Wanita G2P1A0 Hamil aterm dengan Letak

lintang dan Plasenta Previa Totalis

Grace Raveena Widelia Worumi
112022113

Dokter pembimbing:
dr. Yusuf Manga, Sp. OG

 KEPANITERAAN KLINIK ILMU KEBIDANAN

FAKULTAS KEDOKTERAN UKRIDA JAKARTA
RUMAH SAKIT UMUM DAERAH CENGKARENG
PERIODE 12 SEPTEMBER – 19 NOVEMBER 2022
 IDENTITAS PASIEN
Nama : Ny. M
TTL : Jakarta, 11-12-1982 (40 tahun) 
Status perkawinan : Menikah
Pekerjaan : IRT
Pendidikan : SLTA
terakhir : Islam
Agama : Jakarta
Suku : Tn. X
Nama suami : G2P1A0
GPA : 85-69-70
Nomor RM : 13 Oktober 2022
Tanggal masuk RS
Anamnesis: Autoanamnesis di ruang Tanggal: 14 Oktober
Anggur 2022 
Keluhan Utama

Hamil aterm, ingin melakukan operasi SC karena bayi letak lintang dan plasenta menutupi jalan
lahir.  

Riwayat penyakit sekarang

Wanita G2P1A0 hamil aterm, berusia 40 tahun datang ke Poli kebidanan RSUD Cengkareng
pada tanggal 13 Oktober 2022 pukul dengan rujukan dari RS Mitra Keluarga. Pasien dirujuk
untuk melakukan operasi Sectio caersarea (SC) karena letak bayi lintang dan plasenta menutupi
jalan lahir. Pasien mengaku mengetahui plasenta menutupi jalan lahir pada usia kira – kira 8
bulan saat pemeriksaan USG di RS Mitra. Saat datang ke poli kebidanan pasien tampak baik,
pasien mengatakan tidak ada darah, lendir atau air – air yang keluar dari jalan lahir. Rasa nyeri
pada perut disangkal.  Pasien tidak ada alergi terhadap makanan, cuaca atau obat – obatan
tertentu. 
Riwayat Haid
Menarche : 12 tahun  
Siklus haid : 28 hari, Teratur  
Lama haid : 3 – 5 hari   
Banyak Haid : 2 – 3 ganti pembalut  
HPHT : 15 Januari 2022  
HPL (HPHT) : 24 Oktober 2022 

Riwayat Perkawinan
Perkawinan : 1x 
Menikah usia : 2019 
Lama menikah :  4 tahun 

Riwayat Kehamilan dan Persalinan

• G2P1A0 
• Anak pertama: laki – laki, lahir tahun 2013, cukup bulan, lahir secara spontan dibantu oleh bidan, BBL 2900 gram.    

Riwayat Kehamilan dan Persalinan

• Pasien menggunakan KB suntik 3 bulan sejak melahirkan anak pertama (tahun 2013) 
Riwayat Haid
Pemeriksaan antenatal rutin dilakukan di puskesmas duri kosambi.  

Riwayat Penyakit Dahulu

Pasien memiliki riwayat TB. Pengobatan selesai 31-08-2022

Riwayat Penyakit Keluarga

Hipertensi  Ibu

Riwayat Kebiasaan, Sosial, Ekonomi

Pasien tinggal bersama dengan suaminya di rumah pribadi. Lingkungan tempat tinggal pasien padat penduduk. Hubungan
pasien dengan keluarganya baik.  Pasien tidak memiliki riwayat konsumsi alkohol, merokok atau menggunakan obat –
obatan terlarang. 
IGD Tanggal: 14 Oktober
Ponek 2022 

Pemeriksaan Fisik Thorax:

• Mammae : simetris, payudara kanan dan kiri mengencang,
• Keadaan umum : Baik  hiperpigmentasi pada kedua areola, retraksi puting (-/-)  
• Kesadaran : Compos mentis   • Cor : BJ I – II murni, reguler, murmur (-), gallop (-) 
• Tekanan darah : 136/98 mmHG  • Pulmo : suara napas vesikuler, ronkhi (-/-), wheezing (-/-) 
• Nadi : 80x  
• Suhu : 36,6   Abomen
• Pernapasan : 20x   • Inspeksi : membucit, simetris 
• SpO2 : 100%   • Palpasi : massa gravidarum (+) 
• Tinggi badan : 144 cm   • Hati : tidak dapat dinilai 
• Berat badan : 46 kg  • Limpa : tidak dapat dinilai 
• IMT : 22,2   • Auskultasi : bising usus (+) normal  

Status Generalis
• Kepala : Normocephal, rambut hitam, merata, tidak mudah rontok 
• Mata : Pupil isokor o/ 3mm, reflek cahaya (+/+), konjuntiva anemis (-/-), sklera    ikterik (-/-) 
• Telinga : normotia, sekret (-/-), deformitas (-/-) 
• Hidung : bentuk normal, simetris, sekret (-/-) 
• Mulut : tonsil T1/T1, faring tidak hiperemis  
 Pemeriksaan Obstetri
Inspeksi
• Wajah : Cholasma gravidarum (-) 
• Leher : Hiperpigmentasi (-) 
• Payudara : pembesaran payudara (+), puting susu menonjol (+), cairan mammae (-) 
• Abdomen : membesar, Striae gravidarum (+), bekas oprasi (-) 
Palpasi
• Nyeri tekan (-)

Pemeriksaan Leopold
Leopold I   Kosong  
Teraba bulat keras di sebelah kanan pasien
(kesan: kepala), teraba bagian keras panjang
Leopold II  
seperti papan di sebelah kiri pasien (kesan: • TFU :  28 cm 
punggung kiri)  • DJJ : 136x/menit, gerakan janin (+)  
Leopold III   Kosong   • His : tidak ada  
• Inspekulo : tidak dilakukan
Leopold IV   Tidak dapat dilakukan   • VT : tidak dilakukan  
 Pemeriksaan penunjang
Hema 1
• Hb : 11.8 g/dL 
• Ht : 35% 
• Leukosit : 16.3 10’3/uL 
• Trombosit : 309 10’3/uL 

USG
31 Oktober 2022
• JTH/O/Plasenta corpus posterior/ICA cukup/BPD 6.69/AC 21.79/FL 5.14/GW 28
mg/ TBJ 1011 gr/TP 23-10-2022 

11 September 2022
• JTH/presentasi lintang/plasenta anterior/ICA cukup/BPD 8.83/AC 27.50/FL
6.27/GW 33-34 minggu/laki-laki/TP 23.10.2022 

2 Oktober 2022
• JTH/presentasi lintang/ICA cukup/AC 31.78/TBJ 2573 gr/GW 37
mg/laki-laki/plasenta posterior previa/TP 23.10.2022 

7 Oktober 2022
JTH/DJJ(+)/ ICA cukup/PPT/BPD 9.15/AC 32.2/FL 7.3/TBJ 3006gr/ hamil 37 07/10/2022
minggu/ EDD 28-10-2022 
Pemeriksaan CTG

Kategori 1
Resume

Wanita G2P1A0 hamil 37 minggu datang ke RSUD cengkareng dengan rujukan dari RS Mitra Keluarga untuk melakukan
operasi sectio caesarea (SC) karena presentasi lintang dan plasenta previa totalis. Pada pemeriksaan fisik didapatkan
leopold I kosong, leopold II teraba kepala janin berada pada sebelah kanan dan TFU 28 cm. Pemeriksaan USG
didapatkan plasenta menutupi seluruh OUI kesan plasenta previa totalis. Pemeriksaan CTG didapatkan hasil kategori I.  

Diagnosa
G2P1A0, hamil 37 minggu, janin tunggal hidup, presentasi lintang, dengan plasenta previa totalis.    

Rencana Tatalaksana

• Tirah baring 
• Cefotaxime 1 gram pre op  
• Sectio caesarea elektif 14/10/2022 (13.00 WIB) 
Laporan Operasi Tanggal: 14/10/2022 Jam Mulai: 13.00 Jam Selesai: 14.00

• Diagnosa pre op : G2P1A0 hamil aterm + PPT + letak lintang  

• Jumlah perdarahan ± 300cc
• Urine output ± 400 cc
• Insisi abdomen Pfannenstil
• Tidak tampak perlengketan uterus
• Insisi uterus transperitoneal profunda secara tajam
• Air ketuban jernih dan cukup
• Bayi dilahirkan dengan menarik kaki (bayi ...)
• Plasenta berimplantasi di corpus belakang menutupi OUI, dilahirkan dengan tarikan ringan
• Kelainan plasenta pervia totalis
• Kedua tuba dan ovarium normal
• Diagnosa post op : P2A0 post SC a/i h aterm + PPT + letak lintang 

Instruksi Post Op

• Cefotaxime 3x1 
• Ketoprofen supp 3x1  
 Prognosis
 Ad Vitam : Ad bonam 
 Ad Functionam : Ad bonam 
 Ad Sanationam : Ad bonam 
 Subjektif:  
15/10/2022  Pasien mengeluh nyeri pada bekas luka oprasi saat miring kiri, mika miki (+), duduk (+) BAK (-),
(12.00 WIT)  BAB (-), Flatus (+), 
Ruangan Rambutan   Objektif: 
TD: 134/88 mmHg      Suhu: 36,2 
HR: 80x/menit             RR: 20x/menit  
Abdomen:  TFU 2 jari dibawah pusat 
Hb pre op: 12.2/37/7.4/320 
Assesement: 
P2A0 post SC a/i PPT + letak lintang 
Planning: 
Cefotaxime 3x1 gr lanjut cefixime 2x200 mg 
Ketoprofen supp 3x1 lanjut asam mefenamat 3x 500mg  
RL + Synto 20 IU/8 jam untuk 24 jam  

Subjektif:  
16/10/2022  Pasien mengeluh nyeri pada bekas luka operasi, BAB (-), BAK (+), jalan (+), ASI (-) 
(12.00 WIT)  Objektif: 
Ruang Rambutan  TD: 154/89mmHg      Suhu: 36,8 
HR: 66x/menit             RR: 20x/menit  
Abdomen: TFU 2 jari dibawah pusat 
Hb post op: 11.8/16.3/309 
Assesment:  
P2A0 post SC a/i PPT + letak lintang 
Planning: 
Ketoprofen supp 3x1 lanjut asam mefenamat 3x500mg  

Follow Up After Surgery

 Subjektif:  
17/10/2022  Pasien mengeluh nyeri pada bekas luka operasi kalau jalan tapi tidak mengganggu, BAB (-), BAK
(07.00 WIB)  (+), jalan (+), ASI (-) 
Ruangan Rambutan   Objektif: 
TD:  151/96 mmHg      Suhu: 36,8 
HR: 87x/menit             RR: 20x/menit  
Abdomen:  TFU 2 jari dibawah pusat 
Hb post op: 11.8/16.3/309 
GV (+) luka baik  
Assesment:  
P2A0 post SC a/i PPT + letak lintang 
Planning: 
R/ observasi tekanan darah 1x24 jam 
Asam mefenamat 3 x 250 mg 
Dopamed 2 x 250 mg  
Subjektif:  
18/10/2022  Pasien tidak ada keluhan, ASI (-), BAB spontan (+), BAK spontan (+) 
(07.00 WIB)  Objektif: 
Ruangan Rambutan  TD:  123/77 mmHg      Suhu: 36,5 
HR: 86x/menit             RR: 20x/menit  
Abdomen:  TFU 2 jari dibawah pusat 
Hb post op: 11.8/16.3/309 
Assesment: 
P2A0 post SC a/i PPT + letak lintang  
Planning: 
R/ Pulang  
Dopamed 3 x 250 mg 
Letak lintang 
 CONTENTS OF THIS TEMPLATE
Here’s what you’ll find in this Slidesgo template:
1. A slide structure based on a clinical case, which you can easily adapt to your needs. For more info on how to
edit the template, please visit Slidesgo School or read our FAQs.
2. An assortment of illustrations that are suitable for use in the presentation can be found in the
alternative resources slide.
3. A thanks slide, which you must keep so that proper credits for our design are given.
4. Two resources slides, where you’ll find links to all the elements used in the template.
5. Instructions for use.
6. Final slides with:
7. The fonts and colors used in the template.
8. A selection of illustrations. You can also customize and animate them as you wish with the online
editor. Visit Stories by Freepik to find more.
9. More infographic resources, whose size and color can be edited.
10. Sets of customizable icons of the following themes: general, business, avatar, creative process,
education, help & support, medical, nature, performing arts, SEO & marketing, and teamwork.

You can delete this slide when you’re done editing the presentation.
 TABLE OF CONTENTS
01 04
ABOUT THE PATIENT TREATMENT
Here you could describe the Here you could describe the
topic of the section topic of the section

02 05
DISCUSSION PATIENT MONITORING
Here you could describe the Here you could describe the
topic of the section topic of the section

03 06
DIAGNOSIS THANKS
Here you could describe the Here you could describe the
topic of the section topic of the section
INTRODUCTION

Mercury is the closest planet to the Sun

and the smallest one in the Solar
System—it’s only a bit larger than the
Moon. The planet’s name has nothing
to do with the liquid metal, since it was
named after the Roman messenger god
 IDENTIFYING INFORMATION

MARS JUPITER SATURN

Despite being red, Mars is Jupiter it’s a gas giant and Saturn is the ringed one.
a cold place. It’s full of iron the biggest planet in the It’s composed of hydrogen
oxide dust Solar System and also helium
01
ABOUT THE
PATIENT
You can enter a subtitle
here if you need it
PATIENT MEDICAL HISTORY

2008 2013 2019

Despite being Mercury is the Saturn is the

red, Mars is a closest planet ringed one, it’s
cold place to the Sun a gas giant

AGE: 25
GENDER: Male
ALLERGIES: None
LOCATION: Madrid, Spain
 REVIEW OF SYSTEMS

MARS JUPITER
Despite being red, Jupiter is a gas giant
Mars is a cold place and the biggest planet

SATURN MERCURY
Saturn is the ringed Mercury is the closest
one. It’s a gas giant planet to the Sun
PHYSICAL EXAMINATION

SATURN
This is the ringed one. It’s a gas giant,
composed mostly of hydrogen and
helium
MARS
Despite being red, Mars is a cold place.
The planet is full of iron oxide dust

JUPITER
Jupiter is a gas giant and the biggest
planet in the Solar System
A PICTURE IS
WORTH A
THOUSAND
WORDS
 FINDINGS
EVOLUTION PREVALENCE

70%

35%

10%

To modify this graph, click on it, follow the link, change 200,000,000
the data and paste the new graph here, replacing this Saturn is the ringed one
one
 02
DISCUSSION
You can enter a subtitle
here if you need it
 DISCUSSION

DR. ANNE SMITH

“Jupiter is the biggest planet in
the Solar System”

DR. JOHN JAMES DR. JENNA DOE

“Saturn is the ringed “Despite being red,
one. It’s a gas giant” Mars is a cold place”
 DISCUSSION
SUMMARY
Mercury is the closest planet to
the Sun and the smallest one in
the Solar System—it’s only a bit
larger than the Moon
 COMPARISON

JUPITER VENUS MERCURY MARS NEPTUNE

03
DIAGNOSIS
You can enter a subtitle
here if you need it
 DIAGNOSIS

MERCURY VENUS MARS

Mercury is the closest It has a beautiful name, Despite being red, Mars
planet to the Sun but it’s terribly hot is a cold place

JUPITER SATURN NEPTUNE

It’s the biggest planet Saturn is the ringed one Neptune is the farthest
in the Solar System and a gas giant planet from the Sun
4,498,300,000
Big numbers catch your audience’s attention
 OUR NUMBERS

35,000 18,000
Mercury is the closest Venus has a beautiful name
planet to the Sun and the and is the second planet
smallest

74,000 67,000
Jupiter is the biggest planet Neptune is the farthest
in the Solar System planet from the Sun
 04
TREATMENT
You can enter a subtitle
here if you need it
 TREATMENT

VENUS
Venus has a beautiful
name and is the second
planet from the Sun

MERCURY
It’s the closest planet to
the Sun and the smallest
one in the Solar System
05
PATIENT
MONITORING
You can enter a subtitle
here if you need it
PATIENT MONITORING
MERCURY

MARS WEEK 1
SATURN

WEEK 2 WEEK 3

MERCURY MERCURY

MARS MARS

SATURN SATURN
CONTRAINDICATIONS & INDICATIONS
● Here you could describe a
reason to stop the treatment
● Here you could describe a
reason to stop the treatment
● Here you could describe a
reason to stop the treatment
● Here you could describe a
reason to stop the treatment
● Here you could describe a
reason to start the treatment
● Here you could describe a
reason to start the treatment
● Here you could describe a
reason to start the treatment
● Here you could describe a
reason to start the treatment
 POST-PREVENTION

MARS JUPITER VENUS NEPTUNE

Despite being Jupiter is a gas Venus has a Neptune is the

red, is actually a giant and the beautiful name, farthest planet
cold place biggest planet but it’s very hot from the Sun
 CASE TIMELINE

DAY 1 DAY 3
Jupiter is the biggest Saturn is the ringed
planet of them all one and a gas giant

Mercury is the Despite being red, Mars

closest planet to the is actually a cold place
Sun
DAY 2 DAY 4
CONCLUSIONS

Mercury is the closest planet to the Sun

and the smallest one in the Solar
System—it’s only a bit larger than the
Moon. The planet’s name has nothing
to do with the liquid metal, since it was
named after the Roman messenger god
 REFERENCES

● AUTHOR (YEAR). Title of the publication . Publisher

● AUTHOR (YEAR). Title of the publication . Publisher
● AUTHOR (YEAR). Title of the publication . Publisher
● AUTHOR (YEAR). Title of the publication . Publisher
● AUTHOR (YEAR). Title of the publication . Publisher
● AUTHOR (YEAR). Title of the publication . Publisher
 OUR TEAM

DR. JOHN JAMES DR. ANNE SMITH DR. JENNA DOE

“It’s the ringed one. It’s “Jupiter is a gas giant “Despite being red, is a
composed mostly of and the biggest planet cold place. It’s full of
hydrogen and helium” in the Solar System” iron oxide dust”
MULTIMEDIA
You can replace the images on
these screens with your own
work. Just delete these ones, add
yours and center them properly
THANKS

Do you have any questions?

addyouremail@freepik.com
+91 620 421 838
yourcompany.com

CREDITS: This presentation template was created by

Slidesgo, including icons by Flaticon, infographics &
images by Freepik and illustrations by Stories

Please keep this slide for attribution

ALTERNATIVE RESOURCES
 RESOURCES

VECTORS ● Health professional team

● Pollution on human body infographic ● Person with a cold
● Medicine elements background in flat styl ● Remedy
e
● Virus transmission
● Person with medical mask
STORIES ● Degree
● Doctor ● Taking notes
● Online Doctor ● Bottle of water
● Insurance
● Fighting against Coronavirus
● Winning the battle against Coronavirus
 RESOURCES

PHOTOS
● Front view of doctor with medical mask posing with crossed arms
● Front view doctor with copy-space
● Beautiful doctor holding a folder with copy space
● Close-up colourful pills spilled from plastic bottle

ICONS
● Hospital Icon Pack
 Instructions for use (free users)
In order to use this template, you must credit Slidesgo by keeping the Thanks slide.

You are allowed to:

● Modify this template.
● Use it for both personal and commercial purposes.

You are not allowed to:

● Sublicense, sell or rent any of Slidesgo Content (or a modified version of Slidesgo Content).
● Distribute this Slidesgo Template (or a modified version of this Slidesgo Template) or include it in a database or in
any other product or service that offers downloadable images, icons or presentations that may be subject to
distribution or resale.
● Use any of the elements that are part of this Slidesgo Template in an isolated and separated way from this
Template.
● Delete the “Thanks” or “Credits” slide.
● Register any of the elements that are part of this template as a trademark or logo, or register it as a work in an
intellectual property registry or similar.

For more information about editing slides, please read our FAQs or visit Slidesgo School:
https://slidesgo.com/faqs and https://slidesgo.com/slidesgo-school
 Instructions for use (premium users)
In order to use this template, you must be a Premium user on Slidesgo.

You are allowed to:

● Modify this template.
● Use it for both personal and commercial purposes.
● Hide or delete the “Thanks” slide and the mention to Slidesgo in the credits.
● Share this template in an editable format with people who are not part of your team.

You are not allowed to:

● Sublicense, sell or rent this Slidesgo Template (or a modified version of this Slidesgo Template).
● Distribute this Slidesgo Template (or a modified version of this Slidesgo Template) or include it in a database or in
any other product or service that offers downloadable images, icons or presentations that may be subject to
distribution or resale.
● Use any of the elements that are part of this Slidesgo Template in an isolated and separated way from this
Template.
● Register any of the elements that are part of this template as a trademark or logo, or register it as a work in an
intellectual property registry or similar.

For more information about editing slides, please read our FAQs or visit Slidesgo School:
https://slidesgo.com/faqs and https://slidesgo.com/slidesgo-school
 Fonts & colors used
This presentation has been made using the following fonts:

Montserrat
(https://fonts.google.com/specimen/Montserrat)

Lato
(https://fonts.google.com/specimen/Lato)

#e6f8f6ff #5bcec7ff #a4e4e0ff #76aaa7ff #455a64ff #474f85ff #f2f2f2ff #cfcfcfff

 Stories by Freepik
Create your Story with our illustrated concepts. Choose the style you like the most, edit its colors, pick
the background and layers you want to show and bring them to life with the animator panel! It will boost
your presentation. Check out How it Works.

Pana Amico Bro Rafiki Cuate

 Use our editable graphic resources...
You can easily resize these resources without losing quality. To change the color, just ungroup the resource
and click on the object you want to change. Then, click on the paint bucket and select the color you want.
Group the resource again when you’re done. You can also look for more infographics on Slidesgo.
 JANUARY FEBRUARY MARCH APRIL MAY JUNE

PHASE 1

Task 1

Task 2

PHASE 2

Task 1

Task 2

JANUARY FEBRUARY MARCH APRIL

PHASE
1

Task 1

Task 2
Medical Infographics
 ...and our sets of editable icons
You can resize these icons without losing quality.
You can change the stroke and fill color; just select the icon and click on the paint bucket/pen.
In Google Slides, you can also use Flaticon’s extension, allowing you to customize and add even more icons.
Educational Icons Medical Icons
Business Icons Teamwork Icons
Help & Support Icons Avatar Icons
Creative Process Icons Performing Arts Icons
Nature Icons
SEO & Marketing Icons