Obgyn 3.4 - IUGR, IUFD, PPI, Perdarahan TM II Flashcards

1
Q

IUGR memiliki ciri

A

EFW < persentil 10

BBL < 2500 gram

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2
Q

Etiologi IUGR

A
  1. Genetik (aneuploidy)
  2. Infeksi TORCH, CMV
  3. Anomali struktur (CHD, NTD)
  4. Infark, abrupsi plasenta, TTTS
  5. Malnutrisi, rokok, alkohol
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3
Q

Penambahan berat badan normal janin

A

5 g/hari pada 15 minggu
15/20 g/hari pada 24 minggu
30-35 g/hari pada 34 minggu

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4
Q

Menilai berat badan janin relatif terhadap usia gestasional digunakan?

A

Lubcencho Growth Curve

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5
Q

Menilai IUGR simetris/asimetrik menggunakan?

A

Ponderal Index
PI = 100 x BB/PB^3

Nilai normal 2-2,5 (simetrik)

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6
Q

Perbedaan IUGR simetris dan asimetris

A

Simetris

  1. Semua parameter ukuran abnormal
  2. Etiologi : decreased growth potential

Asimetris

  1. Kepala normal, sisanya abnormal
  2. Etiologi : perfusi placenta menurun
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7
Q

IUFD adalah

A

Kematian janin dalam uterus pada usia gestational > 20 minggu, BB > 500 gram

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8
Q

Tipe IUFD

A
  1. Early (13-20 minggu)
  2. Intermediate (20-28 minggu)
  3. Late (>28 minggu)
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9
Q

Etiologi IUFD

A
  1. Janin (malformasi kongenital, kelainan kromosom, infeksi, asfiksia, gangguan pertumbuhan)
  2. Placental (abruptio, trauma, infark, trombosis, infeksi, previa)
  3. Maternal (penyakit sistemik, trauma, hipoksia, dll)
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10
Q

Pemfis IUFD

A
  1. Tidak ada gerak janin
  2. Tinggi fundus lebih kecil dari seharusnya
  3. DJJ absent
  4. BB ibu tidak meningkat
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11
Q

PP IUFD

A
  1. Hipofibrinogenemia

2. USG (Spalding sign)

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12
Q

PPI ditandai dengan

A

Kontraksi uterus reguler dengan dilatasi servix progresif, penipisan cervix kurang dari 37 minggu

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13
Q

Diagnosis PPI

A

Pemeriksaan abdomen, cervix, inspekulo

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14
Q

Tatalaksana persalinan preterm

A
  1. Tokolitik (menunda kelahiran)
  2. Kortikosteroid
  3. Transpor ke faskes yang memadai
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15
Q

Pilihan Tokolitik

A
  1. B-sympathomimetics (Ritodrine)
  2. Inhibitor PG synthetase (indomethacin)
  3. CCB (Nifedipine)
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16
Q

Obat dan dosis kortikosteroid pada preterm

A

Betamethasone 12 mg IM 2 kali/ hari

Dexamethasone 6 mg IV 4 kali/hari