Pre Eklamsia Berat (PONED)
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![Page 1: Pre Eklamsia Berat (PONED)](https://reader035.fdocument.pub/reader035/viewer/2022081506/55cf91b5550346f57b8fe99d/html5/thumbnails/1.jpg)
G3P2A0 39-40 minggu
Janin Tunggal Hidup
Belum Inpartu
PEB
Disusun Oleh : Dr. EgyBd. Len
Bd. YuniZr. Lynda
Zr. Vivi
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IDENTITAS
Nama : Ny. EC
Umur : 33 tahun
Alamat : Kuanino
Pekerjaan : Swasta
Agama : Islam
Tanggal masuk : 8 September 2014 jam 12.25 Wita
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ANAMNESIS
Keluhan Utama :
Tensi tinggi, kaki bengkak, nyeri saat berkemih
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RPS
Pasien datang ke RS Yohanes atas rujukan dr PKM Sikumana a.i tensi tinggi kaki bengkak dan nyeri saat berkemih. Tidak ada keluhan nyeri kepala, nyeri ulu hati dan pandangan kabur. Pasien ANC rutin di PKM selama 2 bln terakhir dan tidak ada keluhan tensi tinggi sebelumnya. Kehamilan saat ini adalah kehamilan dari suami kedua.
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RPD
Pasien mengaku tidak pernah mengalami tensi tinggi sebelumnya. Riw. DM, Anemia disangkal.
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Riwayat Obstetri
HPHT : 8 desember 2013
Taksiran Persalinan : 15 september 2014
Riwayat Persalinan Sebelumnya :
I. 1996/di rumah/bidan/spontan/aterm/laki2/3000gr
II. 2001/di rumah/bidan/spontan/aterm/perempuan/3000gr
III.2014/saat ini
Riwayat Kontrasepsi : pil
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PEMERIKSAAN FISIK
Keadaan Umum : TSS
Kesadaran : Compos Mentis
Tanda - Tanda VitalTekanan Darah : 200/130 mmHg
Frekuensi Nadi : 80x/mnt
Frekuensi Pernapasan : 20x/mnt
Suhu : 36,5° C
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Kepala : CA-/-, SI-/-,
Thorax : dbn
Abdomen : Cembung, gravid, BU +,
nyeri tekan -
Extremitas : odem tungkai bawah +/+
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Status Obs
TFU 1/2 pusat-px (31 cm),
Janin Tunggal, hidup
puka, letkep
DJJ + 144x/ mnt
Gerak janin +
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Pemeriksaan Dalam
Tidak dilakukan
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Pemeriksaan Penunjang
Darah Lengkap (17 November 2013)
RBC: 4,800,000 /mm³
Hb : 12,5 gr%
PCV : 33 %
PLT : 204,000 /mm³
WBC :11,800 /mm³
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Kimia Darah (17 November 2013)
SGOT : 16 IU/L
SGPT : 10 IU/L
Ureum : 23 mg/dl
Kreatin :0,59 mg/dl
GDS: 78 mg/dl
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Urin Lengkap (17 November 2013) BJ : 1,020
pH : 6
Leukosit : +3
Nitrit: -
Protein: +1
Glukosa: -
Keton : +1
Bilirubin: -
Eritrosit : +2
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DIAGNOSA MASUK
G3P2A0 39-40 minggu Janin Tunggal Hidup
Belum InpartuPEBISK
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OBSERVASI DAN PENATALAKSANAAN
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Tanggal / jam
Keadaan Pasien Terapi / Tindakan
Ket
8 Septemberr 201421.30
S : sedikit pusing, nyeri saat berkemih
O : Kesadaran CMTD : 200/130mmHgN :80x/mntRR: 20X/mntt : 36.5 ° C DJJ +, 144x/mntHis –Prot: +1Urin : 200cc (Tampak bercak darah saat pemasangan kateter)
Nifedipin 10mg Sublingual
IVFD RL 500cc, 20tpm
Pasien masih menunggu persetujuan dr keluarga utk dilakukan tindakan
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Tanggal / jam
Keadaan Pasien Terapi / Tindakan
Ket
8 Septemberr 201421.45
S : sedikit pusing, nyeri saat berkemih
O : Kesadaran CMTD : 200/130mmHgN :80x/mntRR: 20X/mntt : 36.5 ° C Reflex Patella: +DJJ +, 144x/mntHis –Prot: +1Urin: 200cc, tampak bercak darah
MgSO4 40% 4g dlm 10 cc Aquades IV 5mnt
MgSO4 40% 6g dlm RL 500cc, 28tpm6 jam pertama
Rencana SC Elektif besok pagi
Cefo 1 gr Vial IV/ 12 jam
9 Septemberr 2014
03.45
S : sedikit pusing
O : Kesadaran CMTD : 180/100mmHgN :80x/mntRR: 18X/mntt : 36.5 ° C Reflex Patella: +DJJ +, 153x/mntHis –
MaintenanceMgSO4 1g dlm RL 500cc
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PROSEDUR TINDAKAN
1. Informed consent2. Persiapan penolong (cuci tangan dan
memakai APD)3. Persiapan alat 4. Persiapan Obat5. Pantau TTV, DJJ, Reflex patella
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TERIMA KASIH