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PLASENTA PREVIA

TOTALIS
NENI SETIYOWATI
20110310011

PENDAHULUAN
Perdarahan

obstetrik

pada

kehamilan

trimester ketiga akibat plasenta previa pada


umumnya adalah perdarahan

berat sehingga

jika tidak mendapat penanganan yang cepat


bisa mendatangkan syok fatal
Prevalensi plasenta previa pada tahun 2009,
sekitar
2009).

320

dari

100.000

kelahiran

(WHO,

TINJAUAN PUSTAKA
Definisi
Plasenta previa adalah plasenta yang berimplantasi pada segmen
bawah rahim sedemikian rupa sehingga menutupi seluruh atau
sebagian dari ostium uteri internum.
Plasenta previa totalis atau komplit
Plasenta previa parsialis
Plasenta previa marginalis
Plasenta letak rendah
Vasa previa

INTRODUCTION
Jenis Plasenta Previa

TINJAUAN PUSTAKA
Faktor risiko
Paritas tinggi
Usia lanjut
Cacat rahim (misalnya bekas bedah sesar,
kerokan, miomektomi)
Cacat bekas bedah sesar
Merokok
Plasenta yang terlalu besar seperti pada
kehamilan ganda dan eritroblastosis

TINJAUAN PUSTAKA
Gejala klinis
Ciri yang menonjol pada plasenta previa adalah
perdarahan uterus keluar melalui vagina tanpa
rasa nyeri. Perdarahan biasanya baru terjadi
pada akhir trimester kedua ke atas.

TINJAUAN PUSTAKA
Diagnosis
Transabdominal ultrasonograf.
Pemeriksaan transabdominal ultrasonografi yang
dilakukan

dalam

dikosongkan

akan

keadaan

kandung

memberi

kemih

kepastian

yang

diagnosis

plasenta previa dengan ketepatan tinggi sampai 96% 98%.

Transvaginal ultrasonograf
Di tangan yang tidak ahli bisa memprovokasi perdarahan lebih
banyak. Di tangan yang ahli dapat dicapai 98% positive predictive
value dan 100% negative predictive value
Transperineal sonograf
dapat mendeteksi ostium uteri internum dan segmen bawah rahim.
Teknik ini dilaporkan 90% positive predictive value dan 100%
negative prective value
Magnetic Resonance Imaging (MRI)
kalah praktis jika dibandingkan dengan USG .

RESEARCH METHODOLY
Research Design
A non-experimental research with cross-sectional study. Subject
divided into test-group and control-group.

Time and Location of Research


Oktober to Desember 2014.

Srumbung, Magelang

RESEARCH METHODOLY
Population
Sample

All patients with type II diabetes


mellitus in IDD endemic area
Test group
Control group

Variable
Independent Variable:
Patients with type II diabetes mellitus in IDD endemic area
Dependent Variable:
Serum total cholesterol level

RESEARCH METHODOLY
Operational Definition
Hypothyroid
condition

Determined by scoring result with total score>


20.

Cholesterol
level

Measured with enzimatic method, normal <200


mg/dl

Fasting blood
sugar level
(GDP)

Screened with easy touch, normal <126 mg/dl +


3 specific symptomps

IDD endemic
area

region where the average consumption of iodine


population is not sufficient for the body, so that
causing hypothyroidism

RESEARCH METHODOLY
Tools and materials
Injection needle 5 cc, handscoon, alcohol swab, easytouch,
torniquet, coolbox and dryice, blood tube
Laboratory instruments
Chemicals materials
Material examined :blood from mediana cubiti vein, then was
taken its serum

Research Framework
Subject in IDD endemic area
Data collecting of patients with type II DM
at the primary health center, Srumbung

Physical examination, skoring, and


blood sampling

Test group
(hypothyroid, skoring > 20)

Control group
(non-hypothyroid, skoring < 20)

Examination of serum
total cholesterol level

RESEARCH METHODOLOGY

Data Analyzing
Normal data : Independent Sample t-Test
Abnormal data : Mann Whitney test

RESULT AND DISCUSSION


Characterictics of respondents
Patients with type II DM
GDP >126 mg/dl
Skoring of hypothyroid and nonhipotiroid condition
Hypothyroid
Normal (non-hypothyroid)
Level of serum total cholesterol
HYPOTHYROID
Normal
Abnormal
NON-HYPOTHYROID
Normal
Abnormal

30

100

15
15

50
50

2
13

13,33
86,67

10
5

66,67
33,33

RESULT AND DISCUSSION

AVERAGE

Serum Total
Cholesterol
Level (mg/dl)

Test Group
(Hypothyroid
Type II DM)

Control Group
(Non-Hypothyroid
Type II DM)

254,733 40,631

193,84 26,516

RESULT AND DISCUSSION

RESULT AND DISCUSSION

The value of different test on Sig. (2-tailed) is


0.000 (p <0.05), it means that the serum total
cholesterol levels in hypothyroidism type II
diabetes mellitus differ significantly with serum
total cholesterol levels in non-hypothyroid type
II diabetes mellitus.

RESULT AND DISCUSSION

Discussion
In the case of type II diabetes mellitus, there is increasing of
cholesterol level caused by insulin resistance
Goiter in the case of iodine deficiency due to thyroid cells
become hyperactive and hypertrophic in an attempt to absorb
the rest of remaining iodine in the blood.
Thyroid hormones decrease cholesterol level in the blood

RESULT AND DISCUSSION


Discussion

The Role of Thyroid Hormones in Cholesterol Metabolism

CONCLUSION

This study showed that serum total cholesterol levels in


patients with hypothyroid type II diabetes mellitus ( 254.733
40.631 mg / dl) significantly higher ( <0,05 ) compared
with patients with non-hypothyroid diabetes mellitus type II
(193.84 26 516 mg / dl)

SUGGESTIONS

Further research is needed about the changing of total serum

cholesterol levels in patients with hypothyroid and non-hypothyroid


type II DM with more detail inclusion and exclusion criteria

Need to do a follow-up of research about the condition of non-

hypothyroid and hypothyroid which is associated with other


parameters that have not been investigated

SUGGESTIONS

Diagnosis determination of hypothyroid and non-hypothyroid


should be done with more adequate examination

Socialization and education about how to manage hypothyroidism,


type II diabetes mellitus, and abnormal cholesterol levels to improve
the quality of life in Srumbung society.