Lapsus KPD B

8/18/2019 Lapsus KPD B

1/44

LAPORAN KASUS (MARET 2016)

KETUBAN PECAH DINIPADA KEHAMILAN

PRETERM Tri Kurniawan (C 111 11 323)P!"i!"in# $ %r& Ern' Mur' N'n#iSu*r+i,r $ %r& Ar!'n O!an- S*O. (K)

Ba#ian O"ra/ua K%,/

Ma/aar2016


2/44

LAPORAN KASUS

BAB I


3/44

I%nia Pain

Na!a $ N'

Tan##a Lair $ 245415

U!ur $ 25 Taun

RM $ 7288

HPHT $ 240542019

UK $ 2 !in##u 7 ari

TP $ 0940642016

Sau O"ri/ $ .1P0A0

MRS $ 1140342016- 1$13


4/44

Ana!ni

Keluhan utama $ Kuar air /u"an %ari :aan air

Anamnesis terpimpin $

I"u Mau/ Ru!a Sa/i ru:u/an %ari RSUD Pan#/* %n#an

%ia#n,i .1P0A0 #ra+i% 2 !in##u 7 ari ; /u"an *


5/44

P!ri/aan ii/

Status Generalis$ KU "ai/- •Lin#/ar Pru $ 7

• Ta/iran Bra ?anin $ 1750 #r•Siu $ M!an:an#

•Pun##un# $ Kanan

•Ba# Tr"awa $ K*aa

•Pri!aan $ 949

•Hi$ >

•D??$ 170=4!ni

•.ra/an :anin %iraa/an i"u

•Ana/ /an un##a


6/44

P!ri/aan ii/

Inspekulo:

Ta!*a/ *,ri, i


7/44

P!ri/aan Pnun:an#

La",ra,riu! (1140342016)

K

Kesan : Leukositosis Ringan

Paramater Hasil Rujukan@BC 13-370 7>10 34 uL

H.B 11-3 11>16 #4%L

HCT 37- 33>70

PLT 365 190&000>790&000

CT4BT 43 >1043>

.DS 1 170 !#4%L

.OT4.PT 15417 35471 4uL

Ur4Cr 1140-62 Ur$ 10>90- Cr$ L/$1-3- Pr$ 1-1

H"A# N,n Ra/i N,n Ra/i


8/44

P!ri/aan Pnun:an#

Ura,n,#raF Tran A"%,!ina (114342016).ra+i% un##a- i%u*

*rnai /*aa- *u/iri- *ana %i

Gravi tungghiup !" minhari


9/44

Ru!

S,ran# wania uia 25 aun- .1P0A0- HPHT 2>5>2019- UK 2 !in##u 7 ari- TP 09>06

Ru!a Sa/i ru:u/an %ari RSUD Pan#/* %n#an %ia#n,i .1P0A0 #ra+i% 2 !in##u 7 *

Dari *!ri/aan in*/u, %i%a*a/an *r!u/aan *,ri, i


10/44

Ru! (C,n&)

Pa%a /au ini i%a/ %ia/u/an *!ri/aan %aa!- /arna *

%aa! %a*a !nin#/a/an ri/, in/i *a%a /au /u"an *


11/44

Dia#n,i

G#P$A$ Gravi !% minggu & ha

Ketu(an Pe)ah Dini


12/44

Pnaaa/anaan

ID RL 25 *r !ni

Taaa/ana /,nr+ai

In:/i CaGi%i! 1 #r412:a! I

O"r+ai Hi- D??4?a! %an an%a>an%a *rainan


13/44

,,w U*Prawaan Hari I ( Sa"u- 12 Mar 2016)

T# SOA Inru/i

12434201606&00

S$ >O$ KU$ Bai/- Sa%ar

TD$ 100460

N$ 55=4!ni

P$ 16=4!ni

S$ 36- C

P!ri/aan Luar$ TU$ 20

Hi$ >

D??$ 136=4!ni

u=u$ Dara (>)

BAK$ LanAwai KU- D??- Hi

>In:/i CaGi%i! 1 #4 12

?a!4 Inra+na

>P!aan#an Paru- In:/i

D=a!a,n 6 !#4 12 :a!4

Inra!u/uar (7=)> B% R


14/44

,,w U*Prawaan Hari II ( Aa% 13 Mar 2016)

*gl S+A Instruksi

134342016

06&00

S: *iak aa keluhan

O$ KU$ Bai/- Sa%ar

TD$ 10040 !! H#

N$ 52=4!ni

P$ 20=4!ni

S$ 36-9 C

Pemeriksaan Luar:

TU$ 20

Hi$ (>)

D??$ 175=4!ni

u=u$ Air /u"an (>)

BAK$ Pr /ar- /unin# :rni 60ID RL 25 *r !ni

>In:/i CaGi%i! 1 #4 12

Inra+na

>In:/i D=a!a,n 6 !

:a!4 Inra!u/uar

*u/u 15&00 @ITA


15/44

Prawaan Hari III ( Snin- 17 Mar 2016)

Prawaan Hari III ( Snin- 17 Mar 2016)

,,w U*

*gl S+A Instruksi

17434201

6

06&00

S$ Kuar air /u"an

O$ KU$ Bai/- Sa%ar

TD$ 10040 !!H#

N$ 55=4!ni

P$ 16=4!ni

S$ 36- C

P!ri/aan Luar$

TU$ 20

Hi$ >

D??$ 172=4!ni

u=u$ Air Ku"an (>)

BAK$ Pr/ar

BAB$ Bu!

A$ .1P0A0 .ra+i% 2 !in##u 9 ari

; KPD PH 3

P$

>Awai KU- D??- Hi %an an%a>

an%a *r%araan

>ID RL 25 *r !ni

>In:/i CaGi%i! 1 #4 12

?a!4 Inra+na

Hai US. (174342016)$

.ra+i% un##a- i%u*- *a


16/44

TIN?AUAN PUSTAKAKETUBAN PECAH DINI

BAB II


17/44

DFnii

Ketu(an Pe)ah Dini ( amniorrhexis –

premature rupture of the membrane PROM )a%aa pe)ahn,a selaputkorioamniotik %ian%ai %n#an/uarn'a an%ain*aru)&

Soewarto S. Ketuban Pecah Dini. In: Prawirohardjo S, editor. Ilmu Kebidanan Ed IV. Jakarta: PT Bina Putaka Sarwono Prawirohardjo! "##$. %. &''

)".


18/44

Tr!in,,#i

Premature Rupture Of The Membrane (PROM) $ P


19/44

E*i%!i,,#i

S


20/44

Ana,!i u Inraurin

Sa*u Ku"an a%aa a*u'an# !!"un#/u u- *a


21/44

Ei,,#i

Ki%a/!a!*uanr+i/u4!!*raan/an /a!ian

Tr:a%i *ni*ian%an *!"u/aan

r+i/ an*a n'ri

.:aa $P*aann%ir %an %ara

In/,!*ni r+i/

.!i

Trau!a(a!ni,ini-u"&/ua- *!&Daa!)

P,ii%ra!ni,n

Ma/r,,!ia

Pnin##ian

/ananinraurin

GardvaginstrephemoTrichovaginstaph

Mn#/aa+a#in!n#*r,/,a#

Riwa'"r"ariwa'"ru/u'an#

In/i

Aunnin9ham . Preterm 8abour. In: al. Ae, editor.


22/44

Ei,,#i

DFini+ia!in C(Aa! a/,r"a)

?u#a %a*a%iu"un#/an%n#an a/,r,i,/,n,!i

a/,rNurii

16>32+ 7

Riwa'aKPD

"u!n'a L

in

L",

Kainan

La/

Ja*aleri +. Premature u%ture o- the embrane. edca

"#/& arch /&th3!

(

+aron B. J, >., Errol . Aontem%orar; Dia9noi and ana9ement Preterm Premature

u%ture o- the embrane. e4iew o- btetric and ;necolo9;. "##)!/?/@://(""

Strau SPJ. Premature u%ture o- the =etal embrane. > En9 J ed. /$$)!66)?/#@:&&6('#. Ja*aleri +. Premature u%ture o- the embrane. edca

"#/& h /&th3

http://emedicine.medscape.com/article/261137-overview#a1http://emedicine.medscape.com/article/261137-overview#a1


23/44

Pa,Fi,,#i

Pa,Fi,,#i r:a%*


24/44

Dia#n,i

Ana!ni

P!ri/aan ii/

P!ri/aan

Pnun:an#

Ana!ni$

Tr%a*a ri1a,at pelepasan air %ari :aan air- "r"au amis- "rwarna

jernih- %a*a keluar seikit4seikit aau men,em(ur

Pri!"an#/an


25/44

P!ri/aan Pnun:an#US. A"%,!n

• Unu/ !ia a%a i%a/n'a,i#,'%ra!ni,n

AI ( !mniotic "luid #ndex )Mn:u!a/an /%aa!an +ri/a %ari/an,n# r"ar %i 7 /ua%ran uru&

Cara $ "a#i a"%,!n !n:a%i 7 /ua%ran- :u!a/an 7 /%aa!an +ri/an'a&

N,r!a "ia anara 9 27

$ingle Poc%et Mn#u/ur /%aa!an +ri/a 1 /an,n#a:a

N,r!a $ 2 5

• Unu/ !nnu/an uia/a!ian

• Unu/ !ia a/ :anin

• Unu/ !nnu/an "ra"a%an :anin

+aron B. J, >., Errol . Aontem%orar; Dia9noi and ana9ement Preterm Prematureu%ture o- the embrane. e4iew o- btetric and ;necolo9;. "##)!/?/@://(""


26/44

P!ri/aan Pnun:an#• La(oratorium

• Dara Ruin (u/,i) In/i

• CRP- Pr,Ca


27/44

Prini* Pnaaa/anaan

• Br%aar/an Uia .ai

•

A%a i%a/n'a *n'ui

27 @ 32 @ 37 @ 3 @

Pr+ia" PrTr!

K,nr+ai + A/i4In%u/i

Pr!auria

In/i

K ,r (i/,) (r,i

%

K ,n)r +a (i E

O")r +a)i

Hi)- D ? ?

An (i"i, (i/

Pr!auria

InE /

An( i"i,(

In%u/

Su%a2 ( r :a%i *!a( an#an *ar u- BB In%u/i *rainan


28/44

Pnaaa/anaan

gg *

>Pr,Fa/i ani"i,i<

#r,u* B

.!4 .& 3inggu >Mana:!n kon

ke)uali :i/a (ukti

suah aa (a!ni,<

%ian:u/an %n#an

>Mana:!n konser

ethametason #! m

osis aau Deksame

I/3 alam & %,i un

>Bri/an anti(ioti

unu/ !!*r*an:a

a!*iiin 2 #ra! %n#

290 !# ia* 6 :a!

*!"rian a!,/iiin

333 !# ia* 5 :a! u

!&4.# 3inggu Mana:!n konserv

Ba!a,n 12 !#

%,i aau D/a!

%aa! 7 %,i unu/ *

>Bri/an anti(ioti

unu/ !!*r*an:a

a!*iiin 2 #ra! %n#

Taaa/ana *a%a Ka!ian

Prr!

Soewarto S. Ketuban Pecah Dini. In: Prawirohardjo S, editor. Ilmu Kebidanan Ed IV. Jakarta: PTBina Putaka Sarwono Prawirohardjo! "##$. %. &''()".

Ja*aleri +. Premature u%ture o- the embrane. edca

"#/& arch /&th3!


29/44

Pnaaa/anaan

Kurang ari !& 3inggu 4SDia/u/an /,

*ain nan#

>Da*a %ia/u/

/,nr+ai- %

*Tr!inai *r

in/i aau ,

"ar- %irai

>Ti%a/ %i

Pa%a /,n%ii Pr+ia"

htt%:55emedicine.medca%e.com5article5"&//6'(o4

http://emedicine.medscape.com/article/261137-overview#a1http://emedicine.medscape.com/article/261137-overview#a1


30/44

Pnaaa/anaan

9sia Kehamilan < .% 3inggu49sia kehaminggu/ S

ianggap asehingga iluar kanselamat/Kehamilanini apat engan ok

gagal seksDapat pulamisoprosto?g intrava" jam makila aa tainfeksi@ (eanti(ioti) an ersa

Pa%a /,n%ii Ar!


31/44

Pnaaa/anaan

Pa%a /,n%ii %n#an *n'ui

9sia Kehamilan Penatalaksanaan

Uia /a!ian "ra*a*un

%n#an a/,r *n'ui

*ri $

• In/i inrauri

• S,ui, *ana

• .awa :anin

• Pr,a* ai *ua

• E+auai %a/ :anin

%n#an KT.

!nun:u//an ai #awa

:anin

>Mana:!n a/

r!inai *ra

( S/i, Bri/an ani"i,

>Bri/an /,ri/,

uia 37

i%a/n'a au

>K,nin# *a%

nan# /,n%ii

>Pria*an

inni n,nau


32/44

A#,ri!a

edina T, ,ill, +. Preterm Premature u%ture o- the

embrane : Dia9noi and ana9ement. +merican =amil;

Ph;ician. "##&!'6?2@:&0$(&2


33/44

K,!*i/ai

K,!*i/ai Ini%n ()

Prainan r:a%i %aa! 1 !in##u 90>9

R*ira,r' Dir S'n%r,! 39

K,!*ri Tai Pua 32>6

K,ri,a!ni,nii 13 60

S,ui, Pa 12

K!aian :anin %aa! Rai! 1 2

edina T, ,ill, +. Preterm Premature u%ture o- the

embrane : Dia9noi and ana9ement. +merican =amil;

Ph;ician. "##&!'6?2@:&0$(&2


34/44

PEMBAHASAN KASUS

BAB III


35/44

Ana!ni

*eori Kasus• Pasien merasa (asah paa

vagina/

• 3engeluarkan )airan (an,ak

ti(a 4ti(a ari jalan lahir atau

seikit4seikit/

•arna )airan iperhatikan/

• elum aa pengeluaran

lenir arah an (er(au khas

• His (elum teratur atau (elum

aa/

• Pain %aan# %n#an

/uar air %ari :aan air

• Riwa'a /uar air /u"an

air :a/ 10 :a! "u

ru!a a/i&

•Cairan 'an# /uar :rni "r"au

• Ti%a/ a%a riwa'a n'

!"u "a/an#


36/44

P!ri/aan ii/

T,ri Kau Tan%a>an%a in/i$

•

Suu i"u 35,

C• Na%i an%a

in/i$• Suu i"u 3-7, C

• Na%i 50 /ai 4 !ni

• D?? 190 =4!ni

T,ri Kau• P!ri/aan %n#an

*/uu! a!*a/ /uar


37/44

P!ri/aan ii/

T,ri KauP!ri/aan %aa!

%ia/u/an $

• S!ini!a !un#/in unu/

!n


38/44

P!ri/aan Pnun:an# T,ri Kau• P!ri/aan u/,i unu/ !n#aui

an%a>an%a in/i

• Kra a/!u !ra "ru"a !n:a%i

"iru

• *H air /u"an a%aa -9

• Dia/u/an *!ri/aan /uur


39/44

Pnaaa/anaan

*eori Kasus

• P!"rian ani"i,i/ *r,Fa/i

%a*a !nurun/an in/i *a%a i"u

• La/u/an *!aan#an *aru %n#an 6

!#4 12 :a!4 i&! "an'a/ 7 /ai

*!"rian

• O"r+ai an%a>an%a *rainan

• O"r+ai a/,r *n'ui *ri

in/i (/,ri,a!ni,nii- /,!*ri ai

*ua- ,i#,i%ra!ni,n)

• Pain %i"ri/an in:/i ani"i

CaGi%i! 14#r412:4i+

• Di"ri/an *!aan#an *

%n#an %/a!a,n 6 !#4

:a! 4 i&! "an'a/ 7

*!"rian

• Dia/u/an ,"r+ai *a%a i"u

:anin ra !n#a!ai an%a>a

*rainan %n#an !n%

a/,r *n'ui *ri D??- a

+ia i"u- %an u# /,nr,


40/44

Ki!*uan

Ku"an *


41/44

Tin:auan Kau

Pa%a /au ini %ia#n,in'a a%aa G#P$A$ grav

minggu & hari (elum inpartu ' Ketu(an pini&

Segala proseur ana!ni- *!ri/aan F*!ri/aan *nun:an#- %an *naaa/anaan u%a %

sesuai engan teori 'an# a%a&


42/44

Pran'aan

1& Nur A!aia $ 1& Ka%aan a*a a:a 'an# "ia !n'"a"/an *,ii *au

2& a/,r ri/, KPD *a%a *ain

u%a $ 1&


43/44

TERIMA KASIH

QDan !ii/ Aa !i*ui raaia an#i %an "u!i %an /*a%a>N'a #aa%i/!"ai/an& Ma/a !"aa Dia %an "rawa/aa /*a%a>N'a& Dani%a/ n#a ra%a* a*a 'an# /a!u /r:a/an (&S Hu% $ 123)


44/44

SELAMAT BELA?AR

Lapsus KPD B

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Transcript of Lapsus KPD B