No.

MR

03

76

78

OBSTETRIC AND GINECOLOGY DEPARTEMENT BUDHI JAYA MOTHER AND CHILD HOSPITAL JL. Dr. Sahardjo No. 120 Jakarta Selatan 12960 Telp. (021) 8292672, 8311722, 8312378 Fax. 8301901

SURGERY REPORT
Nama : Mrs. Dwi Budiana Sex : Female Operator Prof. Dr. H.I.O Marsis, SpOG Anesthetic Asisten dr. Sugianto Instrumentator Asisten Rony Parlindungan Sinaga Observer Pre-surgical Diagnose : previous sectio caecarea + rupture of membrane at 38 weeks of gestation with gravide 2 Para 1 Abortus 0 impartu + Cephalo-Pelvic Disproportion Post-surgical Diagnose : P2A0 and history of sectio caesarean Age : dr. Widodo, SpAn Zr. Dwi Sarita Sharchis 30 Years

Tehnique of operation : 1. Sectio caecarea transperitoneal profunda 2.3.-

Surgery Date : July 23sth 2013 Duration time of surgery : 1 hours 37 minute ( 06.33 08.10 ) Type of surgery Minor Emergency Poliklinik Medium Mayor Elektif

Operation Procedures:
I. II. III. Patient slept in supine position with spinal anastesia Aplied inside the dower catether Aseptic and antiseptic on abdomen adjacent regio until 1/3 proximal upper leg and the operation field was limited with steril doek IV. Pfanenstiel incision was made around fibritio tissue and the skin fold in down abdomen regio was thrown, the incision was made deeper sliece by sliece from cutis, subcutis, fascia, musculus rectus abdominis, and then it separated to lateral section with dull technique, bleeding was taken care off. V. Peritoneum parietal was opened tipside and downside so we can see uterine gravidarum, and the 2 curavor were put inside the right and left abdomen cavity for sperating the uterine and the other organ VI. Transversal incision was made on lower segment of uterus, extend to right and left until we can saw liquor Amnii membran and then the operator brook the liquor amnii membran, liquor amnii was clear, we could saw babys head upper to the pelvis cavity. VII. Babys head was pulled out using manual hand and with mild pressure on the fundus uterine by assistance. Then delivered step by step head, front shoulder, back shoulder, backward trochanter anterior, trochanter posterior, breech and extremitas inferior. VIII. The baby was crying, umbilical cord was clomped on 2 place 5 cm and 7 cm from the umbilical cord, then it was cut between 2 clamp and the baby was delivered. IX. The new born baby was delivered at 07.10 WIB, with female gender, body weight birth 4100 gr, length birth 51 cm, Apgar Score 8/9, anal (+) and didt saw major congenital disorder X. Plasenta was completely born in manual, cavum uterine was cleaned from the residual plasenta tissue until surely clean. Bleeding was controlled.

XI.

Suture was done on lower segmen of uterine at two pole with Chromic cat gut no. 1 and then the miometrium tissue was suture by continue and overhecting First slice of miometrium tissue with Chromic cat gut no. 2 by continue Second slice of miometrium tissue and serosum was suture by continue with Chromic cat gut no. 2

XII. XIII. XIV.

The abdomen cavity was cleaned and 2 curavor was pulled out from the abdomen cavity Before the abdomen cavity was sewed, it was giving cortisone acetate 2,5 mg into peritoneal cavity After sure its no bleeding, abdomen cavity was objed sl ice by slice a. b. c. d. e. Peritoneum parietal was sutured with Chromic acromatic no. 2.0 by continue M. Rectus abdominis was sutured with Chromic acromatic no. 2.0 Fascia was sutured with vicryl no. 1 by jelujur suture Subcutis was sutured with plain cat gut no. 0 by simple suture Cutis was sutured with Monosin no. 3.0 by subkuticuler

XV. XVI. XVII.

Bleeding approximately 200 cc Cavum uterine was cleaned pervaginam The operation wound was cleaned by cleaning stole cell from the vagina, the operation wound was cleaned with Nacl 0,9 % and then it was given antibiotic zalf and then was closed by sufratulle, sterile cassa and tegaderm

XVIII. The operation finished

The condition of patient post operation: General condition Consciouness Blood pressure Pulse rate Respiration Temperature : Look mild sick : Compos Mentis : : : : 130/70 mmHg

80 x/minute 18 x/minute 36,5 oC

Tissue to Pathology of Anatomy : Yes No : Type of tissue ..........................................

Operator,

(Prof. dr. H.I. Oetama Marsis, SpOG)