8/19/2019 cc 14 maret 2016.pptx

1/43

LAPORAN JAGA MALAM DOKTER MUDA

14 Maret 2016

8/19/2019 cc 14 maret 2016.pptx

2/43

DAFTAR PASIEN MASUK 

8/19/2019 cc 14 maret 2016.pptx

3/43

No Identitas Diagnosis Plan/Terapi

1 Ny. ETG2P1A0, 30t01332!!1 UK" 40#3 $%

Ka&a II Feta& '()tre)) ,*et+a- e/a '(-( 1ar( a'a)e*+-'(%ra('a a$(&

ater$

O+t/$e" ay( &a*(&a*(3300 %r, AS 6!

- P($(- er)a&(-a-era%(-a$, *a&a II'(er/eat 'e-%a- a*+$e*)tra*)(

- KIE , (-r$e' /-)e-t- S(a*a- re)+)(ta)( -e-at+)- I-5 (/(&&(- 1 %r

2 Ny. LAP

G1P0A0, 22 t

01332!!!

UK" 3 $%%

IUFD *et+a- e/a'(-( 2 ar( a'a

r($(%ra('a a$(&reter$ 3 $(-%%+ '*a&a 1 a)e a*t( 

O+t/$e" &a*(&a*(,2000 %r, $a)era)( 78

- La-5+t er)a&(-a-era%(-a$

-

O) 9- ea&+a)( 2 5a$- :e* &aratr(+$

3. Ny. ;

P2A0, 30t

01332!6

Rete-)( )()a &a/e-ta #&e+*)(t)()

- M-'*

- K+reta)e e&e*t( 

- I-r$e' /-)e-t, KIE

- K-)+& a-e)te)(

- I- RL #

8/19/2019 cc 14 maret 2016.pptx

4/43

No Identitas Diagnosis Plan/Terapi

8/19/2019 cc 14 maret 2016.pptx

5/43

I'e-t(ta) Pa)(e-

Na$a " Ny. ET Ta-%%a& La(r " 21=0=19

A&a$at " Ka$+-%)e>+, S+ra*arta

Pe*er5aa- " IRT

 Ta-%%a& Ma)+* " 14 Mar 2016

 Ta-%%a& D(er(*)a " 14 Mar 2016

N. RM " 01332!!!

8/19/2019 cc 14 maret 2016.pptx

6/43

Ke&+a- +ta$a

R+5+*a- 'ar( RSUD S+ra*arta

'e-%a- *etera-%a-)e*+-'(%ra('a a$(& ater$ *a&a IIt('a* $a5+

8/19/2019 cc 14 maret 2016.pptx

7/43

R(>ayat Pe-ya*(tSe*ara-%Sera-% G2P1A0, 30 t, UK 40#3 $(-%%+

, r+5+*a- 'ar( RSUD S+ra*arta 'ata-%'e-%a- *etera-%a- )e*+-'(%ra('a.ater$ 'e-%a- *a&a II t('a* $a5+.Pa)(e- $era)a a$(& 9 +&a-. Gera*a-

 5a-(- $a)( '(ra)a*a-, *e-/e-%*e-/e-%terat+r )+'a '(ra)a*a-. A(r *a>a)+'a '(ra)a*a- *e&+ar )e5a* 1r ya-%&a&+ )ee&+$ $a)+* r), &e-'(r 'ara #.Per)a&(-a- )+'a '(($(- )e&a$a 2 5a$'( RSUD )+ra*arta.

8/19/2019 cc 14 maret 2016.pptx

8/43

R(>ayat Pe-ya*(t Da+&+

R(>ayat ;(erte-)( " D()a-%*a&

R(>ayat DM " D()a-%*a&R(>ayat A)$a " D()a-%*a&

R(>ayat A&er%( "

D()a-%*a&R(>ayat Ja-t+-% " D()a-%*a&

8/19/2019 cc 14 maret 2016.pptx

9/43

8/19/2019 cc 14 maret 2016.pptx

10/43

R(>ayat O)tetr(

Me-(*a 1

8/19/2019 cc 14 maret 2016.pptx

11/43

Pe$er(*)aa- F()(*

KU " ?a(*, :$) Me-t()

@(ta& S(%- " TD " 120=0 $$;%

;R " 2

8/19/2019 cc 14 maret 2016.pptx

12/43

Pe$er(*)aa- F()(*

Mata" :A 7=8, SI 7=8

Thorax" /= '-

Abdomen"

S+e&, NT 78, teraa 5a-(- t+-%%a&, I-tra +ter(-, $e$a-5a-%, +*(, re)*e,*ea&a $a)+* a-%%+& 2=3 a%(a-, () 7#8 34

8/19/2019 cc 14 maret 2016.pptx

13/43

Pe$er(*)aa- F()(*

UPD:

Pr$-tr(+$ t('a* teraa

L(-ea ter$(-a&() teraa 1=3 a%(a-

S(-a ()/(a'(/a t('a* teraa

Ar/+) +() 90

Ke)a-" a-%%+& %y-e/(' 7#8

8/19/2019 cc 14 maret 2016.pptx

14/43

Pe$er(*)aa- Pe-+-5a-%

USG: Ta$a* 5a-(- t+-%%a& IU, +*(,re)*e, DJJ 7#8

F? ?PD 91 /$, A: 30, 9! /$, FL6,4 /$, EF?H 3012 %r

P&a/e-ta (-)er)( '( /r+) %ra'e 2, a(r

*et+a- *e)a- *+ra-% Ta* ta$a* *e&a(-a- *-%e-(ta&$ayr, *e)a- 5a-(- )aat (-( 'a&a$

*ea'aa- a(*.

8/19/2019 cc 14 maret 2016.pptx

15/43

Pe$er(*)aa- La 14 032016

;e$%&(- " 12,! %='&

;/t " 39 AL " 141 r(+=+& AT " 14! r(+=+& AE " 4,39 5t=+&

• G&. Dara " • GDS " 161

$%='&• ;)A% "

--rea/t(e

• PT " 11.9• APTT " 32.0

8/19/2019 cc 14 maret 2016.pptx

16/43

Ke)($+&a-Sera-% G2P1A0 30 ta+- UK 40#3 $(-%%+,r(>ayat )tetr( 'a- ert(&(ta) a(*, teraa

 5a-(- t+-%%a&, (-tra+ter(, $e$a-5a-%, +*(,re)*e, *ea&a $a)+* a-%%+& 2=3a%(a-, () 7#8 34

8/19/2019 cc 14 maret 2016.pptx

17/43

D(a%-)()

Ka&a II Feta& '()tre)), *et+a- e/a'(-( 1 ar( a'a )e*+-'(%ra('a

a$(& ater$

8/19/2019 cc 14 maret 2016.pptx

18/43

 Tera(

1. La-5+t er)a&(-a- er a%(-a, *a&a II'(er/eat 'e-a- a*+$ e*)tra*)(

2. I-5e*)( (/(&&(- 1 %r 7I@, )*(- te)t83. KIE, (-r$e' /-)e-t

8/19/2019 cc 14 maret 2016.pptx

19/43

O+t/$e

La(r ay( &a*(&a*( era%(-a$,('+, ??L 3300 %r, AS 6!, a-+)7#8

La(r &a/e-ta, &e-%*a, e-t+*/a*ra$, +*+ra- 20

8/19/2019 cc 14 maret 2016.pptx

20/43

 T(-5a+a- P+)ta*a

8/19/2019 cc 14 maret 2016.pptx

21/43

"et#ban Pe$ahDini

8/19/2019 cc 14 maret 2016.pptx

22/43

◦ Pe/a-ya *et+a- )ee&+$ >a*t+er)a&(-a- '($+&a(

 Defnisi

8/19/2019 cc 14 maret 2016.pptx

23/43

◦ Ha*t+ )aat e/a-ya $e$ra- )a$a(

'($+&a(-ya er)a&(-a-◦ Se$a*(- $+'a +)(a *ea$(&a- )e$a*(-

&a$a er('e &ate-

◦ Pa'a *ea$(&a- ater$ 90 a*a- $e$+&a(

er)a&(-a- 'a&a$ 24 5a$◦ Pa'a *ea$(&a- 234 $(-%%+

0 er)a&(- 'a&a$ >a*t+ 24 5a$

090 er)a&(- 'a&a$ >a*t+ 1 $(-%%+

Periode laten

8/19/2019 cc 14 maret 2016.pptx

24/43

◦ I'(at(*

◦ I-e*)( 7$()" a%(-)() a*ter(a&8

◦ P&y('ra$-(-

◦ I-*$ete- )er(*

◦ A-$a&( +ter(-

◦ A*(at e$a)a-%a- /er/&a%e a'a )er(* ata+

a$-()e-te)()

◦  Tra+$a

enyebab ketuban pecah dini

8/19/2019 cc 14 maret 2016.pptx

25/43

◦ R(>ayat )ee&+$-ya

◦ Pe$er(*)aa- 'e-%a- )e*+&+$ )ter(& 7(-'ar(e$er(*)aa- '(%(ta&8

 /+/( a%(-a

 /a(ra- ter*+$+& '( r-(* )ter(r

 /a(ra- ea) 'ar( )er(*

 e$er(*)aa- ; /a(ra- 7*erta) -(tra(-8 t('a*)e)(*

 er-(-% %a$ara- 'a+- a*()

◦ USG-r$a& (&a 5+$&a /a(ra- /+*+

Diagnosis ketuban pecahdini 

8/19/2019 cc 14 maret 2016.pptx

26/43

◦ I-e*)( et+)=-e-at+)

◦ I-e*)( (+

◦ K$re)( ata+ r&a) ta&( +)at◦ Ga%a& (-'+*)( 'a- '((*+t( &e S:

omplikasi Ketuban Pecah Dini 

Pada kehamilan preterm infeksi fetus dan neonatus

infeksi ibu

prolaps dan kompresi tali pusat

gagal induksi dan diikuti oleh SC

hipoplasia paru (oligohidramnion berat )

deformitas pada fetus

8/19/2019 cc 14 maret 2016.pptx

27/43

◦ N(&a( *e)e5ateraa- (+ 'a- ay(

◦

Pa)t(*a- '(a%-)()◦ N(&a( *ea'aa- )er(* 'e-%a- e$er(*)aa- )e*+&+$

7)ter(&8

◦ :e%a e$er(*)aa- )er(* '(%(ta&

◦ N(&a( *-'()( ya-% $e$er&+*a- $a-a5e$e- &a-5+ta-

e.%. *e-a(*a- )++ ata+ ta*(*ar'( a'a et+) 'a- (+

◦ -(&a( a'a-ya (-'(*a)( +-t+* )e%era $e$+&a( er)a&(-a-

 Manajemen Umum

8/19/2019 cc 14 maret 2016.pptx

28/43

◦ ;(-'ar( e$er(*)aa- 'a&a$

◦ N(&a( a'a-ya (-e*)(

◦ Pert($a-%*a- e$er(a- a-t((t(*

(&a ter5a'( *et+a- e/a '(-( ya-%

te&a &a$a◦ Ma-a5e$e- a*t( ata+ $a-a5e$e-

e*)e*tat( ter%a-t+-% a'a *ea'aa-'a- *e(-%(-a- a)(e-

pada %ehamilan aterm &'(!mingg#)

8/19/2019 cc 14 maret 2016.pptx

29/43

◦ ;(-'ar( e$er(*)aa- 'a&a$

◦ Pert($a-%*a- )ter(' a-te-ata&

◦ Pr&a*)() a-t((t(* (-traart+$

◦ Pa-ta+ ta-'ata-'a (-e*)( )e/ara *&(-() 7-a'(, )++

'a- 'e-y+t 5a-t+-% ay(8◦ Pe$er(a- a-t((t(* ya-% )e)+a( (&a ter5a'(

*r(a$-(-(t()

Pada %ehamilan preterm &(4*(!mingg#)

8/19/2019 cc 14 maret 2016.pptx

30/43

◦ ;(-'ar( e$er(*)aa- 'a&a$

◦

Ster('◦ Pe$er(a- a-t((t(* a-teart+$ 'a- (-traart+$

◦ Pa-ta+ ta-'ata-'a (-e*)( )e/ara *&(-() 7$-(tr )++

'a- -a'( (+, 'e-y+t 5a-t+-% 5a-(-, 'a- $+-/+&-ya

*-tra*)( +ter+) ya-% (r(tae&8

◦ Pe$er(a- a-t((t(* ya-% )e)+a( (&a ter5a'(

*r(a$-(-(t()

◦ Pert($a-%*a- +-t+* $er+5+* *e +)at ya-% &e(

$e$a'a( (&a $+-%*(-

◦ Pera>ata- e*)e*tat( 

ana+emen pada preterm &,(4 mingg#)

8/19/2019 cc 14 maret 2016.pptx

31/43

A-t((t(* ya-% '(a-5+r*a-"

I+ a$(& 'e-%a- *r(a$-(-(t() $e$+t+*a- a-t((t(*

)e*tr+$ &+a)

Penicillin G 5 juta units q 4-6 h IVatau

  Ampicillin 2g IV dilanjutkan 1 g q 4h

atau

Clindamyin 600 ng q 8hIV

8/19/2019 cc 14 maret 2016.pptx

32/43

Feta& '()tre))

8/19/2019 cc 14 maret 2016.pptx

33/43

-.TA DIST0.SS

adalah

?RADIKARDIA JANIN PERSISTEN

yang bila tidak diperbaiki

akan menimbulkan

DEKOMPES!S" #ESPO $"S"O%O&"S

dan menyebabkanKE#'S!K! PE#M!E SSP D! O#&! %!"

SE#! KEM!"!

8/19/2019 cc 14 maret 2016.pptx

34/43

  Et(&%( eta& '()tre)) I+

◦ e-+r+-a- *e$a$+a- $e$a>a*)(%e- (+ A-e$(a ya-% )(%-(*a-

◦ e-+r+-a- a&(ra- 'ara +ter(-  )()( )+(-e ata+ (te-)( &a(-,

ree*&a$)(a

◦ *-'()( (+ ya-% *r-()  (erte-)(

8/19/2019 cc 14 maret 2016.pptx

35/43

Et(&%( Fa*tr Uter&a)e-ta&

◦ K-tra*)( +ter+)

  (er)t($+&a)(, )&+)( &a)e-ta

◦ '()+-%)( +ter&a)e-ta&  (-ar* &a)e-ta&

 *r(a$-(-(t()  '()+-%)( &a)e-ta& '(ta-'a( &eIUGR, &(%('ra$-(-

8/19/2019 cc 14 maret 2016.pptx

36/43

  Et(&%( Fa*tr Ja-(-

◦ *$re)( ta&( +)at  &(%('ra$-(-

 r&a) ta&( +)at  +-t(ra- ta&( +)at

◦ Pe-+r+-a- *e$a$+a- 5a-(- $e$a>a*)(%e- a-e$(a erat  $()a& " ()($+-()a)(, er'araa- et$ater-a&

8/19/2019 cc 14 maret 2016.pptx

37/43

Sirkulasi anin

8/19/2019 cc 14 maret 2016.pptx

38/43

8/19/2019 cc 14 maret 2016.pptx

39/43

8/19/2019 cc 14 maret 2016.pptx

40/43

‘FETAL DISTRESS’

bukan merupakan

sebuah kertas monitor *anin yang

+buruk,-

atau

.airan yang ter/arnai mekonium

-"ni harus disebut sebagai

+kertas pen.atat monitoring yang tidak bagus,

8/19/2019 cc 14 maret 2016.pptx

41/43

8/19/2019 cc 14 maret 2016.pptx

42/43

8/19/2019 cc 14 maret 2016.pptx

43/43

KESIMPULAN

Ga>at Ja-(- $er+a*a- a& ya-%)er(+) 'a- er&+ '(*e-a&t(-'a*a-

Sea(*-ya a'a +*t( A)('e$(a 7;'ara8

Pe$a-ta+a- 'e-y+t 5a-t+-%

e-t(-% " t(a 30 $e-(t 'a&a$ *a&a 1'a- t(a 10 $e-(t 'a&a$ *a&a 2.