DISPROPORSI KEPALA PANGGUL (DKP)2.pptx

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Faadd h h i i l laa N N u urr H Haa n

nddaa y yaann i i F

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ID PASIEN

Naa! Ny Su Naa! Ny Su U"ia U"ia ! ! ## ## $h$h A

Allaaaa$$ ! G! Gll%%&&aann'' M Maannddiirraaaa P%*%raan ! IR+

P%*%raan ! IR+ A'aa

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HMRS! 02,0-,20.2 HMRS! 02,0-,20.2 HPM+ !2/,..,20.. HPM+ !2/,..,20.. H HPPLL ! ! 00##,,00--,,2200..22 U UKK ! #! #--/ / ''''uu

A1! Pa"i%n d%n'an G2P.A0 d%n'an A1! Pa"i%n d%n'an G2P.A0 d%n'an riaya$ S3 .. $h yan' lalu a4i4 &an''ul riaya$ S3 .. $h yan' lalu a4i4 &an''ul "%&i$ da$an' USG di &5li dan "%&i$ da$an' USG di &5li dan di"aran*an un$u* 5&%ra"i $an''al # S%&$ di"aran*an un$u* 5&%ra"i $an''al # S%&$ 20.24

20.24 K

K%n6%n'2 %n6%n'2 a"ih a"ih aran' aran' r%7%"2 r%7%"2 daridari alan lahir () l%ndir darah

alan lahir () l%ndir darah ()() Ri O7"! Ri O7"! I4 200.,a$%r,S3 a4i4 DKP,RS I4 200.,a$%r,S3 a4i4 DKP,RS II hail ini II hail ini o

o Ri %n" "i*lu" 28 hari  $%ra$ur laaRi %n" "i*lu" 28 hari  $%ra$ur laa

 9hari  9hari

o

o Ri AN3 $%ra$ur di 7idan dan RSRi AN3 $%ra$ur di 7idan dan RS o

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P

Paall&& ! ! aanniin n $$uunn''''aall

%anan' &r%"*%& &u*i *%&ala %anan' &r%"*%& &u*i *%&ala 7%lu a"u* &an''ul +FU #.6 7%lu a"u* &an''ul +FU #.6 +:; 2-<='r D;; () hi" ()

+:; 2-<='r D;; () hi" () >+

>+ ! ?,! ?,u $%nu $%nan'an' din dindindin' ?a'' ?a'inaina li6in "%r?i*" $%7al di &5"$%ri5r @  li6in "%r?i*" $%7al di &5"$%ri5r @  6 AK () S+LD ()

6 AK () S+LD () P1 USG!

P1 USG!

anin $un''al in$ra u$%ri D;; ()  anin $un''al in$ra u$%ri D;; () 

'%ra* anin () &r%"*%& &u*i '%ra* anin () &r%"*%& &u*i

&la"%n$a di 65r&u" an$%ri5r *anan &la"%n$a di 65r&u" an$%ri5r *anan $a* $a&a* h%a$5 "u7

$a* $a&a* h%a$5 "u7

&la"%n$a *al"iB*a"i  ani5n &la"%n$a *al"iB*a"i  ani5n 7%r*

7%r*uran' UK 7%rda"ar :PD uran' UK 7%rda"ar :PD -2-2 dan FL /8 "%*i$ar #-

dan FL /8 "%*i$ar #- in''u +:;in''u +:; 2-0. 'r 2-0. 'r TD TD : : 130/80 130/80 mmHgmmHg N N : : 8888xx//mm R R : : 2200xx//mm S S : : 3366..5 5 CC DJ DJJJ : : 13130x0x/m/m T TBB : : 113333ccmm K KUU : : bbaaiikk, , aa!!aa"", , ##aakk a$%mi a$%mi

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DIAGNOSIS

DKP "%*undi'ra?ida h4 a$%r 7d& DKP "%*undi'ra?ida h4 a$%r 7d&

d' ri S3 .. $h yll a4i4 DKP d' ri S3 .. $h yll a4i4 DKP

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+ER

API

Plan R% S3 %l%*$iC Plan R% S3 %l%*$iC O7" KU dan >S

O7" KU dan >S O7" hi" dan D;; O7" hi" dan D;;

P%ri*"a La7 darah l%n'*a& &r%5& P%ri*"a La7 darah l%n'*a& &r%5&

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# S%&$ 20.2 # S%&$ 20.2 +

+%lah dila*%lah dila*u*an S3 %l%*$iC a4i4 DKP dan ri S3 .. $h yll a4i4 DKPu*an S3 %l%*$iC a4i4 DKP dan ri S3 .. $h yll a4i4 DKP d%n'an RA

d%n'an RA

:ayi lahir AS 9,- &%r%&uan 2800'r <96 :ayi lahir AS 9,- &%r%&uan 2800'r <96 D1 !

D1 ! P5"P5"$ S3 $ S3 %l%*$iC %l%*$iC a4i4 DKP a4i4 DKP dan ri dan ri S3 .. S3 .. $h yll $h yll a4i4 Da4i4 DKP H0KP H0 +1 !

+1 ! 3%C$ria13%C$ria15n% 21. A5n% 21. A Kal&r5

Kal&r5C%n "u&& .C%n "u&& .1.1. SF .1.

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P%r$anyaan

A&a*ah r%n6ana $%ra&i yan' di&ilih

A&a*ah r%n6ana $%ra&i yan' di&ilih "udah"udah $%&a$

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PEM:AHASAN

Di"&r5&5r"i *%&ala &an''ul adalah *%adaan Di"&r5&5r"i *%&ala &an''ul adalah *%adaan yan' %n''a7ar*an *%$ida*"%"u

yan' %n''a7ar*an *%$ida*"%"uaian aian an$araan$ara *%

*%&ala anin dan &ala anin dan &an''ul i7u "%hin''a anin&an''ul i7u "%hin''a anin $ida* da&a$ *%luar %lalui ?a'ina4

$ida* da&a$ *%luar %lalui ?a'ina4

DKP da&a$ di"%7a7*an 5l%h &an''ul "%&i$ DKP da&a$ di"%7a7*an 5l%h &an''ul "%&i$ anin yan' 7%"ar a$au&u

anin yan' 7%"ar a$au&un *n *57ina"i an$ara57ina"i an$ara *%duanya

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DKP absolut

DKP absolut_{! &%r7%daan an$ara}_{! &%r7%daan an$ara}_*_*_{%&ala anin}_{%&ala anin}

d%n'an &an''ul i7u "%d%i*ian ru&a "%hin''a d%n'an &an''ul i7u "%d%i*ian ru&a "%hin''a %n'halan'i $%radinya &%r"alinan &%r ?a'ina %n'halan'i $%radinya &%r"alinan &%r ?a'ina dala *5ndi"i 5&$ial "%*ali&un

dala *5ndi"i 5&$ial "%*ali&un

DKP relatif

DKP relatif _{! i*a a*i7a$ *%lainan l%$a* *%lainan}_{! i*a a*i7a$ *%lainan l%$a* *%lainan}

&5"i"i a$au *%lainan d%%*"i "%d%i*ian ru&a &5"i"i a$au *%lainan d%%*"i "%d%i*ian ru&a "%hin''a %n'halan'i &%r"alinan &%r ?a'ina4 "%hin''a %n'halan'i &%r"alinan &%r ?a'ina4

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Fa*$5r anin

F

Fa*$5r a*$5r a7"5lu$!a7"5lu$!

:ayi yan' 7%"ar d%n'an ::<000'r :ayi yan' 7%"ar d%n'an ::<000'r :ayi d' hydr56%&halu"

:ayi d' hydr56%&halu" Fa*$5r r%la$iC!

Fa*$5r r%la$iC!

Mal&5"i"i (&r%"%n$a"i u*a &r"%n$a"i dahi Mal&5"i"i (&r%"%n$a"i u*a &r"%n$a"i dahi *%&ala d%%*"i)

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Fa*$5r a$%rnal

P%ru7ahan 7%n$u* *ar%na *%lainan &%ru7ahan P%ru7ahan 7%n$u* *ar%na *%lainan &%ru7ahan in$rau$%rin%!

in$rau$%rin%!

a) Pan''ul Na%'%l% a) Pan''ul Na%'%l% 7) Pan''ul R57%r$ 7) Pan''ul R57%r$ 6) S&li$ &%l?i" 6) S&li$ &%l?i" d) Pan''ul a"iila"i d) Pan''ul a"iila"i

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2)

2) PP%ru7%ru7ahan 7%nahan 7%n$u* *$u* *arar%na &%ny%na &%ny*i$ &ad*i$ &ada $ulana $ulan'' $ulan' &an''ul dan,a$au "%ndi &an''ul!

$ulan' &an''ul dan,a$au "%ndi &an''ul! a)4 Ra*i$i" a)4 Ra*i$i" 7)4 N%5&la"a 7)4 N%5&la"a 6)4 Fra*$ur 6)4 Fra*$ur

d)4 A$r5B *ari%" n%*r5"i" d)4 A$r5B *ari%" n%*r5"i"

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#)

#) PP%ru7%ru7ahan ahan 7%n$7%n$u* u* *ar*ar%na %na &%ny&%nya*i$ a*i$ *a**a*i!i! a)4 K5*"i$i"

a)4 K5*"i$i"

7)4 Lu*"a"i5 *5*"a 7)4 Lu*"a"i5 *5*"a

<)4 P%ru7ahan 7%n$u* *ar%na &%nya*i$ $ulan' <)4 P%ru7ahan 7%n$u* *ar%na &%nya*i$ $ulan'

7%la*an'! 7%la*an'!

a)4 KiC5"i" 7)4 S*5li5"i" 6)4 S&5ndil5li"$%"i" a)4 KiC5"i" 7)4 S*5li5"i" 6)4 S&5ndil5li"$%"i"

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;%ni" P

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Pan''ul "%&i$

&'&: '&(10, T(12, C &'&: '&(10, T(12, C !iag)$a*i(11, !iag)$a*i(11,5. 5. KmkKmk #%"+a!i i$%"ia #%"i, #%"+a!i i$%"ia #%"i, K%# -%ca aa*,

K%# -%ca aa*, i$k))"!i$ai #%"i i$k))"!i$ai #%"i &T& :

&T& : Di#. $#%"-i$a(.Di#. $#%"-i$a(. Kmk #%"+a!i -)ii

Kmk #%"+a!i -)ii )ki-i#a*i -)# )ki-i#a*i -)#

-%"i#%$ !a$ #"a$%"% -%"i#%$ !a$ #"a$%"% a""%#

a""%#

&B&: Di#. $#%"#b%"(8 &B&: Di#. $#%"#b%"(8

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Dia'n5"i" DKP

Anan%"i"! $in''i 7adan i7u (.=06)  riaya$ Anan%"i"! $in''i 7adan i7u (.=06)  riaya$

&%r"alinan yan' "%7%lunya &%nya*i$ a$au *%lainan &%r"alinan yan' "%7%lunya &%nya*i$ a$au *%lainan $ulan'

$ulan'

P1 B"i*! O"75rn $%"$ dan Mull%r Munr5 K%rr &%n'u*uran P1 B"i*! O"75rn $%"$ dan Mull%r Munr5 K%rr &%n'u*uran $in''i 7adan

$in''i 7adan

P%l?i%$ri *lini" a$au radi5l5'i" un$u* %n'u*ur u*uran P%l?i%$ri *lini" a$au radi5l5'i" un$u* %n'u*ur u*uran &an''ul

&an''ul ;anin 7%"ar ;anin 7%"ar

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P

%%

%%ri*"

ri*"

aan

aan F

F

i"i*

Pada *%hailan a$%r d%n'an &r%"%n$a"i *%&ala d&$ Pada *%hailan a$%r d%n'an &r%"%n$a"i *%&ala d&$ dila*u*an P1!

dila*u*an P1!

O"75rn $%"$! "a$u $an'an %n%*an *%&ala anin dari a$a" O"75rn $%"$! "a$u $an'an %n%*an *%&ala anin dari a$a" *% r

*% r5n''a &an''ul $an'an 5n''a &an''ul $an'an y' lain dil%$a**an &ada y' lain dil%$a**an &ada *%&a*%&alala un$u* %n%n$u*an *%&ala %n5n5l di a$a" "y&hi"i"

un$u* %n%n$u*an *%&ala %n5n5l di a$a" "y&hi"i" a$au $ida*

a$au $ida*

Munr5 K%rr Mull%r! "a$u $an'an %n%*an *%&ala *% r5n''a Munr5 K%rr Mull%r! "a$u $an'an %n%*an *%&ala *% r5n''a &an''ul dua ari $an'an yan' lain

&an''ul dua ari $an'an yan' lain a"u* *% ?a'ina un$u*a"u* *% ?a'ina un$u* %n%$u*an "%7%ra&a auh

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PEL

>IME+RI

>IME+RI PIN+U

PIN+U

A+AS PANGGUL

&%"ki"aa$

&%"ki"aa$ Ø Ø_{'&  &'&}_{'&  &'&}

!i*akka$ !%$ga$ !i*akka$ !%$ga$ m%$gk" C)$+ga#a m%$gk" C)$+ga#a Diag)$a*i %ca"a Diag)$a*i %ca"a ma$a* 4T !a$ ma$a* 4T !a$ k%m!ia$ !ik"a$gi 1.5 k%m!ia$ !ik"a$gi 1.5 cm 7 k%%m-i#a$ &'& cm 7 k%%m-i#a$ &'& !i#%gakka$ bi*a k"a$ !i#%gakka$ bi*a k"a$

CD < 11.5 cm. CD < 11.5 cm.

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A*i7a$ &an''ul "%&i$

;anin! ;anin!

K%lainan &r%"%n$a"i &r5la&" Cuni*uli &r5la&" K%lainan &r%"%n$a"i &r5la&" Cuni*uli &r5la&" %*"$r%i$a" KPD &%rdarahan in$ra*ranial %*"$r%i$a" KPD &%rdarahan in$ra*ranial I7u!

I7u!

Dila$a"i *uran' ru&$ura u$%ri iin%n" B"$ula Dila$a"i *uran' ru&$ura u$%ri iin%n" B"$ula inC%*"i in$ra &ar$u" &ar$u" laa

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P%nan'anan

P%r"alinan &%r657aan dila*u*an a&a7ila %%nuhi P%r"alinan &%r657aan dila*u*an a&a7ila %%nuhi &%r"yara$an

&%r"yara$an (DKP rin'an (DKP rin'an  "yara$  "yara$ hi" *hi" *ua$ 7i"a ua$ 7i"a di&a6udi&a6u &r%"7%l*%& a$%r di RS) dan di*a$a*an 7%rha"il 7ila

&r%"7%l*%& a$%r di RS) dan di*a$a*an 7%rha"il 7ila 7%rha"il7%rha"il lahir "%6ara &%r?a'ina dala *%adaan 7ai*

lahir "%6ara &%r?a'ina dala *%adaan 7ai* S%*"i5 "%"ar%a dila*u*an &ada !

S%*"i5 "%"ar%a dila*u*an &ada !  *%"%&i$an &an''ul 7%ra$

 *%"%&i$an &an''ul 7%ra$

 *%hailan a$%r DKP yan' nya$a  *%hailan a$%r DKP yan' nya$a  &%r"alinan &%r657aan yan' 'a'al  &%r"alinan &%r657aan yan' 'a'al

 *%"%&i$an rin'an d%n'an Ca*$5r ri"i*5  *%"%&i$an rin'an d%n'an Ca*$5r ri"i*5

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:%n$u* &an''ul (PAP) 3ad%ll M5l5y :%n$u* &an''ul (PAP) 3ad%ll M5l5y

Gin%*5id! 5?al +AP ar6-0 Gin%*5id! 5?al +AP ar6-0 An$r5&5id! AP+ ar6-0

An$r5&5id! AP+ ar6-0

Andr5id! an$un' AP+ "&ina %nl ar6-0 Andr5id! an$un' AP+ "&ina %nl ar6-0 Pla$i&%l5id! AP+ar6-0