KEHAMILAN

ABDOMINAL

PEMBIMBING
dr. Muslich, Sp.OG
Oleh
TASYA MAULIDIA NAFISA
20360157
KEPANITRAAN KLINIK SENIOR ILMU GINEKOLOGI
FAKULTAS KEDOKTERAN
UNIVERSITAS MALAHAYATI
RUMAH SAKIT UMUM HAJI MEDAN
2020
 DEFINISI

• Kehamilan Abdominal merupakan kehamilan ektopik dalam arti yang sebenarnya karena merupakan
suatu kehamilan yang terletak sama sekali di luar sistem reproduksi. Kehamilan ektopik sendiri adalah
suatuInsert the Sub
kehamilan yangTitle of Your
terjadi Presentation
luar rongga rahim (kavum uteri).
EPIDEMIOLOGI
01
Contents
Get a modern PowerPoint Presentation that is beautifully designed. I
hope and I believe that this Template will your Time.
Kehamilan Abdominal merupakan kehamilan yang jarang terjadi.
Negara Berkembang 1:402 kehamilan
Negara Maju 1:10.000 kehamilan

02
Contents
Get a modern PowerPoint Presentation that is beautifully designed. I
hope and I believe that this Template will your Time.

Kehamilan Abdomen terjadi 2% dari kehamilan ektopik

03
Contents
Get a modern PowerPoint Presentation that is beautifully designed. I
hope and I believe that this Template will your Time.

04
Contents
Get a modern PowerPoint Presentation that is beautifully designed. I
hope and I believe that this Template will your Time.
ETIOLOGI
Content Here
KEHAMILAN ABDOMINAL PRIMER :

Terjadi apabila ovum difertilisasi dan berimplantasi

langsung di cavum abdomen

Content Here
KEHAMILAN ABDOMINAL SEKUNDER :

Ini terjadi bila fetus keluar dari tempat implantasi primernya

melalui suatu robekan ataupun melalui suatu ujung fimbria dan
berimpantasi di cavum abdomen.

Content Here
Sebagian besar kasus , kehamilan abdominal yang terjadi
merupakan akibat dari implantasi sekunder dari suatu
kehamilan tuba yang pecah. Jarang sekali dijumpai kehamilan
abdominal primer langsung dari cavum abdomen.
PATOFISIOLOGI
Gangguan Mekanik ovum

Kebutuhan embrio tidak terpenuhi dalam tuba

Tuba abortion Ruptur dinding tuba Faktor abortus kedalam

lumen tuba

Kehamilan abdominal
 GEJALA KLINIS
Trias Kehamilan Ektopik
aminorea, nyeri abdomen dan perdarahan.

1. Pada pemeriksaan vagina terdapat nyeri goyang bila serviks

digerakkan,
 Get nyeri pada
a PowerPoint perabaan dan kavumdouglas menonjol
Presentation

karena ada
 Get a PowerPoint Presentation
bekuan
 Get darah
a PowerPoint Presentation
 Get a PowerPoint Presentation
50%
2. Pleuritic chest pain
3. Uterus dapat tumbuh membesar pada 3 bulan pertama akibat
hormon yang dilepaskan plasenta. $234,090
Contents Title
4. Tekanan darah normal, kecuali bila terjadi ruptur.
5. Setelah perdarahan akut suhu tubuh dapat turun atau meningkat
>38 C. $434,090
Contents Title
 FAKTOR RESIKO
1. Infeksi dan kerusakan tuba
2. Salpingitis isthmica nodosa
3. Kelainan zigot
4. Faktor ovarium
5. Merokok
6. Pengunaan kontrasepsi oral, IUD, sterilisasi tuba dengan elektrokoagulasi
meningkatkan kemungkinan untuk kehamilan ektopik. Place Your Picture Here
7. Riwayat menderita kehamilan ektopik sebelumnya
8.
You Riwayat
can simply impressoprasi tuba
your audience and add a unique zing and
appeal to your Presentations. Easy to change colors, photos and
9.
Text. Endometriosis
Get a modern PowerPoint Presentation that is beautifully
designed. I hope and I believe that this Template will your Time,
10. Cacat
Money bawaan
and Reputation. (abnormalitas
Easy to change colors, photos and kongenital)
Text. dari saluran telur
DIAGNOSIS
ANAMNESIS :
1. Nyeri perut
2. Terlambat haid
3. Perdarahan pervaginam
4. Pingsan

1. Tanda-tanda syok hipovolemik

2. Tanda-tanda akut abdomen ( tegang bagian bawah perut, nyeri tekan, cairan
bebas intra abdomen)
3. Ditemukan janin dalam letak tidak normal
4. Tes oksitosin
PEMERIKSAAN
FISIK
VT :
1. Fluxus (+)

12.45%
2. Portio lembut, nyeri goyang & putar (slinger pain)
3. Adanya massa konssistensi lunak-keras, ada nyeri tekan
4. CD menonjol & fluktuasi ( cairan) hematokel
 PEMERIKSAAN PENUNJANG
Add Contents Title

01 Add Text You can simply impress your audience and add a unique zing and appeal to your
Presentations. Easy to change colors, photos and Text.

Pemeriksaan Laboratorium : Add Contents Title

02 Add Text
1. Menunjukan kadar Hb setiap jam akibat perdarahan
You can simply impress your audience and add a unique zing and appeal to your
Presentations. Easy to change colors, photos and Text.

2. Adanya leukositosis (dapat mencapai >30.000/uL

3. Urinary Pregnancy Test, dengan metode inhibisi
Add Contents Title aglutinasi hanya menunjukkan positif

03 Add Text
pada kehamilan You can simply impress your audience and add a unique zing and appeal to your
ektopik sebesar 50-60%
Presentations. Easy to change colors, photos and Text.
4. Serum progesteron kadarnya rendah <5mg/L

Add Contents Title

04 Add Text You can simply impress your audience and add a unique zing and appeal to your
Presentations. Easy to change colors, photos and Text.
Ultrasound Imaging:
Get a modern PowerPoint

1.
Money Reputation.
Presentation that is beautifully
designed. I hope and I believe that this Template will your Time,
USG Abdominal, kehamilan tuba sulit di deteksi dengan metode ini
and Easy to change colors, photos and Text.
Graphic
Infographic
Get a modern PowerPoint Presentation that is beautifully
2. USG
designed. Vaginal,
You can simply impress untuk mendeteksi
your audience and add a
unique zing and appeal to your Presentations. I hope and I
gestasional sac. Pada usa kehamilan >6
minggu,
believe bila
that this Template tidak
will your Time, ditemukan
Money and Reputation.gestasional sac, maka bisa dicurigai kehamilan
Get a modern PowerPoint Presentation that is beautifully
ektopik
designed. Designed
3. Color and ulsed Doppler

Laparoskopy:
Merupakan gold standar untuk menentukan kehamilan ekt opik.
1. Janin didalam suatu kantung kehamilan yang terletak diluar uterus
ALLPPT Layout
Clean Text Slide
2. Janin atau plasenta tampakformenempel
your pada dinding perut
3. Dalam pemeriksaan ulang janin tetal letak abnormal
Presentation

Simple Presentation
 KRITERIA UNTUK KEHAMILAN
ABDOMINAL
1. Tampak janin terpisah dari uterus
Content Here Content Here
2.Get aTidak terlihatnya
modern PowerPoint Presentation dinding uterus antara janin
Get a modern danPowerPointkandung
Presentation
that is beautifully designed. You can simply that is beautifully designed. You can simply
impress kemih
your audience and add a unique
zing and appeal to your Presentations.
impress your audience and add a unique
zing and appeal to your Presentations.

3. Jarak antara bagian-bagian janin dengan dinding abdomen

yang sangat dekat
Content Here Content Here

4.Getis beautifully
that Posisi yang You can tidak
a modern PowerPoint Presentation
designed. simply wajar Get a modern PowerPoint Presentation
that is beautifully designed. You can simply
impress your audience and add a unique impress your audience and add a unique
5.zing Pada USG kehamilan abdominal adalahzingdijumpai
and appeal to your Presentations.
kantong
and appeal to your Presentations.

gestasi atau janin diluar cavum uteri.

Content Here Content Here
Get a modern PowerPoint Presentation Get a modern PowerPoint Presentation
that is beautifully designed. You can simply that is beautifully designed. You can simply
impress your audience and add a unique impress your audience and add a unique
zing and appeal to your Presentations. zing and appeal to your Presentations.
 KOMPLIKASI

You can simply impress your audience and add a unique zing and
appeal to your Presentations.
1. Jaringan tropoblastik persisten
Your Text Here
2. Kehamilan ektopik
You can simply persisten
impress your audience and add a unique zing and
appeal to your Presentations.

Your Text Here

You can simply impress your audience and add a unique zing and
appeal to your Presentations.
 PENATALAKSANAAN
1. Terapi perbaikan keadaan umum IV/tranfuse
2. memberikan konseling dan membuat persetujuan/penolakan
tindakan
3. Operasi (salpingotomi, salingektomi, medge resection konus
uterus, ooforektomi, ambil bagian biobsi gangguan lain
4. Pasca bedah jika tidak ada komplikasi

Your Text Here Your Text Here Your Text Here

You can simply impress your You can simply impress your You can simply impress your
audience and add a unique zing and audience and add a unique zing and audience and add a unique zing and
appeal to your Presentations. Easy appeal to your Presentations. Easy appeal to your Presentations. Easy
to change colors, photos and Text. to change colors, photos and Text. to change colors, photos and Text.
 PENATALAKSANAAN
• PEMBEDAHAN :
1. Kehamilan
Content Here abdominal dapat memicu
perdarahan masif karena kurangnya
You can simply impress your audience and add a unique zing and appeal
to your Presentations. Easy to change colors, photos and Text.

vasokontriksi pembuluh darah yang

hipertrofiContent
setelah
Here pemisahan plasenta
You can simply impress your audience and add a unique zing and appeal
2. Laparotomi umumnya dilakukan melalui
to your Presentations. Easy to change colors, photos and Text.
PowerPoint sayatan vertikal garis tengah
Presentation
3. Kantong Content
janinHeredibuka dengan hati-hati,
You can simply impress your audience and add a unique zing and appeal

kemudian bayi harus dilahirkan di

to your Presentations. Easy to change colors, photos and Text.

daerah yang sedikit pembuluh darah,

serta hindari
Content Here penarikan tali pusat yang
You can simply impress your audience and add a unique zing and appeal
berlebihan. Tali pusat dipotong di dekat
to your Presentations. Easy to change colors, photos and Text.

insersinya (plasenta).
PROGNOSIS
• tergantung
Content Here
kecepatan
You can simply diagnosis
impress your audience and dan
kecepatanadd a unique zing and appeal to your
penanganannya.
Presentations.
TERIMAKASIH