RESPONSI KASUS

CEPHALOPELVIC DISPROPORTION (CPD)

Disusun oleh :
Faesal A. Suans!ah
NP" : #$%##&'$
PE"(I"(IN) :
*+. "ul,a*i Aanullah- S..O)
*+.Rau*a/ul Hi0ah- S..O)
*+. (a1an2 Soe/,ah,o- S..O)
DALA" RAN)KA "EN)IKUTI KEPANITERAAN KLINIK DI
(A)IAN3S"F KE(IDANAN DAN PEN4AKIT KANDUN)AN
RSUD S4ARIFAH A"(A"I RATO E(U (AN)KALAN
KATA PEN)ANTAR
Pu,i s!u0u+ sa!a .an,a/0an 0eha*i+a/ Tuhan 4an2 "aha Esa- 0a+ena
a/as 1e+0a/ *an +aha/5N!a sa!a *a.a/ en!elesai0an +es.onsi 0asus ini /e.a/ .a*a
6a0/un!a. La.o+an 0asus !an2 1e+,u*ul 78e.halo.el9i8 *is.+o.o+/ion (CPD): ini
*isusun *ala +an20a en2i0u/i Ke.ani/e+aan Klini0 "a*!a *i (a2ian 3 S"F
O1s/e/+i *an )ine0olo2i Ruah Sa0i/ Uu Dae+ah S!a+i;ah A1ai Ra/o E1u
(S4A"RA(U) (an20alan. Pa*a 0ese.a/an ini- .enulis in2in en2u8a.0an /e+ia
0asih !an2 se1esa+51esa+n!a 0e.a*a seua .iha0 !an2 /elah 1an!a0 e1e+i0an
1i1in2an 0e.a*a .enulis:
<. *+. "ul,a*i Aanullah- S..O)- sela0u Ke.ala (a2ian 3 S"F Ke1i*anan
*an Kan*un2an RSUD S!a+i;ah A1ai Ra/o E1u (S4A"RA(U)
(an20alan *an *osen .e1i1in2 (a2ian 3 S"F Ke1i*anan *an
Kan*un2an RSUD S!a+i;ah A1ai Ra/o E1u (S4A"RA(U)
(an20alan.
&. *+.Rau*a/ul Hi0ah- S..O)- sela0u *osen .e1i1in2 (a2ian 3 S"F
Ke1i*anan *an Kan*un2an RSUD S!a+i;ah A1ai Ra/o E1u
(S4A"RA(U) (an20alan.
=. *+. (a1an2 Soe/,ah,o- S..O)- sela0u *osen .e1i1in2 (a2ian 3 S"F
Ke1i*anan *an Kan*un2an RSUD S!a+i;ah A1ai Ra/o E1u
(S4A"RA(U) (an20alan.
>. Seua .iha0 !an2 /i*a0 *a.a/ *ise1u/0an sa/u .e+sa/u !an2 /elah
e1e+i0an 1an/uan 0e.a*a .enulis.
A0hi+n!a sa!a en!a*a+i 1ah6a *ala .enulisan +es.onsi 0asus ini
asih 1an!a0 0e0u+an2an. Oleh 0a+ena i/u- 0+i/i0 *an sa+an !an2 1e+si;a/ e1an2un
san2a/ sa!a ha+a.0an *ei 0ese.u+naan +es.onsi 0asus ini.
Seo2a +es.onsi 0asus ini *a.a/ e1e+i0an an;aa/ *an /a1ahan .en2e/ahuan
0hususn!a 0e.a*a sa!a *an 0e.a*a .e1a8a *ala en,alan0an .+a0/e0 seha+i5
ha+i se1a2ai *o0/e+.
Te+ia 0asih.
(an20alan- Dese1e+ &#<<
Penulis
BABI
PENDAHULUAN
1.1.LatarBelakang
Da/a *a+i Reproductive Health Library en!a/a0an /e+*a.a/ <?# sa.ai &##
,u/a 0ehailan se/ia. /ahun. Da+i an20a /e+se1u/ /e+,a*i '?'.### 0ea/ian a/e+nal
a0i1a/ 0o.li0asi 0ehailan *an .e+salinan. Se1a1 0ea/ian /e+se1u/ a*alah
.e+*a+ahan &>-?@- in;e0si *an se.sis <>-A@- hi.e+/ensi *an .+ee0la.si3e0la.si
<&-A@- .e+salinan a8e/ (*is/osia) $-A@- a1o+/us <&-A@- *an se1a1 lan2sun2 !an2
lain %-A@. Se0sio sesa+ea *i Ae+i0a Se+i0a/ *ila.o+0an enin20a/ se/ia. /ahunn!a-
Pa*a /ahun &##& /e+*a.a/ &%-$ @ se0sio sesa+ea *a+i selu+uh .+oses 0elahi+an. Da+i
an20a /e+se1u/- <A-<@ e+u.a0an se0sio sesa+ea .+ie+.
La.o+an Ae+i8an Colle2e o; O1s/+e/i8ian an* )!nae8olo2is/ (ACO))
en!a/a0an 1ah6a se0sio sesa+ea .+ie+ /e+1an!a0 .a*a .+ii2+a9i*a *en2an ;e/us
/un22al- .+esen/asi 9e+/eB- /an.a 0o.li0asi. In*i0asi .+ii2+a9i*a /e+se1u/ un/u0
se0sio sesa+ea a*alah .+esen/asi 1o0on2- .+ee0la.si- *is/osia- ;e/al *is/+ess- *an
ele0/i;. Dis/osia e+u.a0an in*i0asi /e+1an!a0 un/u0 se0sio sesa+ea .a*a .+ii2+a9i*a
se1esa+ $$-%@. An20a ini enun,u00an .enin20a/an *i1an*in20an .eneli/ian )+e2o+!
*00 .a*a <A?' *an <AA> asin25asin2 >A-%@ *an '<->@ *is/osia en!e1a10an
se0sio sesa+ea.
Dis/osia a*alah .e+salinan !an2 a1no+al a/au suli/ *an *i/an*ai *en2an
/e+lalu la1a/n!a 0ea,uan .e+salinan. Kelainan .e+salinan ini enu+u/ ACO)
*i1a2i en,a*i = !ai/u 0elainan 0e0ua/an (.o6e+)- 0elainan ,anin (.assen2e+)- *an
0elainan ,alan lahi+ (.assa2e). Pan22ul se.i/ (.el9i8 8on/a8/ion) e+u.a0an salah
sa/u 0elainan ,alan lahi+ !an2 a0an en2ha1a/ 0ea,uan .e+salinan 0a+ena
0e/i*a0sesuaian an/a+a u0u+an 0e.ala ,anin *en2an .an22ul i1u !an2 1iasa *ise1u/
*en2an *is.+o.o+si se;alo.el9i0. Is/ilah *is.+o.o+si se;alo.el9i0 un8ul .a*a asa
*iana in*i0asi u/aa se0sio sesa+ea a*alah .an22ul se.i/ !an2 *ise1a10an oleh
+a0hi/is. Dis.+o.o+si se;alo.el9i0 se,a/i se.e+/i i/u se0a+an2 su*ah ,a+an2 *i/eu0an-
uun!a *ise1a10an oleh ,anin !an2 1esa+. (e+*asa+0an u+aian *i a/as a0a 0ai
.e+lu en2u+ai0an .e+asalahan *an .ena/ala0sanaan .a*a *is.+o.o+si se;alo.el9i0
se1a2ai salah sa/u .en!e1a1 *is/osia .en/in2 *iili0i oleh *o0/e+.
BABII
TINJAUAN PUSTAKA
3.1. Definisi
Dis.+o.o+si se;alo.el9i0 a*alah 0ea*aan !an2 en22a1a+0a 0e/i*a0sesuaian
an/a+a 0e.ala ,anin *an .an22ul i1u sehin22a ,anin /i*a0 *a.a/ 0elua+ elalui 9a2ina.
Dis.+o.o+si se;alo.el9i0 *ise1a10an oleh .an22ul se.i/- ,anin !an2 1esa+ a/au.un
0o1inasi 0e*uan!a.
3.2 Anatoi Pangg!l
3.2.1. B e n t ! k P a n g g ! l
Pan22ul enu+u/ o+;olo2in!a *i1a2i en,a*i > ,enis .o0o0- !ai/u:
<. " i n e k o i # : Pin/u a/as .an22ul !an2 1un*a+- a/au *en2an
*iae/e+ /+ans9e+sa !an2 l e1i h .an, an2 s e*i 0i / *a+ i .a*a *i ae/ e+
an/ e+ o.os / e+ i o+ *an *en2an .an22ul /en2ah se+/a .in/u 1a6ah .an22ul
!an2 8u0u. luas. Palin2 i*eal- .an22ul .e+e.uan : >'@.
&. A n # r o i # : P i n / u a / a s . a n 2 2 u l ! a n 2 1 e + 1 e n / u 0
s e 2 i / i 2 a 1 e + h u 1 u n 2 a n * e n 2 a n .en!e.i/an 0e *e.an- *en2an s.ina
is0ia*i0a enon,ol 0e *ala *ana+0us .u1is en!e.i/- .an22ul .+ia-
*iae/e+ /+ans9e+sa *e0a/ *en2an sa8+u : <'@.
=. A n t r o $ o i # Diae/e+ an/e+o.os/e+io+ !an2 le1ih .an,an2 *a+i.a*a
*iae/e+ /+ans9e+sa-*an a+0us .u1is en!e.i/ se*i0i/- a2a0 lon,on2 se.e+/i /elu+.
>. P l a t i $ e l o i # Diae/e+ an/e+o.os/e+io+ !an2 le1ih .en*e0
*a+i.a*a *iae/e+ /+ans9e+sa .a*a .in/u a/as .an22ul *an a+0us .u1is !an2 luas-
en!e.i/ a+ah u0a 1ela0an2 : '@.
3.2.2 Pint! Atas Pangg!l
Pin/u a/as .an22ul *i1en/u0 oleh .+oon/o+iu 8o+.us 9e+/e1+a sa8+u- linea
innoina/a- se+/a .in22i+ a/as si;isis. Kon,u2a/a *ia2onalis a*alah ,a+a0 *a+i .in22i+
1a6ah si;isis 0e .+oon/o+iu- Se8a+a 0linis- 0on,u2a/a *ia2onalis *a.a/ *iu0u+
*en2an easu00an ,a+i /elun,u0 *an ,a+i /en2ah !an2 *i+a.a/0an en!usu+ nai0 0e
selu+uh .e+u0aan an/e+io+ sa8+u- .+oon/o+iu /e+a1a se1a2ai .enon,olan /ulan2.
Den2an ,a+i /e/a. ene.el .a*a .+oon/o+iu- /an2an *i 9a2ina *ian20a/ sa.ai
en!en/uh a+8us .u1is *an *i/an*ai *en2an ,a+i /elun,u0 /an2an 0i+i. Ca+a0 an/a+a
u,un2 ,a+i .a*a .+oon/o+iu sa.ai /i/i0 !an2 *i/an*ai oleh ,a+i /elun,u0 e+u.a0an
.an,an2 0on,u2a/a *ia2onalis.
Kon,u2a/a 9e+a !ai/u ,a+a0 *a+i .in22i+ a/as si;isis 0e .+oon/o+iu !an2
*ihi/un2 *en2an en2u+an2i 0on,u2a/a *ia2onalis <-' 8- .an,an2n!a le1ih 0u+an2
<< 8. Kon,u2a/a o1s/e/+i0a e+u.a0an 0on,u2a/a !an2 .alin2 .en/in2 !ai/u ,a+a0
an/a+a 1a2ian /en2ah *ala si;isis *en2an .+oon/o+iu- Selisih an/a+a 0on,u2a/a
9e+a *en2an 0on,u2a/a o1s/e/+i0a se*i0i/ se0ali.
)a1a+ <. Diae/e+ .a*a Pin/u A/as Pan22ul
3.2.3.Pangg!l Tenga% &Pel'i( )a'it*+
Ruan2 .an22ul ini eili0i u0u+an !an2 .alin2 luas. Pen2u0u+an 0linis
.an22ul /en2ah /i*a0 *a.a/ *i.e+oleh se8a+a lan2sun2. Te+*a.a/ .en!e.i/an se/in22i
s.ina is8ia*i0a- sehin22a 1e+a0na .en/in2 .a*a *is/osia se/elah 0e.ala en2a2een/.
Ca+a0 an/a+a 0e*ua s.ina ini !an2 1iasa *ise1u/ *is/ansia in/e+s.ina+u e+u.a0an
,a+a0 .an22ul /e+0e8il !ai/u se1esa+ <#-' 8. Diae/e+ an/e+o.os/e+io+ se/in22i s.ina
is8ia*i8a 1e+u0u+an <<-' 8. Diae/e+ sa2i/al .os/e+io+- ,a+a0 an/a+a sa8+u *en2an
2a+is *iae/e+ in/e+s.ina+u 1e+u0u+an >-' 8.
3.2., Pint! Ba-a% Pangg!l
Pin/u 1a6ah .an22ul 1u0anlah sua/u 1i*an2 *a/a+ naun /e+*i+i *a+i *ua
se2i/i2a *en2an *asa+ !an2 saa !ai/u 2a+is !an2 en2hu1un20an /u1e+ is8ia*i0u
0i+i *an 0anan. Pin/u 1a6ah .an22ul !an2 *a.a/ *i.e+oleh elalui .en2u0u+an 0linis
a*alah ,a+a0 an/a+a 0e*ua /u1e+osi/as is8ii a/au *is/ansia /u1e+u (<#-' 8)- ,a+a0 *a+i
u,un2 sa8+u 0e /en2ah5/en2ah *is/ensia /u1e+u a/au *iae/e+ sa2i/alis .os/e+io+
(%-' 8)- *an ,a+a0 an/a+a .in22i+ 1a6ah si.isis 0e u,un2 sa8+u (<<-' 8).
3.3 Pangg!l Se$it
Dis/osia a*alah .e+salinan !an2 suli/ *an *i/an*ai oleh /e+lalu la1a/n!a
0ea,uan .e+salinan. Dis/osia *a.a/ *ise1a10an oleh 0elainan .a*a se+9i0- u/e+us-
,anin- /ulan2 .an22ul i1u a/au o1s/+u0si lain *i ,alan lahi+. Kelainan ini oleh ACO)
*i1a2i en,a*i /i2a !ai/u:
<. Kelainan 0e0ua/an (.o6e+) !ai/u 0on/+a0/ili/as u/e+us *an u.a!a
e0s.ulsi; i1u.
a. Kelainan his : ine+sia u/e+i 3 0eleahan his
1. 0e0ua/an en2e,an !an2 0u+an2 isaln!a .a*a he+nia a/au sesa0 na;as.
&. Kelainan !an2 eli1a/0an ,anin (.assen2e+)- isaln!a le/a0 lin/an2-
le/a0 *ahi- hi*+ose;alus.
=. Kelainan ,alan lahi+ (.assa2e)- isaln!a .an22ul se.i/- /uo+ !an2
e.e+se.i/ ,alan lahi+.
Pola Kelainan Pe+salinan- Dia2nos/i0- K+i/e+ia *an "e/o*e Penan2anann!a
Pola Persalinan Kriteria Diagnostik Penanganan yang dianjurkan
Penanganan Khusus
Pan22ul *en2an u0u+an no+al /i*a0 a0an en2alai 0esu0a+an 0elahi+an
.e+9a2ina .a*a ,anin *en2an 1e+a/ 1a*an !an2 no+al. U0u+an .an22ul *a.a/
en,a*i le1ih 0e8il 0a+ena .en2a+uh 2iDi- lin20un2an a/au hal lain sehin22a
eni1ul0an 0esuli/an .a*a .e+salinan .e+9a2ina. Pan22ul se.i/ !an2 .en/in2
.a*a o1s/e/+i8 1u0an se.i/ se8a+a ana/ois naun .an22ul se.i/ se8a+a ;un2sional
a+/in!a .e+1an*in2an an/a+a 0e.ala *an .an22ul. Selain .an22ul se.i/ *en2an
u0u+an !an2 0u+an2 *a+i no+al- ,u2a /e+*a.a/ .an22ul se.i/ lainn!a. Pan22ul ini
*i2olon20an en,a*i e.a/- !ai/u:
<. Kelainan 0a+ena 2an22uan .e+/u1uhan in/+au/e+ine: .an22ul Nae2ele-
.an22ul Ro1e+/- s.li/ .el9is- .an22ul asiilasi.
&. Kelainan 0a+ena 0elainan /ulan2 *an3 sen*i: +a0i/is- os/eoalasia-
neo.lasa- ;+a0/u+- a/+o;i- ne0+osis- .en!a0i/ .a*a sen*i sa0+oilia0a *an
sen*i sa0+o0o0si2ea.
=. Kelainan .an22ul 0a+ena 0elainan /ulan2 1ela0an2: 0i;osis- s0oliosis-
s.on*ilolis/esis.
>. Kelainan .an22ul 0a+ena 0elainan .a*a 0a0i: 0o0si/is- lu0sasio 0o0sa-
a/+o;i a/au 0elu.uhan sa/u 0a0i.
Se/ia. .en!e.i/an .a*a *iae/e+ .an22ul !an2 en2u+an2i 0a.asi/as
.an22ul *a.a/ en!e1a10an *is/osia saa/ .e+salinan. .en!e.i/an *a.a/
/e+,a*i .a*a .in/u a/as .an22ul- .in/u /en2ah .an22ul- .in/u 1a6ah .an22ul-
a/au .an22ul !an2 en!e.i/ selu+uhn!a.
3.3.1 Pen*e$itan $int! atas $angg!l
Pin/u a/as .an22ul *ian22a. se.i/ a.a1ila *iae/e+ an/e+io.os/e+io+
/e+.en*e0n!a (0on,u2a/a 9e+a) 0u+an2 *a+i <# 8 a/au a.a1ila *iae/e+ /+ans9e+sal
/e+1esa+n!a 0u+an2 *a+i <& 8. Diae/e+ an/e+o.os/e+io+ .in/u a/as .an22ul se+in2
*i.e+0i+a0an *en2an en2u0u+ 0on,u2a/a *ia2onal se8a+a anual !an2 1iasan!a le1ih
.an,an2 <-' 8. Den2an *ei0ian- .en!e.i/an .in/u a/as .an22ul 1iasan!a
*i*e;inisi0an se1a2ai 0on,u2a/a *ia2onal !an2 0u+an2 *a+i <<-' 8. "en2e+/ (<A>?)
*an Kal/+ei*e+ (<A'&) e1u0/i0an 1ah6a 0esuli/an .e+salinan enin20a/ .a*a
*iae/e+ an/e+o.os/e+io+ 0u+an2 *a+i <# 8 a/au *iae/e+ /+ans9e+sal 0u+an2 *a+i <&
8. Dis/osia a0an le1ih 1e+a/ .a*a 0ese.i/an 0e*ua *iae/e+ *i1an*in20an se.i/
han!a .a*a salah sa/u *iae/e+.
Diae/e+ 1i.a+ie/al ,anin 1e+u0u+an A-'5A-? 8- sehin22a san2a/ suli/ 1a2i
,anin 1ila ele6a/i .in/u a/as .an22ul *en2an *iae/e+ an/e+o.os/e+io+ 0u+an2 *a+i <#
8. Eani/a *en2an /u1uh 0e8il 0eun20inan eili0i u0u+an .an22ul !an2 0e8il-
naun ,u2a eili0i 0eun20inan ,anin 0e8il. Da+i .eneli/ian Thos .a*a =$&
nulli.a+a *i.e+oleh +e+a/a 1e+a/ 1a*an ana0 le1ih +en*ah (&?# 2+a) .a*a 6ani/a
*en2an .an22ul se.i/ *i1an*in20an 6ani/a *en2an .an22ul se*an2 a/au luas.
Pa*a .an22ul se.i/ a*a 0eun20inan 0e.ala /e+/ahan oleh .in/u a/as
.an22ul- sehin22a 2a!a !an2 *i/i1ul0an oleh 0on/+a0si u/e+us se8a+a lan2sun2
ene0an 1a2ian sela.u/ 0e/u1an !an2 enu/u.i se+9i0s. A0i1a/n!a 0e/u1an *a.a/
.e8ah .a*a .e1u0aan 0e8il *an /e+*a.a/ +esi0o .+ola.sus ;uni0uli. Se/elah sela.u/
0e/u1an .e8ah- /i*a0 /e+*a.a/ /e0anan 0e.ala /e+ha*a. se+9i0s *an se2en 1a6ah
+ahi sehin22a 0on/+a0si en,a*i ine;e0/i; *an .e1u0aan 1e+,alan la1a/ a/au /i*a0
saa se0ali. Ca*i- .e1u0aan !an2 1e+lan2sun2 la1a/ *a.a/ en,a*i .+o2nosa 1u+u0
.a*a 6ani/a *en2an .in/u a/as .an22ul se.i/.
Pa*a nuli.a+a no+al a/e+- 1a2ian /e+1a6ah ,anin 1iasan!a su*ah asu0
*ala +on22a .an22ul se1elu .e+salinan. A*an!a .en!e.i/an .in/u a/as .an22ul
en!e1a10an 0e.ala ,anin e2a.un2 1e1as *i a/as .in/u .an22ul sehin22a *a.a/
en!e1a10an .+esen/asi ,anin 1e+u1ah. Pa*a 6ani/a *en2an .an22ul se.i/ /e+*a.a/
.+esen/asi 6a,ah *an 1ahu /i2a 0ali le1ih se+in2 *an .+ola.s /ali .usa/ e.a/ sa.ai
ena 0ali le1ih se+in2 *i1an*in20an 6ani/a *en2an .an22ul no+al a/au luas.
3.3.2 Pen*e$itan $angg!l tenga%
Den2an sa8+u elen20un2 se.u+na- *in*in25*in*in2 .an22ul /i*a0
1e+0on9e+2ensi- ;o+aen is8ia*i0u 8u0u. luas- *an s.ina is8ia*i0a /i*a0 enon,ol
0e *ala- *a.a/ *iha+a.0an 1ah6a .an22ul /en2ah /i*a0 a0an en!e1a10an +in/an2an
1a2i le6a/n!a 0e.ala ,anin. Pen!e.i/an .in/u /en2ah .an22ul le1ih se+in2
*i1an*in20an .in/u a/as .an22ul.Hal ini en!e1a10an /e+hen/un!a 0e.ala ,anin .a*a
1i*an2 /+ans9e+sal sehin22a .e+lu /in*a0an ;o+8e.s /en2ah a/au se0sio sesa+ea.
Pen!e.i/an .in/u /en2ah .an22ul 1elu *a.a/ *i*e;inisi0an se8a+a .as/i
se.e+/i .en!e.i/an .a*a .in/u a/as .an22ul. Keun20inan .en!e.i/an .in/u /en2ah
.an22ul a.a1ila *iae/e+ in/e+s.ina+u *i/a1ah *iae/e+ sa2i/alis .os/e+io+ .an22ul
/an2ah a*alah <=-' 8 a/au 0u+an2. U0u+an /e+.en/in2 !an2 han!a *a.a/ *i/e/a.0an
se8a+a .as/i *en2an .el9ie/+i +oen/2enolo2i0 ialah *is/ansia in/e+s.ina+u. A.a1ila
u0u+an ini 0u+an2 *a+i A-' 8- .e+lu *i6as.a*ai 0eun20inan 0esu0a+an .e+salinan
a.ala2i 1ila *ii0u/i *en2an u0u+an *iae/e+ sa2i/alis .os/e+io+ .en*e0.
3.3.3 Pen*e$itan Pint! Ba-a% Pangg!l
Pin/u 1a6ah .an22ul 1u0an sua/u 1i*an2 *a/a+ elain0an *ua se2i/i2a *en2an
*iae/e+ in/e+/u1e+osu se1a2ai *asa+ 0e*uan!a. Pen!e.i/an .in/u 1a6ah .an22ul
/e+,a*i 1ila *iae/e+ *is/an/ia in/e+/u1e+osu 1e+,a+a0 ? 8 a/au 0u+an2. Pen!e.i/an
.in/u 1a6ah .an22ul 1iasan!a *ise+/ai oleh .en!e.i/an .in/u /en2ah .an22ul.
Dis.+o.o+si 0e.ala ,anin *en2an .in/u 1a6ah .an22ul /i*a0 /e+lalu 1esa+
*ala eni1ul0an *is/osia 1e+a/. Hal ini 1e+.e+an .en/in2 *ala eni1ul0an
+o1e0an .e+ineu. Hal ini *ise1a10an a+0us .u1is !an2 se.i/- 0u+an2 *a+i A##
sehin22a o0si.u/ /i*a0 *a.a/ 0elua+ /e.a/ *i 1a6ah si;isis .u1is- elain0an enu,u
+aus is0io.u1i0 sehin22a .e+ineu /e+e2an2 *an u*ah /e+,a*i +o1e0an.
3., Perkiraan Ka$asitas Pangg!l Se$it
Se1ena+n!a .an22ul han!a e+u.a0a salah sa/u ;a0/o+ !an2 enen/u0an
a.a0ah ana0 *a.a/ lahi+ s.on/an a/au /i*a0- *isa.in2 1an!a0 ;a0/o+ lain !an2
ee2an2 .e+anan *ala .+o2nosa .e+salinan.
Kese.i/an .in/u a/as .an22ul 1e+*asa+0an u0u+an 8on,u2a/a 9e+a (CV):
CV ?-' F <# 8 *ila0u0an .a+/us .e+8o1aan !an2 0eun20inan
1e+a0hi+ *en2an .a+/us s.on/an a/au*en2an e0s/+a0si 9a0u- a/au
*i/olon2 *en2an se8io 8aesa+ia se0un*e+ a/as in*i0asi o1s/e/+i8 lainn!a.
CV G $ 5 ?- ' 8 *i l a0u0an SC .+ i e+ .
CV G $ 8 *i l a0u0an SC .+ i e+ u/ l a0.
Disa.in2 hal5hal /e+se1u/ *ia/as ,u2a /e+2an/un2 .a*a :
<) Hi s a/ au / ena2a !an2 en*o+ on2 ana0.
&) (es a+ n!a , ani n- .+ es en/ as i *an .os i s i , ani n
= ) ( e n / u 0 . a n 2 2 u l
> ) Uu + i 1 u * a n a n a 0 1 e + h a + 2 a
' ) P e n ! a 0 i / i 1 u
Pe+0i+aan .an22ul se.i/ *a.a/ *i.e+oleh *a+i .ee+i0saan uu *an
ananesa. "isaln!a .a*a /u1e+8ulosis 9e+/e1+a- .olio!eli/is- 0i;osis. Pa*a 6ani/a
*en2an /in22i 1a*an !an2 0u+an2 *a+i no+al a*a 0eun20inan eili0i 0a.asi/as
.an22ul se.i/- naun 1u0an 1e+a+/i seo+an2 6ani/a *en2an /in22i 1a*an !an2
no+al /i*a0 *a.a/ eili0i .an22ul se.i/. Da+i ananesa .e+salinan /e+*ahulu ,u2a
*a.a/ *i.e+0i+a0an 0a.asi/as .an22ul. A.a1ila .a*a .e+salinan /e+*ahulu 1e+,alan
lan8a+ *en2an 1a!i 1e+a/ 1a*an no+al- 0eun20inan .an22ul se.i/ a*alah 0e8il.
Pen2u0u+an .an22ul (.el9ie/+i) e+u.a0an salah sa/u 8a+a un/u0
e.e+oleh 0e/e+an2an /en/an2 0ea*aan .an22ul. "elalui .el9ie/+i *alaa *en2an
/an2an *a.a/ *i.e+oleh u0u+an 0asa+ .in/u a/as *an /en2ah .an22ul se+/a e1e+i
2a1a+an ,elas .in/u 1a6ah .an22ul. A*a.un .el9ie/+i lua+ /i*a0 eili0i 1an!a0
a+/i.
Pel9ie/+i +a*iolo2is *a.a/ e1e+i 2a1a+an !an2 ,elas *an e.un!ai
/in20a/ 0e/eli/ian !an2 /i*a0 *a.a/ *i8a.ai se8a+a 0linis. Pee+i0saan ini *a.a/
e1e+i0an .en2u0u+an !an2 /e.a/ *ua *iae/e+ .en/in2 !an2 /i*a0 un20in
*i*a.a/0an *en2an .ee+i0saan 0linis !ai/u *iae/e+ /+ans9e+sal .in/u a/as *an
*iae/e+ an/a+ s.ina is0hia*i0a.
Te/a.i .ee+i0saan ini eili0i 1aha!a .a,anan +a*iasi /e+u/aa 1a2i ,anin
sehin22a ,a+an2 *ila0u0an.> Pel9ie/+i *en2an CT s8an *a.a/ en2u+an2i .a,anan
+a*iasi- /in20a/ 0ea0u+a/an le1ih 1ai0 *i1an*in20an +a*iolo2is- le1ih u*ah- naun
1ia!an!a ahal. Selain i/u ,u2a *a.a/ *ila0u0an .ee+i0saan *en2an "RI *en2an
0eun/un2an an/a+a lain /i*a0 a*a +a*iasi- .en2u0u+an .an22ul a0u+a/- .en8i/+aan ,anin
!an2 len20a.. Pee+i0saan ini ,a+an2 *ila0u0an 0a+ena 1ia!a !an2 ahal.
Da+i .el9ie/+i *en2an .en8i/+aan *a.a/ *i/en/u0an ,enis .an22ul- u0u+an
.an2ul !an2 se1ena+n!a- luas 1i*an2 .an22ul- 0a.asi/as .an22ul- se+/a *a!a
a0oo*asi !ai/u 9olue *a+i 1a!i !an2 /e+1esa+ !an2 asih *a.a/ *ilahi+0an s.on/an.
Pa*a 0ehailan !an2 a/e+ *en2an .+esen/asi 0e.ala *a.a/ *ila0u0an
.ee+i0saan *en2an e/o*e Os1o+n *an e/o*e "ulle+ "un+o Ke++. Pa*a e/o*e
Os1o+n- sa/u /an2an ene0an 0e.ala ,anin *a+i a/as 0ea+ah +on22a .an22ul *an /an2an
!an2 lain *ile/a00an .a*a 0e.ala un/u0 enen/u0an a.a0ah 0e.ala enon,ol *i a/as
si;isis a/au /i*a0. "e/o*e "ulle+ "un+o Ke++ *ila0u0an *en2an sa/u /an2an
ee2an2 0e.ala ,anin *an ene0an 0e.ala 0e a+ah +on22a .an22ul- se*an2 *ua ,a+i
/an2an !an2 lain asu0 0e 9a2ina un/u0 enen/u0an se1e+a.a ,auh 0e.ala en2i0u/i
/e0anan /e+se1u/ *an i1u ,a+i !an2 asu0 0e 9a2ina ee+i0sa *a+i lua+ hu1un2an
an/a+a 0e.ala *an si;isis.
3.. Janin *ang /esar
No+al 1e+a/ neona/us .a*a uun!a >###2+a *an ,a+an2 a*a !an2
ele1ihi '###2+a. (e+a/ 1a*an neona/us le1ih *a+i >###2+a *inaa0an 1a!i 1esa+.
F+e0uensi 1e+a/ 1a*an lahi+ le1ih *a+i >###2+a a*alah '-=@- *an 1e+a/ 1a*an lahi+
!an2 elihi >'##2+a a*alah #->@. (iasan!a un/u0 1e+a/ ,anin >###5'### 2+a .a*a
.an22ul no+al /i*a0 /e+*a.a/ 0esuli/an *ala .+oses elahi+0an. Fa8/o+ 0e/u+unan
ee2an2 .e+anan .en/in2 sehin22a *a.a/ /e+,a*i 1a!i 1esa+. Canin 1esa+ 1iasan!a
,u2a *a.a/ *i,u.ai .a*a i1u !an2 en2alai *ia1e/es elli/us- .os/a/u+i/as- *an
.a*a 2+an*e ul/i.a+a. Selain i/u- !an2 *a.a/ en!e1a10an 1a!i 1esa+ a*alah i1u
hail !an2 a0an 1an!a0- hal /e+se1u/ asih *i+a2u0an.
Un/u0 enen/u0an 1esa+n!a ,anin se8a+a 0linis 1u0anlah e+u.a0an sua/u hal
!an2 u*ah. Ka*an250a*an2 1a!i 1esa+ 1a+u *a.a/ 0i/a 0e/ahui a.a1ila selaa .+oses
elahi+0an /i*a0 /e+*a.a/ 0ea,uan saa se0ali .a*a .+oses .e+salinan no+al *an
1iasan!a *ise+/ai oleh 0ea*aan his !an2 /i*a0 0ua/. Un/u0 0asus se.e+/i ini san2a/
*i1u/uh0an .ee+i0saan !an2 /eli/i un/u0 en2e/ahui a.a0ah /e+,a*i se;alo.el9i0
*is.+o.o+si. Selain i/u- .en22unaan ala/ ul/+asoni8 ,u2a *a.a/ en2u0u+ se8a+a /eli/i
a.a1ila /e+*a.a/ 1a!i *en2an /u1uh 1esa+ *an 0e.ala 1esa+.
Pa*a .an22ul no+al- 1iasan!a /i*a0 eni1ul0an /e+,a*in!a 0esuli/an *ala
.+oses elahi+0an ,anin !an2 1e+a/n!a 0u+an2 *a+i >'##2+a. Kesuli/an *ala
.e+salinan 1iasan!a /e+,a*i 0a+ena 0e.ala ,anin 1esa+ a/au 0e.ala 0e+as !an2 1iasan!a
/e+,a*i .a*a .os/a/u+i/as /i*a0 *a.a/ easu0i .in/u a/as .an22ul- a/au 0a+ena 1ahu
!an2 le1a+ suli/ elalui +on22a .an22ul. (ahu !an2 le1a+ selain *a.a/ *i/eu0an .a*a
,anin !an2 eili0i 1e+a/ 1a*an le1ih ,u2a *a.a/ *i,u.ai .a*a anense;alus. Canin
*a.a/ enin22al selaa .+oses .e+salinan *a.a/ /e+,a*i 0a+ena /e+,a*in!a as;i0sia
*i0a+ena0an selaa .+oses 0elahi+an 0e.ala ana0 su*ah lahi+- a0an /e/a.i 0a+ena
le1a+n!a 1ahu en2a0i1a/0an /e+,a*in!a a8e/ *ala elahi+0an 1a2ian ,anin !an2
lain. Se*an20an .ena+i0an 0e.ala ,anin !an2 /e+lalu 0ua/ 0e 1a6ah *a.a/
en2a0i1a/0an /e+,a*in!a 8e*e+a .a*a ne+9us 1+a0hialis *an us0ulus
s/e+no0lei*oas/oi*eus.
=.$. Penatalaksanaan
3.0.1. Persalinan Per(o/aan
Se/elah *ila0u0an .enilaian u0u+an .an22ul se+/a hu1un2an an/a+a 0e.ala
,anin *an .an22ul *a.a/ *i.e+0i+a0an 1ah6a .e+salinan *a.a/ 1e+lan2sun2 .e+ 9a2inan
*en2an selaa/ *a.a/ *ila0u0an .e+salinan .e+8o1aan. Ca+a ini e+u.a0an /es
/e+ha*a. 0e0ua/an his- *a!a a0oo*asi- /e+asu0 oula2e 0a+ena ;a0/o+ /e+se1u/
/i*a0 *a.a+ *i0e/ahui se1elu .e+salinan.
Pe+salinan .e+8o1aan han!a *ila0u0an .a*a le/a0 1ela0an2 0e.ala- /i*a0 1isa
.a*a le/a0 sun2san2- le/a0 *ahi- le/a0 u0a- a/au 0elainan le/a0 lainn!a. Ke/en/uan
lainn!a a*alah uu+ 0eailan /i*a0 1oleh le1ih *a+i >& in22u 0a+ena 0e.ala ,anin
1e+/a1ah 1esa+ sehin22a su0a+ /e+,a*i oula2e *an a*a 0eun20inan *is;un2si
.lasen/a ,anin !an2 a0an en,a*i .en!uli/ .e+salinan .e+8o1aan.
Pa*a ,anin !an2 1esa+ 0esuli/an *ala elahi+0an 1ahu /i*a0 a0an selalu *a.a/
*i*u2a se1elun!a. A.a1ila *ala .+oses 0elahi+an 0e.ala 1a!i su*ah 0elua+
se*an20an *ala elahi+0an 1ahu suli/- se1ai0n!a *ila0u0an e.isio/o! e*ioa/e+al
!an2 8u0u. luas- 0eu*ian hi*un2 *an ulu/ ,anin *i1e+sih0an- 0e.ala *i/a+i0 8u+a
0e1a6ah *en2an ha/i5ha/i *an /en/un!a *en2an 0e0ua/an /e+u0u+. (ila hal /e+se1u/
/i*a0 1e+hasil- *a.a/ *ila0u0an .eu/a+an 1a*an 1a!i *i *ala +on22a .an22ul-
sehin22a en,a*i 1ahu *e.an *iana se1elun!a e+u.a0an 1ahu 1ela0an2 *an lahi+
*i1a6ah si;isis. (ila 8a+a /e+se1u/ asih ,u2a 1elu 1e+hasil- .enolon2
easu00an /an2ann!a 0e*ala 9a2ina- *an 1e+usaha elahi+0an ,anin *en2an
en22e+a00an *iu0a *a*an!a. Un/u0 elahi+0an len2an 0i+i- .enolon2
en22una0an /an2an 0anann!a- *an se1ali0n!a. Keu*ian 1ahu *e.an *i.u/a+ 0e
*iae/e+ i+in2 *a+i .an22ul un/u0 elahi+0an 1ahu *e.an.
Pe+salinan .e+8o1aan a*a *ua a8a !ai/u /+ial o; la1ou+ *an /es/ o; la1ou+.
T+ial o; la1ou+ se+u.a *en2an .e+salinan .e+8o1aan *i a/as- se*an20an /es/ o; la1ou+
se1ena+n!a a*alah ;ase a0hi+ *a+i /+ial o; la1ou+ 0a+ena 1a+u *iulai .a*a .e1u0aan
len20a. *an 1e+a0hi+ & ,a 0eu*ian. Saa/ ini /es/ o; la1ou+ ,a+an2 *i2una0an 0a+ena
1iasan!a .e1u0aan /i*a0 len20a. .a*a .e+salinan *en2an .an2ul se.i/ *an
/e+*a.a/ 0ea/ian ana0 !an2 /in22i .a*a 8a+a ini.
Ke1e+hasilan .e+salinan .e+8o1aan a*alah ana0 *a.a/ lahi+ son/an .e+ 9a2ina
a/au *i1an/u e0s/+a0si *en2an 0ea*aan i1u *an ana0 1ai0. Pe+salinan .e+8o1aan
*ihen/i0an a.a1ila .e1u0aan /i*a0 a/au 0u+an2 se0ali 0ea,uannn!a- 0ea*aan i1u
a/au ana0 0u+an2 1ai0- a*a lin20a+an 1an*l- se/elah .e1u0aan len20a. *an 0e/u1an
.e8ah 0e.ala /i*a0 asu0 PAP *ala & ,a es0i.un his 1ai0- se+/a .a*a ;o+8e.s
!an2 2a2al. Pa*a 0ea*aan ini *ila0u0an se0sio sesa+ea.
3.0.2 Seksio Sesarea
Se0sio sesa+ea ele0/i; *ila0u0an .a*a 0ese.i/an .an22ul 1e+a/ *en2an
0ehailan a/e+- a/au *is.+o.o+si se.halo.el9i0 !an2 n!a/a. Se0sio ,u2a *a.a/
*ila0u0an .a*a 0ese.i/an .an22ul +in2an a.a1ila a*a 0o.li0asi se.e+/i
.+ii2+a9i*a /ua *an 0elainan le/a0 ,anin !an2 /a0 *a.a/ *i.e+1ai0i.
Se0sio sesa+ea se0un*e+ (sesu*ah .e+salinan selaa 1e1e+a.a 6a0/u) *ila0u0an
0a+ena .e+alinan .e+o1aan *ian22a. 2a2al a/au a*a in*i0asi un/u0 en!elesai0an
.e+salinan sele0as un20in se*an20an s!a+a/ .e+salinan .e+ 9a2ina 1elu *i.enuhi.
3.0.3. Sifisiotoi
Tin*a0an ini *ila0u0an *en2an eisah0an .an22ul 0i+i *an 0anan .a*a
si;isis. Tin*a0an ini su*ah /i*a0 *ila0u0an la2i.
3.0., Kraniotoi #an Klei#otoi
K+anio/oi a*alah sua/u /in*a0an !an2 e.e+0e8il u0u+an 0e.ala ,anin
*en2an8a+a elu1an2i /en20o+a0 ,anin *an en2elua+0an isi /en20o+a0- sehin22a
,anin *a.a/*en2an u*ah lahi+ .e+9a2ina.
Se*an20an 0lei*o/oi a*alah /in*a0an !an2 *ila0u0an se/elah ,anin .a*a
.+esen/asi 0e.ala *ilahi+0an- a0an /e/a.i 0esuli/an un/u0 elahi+0an 1ahu 0a+ena
/e+lalu le1a+. Se/elah ,anin enin22al- /i*a0 a*a 0e1e+a/an un/u0 ela0u0an
0lei*o/oi (eo/on2 0la9i0ula) .a*a sa/u a/au 0e*ua 0la9i0ula
(A( III
LAPORAN KASUS
I. I#entitas Pasien
Naa Is/e+i : N!. H
Suai : Tn. S
Uu+ Is/e+i : &$ /h
Suai : 5 /h
Pe0e+,aan Is/e+i : I1u +uah /an22a
Suai : Tani
Pen2hasilan Is/e+i : 5
Suai : Ta0 enen/u
Alaa/ : Ta*un2*uh5(an20alan
No. R" : <#=&<<
II. Ananesa &tanggal 1121222111 ole% D3 4aesal A. S!ans*a%+
Pasien *i0i+i oleh 1i*an 0e IRD Ruah Sa0i/ S!a+a1u (an20alan .a*a
ha+i 0ais #<5<&5&#<< ,a &<.<' 6i1 *en2an 0eluhan aeno+hoe <# 1ulan-
.asien e+asa 0en8en250en8en2 ulai ,a <>.##- 0e/u1an e+e1es se,a0
<in22u !an2 lalu- 0elua+ *a+ah 9a2ina se*i0i/- /in22i 1a*an <>#8.
Kel!%an !taa
Sus.e8/ CPD
5i-a*at Pen*akit Sekarang
Di+asa0an ules 3 0en8en250en8en2
Kelua+ *a+ah *an len*i+ .e+9a2ina
Ke/u1an e+e1es se,a0 < in22u !an2 lalu
Di+asa0an a*an!a 2e+a0an ,anin
5i-a*at Pen*akit Da%!l!
Ti*a0 a*a +i6a!a/ 0elaianan ,an/un2- .a+u- ha/i- 2in,al- D"- hi.e+/ensi
*an 0elainan lain !an2 *a.a/ 1e+.en2a+uh .a*a 0ehailan.
5i-a*at Sosial
Ti*a0 e+o0o0 *an inuan al0ohol
"inu ,au
"inu o1a/ *a+i 1i*an
Hai#
Hai* /e+a0hi+ /an22al &&5#&5&#<<
Pe+0i+aan .e+salinan /an22al &A5<<5&#<<
"ena+8he uu+ <& /h
Si0lus /e+a/u+
Laa : Se*an2
D!seno++hea : Ti*a0
5i-a*at 6/stetrik
)I P#####
Ni0ah < 0ali
III. Stat!s Presens &2171272111+
Kea*aan uu : Cu0u.
Kesa*a+an : Co.os en/is
Tin22i 1a*an I (e+a/ (a*an : <># 8
Vi/al si2n
Tensi : <<#3%# H2 Na*i : ?>B3eni/
RR : <?B3eni/ Suhu : =%-'J C (+e8/al)
Ke.ala
Anei : (5) I0/e+us : (5)
C!anosis : (5) D!.sneu : (5)
Lehe+
T+a0ea *i/en2ah
Ti*a0 a*a 1en,olan a1no+al
Ti*a0 a*a 1en*un2an 9ena
Tho+aB
Sie/+is
Ti*a0 a*a 1en,olan- assa- lu0a 1e0as o.e+asi- *an
1en/u0an a1no+al lainn!a.
Can/un2
S< S& /un22al
"u+u+ (5) 2allo. (5)
Pa+u5.a+u
Sua+a na.as 9esi0ule+
EheeDin2 (535) +on0i (535)
Pa!u*a+a no+al
A1*oen
(isin2 usus $K3eni/
He.a+ /i*a0 /e+a1a *an /i*a0 n!e+i /e0an
Lien /i*a0 /e+a1a *an /i*a0 n!e+i /e0an
)in,al /i*a0 /e+a1a *an /i*a0 n!e+i /e0an
)eni/alia e0s/e+na : oe*e 9ul9a (5)
E0s/+ei/as
A0+al han2a/ oe*e
L L 55 55
L L 55 55
Re;leB ;isiolo2is (L)
Re;leB .a/olo2is (5)
IV. Stat!s 6/sterik!s
"u0a
Chloasa 2+a9i*a+u (5)
EBo.h/halus (5)
Lehe+
S/+ua (5)
Tho+aB
"aae : "e1esa+ *an Te2an2
A1*oen
Ins.e0si : Pe+u/ e1esa+ 0e*e.an- sie/+is
Pal.asi :
Leo.ol* I : Tin22i ;un*us u/e+i & ,a+i 1a6ah .+o8essus
B!.hoi*eus (=A8)
Leo.ol* II : Le/a0 .un22un2 0anan
Leo.ol* III : (a2ian /e+1a6ah ,anin Ke.ala- Ke.ala 1elu
asu0 .in/u a/as .an22ul
Leo.ol* IV : 0e.ala 1elu asu0 PAP
Pe+0usi : /!.ani
e/eo+isus (5)
Aus0ul/asi : Den!u/ ,an/un2 ,anin (L) (<=5<>5<>)
Pee+i0saan *ala
Pe1u0aan =,a+i
Ke/u1an (5)
V. La/oratori!
H1 : A-> 2 @ (/alMuis/)
VI. Diagnosa
)I P##### A3T3H CPD- PSR in.a+/u 0ala I ;ase la/en
8II. Tera$i
P+insi. .ena/ala0sanaan CPD .a*a .an22ul se.i/ +in2an a*alah /+ial o; la1o+
(.e+8o1aan .e+salinan). Hal ini 1e+*asa+0an 1ah6a selaa .+oses .e+salinan
/e+,a*i .e+i.i/an (oul2e) /ulan2 0e.ala ,anin- e+e2an2n!a hu1un2an
/ulan2 .an22ul *an *o+on2an his a*e0ua/ !an2 /e+us ene+us sehin22a
en2a0i1a/0an u0u+an 0e.ala le1ih en2e8il se*an2 u0u+an .an22ul se*i0i/
le1ih luas. Dan *a+i hasil o1se+9asi *a+i ,a &<.=# sa.ai ,a #'.## /en!a/a
/e+,a*i .+o/e8/ion *iso+se+ (.e+.an,an2an ;ase a0/i; *an .enu+unan 0e.ala)
sehin22a .a*a 0ehailan ha+us *i /e+inasi *en2an se8/io 8aesa+ea in*i0asi
CPD.
Pe+sia.an I1u :
Pen*e+i/a *i1e+i a0anan !an2 u*ah *i8e+na .a*a ala se1elu
o.e+asi
Puasa se0i/a+ $ ,a se1elu o.e+asi
Pasan2 in;us RL Flas I
Pasan2 Daue+ 8a/e/e+
La0u0an s8e+en/

La.o+an O.e+asi Se8/io Caesa+ia :

<. An/ise./i8 la.an2an o.e+asi *en2an 1e/a*ine <# @ *an
*i.e+se.i/ *en2an *u0 s/e+il
&. Insisi 0uli/ .e+u/ *an su10u/is lo6 i*line .a*a 1e0as lu0a
o.e+asi
=. Sa!a/an 0e8il .a*a ;asia us8ulus +e8/i a1*ois *an *en2an
1an/uan .inse/ ana/ois lalu ;as8ia *i2un/in2 0e1a6ah *an 0ea/as
>. ". Re8/i a1*ois *i 0ua00an se8a+a /u.ul 0e la/e+al
sehin22a .e+i/oneu 1e1as
'. Pe+i/oneu .a+ie/alis *i,e.i/ *en2an .inse/ ana/ois- *ian20a/-
*i2un/in2 0ea/as *an 1a6ah- .in22i+5.in22i+n!a *i 0le (.e+i/oneal
0le)
$. E0s.lo+asi :
U/e+us se1esa+ a/e+
A*ne0sa 0anan 0i+i no+al
Te+a.i LSCS (Lo6e+ Se2en/ Caesa+ean Se8/ion) :
Insisi se2en 1a6ah +ahi elin/an2 (/+ans9e+sal) N <# 8
1e+1en/u0 0on0a; sa.ai en*oe/+iu. En*oe/+iu *i/e1us
se8a+a /u.ul *en2an ,a+i.
Canin *ilahi+0an *en2an elu0si+ 0e.ala
A.2a+ S8o+e ?5A 3 ,enis 0elain la0i5la0i 3 1e+a/ &$## 2 3 .an,an2 >A
8
Ke/u1an ,e+nih
Plasen/a *i ;un*us len20a.- *ilahi+0an se8a+a anual
%. Se2en 1a6ah +ahi *i,ahi/ se8a+a ,elu,u+ ;es/oon *en2an
1enan2 8+oiB no.&.
?. Ca9u a1*oen *i/u/u. lan2sun2- *i,ahi/ la.is *ei la.is.
5 Fas8ia .+e8/i a1*oinis *i,ahi/ se8a+a ,elu,u+ ;es/on *en2an 1enan2
sa;il no.<
5 Kuli/ *i,ahi/ sa/u5sa/u si*e.
Dia2nosa P+e O.e+asi (DPO) : )I P##### A3T3H /+ial o; la1o+ 2a2al CPD- PSR in.a+/u
0ala I ;ase a0/i;
Dia2nosa Du+an/e O.e+asi (DDO) : )I P##### A3T3H /+ial o; la1o+ 2a2al CPD- PSR
Te+a.i : LSCS (Lo6e+ Se2en/ Caesa+ea Se8/ion)
Te+a.i Pos/ O.e+asi :
In;us RL I D' &:&
Ce;o/aBie =B< 9ial
D+i. in*uBin < a. sa.ai *en2an &> ,a
Vi/ain (< =B< a.
KalneB =B< a.
Pos.a+2in =B< a.


(A( IV
PE"(AHASAN
(e+*asa+0an u+aian la.o+an 0asus .a*a 1a1 se1elun!a- 1e+i0u/ a0an *i1ahas
*ia2nosis *an .enan2anan 0asus ini. N!.H usia &$ /ahun *en2an 0ehailan >#
in22u *i*a.a/0an *a/a HPHT & 5&5 &#<< .e+0i+aan ha+i .e+salinan &A5<<5
&#<<. Da+i ananesis *i*a.a/0an .asien *a/an2 *en2an 0eluhan aeno+e
<# 1ulan- ules5ules ulai ,a <>.##- .en*a+ahan .e+9a2ina .osi/i;- *an
0e/u1an e+e1es se,a0 < in22u !an2 lalu- Pasien e n 2 a 0 u / i * a 0
e i l i 0 i + i 6a ! a / s a 0 i / . a n 2 2 u l - a u . u n 8 e * e + a . a n 2 2 u l .
Da + i .ee+i0saan lua+ o1s/e/+i *i*a.a/0an ,anin /un22al a/e+ hi*u..
Ke.ala ,anin 1elu easu0i .in/u a/as .an22ul. Da+i .ee+i0saan
.el9ie/+i 0linis *i*a.a/0an L O n e a i n n o i n a / a / e + a 1 a s e l u + u h n ! a -
n o + a l l O n e a i n n o i n a / a / e + a 1 a < 3 = 5 < 3 = - e.e+0ua/ *u2aan
a*an!a .en!e.i/an /+ans9e+sal .in/u a/as .an22ul.
Da+i +uus Cohnson5Tosha80 *i*a.a/0an /a0si+an 1e+a/ ,anin &>?# 2+.
sehin22a *a.a/ *isin20i+0an a*an!a a0+osoia. Pa*a .asien ini *ila0u0an
.a+/us .e+ 8o1aan naun 2a2al - !an2 s ea0i n en2ua/ 0an *u2aan
0e a+ ah *i s .+ o.o+ s i se;alo.el9i0. Pasien en,alani se0sio 8aesa+ia
se/elah .a+/us .e+8o1aan 2a2al- *an *i*a.a/0an 1a!i la0i5la0i *en2an 1e+a/ lahi+
&$## 2+. Pa*a .asien *i1e+i0an /e+a.i !ai/u an/i1io/i0 un/u0 en2hin*a+i
in;e0si !an2 e+ u.a0an 0o.l i 0as i o.e+ as i - anal 2e/ i 0 un/ u0
en2hi l an20an + as a s a0i / - e/ h!l e+ 2oe/ + i n un/ u0 u/ e+ o/ oni 0a.
(A( IV
KESI"PULAN
<. Ce.halo.el9i8 Dis.+o.o+/ion (CPD) a*alah *ia2nosa e*is !an2 *i2una0an
0e/i0a 0e.ala 1a!i *in!a/a0an /e+lalu 1esa+ un/u0 ua/ ele6a/i .an22ul i1u.
Dis.+o.o+/ion se;alo.el9i8 a*alah 0ea*aan !an2 en22a1a+0an
0e/i*a0sesuaian an/a+a 0e.ala ,anin *an .an22ul i1u sehin22a ,anin /i*a0 *a.a/
0elua+ elalui 9a2ina. Dis.+o.o+si se;alo.el9i8 *ise1a10an oleh .an22ul
se.i/- ,anin !an2 1esa+ a/au.un 0o1inasi 0e*uan!a.3
&. Pa*a i1u ini *i+asa0an ules 3 0en8en250en8en2 se,a0 ,a <>.##- 0elua+ *a+ah
.e+9a2ina- 0e/u1an e+e1es se,a0 <in22u !an2 lalu. Se*an20an *a+i
.ee+i0saan *ala a*a .e1u0aan se+9i0s =8. Sehin22a *a.a/ *i0a/a0an i1u
ini in.a+/u.
=. Dia2nosa a0hi+ )I P##### A3T3H *en2an CPD- PSR.
>. Ka+ena /+ial a; la1ou+ 2a2al- a0a /e+inasi 0ehailan *ila0u0an *en2an
se0sio 8esa+ea.
DA4TA5 PUSTAKA
Sai;u**in A(. Ilu Ke1i*anan Sa+6ono P+a6i+oha+*,o. E*isi Kee.a/. Ca0a+/a: (P5
SP- &##?.
Cunnin2ha F)- )an/ FN- Le9eno KC- *00. O1s/e/+i Eillias. E*isi &<. Ca0a+/a:
E)C- &##'.
Ein0,osas/+o H. Ilu Ke1i*anan. E*isi Ke/i2a. Ca0a+/a: 4(P5SP- &##%.
(a2ian O1s/e/+i I )ine0olo2i Fa0ul/as Ke*o0/e+an Uni9e+si/as Pa*,a*,a+an (an*un2.
O1s/e/+i Fisiolo2i. (an*un2: Eleen- <A?=.
Sa+i Ea+*ani "P- In*i0asi O.e+asi Caesa+ Pa*a Pasien Den2an Dis.+o.o+si Ke.ala
Pan22u-h//.:33666.;0u!e8ase.ne/36i0i3in*eB..h.P
.a2eGin*i0asiLo.e+asiL8aesa+L.a*aL.asienL*en2anL*is.+o.o+siL0e.alaL.an22ulIh
i2hli2h/Gsea+8h- && o; Se.- &#<# Q#=:#% UTCR
P1l &' Dis/osia E/ Causa C.* Pa/a- h//.:33666.s8+i1*.8o3*o83'A?'$<&>3P1l5&'5
Dis/osia5E/5Causa5CPD5Pa/a
P+esus C.* Ruu- h//.:33666.s8+i1*.8o3*o83%'%#<=<A3PRESUS5CPD5RUU