Maternal Fetal Division/Dwicky Limbersia Aries

Period July, 21st – 28th , 2020

No Date of Date of Patient Name Detail of Patient Treatment Recommendation

Admission Discharge (Age/LMP/MR)
1 July, 20th Mrs. N G2P1A0  Spontaneous vertex delivery  Exclusive breastfeeding for 6
2020 38 years old months
LMP : 07/11/2019 Chief Complain : Lower abdominal  Vaginal Hygiene
MR : 919474 pain with bloody show and  Educate the patient and
amniotic fluid leakage since 6 family about patient and
hours before admitted baby condition
 Family Planning Counseling
Ultrasonography Finding: and education: IUD
EFW 1676 gr

Pre-Treatment Diagnosis:
G2P1A0 36 weeks 4 days of
gestational age in latent phase 1st
stage of labor + IUGR Suspected

Post-Treatment Diagnosis :
IUGR + Preterm Delivery +
Asphyxia of the Newborn

Outcome :
Female, BW : 1360 gram, BL : 37
cm, A/S : 6/9 , New Ballard
Score:34 similar with 36 weeks

2 July, 15th Mrs. E G3P2A0  Neurosurgery division :  Monitoring patient’s general

2020 29 years old Consult by Neurosurgeon with Assessment : condition and vital sign
LMP : G3P2A0 30 weeks of gestational Meningioma suspected  Early Mobilization
18/12/2019 age + Loss of consciousness due to Therapy :  Wound Hygiene
MR : 918626 Meningioma - Craniotomy +  Breast Binding
Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020

Micro surgery  Educate the patient about

Chief complain : Loss of
consciousness since 1 day before
hospital admission
History of fetal lung maturation
with dexamethasone 6 mg/12
hours/IM (4 times admission)
(July, 1st 2020)
1st Caesarean section in July 2008
due to cephalopelvic disproportion
2nd Caesarean section in March
2017 due to cephalopelvic
disproportion
 Ceftriaxone 1 gr/ 12 the risks and complications in
hours/ intravenous next pregnancies
 Omeprazole 40 mg/ 12  The Subsequent pregnancy
jam/ intravenous should be more than 18
 Dexamethasone 5mg / 8 months
hours/ intravenous  Antenatal Care for the next
 Paracetamol 500 mg/ 8 pregnancy should be at the
hours/ intravenous obstetrician
 Family Planning Counseling
 Lower segment transverse and education: IUD
caesarean section  Consult to Obstetrics and
Gynecology Social Division

EFW : 1680 gram

Head CT-Scan in Hermina Hospital

(27/06/2020) :
Mass in the right frontal lobe,
meningioma suspected

Pre Operative Diagnosis :

G3P2A0 30 weeks of gestational
age + 2 Previous caesarean section
+ IUFD + Right Frontotemporal
Meningioma

Post Operative Diagnosis :

2 Previous Caesarean Section +
IUFD + Right Frontotemporal
 Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020

Meningioma

Outcome :
Male, BW : 1860 gram, BL : 41 cm,
A/S : 0/0 , Maceration Grade 2

3 July, 19th Mrs. S G2P1A0  O2 8 lpm via NRM  Monitoring patient’s general
2020 40 years old 1st caesarean section in June 2017  Urinary catheter insertion condition and vital sign
LMP : due to nuchal cord and  4 gr 40% MgSO4 in 100 cc  Early Mobilization
hypertension NaCl 0,9% 73 dpm within 30  Wound Hygiene
10/01/2020
minutes  Educate the patient and
MR : 919414 Chief complain :  6 gr 40% MgSO4 in 500 cc family about patient and
Vaginal bleeding since 10 hours RL 28 dpm for 24 hours baby condition
before admitted. Abdominal pain after delivery  Control blood pressure
(-)  Fetal lung maturation with regularly until 12 weeks after
Dexamethasone 6 mg/12 delivery
Headache (-) hours/ intramuscular
Epigastric pain (-) (4 times admission)
Blurred vision (-)  Tranexamic acid 500 mg/
History of Hypertension (+) 8 hours/ intravenous
 Nifedipine 10 mg/ 8 hours/
BP : 187/100 mmHg oral
Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020

EFW : 1046 gram  Consult to Kidney

Hypertension Division :
Inspeculo : -Perdipine 1.5 mcg/BW/
Bleeding (+) minute/syringe pump
-Systolic blood pressure
Laboratory Result at Wahidin target : 150 mmHg
Sudirohusodo Hospital -Low Sodium Diet
(July, 19th 2020)  Lower segment transverse
Urid Acid : 7.1 mg/dl caesarean section
Proteinuria : +1  Tubectomy bilateral

Ultrasonography (July, 19th 2020)

Ultrasonography (July, 19th 2020):

EFw: 1046 gr
Absent of End Diastolic (Doppler)
 Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020

Pre Operative Diagnosis :

G2P1A0 27 weeks 2 days of
gestational age + Antepartum
hemorrhage due to Marginal
Placenta Previa + Superimposed
Preeclampsia + 1 previous
caesarean section + Female
Sterilization Acceptor Candidate

Post Operative Diagnosis :

Antepartum hemorrhage due to
Marginal Placenta Previa +
Superimposed Preeclampsia + 1
previous caesarean section +
Female Sterilization Acceptor +
Asphyxia of the Newborn

Outcome :
Male, BW : 900 gram, BL : 35 cm,
A/S : 6/8 , New Ballard Score:20
similar with 32 weeks

4 July, 19th Mrs. L G1P0A0  Intrauterine resuscitation :  Early Mobilization

2020 26 years old Referred by Permata Hati Hospital
LMP : 16/10/2019 with G1P0A0 39 weeks 4 days of
MR : 919422 gestational age in latent phase 1st
stage of labor + Patient’s under
surveillance COVID-19
Chief Complain : Lower abdominal
Oxygen 10 lpm by NRM, left
lateral positioning, rapid
crystalloid infusion, fetal
monitoring
 Emergency Lower segment
transverse caesarean
section
 Wound Hygiene
 Breast Binding
 Educate the patient about
the risks and complications in
next pregnancies
 The Subsequent pregnancy
Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020
pain with bloody show since 6
hours before admitted
History of cough and Fever 2
weeks ago, sneezing denied
FHR pre-rescucitation: 100 bpm
FHR post-rescucitation: 102 bpm
Laboratory Result (July, 19th 2020
in Permata Hati Hospital)
SARS-CoV-2 IgM Antibody : Non-
Reactive
SARS-CoV-2 IgG Antibody :
Reactive
Laboratory Result (July, 19th 2020
in Wahidin Sudirohusoso
Hospital)
Thrombocyte: 76.000 /µl
Neutrophil : 78,20%
Lymphocytes : 14,1%
NLR : 5,43
Radiology results
(July, 19th 2020 in Wahidin
Sudirohusoso Hospital)
Bilateral Pneumonia, Covid Typical
 Consult to Pulmonology should be more than 18
Department months
Assessment : Covid-19  Antenatal Care for the next
Therapy : pregnancy should be at the
- Hospitalized at Infection obstetrician
Centre  Family Planning Counseling
- Azithromycin 500mg/24 and education: COCP
hours/ oral  Self Isolation
- Vitamin B Complex  Educate the patient and
400mg/ 24 hours / oral family about patients
- Vitamin C 500mg /8 condition, use the mask,
hours/ oral washing hands, and physical
- Zinc 20 mg/ 24 hours/ distancing
oral  Consult to Social Obstetrics
- Oseltamivir 75 mg/12 and Gynecology Division
hours/oral
 Consult to HOM
Department
Assessment :
Thrombocytopenia et causa
Idiopathic Trombocytopenic
Purpura Suspected
Therapy :
- Tranfusions 3 bags of
Thrombocyte
Concentrate
- Waiting for Peripheral
Blood Smear results
Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020

PCR Test for Covid-19(20/7/2020

in Wahidin Sudirohusoso
Hospital) : Positive

Pre-Operative Treatment:
G1P0A0 39 weeks 4 days of
gestational age in latent phase 1st
stage of labor + Fetal Distress +
Thrombocytopenia et causa
Idiopathic Trombocytopenic
Purpura Suspected + Covid-19
Suspected

Post-Operative Treatment :
Covid-19 + Still Birth +
Thrombocytopenia et causa
Idiopathic Trombocytopenic
Purpura Suspected + Term
Delivery

Outcome :
Male, BW : 3500 gram, BL : 50 cm,
A/S : 0/0
 Maternal Fetal Division/Dwicky Limbersia Aries
Period July, 21st – 28th , 2020

Total cases :4 Family Planning: 1

Vaginal Delivery :1 Female Sterilization : 1
Caesarean Section :3

Makassar, July 29th , 2020

Known By :

Chief Team A Chief Team B Chief Team C

dr. Eva Kurnianti dr. Ary Rizqi Rachman dr. Andre Septian Putra

Chief Team D Chief Team E Chief Team F

dr. Bambang Hady Pratama dr. Juan dr. Ricky Eko Januar Silaen

Supervisor,

Dr. dr. Efendi Lukas, Sp.OG (K)