Delivery Suite RSUDZA

Tuesday - Wednesday, October 24 - 25 2023

Supervisors:
dr. Rusnaidi, OBGYN (C) (On-call)
dr. Tgk Puspa Dewi OBGYN (C)
dr. Niken Asri Utami, OBGYN (C)

Residents :
Marlia / Liza – Feby - Susan/ Abip/ Bowo - Noni / Mika -Dafi
 Reporting
3 Procedures :
• 1 Vaginal Delivery
• 2 C-Sections
PROCEDURE CASE PROCESS RESULT

1. Vaginal Mrs. MY, 31 y.o, My 1-35-31-13 Informed consent  Consult with Born male baby, BW
Delivery Chief Complaint : Mother want to bear down DPJP  Plan for vaginal delivery  3200gr, BL 49 cm, AS
Anamnesis: FHR 148 bpm, Contraction : 8/9, BS 40-42 weeks
• Patient came to emergency room. mother want to bear down, contraction, bloody show 5x/10’’/50’’, VT : complete Placentae born
and Water broke was felt, Fetal movement was active dilatation, Occiput Anterior, soft, completely
• Patient admitted 9 months pregnant. LMP: 11/01/2022 EDD : 18/10/2023 corresponds thickness 1 cm, Ø 10 cm amniotic Perineal Rupture
to 40 weeks 3 days weeks gestational age membrane was negative, Head on grade II →
• Patient ANC to OBGYN was denied and midwife 4 times . Defecation and miction were H IV→ 2nd phase of labor  Lead Perineoraphy
within normal limit. mother to bear down
• Vaginal discharge was felt

Obstetric history :
1.Female, 12 yo, 3200 gram, vaginal delivery, at midwife
Mika (1A)/ 2.Male, 7 yo, 2700 gram,vaginal delivery, at telaga bunda hospital
Noni (T1B) 3.Male, 2.5 yo, 3700 gram, vaginal delivery , at midwife
dr.Rusnaidi, 4.Current pregnancy
OBGYN (C)
Physical examination :
FP :DMPA
BP 120/80 mmHg, HR 87 bpm, RR 20x/I , T 36,5⁰ C
Obstetrical finding:
FH 38 cm, back on the left, head presentation, 1/5, FHR 148 bpm
Contraction : 5x/10’/50”
I : tampak kepala pada vulva
IO : tidak dapat dilakukan
VT : Ø complete dilatation, Occiout Anterior, amniotic membrane was negative, Head on
Hogde IV

Non Book Case

mother want to G4P3A0 40-41 weeks gestasional age , singleton live head presentation, Second Stage of
bear down Labor
Mother and baby are
in good condition,
already Discharged
Procedure Case Process Result

2 . C-Section Mrs. IF 29 yo Informed consent  discussion with Born Male baby, BW 2.900
MR 1-18-80-70 DPJP  emergency C-Section  grams, BL 48 cm, A/S 8/9, BS
Chief complaint : post date pregnancy consult Anesthesia and perinatology 40-42 wga, nill amniotic fluid,
• Patient was sent by OBGYN for Post date pregnancy and division placenta born completely
oligohydramnion, She also complaints for decreased fetal movement.
• Contraction, bloody show, water broke were denied
• Patient admitted 9 months pregnant. LMP 06/01/2023, EDD
13/10/2023 ~ 41w1d.
• Patient had ANC at OBGYN 3 times and has never had ANC with
midwife. Defecation and urinary was within normal limit
Susan (T2B) / Physical Examination :
Marlia (T4B) GC: Good, CM W: 94 kg H : 158 cm BMI: 37,7 Kg/m2
Dr. Niken Asri Utama, BP 120/80 mmHg, HR 92 x/minute, RR 20 x/Minute, T 36,6⁰ C
OBGYN (C) Obstetric History
1. Male, 3 yo, 3200 gr, Vaginal Delivery at RSUDZA
2. Current pregnancy
Obstetrical Findings : FP : IUD interval
FH 38 cm ,contractions negative, back on the right side, FHR: 140 bpm,
head presentation, Station 5/5,
I : v/u normal limit
Io : Portio Smooth, closed ostium, Flour (-), fluxus (-), Nitrazin Test (-)
VT : posterior, Soft, Closed OUE, Thikness 3 cm, dilatation 0 cm, Hodge 1
CTG Category I
USG
Non Book Case
Referred from OBGYN Singleton, FHR positive, head presentation
due to post date BPD : 9,22 cm HC : 35,80 cm
pregnancy and severe AC : 34,67 cm FL : 6,15 cm
oligohydramnion ICA : 2,5 cm EFW : 3000 gr
Placenta : fundal to Corpus Anterior Mother are in good condition
Conclusion : Singleton live head presentation, 41-42 weeks and baby rooming in

G2P1A0 41-42 weeks gestasional age, Singleton Live Head Presentation,

severe oligohydramnion (AFI 2,5 cm), not in labor,

C-Section due to severe oligohydramnion.

Procedure Case Process Result

3. C-Section Mrs. AH, 33 yo CM 1-07-41-81 Informed consent  discussion with Born Male baby, BW
Chief complaint : Contraction supervisor  Consult to 3300 grams, BL 50 cm,
• Patient sent by OBGYN with chief complaint contraction since 1 day anesthesiology and perinatology A/S 8/9, BS ˜ 38-40
before admission. Bloody slime and Water broke was denied, division  Emergency C-section weeks, clear amniotic
• Patient admitted 9 month pregnant. LMP 31-01-2023, EDD 07-11-2023 fluid, placenta born
correspond to 38 W 1 D wga. completely
• Last US examination revealed fetus within normal limits
• Defecation and urinary were within normal limit.
Obstetric History
1. Female, 10 y.o, 2800 grams, SC due to Oligohidramnion in RSUDZA
Susan (T2B) / 2. Female, 5 y.o, 3200 grams, SC due to previous SC 1 times in RSUDZA.
Marlia (T4B) 3. Current Pregnancy
Dr. Tgk Puspa
Dewi, OBGYN Obstetrical Findings :
(C) FH : 33 cm, contraction 1x/10’’/20’’, back at right side, head presentation,
station 4/5 , FHR 140 bpm, EFW 3255 gr
I : V/U within normal limit
Io : Portio livide, Opened ostium, fluxus (-), flour (-), nitrazin test (-)
VT : posterior, soft, t 3 cm, 0 cm dilatation, Head H I FP : Tubektomi Pomeroy
USG
Head presentation, Singleton (+), FHR (+)
Placenta on fundal to corpus posterior
BPD : 9,35 cm AC : 33,85 cm
HC : 33,06 cm FL : 7,09 cm
AFI : 7 cm EFW : 3211 gr
Clear zone (+) Lacuna (-) Bridging vessel (-)
Conclusion: singleton live Head presentation ˜ 38-39 weeks
Non Book CTG category 1
Case
Patient Sent G3P2A0 38-39 weeks gestational age, singleton live head presentation,
by OBGYN Previous C-section 2 times, In Labor
with
contraction
C-section due to Previous C-section 2 times, In Labor Mother and baby are in
good condition in the
ward
THANK YOU