View
260
Download
0
Category
Preview:
DESCRIPTION
ppt
Citation preview
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 1/36
PRESENTASI KASUS
G1P0A0 HAMIL 39-40 MINGGU DENGANPREEKLAMSIA BERAT
Disusun Oleh
R!"#u Shin$! P%!in&
11'014011
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 2/36
IKHTISAR KASUS
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 3/36
IDENTITAS
N!"! N() MUsi! 3' $!hunPe*e%+!!n IRT
A&!"! Isl!"Su*u Sun,!Al!"!$ !l!n *!".un& #!h!%i/e$e%!n R$ R2 4
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 4/36
KELUHAN UTAMA
n(e%i .e%u$ "en+!l!% *e .in&&!n&
Keluhan Tambahan:Kelu!% !i%-!i% se+!* 1 +!" SMRSMules-"ules
Keluh!n *!*i #en&*!* se+!* 1 #ul!n!n l!lu
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 5/36
An!* .e%$!"! H!"il 39-40 "in&&u
HPHT 10 Dese"#e% '01
AN $i,!* $e%!$u% H-9 #ln TD $in&&i USG 5-6
Kelu!% !i%-!i% se+!* 1 +!" SMRS
Mules-"ules
N(e%i ulu h!$i 5-6 "u!l 576 "un$!h 576
Ke,u! *!*i #en&*!* se+!* 1 #ul!n SMRS
Ge%!* +!nin 576
Riwayat PenyakitSekarang
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 6/36
RI8AAT PENAKIT DAHULU RI8AAT PENAKIT KELUARGA
Hi.e%$ensi 5-6DM 5-6
Pen(!*i$ !n$un& 5-6
As$h"! 5-6
Ale%&i 5-6Pen(!*i$ &in+!l 5-6
He.!$i$is 5-6
Hi.e%$ensi 5-6
DM 5-6
Pen(!*i$ !n$un&5-6 As$h"! 5-6
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 7/36
RIA!AT "#STETRI$%INEK"L"%I
Men!%:he14 $!hun si*lus '; h!%i '-3 .e"#!lu$ .e%h!%in(e%i s!!$ h!i, 576)
Meni*!h 1 < usi! .e%ni*!h!n ' T!hun
%&P'A'H!"il ini
HPHT 10 Dese"#e% '014 T!*si%!n Pe%s!lin!n 1= Se.$e"#e% '01Ri2!(!$ AN 4< ,i .us*es"!sRi2!(!$ USG Ti,!* .e%n!h USG
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 8/36
PEMERIKSAAN (ISIK
Ke!,!!n u"u" B!i* Kes!,!%!n >".>s Men$is
GS E4?M
T!n,! ?i$!l Tekanan )arah : &*'+&&' mmHg @%e*uensi n!,i 9 <"eni$ %e&ule%
*u!$ @%e*uensi n!.!s '3 <"eni$ ,!n&*!l
Suhu 3>
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 9/36
STATUS %ENERALIS
M!$! A -- SI -- e,e"! .!l.e#%! --
>% S1-S' %e&ule% "u%"u% 5-6 &!ll>. 5-6
Pul"> Su!%! n!!s /esi*ule% Rh778h--
A#,>"en Lih!$ s$!$us >#s$%e$i*us)
E*s$%e"i$!s !*%!l h!n&!$ RT C 'E,e"! 77
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 10/36
STATUS "#STETRI
Ab),men
Ins.e*si Si"e$%is "e"#es!% sesu!i ,en&!n *eh!"il!n
s$%i!e &%!/i,!%u" 576 #e*!s lu*! >.e%!si 5-6
P!l.!si
Le>.>l, I T@U 30 :" $e%!#! s!$u #!&i!n #es!%
#ul!$ lun!* $i,!* "elen$in&)Le>.>l, II K!n!n $e%!#! #!&i!n-#!&i!n *e:il +!nin)
Ki%i $e%!#! #!&i!n *e%!s se.e%$i .!.!n)
Le>.>l, III Te%!#! s!$u #!&i!n #es!% #ul!$ *e%!s
,!n "elen$in&
Le>.>l, I? *>n/e%&en
TB 3'& His - <10 K>n$%!*si - D++ 14;
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 11/36
STATUS %INEK"L"%I
Pemerik-aan )alam
Ins.e*si ? U $en!n& len,i% ,!%!h 5-6
Ins.e*ul> P>%$i> li:in >s$iu" $e%#u*!
>u% 5-6 e< 5-6 /!ls!/! 576
?T F :" e) 0 *e$u#!n 5-6.%esen$!si *e.!l! HI $e%!#! "!sih$in&&i ,en>"in!$>% #elu" +el!s $i,!*$e%!#! #!&i!n $e%*e:il +!nin !$!u $!li.us!$)
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 12/36
L
A#"RAT"
RIU
M
HB 1'= &,l
RB '1 M,l
HT 490
8B 11'' K,l PLT 13 K,l
H#sA& 5-6
P%>$einu%i! 7'
SGOT '1 ul SGPT '= ul
GDS 111 &
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 13/36
DIA%N"SIS
I#u G1P0A0 H!"il 39-40 "in&&u ,en&!nP%ee*l!"si! Be%!$
!nin Tun&&!l hi,u. in$%! u$e%in Le$!*"e"!n+!n& P%esen$!si #el!*!n& *e.!l!
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 14/36
PROGNOSIS
A, ?i$!" ,u#i! !, #>n!"
A, S!n!$i>n!" #>n!"
A, @un&$i>n!" ,u#i! !, #>n!"
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 15/36
SIKAP
Pl!nnin& Di!&n>s$i* e* D!%!h Len&*!. un&si h!$i
5SGOT ,!n SGPT6 GDS U%inelen&*!.
Pl!nnin& Te%!.i P%i"!%( ,!n se:>n,!%(
su%/ei Ai%2!( - O' *!nul ' l."
B%e!$hin& - .enil!i!nh!"#!$!n +!l!n n!!s
i%:ul!$i>n - .e"!s!n&!nI? line 5 I?@D RL '0 $."6
Dis!#ili$( - .enil!i!n*es!,!%!n
Kel>l! .%ee*l!".si! P!s!n& RL D%i. M&SO4
40 4 &%!"
Pe"#e%i!n >#!$
!n$ihi.e%$ensi -Nie,i.in 10 "&; +!"
Pe"#e%i!n An$i#i>$i* JA".i:ilin ' &%I?
Pe"!s!n&!n D K>nsul SP? .%>
>#se%/!si *e"!+u!n.e%s!lin!n
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 16/36
ANALISA KASUS
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 17/36
• TD i#u 14090 s!!$usi! *eh!"il!n i#u '0"in&&u
• P%>$einu%i! 7'
Pre
eklam.-ia
#erat
•Penin&*!$!n *!,!% eni"h!$i
• N(e%i e.i&!s$%iu"•E,e"! .!%u
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 18/36
INI
O#se%/!si TNP+!"S 4+!" his D 1
+!" O#se%/!si $!n,!-
$!n,! .e%#u%u*!nPEB
e* l!#>%!$>%iu" TG USG
M&SO4 4 &% i)/
,il!n+u$*!n 1 &% +!" Nie,i.in 4 < 10 "&
NA 3 < 00 "&.>
?i$ '< 400"& i/
Res$%i*si :!i%!n100:: '4 +!"#!l!n sei"#!n&
+!" L!si< '< 40"& i/
Terapi pada pasien ini sudah
sesuai dengan tatalaksana PEB
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 19/36
TIN/AUAN PUSTAKA
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 20/36
PENDAHULUAN
T!hun '010AKI ''; .e%-100)000 *el!hi%!nhi,u.
Penyebab utama kematian ibu:
'; .e%,!%!h!n'4 e*l!".si!11 Ine*si
Kasus Preeklamsia:Di Negara berkembang0,3-0,7%,Di Negara maju sekitar 0,05-0,1%
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 21/36
%angguanHi.erten-i
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 22/36
Hi.e%$ensi *%>ni* TD 14090 ""H& se#elu" *eh!"il!n!$!u ,i,i!&n>sis se#elu" u"u% *eh!"il!n
'0 "in&&u)
Hi.e%$ensi &es$!si>n!l Te*!n!n ,!%!h 14090 ""H& un$u*.e%$!"! *!li sel!"! *eh!"il!n se$el!h u*'0 "in&&u Ti,!* !,! .%>$einu%i! TD *e"#!li n>%"!l C 1' "in&&u.>s$.!%$u"Di!&n>sis .!s$i ,i$e&!**!n .>s$.!%$u"D!.!$ ,ise%$!i &e+!l! .%ee*l!".si! 5n(e%ie.i&!s$%iu" !$!u $%>"#>si$>.eni!6
Hi.e%$ensi *%>ni* ,en&!nsu.e%i".>se, .%ee*l!".si!
P%>$einu%i! 300 "&'4 +!" .!,!.e%e".u!n (!n& hi.e%$ensi $!.i $i,!* !,!.%>$einu%i! se#elu" u"u% *eh!"il!n '0"in&&uPenin&*!$!n $i#!-$i#! .!,! .%>$einu%i!!$!u TD !$!u $%>"#>si$ C 100)000""3.!,! .e%e".u!n ,en&!n hi.e%$ensi ,!n.%>$einu%i! se#elu" u"u% *eh!"il!n '0
P%ee*l!".si!K%i$e%i! "ini"u" TD 14090 ""H& se$el!h u"u%*eh!"il!n '0 "in&&uP%>$einu%i! 300 "&'4 +!" !$!u 71,i.s$i:*
P%ee*l!".si! #e%!$ TD 10110 ""H&P%>$einu%i! ' &'4 +!" !$!u 7' ,i.s$i:*K%e!$inin se%u" 1' "&,l *e:u!li,i*e$!hui n!i* se#elu"n(! T%>"#>si$ C 100)000""3Mi:%>!n&i>.h!$i: he">l(sis 5.enin&*!$!nLDH6Penin&*!$!n ALT !$!u ASTN(e%i *e.!l! .e%sis$en !$!u &!n&&u!n/isu!lN(e%i e.i&!s$%i* .e%sis$en
E*l!".si!Ke+!n& (!n& $i,!* ,ise#!#*!n >leh h!l l!in.!,! .e%e".u!n (!n& "en,e%i$!.%ee*l!".si!
KLASI@IKASI
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 23/36
Bil! ,i+u".!i s!$u !$!u le#ih $!n,!&e+!l!
#e%i*u$
• TD 10 110 ""H&•P%>$einu%i! &% '4 +!" !$!u *u!li$!$i37 47
•Oli&u%i! 00 "l '4 +!" ,ise%$!i *en!i*!n*!,!% *%e!$inin ,!%!h•Penin&*!$!n *!,!% eni" h!$i ,!n !$!ui*$e%us•G!n&&u!n /isus ,!n :e%e#%!l•N(e%i e.i&!s$%iu"•E,e"! .!%u !$!u si!n>sis•Pe%$u"#uh!n +!nin in$%! u$e%in (!n&$e%h!"#!$ 5IU@GR6•HELLP S(n,%>" 5H He">l(sis E Ele/!$e, L Li/e% en("e LP L>2 Pl!$ele$
>un$s6
P%ee*l!"si! Be%!$
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 24/36
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 25/36
ETIOLOGI
Te>%i *el!in!n /!s*ul!%is!si .l!sen$!
Is*e"i! .l!sen$! %!,i*!l #e#!s ,!n,isun&si en,>$el
In$>le%!nsi i"un>l>&i* !n$!%! i#u ,!n +!nin
A,!.$!si *!%,i>/!s*ul!%
Gene$i* Te>%i ,esiensi &ii
In!"!si
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 26/36
I-kemia .la-enta
TE
"Ri
Kel!in!n ?!s*ul!%is!si .l!sen$!
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 27/36
PAT"(ISI"L"%I
Pen(!*i$?!s*ul!% i#u
T%>>#l!sBe%le#ih!n
G!n&&u!nPl!sen$!si
@!*$>% &ene$i*I"un>l>&i*in!"!si
Q!$ .e%us!*Si$>*in
Pe%>*si,!se le"!*Penu%un!n .e%usi
U$e%>.l!sen$!
Q!$ /!s>!*$iP%>s$!&l!n,in
Ni$%!$ >*si,!seen,>$elin
$%>"#>si$>.eni
.%>$einu%i!he">*>nsen$%!siE,e"!
AKTI?ASIKOAGULASI
KEBOORANKAPILER
AKTI?ASIENDOTEL
?ASOSPASME
Is*e"i! he.!%
S>lusi>Oli&u%i!
Ke+!n&
Hi.e%$ensi
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 28/36
PATOGENESIS PREEKLAMSIA
G!n&&u!n %e.>ns i""une ,!n in!si$%>>#l!s$hi.>*si! $%>>#l!s$ "enin&*!$n(! !$$>*si* %!,i*!l #e#!s :($>:ine eni"! .%>$e>li$i* *e%us!*!n en,>$el)
Ke%us!*!n en,>$el .%>s$!:(:lin 5/!s>,il!$>%6 ,!nni$%i: ><i,e $u%un) En,>$ilin 5/!s>:>n$%i:$>%6 n!i*
i*! ,ii*u$i /!s>*>ns$%i*si
!&e&!si .l!$ele$
$h%>"#><!ne ,!n se%>$>nin 5/!s>*>ns$%i*$>%6 n!i*) D!l!" "i*%>si%*ul!si !*!n $e%#en$u* $h%>"#in
"i:%>!n&i>.!$h( $h%>"#>:($>.eni! ,!n he">lisis) Pe%"e!#ili$!s ,in,in& .e"# ,!%!h $u%un e,e"!
/>l .l!s"! $u%un 5he">*>nsen$%!si6
A*i#!$ ,!%i se"u! ,i!$!s "!*! he">,in!"i* i#u$e%&!n&&u (!n& ,i$!n,!i ,en&!n .enu%un!n />lu"e.l!s"! .enin&*!$!n .e%i.he%!l /!s:ul!% %esis$!n:e ,!n$e*!n!n ,!%!h se#!&!i "e*!nis"e *>".ens!si !*!n"enin&*!$
';
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 29/36
Pe%u#!h!n *!%,i>/!s*ule%• Re&ul!si />lu"e ,!%!h• O$!* e,e"! ., *>%$e< :e%e#%i .e%,!%!h!n
• Ali%!n ,!%!h ,!n un&si ,i &in+!l• Pl!sen$! ,!n u$e%us insusiensi u$e%>.l!sen$e% &&n
.e%$u"#uh!n +!nin hi.>*si! &!2!$ +!nin• P!%u e,e"! .!%u• M!$! s.!s"e .),%h s*>$>"! ,i.l>.i!
PERU#AHAN (ISI"L"%IKPAT"L"%IK
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 30/36
Penatalak-anaan
SIKAP TERHADAP PENAKIT
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 31/36
Pe"#e%i!n >#!$!n$i*e+!n&
L>!,in& ,>se
•4 !$!u &%!" I)"sel!n+u$n(! 4 &%!"i)" $i!. 4- +!")
Syarat -yarat
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 32/36
Syarat -yarat.emberian
MgS"0
• H!%us $e%se,i! !n$i,>$u" M&SO4 *!lsiu" &lu*>n!s10 1 &%!" 510 ,!l!" 10::6 ,i#e%i*!n i/ sel!"! 3"eni$
• Ree*s .!$ell! 576 *u!$
• @%e*uensi .e%n!.!s!n 1 *!li "eni$
• M&SO4 ,ihen$i*!n #il! !,! $!n,! $!n,! in$>*si*!si ,!nse$el!h '4 +!" .. !$!u '4 +!" se$el!h *e+!n& $e%!*hi%)
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 33/36
PEMBERIAN ANTIHIPERTENSI
$e*!n!n sis$>li* 140 ""H& ,!n!$!u $e*!n!n ,i!s$>li: 90""H&)
Antihi.erten-i
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 34/36
SIKAP TERHADAP KEHAMILAN
K , n - e r 1 a t i 2 3 e k - .
e k t a t i 2 4
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 35/36
SIKAP TERHADAP KEHAMILAN
I#u
A k t i 2 3 a
g g r e - - i 1 e m
a n a g e m e n t 4
7/21/2019 Ppt Peb Shinta Revisi
http://slidepdf.com/reader/full/ppt-peb-shinta-revisi 36/36
KESIMPULAN
Di!&n>sis .!,! .!sien ini su,!h $e.!$ sesu!i ,en&!n!n!"nesis .e"e%i*s!!n si* ,!n .enun+!n& (!i$uG1P0A0H0 39-40 "in&&u THIU ,en&!n P%ee*l!".si!
#e%!$)
Pen!$!l!*s!n!!n (!n& ,il!*u*!n ,i RSUD K>+!! su,!h$e.!$ (!i$u ,en&!n $e%!.i !*$i ,!n $e%"in!si *eh!"il!nse:e.!$n(! .e"#e%i!n M&SO4 ,!n .e%!2!$!n in$ensi$e%h!,!. *>".li*!si (!n& $e%+!,i
Pen:e&!h!n !n$e.!%$u" #e%u.! AN (!n& ,il!*u*!n.e%lu ,i.e%#!i*i $e%u$!"! *ine%+! .%>/i,e% !&!% AN
le#ih $e%!$u%) Bil! AN ,il!*u*!n ,en&!n i,e!l*e"un&*in!n !,!n(! *>".li*!si #is! ,ihin,!%i)
Recommended