SCENARIO C Blok XVII Batch 2018

“My Fourth Pregnancy”

Mrs. S, 37 years old, G4P2A1, 37 weeks pregnant, came to the emergency department of RSMP with a chief complain
of blurry vision since one days ago. This complain also followed with severe headache. Mrs. S tries to relieve the complain by
taking some painkillers but the complain were not reduced. Mrs. S also claims that she often suffers from frequent headache but
not as severe as this one, then Mrs. S brought to the village midwife, and the midwife said that Mrs. S had high blood pressure
so she reffers her to the hospital.
Since 1 days ago, Mrs. S also complained of epigastric pain without nausea and vommiting. Mrs. S claimed that she
had history of high blood pressure during the third pregnancy and also claimed that she is nine months pregnant and still able to
feel the baby movement. Mrs. S only did ANC once during this pregnancy.

Physical examination:
General appearance: looks moderately sick, sensorium: compos mentis, GCS: 15
Vital Sign: BP: 200/120mmHg, Pulse: 84 x/m, RR: 20x/menit, Temp: 36,80C
Head: anemic conjungtive (-)
Thorax: cor and pulmo within normal range
Ekstremity: edeme ekstremity (+/+)

Obstetry Examination
External examination : Fundus uteri height 3 fingers below the procesus xiphoideus (28cm), elongated, left back, lowest part is
head, descending 5/5, HIS 2x/10minute/25 seconds, Fetal Heart sound: 136x/minute.
Internal examination : soft portio, anterior, effacement 20%, opening 2 cm, head hodge I-II, denominator front right small
crown, amniotic membrane complete.

Laboratory Examination:
Routine Blood : Hb:12 g/dl, leucocyte : 9000/mm3, thrombocyte: 200.000/mm3
Urinalysis : Protein (+++)