DR.

LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA

PERIOD AUGUST 14th – 17th , 2022

Patient Name
No Date of Admission Detail of Patient Treatment Recommendation
(Age/LMP/MR)

1. 16-08-2022 • Name : Ms. Misbah Miss • Ceftriaxone 1 gram/single • Avoid constipation

• DOB : 08-12-2012 dose/intravenous • Educate to increase fiber
• (9 years old) History of trauma 4 hours before admission • Consult to urogynecology intake and drinking plenty
• MR : 169922 division of water
Chief complaint: • Consult to urogynecology
• Referred from :
Perineal rupture division
• (primary health
care) Physical Examination :
• Educational level: Active bleeding (-)
elementary School BP: 110/70 mmhg
Insurance : BPJS HR: 115 bpm

Pre-Operative Diagnosis:
4th Degree Perineal Tear – (recto perineal tear)
 DR. LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA
PERIOD AUGUST 14th – 17th , 2022

2 14-08-2022 • Name : Mrs. Suriani Pre-Treatment Diagnosis : • Spontaneous Vertex Delivery • Exclusive Breastfeeding
• DOB : 09-06-1995 G2P1A0 39 weeks of gestational age in Active • Early initiation of for 6 months
• (27 years old) phase 1st stage of Labor + IUD Acceptor Candidate breastfeeding • Vaginal hygiene
• MR : 276044 • Repair of Perineal Laceration • Control for IUD
Post-Treatment Diagnosis :
• LMP : 14-11-2021 • IUD Insertion
Term delivery + second degree of perineal
• Referred from : -
laceration + IUD Acceptor
• Educational level:
Junior High School
Outcome :
Insurance : BPJS
Male, BW : 3100 gram, BL : 50 cm, A/S : 8/10
3 15-08-2022 • Name : Mrs. muliati Pre-Treatment Diagnosis : • Spontaneous Vertex Delivery • Exclusive Breastfeeding
• DOB : 03/02/2000 G1P0A0 37 weeks 4 days of gestational age in • Early initiation of for 6 months
• 22 years old Active phase 1st stage of Labor Breastfeeding • Vaginal hygiene
• LMP : 25/11/2021 • Repair of Perineal Laceration • Family planning
• MR : 277201 Post-Treatment Diagnosis : counselling and
• Referred from : - Term delivery + second degree of perineal education: IUD
• Payment : BPJS laceration
• Educational : Senior
High School Outcome :
Male, BW : 2920 gram, BL : 49 cm, A/S : 7/9
4 15-08-2022 • Name : Mrs. Sairah Pre-Treatment Diagnosis : • Spontaneous Vertex Delivery • Exclusive Breastfeeding
• DOB : 04/07/1992 G2P1A0 38 weeks 5 days of gestational age in • Early initiation of for 6 months
• 30 years old Active phase 1st stage of Labor + IUD Acceptor Breastfeeding • Vaginal hygiene
• LMP : 17/11/2021 Candidate • Control for IUD
• IUD Insertion
• MR : 277207
• Refer from : - Post-Treatment Diagnosis :
• Payment : BPJS Term delivery + IUD Acceptor
• Educational : junior
High School Outcome :
Female, BW : 3220 gram, BL : 51 cm, A/S : 8/10
5 16-08-2022 • Mrs. Artina Pre-Treatment Diagnosis : • Spontaneous Vertex Delivery • Exclusive Breastfeeding
• DOB : 29/11/1996 G1P0A0 39 weeks 6 days of gestational age in • Early initiation of Breastfeeding for 6 months
• 25 years old phase 2nd stage of Labor • Repair of Perineal Laceration • Vaginal hygiene
• LMP :10/11/2021 • Family planning
• MR : 277211 Post-Treatment Diagnosis : counselling and
• Refer from : - Term delivery + second degree of perineal education: IUD
• Payment : BPJS laceration
• Educational : Senior
High School Outcome :
Female, BW : 3100 gram, BL : 49 cm, A/S : 8/10
 DR. LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA
PERIOD AUGUST 14th – 17th , 2022

6 16-08-2022 • Mrs. Syahruni Pre-Treatment Diagnosis : • Spontaneous Vertex Delivery • Exclusive Breastfeeding
• DOB : 23/08/1993 G3P2A0 38 weeks 3 days of gestational age in Active • Early initiation of for 6 months
• 28 years old phase 1st stage of Labor + IUD Acceptor Candidate Breastfeeding • Vaginal hygiene
• LMP : 20/11/2021 • Repair of Perineal Laceration • Control for IUD
• MR : 277212 Post-Treatment Diagnosis :
• IUD Insertion
• Refer from : - Term delivery + second degree of perineal laceration
• Payment : BPJS + IUD Acceptor
• Educational : Senior
High School Outcome :
Male, BW : 3350 gram, BL : 49 cm, A/S : 8/10
7 14-08-2022 • Mrs. Nurlaela G1P0A0 • Curettage • Family planning
• 23 years old 9 weeks 3 days of gestational age counseling and
• DOB : 30/08/1998 education : Barrier
• LMP :09/06/2022 Chief Complaint:
• MR : 277166 History of vaginal bleeding since 5 hours before
• Refer from : - admission
• Payment : BPJS
• Educational : Senior Physical Examination :
High School ICO/ECO : dilated/dilated
Fluxus : blood (+)

Pre-Operative Diagnosis :
Incomplete Abortion

Post- Operative Diagnosis :

Incomplete Abortion
8 15-08-2022 • Mrs. Suriani G3P2A0 • Curettage • Control for IUD
• 29 years old 10 Weeks 5 days of Gestational Age • IUD insertion
• DOB : 19/07/1993
• LMP :01/06/2022 Chief complaint:
• MR : 172495 Vaginal bleeding since 6 hours before admission
• Refer from : -
• Payment : BPJS ICO/ECO : Dilated/Dilated
Urine pregnancy test : (+)
• Educational : Senior
High School
Pre-Operative Diagnosis:
Incomplete abortion + IUD acceptor candidate

Post-Operative Diagnosis:
Incomplete abortion + IUD acceptor
 DR. LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA
PERIOD AUGUST 14th – 17th , 2022

9 16-08-2022 • Mrs. Nurlaela G4P2A1 • Curettage • Family planning

• 30 years old 10 weeks 4 days of gestational age counseling and
• DOB : 20/08/1992 education : Barrier
• LMP :03/06/2022 Chief Complaint:
• MR : 277223 History of vaginal bleeding since 2 days before
• Refer from : - admission
• Payment : BPJS
• Educational : junior Physical Examination :
High School ICO/ECO : dilated/dilated
Fluxus : blood (+)

Pre- Operative Diagnosis :

Incomplete Abortion

Post- Operative Diagnosis :

Incomplete Abortion
10. 14-08-2022 • Name : Mrs. N G4P2A1 • Dilatation and Curettage • Observation of general
• DOB : 09-06-1987 GA : 25 weeks 5 days condition, vital signs,
• (35 years old) and vaginal bleeding
Vaginal Bleeding (+), Abdominal enlargement • Family planning
• MR : 175209
since 2 months ago counselling and
• LMP : 15-02-2022
Nausea and vomiting (+) education : Barrier
• Referred from :
Polyclinic • Β-HCG serial
Physical examination : measurements
• Educational level: Fundal Height: 3 fingers above umbilical
Junior High School • Follow up for
ECO/ICO : not dilated/ not dilated histopathology result
• Insurance : BPJS
Laboratory examination :
B-HCG: 963.541 IU/ml

Thorax X-ray
Within normal limit
DR. LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA
PERIOD AUGUST 14th – 17th , 2022

Ultrasonography:

Pre-Operative Diagnosis :
Hydatidiform mole

Post-Operative Diagnosis :
Hydatidiform mole
 DR. LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA
PERIOD AUGUST 14th – 17th , 2022

Total Cases : 10
Conservative :1
Vaginal Delivery :6
Curettage :3

Family Planning :4
IUD :4
Implant :-

Makassar, August 18th, 2022

Known By :
Chief A Chief B

dr. Dwicky Limbersia Aries dr. Prilly Astari

(dr. Nurul Fajri Syamsuri, dr. Hambrian (dr. Agus Pratama Ponijan, dr. Jessica Refanya
Wijaya, dr.Sitti Nurmarati Yuni R) Labora, dr. Muh. Fadhil Asyraq Rahim)

Supervisor,

dr. Syahruni Syahrir, Sp.OG(K)

DR. LAPALALOI MAROS HOSPITAL / HAMBRIAN WIJAYA

Period August 14th – August 17th , 2022