Duty Report RSUDZA

Friday, August 2st 2019

Supervisors:
DR. Dr. Cut Meurah Yeni, OBGYN (C)
Prof. DR. Dr. Mohd Andalas, OBGYN, FMAS
Dr. Tgk Puspa Dewi, OBGYN
Dr. Hilwah Nora,M.Med. Sci. ART, OBGYN (C)

Residents:
Razi/ Nisa/Riza-Fikri/Jani/Juanda-Hendri
 Reporting
5 Procedures :

5 Caesarean Sections
 Procedure Case Outcome
1. C-section Mrs. CM, 21 yo Born female baby, 3500
MR 1-21-66-80 grams, 49 cm, AS 8/9 BS ~
38-40 Week ,
G1 39-40 WGA, Singleton Live Head Presentation, Dyctocia Diminished amniotic fluid
Second Stage of Labor, Failed of Vacuum Extraction Placentae born completely

C-Section due to failed of Vacuum extraction

Obstetrical Findings:
Hendri Fundal height: 34 cm back on the left side, head presentation,
(T1B)/ Riza 2/5, contraction 4x/10’/45” FP: DMPA
FHR: 140 bpm, EFW 3410 gr
(T3A)
Prof. Dr. dr. I : vulva was with normal limit
Mohd. VT : Complete of dilatation, head Hodge III-IV, Subocciput
Andalas, anterior, amniotic membrane negative
OBGYN - CTG category 1
FMAS
Process :
Consult to DPJP  Informed consent  Consult to
Anasthesiology and Perinatology  Emergency C- Section
Non Book other and baby are in good
Case: condition in the ward
Sent by
OBGYN
 Procedure Case Result
C-Section Mrs. IW, 28 yo Born male baby, BW
MR 0-95-64-67 3800 g, HC 37 cm, BL
47 cm, AS 8/9,
G1 40-41 WGA, Singleton Live Head Presentation, Cephalo Pelvic BS~38-40 weeks
Disproportion, In Labor Clear amniotic fluid
Placenta born
C-Section due to Cephalo Pelvic Disproportion, In Labor completely

Jani T2B) / Obstetric state:

Fikri (T3A) FH : 38 cm , back at left side, head presentation, 5/5, Contraction
2x/10’/25”, FHR : 150 bpm EFW : 3875 gram FP: DMPA
dr. Tgk. Puspa I : V/U wnl
Dewi, OBGYN Io : Portio livide, open OUE, fluxus (+), valsalva test (-)

VT : portio axial, soft, t 1 cm, 2 cm dilatation, Head Floating

Mother and baby
Osborn Test : (+) were in good
condition in ward
Non Book Case Clinical Pelvimetry:
Reffered by Promontorium not palpated, linea inominata 1/3 anterior sin/dex,
OBGYN spina ischiadica sharp, DI 9,5 cm, arcus pubis > 90 ⁰ adequate
pelvic

Process :
Informed Consent  Consult to anesthesiology and perinatology
division  C-section
 Procedure Case Outcome

3. C-Section Mrs AP, 33 yo Born Female baby, BW

MR 0-94-01-99 4200 grams
BL 47 cm, AS 8/9,
G1 37 – 38 WGA, Singleton Live Head Presentation, Impending BS ~ 38-40 week
Eclampsia, Susp Macrosomia, Not In Labor mother with : Clear amniotic fluid
obesity morbid (47,9 kg/m2) Placenta born completely
Primary Infertile 8 year

C-Section due to Clinical finding :

Blurred vision ((+), nausea (+) vomitus ((+) frontal headache (+)
Riza (T2B)/ BP : 160/100 mmHg, protein urine (++) FP : DMPA
Razi (T4A)
Dr. Tgk Puspa Obstetrical State
Dewi, OBGYN FH : 38 cm, back at left side, Head presentation, 4/5, no contraction,
FHR 138 bpm EFW : 4030grams
I : vulva/urethra within normal limit
Io : livide portio, OUE closed, fluor (-), fluxus (-),valsava test (-)
VT : Portio posterior, firm, t 3 cm, ⏀ 0 cm, Head hodge 1

Non Book Case CTG categori I

Patient was
sent by OBGYN Process :
Management PEB  MgSO4 40% 4 gr, continoues with maintenance
1 g/hr, Nifedipine 10 mg titration, maintenance Adalat Oros 1x30 mother and baby were in
mg, consult to internist, opthalmologist division  Consult DPJP  good condition in the ward
Informed consent  consult anesthesiology, perinatology division
C-Section
 Procedure Case Result
C-Section Mrs. QA, 24 yo Born female baby,
MR 1-21-66-28 BW 2900 g, HC 37
cm, BL 46 cm, AS
G1 37-38 WGA, Singleton Live Head Presentation, Cephalo Pelvic 8/9, BS~38-40 weeks
Disproportion, In Labor Clear amniotic fluid
Placenta born
C-Section due to Cephalo Pelvic Disproportion, In Labor completely

Jani T2B) / Obstetric state:

Fikri (T3A) FH : 31 cm , back at left side, head presentation, 5/5, Contraction
2x/10’/25”, FHR : 140 bpm EFW : 2945 gram FP: DMPA
Dr. Hilwah I : V/U wnl
Nora, M.Med, Io : Portio livide, open OUE, fluxus (+), valsalva test (-)
Sci, ART, OBGYN
(C) VT : portio posterior, soft, t 12cm, 1 cm dilatation, Head Floating

Osborn Test : (+) Mother and baby

were in good
Clinical Pelvimetry:
Promontorium not palpated, linea inominata 1/3 anterior sin/dex, condition in ward
spina ischiadica sharp, DI 9,5 cm, arcus pubis > 90 ⁰ adequate
Non Book Case pelvic
Reffered by
OBGYN Process :
Informed Consent  Consult to anesthesiology and perinatology
division  C-section
 Procedure Case Result

5. C – Section Mrs. YM, 28 y.o Born Baby I:

MR 1-21-66-35 Male baby, BW 2200 gr, BL
43 cm, AS 8/9, BS ~ 38-40
weeks
G3P1A1 38-39 WGA, Gemelli Monochorionic Monoamniotic Baby II :
Both Alive Breech-Transver Lie Presentation, Second Fetus Male baby, BW 1400 gr, BL
Suspected Congenital Abnormalities, PROM 15 Hours (AFI 6), 37 cm, AS 7/9, BS ~ 32-34
Jani (T2B)/ Suspected Intra Uterine Growth Restriction, not in labor weeks
Risma (T4B) Diminished Amniotic fluid
C-Section due to Gemelli Breech-Transver Lie Presentation, Placenta born completely
DR. Dr. Cut Meurah PROM 15 Hours (AFI 6), Suspected Intra Uterine Growth (Monochorionic
Yeni, OBGYN (C) Monoamniotic)
Restriction, not in labor

Obstetrical Status :
Fundal height 40 cm, no contraction, FHR 1= 140 bpm, FHR 2 =
153 bpm
Non Book Case I : V/U wnl FP: DMPA
Sent by Graha Bunda Io : Smooth Portio, closed ostium, Flour positive, Fluxus negative,
Hospital Idi Valsalva positive, Nitrazin test positive
VT : Posterior, soft, thick, no dilatation, Sacrum Hodge I

Process:
Antibiotic Prophylaxis  Consult DPJP Informed consent,
Consult to Anesthesiologist and Perinatologist  C-Section
Mother and baby are in
good condition in the ward