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Maternal Fetal Division / A.

Akhdar NS Pawi
Period April 21st – 24th, 2019

Date of Date of Patient Name


No Detail of Patient Treatment Recommendation
Admission Discharge (Age/LMP/MR)
1. 22/04/2019 Mrs. H 07.43 am (at Emergency Room) - Oxygen 8 liters/minute - Observation
21 Years Old G1P0A0 via Non Rebreathing of general
LMP : Referred from dr.Dody Sarjoto Hospital with Mask condition,
23/07/2018 G1P0A0 39 weeks of gestational age in vital signs,
MR : 880663 - Urinary catheterization
Active phase First stage of Labor + contraction,
Parturientum Eclampsia. - Drips 6 grams MgSO4 and bleeding.
History of seizure once an hour before 40% in 500 cc Ringer
Lactate 28 dpm until 24
admitted.
hours after delivery or
History of administration 4 grams MgSO4 40% in
last seizure
100 cc NaCl 0,9% at dr.Dody Sarjoto Hospital.
- Nifedipine 10 mg/8
GCS : E4V5M6 hours/ oral
Blood pressure : 160/100 mmHg
- Mediolateral
Body weight : 100 kg
episiotomy
Body height : 160 cm
BMI : 39,06 kg/m2 - Spontaneous vertex
AST : 229 U/l delivery
ALT : 137 U/l - Repair of perineal
Albumin : 1,9 g/dl episiotomy laceration
Random blood glucose : 87 mg/dl
Urine protein : negative
Maternal Fetal Division / A. Akhdar NS Pawi
Period April 21st – 24th, 2019

Pre Treatment Diagnosis :

G1P0A0 39 weeks of Gestational Age in


Second stage of Labor + Parturientum
Eclampsia + Obesity grade 2

Post Treatment Diagnosis :


Parturientum Eclampsia + Partial HELLP
Syndrome + Term delivery + Second degree
perineal episiotomy laceration + Obesity
grade 2 + Hypoalbuminemia

Outcome :
Female, BW : 2105 g, BL : 47 cm, AS : 7/9,
Ballard score : 36 (39 weeks)

09.00 am (at Emergency Room)


S : seizure (+) for 2 minutes - Oxygen 8 liters/minute - Observation
via Non Rebreathing of general
O : Blood Pressure : 210/110 mmHg
Mask condition,
Heart Rate : 120 times per minute
vital signs,
Respiratory Rate : 22 times per minute - Airway, Breathing, and
contraction,
Temperature : 37,1oC Circulation Stabilization
and bleeding
Maternal Fetal Division / A. Akhdar NS Pawi
Period April 21st – 24th, 2019

A : Puerperalis Eclampsia + Partial HELLP - 2 grams MgSO4 - Control for


Syndrome + Obesity grade 2 + 40%/intravenous blood
Hypoalbuminemia pressure until
- Consult to
Anesthesiologist : 12 weeks
after delivery
ICU hospitalization - Exclusive
breastfeeding
for 6 months
- Antenatal
care for
subsequent
delivery
11.00 am (at ICU) - Anesthesiologist :
should be at
S : seizure (+). Agitated (+) Obstetricians
O : Blood Pressure : 200/110 mmHg Intubation - Family
Heart Rate : 124 times per minute planning :
Phenytoin 40
Respiratory Rate : 22 times per minute mg/hour/intravenous Intra Uterine
Temperature : 37,1oC Contraceptive
A : Puerperalis Eclampsia + Partial HELLP Furosemide 20 mg/8 Device
Syndrome + Obesity grade 2 + hours/intravenous - Control at
Hypoalbuminemia Midazolam 3 Clinical
mg/hour/intravenous Nutritionist
outpatient
Maternal Fetal Division / A. Akhdar NS Pawi
Period April 21st – 24th, 2019

Ceftriaxone 2 grams/24 policlinic for


hours/intravenous dietary
management
Nitroglycerine 25
cc/hour/syringe pump
intravenously

Ranitidine 50 mg/12
hours/intravenous

Amlodipine 10 mg/ 24
hours/NGT

Fentanyl 40
micrograms/hour/syrin
ge pump intravenously

Bisoprolol 2,5 mg/24


hours/NGT

Human Albumin 25%


Transfusion 100 cc/
intravenous
Maternal Fetal Division / A. Akhdar NS Pawi
Period April 21st – 24th, 2019

CT – SCAN THORAX X-RAY :

Normal Right pleural effusion and Cardiomegaly with aortic dilatation


Maternal Fetal Division / A. Akhdar NS Pawi
Period April 21st – 24th, 2019

Total Miscarriage Total


Total Cases :1 Incomplete : -
Vaginal Delivery :1 Complete : -
Lower Segment Caesarean Section :- Missed Abortion : -
Conservative :- Blighted Ovum : -
Myomectomy :-
Hysterectomy Sub Total/ Total :-
Salpingo-oophorectomy :-
Transferred to other hospital :-

Mortality/Nearmiss Total
Maternal : 1
Perinatal : -

Family Planning:
Natural :… Hormonal Combination :… Female Sterilization : ..
Barrier :… Hormonal Progestin :… IUD : ..
Maternal Fetal Division / A. Akhdar NS Pawi
Period April 21st – 24th, 2019

Makassar, April 25th, 2019

Known By:
Supervisor:

Dr. dr. Deviana Soraya Riu, SpOG (K)