RSUD PROVINSI KEPULAUAN RIAU

Jl. Indun Suri Simpang Busung No. 1

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SPO
PERSALINAN KURANG BULAN (PRETERM)
No.Do/um!n
RSUDUB.KEB.0#(.#('
No R!1isi
#2#
3alaman 4
12 *
anggal !r5i6
No1!m5!r (#17
Di6!6ap/an 4
Dir!/6ur RSUD Pro1insi KEPRI
dr. Didi Kusmar8adi9 Sp O0
NIP.1,))#$71 1,,,#( 1 ##1
Batasan
P!rsalinan preterm adala: p!rsalinan ;ang 5!rlangsung
an6ara umur /!:amilan (#<7) minggu dari :ari p!r6ama :aid
6!ra/:ir "3P3% a6au an6ara :ari /! 1&# sampai (*, d!ngan
5!ra6 la:ir 8anin /urang dari (*## gram.
Faktor Risiko
Penyebab yang pasti diketa!i"
-a/6or risi/o 6!r8adin;a p!rsalinan preterm ;ai6u 4
1. K!6u5an p!=a: dini "KPD%9 /romioamnioni6is9 5a/6!riuri9
/olonisasi mi/roorganism! pada g!ni6al "0rop B
S6r!p6o/o/us+ dll%.
(. Ri>a;a6 p!rsalian pr!6!rm a6au /on6ra/si2an=aman
p!rsalinan pr!6!rm s!5!lumn;a.
7. Ri>a;a6 a5or6us s!5!lumn;a "A5or6us (. panda
6rim!s6!r /!dua%.
&. Ri>a;a6 a5or6us imin!ns panda /!:amilan ini.
*. P!rdara:an an6!par6um+ plas!n6a pr!1ia2solusio
plas!n6a.
). 3ip!r6!nsi dalam /!:amilan
$. S!r1i/s im/omp!6!n a6au ri>a6;a6 6inda/an /onisasi.
'. S!r1i/s m!m!nd!/ ? 7 =m9 dan a6au m!m5u/a l!5i: dari
1 =m9 panda /!:amilan 7( minggu "p!m!ri/saan US0%.
,. K!lainan u6!rus "8arang%
1#. Op!rasi a5dom!n >a/6u /!:amilan
11. P!rna: m!la:ir/an 8anin ma6i9 /!lainan /ong!ni6al.
1(. P!n;a/i6 i5u 6!ru6ama p!n;a/i6 in@!/si sis6!mi/ ;ang
5!ra6.
17. K!:amilan d!ngan ala6 /on6ras!psi ra:im "AKDR% insi6u.
1&. Pi!lon!@ri6is
1*. K!:amilan mul6i@!6us+ poli:idramnion9 oligo:idramnion.
1). K!lainan l!6a/
1$. Dia5!6!s A!li6us
1'. P!n;ala:gunaan2/!=anduan NAPBA "nar/o6i/a9
psi/o6ropi/a9 dan Ca6 adi/6i@ lainn;a%
1,. rauma @isi/2psi/is.
#iagnosis 1. 0!8ala A>ala
1. Rasa n;!ri26!gang panda p!ru6 5a>a: (low
abdominal pain/cramps)
(. N;!ri pinggang (low backache)
7. Rasa p!n!/anan panda 8alan la:ir
&. B!r6am5a:n;a =airan 1agina
*. P!rdara:an p!rdara:an 5!r=a/2l!ndir 5!r=ampur
dara:
(. 0!8ala d!@ini6i@
A!m!nu:i /ri6!ria p!rsalinan pr!6!rm m!lipu6i 4
a. Kon6ra/si u6!rus ;ang 6!ra6ur "1 /ali a6au l!5i:
dalam 1# m!ni6 a6au '. dalam 1 8am%
5. P!ru5a:an s!r1i/s s!p!r6i 4
< P!m5u/aan s!r1i/s D ( =m
< P!nda6aran s!r1i/s
=. P!rlu dila/u/an p!nilaian 6!r:adap ada 6ida/n;a
@a/6or !6iologi dan /!mung/inan /ompli/asi s!p!r6i 4
Ada 6ida/n;a plas!n6a pr!1ia
K!adaan /!6u5an "in6a/ a6au suda: p!=a:%
Ada 6ida/n;a /orioamnioni6is
Ada 6ida/n;a in@!/si sis6!mi/
Ada 6ida/n;a poli:idramnion
Ri>a;a6 o5s6!6ri s!5!lumn;a
Pengobatan
(. Kon@irmasi umur /!:amilan d!ngan 5!r5agai =ara
"3P39 US0 pada 6rim!s6!r p!r6ama9 r!/am m!dis9 dll%.
7. P!nilaian /on6ra/si u6!rus "laman;a9 in6!nsi6asn;a9
@r!/u!nsin;a dan p!ngarun;a 6!r:adap p!m5u/aan
s!r1i/s%.
&. P!man6auan 6anda<6anda 1i6al i5u
*. P!man6auan d!6a/ 8an6ung 8anin
). P!m!ri/saan 6am5a:an 4 Ul6rasonogra@i un6u/ m!nilai
pr!s!n6asi9 5om!6ri 8anin9 anomali9 1!losi6as ar6!ri
um5ili/alis "Doppl!r%9 Ind!/s =airan /!6u5an
"A-I%9 p!m!ri/saan plas!n6a9 mor@ologi s!r1i/s "pan8ang9
diam!6!r /analis s!r1i/alis dan ada 6ida/n;a funelling%.
$. ira: 5aring "la6!ral /!/iri a6au s!mi -o>l!r%
'. Bila diduga ada /orioamnioni6is9 la/u/an /ul6ur dan 5!ri
an6i5io6i/.
,. P!m5!rian o5a6<o5a6an 6o/oli6i/ "li:a6 BAB p!m5!rian
o5a6 6o/oli6i/%
1#. P!m5!rian o5a6<o5a6an p!ma6angan paru<paru 8anin
Di5!ri/an panda s!mua >ani6a :amil an6ara (&<7& minggu
D!/sam!6ason9 * mg 6iap 1( 8am "i.m% sampai
& dosis
B!6am!6ason9 1( mg "i.m% sampai ( dosis
d!ngan in6!r1al (& 8am
#iagnosis #i$erensia%
Kon6ra/si Bra.6on 3i=/s
Kon6ra/si Bra.6on 3i=/s si@a6n;a 6ida/ 6!ra6ur9 6ida/ ri6mis9
6ida/ 5!gi6u sa/i6 dan 6ida/ m!nim5ul/an p!ru5a:an s!r1i/s.
KON&RAKSI PRE'A&UR
< -a/6or Risi/o
< Kon@irmasi Umur K!:amilan < US0
< Kon6ra/si U6!rus < K0
< P!ru5a:an s!r1i/s

< ira: 5aring
< O5a6 6o/oli6i/
"li:a6 5a5 p!m5!rian o5a6 6o/oli6i/%
< O5a6 p!ma6angan paru "/or6i/os6!roid%
< La5 p!nun8ang un6u/ @a/6or r!si/o
O5s!r1asi
!rapi 5!r:asil !rapi gagal

P!m5!rian 6o/oli6i/ P!rsalinan
di6!rus/an s!suia
d!ngan p!doman
Da@6ar Pus6a/a
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