II.

OBSTETRICS INPATIENT’S REPORTS

Sunday, April 5th 2015 until Wednesday, June 8th , 2015

Physiological Patients : - cases

Pathological Patients : - cases
Total : - cases

Chief Obstetrics Inpatient

dr. Erliyanna Tolu Saputri : - cases
dr. Lydia Octavia : - cases

Gestosis : 7 cases
PROM : 1 cases
Post partum haemorrhage : 3 cases
Antepartum haemorrhage : 1 cases
Prior CS : 2 cases
Others : 4 cases
TOTAL : 18 cases

No Initial Age Diagnosis Treatment Physician

Severe Preeclampsia LSCS
1. IRM 32 TAG
( O14.1+ N 750) (669.7)
Severe Preeclampsia Spontaneous delivery
2. RAN 16 MRZ
( O14.1) (80.0)
Severe Preeclampsia + partial LSCS + Pomeroy Tubectomy
3. MAL 40 HELLP syndrome AR-TAG
(669.7)
( O14.2)
Severe Preeclampsia + partial Spontaneous delivery
4. ELL 36 HELLP syndrome RIS
(80.0)
(O14.1)
Severe Preeclampsia Spontaneous delivery
5. END 35 RIS
( O14.1) (80.0)
Severe Preeclampsia + partial LSCS
6. NUR 33 HELLP syndrome TAG
(669.7)
( O14.1)
Severe preeclampsia + PROM LSCS
7. WIN 34 WHY
(O14.1+ O42.9) (669.7)
PROM + prior CS LSCS
8. TIN 31 IVS
( O42.9) (669.7)
Ante Partum Hemorrhage LSCS+ Pomeroy tubectomy
9. KAM 40 ALT
( O46.9) (669.7)
 Post Partum Hemorrhage
10. MAR 33 Brandt Andrew’s manouvre CSA
( O44.1)
Post Partum Hemorrhage
11. NUR 35 Brandt Andrew’s manouvre LEL
( O44.1)
Post Partum Hemorrhage Curretage
12. DAR 35 IDA
( O44.1) (69.52)
Preterm Spontaneous delivery
13. NUR 31 NRM
(P07.32) (80.0)
Prior CS Spontaneous delivery
14. LIL 28 NRM
(654.20) (80.0)
Prior CS Spontaneous delivery
15. DIA 27 ULI
(654.20) (80.0)
Prolong 2nd stage Forceps extraction
16. JAY 26 FOR
(O63.1) (669.51)
Uterine inertia LSCS
17 MEG 28 ADS-HI
(O62.1) (669.7)
Malposition LSCS+ Pomeroy tubectomy
18 JUM 46 WNI
(652.83) (669.7)

MATERNAL MORTALITY
No. Initial Age Diagnosis Treatment Physician
- - - - - -

dr.
1 05-04-15 Conservative Management
8:51 AM Mrs.LUS/19/UA/VIL/xxx
05-04-15 D/ G1P0A0 34 weeks of gestational age not inlabour with antepartum haemorrhage
07:00 AM c.b total placentae previa, SLF cephalic presentation
Hb: 9 g/dl M/ Expectative management
WBC : 13.100 /mm3 Vital sign observation
PLT : 403.000 /mm3
IVFD RL gtt xx/mnt
Ceftriaxone 1 g/12 hours IV
Nifedipine 10 mg/ 6 hours p.o
Dexamethasone 6mg /12 hours IV
US confirmation
US confirmation (NS):
C/ 34 weeks gestational age SLF cephalic presentation with total placentae previa+
BPP 10
xx-04-15 D/ G1P0A0 34 weeks of gestational age not inlabour with antepartum haemorrhage
07:00 AM c.b total placentae previa, SLF cephalic presentation
Hb: 9 g/dl M/ Expectative management
WBC : 13.100 /mm3 Vital sign observation
PLT : 403.000 /mm3
 IVFD RL gtt xx/mnt
Ceftriaxone 1 g/12 hours IV
Nifedipine 10 mg/ 6 hours p.o
Dexamethasone 6mg /12 hours IV
Mother were in good condition

2. 05-04-15 Vacum Extraction due to prolonged 2nd stage (outside) + PROM 20 hours
04:00 PM Mrs.DIA/25/RA/VIL/xxx
D/ G1P0A0 39 weeks of gestational age inlabour 2nd stage with PROM 20 hours SLF
cephalic presentation
15-04-15 D/ P1A0 post vacum extraction due to prolonged 2nd stage (outside) + PROM 20
06:00 PM hours
Female live baby, BW 3000 g, BL 51 cm, AS 8/9 FTAGA
M/ Vital signs observation
Hb: 13,9 g/dl Cefadroxyl 500mg/ 12 hours
WBC: 24.500 mm3
Plt: 258.000 mm3
Mefenamic acid 500mg/8 hours
CRP qualitative (+)

Mother and baby were in good condition

3 06-04-15 Conservative Management

06:27 AM Mrs.LIN/22/UA/VIL/xxx
06-04-15 D/ G1P0A0 35 weeks of gestational age not inlabour with PROM 2 hours, SLF
06:27 AM cephalic presentation

Hb: 10,9 g/dl M/ Expectative management

Wbc : 11.300 /mm3 Vital sign observation
Plt: 227.000 mm3
CRP qualitative (-)
IVFD RL gtt xx/mnt
Ceftriaxone 1 g/12 hours IV
Nifedipine 10 mg/ 6 hours p.o
Dexamethasone 6mg /12 hours IV
US confirmation
06-04-15 US confirmation (NS):
10:30 AM C/ 36 weeks gestational age SLF cephalic presentation with oligohidramnios+ BPP 8

4. 06-04-2015 Brandt Andrew Manuvre

Mrs.NEL/32/RA/ASR/COR
04:08 AM D/ P3A0 post Brandt Andrew (1/2 hour outside) with incarcerated placentae
2. 10-06-2014 LSCS due to maternal distress + Pomeroy tubectomy
Mrs.MAL/40/RA/AR-TAG/ZLI
08:00 PM D/ G4P3A0 34 weeks gestational age not inlabor with severe preeclampsia +
GI : 5 partial HELLP syndrome + decompensatio cordis FC NYHA IV SLF
BS: 3 cephalic Presentation
LDH : 1068 U/l
US ER (EST) :
- SLF cephalic presentation
- Fetal biometry :
BPD : 90,4 mm FL : 65,3 mm
HC : 304 mm EFW : 2320 g
AC : 298 mm
- Placenta at posterior corpus of uterine
- Amniotic fluid was enough, SP : 2.5 cm
C/ 37 weeks gestational age SLF cephalic presentation
M/ Stabilisation 3 hours
Methyldopa 250 mg/ 8 hours
Laboratory examination
Consult to Internal Medicine, Opthalmology, Anesthesiology Departments and
ICU
Evaluation with gestosis task
P/ Abdominal delivery
Consult to consultant on duty (dr.H.Azhari, SpOG(K)) :
Agreed to perform abdominal delivery after optimalization
Internal Medicine Department:
C/ - CHF c.b PPHD
- Hypertension stage 2
- Severe preeclampsia
S/ - bed rest
- O2 6 l/m
- digoxine 0.25 mg/24 hours
 - methyldopa 250 mg/12 hours
- join care with Cardiology Division of Internal Medicine Department
02:00 AM Male live baby was born, BW : 2400 g, BL: 46 cm, AS 8/9 PT AGA
02:05 AM Placenta was delivered completely, PW: 400 g, UCL: 47 cm, Ø 16 x 17 cm