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  • Late PPH Kasus Makmur Sitepu

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    sridhani
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    This document discusses late postpartum hemorrhage (PPH) and retained placenta. It provides background on late PPH, which is defined as abnormal bleeding between 24 hours and 6 weeks after birth. Late PPH occurs in 1% of women, usually between 8-21 days postpartum. The document then discusses causes of late PPH like endometritis and retained placental tissue. It also presents a case study of a 35-year-old woman who came in 2 weeks after spontaneous birth with vaginal bleeding, and was diagnosed with retained placental tissue based on an ultrasound. The management of late PPH involves antibiotics, uterotonics, and evacuation of the uterus if needed.

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    Kasus Late PPH HGH

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    This document discusses late postpartum hemorrhage (PPH) and retained placenta. It provides background on late PPH, which is defined as abnormal bleeding between 24 hours and 6 weeks after birth. Late PPH occurs in 1% of women, usually between 8-21 days postpartum. The document then discusses causes of late PPH like endometritis and retained placental tissue. It also presents a case study of a 35-year-old woman who came in 2 weeks after spontaneous birth with vaginal bleeding, and was diagnosed with retained placental tissue based on an ultrasound. The management of late PPH involves antibiotics, uterotonics, and evacuation of the uterus if needed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    30 views20 pages

    Late PPH Kasus Makmur Sitepu

    Uploaded by

    sridhani
    This document discusses late postpartum hemorrhage (PPH) and retained placenta. It provides background on late PPH, which is defined as abnormal bleeding between 24 hours and 6 weeks after birth. Late PPH occurs in 1% of women, usually between 8-21 days postpartum. The document then discusses causes of late PPH like endometritis and retained placental tissue. It also presents a case study of a 35-year-old woman who came in 2 weeks after spontaneous birth with vaginal bleeding, and was diagnosed with retained placental tissue based on an ultrasound. The management of late PPH involves antibiotics, uterotonics, and evacuation of the uterus if needed.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 20

    Kasus Late PPH

    makmur sitepu

    Divisi Feto-Maternal Departemen Obgin FK-USU/RS. HAM


    Page 1

    Background
    Late Post Partum Haemorrhage is defined as abnormal or excessive bleeding from the birth canal between 24 hours and 6 weeks following the birth.

    Late PPH occurs in 1% of postpartum women and commonly occurs between 8 21 days postpartum.

    Page 5

    Causes of late postpartum hemorrhage

    Page 6

    A proposed standardized system for reporting postpartum ultrasound scan. Adapted from Neill et al.,
    200224

    Page 7

    Normal Ultrasound Uterine postpartum

    Page 8

    Endometritis

    Page 9

    Retained Placental

    Page 10

    Retained Placental (echogenic mass)

    Page 11

    Retained Placental and post evacuation

    Page 12

    Page 13

    The management of late postpartum hemorrhage

    Page 14

    Ny. RP, usia 35 tahun. P4A0 datang bersama suami dengan keluhan perdarahan pervaginam. Gumpalan darah positif. Ny.RP baru melahirkan spontan 2 minggu yang lalu

    More Info I:
    Pemeriksaan fisik : Vital sign : sensorium = compos mentis lemah TD = 90/70 mmHg Nadi = 100x/i , tekanan/volume cukup RR = 20x/i Temperatur = afebris Hb: 9 gr%, Leokusit: 8.000/ mm3, Thrombosit: 256.000

    Page 15

    Pemeriksaan obstetri : Inspekulo: vagina licin, servik licin, darah mengalir dari ostium uteri eksterna (OUE) VT: Uterus antefleksi, ukuran 10 cm, kontraksi lemah Adneksa dan parametrium = tidak ada kelainan

    More Info II : (pada tutorial ke- 2) USG : Uterus anteflexi, ukuran 10x8 cm. Dijumpai bayangan hyperechoic dalam cavum uteri ukuran 3x2 cm kemungkinan berasal dari jaringan. Adnexa : tidak ada kelainan Kesimpulan : Sisa konsepsi

    Page 16

    Am J Obstet Gynecol. 1990 Sep;163(3):823-5. Preterm delivery: a risk factor for retained placenta. Romero R, Hsu YC, Athanassiadis AP, Hagay Z, Avila C, Nores J, Roberts A, Mazor M, Hobbins JC. Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06510.

    Abstract The purpose of this study was to determine whether preterm delivery, with and without intraamniotic infection, is a risk factor for retained placenta. This complication occurred more frequently in women with preterm vaginal delivery than in women with term vaginal delivery (9.1% [21/231] vs 1.1% [6/561]; p less than 0.00001; odds ratio = 9.25). There was no significant difference in the prevalence of retained placenta between women with preterm labor and intact membranes and those with preterm premature rupture of membranes (8% [10/125] vs 10.4% [11/106]; p greater than or equal to 0.05). A positive amniotic fluid culture or clinical chorioamnionitis was not associated with a higher incidence of retained placenta. This study indicates that preterm delivery is associated with an increased risk of complications of the third stage of labor.

    Grading Placenta

    Analisa Kasus
    Late PPH: 2 minggu Perbaiki KU Antibiotika 12 24 jam Uterotonika Evakuasi dengan kuretase.

    Page 19

    Page 20

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