Duty Report RSUDZA

Thursday, April 4th 2019

Supervisors :
dr. Tgk Puspa Dewi, OBGYN (Oncall)
dr. Cut Rika Maharani, OBGYN

Residents :
Imam / Fahri-Risma / Tama-Mala-Didi / Fikri / Rendy / Budi
Reporting
3 Procedures :
• 2 Vaginal Deliveries
• 1 C- Section
 Procedure Case Outcome
1. Vaginal Mrs. S, 31 yo Born male baby 2800 g,
Delivery with MR 1-11-49-63 48 cm, AS 9/10,
Induction BS ~ 38 - 40 weeks
G2P1 37-38 wga Singleton Live Head Presentation, PROM 8 Placenta born completely
Hours (AFI 6), Unfavourable Cervix (PS 4), Not in Labor Perineum rupture grade I
 Haemostasis

Obstetrical State:
FH 31 cm, back at the left side, head presentation, 4/5 ,
Contraction: irregular, EFW 2945 g, FHR 142 bpm
I : V/U within normal limit
Io : portio livide, opened OUE, fluxus (-), valsava test (+), Nitrazin test (+) FP : DMPA
VT : Posterior, soft, thickness 2 cm, 1 cm dilatation, head on Hodge I-II
(PS 4)

CTG category I

Process:
Budiman (T1A)/ Informed consent prophylaxis antibiotic, plan for vaginal delivery with
Fikri (T2B)/ induction of labor with oxytocin 5IU in 500 cc RL 12 dpm on 5 hours
dr.Tgk Puspa observation FHR 140x/I, contraction : 2x/10’/25”, VT : Axial, smooth,
Dewi, OBGYN t1 cm, 3cm, head on Hodge I-II (PS7)  acceleration of labor with 5IU
Oxytocin in 500 ml RL, titration/30 minute, start from 12 dpm until
adequate contraction on 3 hours observation  FHR 150x/I,
Mother and baby were in
Contraction 4x/10’/40”, VT :  7 cm, amniotic membrane (-), small
fontanell right anterior, head on Hodge II-III (active phase of labor)  on good condition in the
Non Book Case 3 hours observation  complete dilation, small fontanell anterior, head ward
on Hodge III-IV (2nd stage of labor)  led mother to bear down
 Procedure Case Outcome
2. Vaginal Mrs. NR, 24 yo Born male baby 3100 g,
Delivery MR 1-11-49-63 48 cm, AS 9/10,
BS ~ 38 - 40 weeks
G1 37-38 wga Singleton Live Head Presentation, Rupture of Placentae born
Membrane 6 Hours (AFI 5), Favourable Cervix (PS 6), In Labor completely
Perineum rupture grade
2 Perineorraphy
Obstetrical State:
FH 32 cm, back at right side, head presentation, 4/5 , Contraction:
2x/10/20” , EFW 3100, FHR 140 bpm
I : V/U within normal limit
Io : portio livide, opened OUE, fluxus(+), valsava test (+), Nitrazin test (+)
VT : axial, soft, thickness 1 cm, 2 cm dilatation, head on Hodge I-II (PS 6)
FP : DMPA
CTG category I
Fahri (T3B) /
Process:
Fikri (T2B)/ Informed consent prophylaxis antibiotic, plan for vaginal delivery with
dr.Cut Rika, acceleration of labor with 5IU Oxytocin in 500 ml RL, titration 4 dpm/30’
OBGYN until adequate contraction, start from 8 dpm  on 3 hours observation 
FHR 145x/i, contraction: 4x/10’/35”, VT :  6cm, amniotic membrane (-), Mother and baby were in
Book Case small fontanell right anterior, head on Hodge II-III (active phase of labor) good condition already
Reffered by  on 4 hours observation  complete dilation, small fontanell anterior, discharged
head on Hodge III-IV (2nd stage of labor)  led mother to bear down
OBGYN
 Procedure Case Outcome
1. C-Section Mrs. RS, 22 y.o Born female baby,
MR 1-12-47-22 BW 3400gr, BL 48cm,
AS 7/9, BS~38-40 weeks
G2P1 39-40 wga, Singleton Live Head Presentation PROM 1 day Nill amniotic fluid
(AFI 1), Previous C-Section 1x (IDT 20 Months) Not in Labor, Placenta born completely
Non Reassuring Fetal Status

C-Section due to non reassuring fetal status

Obstetric Status:
FH 35 cm, back at left side, head , 5/5,
Contraction negative, FHR 170 bpm, EFW: 3410 g FP : IUD Trancesarean
I : v/u wnl
Io : portio livid, closed OUE, Fluxus (-), valsava test (+), nitrazin test (+)
Rendy (T2A) / VT: posterior, smooth, t 2cm, Ø 0 cm, head on hodge I
Risma (T3B)
CTG Category 2
dr. Tgk Puspa
Dewi, OBGYN Process:
CTG category II, FHR 170 bpm intrauterine resuscitation 30 minutes
CTG still category II, FHR 165 bpm Non reassuring fetal status  Inform
consent  antibiotic prophylaxis  consul to anesthesiology dan
Non Book Case perinatology division  C-section
Came by her 30 minutes
Now mother and baby
CTG category II CTG category II
own will due to resusitation were in good condition in
water broke the ward