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Retained Placenta

BAGIAN/SMF OBSTETRI dan GINEKOLOGI

BLUD RSUD MEURAXA 

201

S!"e#$i%&#

D#' Ta!() *a+,!di S"' OG

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Int#&d!cti&n

• -&."licated !" t&' & all $adeli$e#ie%'

•P&tentiall, t+#eatenin3c&."licati&n

• T+e .&%t c&..&n & "&%t"

+e..&#a3e

7/18/2019 Retained Placenta

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-a%e Re"&#t

7/18/2019 Retained Placenta

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 Ana.ne%i%

• Patient ca.e t& RSUD M5it+ c+ie c&."lain 6l#&. +e# $a3ina ate# ndeli$e#, %ince a da,% a3&'

• Bl&&d &!t"!t a6&!t 1' L•  Ate# 6leedin37 "atient ain

• O6% +i%t&#, 8 n&#.al ate#.7 ,ea#% a3&7 +ealt+ 9O'

7/18/2019 Retained Placenta

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P+,%ical E4a.inati&nGene#al

(ndin3%

L&cal (ndin3%

:in%"ec!l&;• Gene#al c&ntiti&n 8 Bad

• -&n%ci&!%ne%% 8 -M

• BP 8 100/<0..=3

• =R 8 100 6eat/.7#e3!la#

• RR 8 2 ti.e/.

• T 8 >'1 0-

• Placenta :?;

• R!"t!# P&#ti& :?;

• Bleedin3 a6&!t 00cc

• St&cell :?;

7/18/2019 Retained Placenta

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*&#) U"

La6&#at&#,

(ndin3% Jenispemeriksaan  July 6 2015 July 7 2015

Hb  ' 3#/dl 9.1 gr/dl

Erytrocyte 1'@1'10</.. 72' 10</..

Leucocyte 10''10/.. 1'>'10/ ..

Trombocyte 21'10

 / ..

1<0'10

/ ..

Ht  1'< 27@

7/18/2019 Retained Placenta

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*&#) U"USG O6%/!l, <t+

• Placenta ti%%!e a6&!t C4c.

%!e

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Dia3n&%eP&%t "a#t!. +e..&#a3e%!%"' #etained "lacenta

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T#eat.ent

In +&%"ital 5a#d S!#3ical Inte#$enti&nPe#c!#&"e#&&

• IFD RL 203tt/i•

PR- t#an%!%i&n < )&l!ntil =610• -e&ta4i.e 13#/12

+&!#%• O4,t&cin d#i" in 00cc

RLP&%t c!##ata3e• D#i" .et#&nida&le• -e&ta4i.e 13#/12

+&!#%

7/18/2019 Retained Placenta

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P#&3n&%i%

• !& ad ita. 8 D!6ia ad

• !& ad F!ncti&na. 8 D!6&na.

• !& ad Sanacti&na. 8 D!6&na.

7/18/2019 Retained Placenta

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Lite#a#,

7/18/2019 Retained Placenta

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 Anat&., & Placenta

7/18/2019 Retained Placenta

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De(niti&n

• I% "lacenta d&e%nHt d0 t& C .in!te ate#5a% deli$e#ed

•

Oten acc&."anied+ea$, 6leedin3

7/18/2019 Retained Placenta

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-la%%i(cati&n

• Placenta acc#e

• Placenta inc#e

•

Placenta "e#c#

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*&#) U"

ObstetriUS

!"#

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Dia3n&%e

 Ana.ne%i%

P+,%icalE4a.inati&n

*&#) U

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T#eat.ent

Man!al#e.&$al

Ute#&t&nicd#!3%

U.6ilical inecti&

7/18/2019 Retained Placenta

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P#&3n&%i%

• -&..&nl, 3&&d'

• Ba%ed &n acc!#ac, &dia3n&%i% and a""#&"#iatet#eat.ent'

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Di%c!%%i&n

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Di%c!%%i&n

Findin3% T+e&#,

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T+an) 9&!LetH% Di%c!%%

7/18/2019 Retained Placenta

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Ree#ence

1' *ee)%7 And#e5' T+e #etained "lacenta' A# =ealt+ Sci' 2001' 1:1;8<

2' U#ne# F7 i..e#.ann R7 K#at A' Man!al Re.&$al & t+e "lace $a3inal deli$e#,8 An !n%&l$ed "#&6le. in &6%tet#ic' =inda5i J&P#e3nanc,' 201C'

' Ni)&la%en S7 Let+ L&))e3aa#d E7 Be#3+&lt T' Re&cc!#ence & "lacenta at $a3inal deli$e#,8 an &6%e#$ati&nal %t!d,' AOGS' 201' @28

C' Belac+e5 J7 -nattin3i!% S7 M!licL!t$ica A7 E!#eni!% K7 A4el%%&n O7 * AK' Ri%) & #etained "lacenta in 5&.en "#e$i&!%l, deli$e#ed 6, c%ecti&n8 a "&"!lati&n6a%ed c&+&#t %t!d,' BJOG' 201' 121822C22@