2. Bioprofile Janin (Rhr)
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BIOPHYSICAL PROFILE JANIN :
SALAH SATU TEST ANTEPARTUM
MEMANTAU KESEJAHTERAAN JANIN – DETEKSI HIPOKSIA
KRONIS
MENCEGAH KEMATIAN JANIN INTRAUTERIN
INTERVENSI / TERMINASI KEHAMILAN
BIOPHYSICAL PROFILE JANIN :
SALAH SATU TEST ANTEPARTUM
MEMANTAU KESEJAHTERAAN JANIN – DETEKSI HIPOKSIA
KRONIS
MENCEGAH KEMATIAN JANIN INTRAUTERIN
INTERVENSI / TERMINASI KEHAMILAN
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DILAKUKAN PADA :
UMUR KEHAMILAN > 28 MINGGU
KEHAMILAN RESIKO TINGGI KEHAMILAN LEWAT WAKTU DM HDK BOH : IUFD / STILL BIRTH KEHAMILAN USIA LANJUT GEMELLI – DISCORDANT APS
DILAKUKAN PADA :
UMUR KEHAMILAN > 28 MINGGU
KEHAMILAN RESIKO TINGGI KEHAMILAN LEWAT WAKTU DM HDK BOH : IUFD / STILL BIRTH KEHAMILAN USIA LANJUT GEMELLI – DISCORDANT APS
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PEMERIKSAAN LAIN YANG DICURIGAI :
IUGR
GERAK JANIN BERKURANG
OLIGOHIDRAMNION
PENGAWASAN JANIN RUTIN
PEMERIKSAAN LAIN YANG DICURIGAI :
IUGR
GERAK JANIN BERKURANG
OLIGOHIDRAMNION
PENGAWASAN JANIN RUTIN
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CARA PEMERIKSAAN
1. FETAL HEART RATE (FHR) – NONSTRESS TEST
2. PERNAFASAN JANIN
3. PERGERAKAN JANIN
4. TONUS OTOT JANIN
5. JUMLAH CAIRAN KETUBAN
DIBUAT SCORE 10 : TIDAK PERLU INTERVENSI
CARA PEMERIKSAAN
1. FETAL HEART RATE (FHR) – NONSTRESS TEST
2. PERNAFASAN JANIN
3. PERGERAKAN JANIN
4. TONUS OTOT JANIN
5. JUMLAH CAIRAN KETUBAN
DIBUAT SCORE 10 : TIDAK PERLU INTERVENSI
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PATOFISIOLOGI
INSUFISIENSI PLASENTA, HIPOKSIA JANIN YANG BERAT DAN LAMA
DEPRESI FUNGSI SUSUNAN SYARAF PUSAT (SSP)
KEGIATAN BIOFISIK AKAN TERGANGGU
PATOFISIOLOGI
INSUFISIENSI PLASENTA, HIPOKSIA JANIN YANG BERAT DAN LAMA
DEPRESI FUNGSI SUSUNAN SYARAF PUSAT (SSP)
KEGIATAN BIOFISIK AKAN TERGANGGU
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FHR MONITORING NST (KTG)
HARUS DIPERHATIKAN :
BASE LINE RATE : 140 BPM
TACHYCARDIA : > 160 BPM
BRADYCARDIA : < 120 BPM
VARIABILITAS : PERBEDAAN DENYUT PER DENYUT (SHORT TERM VARIAB.)
ACCELERASI : PENINGKATAN DENYUT JANTUNG KARENA AKTIFITAS JANIN, NORMAL : 5 – 25 BPM (LONGTERM VARIABILITY).
SEBAGAI RESPON TERHADAP GERAKAN JANIN
FHR MONITORING NST (KTG)
HARUS DIPERHATIKAN :
BASE LINE RATE : 140 BPM
TACHYCARDIA : > 160 BPM
BRADYCARDIA : < 120 BPM
VARIABILITAS : PERBEDAAN DENYUT PER DENYUT (SHORT TERM VARIAB.)
ACCELERASI : PENINGKATAN DENYUT JANTUNG KARENA AKTIFITAS JANIN, NORMAL : 5 – 25 BPM (LONGTERM VARIABILITY).
SEBAGAI RESPON TERHADAP GERAKAN JANIN
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TACHYCARDIA DAPAT TERJADI PADA KEADAAN :
HIPOKSIA JANIN (RINGAN/KRONIK)
KEHAMILAN PRETERM (< 30 MINGGU)
INFEKSI IBU ATAU JANIN
IBU DEMAM ATAU GELISAH
IBU HIPERTIROID
OBAT-OBATAN (ATROPIN, BETA MIMETIK)
TACHYCARDIA DAPAT TERJADI PADA KEADAAN :
HIPOKSIA JANIN (RINGAN/KRONIK)
KEHAMILAN PRETERM (< 30 MINGGU)
INFEKSI IBU ATAU JANIN
IBU DEMAM ATAU GELISAH
IBU HIPERTIROID
OBAT-OBATAN (ATROPIN, BETA MIMETIK)
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BRADYKARDIA DAPAT TERJADI PADA KEADAAN :
HIPOKSIA JANIN (BERAT/AKUT)
HIPOTERMIA JANIN
BRADI ARITMIA JANIN
OBAT-OBATAN (PROPANOLOL/OBAT ANASTESIA LOKAL)
JANIN DENGAN KELAINAN JANTUNG BAWAAN
BRADYKARDIA DAPAT TERJADI PADA KEADAAN :
HIPOKSIA JANIN (BERAT/AKUT)
HIPOTERMIA JANIN
BRADI ARITMIA JANIN
OBAT-OBATAN (PROPANOLOL/OBAT ANASTESIA LOKAL)
JANIN DENGAN KELAINAN JANTUNG BAWAAN
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KTG UNTUK MONITORING EKSTERNALKTG UNTUK MONITORING EKSTERNAL
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NST : NORMAL (SCORE 2)
ACCELERASI > 2 DALAM 20 – 40 MENIT
ACCELERASI BERLANGSUNG > 15 DETIK
DENGAN VARIABILITAS > 15 BPM.
NST : NORMAL (SCORE 2)
ACCELERASI > 2 DALAM 20 – 40 MENIT
ACCELERASI BERLANGSUNG > 15 DETIK
DENGAN VARIABILITAS > 15 BPM.
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PERNAFASAN JANIN :
SUDAH DAPAT DIAMATI PADA KEHAMILAN > 14 MINGGU,
BERBEDA DENGAN PERNAFASAN NEONATAL
TIDAK TERUS MENERUS
TERBALIK : INSPIRASI : - DINDING THORAX
MENGEMPIS
- DIAPRAGMA TURUN
- RONGGA PERUT
MENONJOL
EXPIRASI : KEBALIKANNYA
PERNAFASAN JANIN :
SUDAH DAPAT DIAMATI PADA KEHAMILAN > 14 MINGGU,
BERBEDA DENGAN PERNAFASAN NEONATAL
TIDAK TERUS MENERUS
TERBALIK : INSPIRASI : - DINDING THORAX
MENGEMPIS
- DIAPRAGMA TURUN
- RONGGA PERUT
MENONJOL
EXPIRASI : KEBALIKANNYA
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KEBUTUHAN PERNAFASAN DIDUGA :
UNTUK PERGANTIAN AIR KETUBAN DALAM PROSES
PEMATANGAN PARU
SUMBER AIR KETUBAN DISAMPING URINE JANIN
PERNAPASAN JANIN SCORE 2 :
DALAM 30 MENIT EPISODE PERNAPASAN 1
BERLANGSUNG DALAM 30 DETIK.
KEBUTUHAN PERNAFASAN DIDUGA :
UNTUK PERGANTIAN AIR KETUBAN DALAM PROSES
PEMATANGAN PARU
SUMBER AIR KETUBAN DISAMPING URINE JANIN
PERNAPASAN JANIN SCORE 2 :
DALAM 30 MENIT EPISODE PERNAPASAN 1
BERLANGSUNG DALAM 30 DETIK.
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SAGITAL LONGITUDINAL SCAN KEHAMILAN 20 MG.
DI APHRAGMA DAN SUBPHRENIC AREA
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COLOR DOPLER SIKLUS PERNAFASAN ALIRAN CAIRAN DITHACHEA:
MERAH : EXPIRASI BIRU : INPIRASI
COLOR DOPLER SIKLUS PERNAFASAN ALIRAN CAIRAN DITHACHEA:
MERAH : EXPIRASI BIRU : INPIRASI
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PERGERAKAN JANIN : SUDAH MULAI TERLIHAT PADA KEHAMILAN 7,5 – 9 MINGGU
KEHAMILAN 20 – 30 MINGGU GERAKAN SUDAH TERKOORDINASI
ADA SIKLUS : TIDUR DAN BANGUN – BERVARIASI 20 – 75 MENIT
PERGERAKAN JANIN SCORE : 2
DALAM 30 MENIT DIJUMPAI GERAKAN ANGGOTA GERAK DAN TUBUH SEBANYAK 3.
PERGERAKAN JANIN : SUDAH MULAI TERLIHAT PADA KEHAMILAN 7,5 – 9 MINGGU
KEHAMILAN 20 – 30 MINGGU GERAKAN SUDAH TERKOORDINASI
ADA SIKLUS : TIDUR DAN BANGUN – BERVARIASI 20 – 75 MENIT
PERGERAKAN JANIN SCORE : 2
DALAM 30 MENIT DIJUMPAI GERAKAN ANGGOTA GERAK DAN TUBUH SEBANYAK 3.
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KEHAMILAN 21 MINGGU, KEDUA TUNGKAI FLEXIKEHAMILAN 21 MINGGU, KEDUA TUNGKAI FLEXI
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KEHAMILAN 12 MINGGU GEMELLI, SATU KANTUNG KEDUA LENGAN FLEXIKEHAMILAN 12 MINGGU GEMELLI, SATU KANTUNG KEDUA LENGAN FLEXI
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TONUS OTOT :
SAMA DENGAN GERAKAN JANIN, TERLIHAT MULAI : 7,5 – 9 MINGGU
EPISODE AKTIF EXTENSI DAN FLEXI ANGGOTA GERAK ATAU GERAKAN MEMBUKA DAN MENUTUP TANGAN
TONUS TOT SCORE : 2
DIJUMPAI EPISODE EXTENSI – FLEXI ATAU GERAKAN MEMBUKA DAN MENUTUP TANGAN.
TONUS OTOT :
SAMA DENGAN GERAKAN JANIN, TERLIHAT MULAI : 7,5 – 9 MINGGU
EPISODE AKTIF EXTENSI DAN FLEXI ANGGOTA GERAK ATAU GERAKAN MEMBUKA DAN MENUTUP TANGAN
TONUS TOT SCORE : 2
DIJUMPAI EPISODE EXTENSI – FLEXI ATAU GERAKAN MEMBUKA DAN MENUTUP TANGAN.
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AFI : AMNIOTIC FLUID INDEX
DASAR : PENURUNAN PERFUSI PLASENTA SSP JANIN PENURUNAN RENAL
BLOOD FLOW JANIN URINE BERKURANG
OLIGOHIDRAMNION.
OLIGOHIDRAMNION JARANG DIJUMPAI PADA AWAL
KEHAMILAN, KALAU TERJADI PROGNOSA JELEK.
AFI : AMNIOTIC FLUID INDEX
DASAR : PENURUNAN PERFUSI PLASENTA SSP JANIN PENURUNAN RENAL
BLOOD FLOW JANIN URINE BERKURANG
OLIGOHIDRAMNION.
OLIGOHIDRAMNION JARANG DIJUMPAI PADA AWAL
KEHAMILAN, KALAU TERJADI PROGNOSA JELEK.
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CARA PEMERIKSAAN :
UTERUS HAMIL DIBAGI 4 QUADRAN
TRANSDUSER DITEMPATKAN PADA TIAP QUADRAN
SESUAI DENGAN AXIS LONGITUDINAL
DIHITUNG JARAK RUANGAN TERBESAR SECARA TEGAK
LURUS : DINDING UTERUS – BAGIAN JANIN
JUMLAH 4 QUADRANT 5 CM, ATAU 1 QUADRANT 2
CM SCORE : 2
CARA PEMERIKSAAN :
UTERUS HAMIL DIBAGI 4 QUADRAN
TRANSDUSER DITEMPATKAN PADA TIAP QUADRAN
SESUAI DENGAN AXIS LONGITUDINAL
DIHITUNG JARAK RUANGAN TERBESAR SECARA TEGAK
LURUS : DINDING UTERUS – BAGIAN JANIN
JUMLAH 4 QUADRANT 5 CM, ATAU 1 QUADRANT 2
CM SCORE : 2
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PUSAT DAN LINIA ALBA DIGUNAKAN SEBAGAIPEMBAGI KUADRAN
PUSAT DAN LINIA ALBA DIGUNAKAN SEBAGAIPEMBAGI KUADRAN
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PENILAIAN BIOPPHYSICAL PROFILE :
SCORE : 8 – 10 – NORMAL : TEST DIULANG
/ MINGGU
SCORE : 6 MERAGUKAN : TEST
DIULANG DALAM 24 JAM
SCORE : 4 – 2 – 0 : FATUS DALAM
BAHAYA SEGERA
DILAHIRKAN
KALAU TERJADI OLIGOHIDRAMNION PERHATIAN
KHUSUS MESKIPUN SCORE BAIK
PENILAIAN BIOPPHYSICAL PROFILE :
SCORE : 8 – 10 – NORMAL : TEST DIULANG
/ MINGGU
SCORE : 6 MERAGUKAN : TEST
DIULANG DALAM 24 JAM
SCORE : 4 – 2 – 0 : FATUS DALAM
BAHAYA SEGERA
DILAHIRKAN
KALAU TERJADI OLIGOHIDRAMNION PERHATIAN
KHUSUS MESKIPUN SCORE BAIK
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CONTRACTION STRESS TEST (CST) OXYTOCIN CHALLENGE TEST (OCT)
HUBUNGAN ANTARA KONTRAKSI UTERUS DAN FHR
UNTUK MENGETAHUI ADANYA HIPOKSIA JANIN
PRINSIP : JANIN SEHAT DPT MENTOLERANSI
KONSUMSI
OXYGEN SELAMA KONTRAKSI
UTERUS, SEDANGKAN JANIN DGN HIPOKSIA
MENUNJUKKAN DESELERASI
LAMBAT ATAU
DESELERASI VARIABEL
CONTRACTION STRESS TEST (CST) OXYTOCIN CHALLENGE TEST (OCT)
HUBUNGAN ANTARA KONTRAKSI UTERUS DAN FHR
UNTUK MENGETAHUI ADANYA HIPOKSIA JANIN
PRINSIP : JANIN SEHAT DPT MENTOLERANSI
KONSUMSI
OXYGEN SELAMA KONTRAKSI
UTERUS, SEDANGKAN JANIN DGN HIPOKSIA
MENUNJUKKAN DESELERASI
LAMBAT ATAU
DESELERASI VARIABEL
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KONTRA INDIKASI :
KPD, PERDARAHAN TRIMESTER III
PLACENTA PREVIA, BEKAS SC KLASIK
GEMELLI, CERVIX INCOMPETEN
KEMUNGKINAN PARTUS PREMATURUS
KONTRA INDIKASI :
KPD, PERDARAHAN TRIMESTER III
PLACENTA PREVIA, BEKAS SC KLASIK
GEMELLI, CERVIX INCOMPETEN
KEMUNGKINAN PARTUS PREMATURUS
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FUNGSI : TEMPAT PERTUMBUHAN JANIN
JANIN DAPAT BERGERAK BEBAS
BANTALAN TERHADAP TRAUMA
MENGATUR TEMP. KONSTAN
MEMBANTU PEMBESARAN RONGGA UTERUS
MEMBANTU DILATASI CERVIX PADA PERSALINAN
MEMPENGARUHI PERTUMBUHAN JANIN : AIR
KETUBAN MORBIDITAS DAN MORTALITAS
FUNGSI : TEMPAT PERTUMBUHAN JANIN
JANIN DAPAT BERGERAK BEBAS
BANTALAN TERHADAP TRAUMA
MENGATUR TEMP. KONSTAN
MEMBANTU PEMBESARAN RONGGA UTERUS
MEMBANTU DILATASI CERVIX PADA PERSALINAN
MEMPENGARUHI PERTUMBUHAN JANIN : AIR
KETUBAN MORBIDITAS DAN MORTALITAS
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SIRKULASI AIR KETUBAN :
NORMAL BERADA DALAM DINAMIK EQUILIBRIUM
SEL, KETUBAN, TALI PUSAT, KULIT JANIN, SAL.
PENCERNAAN, SAL. PERNAFASAN DAN SAL. KENCING
12 MG JANIN SUDAH MENELAN AIR KETUBAN
DI TELAN JANIN : 200 – 450 CC / HARI
½ URINE JANIN DITELAN
CAIRAN PLASMA IBU BERPERAN 29 – 36 MG
SIRKULASI AIR KETUBAN :
NORMAL BERADA DALAM DINAMIK EQUILIBRIUM
SEL, KETUBAN, TALI PUSAT, KULIT JANIN, SAL.
PENCERNAAN, SAL. PERNAFASAN DAN SAL. KENCING
12 MG JANIN SUDAH MENELAN AIR KETUBAN
DI TELAN JANIN : 200 – 450 CC / HARI
½ URINE JANIN DITELAN
CAIRAN PLASMA IBU BERPERAN 29 – 36 MG
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JUMLAH CAIRAN KETUBAN
12 MG : 60 CC 40 MG : 840 CC
34 MG : 1000 CC 42 MG : 540 CC
JUMLAH TERGANTUNG : UMUR KEHAMILAN, BESAR JANIN, UKURAN PLASENTA
PENGUKURAN JUMLAH AIR KETUBAN : AFI
SUBJEKTIF : PENGALAMAN SONOGRAFER (JUGA BAIK)
AFI : 50 – 200 MM : NORMAL
> 200 MM : POLIHIDRAMNION
< 50 MM : OLIGO HIDRAMNION
JUMLAH CAIRAN KETUBAN
12 MG : 60 CC 40 MG : 840 CC
34 MG : 1000 CC 42 MG : 540 CC
JUMLAH TERGANTUNG : UMUR KEHAMILAN, BESAR JANIN, UKURAN PLASENTA
PENGUKURAN JUMLAH AIR KETUBAN : AFI
SUBJEKTIF : PENGALAMAN SONOGRAFER (JUGA BAIK)
AFI : 50 – 200 MM : NORMAL
> 200 MM : POLIHIDRAMNION
< 50 MM : OLIGO HIDRAMNION
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PENGUKURAN FLUID POCKET YG TERBESAR :
> 2 cm, 8 cm JUMLAH AIR KETUBAN NORMAL
> 8 cm
8-12 cm POLYHIDRAMNION RINGAN
12-16 cm POLYHIDRAMNION SEDANG
> 16 cm POLYHIDRAMNION BERAT
1 cm, < 2 cm BORDERLINE AMNIOTIC FLUID VOLUME
< 1 cm OLIGO HIDRAMNION
PENGUKURAN FLUID POCKET YG TERBESAR :
> 2 cm, 8 cm JUMLAH AIR KETUBAN NORMAL
> 8 cm
8-12 cm POLYHIDRAMNION RINGAN
12-16 cm POLYHIDRAMNION SEDANG
> 16 cm POLYHIDRAMNION BERAT
1 cm, < 2 cm BORDERLINE AMNIOTIC FLUID VOLUME
< 1 cm OLIGO HIDRAMNION
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PENYEBAB OLIGOHIDRAMNION
JANIN : KELAINAN UROGENITAL
IBU : KETUBAN BOCOR, HDK, POSMATURITAS
PLASENTA : INSUFISIENSI PLASENTA
PENYEBAB POLI HIDRAMNION
JANIN : NTD, OBST. SAL. PENCERNAAN, KELAINAN JANTUNG, IMUN DAN NON IMUN FETAL
HIDROPS
IBU : DM, RH INCOMPATIBILITI
PENYEBAB OLIGOHIDRAMNION
JANIN : KELAINAN UROGENITAL
IBU : KETUBAN BOCOR, HDK, POSMATURITAS
PLASENTA : INSUFISIENSI PLASENTA
PENYEBAB POLI HIDRAMNION
JANIN : NTD, OBST. SAL. PENCERNAAN, KELAINAN JANTUNG, IMUN DAN NON IMUN FETAL
HIDROPS
IBU : DM, RH INCOMPATIBILITI
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KEHAMILAN 22 MG – TRANSVER SCAN JUMLAH
CAIRAN KETUBAN CUKUP
KEHAMILAN 22 MG – TRANSVER SCAN JUMLAH
CAIRAN KETUBAN CUKUP
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KEHAMILAN 26 MG – SAGITAL SCAN
OLIGOHIDRAMNION POKET TERBESAR 1,8 CM
KEHAMILAN 26 MG – SAGITAL SCAN
OLIGOHIDRAMNION POKET TERBESAR 1,8 CM
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KEHAMILAN 24 MG – TRANSVER SCAN
POLIHIDRAMNION
KEHAMILAN 24 MG – TRANSVER SCAN
POLIHIDRAMNION
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POLY HIDRAMNIOS WITH A LEFT DIAPHRAGMATIC HERNIA. TRANSVERSE
SCAN AT 21 WEEKS. THE STOMACH IS NOT VISUALIZED
POLY HIDRAMNIOS WITH A LEFT DIAPHRAGMATIC HERNIA. TRANSVERSE
SCAN AT 21 WEEKS. THE STOMACH IS NOT VISUALIZED
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MARKED POLYHIDRAMNIOS. TRANSVERSE SCAN AT 22 WEEKSMARKED POLYHIDRAMNIOS. TRANSVERSE SCAN AT 22 WEEKS
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SCANT AMNIOTIC FLUID. LONGITUDINAL SCAN AT 26 WEEKS. THE
LARGEST FLUID POCKET MEASURES 1.8 CM
SCANT AMNIOTIC FLUID. LONGITUDINAL SCAN AT 26 WEEKS. THE
LARGEST FLUID POCKET MEASURES 1.8 CM
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SEVERE OLYGO HIDRAMNIOS DUE TO PREMATURE RUPTURE OF THE
MEMBRANES. LONGITUDINAL SCAN AT 23 WEEKS.
SEVERE OLYGO HIDRAMNIOS DUE TO PREMATURE RUPTURE OF THE
MEMBRANES. LONGITUDINAL SCAN AT 23 WEEKS.
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USG PLASENTAUSG PLASENTA KEHAMILAN 10 MG JELAS DIBEDAKAN DENGAN JARINGAN
SEKITAR (DISK SHAPED ORGAN)
CHORIONIC PLATE : BATAS PLASENTA DAN RONGGA AMNION
BASAL PLATE : BATAS JARINGAN PLASENTA DAN DINDING UTERUS
8 – 20 MG : JARINGAN HOMOGEN, ECHOGENIC TEBAL SAMPAI 3 CM
> 20 MG : VENOUS LAKE (+), KALSIFIKASI (+) TEBAL 4 - 5 CM
KEHAMILAN 10 MG JELAS DIBEDAKAN DENGAN JARINGAN SEKITAR (DISK SHAPED ORGAN)
CHORIONIC PLATE : BATAS PLASENTA DAN RONGGA AMNION
BASAL PLATE : BATAS JARINGAN PLASENTA DAN DINDING UTERUS
8 – 20 MG : JARINGAN HOMOGEN, ECHOGENIC TEBAL SAMPAI 3 CM
> 20 MG : VENOUS LAKE (+), KALSIFIKASI (+) TEBAL 4 - 5 CM
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GRADING PLASENTAGRADING PLASENTA
GRADE 0 : TRIMESTER I DAN II
CHORIONIC PLATE LICIN, HOMOGEN
SUBSTANSI BERGANULASI
DENSITAS (-)
GRADE 0 : TRIMESTER I DAN II
CHORIONIC PLATE LICIN, HOMOGEN
SUBSTANSI BERGANULASI
DENSITAS (-)
GRADE I : SESUDAH KEHAMILAN 26 MG
CHORIONIC PLATE MULAI BERGELOMBANG
DIJUMPAI ECHOGINIC AREA 1- 4 CM PADA SUBSTANSI PLASENTA SEJAJAR BASAL PLATE
GRADE I : SESUDAH KEHAMILAN 26 MG
CHORIONIC PLATE MULAI BERGELOMBANG
DIJUMPAI ECHOGINIC AREA 1- 4 CM PADA SUBSTANSI PLASENTA SEJAJAR BASAL PLATE
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GRADE II : SESUDAH KEHAMILAN 26 MG
CHORIONIC PLATE JELAS, BERGELOMBANG
SUBSTANSI : TERBAGI DENSITAS BENTUK
KOMA DARI CHORIONIC PLATE TIDAK
SAMPAI DASAR PLASENTA
ECHOGENIC AREA : MAKIN BESAR – PANJANG
DAN BANYAK SEJAJAR DGN BASAL PLATE
GRADE II : SESUDAH KEHAMILAN 26 MG
CHORIONIC PLATE JELAS, BERGELOMBANG
SUBSTANSI : TERBAGI DENSITAS BENTUK
KOMA DARI CHORIONIC PLATE TIDAK
SAMPAI DASAR PLASENTA
ECHOGENIC AREA : MAKIN BESAR – PANJANG
DAN BANYAK SEJAJAR DGN BASAL PLATE
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GRADE III : SESUDAH KEHAMILAN 35 MG
HANYA 15% KASUS
CHORIONIC PLATE :
- TERBAGI DALAM KOMPARTEMEN,
BANYAK HIPOECHOIC AREA
- DENSITES IREGULER DEKAT CHORIONIC
PLATE
- ECHOGENIC AREA : SEMAKIN LUAS
GRADE III : SESUDAH KEHAMILAN 35 MG
HANYA 15% KASUS
CHORIONIC PLATE :
- TERBAGI DALAM KOMPARTEMEN,
BANYAK HIPOECHOIC AREA
- DENSITES IREGULER DEKAT CHORIONIC
PLATE
- ECHOGENIC AREA : SEMAKIN LUAS
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SKEMATIK GRADING PLASENTASKEMATIK GRADING PLASENTA
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PLASENTA GRADE 0, KEHAMILAN 16 MGPLASENTA GRADE 0, KEHAMILAN 16 MG
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PLASENTA GRADE 0, KEHAMILAN 17 MGPLASENTA GRADE 0, KEHAMILAN 17 MG
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PLASENTA GRADE I, KEHAMILAN 33 MGPLASENTA GRADE I, KEHAMILAN 33 MG
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PLASENTA GRADE II, KEHAMILAN 36 MGPLASENTA GRADE II, KEHAMILAN 36 MG
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PLASENTA GRADE III, KEHAMILAN 39 MGPLASENTA GRADE III, KEHAMILAN 39 MG
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KEPUSTAKAANKEPUSTAKAAN AGUS ABADI, KARDIOTOKOGRAFI JANIN, IN ACCREDITED ULTRASOUND
WORKSHOP, SURABAYA, MARCH 27-28, 2002
HARYONO ROESHADI, BIOPHYSICAL PROFILE JANIN, PENGGUNAAN USG TERKINI DALAM BIDANG OBSTETRI, WORKSHOP USG, MEDAN 20-21 MARET 2005.
SUSAN MARTIN TUCKER, PATTERN RECOGNITION AND INTERPRETATION IN FETAL MONITORING AND ASSESMENT, MOSBY POCKET GUIDE FIFTH ED. 2004
G WEBER AND E. MERZ, AMNIOTIC FLUID IN ULTRASOUND IN OBSTETRIC AND GYNECOLOGY, VOL 5 OBSTETRICS, EBER HARD MERZ SECOND EDITION. 2005
F. GARY CUNNINGHAM ET AL, INTRA PARTUM ASSESMENT, WILLIAMS OBSTETRICS 21 ST EDITION MC GRAW HILL.
AGUS ABADI, KARDIOTOKOGRAFI JANIN, IN ACCREDITED ULTRASOUND WORKSHOP, SURABAYA, MARCH 27-28, 2002
HARYONO ROESHADI, BIOPHYSICAL PROFILE JANIN, PENGGUNAAN USG TERKINI DALAM BIDANG OBSTETRI, WORKSHOP USG, MEDAN 20-21 MARET 2005.
SUSAN MARTIN TUCKER, PATTERN RECOGNITION AND INTERPRETATION IN FETAL MONITORING AND ASSESMENT, MOSBY POCKET GUIDE FIFTH ED. 2004
G WEBER AND E. MERZ, AMNIOTIC FLUID IN ULTRASOUND IN OBSTETRIC AND GYNECOLOGY, VOL 5 OBSTETRICS, EBER HARD MERZ SECOND EDITION. 2005
F. GARY CUNNINGHAM ET AL, INTRA PARTUM ASSESMENT, WILLIAMS OBSTETRICS 21 ST EDITION MC GRAW HILL.