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Presentator:
Nadia Ghaisani Qumairi 110100137
Anggia Anggraeni 110100290
Indiran Vadivalu 110100456
S u p e r v i s o r : d r. F a d j r i r, M . K e d ( O G ) , S p . O G
Mentor : dr. Ahmad Shafiq
•Preterm labor is the presence
of contractions of sufficient
strength and frequency to
Definition effect progressive
(WHO) effacement and dilatation of
the cervix between 20 and
37 weeks’ gestation
Although it has an incidence of 10%,its
contribution to neonatal morbidity and
mortality is high ranges from 50 – 70%.
Survival by gestational age among
live-born resuscitated infants
- Infection
-Hypothermia
-Retinopathy
Hypoglycaem
of
ia
prematurity
RISK FACTORS
Myomata (particularly
submucosal or
subplacental)
Bicornuate
uterus
RISK FACTORS
Infectious causes
Chorioamnionitis
Bacterial vaginosis
Asymptomatic bacteriuria
Cervical/vaginal colonization
Fetal causes
Intrauterine fetal death
Intrauterine growth retardation
Congenital anomalies
DIAGNOSIS
Bed rest
Hydrate the patient
Assess cervical status, progress of labour and presenting part.
Vaginal swab for bacteria vaginosis and B streptococcus and
give antibiotic
TOCOLYTIC THERAPY
Nifedipine: Inhibits the inward current of calcium iron during the 2nd phase of the
•action
Dexamethasone andmuscle
potential of uterine betamethasone
• for fetal maturation reduces mortality, respiratory distress
syndrome
Side effects: and intraventricular hemorrhage in infants between
28 and 34 weeks of gestation.
1- Headache 2- Hypotension
• benefits
3-Flushing
start at 24 hours
4- Tachycardia
and last up to seven days after
treatment
• The potential benefits or risks of repeated administration of
corticosteroids after seven days are unknown.
ANTIBIOTIC THERAPY
LMP : 24/04/2016
EDD : 31/01/2017
ANC : 1x Midwife
History of pregnancy :
1. Current pregnancy
Vital Signs
Cons : Fully Alert Anemic : (-)
BP : 110/70 mmHg Icteric : (-)
Pulse : 88 x/i Cyanosis : (-)
RR : 20 x/i Dypsnoe : (-)
Temp : 36,8°C Edema : (-)
Localized State :
Head : Anemic inferior Palpebra Conj (-)/(-), icteric (-)/(-)
Neck : within normal limits
Thorax : Respiratory sound : vesiculer
Additional sound : Wheezing(-)/(-), Rhales (-)/(-)
• Abdomen : asymetrically enlarged
• Fundal Height : between umbilicus and xypoid proccess
(26 cm)
• Tension part : Left
Obtetric State • Lower part
• Fetal Movement
: head
: (+)
• Uterine contraction : 45”
• Fetal Heart Rate : 140 bpm
• EFW : 1800-2000gr
• No exam
USG-TAS
LABORATORY FINDINGS ON NOVEMBER
18 TH 2016
HB : 11 N: 12-14 GR/DL
LEUKOCYTE : 9510 N:4000-11000/UL
HEMATOCRIT : 37 N: 36,0-42,0/%
PLATELET : 256.000 N: 150.000-400.000/UL
UREUM : 9 N: 10-50 MG/DL
CREATININ : 0.61 N: 0,6-1,2 MG/DL
• Diagnosis :
PG + IUP (28-30) wga+ Head Presentation + Live Fetus + second stage
of labour
• Therapy :
• IVFD RL 20gtt/I
• Spontaneuos Vaginal Delivery
• Follow the progress of Labor
• Prognosis : good
LABOR REPORT
Planning:
• Blood Workup 2 hours post SVD
• Monitoring vital sign, uterine contraction, and bleeding
Neonatus:
• Date of Birth : 18/ 11 /2016
• Condition : Live
• APGAR Score : 7/8
• Sex : Boy
• Body Weight : 1700 gr
• Body Height : 39 cm
MONITORING POST SVD
Pulse/minute 76 80 80 80 78 78 80
Respiratory/
24 24 24 24 24 24 24
minute
Bleeding (cc) 10 cc 10 cc 10 cc 10 cc 15 cc 15 cc 15 cc
FOLLOW UP
Saturday, November 19th 2016 Diagnosis Management