Ruptur Uteri yang Tidak

TerdiagnosaPada G3P2A0H0 Parturien

Aterm 37-38 MingguKala 1 Fase Aktif
+ Letak Sungsang + IUFD

dr. Arga Kafi Perdana

Daftar Isi

01 02 03
Pendahuluan Laporan Kasus Tinjauan Pustaka

04 05 06
Pembahasan Kesimpulan Daftar Pustaka
01 Pendahulua
n
Ruptur uteri atau peristiwa robeknya uterus merupakan
peristiwa yang sangat berbahaya, yang umumnya terjadi pada
saat persalinan, dan kadang-kadang juga pada kehamilan tua.
Insidensi terjadinya ruptur uteri pada ibu hamil cukup tinggi.
Frekuensi ruptur uteri di rumah sakit-rumah sakit besar di
Indonesia berkisar antara 1:92 sampai 1:294 persalinan. Angka
insidensi ini cukup tinggi jika dibandingkan dengan  negara-
negara maju (antara 1:1250 sampai 1:2000 persalinan).
Penyebab ruptur uteri yang paling sering adalah terpisahnya
jaringan parut akibat seksio sesarea sebelumnya dan peristiwa
ini kemungkinan semakin sering terjadi bersamaan dengan
timbulnya kecenderungan untuk memperbolehkan partus
percobaan pada persalinan dengan riwayat seksio sesarea.
Faktor predisposisi ruptur uteri lain yang sering dijumpai
adalah riwayat manipulasi atau operasi traumatik, misalnya
kuretase, perforasi, dan miomektomi.

Penulis tertarik untuk membahas mengenai kasus ruptur uteri ini

karena etiologi terjadinya rupture uteri pada kasus ini masih
belum dapat ditegakkan dengan jelas, masih berupa dugaan
dugaan sementara.
02
Laporan Kasus
 Anamnesis
02/04/2021
07.00 Awalnya pasien mengeluh nyeri pinggang menjalar ke
ari ari hilang timbul dan keluar lendir campur darah

09.00 Pasien kemudian datang ke bidan. Di bidan pasien di

observasi dan dipasang infus.

Pasien dirujuk ke RS Swasta di Padang karena nyeri

perut hebat, gerak anak tidak terasa dan DJJ di bidan
sulit ditemukan. Pasien di periksa darah dan di USG di
15.15 RS swasta , dan dari pemeriksaan di dapatkan IUFD,
letak sungsang dan hiperglikemia, pasien direncanakan
untuk terminasi kehamilan per abdominam di RS
Nama : Ny. S
Swasta tsb, saat sudah masuk ruang operasi Pasien
Umur : 32 tahun dalam keadaan syok, pasien di lakukan resusitasi
Alamat : Padang cairan, dipasang infus 2 jalur, masuk 5 kolf RL dan 1
Pekerjaan : IRT kolf HES, diberikan dexamethasone 2 ampul,
No. MR : 01102726 cefazoline 1 gram dan novorapid 10 unit SC. Rencana
Pendidikan : SMP operasi dibatalkan karena membutuhkan ruang intensif,
Tgl Masuk : 03/04/2021 kemudian pasien dirujuk ke ponek RSUP Dr.M.Djamil
dengan terpasang infus 2 jalur dan kateter
Riwayat Penyakit Sekarang
 Nyeri seluruh lapangan perut sejak 6 jam SMRS, makin lama makin hebat.
 Nyeri pinggang menjalar ke ari-ari (+) 10 jam SMRS
 Keluar lendir campur darah dari kemaluan (+) 10 jam SMRS
 Keluar air banyak dari kemaluam (+) 4 jam SMRS
 Keluar darah yang banyak dari kemaluan (+) berwarna merah gelap, sejak 4 jam SMRS
 Tidak haid sejak ± 9 bulan yang lalu
 Gerak anak dirasakan sejak 5 bulan yang lalu
 Gerak anak tidak terasa sejak 8 jam SMRS
 ANC : Kontrol kehamilan ke bidan 3 kali, yaitu pada usia kehamilan 3, 5 dan 8 bulan,
tidak pernah kontrol ke Sp.OG
 Riw penggunaan kontrasepsi (-)
 HPHT : 14-07-2020 TP : 21-4-2021
 Demam (-), Batuk (-), Sesak nafas (-)​
 Riwayat bepergian keluar kota dalam 14 hari terakhir (-)
 Riwayat kontak dengan pasien terkonfirmasi positif COVID-19 disangkal​
Riwayat Penyakit Dahulu
 Riwayat ashtma, terakhir serangan 20 tahun yang lalu

Riwayat Pernikahan
Riwayat
 2x pada tahun 2010 dan 2020

Kehamilan/Abortus/
Identifying information

01 02 03

Mars Jupiter Venus

Despite being red, Mars is a Jupiter is a gas giant, and Venus has a beautiful name
cold place full of iron oxide the biggest planet in the and the second planet from
dust Solar System the Sun
Awesome words
Review of systems

Mars Venus
Despite being red, Mars is Venus is the second planet
a cold place from the Sun

Mercury Neptune
Mercury is a bit larger than Neptune the farthest planet
the Moon from the Sun
Physical examination

Mars Saturn
Despite being red, it’s a Saturn is the ringed one
very cold place and a gas giant

Mercury Venus
It’s the closest planet to It’s the second planet
the Sun from the Sun
A picture is
worth a
thousand
words
Findings

Mercury
Mercury is the closest
planet to the Sun

Venus
Venus is the second planet
from the Sun

To modify this graph, click on it, follow the link, change the data and
paste the new graph here
“This is a quote, words full of wisdom that
someone important said and can make the
reader get inspired.”

—Someone Famous
Discussion

“Saturn is composed “Jupiter is in fact the “Mercury is the smallest

mostly of hydrogen and biggest planet in the Solar planet in the Solar System”
helium” System”

Dr. Helena Stone Dr. John Smith Dr. Jenna Doe

Discussion summary

Result A
01 Neptune is the farthest planet
from the Sun

Result B
02 Venus has a beautiful name, but
it’s terribly hot

Result C
03 Despite being red, Mars is
actually a cold place
Comparison

Jupiter Mercury Venus Mars

It’s the closest planet to

the Sun

It’s the smallest one in the

Solar System

It’s only a bit larger than

the Moon

It was named after a

Roman god
Diagnosis

01 02 03
Mercury Venus Mars
Mercury is the closest planet Venus has a beautiful name, Despite being red, Mars is
to the Sun but it’s very hot actually a cold place

04 05 06
Jupiter Saturn Neptune
It’s the biggest planet in the Saturn is the ringed one and a Neptune is the farthest planet
Solar System gas giant from the Sun
Treatment

Mercury Venus
The planet’s name has nothing to do It’s the second-brightest object in the
with the liquid metal, since it was night sky after the Moon, and its
named after the Roman messenger god atmosphere is extremely poisonous
Patient monitoring

Week 01 Week 02

Venus Venus

Mercury Mercury

Week 03 Week 04

Venus Venus

To modify this graph, click on it, follow the

link, change the data and paste the new Mercury Mercury
graph here
Here are some percentages

59% 80%

Saturn Venus
Saturn is the ringed one and Venus has a beautiful name,
a gas giant but it’s very hot
7,498,300
Big numbers catch your audience’s attention
Contraindications & indications

Contraindications Indications

Here you can describe the reason to Here you can describe the reason to
stop the treatment start the treatment

Here you can describe the reason to Here you can describe the reason to
stop the treatment start the treatment

Here you can describe the reason to Here you can describe the reason to
stop the treatment start the treatment
Post-prevention

Mars Saturn
Despite being red, it’s a Saturn is the ringed one
very cold place and a gas giant

Mercury Venus
It’s the closest planet to It’s the second planet
the Sun from the Sun
Case timeline

Day 01 Day 02 Day 03 Day 04

Venus Mercury Mars Jupiter

Venus is the second Mercury is the Mars is a cold place Jupiter is a gas giant
planet from the Sun closest planet to the full of iron oxide and the biggest
Sun dust planet
Conclusions
Mercury is the closest planet to
the Sun and the smallest one in
the Solar System—it’s only a bit
larger than the Moon
References
● AUTHOR (YEAR). Title of the
publication. Publisher
● AUTHOR (YEAR). Title of the
publication. Publisher
● AUTHOR (YEAR). Title of the
publication. Publisher
● AUTHOR (YEAR). Title of the
publication. Publisher
● AUTHOR (YEAR). Title of the
publication. Publisher
● AUTHOR (YEAR). Title of the
publication. Publisher
Our team

Dr. Helena Patterson

The planet’s name has nothing to do
with the liquid metal, since Mercury
was named after the Roman messenger
god

Dr. John Smith

It’s the second-brightest object in the
night sky after the Moon, and its
atmosphere is extremely poisonous
This is a map

Saturn
Saturn is the ringed one
and a gas giant

Mars
Despite being red, it’s a
very cold place

Mercury
It’s the closest planet to
the Sun
Desktop
software
You can replace the image
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Tablet app
You can replace the image on
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 Mars
Despite being red, it’s a
cold place

Mobile web
Mercury
You can replace the image
with your own work. Delete It’s the closest planet to
this one, add yours and center the Sun
it properly

Saturn
Saturn is the ringed one
and a gas giant
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