ABORTUS IMMINENS-Ade.ppt Power Point

ABORTUS IMMINENS PEMBIMBING Dr. SRI LESTARI, SpOG PRESENTAN ADE IRMA IR MA YOETICEA YOETICEA 030.98.002 OPONEN YESSICA WILANDA SUSANTI MELLYA SESWITA

KEPANITERAAN KLINIK KEBIDANAN DAN KANDUNGAN FAKULTAS KEDOKTERAN UNIVERSITAS TRISAKTI PERIODE 27 SEPTEMBER – 4 DESEMBER 2004 RSUP FATMAWATI AKARTA

A!"r#$%& '(')'* p+-*+#' /+*')' %+!+)$ 1'/#$', ('' *'%) /"%+p% !+)$ ('p'# *($p ()$'r /'($-', !+r$%' /$r'- ('r 20 --$ (' !+r'# !'(' /$r'- ('r 00 -r. A!"r#$% ('p'# (-")"-/' '#'% ('%'r & 4. '!"r#$% %p"#' 5 '!"r#$% +% 5 '!"r#$% %p+% 5 '!"r#$% /"p)+#$% 5 '!"r#$% /"p)+#$% 2. '!"r#$% pr"6"/'#$% 5 '!"r#$% +(7')% 5 '!"r#$% /r')%

A!"r#$% +% & ')'* p+r%#1' #+r'(' p+r('r'*' ('r $#+r$% p'(' /+*')' , 20 --$ (+-' BB ' 00-r #'p' (%+r#' (+-' '('' p+!$/'' %+r6/% (' (+-' '#'$ #'p' (%+r#' r'%' $)+%5$)+% (' *'%) /"%+p% '%* ( (')' $#+r$%.

IKTISAR KASUS I IDENTITAS Pasien Suami N'' N.S T F U$r 39 #* :8 #* A-'' /'#")/ /'#")/   P+((/' SMP SMP P+/+r'' IRT !$r$* S$/$ '1' '1' A)''# 7)'('/ 7)'('/   Masuk RS tgl 1 okt 2004 !k 21"#0$ %&  II ANMAMNESIS A$#"''+%% #-) 4 "/#"!+r 200:, p$/$) 22.00 A. /+)$*' U#'' &elua' (a'a) (a'i kemaluan se*ak ± + *am SMRS

B R1''# P+'/# S+/'r'P'%+, N S, 39 #'*$ ('#'- (+-' /+)$*' /+)$'r ('r'* ('r'* ('r /+')$' %+'/ ; ' SMRS, (%+r#' 7'r' %+p+r# 'r (' )+(r, $)+%5 $)+% (r'%'/' %+'/ 2 *'r '- )')$. R1''# #r'$' %+!+)$' (%'-/'). P'%+ +-'/$ *') : !$)', PT 2 + 200:, TP : 'r+# 200, ANC ( p$%/+%'%, #('/ #+r'#$r. C. R1''# +%#r$'% M+'r7*+ 4 #*, %/)$% *'( 28 *'r )''' < *'r, !''/' 3 p+!')$#=*'r, +r *'( #('/ '('

D. R1''# p+r/'1' M+/'* p+r#'' /'), p'(' $$r 2: #*, )''' p+r/'1' 4 #* E. R1''# /+*')' (' /+)'*r' %+!+)$' K+*')' & -r'6(' :, p'r' 3, '!"r#$% 0 4. T* 4994, )'/5)'/, BB 2?@ 5 ANC & ( p$%/+%'%, #('/ #+r'#$r

G.R1''# KB & #('/ p+r'* KB . R1''# p+'/# D%'-/') I. R1''# "p+r'% T('/ p+r'* . R1''# p+'/# /+)$'r-' T('/ '(' K. R1''# /+!'%'' (r pr!'( M+r"/"/,')/"*"),'$ (' 'r/"!' (%'-/') L. R1''# -+/")"-% K+p$#*' %+'/ 4 #'*$ '- )')$,  >!'$ ?, -'#') ?@!+r"!'# #('/ #+r'#$r ( p$%/+%'%

III PEMERIKSAAN FISIK  A. S#'#$% -++r')% &,-kes . sakit se(ang - /M TD . 110-70 mmg FN & 400 = FP & 2: = TB=BB %/r- & 4;4 7=  /BB %!) *') &:; /K+p')' & "r"7+p*'), r'!$# *#', #('/ $('* (7'!$# M'#' & /"$-#6' '+%, %/)+r' #('/ /#+r/  M$)$# & #"%) T45T4, 'r- *p+r+%>5@, -- -+)- (!N L+*+r & KGB (' /+)+'r #r"( #('/ #+r'!' +!+%'r T"r'/% & ''+ & %+#r%, *p+rp-+#'% p'(' /+($' 'r+")', r+#r'/% p$##- >5@ C"r & S45S2 r+-$)+r, $r$r >5@, -'))"p >5@ P$)" & SN 6+%/$)+r, r*"/ (' 1*++- >5@ A!("+ & )*'# %#'#$% -+/")"-% A"-+#') & )*'# %#'#$% -+/")"-% E#r+#'% & '/r') *'-'#, +(+' #$-/' >5@

B STAT,S INE&O3OIS A!("+& Ins!eksi . memun5it P')'p'% & NT %$pr' p$!$% >5@, NL >5@, (+'% $%7$)'r >5@ P+r/$% & %*#- ($))+%% >5@ A$%/$)#'% & !%- $%$% >?@ "r'), D >?@ A"-+#') I & 6$)6'=$r+#r' #+'-, +(+' >5@, 6'r%+% >5@, #'p'/ ('r'* M+-')r ('r #r"#$% 6'-', I" & p"r#" )6(+, "%#$ #+r#$#$p, )$"r>5@, )$$%>?@, #'p'/ ('r'* +-')r V# & P"r#" /+'), +r -"'- p"r#">5@ III. PEMERIKSAAN PENUNANG 4. L'!"r'#"r$ D'r'*  # & 32 6")  ! & 40,< -=() L+$/" & 4;.;00 $) Tr"!" & 2:9.000 $) GDS & 444 -=() 2. USG & %+%$' (+-' $$r /+*')' 48549 --$, +#$% *($p, p)'%+#' ( !+)'/'- , B >?@, -+r'/ >?@, 'r /+#$!' >?@

I%" RES,ME P'%+ N.S 39 #* ('#'- (+-' /+)$*' p+r('r'*' ('r /+')$' %+'/ ; ' SMRS. (%+r#' 7'r' %p# )+(r (' 'r, $)+% >?@, r1''# #r'$' %+!+)$' (%'-/'). PT & 255200: TP & :535200 ANC & p$%/+%'%, #('/ #+r'#$r P'(' p++r/%'' %/ (('p'#/' & 5 S#'#$% -++r')% & (!N 5 S#'#$% -+/")"-% & A!("+ & NT %$pr' p$!% >?@, (+'7+ $%7$)'r >5@, +r %$pr' p$!% >?@, %*#- ($))+%% >5@, D >?@

P++r/%'' p+$'- & LAB &)+$/"%#"%% USG &/+%' %+%$' (+-' $%' /+*')',+#$% *($p V. DIAGNOSIS 5G:P3  4< --$ 5 A!"r#$% +% 5)+/"%#"%% +7 )"$r ')!$% VI. DIAGNOSA BANDING 5/+# 5")' *('#("%' VII. PROGNOSIS I!$ & D$!' '(' !"' ' & ($!'

VIII. PENATALAKSANAAN O!%+r6'% TNSP, *%, B, USG !+(r+%# A"/%) 300I!" 44 Pr"+( %$pp 34 D$6'()' 24

T-) 405405200: >p/. 04.00@ S & O% ('#'- /+!') /+ VK (+-' p+r('r'*' %+'/ 40 ' SMRS ,Dr* +r'* , /+#'), %p# -$p')' ('--, /+)$'r 'r>?@, $)+% >?@, (+'>5@, O& S# -++r')% &TD & 90=;0 RR&20= N & 8:= S &3;,; C M'#' & CA ?=? C=P & (!N A!( & T'(' '/$# '!( >5@ S# "!%#+#r& I& #'p'/ ' ((+p' 6$)6' VT&#+r'!' #') p$%'# ( "%#$ L'!&DPL9,:=28=28.00=32.000 GDS 98 -=() A& G:P3A048-A!"r#$% /"p)# L+/"%#%% %$%p  #r' -+#') A+' +7 p+r('r'*' P& O!%6 TNSP, P+r('r'*' I$% %#"%" 20 $ $%'*'/' )'*r  #"#" B)' #(/ )'*r  #"#" /$r+#'%+ ; ' %#)* ABK+('7)) 2 -r +"!" 24

T-) 40=40 > p/) 42.00@ ()'/$/' /$r+#'%+ (')' SA? 6')$ 5 %"('%+  43 7 AF 5 (- /$r+# #'' (/+)$'r/' 'r-'  2 77, %#)* %!)' (- '!"r#$% #'/+)$'r  0 77 5 +#+r- 20,2- IV )'! & 9,:=28=28.00=32.00 GDS& 98 -=()

T-) 44=40 S& #('/ '(' /+)$*' O& /$=/+% & %'/# %(-=CM TD & 90=;0 N & 8: = RR & 20 = S & 3;,9 C '#' & CA ?=? C=P & (!N '!( & #'(' '/$# >5@ A& p'%7' /$r+# P& '"/% 300*+"!" 44 +#+r- 34

ANALISA KASUS

Ao'tus e'(asa'kan (e6inisina a(ala) !engelua'an )asil konse!si seelum *anin (a!at )i(u! (ilua' kan(ungan (engan usia ku'ang (a'i 20 minggu (an e'at *anin elum men5a!ai 800 g'" &elu)an utama !a(a ao'tus a(ala) !e'(a'a)an !e'9aginan (imana !a(a  !asien ini" N s  #: t) (atang (engan kelu)an !e'(a'a)an !e'9aginam se*ak ± + *am SMRS (ise'tai kelu)an tama)an e'u!a 'asa mules kelua' 5ai'an (an len(i' " Se'ta !a(a !eme'iksaan 6isik ti(ak te'(a!at (ilatasi se'9ik" Penea ao'tus se5a'a ga'is esa' te'agi men*a(i (ua e'(asa'kan 6akto' mate'nal (an 6akto' )asil konse!si " !a(a !asien ini !eneana masi)  !e'lu (i5a'i" Da'i 6akto' konse!si kelainan !e'kemangan mau!un  !e'tumu)an )asil konse!si (a!at meneakan kematian *anin mau!un 5a5at  teta!i (a'i )asil !eme'iksaan ,S ti(ak (i(a!ati kelainan" Penea lain isa e'u!a kelainan k'omosom  (a'i ee'a!a !enelitian tama!ak );a 80!+( r+%#@, P+!+r' '#!"#/' ( % '(')'* $#$/ +-'#'% +/% #('/ $#$/ +7+-'* #+r'(' '!"r#$%. P+!+r' ($6'()' '(')'* $#$/ #"/")%% (%+r#' p+!+r' '')-+#/ !+r$p' pr"+( %$pp. D' p+!+r' !" %+!'-' #+r'p %$p"r#. P+!+r' *"r" pr"-+%#+r" p'(' '!"r#$% +% '%* +r$p'/' /"#r"6+r% %+!'! H/+!+r*'%)' (')' p+--$'' "!'#  %+r- +-'/!'#/' #('/ )+!* ('r /+('' missed abortion.