Hospital/ Dewi Novita Hospital/ Dewi Novita

Obstetrics
st and Gynecology
th Social Division
st / Yuliati
th

May 19th – May 23th 2021

N
PROBLEM IDENTIFICATION SITUATION ANALYSIS EFFORTS ALREADY MADE PLAN TO FOLLOW UP
O
1 Mrs. M/28  Critical emergency Educate the patient, husband  Keep continue
y.o obstetrics situation (AGDO) and family about: psychosocial support from
 A near miss case  The condition of the husband and family to the
P2A1  Referred from Pangkep patient, plan of action, patient in order to enhance
Referred by Pangkep Hospital with Hospital for Intensive Care the risk her recovery
HELLP Syndrome and Acute Kidney Unit and need special  The benefits of medical  Recommend to referring
Injury treatment Maternal Fetal interventions and hospital to monitoring
History of vaginal delivery 3 days ago Division, prognosis blood pressure 12 weeks
with IUFD  Timely Referral (RTW)  the importance after delivery and
History of curettage 2 days ago due to from Pangkep Hospital psychosocial support to possibility of complication
rest placenta  Very high risk pregnancy : the patient in order to in the future
 Hellp syndrome enhance her recovery  Provide good team working
GCS : E4M6V5  Advise to the patient between government,
 Postpartum
BP : 146/74mmHg routine control and health provider in order to
Hemorrhage
Laboratory findings : possibility of complication offering better health care
 Frequent ANC at PHC 2
WBC : 25.400/ul in the future service and preparation
times
HGB : 9,0 gr/dl  Advice for next pregnancy especially in emergency
PLT : 73.000/ul  Low educational level
to routine control in case
HCT : 27%  Low socio-economic status
primary health care or  Recommend to the
Ur : 109 mg/dl hospital and always obey government (health
Cr : 4.92 mg/dl all recommendation provider) to keep always
GOT : 186 U/L during pregnancy routine providing
GPT : 101 U/L  the referral hospital follow counseling about all risk in
Albumin : 2,0 gr/dL up helping and remains pregnancy, record and
LDH : 3935 U/L concerned with the report all case high risk
progress of the patient's pregnancy
Pre-Treatment Diagnosis : recovery  Collaborate between
HELLP Syndrome + Acute Kidney health providers and
Injury + Moderate Anemia BKKBN to continue to
aggressively provide
Treatment : counseling on the
IVFD Ringer Lactate 28 dpm importance of

Consult to Nephrology and
Hypertensive Disease Division
Consult to Clinical Nutrition Division
2 Mrs. S/
22 years old
P2A0
Referred by Thalia Hospital with
Eclampsia puerpuralis
Seizure 2 times at Thalia hospital
History of delivery at Thalia Hospital
since 15 days ago before admission
GCS 9 (E2M4V3)
BP : 190/110 mmHg
HR : 92 bpm
RR : 25 tpm
T : 36.8 C
Proteinuria : +++
Pre Treatment Diagnosis
P2A0 +Postpartum Day 15
+Eclampsia Puerpuralis
Post Treatment Diagnosis
P2A0 +Postpartum Day 15
+Eclampsia Puerpuralis
Treatment :
 Oropharyngeal tube insertion
 Oxygen 10 Lpm via NRM
 6 gr MgSo4 in 500 cc RL 28
drops/minute until 24 hours
post last seizure
Hospital/ Dewi Novita
Obstetrics
st and Gynecology
th
May 19th – May 23th 2021
 Critical emergency
obstetrics situation (AGDO)
 A near miss case
 Referred from Thalia
Hospital for Intensive Care
Unit
 Timely Referral (RTW)
from Thalia Hospital
 High risk pregnancy :
Eclampsia
 Frequent ANC at PHC and
Obstetrician > 4 times
 Middle educational level
 Low socio-economic status
Hospital/ Dewi Novita
Social Division
st / Yuliati
th
Educate the patient, husband
and family about:
 The condition of the
patient, plan of action, the
risk
 The benefits of medical
interventions and
prognosis (ICU treatment)
 the importance
psychosocial support to
the patient in order to
enhance her recovery
 Advise to the family
routine control, and
possibility of complication
in the future after
recovery
 Advice for next pregnancy
to routine control in
primary health care or
hospital and always obey
all recommendation
during pregnancy
 Advise about family
planning IUD 4 weeks
after delivery
contraception, especially
for high-risk pregnancies
 Keep continue
psychosocial support from
husband and family to the
patient in order to enhance
her recovery
 Recommend the referring
hospital to continue
monitoring patient with
high risk in pregnancy and
advice patient with high
risk to routine control to
primary health care (blood
pressure until 12 weeks)
 Recommend to the
government (health
provider) to keep always
routine providing
counseling about all risk in
pregnancy and screening
for preeclampsia since in
early trimester
 Collaborate between
health providers and
BKKBN to continue to
aggressively provide
counseling on the
importance of
contraception, especially
for high-risk pregnancies
 Hospital/ Dewi Novita Hospital/ Dewi Novita
Obstetrics
st and Gynecology
th Social Division
st / Yuliati
th

May 19th – May 23th 2021

 Urinary catheterization
 ICU observation
 Assessment by
Anesthesiologist Department :
Nicardipine 0,05 mcg/kgBW/SP
Consult to Neurologist :
Piracetam 3 gr/8
hours/Intravenous
 Hospital/ Dewi Novita Hospital/ Dewi Novita
Obstetrics
st and Gynecology
th Social Division
st / Yuliati
th

May 19th – May 23th 2021

RECAPITULATION OF REFERRED CASE

CASE TOTAL CASE HOSPITAL
Referred 2 Syekh Yusuf Hospital, Wahidin
Sudirohusodo Hospital
Non-referred - -

RECAPITULATION OF COVID-19 CASE

CASE TOTAL CASE HOSPITAL
Covid-19 - -
Non-Covid-19 2 Syekh Yusuf Hospital, Wahidin
Sudirohusodo Hospital

RECAPITULATION OF NEAR MISS AND MISS

CASE TOTAL CASE HOSPITAL
Near miss 2 Syekh Yusuf Hospital, Wahidin
Sudirohusodo Hospital
Miss -

Makassar, May 20th 2021

Acknowledge By
Supervisor

dr. A. Nursanty A. Padjalangi, Sp.OG (K)