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    Morning Report 26th October 2012 - Eklampsi

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    Arja' Waas
    1) A 23-year-old woman (Mrs. F) was admitted to the hospital at 14:50 on October 26th, 2012 for labor and delivery. She was 40 weeks pregnant, had high blood pressure (190/110), and experienced two convulsions, indicating eclampsia. 2) She underwent an emergency c-section at 19:15 due to fetal distress. A 3.1kg male infant was delivered with good APGAR scores. The placenta was manually removed and blood loss was approximately 300cc. 3) Over the next few days, both mother and baby were closely monitored. The mother's condition stabilized and she was discharged on the 28th. The

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    Morning Report 26th October 2012 - Eklampsi

    Uploaded by

    Arja' Waas
    33 views9 pages
    1) A 23-year-old woman (Mrs. F) was admitted to the hospital at 14:50 on October 26th, 2012 for labor and delivery. She was 40 weeks pregnant, had high blood pressure (190/110), and experienced two convulsions, indicating eclampsia. 2) She underwent an emergency c-section at 19:15 due to fetal distress. A 3.1kg male infant was delivered with good APGAR scores. The placenta was manually removed and blood loss was approximately 300cc. 3) Over the next few days, both mother and baby were closely monitored. The mother's condition stabilized and she was discharged on the 28th. The

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    Morning Report 26th October 2012_Eklampsi

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    Morning Report 26th October 2012_Eklampsi

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    1) A 23-year-old woman (Mrs. F) was admitted to the hospital at 14:50 on October 26th, 2012 for labor and delivery. She was 40 weeks pregnant, had high blood pressure (190/110), and experienced two convulsions, indicating eclampsia. 2) She underwent an emergency c-section at 19:15 due to fetal distress. A 3.1kg male infant was delivered with good APGAR scores. The placenta was manually removed and blood loss was approximately 300cc. 3) Over the next few days, both mother and baby were closely monitored. The mother's condition stabilized and she was discharged on the 28th. The

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    33 views9 pages

    Morning Report 26th October 2012 - Eklampsi

    Uploaded by

    Arja' Waas
    1) A 23-year-old woman (Mrs. F) was admitted to the hospital at 14:50 on October 26th, 2012 for labor and delivery. She was 40 weeks pregnant, had high blood pressure (190/110), and experienced two convulsions, indicating eclampsia. 2) She underwent an emergency c-section at 19:15 due to fetal distress. A 3.1kg male infant was delivered with good APGAR scores. The placenta was manually removed and blood loss was approximately 300cc. 3) Over the next few days, both mother and baby were closely monitored. The mother's condition stabilized and she was discharged on the 28th. The

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 9

    MORNING REPORT

    October 26th, 2012

    Supervisor : dr. Made Widya


    Mahayasa, Sp.OG
    Medical Students :
    Diah, Rani, Dini, Rifka, Era, Vera, Farid,
    Wawan
    CASES RESUME

    NORMAL LABOR

    PATHOLOGY LABOR

    1. G3P2A0L2 40-41 weeks S/L/IU head presentation with


    postdate and failed drip 2nd serial
    2. G1P0A0L0 A/S/L/IU with eclampsia + Susp. Macrosomia +
    2nd Stage of Labor neglected.

    Case report
    Name

    : Mrs.F

    Age

    : 23 years old

    Address : Kr. Bucu, Labuapi


    Admitted : October 26th 2012, 14.50 WITA

    Time

    Subject
    Chronologist (26/10/2012,
    in Gerung GH):
    S: Patient pregnant 9
    months, came to PHC
    confessed Abdominal pain
    since 02.00
    (26/20/2012), rupture of
    membrane since 06.00
    (26/10/2012). Blur vision
    (-), vomiting (-), nausea
    (-). Patient suddenly
    convulsion 2 times at
    13.30 and 14.20
    (26/10/2012)
    O:
    GC: weak
    BP: 190/110
    PR: 94 x/min
    RR: 24x/min
    T: 39,6c
    FHR : 14-14-14
    UC : 2x/10 ~25
    UFH: 38cm
    EFW : 3875 gram
    VT : complete, eff 100%,
    amnion (-), head palpable
    HI, caput (+),
    impalpable small part and
    umbilical cord.,
    A:
    G1P0A0L0 A/S/L/IU head
    presentation + eklampsia
    + big baby + 2nd Stage of
    Labor + Febris

    Object
    Lab:
    Hb = 12,2g/dl
    Rbc = 4,40
    WBC : 31,81
    Plt = 314
    Hct = 37,8%
    HbSAg = (-)
    Protein urine : +3
    SGOT : 102
    SGPT : 50

    Assessment

    Planning

    TIME

    SUBJECTIVE
    P:
    - Observed mother and
    fetal well being.
    -Observed impanding
    eclampsia
    -Coo Sp.OG Out of
    Town
    -O2 5 Lpm
    -Ceftriaxon 1 gr/ IV
    (13.30)
    -Nifedipin 10 mg
    (13.30)
    -Drip MgSO4 40% g gr
    28 tpm (13.30)
    -Bolus MgSO4 40% 4
    gr/IV
    -Referred to NTB GH

    OBJECTIVE

    ASSESSMENT

    PLANNING

    TIME
    17.00

    SUBJECTIVE

    OBJECTIVE

    ASSESSMENT

    CTG Patient

    G1P0A0L0
    A/S/L/IU with
    eclampsia +
    Susp.
    Macrosomia +
    2nd Stage of
    Labor neglected
    + Fetal distress

    19.15

    PLANNING
    DM Coo Result CTG
    Advice: CS 18.00
    Preoperation:
    Inj. Ceftriaxone 1 gr

    CS began
    Amnion fluid: meconeal
    Baby was born (19.20).
    male. 3100 g. AS 3-5.
    Anus (+). Congenital
    anomaly (-).
    Placenta was born.
    Manually. Complete.
    500 gram.
    Bleeding 300cc

    21.30

    GC : weak
    BP : 120/80mmHg
    PR : 88x/minute
    RR : 20x/minute
    T : 37,1C
    UC: (+)
    UFH : 2 finger
    umbilicus
    UT: 550 cc/6 h
    Lochea: (+)

    2 hours post CS

    below

    Mother in ICU
    mother
    Observation
    and baby well being.
    Observation : vital
    sign, bleeding, uterus
    contraction,
    urine
    output.

    TIME
    23.00

    SUBJECTIVE

    OBJECTIVE
    GC : well
    BP : 120/80 mmHg
    PR : 81 bpm
    RR : 24 bpm
    T : 36.2C
    Urine : 500 cc
    UFH : 2 fingers below
    the umbilicus
    Lochea rubra : +

    01.00

    GC : well
    BP : 120/80 mmHg
    PR : 81 bpm
    RR : 24 bpm
    T : 36.2C
    Urine : 500 cc

    03.00

    GC : well
    BP : 120/80 mmHg
    PR : 88 bpm
    RR : 24 bpm
    T : 36.2C
    Urine : 500 cc

    27/10
    /2012

    GC : well
    BP : 130/80 mmHg
    PR : 89 bpm
    RR : 24 bpm
    T : 36.2C
    UFH : 2 fingers below
    the umbilicus
    Lochea rubra : (+)
    Baby in NICU :
    GC : well
    PR : 120 bpm
    RR : 52 bpm
    T : 36,4oC

    07.00

    ASSESSMENT

    PLANNING
    Ceftriaxone 1
    hour
    Ranitidine 1
    hours
    Kaltrofen Sup
    Diazepam iif
    Konvulsion
    Check CBC post
    BG

    1st day post CS

    gr/ 12
    A/

    12

    patient
    Op and

    Observe mother and


    baby well being.
    CBC Result :
    Hb : 9,8 g/dL
    WBC : 21,7 x 103 /uL
    RBC : 3,69 X 10
    PLT : 185 X 10
    BG : 93
    Observation : vital sign,
    bleeding,
    uterus
    contraction,
    urine
    output.

    TIME

    SUBJECTIVE

    OBJECTIVE

    11.30

    GC : well
    BP : 130/90 mmHg
    PR : 76 bpm
    RR : 20 bpm
    T : 36.C
    UFH : 2 fingers below
    the umbilicus
    Lochea rubra : +

    28/10
    /12
    07.00

    GC : well
    BP : 120/80 mmHg
    PR : 84 bpm
    RR : 24 bpm
    T : 36.2C
    UFH : 2 fingers below
    the umbilicus
    Lochea rubra : (+)
    Baby in NICU :
    GC : well
    PR : 120 bpm
    RR : 52 bpm
    T : 36,4oC

    ASSESSMENT

    PLANNING
    Observe mother and
    baby well being.
    Anestethist suggest to
    move at Melati Room
    Observe mother and
    baby well being.
    Observation : vital sign,
    bleeding,
    uterus
    contraction,
    urine
    output.

    2nd day post SC

    Observe mother and


    baby well being.
    Observation : vital sign,
    bleeding,
    uterus
    contraction,
    urine
    output.

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