KEGAWATDARURATAN OBSTETRI

Dr. Tri Wahyudi, SpOG

Bagian Obstetri dan Ginekologi
RSUD.Dr.Soedarso
Pontianak
Diseluruh dunia, satu wanita meninggal
setiap menit akibat komplikasi kehamilan.

Di Negara Berkembang, kematian maternal

memang jarang terjadi, namun diperkirakan
sekitar 2/3 pelayanan maternal diberikan
dengan layanan substandard
Yang termasuk kegawatdaruratan
obstetrik :

Perdarahan obstetrik
Eklampsia
Emboli paru
Emboli air ketuban
Prolapsus talipusat
Retensio plasenta
Distosia bahu
Inversio Uteri
Ruptura
PRINSIP PENATALAKSANAAN

Antisipasi dan kesiapsiagaan

Peralatan medis siap pakai
Semua staf dapat mengoperasionalkan
dengan baik, cepat dan benar.
Pada kasus obstetri ada 2 jiwa yang harus
diselamatkan yaitu Ibu dan Anak
Dalam situasi kegawatdaruratan maka
hitungan detik sangat berharga
Kepanikan bukan jawaban yang baik
ON IDENTIFICATION OF AN EMERGENCY

Call for help. Emergency bleep the obstetrical

emergency team. This should a senior
obstetrician and anaesthetist, the theatre
team, a paediatrician, midwifery sister, a
porter and the junior medical staff
Apply ABC if appropriate :

Airway : Place patient head down,

maintain airway patency. Give O2 15
l/min via facemask, attach pulse oximeter
Breathing : Asses, monitor respiratory
rate, ventilate if indicated
Circulation : Insert two grey / brown i.v
cannulae. Take full set of bloods ( FBC,
coagulation , crossmatch, urea and
electrolytes, and liver function tests). In
all cases of severe haemorrhage give 1
litre 0.9% Saline stat
Chek Maternal observation as approrpiate,
e.g pulse, blood pressure, O2
saturationmonitoring and bladder catheter
for urinary output measurement. At this
point see the aprropriate management
guidelines for particular emergency as well
as :
Considering an ECG, blood glucosa
measurement, centravenous monitoring
and an arterial line
Using a compression cuff and warmer to
give fluids if rapid administration is
indicated
Remembering o document fully in
notes all observations, procedures
and actions with date, timings, a
signature and a printed name
Remembering the mother’s partner.
Although some partners might wish
to wait outside, others may prefer to
stay in the room
TERIMA KASIH