Disturbed Ectopic Pregnancy.ppt

7/24/2019 Disturbed Ectopic Pregnancy.ppt

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Disturbed EctopicDisturbed Ectopic

PregnancyPregnancy


2/17

Case ReportCase Report

IdenIdentity:tity: NNameame :: Ni Nyoman SriNi Nyoman Sri

AgeAge :: 30 years old30 years old

EducationEducation :: primary schoolprimary school

ccupationccupation : house!i"e: house!i"e

ReligionReligion : #indu: #indu

RaceRace : $ali: $ali AAddressddress ::%embua&' Narmada%embua&' Narmada

(RS(RS : ): )**+0,+)0+0,+)0-0-0


3/17

AnamnesisAnamnesis

Keluhan utama:Keluhan utama: Patient con"ess lo!er abdominal painPatient con"ess lo!er abdominal painRiwayat penyakit sekarang:Riwayat penyakit sekarang:

Patient referred from Narmada PHC with hypovolemic

shock et causa suspect Abortus infectious. Chronologist: Patient came to Narmada PHC at 8 p.m !"#$%#!$&$'confess vaginal bleeding since three days ago withvolume &$ ( &) cc with descend conciousness* late

menstrual periode for ! months.


4/17

+,amination at Narmada PHC:

-eneral condition : well

Conciousness : somnolen

ital sign : /P 0$ mmHg palpation

P1 &!$ , # minutes* weak pulse

11 !8 , # minutes

2a, 3%*) $CHead 4 neck : eye anemi 5#5 * icterus 5#5


5/17

2hora, : 6Cor : 7&7! 7ingle# reguler#mur5mur 5 *

gallop 5

6Pulmo: ves #* wh9 5#5* rh5#5Abdomen : distention 5'

+,tremity : cold

2 : C & cm* unpalpable tissue* bad smell* active

bleeding* yellowish secret.

PP test :


6/17

Menstrual historyMenstrual history:: menstrual cycle usuallymenstrual cycle usually).).daysdays"or"orl /+,l /+, dayddayd%(P%(P::0310/1)0-00310/1)0-0

Family planning historyFamily planning history :: ne2erne2er Obstetric historyObstetric history ::

1. Abortus, 3 month, 1, years ago1. Abortus, 3 month, 1, years ago

!. this!. this "arlier history #isease"arlier history #isease:: D( +4' asthma +4' #5 +4'D( +4' asthma +4' #5 +4'

miocard in"ar& +4' hepatitis +4miocard in"ar& +4' hepatitis +4

Family history #iseaseFamily history #isease:: +4+4 Riwayat alergiRiwayat alergi :: +4+4


7/17

Physical E6aminationPhysical E6amination

-eneral status : wellConciousness : +" ) ;0

/P : &&$#%$ mmHg

P1 : &$$, #00 mg 3 6 -4Asam (e"enamat >00 mg 3 6 -4

;itamin $ omple&s - 6 -;itamin $ omple&s - 6 -


11/17

(/

5D: =01>0 mm#g5D: =01>0 mm#g

N: --0 61menitN: --0 61menit

RR : ). 61menitRR : ). 61menit

5a6 : 3/'> C5a6 : 3/'> C

(ata : anemis @1@4(ata : anemis @1@4

Cor1Pulmo : dalam batasCor1Pulmo : dalam batas

normalnormalE6tr: hangat' pucatE6tr: hangat' pucat

Post %aparotomi Post %aparotomi

Salnge&tomiSalnge&tomi

de6tra@syo&de6tra@syo&

ter&ompensater&ompensassii

o bser2asi esra lbuo bser2asi esra lbu

o bser2asio bser2asi

perdarahanperdarahan

o bser2asi tandao bser2asi tanda

2ital2ital

o R% )* tts1mnto R% )* tts1mnt

Amo6icillin >00 mgAmo6icillin >00 mg

3 6 -3 6 -

o Chec& laboratoriumo Chec& laboratoriumD% #$sAgD% #$sAg

-030-030 PasienPasien

mengeluhmengeluh

lemaslemas

B: %emahB: %emah

esadaran : E*;>(/esadaran : E*;>(/

5D: -001/0 mm#g5D: -001/0 mm#g

N: --0 61menitN: --0 61menit

RR : )> 61menitRR : )> 61menit

5a6 : 3/'> C5a6 : 3/'> C

(ata : anemis(ata : anemisCor1Pulmo : dalam batasCor1Pulmo : dalam batas

normalnormal

E6tr: hangat' pucatE6tr: hangat' pucat

#asil lab:#asil lab:

#b: ,'= g8#b: ,'= g8

%eu: -0=00 1mm3%eu: -0=00 1mm3

Plt: -,*000 1mm3Plt: -,*000 1mm3

#ct : )0'38#ct : )0'38

Post %aparotomi Post %aparotomi

Salnge&tomi de6traSalnge&tomi de6tra

%apor super2isor'%apor super2isor'

usul untu&usul untu&

trans"use darahtrans"use darah

Dimulai' ad2ice :Dimulai' ad2ice :

belum perlubelum perlu

tran"usi lan7ut&antran"usi lan7ut&an

in"use R% loadingin"use R% loadingdan pantau 2italdan pantau 2ital

sign dan rhon&isign dan rhon&i

halus basalhalus basal


12/17

!a&tu!a&tu Sub7ectSub7ect b7ectb7ect AssessmentAssessment PlanningPlanning

--00--00 B: %emahB: %emah


5D: -001/0 mm#g5D: -001/0 mm#g

N: -00 61menitN: -00 61menit

RR : )) 61menitRR : )) 61menit

5a6 : 3/', C5a6 : 3/', C

(ata : anemis(ata : anemis

Cor1Pulmo : dalamCor1Pulmo : dalam

batasbatas

normalnormal


Post %aparotomi @Post %aparotomi @


de6trade6tra

bser2asi ;italbser2asi ;ital

SignSign

--30--30 Pasien merasaPasien merasa

&ondisinya&ondisinya

lebih bai&lebih bai&

B: SedangB: Sedang


5D: -001,0 mm#g5D: -001,0 mm#g

N: -00N: -00 ()menit()menit

RR :RR : )0 61menit)0 61menit

5a6 : 3/', C5a6 : 3/', C

Post %aparotomi *Post %aparotomi *


de6trade6tra

bser2asi esrabser2asi esra

IbuIbu

bser2asibser2asi


Obser*asi tan#aObser*asi tan#a

*ital*ital

Chec&Chec&

laboratoriumlaboratorium

D%: #b beso& pagiD%: #b beso& pagi

) 0 )00=


13/17

)-+0,+)00=)-+0,+)00=


0,000,00 Pasien dalamPasien dalam

&ondisi bai&&ondisi bai&

B: bai&B: bai&

esadaran : E3;*(>esadaran : E3;*(>

5D: --01,0'5D: --01,0'

N: -00 61mtN: -00 61mt

RR : )0 61menitRR : )0 61menit

(ata: anemis @1@4(ata: anemis @1@4Cor1Pulmo : dalam batasCor1Pulmo : dalam batas

normalnormal

E6tr: hangat'@1@4E6tr: hangat'@1@4

%ochia rubra : @%ochia rubra : @

#asil %ab:#asil %ab:

Post %aparotomi hariPost %aparotomi hari

-- Salnge&tomiSalnge&tomi

de6trade6tra

A bser2asi esra IbuA bser2asi esra Ibu

bser2asibser2asi


bser2asi tanda 2italbser2asi tanda 2ital

As (e"enamat 3 6 -As (e"enamat 3 6 -

>00 g>00 gS< -6IS< -6I

;it $;it $

An7ur&an ma&an danAn7ur&an ma&an dan

minumminum

-000-000 Pasien dalamPasien dalam

&ondisi bai&&ondisi bai&

B: bai&B: bai&


5D: --01,0' N: =. 61mt5D: --01,0' N: =. 61mtRR : )0 61menitRR : )0 61menit

(ata: anemis @1@4(ata: anemis @1@4


normalnormal

E6tr: hangat'@1@4E6tr: hangat'@1@4



--Salnge&tomiSalnge&tomi

de6trade6tra

bser2asi esra Ibubser2asi esra Ibu

bser2asibser2asi

perdarahanperdarahanbser2asi tanda 2italbser2asi tanda 2ital


minum' mobilisasiminum' mobilisasi

bertahapbertahap

-*00-*00 Ibu tida& adaIbu tida& ada

&eluhan&eluhan

B: %emahB: %emah


5D: --01,0' N: =* 61mt5D: --01,0' N: =* 61mt

RR : )* 61menitRR : )* 61menit

(ata: anemis @1@4(ata: anemis @1@4

Cor1Pulmo :Cor1Pulmo : #alam batas#alam batas

normalnormal


@1@'@1@4@1@'@1@4


Post %aparotomiPost %aparotomi


de6trade6tra


bser2asibser2asi


bser2asi tanda 2italbser2asi tanda 2ital

In7e&si ampicillin -In7e&si ampicillin -

g1. 7amg1. 7am


>00 g>00 g


minumminum


14/17

))+0,+))+0,+

)00=)00=


0,000,00 Ibu tida& adaIbu tida& ada

&eluhan&eluhan

B: $ai&B: $ai&


5D: --01,0' N: .. 61mt5D: --01,0' N: .. 61mtRR : )0 61menitRR : )0 61menit

(ata: anemis +1+4(ata: anemis +1+4


normalnormal

E6tr: hangatE6tr: hangat

%ochia rubra: @%ochia rubra: @


&e+) @&e+) @

Salngelctomi de6traSalngelctomi de6tra


bser2asibser2asi

perdarahanperdarahanbser2asi tandabser2asi tanda2ital2ital


>00 g>00 g

S(/esadaran: E*;>(/

5D: --01,0' N: .* 61mt5D: --01,0' N: .* 61mt




normalnormal

E6tr: hangat @1@4E6tr: hangat @1@4


Post %aparotomi hariPost %aparotomi hari&e+)&e+)

Salnge&tomi de6traSalnge&tomi de6tra

bser2asi esra Ibubser2asi esra Ibubser2asibser2asiperdarahanperdarahan

bser2asi tandabser2asi tanda2ital2ital


15/17

)3+0,+)00=)3+0,+)00=

9a&tu9a&tu Sub7ectSub7ect b7ectb7ect AssessmentAssessment PlanningPlanning

$%.$$$%.$$ Ibu tida& ada&eluhan

B: $ai&B: $ai&

esadaran: E*;>(/esadaran: E*;>(/

5D: -)01.0' N: .* 61mt5D: -)01.0' N: .* 61mt



Cor1Pulmo : dalamCor1Pulmo : dalambatasbatas

normalnormal

E6tr: hangat @1@4E6tr: hangat @1@4


Post %aparotomiPost %aparotomi

harihari

&e+3&e+3

Salnge&tomiSalnge&tomide6trade6tra

As (e"enamat 3As (e"enamat 3

6 -6 -

>00 g>00 g

S


16/17

PE($A#ASANPE($A#ASAN

AnamnesisAnamnesis

Pemeri&saan


17/17

SEIANSEIAN

9ASSA%A(9ASSA%A(

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Disturbed Ectopic Pregnancy.ppt