Date post: | 06-Jul-2018 |
Category: |
Documents |
Upload: | safrilia-gandhi |
View: | 220 times |
Download: | 0 times |
of 33
8/17/2019 Usia kehamilan aterm post term
1/33
USIA KEHAMILAN
SAFRILIA GANDHI M
1310211081
8/17/2019 Usia kehamilan aterm post term
2/33
Menentukan usiakehamilan sana
!entin untukmem!e"ki"akantaksi"an
!e"salinan
#u$uan
8/17/2019 Usia kehamilan aterm post term
3/33
USIA KEHAMILAN
Usia kehamilan %a!at %itentukan %enan&
1' #anal hai% te"akhi"
2' Ge"akan $anin !e"tama 18 ( 20 minu !a%a!"imi"a)i%a* 1+ minu !a%a multi"a)i%a
3' #e"%ena" %en,ut $antun !e"tama-10.12 m/' #ini un%us ute"i
' USG
8/17/2019 Usia kehamilan aterm post term
4/33
#INGGI FUNDUS U#ERI
8/17/2019 Usia kehamilan aterm post term
5/33
UL#RASNGRAFI -USG/
8/17/2019 Usia kehamilan aterm post term
6/33
Usiakehamil
an
4"ete"m
5 36minu
Ate"m
36 ( 2minu
47stte"m
2minu
8/17/2019 Usia kehamilan aterm post term
7/33
4RE#ERM
8/17/2019 Usia kehamilan aterm post term
8/33
DEFINISI
• Dise9ut $ua !"ematu"e
• :a,i ,an lahi" !a%a usia kehamilan 36 minu atau k
-;H/
• 4"ematu" lan$ut 3 ( 3+ minu
• Am9an )ia9ilitas 22 ( 2 minu
8/17/2019 Usia kehamilan aterm post term
9/33
E4IDEMILGI
• 30 ( 3 < te"in%ikasi*
8/17/2019 Usia kehamilan aterm post term
10/33
Eti7l7i
4elahi"an atasin%ikasi me%is i9u =
$anin sehina!e"salinan %iin%uksi = S>
30 ( 3 <
!"eeklamsia* %ist"ess $a!lasenta* ke?il masa k
!e"%a"ahan tan!a se9a9*
is7imunisasi R4e"salinan ku"an9ulan s!7ntan takte"$elaskan %enan
sela!ut ketu9anutuh
0 ( <
;ith%"a@l !"7este"7ne !"7stalan%in* inisiasi 7ks
inamasi %esi%u
Ketu9ah !e?ah %ini!"ete"m -44RM/
i%i7!atik
30 ( 3 <
Ineksi int"aamni7n* s7s.e"en%ah* k" iBi* "7k7k* R4D
Kelahi"an multi$anin
8/17/2019 Usia kehamilan aterm post term
11/33
FAK#R RISIK
•Me"7k7k* !eninkatan :: i9u t%k a%ekuat* !en na"k79a
Ga,a hi%u!
Akti)itas 9e"at saat kehamilan
Fakt7" enetik
• Kulit hitam * status s7s.ek "en%ah
Kesen$anan "as %an etnik
• Rentan anta" kehamilan 5189l=C9l
Inte")al anta"a kehamilan
• Akt) sist imun sit7kin 4G meninkat•U"e7!lasma u"eal,ti?um %an M,?7!lasma h7m7nis
Ineksi
8/17/2019 Usia kehamilan aterm post term
12/33
4ERMASALAHAN 4ADA 4ERSALINAN4RE#ERM
Jangka Pendek Jangka Panjang
1' Kematian ne7nates2' Res!i"at7", Dist"ess S,n%"7me3' 4e"%a"ahan int"a=!e"i)ent"ikule"' Ne?"7t7Bin Ente"7 >ilitis' Dis!lasi 9"7n?7.!ulm7na"
+' Se!sis6' 4aten %uktus a"te"i7sus
Kelaianan neu"7l7i?• Se"e9al !alsi• Retin7!ati• Ketulian• Reta"%asi mental
• Disunsi neu"79eha)i7"
8/17/2019 Usia kehamilan aterm post term
13/33
DIAGNSIS
• Ge$ala
K7nt"aksi t%k te"atu"* t%k "itmik %an n,e"i a%a=t%k "an?u
Hi?ks
Ge$ala !enekanan !anul* k"am* ?i"an )aina en?e"* n,e"i
9lk kelahi"an akan %an se%an 9e"lansun
• 4e"u9ahan se")i
Dilatasi se")iks asim!stlh !e"tenahan kehamilan FR
ku"an 9ln
4an$an se")iks & "ata2 3 mm !% 2 m
8/17/2019 Usia kehamilan aterm post term
14/33
DIAGNSIS
• Fi9"7nektin $anin
Glik7!"7tein ,an ikut 9e"!e"an %alam a%hesi inte"selula
im!lantasi %an !emeliha"aan a%hesi !lasenta !a%a %esi%ua
Ka%a" %i %a"ah i9u %an amni7n
Deteksi !% sek"et se")ik7)ainal
% ! enB,mimmun7s7"9ent assa, & !7siti 9ila 0n=ml
8/17/2019 Usia kehamilan aterm post term
15/33
#A#A LAKSANA
1' #7k7lisis
Di9e"ikan untuk &
• Men?eah m7"talitas %an m79i%itas !a%a 9a,i !"ematu"e
• Mem9e"ikan kesem!atan !a%a k7"tik7ste"7i%
• Mem9e" kesem!atan t"anse" int"aute"ine
• !timalisasi !e"s7nel
9at 79atan
• Kalsium anta7nis & Nie%i!in
• 9at .mimetik & te"9utalin* "it"7%in* is7ksu!"in* sal9utam7l
• Sulas manesikus %an anti!"7stlan%in -$a"an %i!akai k"nasam!in/
8/17/2019 Usia kehamilan aterm post term
16/33
#A#A LAKSANA
1' #7k7lisis
•. #7k7litik %i9e"ikan 8 $am !e"tama' 9at.79at ,an %iunakan&
•. Nie%i!in& 3 10 m !e" 7"al* A#AU
•. #e"9utalin sulat 1000 -2 am!ul/ %alam 00 ml la"utan inu
%7sis a@al !em9e"ian 10 tetes=menit lalu %inaikkan tetes=mmenit hina k7nt"aksi hilan* A#AU
•. Sal9utam7l& %7sis a@al 10 m I %alam 1 lite" ?ai"an inus 10
ika k7nt"aksi masih a%a* naikkan ke?e!atan 10 tetes=menit se
sam!ai k7nt"aksi 9e"henti atau %en,ut na%i 120= menit ke
%i!e"tahankan hina 12 $am setelah k7nt"aksi hilan
8/17/2019 Usia kehamilan aterm post term
17/33
#A#A LAKSANA
1' #7k7lisis
K7nt"ain%ikasi &
•. Usia kehamilan %i 9a@ah 2 %an %i atas 3 minu
•. 4em9ukaan 3 ?m
•. A%a tan%a k7"i7amni7nitis -ineksi int"aute"in/* !"eek
atau !e"%a"ahan akti
•. A%a a@at $anin
•. anin meninal atau a%an,a kelainan k7nenita
kemunkinan hi%u!n,a ke?il
8/17/2019 Usia kehamilan aterm post term
18/33
#A#A LAKSANA
2' K7"tik7ste"7i% untuk !ematanan !a"u $anin'
Deksametas7n + m IM setia! 12 $am se9an,ak kali* A#AU :etametas7n
2 $am se9an,ak 2 kali
3' Anti9i7tika !"7Jlaksis %i9e"ikan sam!ai 9a,i lahi"' 4ilihan anti9i7tika ,an
untuk !e"salinan !"ete"m -untuk men?eah ineksi st"e!t7k7kus "u! :/
Am!isilin& 2 I setia! + $am* A#AU !enisilin G 2 $uta unit I setia!
Klin%amisin& 3 300 m 4 -$ika ale"i te"ha%a! !enisilin/
Anti9i7tika ,an %i9e"ikan $ika !e"salinan !"ete"m %ise"tai %enan ketu
a%alah e"it"7misin 00 m !e" 7"al A#AU K7m9inasi am7ksilin %enan a
ti%ak %iunakan ka"ena %a!at memi?u te"$a%in,a ente"7k7litis nek"7tikans
8/17/2019 Usia kehamilan aterm post term
19/33
#A#A LAKSANA
' #i"ah 9a"in
' In%uksi !e"salinan
8/17/2019 Usia kehamilan aterm post term
20/33
8/17/2019 Usia kehamilan aterm post term
21/33
4S# #ERM
8/17/2019 Usia kehamilan aterm post term
22/33
DEFINISI
• kehamilan ,an 9e"lansun sam!ai 2 minu atau
%ise9ut $ua kehamilan se"7tinus'
8/17/2019 Usia kehamilan aterm post term
23/33
E4IDEMILGI
• :an,ak meninal aki9at asJksia %an as!i"asi mek7ni
8/17/2019 Usia kehamilan aterm post term
24/33
E#ILGI
• 4ena"uh !"7este"7ne #i%ak te"$a%i !enu"unan ka%atau!un eek !"7este"7ne
• #e7"i 7ksit7sin Ku"ann,a !ele!asan 7ksit7sin
• #e7"i k7"tis7l=A>#H $anin ti%ak %ihasilkan atau ku"an
k7"tis7l
no !enu"unan !"7es"e"7n* !eninkataneste"7en* !eninkatan !"7stalan%in
• He"e%ite"
8/17/2019 Usia kehamilan aterm post term
25/33
MANIFES#ASI KLINIS
• 1 ( 3 mnu* te"$a%i ka"ena hilann
eek !"7tekti )e"ni kase7sa
• Kulit ke"i!ut -men?7l7k !a%a tanan %
kaki/ %an te"kelu!as* tu9uh !an$an %
@astin -ku"us/* matu"itas lan$ut ka"e
mata 9a,i te"9uka* tam!ak tua %
Sin%"7ma !"ematu"itas
8/17/2019 Usia kehamilan aterm post term
26/33
MANIFES#ASI KLINIS
• 4enu"unan ka%a" est"i7l %an !lasental lakt7en !enu"unan un
!lasenta Deene"asi !lasenta penimbunan Ca2+ a@at $
9ahkan kematian
• #e"$a%i !"7ses %eene"asi $a"inan !lasenta se!e"ti e%ema* tim9u
J9"in7i%* J9"7sis* th"7m97sis* %an ina"k )ili
• Sela!ut )askul7sinsial 9e"tam9ah te9al %an $umlahn,a 9e"ku"an
menu"unkan mekanisme t"ans!7"t !lasenta
• Ka%a" e"it"7!7ietin %a"ah tali !usat meninkat se?a"a siniJkan !
kehamilan ,an men?a!ai 1 minu atau le9ih
• 4e"tam9ahan 9e"at 9a%an hina sanat 9esa" !a%a saat lahi"
Disunsi !lasenta
8/17/2019 Usia kehamilan aterm post term
27/33
MANIFES#ASI KLINIS
• Ga@at $anin ante!a"tum %an %ist"ess $aninint"a!a"tum me"u!akan k7m!"esi tali !usat,an %ise9a9kan 7leh 7li7hi%"amni7n
Dist"ess $anin
• 7lume ?ai"an amni7n te"us 9e"ku"an setela38 minu me?7nium %ile!askan ke ?ai"anamni7n ,an se%ikit me?7nium te"lalu kent
%an te9al
me?7nium as!i"ati7n s,n%"7me
li7hi%"amni7n
8/17/2019 Usia kehamilan aterm post term
28/33
DIAGNSIS
• Ri@a,at hai%
H4H# ha"us ,akin* siklus te"atu" 28 ha"i* ti%ak minum antihamil seti%akn,a 3 9ulan te"akhi"
• Kehamilan !7stte"m kemunkinan %iaki9atkan &
• Kesalahan H4H#
• Kete"lam9atan 7)ulasi
• Siklus ti%ak te"atu"
8/17/2019 Usia kehamilan aterm post term
29/33
DIAGNSIS
• Ri@a,at !eme"iksaan antenatal• #es kehamilan :ila tes imun7l7ik %ilakukan setelah telat 2 hamil + minu
• Ge"ak $anin
• 4"imi"a)i%a te"asa e"akan 18 min
• multi"a)i%a te"asa e"akan 1+ minu
• D• Stet7sk7! Laenne? 18.20 minu te"%ena" !e"tama
• D7!!le" 10.12 minu te"%ena" !e"tama
• #ini un%us
• USG
• Ra%i7l7i
8/17/2019 Usia kehamilan aterm post term
30/33
DIAGNSIS
• 4eme"iksaan la9• Ka%a" lesitin=s!in7mielin
• Ka%a" A#>A
• Sit7l7i ?ai"an amni7n
• Sit7l7i )aina
8/17/2019 Usia kehamilan aterm post term
31/33
#A#A LAKSANA
• In%uksi !a"tus %n !emasanan 9al7n katete" F7le,
• In%uksi %n 7ksit7sin ksit7sin IU %lm inus %et"7
• :e%ah S>
• InsuJsiensi !lasenta %n kea%aan se")iks 9lm matan
• 4em9ukaan , 9lm lenka!* !a"tus lama* %an a@at $anin• 4"imi"a)i%a tua* kematian $anin %lm kan%unan* !"e eklamsi
hi!e"tensi menahun
8/17/2019 Usia kehamilan aterm post term
32/33
8/17/2019 Usia kehamilan aterm post term
33/33
• :ila nilai !el)is -4S/ 8 in%uksi !e"salinana kemun
9esa" akan 9e"hasil
• 4S %"i! 7ksit7sin
• 4S 5 4ematanan se")iks te"le9ih %ahulu !enu
4S LAGI