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Skenario A blok 23Tahun 2014 A woman attends a routine antenatal appointment at 31 weeks gestation.

She is 26 years old and this is her i th pregnan!y. "e has our !hildren# all spontaneous $aginal deli$eries at term. "er ourth !hild is 1% months old and the deli$ery was !ompli!ated by a postpartum haemorrage &''"( re)uiring a 4 unit blood trans usion. She is re ered by midwi e to do!tor &publi! health !entre( with possibility o bree!h presentation. The mother !omplains o malaise and di**y. +ue to her e!onomi! !ondition# she admits that during her pregnan!y she only eats some ood that she !an a ord to buy she eels generally tired and attributes this to !aring or her our young !hildren. She reports good etal mo$ements &more than 10 per day( ,lari ikasi istilah 1. 'regnan!y - suatu keadaan mengandung embrio atau etus yang bertumbuh di dalam tubuh setelah penyatuan sel telur dengan spermato*oa 2. Antenatal - Sebelum kelahiran 3. .estation - periode waktu bayi berada dalam rahim lama periode nya adalah 3% / 42 minggu 4. 'ostpartum hemmorage - perdarahan per$aginam yang melebihi 000 ml setelah melahirkan 0. 1ree!h 'resentation - presentasi lahirnya sungsang atau terbalik 6. 2alaise - perasaan tidak nyaman yang samar3samar 4. +i**y - sensasi terombang ambing dan perasaan adanya pergerakan di dalam kepala atau tidak seimbang %. 5etal - berkenaan dengan etus atau periode perkembangannya 6. 'ale - pu!at# seperti pada kulit

7denti ikasi masalah 1. A woman attends a routine antenatal appointment at 31 weeks gestation. She is 26 years old and this is her i th pregnan!y. "e has our !hildren# all spontaneous $aginal deli$eries at term 2. "er ourth !hild is 1% months old and the deli$ery was !ompli!ated by a postpartum haemorrage &''"( re)uiring a 4 unit blood trans usion 3. She is re ered by midwi e to do!tor &publi! health !entre( with possibility o bree!h presentation 4. The mother !omplains o malaise and di**y 0. +ue to her e!onomi! !ondition# she admits that during her pregnan!y she only eats some ood that she !an a ord to buy she eels generally tired and attributes this to

!aring or her our young !hildren. She reports good etal mo$ements &more than 10 per day( 6. 'hysi!al e8ams 4. 9aboratorium e8ams

Analisis masalah 1. A woman attends a routine antenatal appointment at 31 weeks gestation. She is 26 years old and this is her i th pregnan!y. "e has our !hildren# all spontaneous $aginal deli$eries at term a. 1erapa usia ideal ibu untuk hamil: 1 b. 1agaimana perkembangan ;anin usia 31 minggu: 2 !. Apa sa;a dampak bagi ibu dengan riwayat grandemulti gra$ida: 3

2. "er ourth !hild is 1% months old and the deli$ery was !ompli!ated by a postpartum haemorrage &''"( re)uiring a 4 unit blood trans usion a. Apa makna dari riwayat Her fourth child is 18 months old and the delivery was complicated by a postpartum haemorrage (PPH) requiring a 4 unit blood transfusion : 4 b. 1erapa ;arak waktu normal antar kehamilan: 0 !. Apakah dampak ;arak waktu kehamilan yang dekat: 6 d. Apa etiologi dari ter;adi nya postpartum haemmorage: 4

3. She is re ered by midwi e to do!tor &publi! health !entre( with possibility o bree!h presentation a. Apa sa;a ma!am3ma!am persentasi kelahiran: % b. <elaskan gambaran bree!h presentation: 6 !. 1agaimana etiologi dan mekanisme bree!h presentation: 10

4. The mother !omplains o malaise and di**y a. 1agaimana etiologi dan mekanisme malaise dan di**y pada kasus: <elaskan hubungannya: 11 b. 1agaimana dampak kondisi ibu terhadap kondisi ;anin: 12

0. +ue to her e!onomi! !ondition# she admits that during her pregnan!y she only eats some ood that she !an a ord to buy she eels generally tired and attributes this to !aring or her our young !hildren. She reports good etal mo$ements &more than 10 per day( a. 1agaimana nutrisi yang baik untuk ibu dan ;anin: 13 b. 1agaimana hubungan kondisi ibu pada kasus dengan keluhan: 14

6. 'hysi!al e8ams a. 1agaimana interpretasi dari physi!al e8ams: &127: 1': 'ulse: ==: 'alpebral !on;u!ti$al looked pale: "ard parts are palpabled in the right side o mothers abdomen( 10 b. <elaskan mekanisme abnormal dari physi!al e8ams: 16 4. 9aboratorium e8ams a. 1agaimana interpretasi dari 9aboratorium e8ams: 14 b. <elaskan mekanisme abnormal dari laboratorium e8ams: 1% %. +i erent diagnosis: 16 6. "ow to diagnose: 20 10. >orking diagnose: 21 11. 5aktor resiko: 22 12. ?pidemiologi: 23 13. 'atogenesis: 24 14. Tatalaksana armako dan non armako: 20 10. ,omplikasi: 26 16. 'en!egahan: 24 14. 'rognosis: 2% 1%. S,+7: 26

"ipotesis - >anita 26 tahun dengan kehamilan kelima diduga menderita anemia de isiensi besi

97 1. 'erubahan anatomi dan isiologi selama kehamilan 2. 'erkembangan ;anin 3. Anemia de isiensi besi

'embagian tugas Tatia Shel$i Ali Amir @dis =oby Aatasha 7ndah 7rin =eyhan Aulia Satria - 1#13#20#%#20 97 - 1 - 2#14#26#6#21 97 - 2 - 3#10#24#10#22 - 4#16#2%#11#23 - 0#14#26#12#24 - 6#1%#1#13#20 97 - 3 - 4#16#2#14#26 97 - 1 - %#20#3#10#24 97 - 2 - 6#21#4#16#2% 97 - 3 - 10#22#0#14#26 - 11#23#6#1%#1 97 - 2 - 12#24#4#16#2 97 - 3 97 - 1 97 - 3 97 - 1 97 - 2

+ikarenakan kita semua wa;ib untuk men!ari semua ;awaban# maka pada hari kedua ;ika ada teman3teman sekalian yg memiliki ;awaban selain dari nomor3nomor tugas yg sudah diberikan harap disampaikan pada saat tutorial dan ;awaban tsb dilampirkan dalam so t!opy yg akan dikumpulkan ke saya# supaya diskusi kita ;adi menarik dan isi dari laporan tutorial kita nanti ;uga bisa lengkap tanpa bolong3bolong. "ehe. @h iya satu lg# tolong dikumpul dalam bentuk so t!opy &.do!( ya# Trims. -+