Kelainan pada Payudara

Presentan:
Rayhan Fajar Matheza
Aulia Lathifah
Syilviyanti Renny

Perseptor: dr. Roza Sri Yanti, Sp.OG(K)

 Bendungan

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 KELAINAN PADA MAMMAE
1. Pembendungan air susu

Terjadi pada :

• Bayi yang belum menyusu dengan baik. Kelenjar

kelenjar mammae tidak dikosongkan dengan baik.

Gejala :

• Pada perabaan terasa panas, keras dan nyeri.

• Suhu badan tidak naik
• Puting susu mendatar
Kadang kadang ASI terhalang akibat duktuli laktiferi
menyempit karena pembesaran vena dan pembuluh limfe.
Penanganan :
●Menyokong mammae dengan BH
●Pemberian analgetika
●Diusahakan melakukan pijitan ringan pada mammae
sebelum menyusui
●Kadang kadang diberikan stilbestrol 3x1mg selama 2-3
hari.
Manajemen Laktasi
Mastitis
Mastitis adalah peradangan
payudara yang dapat atau
tidak disertai infeksi dan
biasanya berlangsung pada
minggu kedua dan ketiga
paskapersalinan
 Epidemiologi
The American Society
Amerika Serikat
241.240 wanita

Kanada
24.600 orang

Indonesia
876.665
orang
Terdapat peningkatan kejadian mastitis
sebanyak 33% pada wanita menyusui
 Faktor Resiko
1. Terdapat riwayat mastitis pada anak sebelumnya
2. Puting lecet
3. Frekuensi menyusui yang jarang atau waktu menyusui yang pendek.
4. Pengosongan payudara yang tidak sempurna
5. Pelekatan bayi pada payudara yang kurang baik.
6. Ibu atau bayi sakit
7. Frenulum bayi pendek
8. Produksi ASI yang terlalu banyak
9. Berhenti menyusu secara cepat/ mendadak, misalnya saat bepergian
10. Penekanan payudara misanya oleh bra yang terlalu ketat atau sabuk pengaman
pada mobil
11.Sumbatan pada saluran atau muara saluran oleh gumpalan ASI, jamur, serpihan
kulit, dan lain-lain
12. Penggunaan krim pada puting
13. Ibu stres atau kelelahan
14. Ibu malnutrisi. Hal ini berhubungan dengan daya tahan tubuh yang rendah
 Etiologi
Statis ASI Infeksi
■ Bendungan Payudara ■ Organisme
■ Frekuensi Menyusui ■ Kolonisasi bakteri
■ Pengisapan pada pada bayi dan
payudara
Payudara
■ Sisi yang disukai dan
■ Epidemik Mastitis
pada nifas
pengisapan yang efisien
■ Rute Infeksi
■ Faktor Mekanis lainnya
Patofisiologi

Peningkata
Payudara
Statis ASI n tekanan
tegang
duktus
 Port d’entree kuman (umumnya Staphylococcus
aureus)

Melalui lecet pada puting

Menjalar perkontinuitatum ke duktulus-duktulus dan

sinus
Diagnosis

An/ PF/ P.penunjang/

• Nyeri • T > 38C • kultur
• Payudara terasa lebih • Payudara bengkak,
berat merah, keras, nyeri
• demam tekan, lecet pada
puting, terdapat nanah
jika sudah abses
Tatalaksana

analgesik
medikamentosa
Th/
Tujuan: antibiotik
mencegah
infeksi dan
komplikasi Non-
medikamen suportif
tosa
Terapi nonmedikamentosa

Kompres
hangat

Meningkatkan Tindakan
masase
asupan gizi suportif

edukasi
Edukasi
Tetap menyusui bayi, kecuali bila sudah abses (dengan posisi
dan pelekatan yang baik)

Pompa ASI

Gunakan Pakaian tidak ketatpakaian yang

tidak ketat

Jaga higiene
Terapi medikamentosa
• Indikasi:
• jumlah dan kultur sel dan koloni bakteri
tersedia dan menunjukkan infeksi, atau

antibiotik • gejala sudah parah sejak awal, atau

• celah puting terlihat, atau
• gejala tidak membaik setelah 12-24 jam
pengeluaran ASI membaik

analgesik • Ibuprofen (sampai dosis 1,6 gram

per hari tidak terdeteksi pada ASI )
Komplikasi

Penghentian Mastitis kronis

menyusui mendadak

Abses Infeksi jamur

Prognosis

Bonam jika
ditatalaksana
dengan adekuat
 Abses

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Epidemiologi
Abses
Mastitis (5-11%)
Laktasi (2-3%) >> usia subur (32 th)

DM

Perokok Usia dekade

Non Laktasi
keempat
Obesitas

Tindik puting
 EtioPatofisiologi
Paling umum adalah S.
Duktus laktiferus
aureus, tetapi dalam
beberapa kasus, mengalami epidermalisasi
Streptococci, dan di mana produksi keratin
Staphylococcus epidermidis dapat menyebabkan
juga mungkin terlibat duktus terhambat, dan
dapat menyebabkan
pembentukan abses.
Abses yang berhubungan
Infeksi sering muncul pada dengan laktasi biasanya
minggu kedua pascapartum dimulai dengan abrasi atau
dan sering dipicu dengan jaringan di puting susu,
adanya stasis ASI
yang menjadi titik masuk
bakteri.
 Diagnosis
• Riwayat nyeri payudara,
• eritema,

Anamnesis
• rasa hangat, dan kemungkinan edema.
• Riwayat laktasi, infeksi payudara dan pengobatan
sebelumnya
• Gejala sistemik : demam, mual, muntah
• Discharge
• Penyakit lainnya: DM

Book 2
• eritema, indurasi, rasa hangat, dan nyeri tekan saat
palpasi
• ada massa atau area fluktuasi yang teraba.
• ada cairan purulen di puting atau tempat fluktuasi.
• demam atau takikardia
Abses
nifas
Abses nonperperal
sentral
Tatalaksana
 Month at a Glance
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dic

Mon Tue Wed Thu Fri Appointments This month’s goals

10:00 Meeting Teach about biology

13:00 Lunch More time for lesson 2

To Do:
Review lesson 2 for tomorrow
 Weekly Planner
Hour Monday Tuesday Wednesday Thursday Friday
8:30 / 9:30 Lesson 1 Lesson 3 Lesson 5

9:30 / 10:30 Lesson 1 Lesson 2 Lesson 3 Lesson 5

10:30 / 11:30 Activities Lesson 4 Lesson 4 Activities

11:30 / 12:30 Lesson 2 Activities Activities

12:30 / 13:30 Lesson 3 Review Exam

13:30 / 14:30 Exam

Notes Write something important here

Priorities Date:

Write a pending task here Leave for later

Write a pending task here

Write here your
Write a pending task here important notes

Write a pending task here

Write a pending task here

No need to do it
Write a pending task here

Write a pending task here

Write here your
Write a pending task here important notes
 Class’s Projects

Deadline Priority Title Description Timeline

9/30/20 Science project Describe the project 30 days

10/23/20 Biology project Describe the project 20 days

9/23/20 History project Describe the project 15 days

Dinosaurus project Describe the project 40 days

Human Body project Describe the project 60 days

Literature project Describe the project 10 days

 Projects Calendar
Jan Feb Mar Apr May Jun Jul
Project 1

Saturn is a gas giant

composed of mostly of
hydrogen and helium
Project 2

Mercury is the closest object to the Sun and also the

smallest planet in the Solar System
Project 3

Despite being red, Mars is a very cold planet full of

iron oxide dust
 Events
Su M Tu W Th F Sa
21 22 23 24 25 26 27

Tuesday, 23
No events

Mercury Jupiter Mars Neptune

Mercury is the Despite being
Jupiter is the Neptune is the
smallest red, Mars is a
biggest planet farthest planet
planet cold place
 Important Dates
January February March April
14/ Valentine’s day

May June July August

4/ Independence

September October November December

7/ Labor day 12/ Columbus day 26/ Thanksgiving
Daily Planner
Date:

Hour Tasks Description

9:00 English Mercury is the smallest planet

10:00 Meeting Jupiter is the biggest planet

11:00 Math Despite being red, Mars is a cold place

12:00 History Neptune is the farthest planet

13:00 Activity It’s the biggest planet in the Solar System

14:00 Art Saturn is the ringed one and a gas giant

15:00 Exam Venus has a beautiful name, but it’s hot

 Classroom Expenses

Description Budget Actual Difference Date/Note

Computers $50,000 $40,000 $10,000 New students

Tablets $20,000 $5,000 $15,000 Old damaged

Video projectors $100,000 $40,000 $60,000 Missing projectors

Classroom supplies $10,000 $2,000 $8,000 It is not enough

Budgeted Actual Difference Total

$180,000 $87,000 $93,000 $180,000
Classroom Expenses
60% 75%
Mars Neptune
Despite being red, It’s a gas giant and
Mars is a cold place the biggest planet

53% 61%
Mercury Venus
Mercury is the Venus is the second
smallest planet planet
 Lesson Plan

Unit Subject Goal

Mercury is the closest Venus has a beautiful name, Despite being red, Mars is a
planet to the Sun but it’s hot cold place

Key Point Activity Exam

Neptune is the farthest It’s the biggest planet in the Saturn is the ringed one and
planet Solar System a gas giant

Notes Write something relevant here

 Theme Planner
Subject Biology Subject English

Theme Characteristics of mammals Theme Pronunciation

Ideas Use a worksheet Ideas Listening to music

Resources Educational video Resources Lyrics and videos

Subject Math Subject Literature

Theme Multiplication and division Theme Women in literature

Ideas Exercises Ideas Female authors

Resources Math website Resources List of different books

 Goal-Setting Activities

Time Activity Today Goals

1h Describe your activity Describe your goals

2h Describe your activity Describe your goals

3h Describe your activity Describe your goals

2h Describe your activity Describe your goals

1h Describe your activity Describe your goals

3h Describe your activity Describe your goals

 Planning

Mars Saturn
Today Mars is a cold Saturn is the Goal
place ringed one
Ma Ma
r y
Apr Jun
Venus Jupiter Mercury
Venus has a It’s the biggest Mercury is the
beautiful name planet smallest planet
 Reading Log
Leve
Student Name Book #pgs Start date Finish Date
l
Martha Doe 8 Mars is a cold place 120 09/10/20 10/10/20

Alex Reznor 6 It has a beautiful name 60 09/10/20 10/10/20

Marie Jane 8 Saturn is the ringed one 130 09/10/20 10/10/20

James Tresor 9 Mercury is the closest planet 200 09/10/20 10/10/20

Anna Moore 10 It’s the biggest planet 250 09/10/20 10/10/20

Anthony Mars 8 It is the farthest planet 110 09/10/20 10/10/20

 Book Report
Title: Author: Pages:

What is this book about?

Who are the main characters?

Date: Daily Schedule
Todays 07:00
priority 08:00
09:00 Math class
Review lesson 2 for
tomorrow 10:00
11:00 English class
12:00
13:00 Lunch time
Notes 14:00
15:00 Activities
Mars is actually a 16:00
cold place and Venus 17:00 Meeting
has a beautiful name
A Picture of the Students
 Student Checklist
Date:

Student Name Mon Tue Wed Thu Fri

Martha Doe

Alex Reznor

Marie Jane

James Tresor

Anna Moore

Jimmy Jazz
 Student Information

Information Needs help with

Student’s name: Jenny Jackson Write here your important notes
Subjects: Math, Geometry
Progress dates: 11.20.20
Grades: 5.4

Reinforcement
exercises
Write here your important notes
 Student Progress

Student:

First Period

Second Period

Third Period

Fourth Period
To modify this graph, click on it, follow the link, change the
data and paste the new graph here, replacing this one
 Student’s Report Calendar
It is a gas giant and also the
biggest planet of them all
First
Despite being red, Mars is a cold
place
Second
Venus has a nice
name, but it’s hot
Third
Saturn a gas giant made of
hydrogen and helium
Fourth

Jan Mar May Jul Sep Nov

 Field Trip Planner

Month Date Duration Location Things to do

July 14 8 days Brazil Mars is a cold place

August 26 15 days Spain Venus has a beautiful name

September - - - -

October - - - -

November 1 20 days Australia Neptune is the farthest planet

December 08 5 days California Saturn is a gas giant

Students’ Birthdays Month:

Write here the students

birthday!

■ 12 / Marie Breton

■ 18 / John Doe

■ 21/ David Michael

■ 28/ Lana Parker

■ 30/ Susan Travers

■ 31/ Dani Smilek

 Thanks!
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