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Obstetric Chief on duty: Dr.

Hendra Sugama Saputra


Monday, December 1st, 2014 at 07.00 AM - Tuesday, December 2nd, 2014 at 07.00 AM
Consultant on duty: Dr. H. Iskandar Zulqarnain, SpOG(K)
1

01.12.2014
05.30 PM
Hb: 7.6 g/dl
WBC : 13.500/mm3
Plt : 198.000/L
CRP (-)

Conservative management
Mrs.IND/23/UA/LAT/SAN
D/ G2P1A0 34 weeks gestational age not inlabor with PROM 16 hours SLF cephalic presentation
+ moderate anemia
US ER (IDA) :
- SLF cephalic presentation
- Fetal biometry :
BPD 8,49 cm
FL 6,21 cm
HC 29,8 cm
EFW 2160 g
AC 29,2 cm
- Amniotic fluid AFI
1,08 0,80 = 6,06 cm
2,12 2,06
- Placenta at anterior of uterine corpus
C/ 34 weeks gestational age SLF cephalic presentation
M/ Conservative management
Nifedipine 10 mg tab / 6 hours
Ampicillin 1 g iv (ST)/6 hours
Dexamethason inj 12 mg / 24 hours (2 days)
PRC transfusion
P/ US confirmation

US (PM) :
- SLF cephalic presentation
- Fetal biometry :
BPD 8,05 cm
FL 6,68 cm
HC 30,58 cm
EFW 2182 g
AC 29,47 cm
- Amniotic fluid AFI
1,16 0,36 = 2,95 cm
0,76 0,67
- Placenta at anterior of uterine corpus
- There was 2x umbilical cord strangulation
- BPP : FM 2 FB 2 FT 2 ICA 0 NST 2 8
- Cervical length 2,4 cm
C/ 34 weeks gestational age SLF cephalic presentation + BPP 8 + cervical length 2,4 cm + 2x
umbilical cord strangulation + oligohidramnios
2.

01.12.14

Conservative management

08.20 PM

D/ G1P0A0 33 weeks gestational age not inlabor with PROM 9 hours SLF cephalic presentation

Hb: 11.4 g/dl


WBC : 21.700/mm3
Plt : 343.000/L
CRP (-)

Mrs. FEN/28/RA/LAT/ASN

US ER (IDA) :
- SLF cephalic presentation
- Fetal biometry :
BPD 8,4 cm
FL 6,17 cm
HC 28,9 cm
EFW 1840 g
AC 27,5 cm
- Amniotic fluid AFI
1,12 1,03 = 5,17 cm
1,35 1,67
- Placenta at posterior of uterine corpus
C/ 33 weeks gestational age SLF cephalic presentation
M/ Conservative management
Nifedipine 10 mg tab / 6 hours
Ampicillin 1 g iv (ST)/6 hours
Dexamethason inj 12 mg / 24 hours (2 days)
P/ US confirmation

US

3.

02.12.14
03.30 AM
FHR I : 188 x/m
FHR II: 182 x/m

US confirmation (PM):
- Single life fetus cephalic presentation
- Biometry : BPD : 7.72 cm AC : 24.04 cm EFW : 1408 g
HC : 28.33 cm
FL : 6.36 cm
- Placenta at anterior of uterine corpus
- Amniotic fluid was decreased, AFI : 3.16 cm
- IUGR was suspected
- BPP : 8
C/ 31 weeks gestational age SLF cephalic presentation + IUGR was suspected +
oligohydramnios + BPP 8
LSCS due to fetal distress

Mrs. ELA/18/RA/SUG/MRZ

D/ G1P0A0 38 weeks gestational age inlabor 1st stage active phase with history of ROM 1 day
SLF breech presentation + fetal distress

FHR III : 179 x/m


M/ Intrauterine rescucitation: lateroposition, O2 5l/m
Laboratory examination
Ceftriaxone inj. 2 x 1 g iv (ST)
P/ Abdominal delivery
Consult to consultant on duty agree for abdominal delivery

4.

04.20 AM

Female live baby was born, BW 3000g, BL 47cm, AS 7/9 FT AGA

04.23 AM

Placenta was delivered completely, PW 520 g, umbilical cord length 48cm, 19x20cm

02.12.14
06:00 AM

Mother and baby were in good condition

29.11.14
01.00 PM
GI : 6
Hb : 9.3 g/dl
Plt : 221.000/L
SGOT : 21U/L
SGPT : 13 U/L
LDH : 358 U/L
01.12.14
12.45 PM

5.

LSCS due to impending eclampsia


Mrs.IPA/34/RA/SUG/GIN
D/ G3P2A0 31 weeks gestational age not inlabor with severe preeclampsia SLF breech
presentation
M/Expectative management
MgSO4 inj. protocol
Nifedipine 10 mg / 8 hours
Evaluation with gestosis task
Consult to Internal Departement, Ophthalmology
US (PM):
- SLF breech presentation
- Fetal biometry :
BPD 7,74 cm
FL 5,79 cm
HC 27,82 cm
EFW 1245 g
AC 22,47 cm
- Amniotic fluid was enough
- Placenta at anterior of uterine corpus
- BPP : FM 2, FB 2, FT 2, ICA 2, NST 0 8
C/ 32 weeks gestational age SLF breech presentation + BPP 8 +IUGR was suspected
Consult to supervisor fetomaternal
Advice : Lung maturation 2 days
Terminated the pregnancy
P/ Elective cesarean section (Tuesday, 2 December 2014)

02.12.14
01.00 AM
GI : 4

G3P2A0 31 weeks gestational age not inlabor


presentation
M/ Terminate the pregnancy (abdominal delivery)

10.50 AM

Consult to consultant on duty :


agree for abdominal delivery
Male live baby was born, BW 1200g, BL 37cm, AS 8/9 FT SGA

10.55 AM

Placenta was delivered completely, PW 210 g, umbilical cord length 35 cm, 14x15cm

02.12.14

Mother and baby were in good condition

02.12.14

LSCS due to fetal distress

04.30 AM
FHR I : 188 x/m
FHR II: 182 x/m
FHR III : 170 x/m

with

impending eclampsia SLF cephalic

Mrs. IIN/24/UA/SUG/MRZ
st

D/ G1P0A0 42 weeks gestational age inlabor 1 stage latent phase with PROM 2 days SLF
cephalic presentation + fetal distress

M/ Intrauterine rescucitation: lateroposition, O2 5l/m


Laboratory examination
Ceftriaxone inj. 2 x 1 g iv (ST)
P/ Abdominal delivery
Consult to consultant on duty agree for abdominal delivery
06.50 AM

Male live baby was born, BW 3000 g, BL 49 cm, AS 8/9 FT AGA

06.55 AM

Placenta was delivered completely, PW 510 g, umbilical cord length 49 cm, 18x19cm

02.12.14

Mother and baby were in good condition

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