1. Mrs.Saniti /36 y.

o/
hospitalized october 15
th
2014 /11.45 WIT
!4"2012 3#$3% Wo"& head presentation & chronic
hipertention s'peri(posed se)ere preecla(psia& "ri(it'a
se*'nder & not in labor & +,W 3200 -ra(
chief complain : dizziness
patient was referred from policlinic Ulin Hospital with diagnosed
G4P2012 37-3 !oP" head presentation " chronic hipertention
s#perimposed se$ere preeclampsia" Primit#a se%#nder " not in
la&or " '(! 3200 gram) patient told that she ha$e dizziness
since 3 ho#r admission) *a#sea +-,- $omit +-,- clo#d. e.esight +-,-
#ter#s contraction +-,- water. discharge +-,- &lood. show +-,
Histor. of illness: /el#han ser#pa +", %ehamilan ana% %e-2 +01
140230,- H0 +", 14 +-, 5lergic +-,
Histor. of famil. illness : 14 +-,- H0 +-,
Histor. ofmarriage : 16-1 .ears
Histor. of contraception: in7ection for 3 month
Histor. of la&or : 1) 13372a&ort#s212 wee%s
2)1332midwife2aterm2female23100 g2spontaneo#s
3) 20042hospital2aterm2male23300g2spontaneo#s
4) 20142c#rrent pregnanc.

.
8tat#s Present:
G 9 8: 4-:-;
52<2921 +-2-2-2-,
=P : 1;02100 mmhg- H> : 62m
>> : 162menit 0emp : 3;-7 92P
: $esi%#ler "2" >h -2-
8tat#s ?&stetri:
@< : (H 31 cm contraction : +-,
@<< : p#ngg#ng %anan (H> A11 -11-13
@<<< : leta% %epala
@<B : &el#m mas#% P5P
B0: C +-,2 &agian ter&awah 7anin masih tinggi2P8 2
/!4"2012 3#$3% Wo"& head presentation & chronic hipertention
s'peri(posed se)ere preecla(psia& "ri(it'a se*'nder & not in
labor & T01 3200 -ra(
P,

?2 mas%er ;- lpm

<nf#s " 19

9omplete la&orator. chec%

4g8?4 regiment

*ifedipine 3610 mg

4etil dopa 362:0 mg

*80 if the res#lt good Pro per$aginam termination

and repening misoprostol 46:0 mg2; ho#rs #ntil P8 :

<f P8 : pro ?1

=alance cairan

Pro percepat %ala << &ila inpart#

?&ser$ation stat#s present2B82(H>2tanda2

impending2tanda2 inpart#
2S! "oliclinic october 15
th
2014
=P1: 31- cm D 3;237
59: 340- D 33
H9 : 310 D 3;237
Plac) 9orp#s anterior2<<<2eno#gh
'(!: 3270 gram
3isite dr.4enny Sp.o!
"*l. 12.00 WIT
5d$ise:

<nformed consent to famil.

Protap P'=
0erminasi->epening misoprostol

'$al#ation ; ho#rs
?&ser$ation stat#s present2B82(H>2tanda2 impending2tanda2
inpart#
e6aminatio res#lt 8at#an
Hemoglo&in 11-1 g2dl
@e#coc.te 14-: ri&#2#l
'ritrosc.te 4)30 7#ta2#l
Hemato%crite 34 $olE
0rom&oc.te 33: ri&#2#l
49B 73-3 F
49H 2:- pg
49H9 32-; E
P025P002<*> 3-:227-220-4 deti%
=8* 102 4g2d@
Urid acid :-3 mg2dl
8G?028GP02@1H 2721:2300 U2<
*a2/29l 1324-12102-: mmol
5o(plete blood chec* october 15
th

2014 611714/

15$10$2014 611714/
Pemeri%saan Hasil
!arna-%e%er#han /#ning m#da-7ernih
=G 1)000
pH 7):
/eton *egatif
Protein-al&#min *egatif
Gl#%osa *egatif
=ilir#&in *egatif
1arah samar *egatif
*itrit *egatif
Uro&ilinogen 0)2
U><*5@<85 +8'1<4'*,
@e#%osit 0-2
'ritrosit 0-1
8elinder *egatif
'pitel 1"
=a%teri *egatif
/ristal *egatif
@ain-lain *egatif
17)00
P8 2 misoprostol 1 :0mcg2$ag2; ho#rs
*e6t e$al#ation : 23)00
23)00
P8 3 misoprostol 2 :0mcg2$ag2; ho#rs
0:)00
P8 3 misoprostol +-,
october 16
th
20148 06.00
8: +-,
?: G98 4:; 5- <- 9- 1-
=P: 1:0230H>: >>: 20 0: 3;)3
92P: normal
80? : contraction +-, 2 6 20H210I (H>: 12-12-11
5, !4"2012 3#$3% Wo"& head presentation &
chronic hipertention s'peri(posed se)ere
preecla(psia& "ri(it'a se*'nder & not in
labor & T01 3200 -ra( on ter(ination
ripenin- (isoprostol
P,

?2 mas%er ;- lpm

>egimen 4g8?4 ses#ai protap P'=

*ifedipine 3610 mg

4etil dopa 362:0 mg

/ons#l #lang %ema7#an persalinan

=alans cairan

Pro percepat %ala << &ila inpart#

4o: /U20B21GG2tanda2
impending2tanda2 inpart#
11)30
Patient sent to operating room
12)1:
9esarian sectio was &eg#n
12)30
=a&. was &orn
Gender : male- weight 3:00 gr-
length -58 ;7- an#s +",- congenital
anomal. +-,
8#rger. report
<nformed consent and anti&iotic proph.la6is
Patient was lied on s#pine position #nder spinal anesthetic
Performed disinfection of operating area J drapped operating area
Performed incision on middle a&domen- a6plorating of ca$#m
a&domen
1) Gra$id aterm #terine
2) *ormal P5 d et s
. Performed @898
1) Performed &ladder Fap
2) Performed low segment #terine incition +2 cm,- widened to lateral
&l#ntl.
3) 0eared amniotic mem&rangt
4) =a&. was &orn +male2 3:00 g243 cm258 ;-7-,
:) Placenta was &orn completel.
;) Performed e$al#ation of &leeding
. 8#t#re the s#rgical wo#nd la.er &. la.er
10)30
Post operation
8, 5cti$e &leeding +-,- pain +-,
?, =PK 13020 H> K;
>>K 24 0 K37-0
(HD #m&ilic#s
9ontraction +",
5, P40004 post cesarian section d#e to totall. placenta pre$ia
P, <B(1 : >@ K2A2224 ho#r
in7 alinamin ( 361
in7 %etorolac 361
in7 $it c 361
in7 ceftria6on 261
in7 transamin 36:00 mg
la&orator. chec% post cesarian section
o6.tocin drip 2 amp 20 dpm till 24 ho#rs post op
o&ser$ation B82F#6#62#ter#s contraction