You are on page 1of 4

KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS SRIWIJAYA
FAKULTAS KEDOKTERAN
UNIT PENDIDIKAN KEDOKTERAN (UPK)

Zona F. Gedung I Kampus Unsri Indralaya OI Sumatera Selatan, Indonesia Telp. 0711 – 580061
atau / or Jl. dr. Muh. Ali Komplek RSUP Palembang 30126, Indonesia, Telp. 0711 – 352342, Fax. 0711 – 373438,

Skenario C Blok 23 Tahun 2014
A female baby was born at Moh.Hoesin Hospital from a 19 years old woman. Her
mother, Mrs. Solehah was hospitalized at Moh.Hoesin Hospital due to contraction. It was
her first pregnancy. She forgot when her first day of last period, but she thought that her
pregnancy was about 8 months. She said that she never had hypertension or other illness
during her pregnancy. Six hours after admitted, she delivered her baby spontaneously.
The labor process was 30 minutes, and rupture of membrane happened one hour before
delivery. The baby didn’t cry spontaneously after birth, and resuscitation was done.
APGAR score at 1 minute was 1, at 5 minute was 3, and at 10 minutes was 7. One hour
later the baby still had grunting and cyanosis.
On physical examination:
Body weight was 1400 gr, body length was 40 cm, and head circumference was 30 cm.
The muscle tone decreased, she poorly flexed at the limbs, she had thin skin, more lanugo
over the body and plantar creased at 1/3 anterior. At 10 minutes of age, she still had
grunting and cyanosis on the whole body. The respiratory rate was 70 x/min, heart rate
was 150 bpm, the temperature was 36oC. There was chest indrawing. Other physical
examinations were within normal limit.
As a general practitioner please analyze the problem and the management.
-----------------------------------------------------------------------------------------------------------For Tutors Only
Learning Objectives:
Students must be able to:
1. Explain the definition and classification of low birth weight infant.
2. Explain risk factors which predispose of low birth weight infant
3. Diagnose low birth weight infant
4. Manage low birth weight infant
5. Explain the definition, risk factor, diagnosis and management of asphyxia
neonatorum
6. Explain the definition, risk factor, diagnosis and management of respiratory
distress
Klarifikasi Istilah
1 Contraction (perut mules)
2 Rupture of membrane (pecah ketuban)
3 First day of last period (HPHT)
4 Apgar score
5 Lanugo
6 Plantar creased
7 Grunting (merintih)
8 Cyanosis (biru)
9 Chest indrawing (retraksi dinding dada)

Lalu lakukan penentuan masa gestasi dengan menggunakan Ballard’s score. Pemeriksaan darah (Hb. dari sini kita dapat memperkirakan bahwa bayi termasuk bayi preterm. Parenteral feeding d. Pemeriksaan apa yang diperlukan pada penderita ini? 9. Berdasarkan berat badan lahir. Beri vitamin K1 0. leukosit. banyak lanugo dan plantar creased hanya didapati 1/3 bagian depan telapak kaki. Apa kemungkinan diagnosisnya? 8. Solehah. berat badan lahir 1400 gram 2. Berat badan 1400 gram. CRP) c. Berat badan 1400 gram. hitung jenis. Apa diagnosis bandingnya? 7. HPHT lupa dan ibu mengatakan usia kehamilannya kira-kira 8 bulan. Pertahankan suhu tubuh dalam batas normal (rawat dalam inkubator) b. Berdasarkan masa gestasi dan berat badan lahir bayi ini diklasifikasikan sebagai apa? Apa yang digunakan untuk mengklasifikasikan bayi baru lahir berdasarkan berat lahir dan masa gestasi baru baru lahir? 4. Kemungkinan penyebabnya (diagnosisnya) adalah penyakit membran hialin. Kultur darah 8. 7. 5. Pemeriksaan yang diperlukan pada penderita ini: a. Sintesis 1. HPHT lupa dan usia kehamilan kira-kira 8 bulan. preterm. 6. dengan menggunakan kurve Lubchenco bayi ini diklasifikasikan sebagai AGA. Apgar score rendah.5 mg intramuskuler c. Bayi merintih dan biru. APGAR skor 1/3/7 4. Bayi merintih dan biru. Dengan menggunakan apa kita dapat menentukan berapa minggu masa gestasinya? 3. apa yang diderita bayi ini? 6. Solehah. trombosit. Rontgen dada b.Identifikasi Masalah 1. Tata laksana penderita ini: a. Bayi Ny. Bayi lahir tidak langsung menangis. perempuan. Diagnosis bandingnya adalah penyakit membran hialin dan transient tachypnea of the newborn (TTN). Analisis Masalah 1. 3. Beri antibiotika sampai kemungkinan infeksi dapat disingkirkan f. HPHT tidak diketahui. Monitoring . apa yang diderita bayi ini  dengan menggunakan Downe’s score maka bayi ini mengalami respiratory distress. Pada penderita ini kita dapati kulit tipis. Faktor risiko pencetus kehamilan prematur pada skenario ini adalah faktor usia ibu yang muda (<20 tahun) 3. Berdasarkan masa gestasi kira-kira 8 bulan dan berat badan lahir 1400. BBLSR lahir spontan dengan asfiksia perinatal dan respiratory distress. Bayi merintih dan biru. apa diagnosisnya? 5. Kadar gula darah d. Bagaimana tatalaksana penderita ini? Hipotesis Bayi Ny. SGA (sesuai dengan usia kehamilan). berdasarkan berat badan lahir bayi ini diklasifikasikan sebagai apa? 2. Beri oksigen e. Bayi tidak langsung menangis setelah lahir. 4. Kemungkinan diagnosisnya adalah penyakit membran hyalin. bayi ini diklasifikasikan sebagai BBLSR 2.

APGAR score at 1 minute was 1. Six hours after admitted. She said that she never had hypertension or other illness during her pregnancy. Her mother. Muh. more lanugo over the body and plantar creased at 1/3 anterior. the temperature was 36oC. heart rate was 150 bpm. APGAR score at 1 minute was 1. body length was 40 cm. As a general practitioner please analyze the problem and the management. and head circumference was 30 cm. It was her first pregnancy. and resuscitation was done. The muscle tone decreased. As a general practitioner please analyze the problem and the management. she still had grunting and cyanosis on the whole body. Solehah was hospitalized at Moh. and head circumference was 30 cm. heart rate was 150 bpm. On physical examination: Body weight was 1400 gr. Indonesia Telp. Mrs. The labor process was 30 minutes. Gedung I Kampus Unsri Indralaya OI Sumatera Selatan. . Mrs. Fax. and rupture of membrane happened one hour before delivery. The respiratory rate was 70 x/min. 0711 – 352342. she had thin skin. On physical examination: Body weight was 1400 gr. 0711 – 373438. Indonesia. The baby didn’t cry spontaneously after birth. body length was 40 cm. she poorly flexed at the limbs. the temperature was 36oC.KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS SRIWIJAYA FAKULTAS KEDOKTERAN UNIT PENDIDIKAN KEDOKTERAN (UPK) Zona F. Solehah was hospitalized at Moh. It was her first pregnancy. KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN UNIVERSITAS SRIWIJAYA FAKULTAS KEDOKTERAN UNIT PENDIDIKAN KEDOKTERAN (UPK) Zona F. Skenario C Blok 23 Tahun 2014 A female baby was born at Moh. Her mother. at 5 minute was 3. and rupture of membrane happened one hour before delivery. but she thought that her pregnancy was about 8 months. and at 10 minutes was 7.Hoesin Hospital from a 19 years old woman. Other physical examinations were within normal limit. Ali Komplek RSUP Palembang 30126. At 10 minutes of age. One hour later the baby still had grunting and cyanosis. Other physical examinations were within normal limit. more lanugo over the body and plantar creased at 1/3 anterior. she had thin skin. Fax. Telp. The baby didn’t cry spontaneously after birth. The labor process was 30 minutes. Skenario C Blok 23 Tahun 2014 A female baby was born at Moh. The muscle tone decreased. Muh. There was chest indrawing. She said that she never had hypertension or other illness during her pregnancy.Hoesin Hospital due to contraction. she poorly flexed at the limbs. and at 10 minutes was 7. Indonesia Telp. The respiratory rate was 70 x/min. She forgot when her first day of last period. Six hours after admitted. One hour later the baby still had grunting and cyanosis. 0711 – 352342. There was chest indrawing. she delivered her baby spontaneously. 0711 – 580061 atau / or Jl. Telp. dr. Ali Komplek RSUP Palembang 30126. she delivered her baby spontaneously. but she thought that her pregnancy was about 8 months. Indonesia. she still had grunting and cyanosis on the whole body.Hoesin Hospital due to contraction. She forgot when her first day of last period. At 10 minutes of age. at 5 minute was 3. and resuscitation was done. 0711 – 580061 atau / or Jl. dr. Gedung I Kampus Unsri Indralaya OI Sumatera Selatan.Hoesin Hospital from a 19 years old woman. 0711 – 373438.