Ery Laksana
Faculty of Medicine Universitas Diponegoro Semarang

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Anestesia untuk Seksio Sesarea pada Pasien dengan Korioamnionitis dan Trombositopenia Dina Paramita; Ery Laksana
Jurnal Anestesi Obstetri Indonesia Vol 3 No 2 (2020): September
Publisher : Indonesian Society of Obstetric Anesthesia and Critical Care (INA-SOACC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47507/obstetri.v3i2.50

Abstract

Infeksi maternal adalah salah satu komplikasi perinatal yang paling umum terjadi. Kejadian kehamilan dengan korioamnionitis merupakan 1% dari kasus di Amerika atau di negara maju sedangkan di negara berkembang kasus ini lebih tinggi. Pasien G3P1A1 31 minggu, umur 23 tahun. Pada pemeriksaan didapatkan hemodinamik stabil dengan tekanan darah:110/70 mmHg, laju nadi: 76x/menit, laju nafas:18 x/menit, suhu 38oC, kesadaran compos mentis, kontak baik. Pada pemeriksaan jantung dan paru dalam batas normal. Pemeriksaan laboratorium didapatkan Hb: 7,2 g/dl, trombosit: 12.000 /ul, lekosit: 27,5/ul, SGOT: 210/ul, SGPT: 141/ul. Pasien diputuskan untuk dilakukan seksio sesarea emergensi. Persiapan operasi yang sebelumnya dilakukan transfusi dengan trombosit konsentrat 3 kolf. Pada saat induksi hemodinamik stabil dilakukan induksi di ruang operasi dengan fentanyl 50 ug, propofol 2 mg/kg BB, rokuronium 0,6 mg/kgBB, dan pemeliharaan anestesi dengan sevofluran, N2O/O2. Selama operasi hemodinamik pasien stabil, saturasi oksigen [SpO2] 99 %, operasi dilakukan selama 1 jam, lahir bayi dengan berat badan 1200 gram, dan dirawat di bangsal bayi resiko tinggi. Pasca bedah pasien sadar penuh dilakukan ekstubasi dan diberikan masker oksigen 6 lt/ mnt dan pasien dirawat di ICU. Pada pemeriksan didapatkan hasil analisa gas darah normal dan kenaikan trombosit yang bertahap. Pada hari ke 3 mencapai 40/ul disertai dengan menurunnya jumlah lekosit dan suhu pasien normal. Pasien diputuskan pindah bangsal dengan rawat bersama dengan penyakit dalam. Anaesthetic for Caesarean Section in Patient with Chorioamnionitis and Thrombositopenia Abstract Maternal infection is one of the most common perinatal complications. The incidence of pregnancy with chorioamnionitis constitutes 1% of cases in the United States or in developed countries whereas in developing countries this case is higher. G3P1A1 patient 31 weeks, age 23 years. on examination, hemodynamically stable blood pressure: 110/70 mmHg, pulse rate: 76x / min, respiratory rate: 18 x / min, temperature 38 oC, composmentis awareness, good contact, on heart and lung examination are within normal limits. Laboratory examination obtained Hb: 7.2 g / dl, platelets: 12,000 / ul, leukocytes: 27.5 / ul, SGOT: 210 / ul, SGPT: 141 / ul. The patient was decided to do cesarean section. Preparation of surgery was done before transfusion with platelet concentrate 3 colf. At the time of stable hemodynamic induction, then induction was carried out in the operating room with 50 ug fentanyl, propofol 2 mg / kg BW, rocuronium 0.6 mg / kgBW and maintenance of anesthesia with sevoflurane, N2O / O2. During hemodynamic surgery the patient is stable, SpO2 is 99%, surgery is carried out for 1 hour, a baby is born weighing 1200 grams and is treated in a high-risk infant ward. After surgery the patient was fully conscious, extubated, and the patient was treated in the ICU. In the examination, the result of normal blood gas analysis and increased a platelets accompanied by a decrease in the number of leukocytes and normal temperature. The patient was decided to move the ward with care together with internal medicine.