Kematian Janin Dalam Kandungan
Kematian Janin Dalam Kandungan
Kematian Janin Dalam Kandungan
Presenter :
Siska Febrina
Prisca Meirinda
Imy Ginting
PATIENT IDENTITY
Name : Mrs. E
Age : 25 years old
Religion : Moslem
Occupation : Housewife
Ethnicity : Jawa
Education : Senior High School
Address : Jl. Pelajar Timur Medan
Admission Date : August 24th, 2013
Admission Time : 11.59 pm
MR number : 89.49.33
HISTORY TAKING
Mrs. E, 25 years old, G3P1A0, Moslem, Jawa, Senior High School,
Housewife, wife of Mr. T, 45 years old, Moslem, Jawa, Senior High
School, entrepreneur, came to ER Dr. Pirngadi General Hospital
with
Chief Complain : Labor Contraction
Description : It has been experienced by the patient
since August 23th, 2013 at 08.30 PM, with bloody show and
history of water broke was not found. History of abdominal
massaged was not found. History of traditional drugs
consumption. Patient couldnt feel fetal movement since one
day ago. History of traumatic and antepartum haemorrhage
was not found. Nocturia (+) 3 times, patient complaint always
hungry and thristy since 3 years ago. Defecation is normal.
History of Previous Illness : Diabetes Mellitus (+),
Hypertension (-)
History of Previous Treatment : -
Menstrual History
HT 29,9%
WBC 10.700
THERAPY
IVFD Ringers Lactate 20 drips/ minute
PLANNING
Spontaneus vaginal delivery
Ripening cervix with baloon catheter before
oxytocin induction
Spontaneous Vaginal Delivery
Report
At 01.00 pm, September 25th, 2013 patient felt
longer, stronger, and closer contractions and the
urge to strain, vaginal examination was done with
complete dilatation. Labor management was
started :
The patient was laid in gynecologic bed with Mc
Robert position with intravenous catheter.
Bladder was emptied and vulva hygiene was
done.
With adequate contraction, head of fetus was
sighted in introitus vagina and stayed than make
episiotomy mediolateral.
With subsequent adequate contraction, patient
was encouraged to strain and head was born
started with posterior fontanella, anterior
fontanella, forehead, face, chin and the rest of
head. After external rotation, with the helpers
hand on biparietal, head is pulled gently
downwards to deliver anterior shoulder and
pulled upwards to deliver posterior shoulder.
Then the head was held on one hand and the
other hand following along on the back
simultaneously to deliver the body.
At 01.30 pm was born a male baby
Umbilical cord was clamped in two point,
then cut in between.
Baby was born with weight 4000 grams,
body length 50 cm, head circumference 34
cm, Apgar Score : 0, anal verge positive.
Then Oxytocin 10 IU intramuscular was injected on
thigh
Placenta was delivered with controlled umbilical
cord stretching, intact, weight 500 grams, with 16
cotyledons (all intact).
The passage was evaluated, found perineal
laceration grade II
Then the laceration was sutured with chromic
catgut 2-0
Evaluation of bleeding : 150 cc
Patients condition after SVD : stable
THERAPY
IVFD Ringers Lactate + Oxytocin 10 IU drip 20
drips/minute
Viccilin inj. 1 gram/ 8 hours
Asam mefenamat tab 3x500 mg
Methyl ergomethrin tab 3 x 1
Planning :