Poli Hi Dr Amnion
Transcript of Poli Hi Dr Amnion
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POLIHIDRAMNION
CASE REPORT
BAIQ FARIANI ZUHRA
H1A 007 007
Pembimbing : dr. Edi P.Wibowo, Sp.OG
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PENDAHULUAN
Cairan amnion mempunai perananpen!in" #a$am menun%an" pro&e&
'e(ami$an #an per&a$inan) *e$ainan %um$a( +airan amnion #apa!
!er%a#i #an &erin"'a$i merupa'anpe!an#a an" pa$in" a,a$ !er$i(a! pa#a
%anin an" men"a$ami "an""uan
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-enuru! .HO an"'a 'e%a#ian (i#ramnion/er'i&ar 11 234 #ari &e$uru( 'e(ami$an#an 3 134 #en"an 'e$ainan %anin)
po$i(i#romnion menin"'a!'an re&i'o
'e$a(iran prema!ur #an re&i'o 'omp$i'a&iper&a$inan HPP #an !er%a#ina 'ema!ian%anin #i#a$am 'an#un"an)
*e%a#ian /e#a( +ae&ar %u"a $e/i( !in""i
#i/an#in"'an pa#a 'e(ami$an /ia&a'arena menurunna 'e&e%a(!eraan %anin
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TIN5AUAN PUSTA*A
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FISIOLO6I CAIRAN A-NION
12 (ari &e!e$a( oum #i/ua(i!er/en!u' &ua!u +e$a( an" #i'e$i$in"i
amnion primi!i8 an" !er/en!u' #e'a!em/roni+ p$a!e me$e/ar #anmena!u #"n /o# &!a$' 9 'orion amnion /eri&i +airan amnion
norma$na /er,arna pu!i( a"a' 'eru(&er!a mempunai /au an" '(a& a"a'ami& #an mani&
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*e(ami$an : 20 min""u !eru!ama#ipro#u'&i me$a$ui &e$apu! amnion #an
'u$i! %anin &e/a"ian $ainna me$a$ui$empen" 'orioni' !a$i pu&a! paru"in%a$ #an &a$uran pen+ernaan
*e(ami$an ; 20 min""u %um$a( +airan
amnion !eru!ama #i!en!u'an o$e(pro#u'&i me$a$ui "in%a$ #an pen"am/i$anme$a$ui &a$uran pen+ernaan
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Pa#a 'e(ami$an $an%u! o$ume +airanamnion &e+ara &u/&!an&ia$ #ia!ur o$e(
pro&e& mene$an o$e( %anin ini/er#a&ar'an pene$i!ian %i'a pro&e&mene$an !er(en!i ma'a 'emun"'inan!er%a#ina (i#roamnion /e&ar
Pa#a %anin an" a!erm pro&e& mene$an/er%um$a( 200 7
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POLIHIDRA-NION
*e$e/i(an +airan 'e!u/an #a$am'an!un" 'e!u/an ai!u #imana o$ume#ari air 'e!u/an ; 2000 m$
Di#ia"no&i& %i'a in#e'& +airan amnion=ICA> pa#a pemeri'&aan US6 ? 20 +ma!au #iama!er er!i'a$ 'an!un" amnion; 3 +m)
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PATOFISIOLO6I
In!e"ra&i #ari a$iran +airan an" ma&u' #an'e$uar #ari 'an!un" 'e!u/an menen!u'an o$ume+airan 'e!u/an)
5anin an" (ampir +u'up /u$an men"e$uar'an@001200 mL urin #an mene$an 210 7
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ETIOLO6I
*e(ami$an 'em/ar
Anoma$i %anin !erma&u' a!re&ia e&o8a"u&=/ia&ana /er(u/un"an #en"an &!u$a
!ra'eoe&o8a"ea$> a!re&ia #uo#enum #ana!re&ia u&u& $ainna)
*e$ainan SSP #an pena'i! neuromu&'u$eran" mene/a/'an #i&8un"&i mene$an
&eper!i anen&e8a$u& #an &pina /i#a) In8e'&i par8oiru&
*e$ainan 'romo&om =!ri&omi 2113 1>
D- pa#a i/u an" !i#a' !er'on!ro$
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EPIDE-IOLO6I
Di Ameri'a Seri'a! po$i(i#ramnion!er%a#i pa#a 14 'e(ami$an) Se/ua(
&!u#i re!ro&pe'!i8 !en!an" (a&i$ US6pa&ien an" #a!an" '$ini' an!ena!a$&e+ara ru!in #i In""ri& menun%u''anprea$en&i 01@4 !er%a#ina
po$i(i#ramnion)
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TANDA DAN 6E5ALA
U'uran u!eru& $e/i( /e&ar #i/an#in" an"&e(aru&na
I#en!i'a&i %anin #an /a"ian %anin me$a$uipemeri'&aan pa$pa&i &u$i! #i$a'u'an
Denu! 5an!un" 5anin =D55> &u$i! !er#en"ar
Ba$o!emen %anin %e$a&
Pemeri'&aan #a$am &e$apu! 'e!u/an!era/a #an menon%o$ ,a$aupun #i $uar (i&
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Po$i(i#ramnion rin"an menu%u''an
&e#i'i! !an#a a!au "e%a$a)Po$i(i#ramnion /era! #apa!mene/a/'an &e&a'e#emae'!remi!a& u$a #an #in#in" peru!neri a/#omen a'u! "an""uanpen+ernaan)
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Pemeri'&aan US6 AFI ;20 +m a!au#iame!er er!i'a$ 'an!on" amnion ; 3
+m Pemeri'&aan ron!"en
Pemeri'&aan $a/ !e& !o$eran&i "$u'o&aimuno$o"i #an in8e'&i %anin (arui&e$i#i'i
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Pena!a$a'&anaan
Hi#roamnion #era%a! rin"an %aran"memer$u'an !erapi)
Ba('an an" #era%a! &e#an" #en"an&e#i'i! "an""uan /ia&ana #apa!#i!an"ani !anpa in!eren&i &ai !er%a#iper&a$inan a!au &ai &e$apu! 'e!u/an
pe+a( &pon!an) Apa/i$a !er%a#i #i&pnea a!au neri
a/#omen a!au apa/i$a ra,a! %a$an &u$i!pa&ien per$u #ira,a! inap
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Terapi #i/a"i 8a&e
1) ,a'!u (ami$
2) ,a'!u /er&a$in) po&! par!um
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*omp$i'a&i
ma$pre&en!a&i %anin 'e!u/an pe+a(pro$ap& !a$i pu&a! per&a$inan pre!erm
#an "an""uan perna8a&an i/u &o$u&iop$a&en!a &er!a HPP)
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Pro"no&i&
Se+ara umum &ema'in /era! #era%a!(i#roamnion &ema'in !in""i an"'a'ema!ian perina!a$)
an"'a 'ema!ian perina!a$ pa#apo$i(i#ramnion an" /er(u/un"an #en"anma$8orma&i %anin a!au p$a&en!a a#a$a(&e'i!ar
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LAPORAN *ASUS
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IDENTITAS
Nama N) u$ia!in
U&ia !a(un
Pe'er%aan IRT A"ama I&$am
Su'u Sa&a'
A$ama! Narma#a R- @7) Ri,aa! 'e$uar air #ari %a$an $a(ir =9>) Len#ir+ampur #ara( => ) "era' %anin ma&i( #ira&a'an)Se&a' =>)
Riwayat Penyakit ahulu: Ri,aa! (iper!en&i =>D- => a&ma => ri,aa! pena'i! %an!un" =>ri,aa! opera&i =9>
Riwayat Penyakit Keluarga: Ri,aa! (iper!en&i=> D- => a&ma => ri,aa! pena'i! %an!un" =>
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!P!" $upa
!"P
Riwayat #$%
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Riwayat K& pi$ *B
Ren'ana K& IUD
Riwayat Ob(tetri:
1) A!erm perempuan 2@00"r norma$/i#an po$in#e& (i#up 20 !a(un
2) A!erm $a'i$a'i 000"r norma$ /i#an
po$in#e& (i#up 1@ !a(un) A!erm perempuan 000"r norma$
/i#an po$in#e& (i#up 11 !a(un
G) Ini
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PE-ERI*SAAN FISI*
*ea#aan Umum /ai' *e&a#aran EG@-"a$$op =>
Paru e&i'u$er =99> r(on'i =>,(eeMin" =>
A/#omen &+ar =9> &!riae
"rai#arum =9> /a$$o!emen!=9> E'&!remi!a& e#ema => a'ra$ (an"a!
=99>
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STATUS OBSTETRI Leopo$# I /o'on"
TFU 7 +m
TB5 37@ "ram
Leopo$# II pun""un" #i&e/e$a( 'anan
Leopo$# III 'epa$a Leopo$# I 'epa$a /e$um ma&u' PAP =@@>
Hi& 1J101@
D55 1)12)1 =1@2Jmeni!> T 1 +m e) 104 'e!u/an =9>
menon%o$ !era/a 'epa$a 'e&an ma&i( !in""i!i#a' !era/a /a"ian 'e+i$ %anin!a$i pu&a!
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PE-ERI*SAAN PENUN5AN6
H6B 10 "#L
RBC @1 J 10
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DIA6NOSIS
6GPA0H ATHIU pre&en!a&i 'epa$a#en"an po$i(i#ramnion9o/&era&i
inpar!u
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RENCANA TINDA*AN
O/&era&i 'e&e%a(!eraan i/u #an %aninpro CT6
O/&era&i 'ema%uan per&a$inanren+ana !ermina&i 'e(ami$anpera"inam)
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BAI
5eni& per&a$inan SCTP In#i'a&i 8e!a$ #i&!re&& po$i(i#ramnion
La(ir !an""a$ %am @0@201G pu'u$ 03)[email protected]
5eni& 'e$amin La'i$a'i AP6AR S+ore @
La(ir Hi#up
Bera! 200 "ram
Pan%an" G< +m Amnion %erni( %um$a( V 1@ $i!er
*e$ainan 'on"eni!a$ =>
Anu& =9>
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PLASENTA
La(ir Spon!an
Len"'ap a
Bera! @00 "ram
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*EADAAN IBU 2 5A- POSTPARTU-
*ea#aan umum &e#an"
6CS EG@- #ari pemeri'&aan US6 ; 20 +m a!aupa#a pemeri'&aan #iame!er er!i'a$ 'an!un" amnion#i#apa!'an ; 3+m) Pa#a 'a&u& ini (a&i$ pemeri'&aanUS6 an" #i$a'u'an #i '$ini' Narma#a #i'a!a'an /a(,a
ICA #eep ; @ +m) Se(aru&na $e/i( #ipa&!i'an /erapa!epa!na +airan amnion !er&e/u! %um$a(na &e(in""a#apa! #iper'ira'an #era%a! po$i(i#ramnion an" #ia$amipa&ien
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pa#a 'a&u& ini "e%a$a an" #ia$ami pa&ien ma&i( rin"an ai!u
pa&ien (ana men"e$u('an neri pin""an" an" men%a$ar'e peru! /a"ian /a,a( an" (i$an" !im/u$) Peru! $e/i( /e&ar#an !era&a $e/i( /era! #ari /ia&ana #ia'ui o$e( pa&ien)Namun #ari in&pe'&i !i#a' !er$i(a! peru! an" &an"a! /un+i!#an !e"an" a!au 'u$i! peru! /er'i$a! #an re!a're!a') Dari
pemeri'&aan &i' #i#apa!'an u'uran !in""i 8un#u& u!eriai!u +u'up /e&ar 7 +m) I#en!i'a&i %anin #an /a"ian %aninme$a$ui pemeri'&aan $eopo$# ma&i( #apa! #i$a'u'an /a"ian!eren#a( %anin ai!u 'epa$a ma&i( #apa! #ira/a namun/a$$o!men! =9>) D55 =9> ma&i( #apa! #i#en"ar namun &uara!er#en"ar &an"a! (a$u& &e(in""a 'a#an" &u$i! !er#en"ar)*arena /e/a&na %anin /er"era' 'epa$a /e$um !er'&ir #an#i#apa!'an 'epa$a /e$um ma&u' PAP &er!a pa#apemeri'&aan #a$am &e$apu! 'e!u/an =9> menon%o$ #an 'e&an'epa$a ma&i( !in""i) Ha$ ini memper'ua! #ia"no&i& un!u'men"ara('an pa&ien men"a$ami po$i(i#ramnion)
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2) Pena!a$a'&anaan
A#apun penan"anan pa#a pa&ien ini &u#a(!epa!ai!u pa&ien #iru%u' un!u' #i$a'u'an !ermina&i
men"in"a! u&ia 'e(ami$an &u#a( a!erm) A#apuna,a$na un!u' penan"ananna #iren+ana'anpera"inam /i$a !i#a' a#a (a$(a$ an" men#e&a'ma'a &i'ap 'i!a menun""u) Di$a'u'an o/&era&i'e&ra i/u #an %anin menun""u !an#a!an#a inpar!u#an o/&era&i 'ema%uan per&a$inan) Namun pa#aper%a$ananna #i#apa!'an a#ana "a,a! %anin&e#an"'an !i#a' a#a 'ema%uan per&a$inan &e(in""a#i$a'u'an &e+!io +ae&area &u#a( !epa!)
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DAFTAR PUSTA*A
Ha+'er an# mooree) Essensial Obstetric and Gynaecologi .2/e)P(i$a#e$pia .B &aun#er& +ompan 12)
Cunnin"(am F6 -a+Dona$# PC Leeno *5 6i$$&!rap LC) WilliamsObstetrics. 21ed) Conne+!i+u! App$e!on an# Lan"e 200