Tugas Obgyn (Roisa Feriani 201320401011096)

8/15/2019 Tugas Obgyn (Roisa Feriani 201320401011096)

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TUGAS OBGYN

OLEH: ROISA FERIANI

201320401011096



1. Preeklampsia berat

Preeklam!"a a#ala$ kela"%a% mala&'%(!" e%#)*el em+'l'$ #ara$ a*a'

,a!k'lar -a%( me%-e+ar l'a! !e$"%((a *er.a#" ,a!)!a!me !e*ela$ '!"a ke$am"la%

20 m"%(('/ me%(ak"+a*ka% *er.a#"%-a e%'r'%a% er&'!" )r(a% #a% e%(ak*"&a%

e%#)*el -a%( me%"m+'lka% *er.a#"%-a $"er*e%!"/ e#ema %)%#ee%#e%/ #a%

#".'ma" r)*e"%'r"a 300m( er 24 .am a*a' 30m(#l 1 a#a #"!*"k #e%(a%

%"la" !a%(a* &l'k*'a*"& !aa* e%(am+"la% 'r"% !e5ak*' 7r"*er"a reeklam!"a +era*:

• Teka%a% #ara$ !"!*)l"k#"a!*)l"k 8 160110 mmH( !e#"k"*%-a e%am

.am a#a #'a kal" emer"k!aa% Teka%a% #ara$ "%" *"#ak me%'r'%

me!k"'% "+' $am"l !'#a$ #"ra5a* #" r'ma$ !ak"* #a% *ela$ me%.ala%"

*"ra$ +ar"%(

• Pr)*e"%'r"a 8 (ram24 .am a*a' 8 3 #"!*"k a#a !amel 'r"%

!e5ak*' -a%( #"k'm'lka% al"%( !e#"k"* ema* .am !ekal"

• Ol"('r"a 400 ml 24 .am

• 7e%a"ka% ka#ar krea*"%"% la!ma 8 1/2 m(#l

• Ga%(('a% ,"!'! #a% !ere+ral : e%'r'%a% ke!a#ara%/ %-er" keala

er!"!*e%/ !k)*)ma/ #a% a%#a%(a% ka+'r

• N-er" e"(a!*r"'m a#a k'a#ra% ka%a% a*a! a+#)me% ak"+a*

*ere(a%(%-a ka!'la (l"!!)%

• E#ema ar' #a% !"a%)!"!

• Hem)l"!"! m"kr)a%("a*"k kare%a me%"%(ka*%-a e%;"m lak*a*

#e$"#r)(e%a!e

• Tr)m+)!"*)e%"a *r)m+)!"* 100000 mm3

• Ol"()$"#r)am%")%/ er*'m+'$a% .a%"% *er$am+a*/ #a% a+r'!")

la!e%*a

• Ga%(('a% &'%(!" $ear kare%a e%"%(ka*a% ka#ar e%;"m ALT #a%

AST

Ge.ala:



a H"er*e%!"

H"er*e%!" mer'aka% kr"*er"a al"%( e%*"%( #alam #"a(%)!a e%-ak"*

reeklam!"a H"er*e%!" "%" !er"%( *er.a#" !a%(a* *"+a<*"+a Ba%-ak

r"m"(ra,"#a #e%(a% '!"a m'#a mem"l"k" *eka%a% #ara$ !ek"*ar 100<

11060<=0 mmH( !elama *r"me!*er ke#'a Pe%"%(ka*a% #"a!*)l"k

!e+e!ar 1 mmH( a*a' e%"%(ka*a% !"!*)l"k !e+e!ar 30 mmH( $ar'!

#"er*"m+a%(ka%

+ Ha!"l emer"k!aa% la+)ra*)r"'m

Pr)*e"%'r"a mer'aka% (e.ala *erak$"r *"m+'l Pr)*e"%'r"a +erar*"

k)%!e%*ra!" r)*e"% #alam 'r"% -a%( mele+"$" 0/3 (rl"*er #alam 'r"% 24

.am a*a' emer"k!aa% k'al"*a*"& me%'%.'ka% 1 !ama" 2 #e%(a%

me*)#e #"!*"k a*a' 8 1 (rl"*er melal'" r)!e! 'r"%al"!"! #e%(a%

me%(('%aka% ka*e*er a*a' m"#!*ream -a%( U%",er!"*a! S'ma*era

U*ara#"am+"l 'r"% !e5ak*' m"%"mal #'a kal" #e%(a% .arak 5ak*' 6 .am

Hem)(l)+"% #a% $ema*)kr"* me%"%(ka* ak"+a* $em)k)%!e%*ra!"

Tr)m+)!"*)e%"a +"a!a%-a *er.a#" Ter.a#" e%"%(ka*a% F>P/

&"+r)%ek*"% #a% e%'r'%a% a%*"*r)m+"% III A!am 'ra* +"a!a%-a

me%"%(ka* #"a*a! 6 m(#l 7rea*"%"% !er'm +"a!a%-a %)rmal *e*a" +"!a

me%"%(ka* a#a reeklam!"a +era* Alkal"% &)!&a*a!e me%"%(ka*

$"%((a 2<3 kal" l"a* Lak*a* #e$"#r)(e%a!e +"!a !e#"k"* me%"%(ka*

#"kare%aka% $em)l"!"! Gl'k)!a #ara$ #a% elek*r)l"* a#a a!"e%

reeklam!"a +"a!a%-a #alam +a*a! %)rmal Ur"%al"!"! #"*em'ka%

r)*e"%'r"a #a% +e+eraa ka!'! #"*em'ka% $-al"%e a!*

E#ema

E#ema a#a ke$am"la% %)rmal #aa* #"*em'ka% e#ema #ee%#e%/

*e*a" ."ka *er#aa* e#ema "%#ee%#e% -a%( #.'ma" #" *a%(a% #a%

5a.a$ -a%( me%"%(ka* !aa* +a%('% a(" mer'aka% e#ema -a%(



a*)l)("! 7r"*er"a e#ema la"% #ar" emer"k!aa% &"!"k -a"*':

e%am+a$a% +era* +a#a% 8 2 )%m"%((' #a% e%'m'ka% a"ra%

#"#alam .ar"%(a% !eara (e%eral"!a*a -a%( #"!e+'* "**"%( e#ema 8 1

!e*ela$ *"ra$ +ar"%( 1 .am

Pe%a*alak!a%aa% :

Pa#a a!"e% reeklam!"a +era* !e(era $ar'! #"+er" )+a* !e#a*"& k'a* '%*'k

me%e(a$ *"m+'l%-a ke.a%( Aa+"la !e!'#a$ 12 ? 24 .am +a$a-a ak'* !'#a$

#"a*a!"/ *"%#aka% *er+a"k a#ala$ me%($e%*"ka% ke$am"la% Se+a(a" e%()+a*a%

me%e(a$ *"m+'l%-a ke.a%(/ #aa* #"+er"ka% lar'*a% ma(%e!"'m !'l&a* @(SO4

20 #e%(a% #)!"! 4 (ram !eara "%*ra,e%a l)a#"%( #)!e #alam 4< me%"*

7em'#"a% #"la%.'*ka% #e%(a% @(SO4 40 !e+a%-ak 12 (ram #alam 00

r"%(er lak*a* RL a*a' !ek"*ar 14 *e*e!me%"* Tam+a$a% ma(%e!"'m !'l&a* $a%-a

#aa* #"+er"ka% ."ka #"'re!"! a!"e% +a"k/ re&lek! a*ella )!"*"& #a% &rek'e%!"

er%a&a!a% le+"$ #ar" 16 kal"me%"* O+a* "%" mem"l"k" e&ek me%e%a%(ka%/

me%'r'%ka% *eka%a% #ara$ #a% me%"%(ka*ka% #"'re!"! Sela"% ma(%e!"'m !'l&a*/

a!"e% #e%(a% reeklam!"a #aa* .'(a #"+er"ka% kl)rr)ma;"% #e%(a% #)!"! 0

m( !eara "%*ram'!k'lar a*a''% #"a;eam 20 m( !eara "%*ram'!k'lar

2. Letak sungsang

Sek"*ar 3< a*a' 3 #ar" 100 +a-" *erak!a la$"r #alam )!"!" !'%(!a%(

Re!"k) +a-" la$"r !'%(!a%( a#a er!al"%a% alam" #"erk"raka% 4 kal" le+"$ +e!ar

#"+a%#"%(ka% la$"r #e%(a% le*ak keala -a%( %)rmal Ole$ kare%a "*'/ +"a!a%-a

la%(ka$ *erak$"r '%*'k me%(a%*"!"a!" *er+'r'k kare%a er!al"%a% -a%( *er*a$a%

ak"+a* .a%"% !'%(!a%( a#ala$ )era!" Nam'%/ *"%#aka% )era!" '%*'k mela$"rka%



.a%"% !'%(!a%( +ar' #"lak'ka% #e%(a% +e+eraa er*"m+a%(a%/ -a"*' )!"!" .a%"%

-a%( +ere!"k) *er.a#"%-a mae*C #" *e%(a$ r)!e! er!al"%a% Aa+"la )!"!"

+)k)%( #" +a5a$ ra$"m #e%(a% !a*' a*a' #'a kak" me%.'%*a" maka kela$"ra%

+a-"%-a $ar'! #e%(a% )era!" !e!ar

Pe%a*alak!a%aa% a#a kea#aa% !'%(!a%( a#ala$ re!'!"*a!" BBL a#ala$

r)!e#'r -a%( #"al"ka!"ka% a#a BBL -a%( *"#ak #aa* +er%a&a! !eara !)%*a%

#a% *era*'r a#a !aa* la$"r a*a' +e+eraa !aa* !e*ela$ la$"r T'.'a% '*ama re!'!"*a!"

a#a BBL a#ala$ '%*'k memer+a"k" er%aa!a% #a% .'(a &'%(!" .a%*'%( +a-"

3. Abortus

A+)r*'! a#ala$ +erak$"r%-a ke$am"la% !e+el'm .a%"% #aa* $"#' #" #'%"a

l'ar/ *a%a memer!)alka% e%-e+a+%-a Ba-" +ar' m'%(k"% $"#' #" #'%"a l'ar

+"la +era* +a#a%%-a *ela$ me%aa" le+"$ #ar"a#a 00 (ram a*a' 'm'r ke$am"la%

le+"$ #ar"a#a 20 m"%((' A+)r*'! !)%*a% mer'.'k kea#a ke('('ra% a#a

ke$am"la% k'ra%( #ar" 20 m"%((' *a%a a#a%-a *"%#aka% me#"! a*a' *"%#aka%

+e#a$ '%*'k me%(ak$"r" ke$am"la%

A+)r*'! #aa* #"+a(" a*a! #'a ()l)%(a% -a"*' a+)r*'! !)%*a% #a% a+)r*'!

r),)ka*'! A+)r*'! !)%*a% a#ala$ a+)r*'! -a%( *er.a#" *a%a *"%#aka% meka%"!

#a% #"!e+a+ka% )le$ &ak*)r<&ak*)r alam"a$ A+)r*'! r),)ka*'! a#ala$ a+)r*'!

-a%( *er.a#" ak"+a* *"%#aka% a*a' #"!e%(a.a/ +a"k #e%(a% memaka" )+a*<)+a*a%

ma''% ala*<ala*



Seara 'm'm/ *er#aa* *"(a &ak*)r -a%( +)le$ me%-e+a+ka% a+)r*'!

!)%*a% -a"*' &ak*)r &e*'!/ &ak*)r "+' !e+a(a" e%-e+a+ a+)r*'! #a% &ak*)r

a*er%al Le+"$ #ar" D0 er!e% a+)r*'! *er.a#" a#a 12 m"%((' er*ama ke$am"la%/

#a% k"ra<k"ra !e*e%(a$ #ar" ka!'! a+)r*'! "%" #"ak"+a*ka% )le$ a%)mal" kr)m)!)m

Se*ela$ mele5a*" *r"me!*er er*ama/ *"%(ka* a+)r!" #a% el'a%( *er.a#"%-a a%)mal"

kr)m)!)m +erk'ra%(

Pa*)(e%e!"! :

7e+a%-aka% a+)r*'! !)%*a% *er.a#" !e(era !e*ela$ kema*"a% .a%"% -a%(

kem'#"a% #""k'*" #e%(a% er#ara$a% ke #alam #e!"#'a +a!al"!/ lal' *er.a#"

er'+a$a%<er'+a$a% %ekr)*"k a#a #aera$ "mla%*a!"/ "%&"l*ra!" !el<!el

era#a%(a% ak'*/ #a% ak$"r%-a er#ara$a% er ,a("%am B'a$ ke$am"la% *erlea!

!el'r'$%-a a*a' !e+a("a% -a%( #""%*erre*a!"ka% !e+a(a" +e%#a a!"%( #alam

r)%((a ra$"m Hal "%" me%-e+a+ka% k)%*rak!" '*er'! #"m'la"/ #a% !e(era !e*ela$

"*' *er.a#" e%#)r)%(a% +e%#a a!"%( "*' kel'ar r)%((a ra$"m ek!'l!" Perl'

#"*eka%ka% +a$5a a#a a+)r*'! !)%*a%/ kema*"a% em+r") +"a!a%-a *er.a#" al"%(

lama #'a m"%((' !e+el'm er#ara$a% Ole$ kare%a "*'/ e%()+a*a% '%*'k

memer*a$a%ka% .a%"% *"#ak la-ak #"lak'ka% ."ka *ela$ *er.a#" er#ara$a% +a%-ak

kare%a a+)r*'! *"#ak #aa* #"$"%#ar" Se+el'm m"%((' ke<10/ $a!"l k)%!e!"

+"a!a%-a #"kel'arka% #e%(a% le%(ka Hal "%" #"!e+a+ka% !e+el'm m"%((' ke<10

,"l" k)r"al"! +el'm me%a%amka% #"r" #e%(a% era* ke #alam #e!"#'a $"%((a *el'r

m'#a$ *erlea! ke!el'r'$a%%-a A%*ara m"%((' ke<10 $"%((a m"%((' ke<12

k)r")% *'m+'$ #e%(a% ea* #a% $'+'%(a% ,"l" k)r"al"! #e%(a% #e!"#'a mak"%

era* $"%((a m'la" !aa* *er!e+'* !er"%( !"!a<!"!a k)r")% la!e%*a *er*"%((al kala'

*er.a#" a+)r*'! Pe%(el'ara% $a!"l k)%!e!" #"#a!arka% 4 ara:



a 7el'ar%-a ka%*)%( k)r")% a#a ke$am"la% -a%( !a%(a* #"%"/

me%"%((alka% !"!a #e!"#'a

+ 7a%*)%( am%")% #a% "!"%-a &e*'! #"#)r)%( kel'ar/ me%"%((alka% k)r")%

#a% #e!"#'a

Pea$%-a am%")% *er.a#" #e%(a% '*'!%-a *al" '!a* #a% e%#)r)%(a%

.a%"% ke l'ar/ *e*a" memer*a$a%ka% !"!a am%")% #a% k)r")% $a%-a

.a%"% -a%( #"kel'arka%

# Sel'r'$ .a%"% #a% #e!"#'a -a%( meleka* #"#)r)%( kel'ar !eara '*'$

7're*a!" #"erl'ka% '%*'k mem+er!"$ka% '*er'! #a% me%e(a$

er#ara$a% a*a' "%&ek!" le+"$ la%.'*

>"a(%)!"!:

@e%'r'* HO 1994/ !e*"a 5a%"*a a#a '!"a rer)#'k*"& -a%(

me%(alam" #'a #ar"a#a *"(a (e.ala !eer*" #" +a5a$ $ar'! #""k"rka%

kem'%(k"%a% *er.a#"%-a a+)r*'!:

• Per#ara$a% a#a ,a("%a• N-er" a#a a+#)me% +a5a$

• R"5a-a* ame%)rea

Ul*ra!)%)(ra&" e%*"%( #alam me%("#e%*"&"ka!" !*a*'! ke$am"la% #a%

mema!*"ka% +a$5a !'a*' ke$am"la% a#ala$ "%*ra'*er"% Aa+"la 'l*ra!)%)(ra&"

*ra%!,a("%al me%'%.'kka% !e+'a$ ra$"m k)!)%( #a% *"%(ka* !er'm $G

k'a%*"*a*"& le+"$ +e!ar #ar" 1D00 mIU er mL 1D00 IU er L/ ke$am"la% ek*)"k

$ar'! #""k"rka% 7e*"ka 'l*ra!)%)(ra&" *ra%!a+#)m"%al #"lak'ka%/ !e+'a$ ra$"m

k)!)%( $ar'! me%"m+'lka% ke'r"(aa% ke$am"la% ek*)"k ."ka ka#ar $G

k'a%*"*a*"& le+"$ +e!ar #ar" 300 mIU er mL 300 IU er L Ra$"m -a%(

#"*em'ka% k)!)%( a#a emer"k!aa% USG #aa* me%("%#"ka!"ka% !'a*' a+)r*'!



k)mle*'!/ *e*a" #"a(%)!"! *"#ak #e&"%"*"& !e$"%((a ke$am"la% ek*)"k

#"!"%(k"rka%

@e%'r'* Sa!*ra5"%a*a #a% ka5a%<ka5a% 200/ #"a(%)!a a+)r*'! me%'r'*

(am+ara% kl"%"! a#ala$ !eer*" +er"k'*:

a A+)r*'! Im"%e%! T$rea*e%e# a+)r*")%

- A%am%e!"! ? er#ara$a% !e#"k"* #ar" .ala% la$"r #a% %-er" er'* *"#ak

a#a a*a' r"%(a%

- Pemer"k!aa% #alam ? &l'k!'! a#a !e#"k"*/ )!*"'m '*er" *er*'*'/ #a%

+e!ar '*er'! !e!'a" #e%(a% 'm'r ke$am"la%

-Pemer"k!aa% e%'%.a%( ? $a!"l USG

+ A+)r*'! I%!""e%! I%e,"*a+le a+)r*")%

- A%am%e!"! ? er#ara$a% #ar" .ala% la$"r #"!er*a" %-er" k)%*rak!"

ra$"m

- Pemer"k!aa% #alam ? )!*"'m *er+'ka/ +'a$ ke$am"la% ma!"$ #alam

ra$"m/ #a% ke*'+a% '*'$ m'%(k"% me%)%.)l

A+)r*'! I%k)mle*'! a*a' a+)r*'! k)mle*'!

- A%am%e!"! ? er#ara$a% #ar" .ala% la$"r +"a!a%-a +a%-ak/ %-er"

k)%*rak!" ra$"m a#a/ #a% +"la er#ara$a% +a%-ak #aa* *er.a#" !-)k

- Pemer"k!aa% #alam ? )!*"'m '*er" *er+'ka/ *era+a !"!a .ar"%(a% +'a$

ke$am"la%# A+)r*'! Ter*'%#a @"!!e# a+)r*")%

- A%am%e!"! < er#ara$a% +"!a a#a a*a' *"#ak

- Pemer"k!aa% )+!*e*r" ? &'%#'! '*er" le+"$ ke"l #ar" 'm'r ke$am"la%

#a% +'%-" .a%*'%( .a%"% *"#ak a#a Pemer"k!aa% e%'%.a%( ? USG/

la+)ra*)r"'m H+/ *r)m+)!"*/ &"+r"%)(e%/ 5ak*' er#ara$a%/ 5ak*'

em+ek'a% #a% 5ak*' r)*r)m+"%

e A+)r*'! Ha+"*'al"! Re'rre%* a+)r*")%



- H"!*er)!al&"%()(ra&" ? '%*'k me%(e*a$'" a#a *"#ak%-a m")ma '*er'!

!'+m'k)!a #a% a%)mal" k)%(e%"*al

- B@R #a% ka#ar -)#"'m #ara$ #"'k'r '%*'k me%(e*a$'" aaka$ a#a

a*a' *"#ak (a%(('a% (la%#'la *$-r)"#ea

& A+)r*'! Se*"k Se*" a+)r*")%

- A#a%-a a+)r*'! : ame%)re/ er#ara$a%/ kel'ar .ar"%(a% -a%( *ela$

#"*)l)%( #" l'ar r'ma$ !ak"*

- Pemer"k!aa% : ka%al"! !er,"kal"! *er+'ka/ *era+a .ar"%(a%/ er#ara$a%

#a% !e+a(a"%-a

- Ta%#a<*a%#a "%&ek!" ala* (e%"*al : #emam/ %a#" ea*/ er#ara$a%/ %-er"

- *eka% #a% le'k)!"*)!"!

-Pa#a a+)r*'! !e*"k : kel"$a*a% !ak"* +era*/ a%a! *"%(("/ me%(("("l %a#"

ke"l #a% ea*/ *eka%a% #ara$ *'r'% !ama" !-)k

Pe%a*alak!a%aa% A+)r*'!:

Pa#a a+)r*'! "%!""e%! #a% a+)r*'! "%k)mle*'!/ +"la a#a *a%#a<*a%#a !-)k

maka #"a*a!" #'l' #e%(a% em+er"a% a"ra% #a% *ra%!&'!e #ara$ 7em'#"a%/

.ar"%(a% #"kel'arka% !eea* m'%(k"% #e%(a% me*)#e #"("*al #a% k're*a!e

Se*ela$ "*'/ +er" )+a*<)+a* '*er)*)%"ka #a% a%*"+")*"ka Pa#a kea#aa% a+)r*'!

k)mle*'! #"ma%a !el'r'$ $a!"l k)%!e!" #"kel'arka% #e!"#'a #a% &e*'!/

!e$"%((a r)%((a ra$"m k)!)%(/ *era" -a%( #"+er"ka% $a%-a '*er)*)%"ka U%*'k

a+)r*'! *er*'%#a/ )+a* #"+er" #e%(a% mak!'# a(ar *er.a#" $"! !e$"%((a &e*'! #a%

#e!"#'a #aa* #"kel'arka%/ kala' *"#ak +er$a!"l/ #"la*a!" #a% k're*a!e #"lak'ka%

H"!*er)*)m"a a%*er")r .'(a #aa* #"lak'ka% #a% a#a e%#er"*a/ #"+er"ka%

*)%"ka #a% a%*"+")*"ka Pe%()+a*a% a#a kela"%a% e%#)me*r"'m a#a a+)r*'!

$a+"*'al"! le+"$ +e!ar $a!"l%-a ."ka #"lak'ka% !e+el'm a#a k)%!e!" #ar"a#a

!e!'#a$%-a @er)k)k #a% m"%'m alk)$)l !e+a"k%-a #"k'ra%(" a*a' #"$e%*"ka%

Pa#a !er,"k! "%k)me*e%/ *era"%-a a#ala$ )era*"& -a"*' )era!" S$"r)#kar a*a'

@>)%al#



4. Solusio plasenta

S)l'!") la!e%*a a#ala$ *erlea!%-a la!e%*a !e+el'm 5ak*'%-a #e%(a%

"mla%*a!" %)rmal a#a ke$am"la% *r"me!*er ke*"(a Terlea!%-a la!e%*a !e+el'm

5ak*'%-a me%-e+a+ka% *"m+'%a% #ara$ a%*ara la!e%*a #a% #"%#"%( ra$"m -a%(

#aa* me%"m+'lka% (a%(('a% e%-'l"* *er$a#a "+' #a% .a%"% Ge.ala kl"%"!%-a

a%*ara la"%:

1 S)l'!") Pla!e%*a R"%(a%

a Terlea!%-a la!e%*a k'ra%( #ar" 14 +a("a%

+ T"#ak mem+er"ka% (e.ala kl"%"k #a% #"*em'ka% !e*ela$ er!al"%a%

7ea#aa% 'm'm "+' #a% .a%"% *"#ak me%(alam" (a%(('a%

# Per!al"%a% +er.ala% #e%(a% la%ar er,a("%am

2 S)l'!") Pla!e%*a Se#a%(

a Terlea!%-a la!e%*a le+"$ #ar" 14 *e*a" +el'm me%aa" 23 +a("a%

+ >aa* me%"m+'lka% (e.ala kl"%"k :

< Per#ara$a% #e%(a% ra!a !ak"*

< Per'* *era!a *e(a%(< Gerak .a%"% k'ra%(

< Pala!" +a("a% .a%"% !'l"* #"ra+a

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