendaknya digunakan untuk
kode primer morbiditas hanya apabila tidak ada
kondisi lain yang terklasifikasi di bab XV terrekam.
Bila kategori-2 ini akan digunakan, rujuklah ke
peraturan Morbidity Coding Rukes di Volume 2.
O80
O81
O82
O83
Single spontaneous delivery
Single delivery by forceps & vacuum extractor
Single delivery by caesarean section
Other assisted single delivery
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DELIVERY (PERSALINAN) (Lanjutan)
O84
Multiple delivery
Use additional code (O80-O83), if disired,
to indicate the method of delivery of each fetus
(janin) or infant (bayi)
(Gunakan nomor kode tambahan yang dapat
diambil antara O80-O83 untuk menjelaskan
cara masing bayi layir, letkep, sungsung dsb.)
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Complications predominantly related to the
puerperium (O86-O92)
Komplikasi yang utamanya terkait masa nifas:
Note: Categories O88.-, O91.-,O92.- include
the listed conditions even if they occur
during pregnancy and childbirth.
Excludes: mental & behavioural disorders associated
with the:
puerperium (F53.-)
ostetrical tetanus (A34)
puerperal osteomalacia (M83.0)
20
Complications predominantly related to the puerperium
(O86-O92) (Lanjutan-1)
O85
Puerperal sepsis
Puerperal endometritis, fever, peritonitis,
septicaemia.
Use additional code (B95-B97), if desired, to
identify infection agent.
Excludes: …
O86
Other puerperal infection
Excludes: infection during labour (O75.3)
21
Complications predominantly related to the puerperium
(O86-O92) (Lanjutan-2)
O87
Venous complications in the puerperium
Includes: in labour, delivery, and the
puerperium.
Excludes: obstetric embolism (O88.-)
venous complications in pregnancy
(O22.-)
O88
Obstetric embolism
Includes: pulmonary emboli in pregnancy,
childbirth or the puerperium
Excludes: embolism complicating abortion
or ectopic or molar pregnancy (O00-O07.
O08.2)
22
Complications predominantly related to the puerperium
(O86-O92) (Lanjutan-3)
O89
O90
Complication of anesthesia during the
puerperium
Includes: maternal complications arising from
the administration of general or local
anaesthetic, analgesic or other
sedation during the puerperium.
Complications of the puerperium, NEC
O91
Infections of breast associated with childbirth
Includes: …
O92
Other disorders of breast and lactation
associated with childbirth.
Includes: …
23
Other obstetric conditions, NEC
(O95-O99)
Note: For use of categories O95-O97 reference should
be made to the mortality coding rules and
guidelines in Volume 2
O95
Obstetric death of unspecified cause
Maternal death from unspecified cause occurring
during pregnancy, labout and delivery, or the
puerperium.
O96
Death from any obstetric cause occurring > than
42 days but < than one year after delivery.
Use additional code, if desired, to identify
obstetric cause of death.
24
Other obstetric conditions, NEC (O95-O99) (Lanjutan-1)
O97
Death from sequelae of direct obstetric causes.
Death from any direct obstetric cause occurring
one year or more after delivery.
O98
Maternal Infectious & parasitic diseases
classifiable elsewhere but complicating
pregnancy, childbirth and the puerperium
Includes: …
Use additional code (Chapter I) if desired, to
identify specific condition.
Excludes: …
25
Other obstetric conditions, NEC (O95-O99) (Lanjutan-2)
O99
Other maternal diseases classifiable elsewhere
but complicating pregnancy, childbirth and the
puerperium.
Note: This categories includes conditions which
complicate the pregnancy state, are
aggravated by pregnancy or are a main
reason for obstetric care and for which
the Alphabetical Index does not indicate
a specific rubric in Chapter XV.
Use additional code, if desired, to identify specific
condition.
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Other obstetric conditions, NEC (O95-O99) (Lanjutan-3)
Excludes:
Infectious and parasitic diseases (O98.-)
Injury, poisoning and certain other
consequences of external causes (S00-T98)
When the reason for maternal care is that the
condition is known or suspected to have
affected the fetus (O35-O36)
Perhatikan Includes dan Excludes yang ada
pada masing kategori.
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LATIHAN PENYELESAIAN SOAL-SOAL
1.
2.
3.
4.
5.
Hamil dengan plasenta previa totalis dan perdarahan
No:
Seksio kaiser emergensi,
No:
Bayi tunggal hidup, cyanosis
No:
Partus normal spontan, letsu
No:
Bayi tunggal hidup
No:
Bayi cenggeng, kurang ASI
No:
Abortus spontan inkomplit,
No:
Infeksi post kuret
No:
Hamil 71/2 bulan sakit febris typhoidea
No:
Partus spontan,
No:
Bayi prematur
No:
Isterus fisiologis
No:
Partus kembar 2, spontan. I letkep, II letsu
No:
bayi prematur (BB < 1.750)
No:
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SOAL LATIHAN MANDIRI
1.
2.
3.
4.
5.
Partus seksio
No:
Kembar dempet terhubung di abdomen
No:
Berat badan kedua bayi di atas 2.250 kg.
No:
Cengeng sulit menete ASI
No:
Persalinan macet
No:
Myoma uteri
No:
Lahir Vakum
No:
Bayi cephalohematom
No:
Partus spontan, cukup bulan, bayi sehat
No:
No:
No:
Persalinan induksi gagal dengan suntikan oxytocin No:
Uterin inertia, akhirnya diseksio dengan hysterectomy No:
Bayi Hydrosefalus toksoplasmosis
No:
Solutio placentae, Seksio, bayi premature BB 490g No:
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