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Disturbed EctopicDisturbed Ectopic
PregnancyPregnancy
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Case ReportCase Report
IdenIdentity:tity: NNameame :: Ni Nyoman SriNi Nyoman Sri
AgeAge :: 30 years old30 years old
EducationEducation :: primary schoolprimary school
ccupationccupation : house!i"e: house!i"e
ReligionReligion : #indu: #indu
RaceRace : $ali: $ali AAddressddress ::%embua&' Narmada%embua&' Narmada
(RS(RS : ): )**+0,+)0+0,+)0-0-0
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AnamnesisAnamnesis
Keluhan utama:Keluhan utama: Patient con"ess lo!er abdominal painPatient con"ess lo!er abdominal painRiwayat penyakit sekarang:Riwayat penyakit sekarang:
Patient referred from Narmada PHC with hypovolemic
shock et causa suspect Abortus infectious. Chronologist: Patient came to Narmada PHC at 8 p.m !"#$%#!$&$'confess vaginal bleeding since three days ago withvolume &$ ( &) cc with descend conciousness* late
menstrual periode for ! months.
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+,amination at Narmada PHC:
-eneral condition : well
Conciousness : somnolen
ital sign : /P 0$ mmHg palpation
P1 &!$ , # minutes* weak pulse
11 !8 , # minutes
2a, 3%*) $CHead 4 neck : eye anemi 5#5 * icterus 5#5
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2hora, : 6Cor : 7&7! 7ingle# reguler#mur5mur 5 *
gallop 5
6Pulmo: ves #* wh9 5#5* rh5#5Abdomen : distention 5'
+,tremity : cold
2 : C & cm* unpalpable tissue* bad smell* active
bleeding* yellowish secret.
PP test :
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Menstrual historyMenstrual history:: menstrual cycle usuallymenstrual cycle usually).).daysdays"or"orl /+,l /+, dayddayd%(P%(P::0310/1)0-00310/1)0-0
Family planning historyFamily planning history :: ne2erne2er Obstetric historyObstetric history ::
1. Abortus, 3 month, 1, years ago1. Abortus, 3 month, 1, years ago
!. this!. this "arlier history #isease"arlier history #isease:: D( +4' asthma +4' #5 +4'D( +4' asthma +4' #5 +4'
miocard in"ar& +4' hepatitis +4miocard in"ar& +4' hepatitis +4
Family history #iseaseFamily history #isease:: +4+4 Riwayat alergiRiwayat alergi :: +4+4
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Physical E6aminationPhysical E6amination
-eneral status : wellConciousness : +" ) ;0
/P : &&$#%$ mmHg
P1 : &$$, #00 mg 3 6 -4Asam (e"enamat >00 mg 3 6 -4
;itamin $ omple&s - 6 -;itamin $ omple&s - 6 -
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(/
5D: =01>0 mm#g5D: =01>0 mm#g
N: --0 61menitN: --0 61menit
RR : ). 61menitRR : ). 61menit
5a6 : 3/'> C5a6 : 3/'> C
(ata : anemis @1@4(ata : anemis @1@4
Cor1Pulmo : dalam batasCor1Pulmo : dalam batas
normalnormalE6tr: hangat' pucatE6tr: hangat' pucat
Post %aparotomi Post %aparotomi
Salnge&tomiSalnge&tomi
de6tra@syo&de6tra@syo&
ter&ompensater&ompensassii
o bser2asi esra lbuo bser2asi esra lbu
o bser2asio bser2asi
perdarahanperdarahan
o bser2asi tandao bser2asi tanda
2ital2ital
o R% )* tts1mnto R% )* tts1mnt
Amo6icillin >00 mgAmo6icillin >00 mg
3 6 -3 6 -
o Chec& laboratoriumo Chec& laboratoriumD% #$sAgD% #$sAg
-030-030 PasienPasien
mengeluhmengeluh
lemaslemas
B: %emahB: %emah
esadaran : E*;>(/esadaran : E*;>(/
5D: -001/0 mm#g5D: -001/0 mm#g
N: --0 61menitN: --0 61menit
RR : )> 61menitRR : )> 61menit
5a6 : 3/'> C5a6 : 3/'> C
(ata : anemis(ata : anemisCor1Pulmo : dalam batasCor1Pulmo : dalam batas
normalnormal
E6tr: hangat' pucatE6tr: hangat' pucat
#asil lab:#asil lab:
#b: ,'= g8#b: ,'= g8
%eu: -0=00 1mm3%eu: -0=00 1mm3
Plt: -,*000 1mm3Plt: -,*000 1mm3
#ct : )0'38#ct : )0'38
Post %aparotomi Post %aparotomi
Salnge&tomi de6traSalnge&tomi de6tra
%apor super2isor'%apor super2isor'
usul untu&usul untu&
trans"use darahtrans"use darah
Dimulai' ad2ice :Dimulai' ad2ice :
belum perlubelum perlu
tran"usi lan7ut&antran"usi lan7ut&an
in"use R% loadingin"use R% loadingdan pantau 2italdan pantau 2ital
sign dan rhon&isign dan rhon&i
halus basalhalus basal
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!a&tu!a&tu Sub7ectSub7ect b7ectb7ect AssessmentAssessment PlanningPlanning
--00--00 B: %emahB: %emah
esadaran : E*;>(/esadaran : E*;>(/
5D: -001/0 mm#g5D: -001/0 mm#g
N: -00 61menitN: -00 61menit
RR : )) 61menitRR : )) 61menit
5a6 : 3/', C5a6 : 3/', C
(ata : anemis(ata : anemis
Cor1Pulmo : dalamCor1Pulmo : dalam
batasbatas
normalnormal
E6tr: hangat' pucatE6tr: hangat' pucat
Post %aparotomi @Post %aparotomi @
Salnge&tomiSalnge&tomi
de6trade6tra
bser2asi ;italbser2asi ;ital
SignSign
--30--30 Pasien merasaPasien merasa
&ondisinya&ondisinya
lebih bai&lebih bai&
B: SedangB: Sedang
esadaran : E*;>(/esadaran : E*;>(/
5D: -001,0 mm#g5D: -001,0 mm#g
N: -00N: -00 ()menit()menit
RR :RR : )0 61menit)0 61menit
5a6 : 3/', C5a6 : 3/', C
Post %aparotomi *Post %aparotomi *
Salnge&tomiSalnge&tomi
de6trade6tra
bser2asi esrabser2asi esra
IbuIbu
bser2asibser2asi
perdarahanperdarahan
Obser*asi tan#aObser*asi tan#a
*ital*ital
Chec&Chec&
laboratoriumlaboratorium
D%: #b beso& pagiD%: #b beso& pagi
) 0 )00=
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)-+0,+)00=)-+0,+)00=
!a&tu!a&tu Sub7ectSub7ect b7ectb7ect AssessmentAssessment PlanningPlanning
0,000,00 Pasien dalamPasien dalam
&ondisi bai&&ondisi bai&
B: bai&B: bai&
esadaran : E3;*(>esadaran : E3;*(>
5D: --01,0'5D: --01,0'
N: -00 61mtN: -00 61mt
RR : )0 61menitRR : )0 61menit
(ata: anemis @1@4(ata: anemis @1@4Cor1Pulmo : dalam batasCor1Pulmo : dalam batas
normalnormal
E6tr: hangat'@1@4E6tr: hangat'@1@4
%ochia rubra : @%ochia rubra : @
#asil %ab:#asil %ab:
Post %aparotomi hariPost %aparotomi hari
-- Salnge&tomiSalnge&tomi
de6trade6tra
A bser2asi esra IbuA bser2asi esra Ibu
bser2asibser2asi
perdarahanperdarahan
bser2asi tanda 2italbser2asi tanda 2ital
As (e"enamat 3 6 -As (e"enamat 3 6 -
>00 g>00 gS< -6IS< -6I
;it $;it $
An7ur&an ma&an danAn7ur&an ma&an dan
minumminum
-000-000 Pasien dalamPasien dalam
&ondisi bai&&ondisi bai&
B: bai&B: bai&
esadaran : E3;*(>esadaran : E3;*(>
5D: --01,0' N: =. 61mt5D: --01,0' N: =. 61mtRR : )0 61menitRR : )0 61menit
(ata: anemis @1@4(ata: anemis @1@4
Cor1Pulmo : dalam batasCor1Pulmo : dalam batas
normalnormal
E6tr: hangat'@1@4E6tr: hangat'@1@4
%ochia rubra : @%ochia rubra : @
Post %aparotomi hariPost %aparotomi hari
--Salnge&tomiSalnge&tomi
de6trade6tra
bser2asi esra Ibubser2asi esra Ibu
bser2asibser2asi
perdarahanperdarahanbser2asi tanda 2italbser2asi tanda 2ital
An7ur&an ma&an danAn7ur&an ma&an dan
minum' mobilisasiminum' mobilisasi
bertahapbertahap
-*00-*00 Ibu tida& adaIbu tida& ada
&eluhan&eluhan
B: %emahB: %emah
esadaran : E3;*(>esadaran : E3;*(>
5D: --01,0' N: =* 61mt5D: --01,0' N: =* 61mt
RR : )* 61menitRR : )* 61menit
(ata: anemis @1@4(ata: anemis @1@4
Cor1Pulmo :Cor1Pulmo : #alam batas#alam batas
normalnormal
E6tr: hangat' pucatE6tr: hangat' pucat
@1@'@1@4@1@'@1@4
%ochia rubra : @%ochia rubra : @
Post %aparotomiPost %aparotomi
Salnge&tomiSalnge&tomi
de6trade6tra
bser2asi esra Ibubser2asi esra Ibu
bser2asibser2asi
perdarahanperdarahan
bser2asi tanda 2italbser2asi tanda 2ital
In7e&si ampicillin -In7e&si ampicillin -
g1. 7amg1. 7am
As (e"enamat 3 6 -As (e"enamat 3 6 -
>00 g>00 g
An7ur&an ma&an danAn7ur&an ma&an dan
minumminum
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))+0,+))+0,+
)00=)00=
!a&tu!a&tu Sub7ectSub7ect b7ectb7ect AssessmentAssessment PlanningPlanning
0,000,00 Ibu tida& adaIbu tida& ada
&eluhan&eluhan
B: $ai&B: $ai&
esadaran : E*;>(/esadaran : E*;>(/
5D: --01,0' N: .. 61mt5D: --01,0' N: .. 61mtRR : )0 61menitRR : )0 61menit
(ata: anemis +1+4(ata: anemis +1+4
Cor1Pulmo : dalam batasCor1Pulmo : dalam batas
normalnormal
E6tr: hangatE6tr: hangat
%ochia rubra: @%ochia rubra: @
Post %aparotomi hariPost %aparotomi hari
&e+) @&e+) @
Salngelctomi de6traSalngelctomi de6tra
bser2asi esra Ibubser2asi esra Ibu
bser2asibser2asi
perdarahanperdarahanbser2asi tandabser2asi tanda2ital2ital
As (e"enamat 3 6 -As (e"enamat 3 6 -
>00 g>00 g
S(/esadaran: E*;>(/
5D: --01,0' N: .* 61mt5D: --01,0' N: .* 61mt
RR : )0 61menitRR : )0 61menit
(ata: anemis +1+4(ata: anemis +1+4
Cor1Pulmo : dalam batasCor1Pulmo : dalam batas
normalnormal
E6tr: hangat @1@4E6tr: hangat @1@4
%ochia rubra : @%ochia rubra : @
Post %aparotomi hariPost %aparotomi hari&e+)&e+)
Salnge&tomi de6traSalnge&tomi de6tra
bser2asi esra Ibubser2asi esra Ibubser2asibser2asiperdarahanperdarahan
bser2asi tandabser2asi tanda2ital2ital
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)3+0,+)00=)3+0,+)00=
9a&tu9a&tu Sub7ectSub7ect b7ectb7ect AssessmentAssessment PlanningPlanning
$%.$$$%.$$ Ibu tida& ada&eluhan
B: $ai&B: $ai&
esadaran: E*;>(/esadaran: E*;>(/
5D: -)01.0' N: .* 61mt5D: -)01.0' N: .* 61mt
RR : )0 61menitRR : )0 61menit
(ata: anemis +1+4(ata: anemis +1+4
Cor1Pulmo : dalamCor1Pulmo : dalambatasbatas
normalnormal
E6tr: hangat @1@4E6tr: hangat @1@4
%ochia rubra : @%ochia rubra : @
Post %aparotomiPost %aparotomi
harihari
&e+3&e+3
Salnge&tomiSalnge&tomide6trade6tra
As (e"enamat 3As (e"enamat 3
6 -6 -
>00 g>00 g
S
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PE($A#ASANPE($A#ASAN
AnamnesisAnamnesis
Pemeri&saan
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SEIANSEIAN
9ASSA%A(9ASSA%A(