panik fm ward 15 desember.ppt

7/25/2019 panik fm ward 15 desember.ppt

1/15

Ward Residents : 1. dr. Novi Rindi2. dr. Widya Nelvi P

Obstetric and Gynecology Department

Medical Faculty University of Sumatera Utara

dr. Pirngadi General Hospital

2!"

F#$OM%$#&'%( )%&D PO&$

$*uesday+ December !"t*2!"

SUP#&,-SO&dr. Fadrir+ M./ed0OG1+ SpOG

dr. enius (umban $obing+ M./ed0OG1+ SpOGdr. &i3a H. 'asution+ SpOG


2/15

Reported:

1. Post Laparatomy d/t Advanced Abdominal Pregnancy + PD6 +

Anemia


3/15

'o -ncome Outcome

1 Mrs. M, 36 yo, P3A0

Diagnose:Post Laparatomy d/t Advanced

Abdominal Pregnancy + PD6 +Anemia

ecent condition:!"lly alert, #P: $%0/&0 mm'g,': (6 )/*, : %0 )/*, : 36,(

14/12/2015'b/Le"/rom:-.-/%6.600/3%.000

' at $%.30 pm : 36$0,6m*1/mL

Therapy :2/ *!D L%0 gtt/i

4*n5. etria)on $ g/$% 2r4*n5. entamycine (0 mg/( 2o"rs

4Drip Metronida7ole 00 mg/( 2r4*n5. anitidine 0 mg/$% 2r4*n5. 8etorolac 30 mg/( 2r4ab P 00 mg/ ( 2r

Planning :

9tabili7ation general condition9Metotre)ate regimen


4/15

P%$-#'$!


5/15

Mrs. M, 36 years old, P3A1, Muslim, Javanese, Junior Hig !"ool,#armer, married to Mr. J, 3$ years old, Muslim, %ata&, Junior Hig!"ool, #armer, "ame to Pringadi 'eneral Hos(ital )it:

*ie+ *om(lain: Adominal Pain

-: t as een e/(erien"ed y te (atient sin"e 3 days ago (ost *0se"tion. nitially, +elt in t )ole adomen. History o+ vaginalleeding 0. Patient ad +ever sin"e 2 days ago, te +ever rise and+all. Patient )as reered +rom oter os(ital )it 4/ : (ostla(arat(my d5t Advan"ed Adominal Pregnan"y P43. Patient gottrans+usion 2 ags o+ PR* in oter os(ital. Mi"turition andde+e"ation in normal limit.

9 History of -llness 4 %st*ma 051+ DM 051+ Hypertension051

9 History of pregnancy:

9 'irl, aterm, 3777 gram, 8!4, mid)i+e, ome, 12 years, ealty

9 %oy, aterm, 9277 gram, 8!4, mid)i+e, ome, 9 years, ealty

9 'irl, aterm, 3777 gram, *0se"tion, !(', os(ital d5t advan"ed

adominal (regnan"y, 3 days, ealty


6/15

tat"s Presens

ens : M Anemic : ;+7 mg5 > ours

04ri( Metronida;ole =77 mg5 > ours

0n. Ranitidin =7 mg5 12 ours

0n. Getorola" 37 mg5 > ours

0-a P*- =77 3/1

Plan:

0m(rove general "ondition

0-rans+usion PR* 9 ag

Re(ort to su(v dr. Ri;a H. Nasution, M.Ged', !(' I A""e(ted


11/15

S %bdominal pain

Presens state!ens : *om(os Mentis

-4 : 1175$7 mmHg

HR : >6 /5iRR : 27 /5i- : 36,=K*

Obstetrical stateAdomen :soe(el, (eristalti" in normal limit#H : diL"utl to assess

8aginal leeding 0, lo"ia rura (eration )ound : "overed y gau;e, surgi"al )ound moistMi"turation : via "ateter, uo( =7 "" ours4e+e"ation : 0, atus

A Post Laparatomy d/t Advanced Abdominal Pregnancy + PD4

P $*erapyIVFD RL20 gtt/i

- Inj. Ceftriaxon 1 g/12 hr- Inj. Gentamycin 80 mg/8 hr- Dri. !etroni"a#o$e %00 mg/8 hr- Inj. Raniti"ine %0 mg/12 hr- Inj. &etoro$ac '0 mg/8 hr- (a) *C( %00 'x1

(ran+f,+ion )ag *RC CG ,antitatie

FOLLOW UP D! 1"th2015


12/15

S %bdominal pain


-4 : 1975@7 mmHg

HR : >> /5iRR : 29/5i- : 36,$K*


8aginal leeding 0, lo"ia rura (eration )ound : "overed y gau;e, surgi"al )ound moistMi"turation : via "ateter, uo( 67 "" ours4e+e"ation : 0, atus

A Post Laparatomy d/t Advanced Abdominal Pregnancy + PD5 + Anemia



- CG ,antitatie re+,$t 3 9 H:G 4 ;8!"+81-*o+t tra+nf,+ion ) 84% g/"L 5 Reort to +. Dr. Ri#a . 6+t 7Gtran+f,+ion 2 )ag *RC

FOLLOW UP D! 14th2015


13/15

Hasil ? N: 36,7092,75?

-romo"yte : 32=.777 5mm3 N: 1=7.7770977.7775l


14/15

S %bdominal pain


-4 : 1175$7 mmHg

HR : >6 /5iRR : 27 /5i- : 3$,=K*


8aginal leeding 0, lo"ia rura (eration )ound : "overed y gau;e, surgi"al )ound moistMi"turation : via "ateter, uo( 67 "" ours4e+e"ation : 0, atus

A Post Laparatomy d/t Advanced Abdominal Pregnancy + PD6 + Anemia



FOLLOW UP D! 15th2015


15/15

$H%'/

panik fm ward 15 desember.ppt

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