WEEKLY REPORT

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

KARANGASEM GENERAL HOSPITAL

SEPTEMBER 14nd – SEPTEMBER 20th 2015

NO KETERANGAN JUMLAH

1 LABOR- Preterm 1- Aterm 10- Postterm 5

TOTAL 162 MODE OF DELIVERY

2.1 PERABDOMINAL 2.1.1 Cesarean Section 7 2.1.2 Laparotomy -2.2 PERVAGINAM 2.2.1 Normal Labor 5

2.2.2.Vacuum Extraction -

2.2.3.Forcep Extraction 3

2.2.4.Bracht 1

2.2.5.Manual Aid

2.2.5.1. Total Extraction -

2.2.5.2. Louvset Mauriceau -

2.2.6.Cunam Mouzeoux -

2.2.7.Others -

TOTAL 16

LAPORAN MINGGUAN RUANGAN/IRD OBSTETRI RSUD KARANGASEM

2

4 FETAL DEATH

- Antenatal 1

- Intranatal -- Postnatal -

Total 1

5 MATERNAL DEATH

- Hemorrhage -

- Infection -

- Preeclampsia / Eclampsia -

- Others -

Total -

33 KONSERVATIVETotal

3

6 ATHOLOGIC CASES

a. Preterm 1

b. Post term 5

c. Dystocia -

d. Neglected labor 1

e. Malposition

- Breech presentation 1

-Transverse lie -

- Face persentation -

f. Gemelli/multiple pregnancy 1

g. Hypertension disorders in pregnancy

- Mild PE -

- Severe PE -

- Gestational hypertension 1

- Superimposed PE -

- Chronic hypertension -

- Eclampsia 1

4

5

h. Antepartum hemorrhage -

i. Previous cesarean section 1

j. Medical and surgical disorder 2

k. Fetal congenital anomalies -

l. PROM 5

m. Fetal emergency 3

n. Postpartum hemorrhage 1

o. IUFD 2

p. Oligohidramion 7

q. Makrosomia -

r. Others -

TOTAL 32

LAPORAN MINGGUAN KASUS PATOLOGIS IRD / VK OBSTETRI RSUD KARANGASEM

A. PRETERM

1. DAG, 25 yo, G2P1001 34-35 weeks, Twin/L-L/head-head presentation, Threatened Preterm Delivery, EFW : 1957/1767 g Conservative 1st of labor (failed conservatif) 2nd stage of labor Spontaneously born 1st Baby ♀, 2100 gram, AS 8-9 Spontaneously born 2nd baby ♀, 1700 gr,AS 8-9 NBS 26~34-36 wks (AGA) Placenta Monochorion-Diamnion

6

B. POST TERM

1. WIK, 33 yo, G2P1001, 42-43 weeks , S/L, EFW : 2945, PS : 3 misoprostol insertion 1st stage of labor 2nd stage of labor fetal distress (FHB : 60 bpm) FE born baby ♀, 3300 g, AS 7-8, Tumor vagina (+), tight cord entanglement 1x, AF less, post matur sign grd I

2. ROS, 25 yo, G2P1001, 41-42 weeks, S/L, oligohidramnion (AFI 2,1), EFW : 2790, PS 3 misoprostol insertion 1st stage of labor 2nd stage of labor spontaneously born baby ♀, 2850 g, AS : 7-8

7

3. ANA, 26 yo, G1P0000, 41-42 weeks, S/L, oligohydramnion (AFI : 2,3), EFW : 2766 g, PS : 3 misoprostol insertion 1st stage of labor 2nd stage of labor fetal distress FE born baby ♂, 3500 gr, AS 7-8, thigh cord entanglement 1x

4. SUA, 27 yo, G3P1011 41-42 weeks S/L BOH, Secondary old primi, Oligohidramnion (AFI : 3.6), EFW 3565 g, PS: 5 oxytocin drip 1st stage of labor 2nd stage of labor spontaneously born baby ♂ 3800 g, AS 8-9

8

5. PAR, 31 yo, G2P1001 42 weeks S/L, Oligohidramnion (AFI: 3.6), EFW 3521 g, PS: 3 misoprostol insertion 1st stage of labor 1st stage of labor (ROM) 2nd stage of labor failure of descent CS born baby ♂, 3250 g, AS: 8-9

9

C. DYSTOCIA

D. NEGLECTED LABOR

1.SRI, 33 yo, G2P1001, 39-40 weeks, S/L, neglated 2nd stage EFW: 3410 g SC born baby ♂ 3300 gr, AS 6-8

E. MALPOSITION

E.1 FACE PERSENTATION

E.2 BREECH PRESENTATION

1. YUL, 19 yo, G1P0000, 37-38 weeks S/L, breech presentation, PROM, EFW: 2722 g CS cito born baby ♀, 2500 g, AS : 7-8

10

E.3 TRANSVERSE LIE

F. GEMELLI/MULTIPLE PREGNANCY

1. A.1

11

12

G. HIPERTENSI DALAM KEHAMILANG.1 PE RINGANG.2 HYPERTENSION DISORDERS IN PREGNANCY1.WIT, 35 yo, G3P0020, 40 weeks, S/L, BOH, LHM (141 cm), Gestational hypertension, PROM >12 hours, EFW : 3410, PS : 1 CS cito born baby ♀, 3300 g, AS 8-9

G.3 CHRONIC HYPERTENSION1.PUT, 25 yo, G1P0000 40–41 weeks S/L superimposed preeclampsia EFW: 3262 g, PS: 4 1st misoprostol insertion 2nd misoprostol insertion 1st stage of labor 2nd stage of labor, fetal distress (FHB 80 bpm) FE born baby ♂, 3200 g, AS 6-8, thigh cord entanglement 1x during observation patient Eclamsia management eclamsia

G.4 SUPERIMPOSED PREECLAMSIAG.5 ECLAMSIA

1. G.4.1

H. Antepartum hemorrhage

I.Previous cesarean section

1. MAN, 28 yo, G3P2003, 39-40 weeks, S/L, LMR( Previous CS 1x), 1st stage of labor, EFW: 3255 g 1st stage of labor (ROM) 2nd stage of labor prolong 2nd stage of labor CS born baby ♂, 3500 g, AS : 8-9

2.RET, 25 yo, G3P1011, 42 weeks, S/L, LMR (Previous CS 1x), PROM > 10 hours EFW: 2945 g CS cito born baby , 2700 ♂

g, AS : 8-9

13

J. MEDICAL AND SURGICAL DISORDER

1. MEN, 31 yo, G3P2002, 18-19 weeks, S/L, CKD stage V, mild anemia (Hb: 8,43), EFW : 295 g PS : 0 misoprostol insertion 1st stage of labor 2nd stage of labor spontaneously born baby, ♀, 200 g, ┼

2. SUA, 28 yo, G1P0000 37-38 weeks, S/IUFD, Gestational trombocytopenia (88.000 µ/L), EFW : 2945 g, PS :1 PS : 5 drip ocytoxin 1st stage of labor 2nd stage of labor spontaneously born baby ♀, 2700 g ┼, congenital anomali (-), placental hematome (-), thigh cord entanglement 1x

14

K. FETAL CONGENITAL ANOMALYL. PREMATURE RUPTURE OF MEMBRANE

1.SUR, 19 yo, G2P1000, 37-38 weeks S/L,ROB, PROM, EFW : 2790 g, PS 4 1st stage of labor (ROM) 2nd stage of labor spontaneously born baby ♀, 2600 g, AS : 8-92.WIR, 37 yo, G5P1031, 40-41 weeks, S/L, BOH, PROM > 12 hours, susp chorioamnionitis, EFW : 3576 CS Cito born baby ♀3600 gram, AS: 7-83.E.2.14.G.2.1

10

M. EMERGENCY OF FETAL

1.B .1

2.B. 3

3.G .5. 1

N. POST PARTUM HEMORRHAGE1.DAR, 31 yo, P3013 Post SVD, Post Hecting ec Portio Laceration day 0O. OLIGOHIDRAMNION

1.YUN, 36 yo, G5P4003, 38-39 weeks, S/L, oligohidramion, EFW: 2637 gr PS: 1 misoprotol insertion PS: 5 oxytocin drip born baby ♀, 2500 g, AS: 8-9

16

2. SUR, 37 yo, G6P4014, 39-40 weeks, S/ IUGR oligohydramnion, EFW: 2298 g PS: 2 induction with ripening misoprostol

3. B.2

4. B.3

5. B.4

6. B.5

17

P. IUFD

1.J.2

Q. MAKROSOMIA

R. OTHER

18

19

2 GYNECOLOGY TUMOR CURRENT BOOKED

CASES

PREVIOUS BOOKED CASES

2.1 BENIGN TUMOR2.1.1. Bartholin cyst2.1.2. Cervical polyp2.1.3. Uterine myoma2.1.4. Ovarial cyst2.1.5. Solid ovarial tumor2.1.6. Hydatidiform mole2.1.7. Endometrioma cyst

2.2. PRECANCER LESSIONS2.3. MALIGNANT TUMOR2.3.1. Vulvar carcinoma2.3.2. Vagina carcinoma2.3.3. Cervical carcinoma2.3.4. Uterine carcinoma2.3.5. Endometrium carcinoma2.3.6. Trophoblastic Malignany Disease2.3.7. OTHERS Subtotal

1---------------

1

--11------------

23 ENDOKRINOLOGI DAN

INFERTILITAS 3.1. Amenore Primer 3.2. Amenore Sekunder 3.3. AUB 3.4. Endometriosis 3.5. Lain-lain (Menometroragia)3.6. Dismenorrhea3.7. Leukorrhea

Subtotal

--------

--------

44 Complications of pegnant 1st CURRENT BOOKED

CASES

PREVIOUS BOOKED CASES

4.1. Threatened Abortions 4.2. Threatened Abortions 4.3. Incomplete Abortions 4.4. Infectious/septic Abortions 4.5. complete Abortions 4.6. Ectopic Pregnancy 4.7. Hyperemesis Gravidarum 4.8. Blighted Ovum 4.9. Death Conceptus

Subtotal

----------

----------

55 OTHER

5.1. Uterine prolapsus 5.2. unwanted pregnant 5.3. IUD transloc ation 5.4. Visum Et Repertum 5.5. Other

Subtotal

---1-1

------

66 OPERASI MINOR

6.1. Biopsy6.2. Incisi / Eksisi6.3. Ekstirpasi6.4. Kuretase6.5. Ekstraksi IUD

Subtotal

------

------

16

7.7. FAMILY PLANNINGCURRENT BOOKED

CASES

PREVIOUS BOOKED CASES

7.1. Condoms

7.2. Oral contraceptives7.3. Injectable contraceptives7.4. IUD 7.5. Implants 7.6. Female sterilization

Subtotal

1--

20-2

23

------

-

17

No CASES DESCRIPTION CURRENT BOOKED

CASES

PREVIOUS BOOKED

CASESTOTAL

1 Low Risk Pregnancy 1.1 Normal 10 3 13 1.2 Complications - - - 1.2.1 Abortions Threatened - - - Inevitable - - - Incomplete - - - Missed Abortion - - - Infectious/septic - - - 1.2.2 Ectopic Pregnancy - - - 1.2.3 Blighted Ovum - - - 1.2.4 Others - - -

2 High Risk Pregnancy 3 3 63 Post Partum

3.1 Vaginal Delivery 5 - 5 3.2 Abdominal Delivery 2 - 2

4 Others - - - TOTAL 20 6 26

WEEKLY REPORT OBSTETRIC OUTPATIENT CLINIC

22

HIGH RISK PREGNANCY

1.AND 37yo, G4P3003 38-39 wks S/L, LMR (prev CS 2x) (TP: 02/11/15)2.SIM 37yo, G2P1001 24-25 wks S/L, asma bronchiale mild attack (TP: 3/1/16)3.SUA yo,G4P3003 38-39 wks S/L, Sekundary old primy, asma bronchiale (TP:30/9/15) 4.ATD 31yo,G1P1001 38-39 wks S/L, LMR (prev CS 1x) (TP: 25/9/2015)5.PAR 32yo,G3P1011 38 wks S/L, HIV invection st I (TP: 22/9/2015) 6.SUC 25yo, G2P0010 32-33 yo S/L, BOH, post tyroidectomy (TP: 7/11/15)7.SUA 33yo, G3P2002 32-33 wks S/L, LMR (prev CS) F.UP Gestasional Hypertension(TP: 3/11/15) 8.SUD 37yo, G3P3002 34-35 wks Gemely/head-tranversa/L-L (TP: 20/10/15) 9.DWI 32yo, G2P1001 37-38 wks S/L LMR(TP: 3/1-0/2015)

23

10. DAW 24yo, G2P1001 34-35 wks, Gemeli/H-H (TP: 25/10/2015)

11. JUL 26yo, G1P0000 28 wks S/L, susp fetal anomally (TP: 9/12/15)

12. SAR 20th, G1P0000 32-33 wks S/L polyhidramnion, kongenital nomally (TP: 7/11/2015)

13. REM 35yo, G3P2002 36-37 wks S/L Gestasional hypertension, mild anemia (TP: 16/10/15)

14. WAS 22yo, G1P0000 41-42 wks S/L (TP:11/9/2015)

15. WAR 43yo, G6P5004 35-36 wks S/L, SNT eutyroid (TP: 22/10/2015)

24

No CASES DESCRIPTION CURRENT BOOKED

CASES

PREVIOUS BOOKED CASES TOTAL

1 GYNECOLOGY INFECTION

1.1 UPPER GENITALIA

1.1.1 PID Grade I - - -1.1.2 PID Grade II - - -1.1.3 PID Grade III /ATO - - -

1.2 LOWER GENITALIA

1.2.1 Vulvitis - - -1.2.2 Vaginitis - - -1.2.3 Bartholinitis - - -1.2.4 Bartholin Abscess - - -1.2.5 Cervicitis - - -1.3 OTHERS - - -

WEEKLY REPORT GYNECOLOGY OUT PATIENT CLINIC

25

No CASES DESCRIPTION CURRENT BOOKED

CASES

PREVIOUS BOOKED CASES TOTAL

2 GYNECOLOGY TUMOR 2.1 BENIGN TUMOR2.1.1 Bartholin cyst - - -2.1.2 Cervical polyp - - -2.1.3 Uterine myoma - 0 02.1.4 Ovarial cyst - 2 22.1.5 Solid ovarial tumor - - -2.1.6 Hydatidiform mole - - -2.1.7 Polyp Vagina - 2 22.2 PRECANCER LESSIONS - - -

2.3 MALIGNANT TUMOR - - -2.3.1 Vulvar carcinoma - - -2.3.2 Vagina carcinoma - - -2.3.3 Cervical carcinoma - - -2.3.4 Endometrium carcinoma - - -2.3.5 Corpus carcinoma - - -2.3.6 Ovarium carcinoma - - -

2.3.7 Trophoblastic Malignancy Disease - - -

2.4 OTHERS - - -26

NO CASES DESCRIPTION CURRENT BOOKED

CASES

PREVIOUS BOOKED CASES TOTAL

3 INFERTILITY AND ENDOCRINE

3.1 Primary amenorheae - - -3.2 Secondary amenorheae - - -3.3 Primary infertility - - -3.4 Secondary infertility - - -3.5 AUB - 1 1

4 FAMILY PLANNING4.1 Condoms - - -4.2 Oral contraceptives - - -4.3 Injectable contraceptives - - -4.4 IUD - - -4.5 Implants - - -4.6 Female sterilization - - -

5 OTHERS5.1 Fistula Recto vagina - - -5.2 Uterine prolaps - 1 15.3 Cryoterapi - - -

TOTAL - 6 627

28

NO NAME AGE/ PARITAS

DX PRE OPERATIF

USG DX PASCA OPERATIF

PA

1 Ni Komang Sari

42 tahun(P2-2 tahun)

Uterine Prolaps grd III

cystorectocele grd III

Post TVH-KA-KPR ec Uterine Prolaps grd III cystorectocele

grd III

-

2 Ni Nengah Latri

34 yo/P1-12 yo

Susp. Infected Ovarian Cyst

Post Laparotomi-

USO ec Ovarian cyst

-

29

NO NAME AGE/ PARITAS

DX PRE OPERATIF

USG DX PASCA OPERATIF

PA

3 Luh Martini

29 yo/P1-6

yo

Cervical polyp Pasca Polip extirpation ec cervika polyp

TERIMA KASIH