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    Sindrom HELLP

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    melatiigd
    - Mrs. F, a 34-year-old woman, was admitted to the hospital on June 1st, 2012 at 12:30 pm for severe preeclampsia and HELLP syndrome at 29-31 weeks of pregnancy. - She underwent a termination of pregnancy through misoprostol insertion and spontaneous vaginal delivery of a 1500 gram female infant on June 2nd, 2012 at 4:15 am. - Following delivery, Mrs. F was monitored in the ICU and nifas ward. Her vital signs and bleeding were stable with conservative treatment and observation.

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    Sindrom HELLP

    Uploaded by

    melatiigd
    31 views8 pages
    - Mrs. F, a 34-year-old woman, was admitted to the hospital on June 1st, 2012 at 12:30 pm for severe preeclampsia and HELLP syndrome at 29-31 weeks of pregnancy. - She underwent a termination of pregnancy through misoprostol insertion and spontaneous vaginal delivery of a 1500 gram female infant on June 2nd, 2012 at 4:15 am. - Following delivery, Mrs. F was monitored in the ICU and nifas ward. Her vital signs and bleeding were stable with conservative treatment and observation.

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    Sindrom HELLP

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    - Mrs. F, a 34-year-old woman, was admitted to the hospital on June 1st, 2012 at 12:30 pm for severe preeclampsia and HELLP syndrome at 29-31 weeks of pregnancy. - She underwent a termination of pregnancy through misoprostol insertion and spontaneous vaginal delivery of a 1500 gram female infant on June 2nd, 2012 at 4:15 am. - Following delivery, Mrs. F was monitored in the ICU and nifas ward. Her vital signs and bleeding were stable with conservative treatment and observation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    31 views8 pages

    Sindrom HELLP

    Uploaded by

    melatiigd
    - Mrs. F, a 34-year-old woman, was admitted to the hospital on June 1st, 2012 at 12:30 pm for severe preeclampsia and HELLP syndrome at 29-31 weeks of pregnancy. - She underwent a termination of pregnancy through misoprostol insertion and spontaneous vaginal delivery of a 1500 gram female infant on June 2nd, 2012 at 4:15 am. - Following delivery, Mrs. F was monitored in the ICU and nifas ward. Her vital signs and bleeding were stable with conservative treatment and observation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 8

    Name : Mrs.

    F
    Age : 34 yo
    Adress : sukamulia, lotim
    No. RM: 039 666
    Admitted: june, 1st 2012 at 12.30

    Time
    1/6/201
    2
    12.30
    Wita

    Subject
    Patient referred from general
    hospital DR. R.SOEDJONO
    Selong with G4P2A1L2 30-31
    wk S/L/IU with eclampsia
    HELLP syndrome. Patient
    seizure 1x at 03.00
    (1/6/2012), patient confess
    epigastric pain, headache,
    and blured vision (-). bloody
    slim (-), FM (+).
    History of DM (-), HT (-),
    asthma (-).
    History of family ilness : DM
    (-), HT (-), asthma (-)
    LMP :8-11-2011
    EDD:15-08-2012
    History ANC : >4x at PHC
    Last ANC : Mei 2012
    USG : 1x
    History of family planning : 3
    month injection
    Next family planning : IUD
    History of obstetric :
    1. female, 9 month, spontan,
    10 yo
    2. female, 9 month, spontan,
    5 yo
    3. Abortus, 3 month
    4. This
    Chronologist
    18.30 (31/05/2012)
    S:Patien came to selong GH
    refered from dr.SpOG with
    headache.

    Object

    assessment

    General status
    GC : well
    BP : 170/120 mmHg
    PR: 88 bpm
    RR: 20 t/m
    T: 36,7 C
    Localis status
    Eye : an (-/-), ict (-/-)
    Pulmo ves (+/+), rh (-/-),
    wh (-/-)
    Cor : s1s2 single reg, M(-),
    G(-)
    Abd : strie gravdarum (+)
    Ext : edema (-/-)
    Obstetric status
    L1 : breech UFH : 30 cm
    EFW : 2945 gram
    L2 : back on the left side
    L3 : head
    L4 : 5/5
    UC : FHB : (+) 13.13.12
    (152bpm)
    VT : -, forniks media
    palpable, the lowest part
    of fetal still high
    Lab:
    WBC : 11,4
    89
    RBC : 4,87%
    32
    HGB : 14,0
    test:
    PLT : 66.000

    SGOT:
    SGPT:
    urine

    G4P2A1L2 29-30
    wk S/L/IU with
    eclampsia HELLP
    syndrome

    Planning
    -Obs. Mother and
    fetal well being
    - O2 nasal 3 ltr/mnt
    -Inf. MgSO4 6 g in RL
    500 ml 28 tpm
    -Transfusion 2 kolf
    PRC
    --nifedipin 3x 10 g
    per oral
    -GP consult to SPV,
    SPV advice:
    termination with
    misoprostol.

    Time

    Subject
    Status obs:
    His:Djj: + 148x bpm
    FH: 24 cm
    VT: not done
    A: G4P2A1L2 30-31 wk S/L/IU
    with severe preeclampsia
    P: conservative treatment
    Bedrest, infusion, DC
    MgSO4 drip
    Nifedipine 3x 10 mg
    Inj. Dexamethasone 16 g (2x
    for 24 hour)
    23.00-01.00 (1/06/2012)
    BP:200/100 metildopa 500
    g 1 tab
    Mg SO4 flash II
    03.00
    S: seizure 1x
    O:
    BP : 180/100 mmHg
    PR: 82 bpm
    RR: 20 t/m
    T: 37 C
    A: G4P2A1L2 30-31 wk S/L/IU
    with eclampsia HELLP
    syndrome
    P:
    Pro terminasi SC
    Continued MgSO4 drip
    Nifedipine 3x 10 mg
    Metildopa 3x 10 mg

    Object

    assessment

    Planning

    Time

    Subject

    Object

    assessment

    Planning

    1/6/201
    2
    16.30
    Wita

    -Insertion
    misoprostol 25mcg
    1st

    20.30

    -Infusion 1 kolf prc

    22.15

    -Insertion
    misoprostol 25mcg
    2nd

    2/6/201
    2
    04.15

    General status
    GC : well
    BP : 140/100 mmHg
    PR: 84 bpm
    RR: 20 t/m
    T: 36,6 C
    FHB: 140 bpm
    His:UO: 800 cc (dark-brown
    urine)

    -Insertion
    misoprostol 25mcg
    3rd

    08.00

    General status
    GC : well
    BP : 160/110 mmHg
    PR: 92 bpm
    RR: 22t/m
    T: 36,6 C
    FHB: 142 bpm
    His:-

    -GP advice
    Dexamethasone
    Injection

    Time

    Subject

    Object

    assessment

    Planning

    10.15

    -Insertion
    misoprostol 25mcg
    4th

    11.00

    -Dexamethasone
    injection 5 mg

    13.00

    General status
    GC : well
    BP : 170/130 mmHg
    PR: 96 bpm
    RR: 20t/m
    T: 36,6 C
    UO: 250 cc
    FHB: + 142 bpm
    His:-

    14.00

    Patient confessed headache

    General status
    GC : well
    BP : 150/110 mmHg
    PR: 80 bpm
    RR: 20t/m
    T: 36,6 C
    UO: 250 cc
    FHB: + 142 bpm
    His:-

    -Nifedipine per oral

    16.50

    -DM co SPV:
    -insertion
    misoprostol 50 mcg

    17.00

    -insertion
    misoprostol 50 mcg
    1st

    Time

    Subject

    Object

    18.00

    20.00

    23.25

    assessment

    Planning
    -SPV advice: prepare
    to SC at 22.00

    General status
    GC : well
    BP : 150/110 mmHg
    PR: 80 bpm
    RR: 20t/m
    T: 36,6 C
    UO: 250 cc
    FHB: + 142 bpm
    His:-

    --GP advice: cek


    CBCpost SC

    SC began
    Baby was born.
    female. 1500 gram.
    AS 3-5. anus (+).
    Congenital anomaly
    (-).
    Amnion clear
    Placenta was born.
    Manually. Complete.
    Bleeding 200cc

    Time

    Subject

    Object

    assessment

    Planning

    3/6/201
    2
    02.00

    Patien at ICU

    BP : 160/100 mmHg
    HR : 100 bpm
    RR : 20 x/m
    T : 36,3 C
    UC : + , good
    UFH : 1 finger below
    umbilicus
    UO : 50 cc
    Active bleeding : -

    2hour post SC

    -Observation GC, VS,


    bleeding

    06.00

    Patien at ICU

    BP : 170/120 mmHg
    HR : 88 bpm
    RR : 20 x/m
    T : 36,5 C
    UC : + , good
    UFH : 2 finger below
    umbilicus
    UO : 100 cc
    Active bleeding : -

    8 hour post SC

    -Observation GC, VS,


    bleeding

    08.00

    Patien at ICU

    BP : 170/110 mmHg
    HR : 88 bpm
    RR : 20 x/m
    T : 36,5 C
    UC : + , good
    UFH : 3 finger below
    umbilicus
    UO : 120 cc
    Active bleeding : -

    10 hour post SC

    -Observation GC, VS,


    bleeding

    BP : 160/120 mmHg
    HR : 88 bpm
    RR : 20 x/m
    T : 36,5 C
    UC : + , good
    UFH : 3 finger below

    12 hour post SC

    -Observation GC, VS,


    bleeding

    10.00

    Time

    Subject

    Object

    assessment

    Planning

    14.00

    Patien at ICU

    BP : 160/110 mmHg
    HR : 90 bpm
    RR : 20 x/m
    T : 36,3 C
    UC : + , good
    UFH : 3 finger below
    umbilicus
    Active bleeding : -

    14 hour post SC

    -Observation GC, VS,


    bleeding

    16.00

    Patien at ICU

    BP : 160/110 mmHg
    HR : 80 bpm
    RR : 20 x/m
    T : 36,5 C
    UC : + , good
    UFH : 3 finger below
    umbilicus
    Active bleeding : -

    16 hour post SC

    -Observation GC, VS,


    bleeding

    16.30

    Patien at nifas

    BP : 150/90mmHg
    HR : 88 bpm
    RR : 20 x/m
    T : 36 C
    UC : + , good
    UFH : 3 finger below
    umbilicus
    Active bleeding : -

    16 hour post SC

    -Observation GC, VS,


    bleeding

    BP : 160/120 mmHg
    HR : 88 bpm
    RR : 20 x/m
    T : 36,5 C
    UC : + , good
    UFH : 3 finger below
    umbilicus
    Active bleeding : -

    2nd day post SC

    -Observation GC, VS,


    bleeding

    04/06/2
    012
    07.00

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