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Penyakit jantung merupakan salah satu PENDAHULUAN penyebab kematian maternal non-obstetrik yang cukup penting Angka kejadian : 0,4-4,1%
Indonesia (2005-2006) : 1,2%
Antepartum Volume meningkat 50% Tahanan Perifer menurun 20% Tekanan darah menurun pada 24 minggu pertama CVP tetap HR meningkat 10-15/m CO meningkat 30-50%
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INTRAPARTUM
CO meningkat 20-30% Tiap kontraksi melepaskan 300-500 ml darah dari uterus ke sirkulasi sistemik BP meningkat 10-20 mmHg tiap kontraksi Posisi terlentang menurunkan CO 30% Konsumsi oksigen meningkat 100%
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POSTPARTUM
CO meningkat 10-20% pada awal periode post partum SV meningkat Refleks bradikardia Menetap 1-2 minggu postpartum
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KLASIFIKASI ETIOLOGIS
Penyakit Jantung Kongenital
Sianotik Asianotik
Abnormal
Sinkop PND Takikardi >120x/menit Aritmia terus menerus Nafas memendek saat istirahat Distensi vena leher Summation gallop Murmur sistolik (4-6/6) Murmur diastolik Nyeri dada Hemoptisis Sianosis
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NYHA CLASSIFICATION
NYHA Class I Patient with cardiac disease but without resulting limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation,dyspnea or anginal pain NYHA Class II Patient with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity result in fatigue, palpitation,dyspnea or anginal pain
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NYHA
Class III
Patient with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity result in fatigue, palpitation,dyspnea or anginal pain
Patient with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
NYHA Class IV
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