Definition
Infection is associated with the proliferation of microorganisms in the human body, along with the body’s reaction to it.
Postpartum infections (puerperal sepsis or fever after childbirth) is a clinical infection in the genital tract that occurs within 28 days after abortion or childbirth (Bobak, 2004).

Etiology
This infection occurs after childbirth, the bacteria enter the body at the time of the birth process. Among them, when membranes rupture before, or during labor is to become a bridge entry of germs in the body through the uterus.
Infection can occur due to bacteria that are often found in the vagina (endogenous) or due to exposure to pathogenic agents from outside the vagina (exogenous) (Bobak, 2004). However, this infection usually does not cause disease in labor, birth or postpartum. Nearly 30 bacteria have been identified under the canals genital (vulva, vagina and cervix) at any time (Faro 1990). While some of it, including some of the fungus, are considered non pathogenic under most environments, and are at least 20, including E. coli, Staphylococcus aureus, Proteus mirabilis and Klebsiella pneumoniae, are pathogenic (Tietjen, L; Bossemeyer, D, & McIntosh, N , 2004).

Clinical Manifestations
Rubor (redness), calor (local fever) caused vasodilation and tumor (swelling) due to exudation. Nerve endings will feel stimulated by inflammation so that there are pain (dolor). Pain and swelling will lead to physiological disorders, and common reactions include headache, fever and increased heart rate (Sjamsuhidajat, R. 1997).

Pathophysiology
The reaction of the body can be a local reaction and may also be the general reaction. In infections with common reaction would involve neurological and metabolic reactions occur at that light-reticular limpo throughout the body, such as the proliferation of phagocytic cells and antibody producing cell (B lymphocyte). Then the local reaction is called an acute inflammatory reaction was continued during a process of tissue destruction by trauma. When the cause of destruction of tissue can be eradicated, then the rest of the damaged tissue called debris, will be in phagocytosis and removed by the body until there is a resolution and healing. When excessive trauma, corrections phagocytic cells sometimes excessively so excessive debris collects in a cavity or abscess formation gathered in other body tissues form flegman (extensive inflammation of connective tissue).

Prevention and Treatment
Reduce or prevent the predisposing factors such as anemia, malnutrition and weakness and treat the illnesses suffered by the mother.
Coitus in late pregnancy should be avoided or minimized and do be careful as it can cause rupture of the membranes. If this happens infection will easily fit in the birth canal. Avoid too long parturition and rupture length / take care that no protracted labor.
Resolving labor with little trauma as possible.
Injury to the vaginal birth for both action and periabdominal, cleaned, stitched as well as possible and maintain sterility.
Prevent bleeding a lot, if there is blood loss should be replaced by a blood transfusion.
All officers in the delivery room should cover the nose and mouth with a mask; suffering from respiratory infections are not allowed into the delivery room.
These tools and fabrics used in childbirth, should be disinfected.
Avoid repeated examination, do when there is a good indication to sterilization, especially if the membranes have ruptured.

Nursing Diagnosis for Postpartum Infections
1. Acute comfortable related to the inflammatory process.
2. Altered Body Temperature related to an increase in the metabolic rate.
3. Anxiety related to change in health status.

DefinitionLow birth weight ( LBW ) is a new baby born weighing at birth less than 2500 g or lower ( WHO , 1961) .In this case can be divided into :

    pure prematurity
    Ie bayipada pregnancy < > corresponding weight .
    Intra- uterine fetal growth retardation ( IUGR )
    That babies born with low weight and not according to gestational age .etiologyCause of preterm birth is unknown , but there are several related factors , namely :

    maternal factors
        Nutrition during pregnancy is lacking , age less than 20 years or 35 years diaatas
        Pregnancy and birth spacing is too close , the work is too heavy
        Maternal chronic diseases : hypertension , heart disease , vascular disorders , smokers
    pregnancy factor
        Pregnant with hydramnios , multiple pregnancy , antepartum haemorrhage
        Complications of pregnancy : preeclampsia / eclampsia , premature rupture of membranes
    fetal factors
        Congenital defects , infection in utero
    Factor is still unknowncomplication

    Meconium aspiration syndrome , neonatal asphyxia , respiratory distress syndrome , hyaline membrane disease
    Dismatur gestasinya preterm especially when times are less than 35 weeks
    Hyperbilirubinemia , patent ductus arteriosus , ventricular brain hemorrhage
    Hypothermia , Hypoglycemia , Hypocalcemia , Anemia , blood clotting disorders
    Infection , Retrolental fibroplasia , necrotizing enterocolitis ( NEC )
    Bronchopulmonary dysplasia , malformations konginetalmanagement

    Adequate resuscitation , temperature regulation , oxygen therapy
    Supervision of the PDA ( Patent ductus arteriosus )
    Fluid and electrolyte balance , adequate nutrition
    Management of hyperbilirubinemia , infection treatment with appropriate antibiotics .Nursing Diagnosis Appears

    Ineffective breathing pattern b / d inadequate lung expansion
    Disruption of gas exchange b / d lack of alveolar ventilation secondary to surfactant deficiency
    High risk of impaired balance of fluid and electrolyte balance b / d inability of the kidneys to maintain fluid and electrolyte balance
    Changes in nutrition less than body requirements related to inadequate supplies of iron , calcium , high metabolism and intake is inadequate .
interventionNursing Diagnosis 1 :Ineffective breathing pattern b / d inadequate lung expansiongoals :Effective breathing patternsCriteria results :

    Decreased oxygen demand
    Spontaneous breath , adequate
    Not claustrophobic .
    There is no retractionintervention

    Give your head a little extension
    Give oxygen by appropriate method
    Observation rhythm , depth and frequency of breathing
Nursing Diagnosis 2 :Disruption of gas exchange b / d lack of alveolar ventilation secondary to surfactant deficiencygoals :Adequate gas exchangecriteria :

    No cyanosis .
    Normal blood gas analysis
    Normal oxygen saturation .intervention :

    Perform suction mucus if necessary
    Give oxygen by appropriate method
    Observation of skin color
    Measure oxygen saturation
    Observation signs of worsening respiratory
    Report a doctor if there are signs of worsening respiratory
    Collaboration in the examination of blood gas analysis
    Collaboration in the examination surfactant
Nursing Diagnosis 3 :High risk of impaired balance of fluid and electrolyte balance b / d inability of the kidneys to maintain fluid and electrolyte balancegoals :good hydrationcriteria :

    Elastic skin turgor
    There is no edema
    Production of urine 1-2 cc / kg / hour
    Blood electrolytes within normal limitsintervention :

    Observation of skin turgor .
    Record intake and output
    Collaboration in the provision of intravenous fluids and electrolytes
    Collaboration in the examination of blood electrolytes .
Nursing Diagnosis 4 :Changes in nutrition less than body requirements related to inadequate supplies of iron , calcium , high metabolism and intake is inadequategoals :adequate nutritioncriteria :

    Weight gain of 10-30 g / day
    There is no edema
    Protein and albumin blood within normal limitsintervention :

    Give ASI / PASI with appropriate methods
    Observation and record tolerance drink
    Weigh weight every day
    Record intake and output
    Collaboration in the provision of total parenteral nutrition if necessary .