3 Scenario

3rd TEAM
 TEAMS MEMBERS
Muhammad jauhan farhad ( 613001603)
Johan Wijayanto ( 613001608)
Ega widhatama ( 6130016013)
Zakiyyatur Rizkiyyah husin ( 6130016018)
Dini putri A ( 6130016023)
Muhammad imamuddin.I.I (6130016028)
Sitti K.Serang ( 6130016033)
Hikmah Shabrina D.I. ( 6130016038)
Fajrul maliki alhaq ( 6130016043)
Nafisa aulia rahmadini ( 6130016048)
Mohammad ilyas febri.P. ( 6130016053)
 Scenario
Pregnancy and lactation

A 23-year-old woman came to the emergency room with severe abdominal pain from 1
day ago. From the anamnesis, the patient got 7 weeks pregnant and never had any
problem with before. The patient also denied the history of vaginal bleeding. On
examination, the patient is seen in a state of moderate diatress and hypotensi with
normal pulse rate. The abdomen is palpable tense (distention) and tenderness on the
right side of the abdomen accompanied by tenderness and muscular defans. The cervix
is closed and the uterus corresponds to a 7 week pregnancy. Levels of beta-human
chorionic gonadotropin positive. 3 days beforehand performed complete blood count
and result showed decrease Hb level. Then done USG abdomen examination and the
result with a viable pregnancy in the womb. Inside the abdominal cavity also looks clean
with large numbers and find masses in the right adnexa. The patient is taken toward a
mass experiment on the adnexa, pain and. Intraoperative rupture occurs in the corpus
luteum along with large amounts of blood in the abdominal cavity. After the bleeding
corpus luteum is removed, surgery is maintained and the patient is taken to post-surgical
recovery room.
 Difficult words
Vaginal bleeding.
Distress.
Distension.
Viabel.
Intraoperative.
Abdomen.
Adnexa.
Ruptura.
.
Corpus luteum.
Muscular defans
HB..
 Keyword
Ruptura corpus luteum.
Vaginal bleeding.
Abdominal distension.
Pregnant 7 weeks.
Abdominal pain.
Decreased levels of hemoglobin (HB).
.
Intraoperative.
 Problem s
identification
1. What physiological changes occur in the patient above
post-surgery?
2. What causes abnormalities in these patients?
3. How is the mechanism of decreasing Hb level?
4. What is the function of HCG?
5. What is the etiology and impact of corpus luteum
rupture?
6. How is fetal development in normal and abnormal
pregnancies at week 7 ?
 Hypothesis
Symptoms such as tenderness, muscular defects,
etc. Are caused by a large rupture of the corpus
luteum in the abdominal cavity seen in the
interoperative, post-operative effects on the
physiological body.
 MIND MAPPING
Pregnant 7
weeks

Abdominal Distension
pain abdomen

- HCG

Decrease in Corpus
HB luteum
Intraoperative

Ruptura
 Learning objective
To know the role of hormones in pregnancy.
To know physiological processes of pregnancy.
To able explain the relevance of pregnancy and
lactation with improved rupture of the corpus
luteum.
To ability explain normal Hb levels.
To able explain the physiology of lactation in
pregnant women.
To ability explain normal fertilization and
implantation.
 HORMONE IN PREGNANCY
Human chorionic gonadotropin
Prevents corpus luteum involution at the end of the
female monthly sex cycle and causes the corpus
luteum to secreate more of its sex hormonrs for the
next few month.
Hormon Estrogen
Proliverative in most reproductive organ and releated
organ in the mother. During pregnancy the excessive
amount of estrogen causes enlargement of the
mother uterus ,breat enlargement and growth
 Hormone progesteron .
Progesterone helps for the development of
conception even befire implantation because it
specifialy increases the secretion of fallopian tubes
and maternal uterus to provide nutrients suitable for
the development of morulla and blastocyst.
Human Chorionic Somatomammotropin Hormone.
Has a weak performance and leads to the formation
of protein tissue. This hormone can cause decreased
insulin sensitivity and decreased glucose utilization in
the mother thus making the amount of glucose
available for more fetus.
physiological processes of
pregnancy
 Ovulation of ovum release
There is displacement of spermatozoa
and ovum.
Zigot movement and growth.
Occurs nidasi (implantation) on the
uterus.
Formation of the placenta.
Grows from conception to term.
Relevance of pregnancy and
lactation with improved rupture
of the corpus luteum.
 The corpus luteum is a very secretory organ, which
secretes large amounts of progesterone and
estrogen.
Progesterone has an effect on fallopian tubes for
pregnancy. It increases the secretion in the mucosa
that lines the fallopian tubes.
Thus, if rupture occurs in the corpus luteum, it can
result in considerable impacts of physiological
changes that occur with the onset of disturbances
in secretions of estrogen and progesterone which
are female sex hormones.
 Normal Hb levels
Kelompok Hemoglobin

Umur (gr/dl)

Anak-anak

6-59bulan 11,0

5-11 bulan 11,5

12-14 bulan 12,0

Dewasa

Wanita>15tahun 12,0

Wanita Hamil 11,0

Pria >15tahun 13,0

women.